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RobertFischer/Parchment Processing.jsx

Last active March 12, 2018 16:51
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Parchment Processing
Raw
Parchment Processing.jsx
// Initialize the loop variables
let currentLine = [] // ops making up the current line
const content = [] // Components that we will ultimately render
// Map parchment attributes to React styling object
const attrsToStyle = (attrs) => {
console.warn("Don't forget to implement styling!");
return {};
};
// Given an array of ops that make up a single "line" of Parchment text,
// instantiate a component and push that component onto the content array.
function opsToComponent(line) {
if(!line) return null; // Empty line = no component
const lineAttributes = _.last(line)['attributes'] || {};
// Handle cases that use different components
const headerLevel = lineAttributes['header'] || false;
if(headerLevel) {
delete lineAttributes['header'];
const key = "quill-header-" + _.size(content);
return <Header key={key} level={headerLevel}>{opsToComponent(line)}</Header>;
}
// TODO Handle list (line attribute)
// TODO Handle indent (line attribute)
// Handle text cases
return _.map(line, ({insert,attributes}, idx) => {
if(insert == "\n" && !attributes) return null;
const key = "quill-text-" + _.size(content) + "-" + idx;
// TODO Handle link
return <Text key={key} style={attrsToStyle(attributes)}>{insert}</Text>;
});
};
const flushLine = () => {
if(_.size(currentLine) > 0) {
const component = opsToComponent(_.cloneDeep(currentLine));
console.info("Pushing Quill component", component);
content.push(component);
}
currentLine = [];
};
// Loop over operations
_.each(ops, (op) => {
console.info("Processing parchment op", op);
currentLine.push(op);
const {insert} = op;
const insertSize = _.size(insert);
const crIdx = insert.lastIndexOf("\n");
if(crIdx === insertSize-1)) { // Has a carriage return at the very end
flushLine();
}
});
flushLine();
return <View>{content}</View>;
Raw
Unique values of the "attributes" object.txt
"background": "#bbbbbb"
"background": "lightgrey"
"bold": true
"bold": true,
"color": "#000000"
"color": "#333333"
"color": "windowtext"
"header": 1
"header": 2
"indent": 1
"indent": 2
"link": "https://847.portal.athenahealth.com/",
"link": "https://goo.gl/maps/dtAWRhqvxSA2"
"link": "https://goo.gl/maps/hEXYi7qwd742"
"link": "http://www.surgerync.com/nutrition-forms.php",
"link": "http://www.surgerync.com/nutrition-portal/bariatric-bistro-recipes.php"
"list": "bullet"
"list": "bullet",
"list": "ordered"
"script": "sub"
"underline": true
Raw
ZZZ All Ops.sql
id | ops
--------------------------------------+-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
65f30bb8-ce03-11e7-9745-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "link to bariatric bistro recipes in practice info", "attributes": {"background": "#bbbbbb"}}, {"insert": "\n"}]
65f30c1c-ce03-11e7-9746-067fbe30e3fa | [{"insert": "Sample Meal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nMeal"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Start Here - ⅓ cup or 3-4 oz. Lean Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Gradually add these foods as you are able to eat more"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Next - ½ cup non startchy veggies"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Last - ⅓ cup whole grain or starchy veggie"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Breakfast, AM Snack, Lunch, PM Snack, Dinner, Evening Snack"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add meal reminders to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f30c8a-ce03-11e7-9747-067fbe30e3fa | [{"insert": "Transitioning"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Tips for Adding Protein When on a “Regular Diet”:\nAdd eggs, tuna, shrimp, and crab to salads"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Non-fat dry milk powder to smoothies "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add diced meats to soups, salads and sauces "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add low fat cheese to sauces, soups, eggs and salads "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try cottage cheese with green salad or mix into casseroles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use low-fat cheese as a snack "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use peanut on vegetables or in sauces "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add beans to soups, salads and casseroles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add tofu to soups, salads and smoothies"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f30d98-ce03-11e7-974a-067fbe30e3fa | [{"insert": "Schedule 8-Week Post-Op Follow Up Appointment"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": " **If not already done in returning home\n"}, {"insert": " Enter date and location", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}, {"insert": "Surgeon clearance to reintroduce regular consistency foods", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f3730a-ce03-11e7-9763-067fbe30e3fa | [{"insert": "Begin Semi-Solid Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Following two weeks of full-liquid diet, you will start the semi-solid diet which is for one week, after you will transition to soft foods at 4 weeks post-op.\n"}]
65f30d48-ce03-11e7-9749-067fbe30e3fa | [{"insert": "Getting to 8-Week Post-Op Follow Up Appointment"}, {"insert": "\n", "attributes": {"header": 1}}]
65f30cee-ce03-11e7-9748-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "After your 8 week post op appointment with your surgeon you will be given the clearance to reintroduce regular consistency foods. Please don’t begin until clearance is given.\n"}]
65f30afa-ce03-11e7-9744-067fbe30e3fa | [{"insert": "Continue Your Workout Plan"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Walk aim for 10,000 steps per day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cardiovascular 30+ minutes a day for 5-6 days a week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Strength Training 2-3 times a week for best result"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stretching and flexibility – stretch 5-10 before exercising"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Contact a personal trainer if you feel you need help"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f313ba-ce03-11e7-974f-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "link to bariatric bistro recipes in practice info", "attributes": {"background": "#bbbbbb"}}, {"insert": "\n"}]
