Fall 2015
Bariatric Center Staff
Answers FAQs
Is strength training going to help with loose tissue?
Yes. Increasing muscle mass will help the overall appearance of loose tissue. It
will also help increase resting metabolism.
Regina Beyer, BS, ACSM Certified Health Fitness Instructor
NMMC is designated as
an Accredited Center by
the Metabolic and Bariatric
Surgery Accreditation and
Quality Improvement
Program. The designation
helps ensure patients that
the health care facility and
surgeon meet stringent
criteria and provide high
quality care. Because of the
designation, more health
plans now cover weight loss
surgery at NMMC.
Bariatric Clinic
408 Council Circle, Suite C
Tupelo
Bariatric Center
830 South Gloster
Tupelo
(662) 377-SLIM (7546)
Toll free:
1-866-908-9465
www.nmhs.net/bariatric_center
Since I have lost a lot of weight, I am “cold on the inside.” What causes that?
Following weight loss surgery, our metabolism is changing, and we lose our
insulation through the fat loss. You will adjust to this, but it is a good idea to
always carry a light sweater with you in the meantime.
Cherri Cox, RN, CBN
How many calories should I be consuming after surgery?
I don’t recommend counting calories, so I do not provide a specific daily calorie
amount. Counting calories is usually not something that you can do long-term
(remember some of your previous attempts with this before surgery that didn’t
provide any lasting results?). Instead, it’s more important to practice mindful eating,
which means to eat slowly, avoid distractions and focus on your meal, so you can
recognize when you are full and make sure to stop at that point. Also, if you are
choosing healthy foods, such as lean proteins, a variety of vegetables and fruits, low
fat or fat free dairy products, and whole grains, there is really no need for counting
calories because these are naturally lower in calories.
April Hancock, MS, RD, LD
What is weight management and why does the insurance company want me to
do that?
The purpose of weight management visits is to prepare you for the lifestyle
changes you will need to implement after surgery. If you are committed to have a
monthly appointment based on your insurance requirements to modify your diet,
exercise and calorie intake, you will be better prepared for the lifelong changes you
will have after surgery. Weight management visits may be with a physician, nurse
practitioner or dietitian (for some insurance companies).
Teri Spain
Continued on next page
FAQs Continued_____________________________________
Will I be able to stop losing weight if I have the surgery?
Your body will not let you go into muscle wasting, so your weight loss
will slow down when you are close to your goal. You will have times during
the process when you feel as if you have stopped losing weight but staying
on track with your protein and exercise will usually get you back on track
with your weight loss.
Vivian Rogers, NP-C, DNP
Why do I have to wait before I get pregnant after weight loss surgery?
Pregnancy requires and takes a lot of the mother’s daily macronutrients,
micronutrients and vitamins, so when you have surgery you are trying to
recover and get all your needed nutrients to help you stay on track with
your weight loss and health. It would be difficult to provide what you need
for yourself and the baby soon after surgery.
Vivian Rogers, NP-C, DNP
Why can’t I take my arthritis medication immediately following my surgery?
NSAIDs and other medication containing ASA can cause bleeding,
or you can develop an ulcer which can also cause a leak after bariatric
surgery. Taking NSAIDs long-term, whether you have had surgery or not,
can still cause ulcers and bleeding. These medications should all be used
in moderation but not sooner than three months following surgery. Always
check with your surgeon prior to starting any medications immediately
after surgery.
Vivian Rogers, NP-C, DNP
Why can’t I have my surgery before the year is out?
Many patients decide to have surgery and have the misconception that
it is a quick process. Most insurance carriers who have bariatric surgery
benefits have certain criteria and guidelines the patient will need to meet
prior to submitting for an approval from their insurance company. Most
carriers will require three to six months weight management. You may
also be required to have other testing based on your health and what the
surgeon or bariatric program will require. With that being said, the best
thing to do when you are seriously considering bariatric surgery is to follow
these steps:
• Call your insurance company and confirm that you have bariatric
benefits and get their specific criteria
• Call the bariatric office and see what their specific criteria is to set up
an appointment
• Speak with your regular health care provider regarding your decision
and get his/her support in the form of a referral letter
• Thoroughly research the bariatric procedure you are considering and
know the risks and benefits
• Start an exercise plan and a good structured diet plan
Vivian Rogers, NP-C, DNP
Setting Goals:
Optimistic but
Realistic,
Challenging but
Attainable
By Laura Mills, R.D.
