Bariatric Life-long Support

Transcription

1 Bellevue Bariatric Program January 2019 Bariatric Life-long Support We are pleased to announce the bariatric team now follows our Kaiser member bariatric patients for a lifetime, not just the first five years after surgery. The reason: patients who attend longer term follow-up visits (annually) may experience better weight loss, maintenance and minimize complications.. The bariatric team provides the special care and management your new anatomy needs (i.e. nutrition, exercise, vitamins, etc.). Weight loss surgery is a tool to help you lose weight and improve health. Utilizing the tool to its full potential requires hard work on your part and ongoing team care. Bottom line: follow up is key for long term success. The Kaiser bariatric team is here to help you on your path to health and weight management. January Issue: Goals Introduction...1 SMART Goal Setting..2-5 Bean Recipes Daily Vitamins...8 Announcements..9 Bariatric Sound-bites... 9 Support Group locations.10 Clinic contact Info Bariatric Team Quote of the Month: Great things never came from comfort zones.

2 Resolutions to lose weight or exercise more are worthy aspirations, but these statements are vague and too broad. The key to successfully integrating healthy habits into your life is to be S.M.A.R.T. with your goal setting. S Specific: clearly define the desired result M Measurable: quantify the objective to know when you have achieved it A Achievable: it s within your scope. Define realistic ways to attain your objective R Realistic: take different constrains into account (resources, environment) T Time-Bound: specify target date for achieving the objective 2 2

3 Answer each question, to refine the steps needed to achieve a goal. Specific What do I want to accomplish? Why is this goal important? Who is involved? What resources or limits are involved? How much? Measurable How many? How will I know when it is accomplished? Achievable How can I accomplish this goal? How realistic is the goal, based on other constraints? Realistic Does this seem worthwhile? Is this the right time? Does this match my other efforts/needs? When do I want to reach this goal? Time-Bound What can I do today? What can I do six weeks from now? What can I do six months from now? 3

4 S.M.A.R.T. Goal: Exercise Goal: I will start exercising This is to too broad and not measurable. SMART goal : I will walk 30 minutes every day at lunch Specific I will walk 5 days a week at work Measurable I will walk for 30 minutes at lunch every day Achievable Bring walking shoes, socks, rain jacket & umbrella to keep at work. Plan to walk building hallways when bad weather. Realistic Start with minutes walks every day for 3 weeks Increase to minutes for 3 weeks Gradually increase to walking 30+ minutes walking every day at work Time-Bound Target: 30 minutes by March 1,

5 S.M.A.R.T. Goal: 5+ servings of Veggies & Fruits A goal of eating better cannot be measured. SMART goal : I will eat 5+ veggie & fruit servings every day Specific Eat more veggies & fruits (Currently eating 1-3 per day) Measurable Eat a minimum of 5 servings of veggies & fruits serving every day. Achievable Make a shopping list of veggies & fruits to add for snacks and meals Realistic Eat minimum of 3 servings every day for 2 weeks. Add 1 veggie per day for 2 weeks. Once at 4 servings every day, add in 1 fruit serving to my day for a total of 5 servings every day. Time-Bound Target: February 11,

6 January 6th is National Bean Day Beans (and legumes) are packed with nutrients (fiber, B-vitamins, fiber) and are a good source of plant protein. Plant proteins are not a complete protein (containing all 9 essential amino acids), so as a bariatric patient, think of them as bonus protein. Beans are low in fat, calories and fill you up. Average cup of beans are 250 calories & 15 grams of protein. Ingredients White Chicken Chili 1 lb. boneless, skinless chicken breast or thighs, chopped 1 medium onion, chopped 1 Tbsp. olive oil 2 garlic cloves 2 (14 oz) cans chicken broth 1 (4 oz) can green chilies 2 teaspoons ground cumin 2 teaspoons dried oregano 1-2 tsp cayenne pepper 3 (14 ½ oz) Great Northern beans, drained & divided 1 cup shredded low fat cheddar cheese Sliced jalapeno pepper (optional) Directions 1. In a Dutch oven over medium heat, cook chicken and onion in oil until lightly browned. 2. Add garlic; cook 1 minute longer. Stir in the broth, chilies, cumin, oregano and cayenne; bring to a boil. 3. Reduce heat to low. With a potato masher, mash one can of beans until smooth. Add to saucepan. 4. Add remaining beans to saucepan. 5. Simmer for minutes or until chicken is no longer pink and onion is tender. 6. Top each serving with cheese and, if desired, jalapeno pepper. Enjoy. 4 6