65f3140a-ce03-11e7-9750-067fbe30e3fa | [{"insert": "Shopping List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review and purchase any missing items\nEgg Beaters"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light or low-fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Boneless/skinless chicken breast"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ground or tender beef/pork/poultry (lean)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen/fresh flaky fish"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned tuna/salmon"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned chopped chicken"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fat-free refried beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shredded light cheese"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen vegetable steamers"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat/light mayonnaise "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat deli meats"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft lettuces (bib, boston, red or baby spinach)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen broccoli/cauliflower "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft vegetables fresh/frozen/canned "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lentils "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen soy patties "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen black bean burgers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "High-protein/Low-fat cheeses (i.e. parmesan or mozzarella) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Wafer cookie texture protein bar"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp/scallops/crab"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "PB2 peanut butter powder"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft vegetables: Green beans, carrots, cauliflower, baby spinach, broccoli (fresh/frozen)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft fruits: Pears, peaches, mandarin oranges (sugar-free frozen or fresh)"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f31464-ce03-11e7-9751-067fbe30e3fa | [{"insert": "Sample Meal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\n"}, {"insert": "Plate Meal", "attributes": {"bold": true}}, {"insert": "\nStart Here - ⅓ cup or 3-4 oz. Lean Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Gradually add these foods as you are able to eat more"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Next - ½ cup non startchy veggies"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Last - ⅓ cup whole grain or starchy veggie"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}, {"insert": "Schedule Meals", "attributes": {"bold": true}}, {"insert": "\n"}, {"insert": "Add soft-food meal times to your calendar (3-4hours for 4 months)", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f314b4-ce03-11e7-9752-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "1/3 cup beans – 4g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup steamed soybeans/edamame – 5g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 string cheese – 7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 egg – 7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup tuna, fish, seafood – 10g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup imitation crab – 3g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup chicken, turkey – 13g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup lean beef or pork – 13g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 soy patter – low fat – 6g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup tofu – 7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f312fc-ce03-11e7-974d-067fbe30e3fa | [{"insert": "Begin Taking Calcium"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. Take calcium supplement doses at least 2 hours before or 2 hours after the multivitamin and iron. Calcium supplements should be spaced throughout the day for increased absorption.\nTake at least 2 hours before or after the multivitamin and iron"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Should be spaced throughout the day for increased absorption"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Call the Envision Store or visit Bariatric Advantage by following the buttons below.\n"}]
65f31284-ce03-11e7-974c-067fbe30e3fa | [{"insert": "Feeling Nauseous"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Common causes"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Eating too fast "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Not chewing well "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eating too much at one time "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drinking liquids with meals "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eating solid foods too soon"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f30de8-ce03-11e7-974b-067fbe30e3fa | [{"insert": "Begin Increasing Workouts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Walk aim for 10.000 steps per day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cardiovascular 30+ minutes a day for 5-6 days a week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Strength Training 2-3 times a week for best result"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stretching and flexibility – stretch 5-10 before exercising"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Contact a personal trainer if you feel you need help"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f31518-ce03-11e7-9753-067fbe30e3fa | [{"insert": "Foods to Eat and Avoid"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Allowed Soft Foods"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Eggs – hard boiled or soft scrambled "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light low fat yogurt "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flakey whitefish "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tuna "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Small shrimp "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Scallops "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crab "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Black bean or soy burgers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lentils "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Beans "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat deli meats thinly sliced "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat cottage cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shredded or soft low-fat cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Wafer texture protein bar"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft cooked vegetables peeled and seeded"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nFoods to Avoid"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Simple carbohydrates "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sticky foods – bread, rice, pasta, macaroni and cheese, peanut butter "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crunchy/fibrous foods – nuts and seeds, popcorn, chips, shredded coconut "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Raw vegetables "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "High fat foods – butters, salad dressings, sour cream, cream cheese, mayo"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tough dry meats (steak, pork chops), use moist preparation methods like stewing, roasting, crockpot "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Rubbery meats – ham, hot dogs, steak"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skins, membranes and seeds of fruits and vegetables "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fibrous vegetables (corn, celery) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fried foods (use added fats conservatively) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Whole milk products (use skim or 1%) "}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f31662-ce03-11e7-9754-067fbe30e3fa | [{"insert": "Guidelines"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nAdvancing the diet"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Start with no more than 2 ounces of ⅓ cup of protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mini-meals should be every 3-4 hours "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try only one new food at a time "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Do not consume liquids with meals (30 minutes before or after) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Always