Goal setting involves establishing
specific, measurable, achievable,
realistic and time-targeted goals.
Goals provide a sense of direction
and purpose. It involves making a
choice, putting forth the effort and
having the persistence to see it
through. Follow the steps listed
below to reach your goal.
1. Identify your goal
• Put it in writing
• Make it specific
• Make it realistic and achievable
• Give the goal a deadline
2. Set a plan
• A goal without a plan is merely
a wish
• How can you achieve it?
• Set short-term goals to reach
the ultimate goal
• Time frame
• To do list
3. Explain the plan
• Make a list of reasons why you
want to attain this goal
• What motivates you?
• Why do you want to lose weight?
4. Measure it
• Find others who are working
toward the same goal
• Support group
• Medical follow-up
5. Fix it
• Identify and avoid former pitfalls
• Do something about it when
it occurs
Can This Be Acid Reflux?
Homemade fried chicken made by Aunt Belle. Tailgating before the big game.
Grilling out with plenty of sweet tea. No Southern celebration would be complete
without food – and lots of it. Often the result of overeating has many Americans
reaching for an antacid instead of another piece of pie because of heartburn. This
common problem afflicts more than 60 million people in the United States. It is
described as a burning sensation in your chest, just behind your breastbone, caused
by stomach acid backing up into your esophagus.
When you swallow, the muscle at the bottom of the esophagus, called the LES or
lower esophageal sphincter, relaxes to allow food to pass into your stomach. The LES
can weaken or relax abnormally – especially when a person overeats – and this causes
the acid to come up into the esophagus, resulting in the symptom of heartburn.
Chronic heartburn or acid reflux (more than three times a week) may be diagnosed as
gastro-esophageal reflux disease or GERD.
Heartburn is the most common symptom of GERD, followed by belching, regurgitating (where fluid refluxes into the throat and/ or mouth) or globus (clearing the throat
or feeling a lump in the throat). Symptoms that are red flags for serious problems are
difficulty swallowing, vomiting blood or weight loss.
A number of patients suffer from atypical symptoms, such as chronic cough, hoarseness, asthma, nausea or a bad taste. We now know that these symptoms can come from
a phenomenon called non-acid reflux disease. In this condition, the contents of the
stomach refluxing back into the esophagus are not acidic in nature, unlike those in acid
reflux. Non-acid reflux sufferers may find help in the same lifestyle modifications or
medications, but consult a gastroenterologist to be certain.
For the millions of Americans who suffer from heartburn, get-togethers can be a
painful affair if not managed properly. Below is a list of certain lifestyle changes a person
can follow to lessen the symptoms of heartburn:
• Avoid food and beverages that can increase symptoms of heartburn, such as:
spicy and fatty foods, alcoholic beverages, peppermints, tomato or citrus juice,
chocolate, coffee, colas and tea.
• Decrease the size of portions at mealtimes. Don’t overeat!
• Eat meals two to three hours before lying down.
• Elevate the head of the bed four to six inches using blocks or telephone books.
• If you are overweight, lose weight.
• Avoid wearing tight fitting clothing that can increase pressure on the abdomen.
• Stop smoking.
If these recommendations do not help, then you should contact your physician.
Therapy then involves medication to reduce acid reflux or laparoscopic or minimally
invasive surgery to stop acid reflux. Specialty trained nurses and physicians at the
Heartburn Center of Mississippi, located at the Center for Digestive Health on North
Mississippi Medical Center’s campus, use the latest technology to help diagnose and
treat both acid and non-acid reflux disease.
To experience heartburn occasionally is common. Most people can manage this by
pushing themselves away from the table and taking an over-the-counter medication. It
these medications don’t completely control symptoms, or if you experience symptoms
of non-acid reflux, a gastroenterologist should be seen. For information or to set up an
appointment, call 1- 877-825-0068.