7 Spicy Garbanzos & Greens Ingredients 2 (14 ½ oz can) chickpeas (garbanzo beans) 1 tablespoons olive oil 1 large onion, diced 1 medium carrot, peeled & diced ½ lb. spicy chicken sausage, diced 2 cloves garlic, minced ¼ teaspoon smoked paprika 1 teaspoon cumin seeds, lightly toasted and coarsely ground 1 lb. kale, washed and cut into ribbons Salt and pepper 2 Tbsp. pine nuts, lightly toasted, optional Directions 1. Put olive oil in a deep, wide skillet over medium-high heat. 2. Add the diced onion & carrot, season with salt and pepper, and cook, stirring occasionally, until softened and lightly browned, about 5 minutes. 3. Add the chicken sausage, cook for a few minutes, then turn heat to medium. 4. Add the garlic, paprika, and 1/2 teaspoon of the cumin, and stir to coat. 5. Add the cooked chickpeas and 1/2 cup broth. 6. Bring to a simmer, add the kale and sprinkle with a little salt. 7. Stir to allow the greens to wilt. Put on the lid and cook for 4 to 5 minutes, until greens are completely cooked. Stir well, taste and adjust seasoning if necessary. 8. Serve & enjoy. Ingredients Smoked Salmon & Black Bean Salad 4 oz. smoked salmon 1 (15-oz) can black beans, drained and rinsed 1/2 medium avocado, diced 1/2 cup cherry tomatoes, halved 1 tablespoon freshly squeezed lime juice (from 1/2 medium lime) 1 teaspoon olive oil 1/4 teaspoon ground cumin 1/8 teaspoon kosher salt Pinch cayenne pepper (optional) Directions 1. Flake the salmon into a medium bowl using a fork or your hands. 2. Add the remaining ingredients and gently toss to combine. 3. Serve on its own or over salad greens. 7 5

8 Daily Vitamins for the Bariatric Patient You need to take these vitamins DAILY and for the REST OF YOUR LIFE. Gastric Bypass (RNY) & Sleeve Gastrectomy Vitamins & Supplements Bariatric formulated multivitamin-mineral with mg iron and 500 mcg Vitamin B12 Vitamin B complex (with 50 mg thiamin) Calcium Citrate with Vitamin D3 (total mg daily) Probiotic Servings per Day* 1 serving 1 serving 2 servings of 600 mg per serving 3 servings of 400 or 500 mg per serving 1 serving *Serving sizes vary with different brands, READ THE LABEL Bellevue Pharmacy is now carrying Bariatric Advantage & Celebrate Vitamins. Buy them at your convenience after the Bariatric Education class or your follow up visits! They re also available online. Bariatric Advantage has a special offer for Kaiser patients. Receive Kaiser member pricing of roughly 20% discount & free shipping with validation code: KAISER. For a full list of our recommended vitamins: bariatric/meds.pdf 8

9 Welcome We are pleased to welcome Liam Malpass, RN, our new Clinical Operations Manager (COM). Liam will take over the reins for Anna Withee, RN, who has been a huge advocate for bariatrics over the years. Thank you Anna for your vision and support of our bariatric patients and program. Bariatric Sound-bites Advice, Ideas, & Tips from your Bariatric Team. The #1 piece of advice I give patients is THOROUGHLY CHEW YOUR FOOD. Eat slowly and mindfully; only what you can in 15 to 20 minutes aiming for the right amount and type of food. Often patients eat too fast and /or too much. They need to learn the difference between feeling full, feeling over full and eating the right amount of food. I often hear patients say I know I ve had enough when it feels like it s about to come back up. This is an example of eating too much and experiencing food reflux or regurgitation. Instead, aim for the right amount of food. Remember your stomach has been dramatically reduced in size. For the first 3-6 months post op it s roughly the size of a shot glass. After six months - 1 year its not much bigger unless you stretch it out by over eating often. This requires you to keep your meals small; eating mindfully, slowly and chewing thoroughly. If you don t chew it well enough you'll be giving it back or regurgitate. ~ by William Young, PA-C 9

10 Bariatric Support Group Locations Bellevue Kaiser Permanente Bellevue Medical Clinic, Room E101/105 Held quarterly, the 3 rd Wednesday of the month January, April, July & October, 6:00-8:00 pm January 16th at 6:00 pm Please call for more information. Overlake Bariatric Support Group Held twice monthly: 2 nd Thursday; 6:00-8:00 pm and 4 th Saturday; 10:00-12:00 pm Overlake Medical Center - PACCAR Education Center Insight Conference Room th Ave. NE, Bellevue, WA Please call (425) for more information. Tacoma MultiCare Center for Weight Loss and Wellness in Tacoma Held on the 4 th Monday of every month, 5:30-6:30 pm 2202 S Cedar St. Suite 300 Tacoma WA Please call (253) for more information. Sumner (led by MultiCare Center WLW staff) YMCA in Sumner Held on the 2 nd Wednesday of every month, 5:30-6:30 pm th St E Sumner WA Please call (253) for more information. 10

11 We want to hear from YOU! What do you want included in the monthly newsletter? Send us your ideas to: Bariatric Team Bariatric Surgeon: Dr. Gupta MD, FRCSC,FACS,FASMBS Diplomate, American Board of Surgery Diplomate, American Board of Obesity Medicine Kaiser Permanente Bellevue Bariatric Program Director Contact Us Nurse: Listen to the Prompts. Press 3. Routine Appointments: Listen to the Prompts. Press 1 Consulting Nurse: *Call the Consulting Nurse line if after 4:00 and weekends, with any symptoms/concerns. Bariatric Team bariatricpatients@kp.org *For specific questions regarding your health, please us through Kaiser s MyChart to ensure privacy. Bariatric PAs: Kat Cozza, PA-C Lynda Crescenzi, PA-C Travis Sears, PA-C Heather Vincent, PA-C William Young, PA-C Bariatric ARNP: Lori Gokee, ARNP Bariatric RN: Sarah Chan, BSN, RN Bariatric Dietitian: Lisa Stariha, RDN, MA ABS Medical Assistant: Karen Kucera, MA-C Clinical Operation Manager: Liam Malpass, RN 11