eat protein first "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid extremes in temperature "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop eating when feeling full "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chew food to applesauce consistency "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Allow a minimum of 20-30 minutes to finish your meals "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take thumbnail sized bites"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Reintroduce meat in the following order"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Flaky fish and seafood "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft cooked eggs "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ground or tender cooked beef, pork, poultry "}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f316d0-ce03-11e7-9755-067fbe30e3fa | [{"insert": "Transitioning"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "How To Make Your Transition to Solid Food A Success\nTry one new food at a time. This helps you to identify those foods you tolerate well and those that you don’t tolerate quite as well initially."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eat slowly and be aware of when you feel full. Your new stomach is very small and will fill very quickly. Try to take at least 20-30 minutes to finish your meal."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chew well. Your new stomach has decreased ability to mechanically and chemically digest food. Help your stomach by chewing well (bout 20-30 times with each bite) to ensure your food will digest easily."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take small bites. Small bites are necessary to avoid filling your stomach too quickly which may cause abdominal pain, cramping, or nausea and vomiting."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Do not drink fluid with your meals. It is important to save the room in your new stomach for nutritious food. Drinking with meals may limit your ability to take adequate amounts of nutrition in the early months after surgery. Drinking with meals may also cause food to empty from your stomach more rapidly and cause stomach cramping and other unpleasant side effects."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid sticky foods. Soft white bread, rolls, buns, pasta (especially if overcooked and large pieces), rice that clumps together, macaroni and cheese are some foods that may cause nausea, stomach cramping and sometimes vomiting."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid crunchy, hard to digest foods for the first 2-3 months. Crunchy and hard to digest foods include: raw vegetables, nuts, popcorn, chips, coconut, olives, pickles, tough fruit/vegetable skins (such as apple, cucumber skin), dried fruit, corn, iceberg lettuce. Some people may tolerate these foods after graduation to regular consistency foods at about 2-3 months post-op if eaten slowly and chewed very well."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid tough or rubbery meats. Avoid steak, pork chops, ham, and other tough meats for the first few months. Meat is a great source of protein, but it is easier to digest when prepared moist and tender, and chewed well. Try a slow cooking method to make your meat tender, such as a crock-pot, boiling or cooking at a low temperature over a long period of time."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid extreme temperatures in foods and beverages. Very hot and very cold foods may cause cramping and pain. We suggest that all foods and fluids be introduced at a moderate temperature to establish tolerance. Sensitivity to temperature is usually temporary and will usually resolve within several weeks."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Limit high fat and high sugar foods. All patients should consume 10 grams or less of total fat per servings and 10 grams or less of sugar per serving. After Roux-en-Y gastric bypass, sweets, desserts, fried, greasy, and rich foods are likely to cause a side effect called dumping syndrome."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f36cfc-ce03-11e7-9756-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "4-8 Weeks: Fork Tender Foods\nFluid (decaffeinated, non-carbonated & sugar free) = 64oz daily "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protein = 60-80 grams daily, 80-100 grams daily for duodenal switch"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nFour weeks after surgery you will receive instruction the dietitian to learn how to safely and healthfully reintroduce soft foods, meal plan, and make proper food choices to aid in continued weight loss and healing.\n\nDue to change in size and function of your stomach after surgery, there are foods and fluids that should be limited or avoided for the first 2-3 months after surgery.\n\nAt your 2 or 3 month follow-up visit with your surgeon, you will be given clearance to reintroduce regular consistency of foods.\n"}]
65f36df6-ce03-11e7-9758-067fbe30e3fa | [{"insert": "Getting to Soft-Food Transition Nutrition Class"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Link to Nutrition Class Location and Directions", "attributes": {"background": "#bbbbbb"}}, {"insert": "\n"}, {"insert": "Have nutritionist or location verify they attended", "attributes": {"background": "#bbbbbb"}}, {"insert": "\n"}]
65f36e50-ce03-11e7-9759-067fbe30e3fa | [{"insert": "Schedule Visit with Nutritionist for Transition to Soft-Foods"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Enter nutrition visit date and location", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f36ea0-ce03-11e7-975a-067fbe30e3fa | [{"insert": "Continue Shopping List for Soft-Food Diet Phase"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Egg Beaters"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light or low-fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Boneless/skinless chicken breast"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ground or tender beef/pork/poultry (lean)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen/fresh flaky fish"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned tuna/salmon"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned chopped chicken"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fat-free refried beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shredded light cheese"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen vegetable steamers"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat/light mayonnaise "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat deli meats"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft lettuces (bib, boston, red or baby spinach)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen broccoli/cauliflower "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft vegetables fresh/frozen/canned "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lentils "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen soy patties "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen black bean burgers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "High-protein/Low-fat cheeses (i.e. parmesan or mozzarella) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Wafer cookie texture protein bar"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp/scallops/crab"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "PB2 peanut butter powder"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft vegetables: Green beans, carrots, cauliflower, baby spinach, broccoli (fresh/frozen)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft fruits: Pears, peaches, mandarin oranges (sugar-free frozen or fresh)"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f36f04-ce03-11e7-975b-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Link to bariatric bistro recipes in practice info", "attributes": {"background": "#bbbbbb"}}, {"insert": "\n"}]