Cindy McDaniel, BSN, RN, CGRN, and Claire Harrelson, RN, CGRN, offer help for heartburn at the
Heartburn Treatment Center of Mississippi in Tupelo.
Healthy
Tailgating
Recipes
From Bariatric Bites Cookbook
Fast &Friendly
Meatballs
(serves 18)
Olive oil flavored cooking
spray
1 (20 oz.) package ground
turkey breast
1 egg, beaten
1/3 cup Italian seasoned
bread crumbs
Optional seasonings: grated
parmesan cheese, finely
chopped onion, garlic,
oregano, and basil
Preheat the oven to 350 F.
Generously spray a 9x13
inch baking dish with olive
oil flavored cooking spray,
and place it in the oven
while preheating. In a
medium bowl, mix together
the ground turkey, eggs,
bread crumbs and seasonings, if desired, using your
hands. Using an ice cream
scoop if possible, form the
meat into golf ball sized
meatballs. Place about 1 inch
apart in the hot baking dish.
Press down to flatten the
bottom just slightly. Bake for
15 minutes in the preheated
oven, then turn them over,
and continue baking for
about 5 minutes, or until
somewhat crispy on the
outside.
Note: 65 calories, 6 grams
protein, 4 grams fat, 1.2 grams
carbohydrate
Recognizing Your Hunger Signals:
How to Gain Control
Keys to Success
By Laura Mills, R.D.
Learning to get back in touch with your hunger signals can
be one of your best tools for getting to a healthy weight and
staying there. Your hunger signals are still there. You just have
to learn how to listen to them again.
Figure out where you are now
Find out what signals you are following. Keep a food journal for two weeks. Write down not only when and what you
eat but also write down what you are doing and feeling before
you started eating. Use a hunger scale to record where you
were on the scales before you ate and how you felt afterwards.
From this, you may notice certain patterns. For example, you
may discover that you almost always eat dinner in front of the
TV. You may find that you always eat an evening snack when
you are not actually hungry.
Hunger Scale
1 Starving, weak, dizzy
2 Very hungry, cranky, low energy, lots of stomach
growling
3 Pretty hungry, stomach is growling a little
4 Starting to feel a little hungry
5 Satisfied, neither hungry nor full
6 A little full, pleasantly full
7 A little uncomfortable
8 Feeling stuffed
9 Very uncomfortable, stomach hurts
10 So full you feel sick
• Eat when your hunger is at a 3 or 4. Don’t wait
until your hunger gets down to a 1 or 2. Getting
too hungry can lead to overeating.
• Once you know what your distractions and
habits are, take control of them.
• When it is time to eat, make healthy choices.
Always eat lean protein choices first followed
by vegetables, fruits and grain products.
• Eat a variety of foods.
• Fill up on fiber.
• Listen to your feeling of fullness and stop eating
when full.
• Keep your “problem foods” or typical cravings
out of sight but don’t deprive yourself of that
food either.
• Lose that acquired taste.
• Don’t skip meals. Be consistent with your meal
schedule on a daily basis. Eating regular meals at
regular times can help you be more aware of
hunger and fullness.
• Stay hydrated. Thirst is often mistaken for hunger.
If you start feeling hungry between meals, start
sipping on some water or other non-calorie
beverage.
• If you get hungry, look back at the previous meal
and make note of what you ate (or didn’t eat).
• Choose solid foods over beverages at meal
times. Avoid drinking with meals.
Bariatric Bites Cookbook Available
The Bariatric Clinic’s Bariatric Bites cookbook is a great resource for
weight loss surgery patients and anyone who wants to eat more healthfully. Each
recipe contains a nutrition analysis for calories, protein, fat, carbohydrate and
fiber content. In addition to more than 200 recipes, the hardbound cookbook
includes healthy recipe substitution tips, as well as long-term tips for achieving
and maintaining weight loss. Bariatric Bites is available for $15 from the NMMC
Bariatric Clinic or by calling 1-866-908-9465. Shipping is available for an
additional $3.