65f37814-ce03-11e7-976e-067fbe30e3fa | [{"insert": "Getting to Your 2 Week Post-Op Appointment"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Link to Post-Op Follow-Up appointment location and directions\nHave staff (desk check in, clinical staff or surgeon) or location verify they went\n"}]
65f36d9c-ce03-11e7-9757-067fbe30e3fa | [{"insert": "Begin Soft Food Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "After attending the Nutrition Class, you will begin the soft-food diet on your fourth week post-op, and will continue for 4 weeks\n"}]
65f36f54-ce03-11e7-975c-067fbe30e3fa | [{"insert": "Shopping List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review and purchase any missing items\nLow fat soups (strained cream-based soups)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light/low-fat almond, soy or lactaid milk"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skim or 1 % milk"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light or low-fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat cottage or ricotta cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free pudding"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of canned beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hummus"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat/fat-free refried beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free Jello"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flavorless protein powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned/fresh/frozen non-gassy veggies (carrots, squash, green beans or peas)"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f370bc-ce03-11e7-975d-067fbe30e3fa | [{"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Add semi-solid meal times to your calendar (for one week)\nAdditional Info: Sample Schedule - Shaded Boxes indicate Protein fortified semi-solid foods and/or fluids "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Un-shaded boxes indicate fluid for hydration "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "No more than 2-4 oz fluid or ⅓-½ cup of semisolid at a time. Times with a star (*) indicate a semi-solid food "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "0 – no food or fluid at these times "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fullness: As you begin to add semi-solids you may begin to feel fullness. For most people fullness feels like a pressure, tightness or heaviness in the center of your abdomen near the breast bone. "}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37134-ce03-11e7-975e-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "1/3 cup cottage cheese – 9g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup hummus or pureed cooked beans – 4g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup plain low-fat Greek yogurt – 8.7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup Snack Pack pudding + (Genepro) – 21.3g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup low-fat ricotta cheese – 9.3g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup protein fortified soup (Healthwise) 5-7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f3718e-ce03-11e7-975f-067fbe30e3fa | [{"insert": "Foods to Eat and Avoid"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nAllowed Semi-Solids"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Strained soups, broth and low fat cream based soups "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat yogurt "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat or 1% ricotta cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hummus "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat or 1% cottage cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protein fortified cooked, mashed or pureed non-gas forming vegetables like: carrots, squash, green beans, or peas "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pureed black, pinto or navy beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fat free refried beans "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protein fortified sugar free and fat free pudding"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nSemi-Solids to Avoid"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Any soup with meat, rice or noodles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Full fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Yogurt with seeds or fruit "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oatmeal "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Full fat cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Regular refried beans or cook beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Full fat, sugar containing puddings"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f371f2-ce03-11e7-9760-067fbe30e3fa | [{"insert": "Fortifying with Protein"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Try adding unflavored protein powders (such as GenPro, Nectar, or Unjury) or non-fat dry milk powder to pureed vegetables, pudding and hot cereals to improve the protein content of food. \n"}]
65f3724c-ce03-11e7-9761-067fbe30e3fa | [{"insert": "Blending Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Cook all vegetables until fork tender"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cut food into thumbnail sized pieces then place in a blender with enough broth, water or low-fat milk to cover the blades"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Blend until the food has reached an applesauce like consistency"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Strain out any lumps, seeds or stringy pieces that do not blend completely"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f372b0-ce03-11e7-9762-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Week Hydrating Fluids + Protein Shakes + Semi-Solid Foods\nDo not drink fluids while eating semi-solids. Stop drinking fluids 30 minutes before a mini-meal and do not start drinking fluids until 30 minutes after finishing a semi-solid meal."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "All liquids from weeks one and two are allowed with the addition of some semi-solid foods."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Semi-solid foods are those that would normally be eaten with a spoon and are applesauce consistency. Avoid skins, seeds, and chunks."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try no more than ⅓ cup of semi-solid food at a time, plan on consuming a semi-solid mini meal every 3-4 hours. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "As you begin to add semi-solids you may begin to feel fullness. For most people fullness after weight loss surgery feels like a gentle tightness, pressure or heaviness right below the breast bone."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37c4c-ce03-11e7-9777-067fbe30e3fa | [{"insert": "Nutrition FAQs"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Link to FAQs in Practice Info", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f37364-ce03-11e7-9764-067fbe30e3fa | [{"insert": "Complete Shopping for Semi-Solid Diet Phase"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Low fat soups (strained cream-based soups)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light/low-fat almond, soy or lactaid milk"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skim or 1 % milk"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light or low-fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat cottage or ricotta cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free pudding"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of canned beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hummus"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat/fat-free refried beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free Jello"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flavorless protein powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned/fresh/frozen non-gassy veggies (carrots, squash, green beans or peas)"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37648-ce03-11e7-9769-067fbe30e3fa | [{"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review meal plan created pre-surgery\nEat every 3-4 hours (4-6 times daily)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Breakfast 1 hour of waking and last meal at least 2 hours before bed"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Schedule "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "12 ", "attributes": {"bold": true}}, {"insert": "– 1-2oz Protein Drink"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "3 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "6 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "9 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Use the above schedule to make sure that you get enough hydration. \nTry to sip on 2oz of fluid over 15 minutes. Drinking too quickly or gulping may cause pain or discomfort. Always measure your fluids – do not sip from large cups.\n"}, {"insert": "Edit full liquid meal times on your calendar ", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f376ac-ce03-11e7-976a-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Full Liquid Protein (start post-op Day 3) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle Milk "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Premier Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nectar Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise High Protein Hot Chocolate "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bariatric Advantage Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pure Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oh Yeah "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chike Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Met Rx Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Unjury"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37706-ce03-11e7-976b-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Hydrating Fluids + Protein Shakes = 64oz fluid\nDrink fluids in no more than 2oz or ⅓ cup portions every 15 minutes and sip on this fluid over 10-15 minutes. Try to drink about 2oz of protein fortified fluid each hour then sip on 6oz of hydrating fluids, totaling 1 cup or 8oz total each hour. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add drink reminder to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Sip slowly, do not gulp, and do not use straws, sippy cups, or sports bottle tops. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Some people experience taste changes after surgery, therefore choose a variety of fluids to keep hydrated and provide a source of protein (examples provided on the following pages). "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "You may be sensitive to very hot and very cold fluids initially. Start drinking fluids that are room temperature and then gradually make them colder and warmer as tolerated. This is usually a temporary side effect and will resolve for most people in several to a few weeks."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f3753a-ce03-11e7-9766-067fbe30e3fa | [{"insert": "Continue to Food Journal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\n"}]
65f37864-ce03-11e7-976f-067fbe30e3fa | [{"insert": "Begin Exercising"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your activity level will be restricted activity for three weeks after the operation. You may walk and perform light household duties as tolerated upon your return home but nothing else. Usually, frequent walks of short duration are tolerated better than one or two long walks that go to or past the point of fatigue. Increase the distance that you walk gradually. \n\n"}]
65f37a30-ce03-11e7-9771-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "link to bariatric bistro recipes in practice info", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f37a8a-ce03-11e7-9772-067fbe30e3fa | [{"insert": "Shopping List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review and purchase any missing items\nNew water bottle"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "⅓ and ½ c measuring cups "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Measuring spoons (teaspoon & tablespoon)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Toddler utensils"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp forks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chopsticks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Small food storage containers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Recommended vitamin and mineral supplements"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of sugar-free/carbonation-free/caffeine-free hydrating fluids"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "3-4 bottles of clear liquid protein (Bring to hospital)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skim/1 % milk OR milk alternative "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Notebook for food journal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of milky-consistency protein shakes "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "New athletic footwear"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "New athletic socks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crockpot "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Blender"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vegetable steamer "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-sodium chicken or vegetable broth"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free jello"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free popsicles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Smaller “saucer” like plates"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
65f37ae4-ce03-11e7-9773-067fbe30e3fa | [{"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review meal plan created pre-surgery\nEat every 3-4 hours (4-6 times daily)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Breakfast 1 hour of waking and last meal at least 2 hours before bed"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Schedule "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "12 ", "attributes": {"bold": true}}, {"insert": "– 1-2oz Protein Drink"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "3 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "6 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "9 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Use the above schedule to make sure that you get enough hydration. \nTry to sip on 2oz of fluid over 15 minutes. Drinking too quickly or gulping may cause pain or discomfort. Always measure your fluids – do not sip from large cups.\n\n"}, {"insert": "Add full liquid meal times to your calendar (for next two weeks)", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f37b48-ce03-11e7-9774-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Full Liquid Protein (start post-op Day 3) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle Milk "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Premier Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nectar Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise High Protein Hot Chocolate "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bariatric Advantage Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pure Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oh Yeah "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chike Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Met Rx Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Unjury"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37b98-ce03-11e7-9775-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Hydrating Fluids + Protein Shakes = 64oz fluid\n\nDrink fluids in no more than 2oz or ⅓ cup portions every 15 minutes and sip on this fluid over 10-15 minutes. Try to drink about 2oz of protein fortified fluid each hour then sip on 6oz of hydrating fluids, totaling 1 cup or 8oz total each hour. \n"}, {"insert": "Add drink reminder to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n\nSip slowly, do not gulp, and do not use straws, sippy cups, or sports bottle tops. \n\nSome people experience taste changes after surgery, therefore choose a variety of fluids to keep hydrated and provide a source of protein (examples provided on the following pages). \n\nYou may be sensitive to very hot and very cold fluids initially. Start drinking fluids that are room temperature and then gradually make them colder and warmer as tolerated. This is usually a temporary side effect and will resolve for most people in several to a few weeks.\n"}]
65f37bf2-ce03-11e7-9776-067fbe30e3fa | [{"insert": "Full Liquid Diet Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "If you did not stay overnight at the hospital, be sure to stay on clear liquids for two days before transitioning to Full Liquid\n\nFor the first two weeks’ post-op you will be on a full liquid diet – you will progress to semi-solid at week 3 post-op\n"}]
65f37ca6-ce03-11e7-9778-067fbe30e3fa | [{"insert": "Registered Dietitians"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Link to Bios in Practice Info", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f37dc8-ce03-11e7-9779-067fbe30e3fa | [{"insert": "Vitamins & Minerals"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "American Society of Metabolic and Bariatric Surgery (ASMBS) recommends that all weight loss surgery patients take a bariatric formulated multivitamin daily.\n All supplements and medications must be chewable or liquid until 30 days post-op.\n"}, {"insert": "Link to Envision & Bariatric Advantage", "attributes": {"background": "lightgrey"}}, {"insert": "\n\nB-Complex"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter.\nIf not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1).\n"}, {"insert": "Add reminder to start first day home post-op to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n\nMulti-Vitamin"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. We recommend a bariatric formulated multivitamin that contains iron. The multivitamin should be taken without food for increased absorption.\nBariatric Advantage Chewable Multi EA (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 500mg Calcium Chew (3 a day)\nCelebrate Chewable Multivitamin (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 500mg Calcium Chew (3 a day) \n + 45mg Iron\nCelebrate Chewable Multi-Complete 60 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 500mg Calcium Chew (3 a day)\nCelebrate Chewable Multi-Complete 45 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 500mg Calcium Chew (3 a day)\nCelebrate Chewable Multi-Complete 36 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 500mg Calcium Chew (3 a day)\nBariatric Fusion Chewable Multivitamin (4 a day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 30mg Iron\nBariatric Advantage Ultra Multi Capsule with Iron (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 500mg Calcium Chew (3 a day)\nAdditional iron is recommended for menstruating women. Consult your surgeon or registered dietitian for more information."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add reminder to start at 4 weeks post-op to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Calcium"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. Take calcium supplement doses at least 2 hours before or 2 hours after the multivitamin and iron. Calcium supplements should be spaced throughout the day for increased absorption.\n"}, {"insert": "Add reminder to start at 4 weeks post-op to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65f37e4a-ce03-11e7-977a-067fbe30e3fa | [{"insert": "Diet Steps"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "After your bariatric surgery, protein and fluid intake are essential to successful recovery. Patients will go home from the hospital on a liquid only diet.\n\n"}, {"insert": "Clear Liquid", "attributes": {"bold": true}}, {"insert": "\nAny sugar free, carbonation free liquid that will allow light to pass through."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\nRemain on clear liquids for the first 48 hours following your surgery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}, {"insert": "Full liquid", "attributes": {"bold": true}}, {"insert": "\nAny liquids or food that is liquid at room temperature. It includes protein shakes and low fat milk. \nBegin following clear liquids diet, remain on full liquids  for 2 weeks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}, {"insert": "Semi-solid ", "attributes": {"bold": true}}, {"insert": "\nTypically foods that would be eaten with a spoon and are applesauce or pureed consistency."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\nBegin following full liquid diet, remain on semi-solids for 1 week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**Between 3 & 4 weeks post-op, you will have a visit with a BSNC registered dietitian"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}, {"insert": "Soft", "attributes": {"bold": true}}, {"insert": "\nFork tender – able to cut, mash or pull apart with a fork. \nBegin following semi-solids diet, remain on soft foods  for 4 - 8 weeks"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37f12-ce03-11e7-977c-067fbe30e3fa | [{"insert": "Lifestyle Changes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Lifestyle changes will include:\n"}, {"insert": "Protein ", "attributes": {"bold": true}}, {"insert": "- 60-80g/day (DS 80-100g/day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluids - ", "attributes": {"bold": true}}, {"insert": "64 fl oz/day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vitamins - ", "attributes": {"bold": true}}, {"insert": "Lifelong vitamin and mineral supplementation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Exercise ", "attributes": {"bold": true}}, {"insert": "- Minimum of 10k steps daily"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f37eb8-ce03-11e7-977b-067fbe30e3fa | [{"insert": "Begin Chew-able or Liquid B-Complex"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Approved B-complex"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter.\nIf not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1).\n"}]
65f37fbc-ce03-11e7-977e-067fbe30e3fa | [{"insert": "Primary Nutrition Goals"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Consume adequate amounts of protein to minimize loss of lean body mass and help facility healing"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take in adequate amounts of fluid to maintain hydration status"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Obtain adequate nutrients for optimal health through healthy food choices and vitamin and mineral supplementations"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f38016-ce03-11e7-977f-067fbe30e3fa | [{"insert": "Exercise Plan Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Treat exercise like a prescription", "attributes": {"bold": true}}, {"insert": "\nYou do not have to like exercise, but you need to do it in order to stay healthy. You also have to do it in order to lose weight. No miracles here. If you have a condition that requires a medication every day, you are going to take this medicine every day. Your body needs exercise every day, so you have to give it what it needs.\n\n"}, {"insert": "Research", "attributes": {"bold": true}}, {"insert": "\nFind out what types of classes your local gym is offering. Does your hospital offer water exercise classes for people with arthritis? Is there a gentle yoga class offered at the community center? You have a greater likelihood of continuing with an exercise that is tailored to your needs and that you enjoy. Explore new types of exercise. \n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Change your routine", "attributes": {"bold": true}}, {"insert": "\nSo you love to walk, but you are bored with it. Sometimes, just changing the direction of your route can make all the difference. Find new places to go walking, change the time of day, or offer to walk your neighbor’s dog.\n\n"}, {"insert": "Find a workout buddy", "attributes": {"bold": true}}, {"insert": "\nLet’s face it, without a coach most athletes would not be where they are now. Why should you be any different? We all need someone to nudge us and make us go the extra mile, especially when it comes to exercise. Find a friend, a neighbor, or personal trainer to meet you at the gym or in the park.\n\n"}, {"insert": "Find your rhythm", "attributes": {"bold": true}}, {"insert": "\nListen to music or books on tape or meditation while you exercise. 15 minutes on the bike can seem like an eternity without music, but with the right music to occupy your brain, it will not seem so long.\n\n"}, {"insert": "Try group activities or sports", "attributes": {"bold": true}}, {"insert": "\nYou don’t need to join the soccer team, but participating in a group activity increases the chance that you will stick to it. Choose water exercise, yoga, or stretching classes. Choose places and times where there are other people who are actively involved in exercise.\n\n"}, {"insert": "Know your weakness", "attributes": {"bold": true}}, {"insert": "\nKnow what makes you give up the program. If going on vacation throws you off your fitness plan, try incorporating exercise into your vacation. If boredom makes you give up, stay interested by changing different types of exercise and times.\n\n"}, {"insert": "Make a schedule", "attributes": {"bold": true}}, {"insert": "\nIf you don’t put exercise into your daily schedule, most likely you will do everything but exercise. Schedule specific activities on specific days, like walking 20 minutes on Monday, yoga class on Tuesday, etc.\n\n"}, {"insert": "Keep a workout log", "attributes": {"bold": true}}, {"insert": "\nWrite down the exercises you do and see how you have improved. Just like weight loss, sometimes one does not see the scale drop, but the inches seem to melt away. It is difficult to keep up with exercise when you do not see the results. Write down the number of repetitions, the weight used, the length of walk, the time, etc.\n\n"}, {"insert": "Just keep moving", "attributes": {"bold": true}}, {"insert": "\nWalk as much as possible between workouts. Park your car farther away. Get off the bus a couple of stops early. Always keep a good pair of walking shoes in your car, should you have unexpected time to take a walk.\n"}]
65fbdc0c-ce03-11e7-9790-067fbe30e3fa | [{"insert": "Helpful Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Tell your nurses and physicians if you are having pain, particularly if it keeps you from moving, taking deep breaths and generally feeling comfortable."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Everyone is different, keep your nurse informed of your pain."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Plan ahead for pain. If you are comfortable lying down, you may still need a pain medication to get up and walk around."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Keep ahead of the pain. Don’t wait for the pain to be at its worst before you push the PCA button or ask for pain medicine. Pain medication works best when used to prevent pain."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f397c2-ce03-11e7-9780-067fbe30e3fa | [{"insert": "Exercise Types"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "There are three forms of exercise that you should incorporate into your new life: cardiovascular, strength-building or training, and flexibility.\n\nCardiovascular"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Cardiovascular exercise is also known as aerobic exercise. Aerobic exercise uses your large muscles and can be continued for long periods. For example, walking, jogging, swimming, and cycling are aerobic activities. These types of exercises drive your body to use oxygen more efficiently and deliver maximum benefits to your heart, lungs, and circulatory system. A simple definition of cardiovascular exercise is any exercise that raises your heart rate to a level where you can still talk, but you start to breathe harder. Your goal is to lose weight; you will need to do some form of cardiovascular exercise for 5 or more days week for 30-45 minutes.\n\nStrength Training"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Strength-building exercises are known as anaerobic exercise. Anaerobic exercise does not have cardio vascular benefits, but it makes your muscles and bones stronger. Strength-building exercises require short, intense effort. People who lift weights or use any type of equipment that requires weights are doing strength building exercise.\n\nStrength-building exercise makes your muscles and bones stronger and increases your metabolism. Your muscles use calories for energy even when your body is at rest. So, by increasing your muscle mass, you are burning more calories all of the time. If you strength train regularly, you will find that your body looks leaner and you will lose fat. Strength building exercises should be performed 2 to3 times a week for best results. Always warm up your muscles for 5 to 10 minute before you begin lifting any type of weight or before performing any resistance exercises.\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Stretching & Flexibility"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Flexibility exercises, which are also anaerobic, tone your muscles through stretching and can prevent muscle and joint problems later in life. A well balanced exercise program should include some type of each exercise from each category.\n"}]
65f6c85c-ce03-11e7-9787-067fbe30e3fa | [{"insert": "Arrange Your Household"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You should give some thought to your living environment.\nAre there many steps in your home?"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Is your bedroom upstairs?"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "How accessible is your bathroom?"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " \nPlease tell your care team about your living environment so they can prepare your going home plan with your specific needs in mind. Nonetheless, a rubber shower head with a detachable hose, long sponge stick (or kitchen tongs), and toilet lift are all useful items.\n"}]
65fbdc84-ce03-11e7-9791-067fbe30e3fa | [{"insert": "Pain Level"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your nurses and doctors will ask you to pick a way that you can describe your pain. This is done to ensure uniform language. Two helpful ways to describe the pain include:\nthe number scale (0 to 10 scale; 0 = no pain; 10 = the worst pain possible) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "the use of words (none, mild, moderate, severe)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Record pain level every 4 hours\n"}, {"insert": "Add pain level schedule to calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/painscale"}}, {"insert": "\n"}]
65f684dc-ce03-11e7-9782-067fbe30e3fa | [{"insert": "Schedule Post-Op Follow Ups"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Bariatric Specialists of NC strives to ensure all of our patients experience a healthy weight loss journey. Your success depends on your dedication to follow-up care which includes office appointments and support group attendance. \n\nPlease note: It is imperative for your health and a successful weight loss journey that you follow up with your surgeon or PA as scheduled. Patients are required to see their Physician or Physician Assistant twice within the first 90 days after surgery.\n\nBariatric Specialists of NC strives to ensure all of our patients experience a healthy weight loss journey. Your success depends on your dedication to follow-up care which includes office appointments and support group attendance. Additional appointments may be deemed necessary by your provider based on procedure type and personal health history.\n2 Weeks "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "8 weeks post-op"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "6-month post-op "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 year"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Annually for up to five years "}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbdba8-ce03-11e7-978f-067fbe30e3fa | [{"insert": "Review Visitors Rules"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Depending on the length of your hospital stay, you may have family or loved ones who wish to visit you after your procedure. It is very important for your visitors to be mindful that you and other patients are recovering from surgery and may be experiencing nausea. \n\nStrong odors such as fried foods, perfumes, and scented lotions may increase your level of nausea. You may not be in a private room right after surgery and recovering in a post-op care unit until your room on the floor is ready. All visitors should be considerate to other patients in recovery areas and refrain from bringing in outside food and beverages.\n\nShould your family and loved ones need to eat, we urge them to do so either before or after their visit. Most of the hospitals we operate at have waiting rooms, cafeterias, and coffee shops for family members to visit while you are in surgery, in recovery, or being attended to by hospital staff. \n\nNurses on the floor and in the recovery areas will notify family members when their loved ones will be ready for visitation and usually encourage family and visitors to eat during this time. For visitors coming directly to your room, please encourage them to eat before or after seeing you and avoid bringing outside food into the hospital.\n\nTypically, your stay in the hospital is not more than a day or two, so when possible, you may want to typically your stay in the hospital is not more than a day or two, so when possible, you may want to delay any prolonged or group visiting until you are comfortably home and feel ready.\n"}]
65fbdce8-ce03-11e7-9792-067fbe30e3fa | [{"insert": "Pain Meds"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "As soon as you are able to tolerate fluids, your medical team will add oral pain medication. Please remember that you are not bothering the staff if you are asking for pain medicine! \n\nThe risk of becoming addicted to pain medicine is very low when it is used for a specific medical purpose such as surgery. If you have concerns your nurses or surgeon are able to explain this further.\n"}]
65fbdb4e-ce03-11e7-978e-067fbe30e3fa | [{"insert": "Prepare Questions Before Discharge"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Prior to your discharge, specific dietary and activity instructions will be reviewed with you, along with precautions and situations when your surgeon should be notified. Discuss your going home concerns with your nurse or discharge coordinator, and prepare any questions you may have before returning home. \n"}]
65fbd856-ce03-11e7-978a-067fbe30e3fa | [{"insert": "Review Common Symptoms"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Irritability, fatigue, soreness."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nausea can be a sign of hunger, sensitivity to smells."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Being tearful (crying) or depressed."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Left shoulder pain."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Insomnia or difficulty concentrating"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "No bowel movement or Flatus for >48 hours after discharge, contact your surgeon's office for recommendations. After bariatric surgery your bowel output may decrease substantially as compared to pre-operatively. For symptomatic constipation, refer to instructions in education guide and/or contact your surgeon's office. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**These are common complaints (related to your anesthesia and or surgery) and will usually go away a few days to a few weeks after surgery.\n"}]
65fbda7c-ce03-11e7-978c-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your date of discharge from the hospital will be determined by your surgeon based on your individual progress. This is the time to ask any questions or concerns you may have before returning home.\n"}]
65fbdfae-ce03-11e7-9797-067fbe30e3fa | [{"insert": "Nutrition FAQs"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Link to FAQs in Practice Info", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
f8955036-f223-11e7-bfb3-067fbe30e3fa | [{"insert": "Depression"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Our experience has shown that in the period of stress, starvation, weight loss, and adjustment to lifestyle changes following weight loss surgeries, mild to severe depression is a frequent problem. Unfortunately, most depressed people do not recognize their depression. You and your family need to be aware of the risk of depression and should look for the signs of depression.\n \nEffective psychological treatments for depression are available. Please contact your primary care doctor, psychiatrist, counselor, or the psychologist who helped in your preoperative evaluation to assist you with any depression problems. If you need help contacting a psychologist in your area, please notify the office. \n \nSevere depression cannot be treated with counseling or medication alone. You will need to work with a professional to find the right treat for you. If you have been taking antidepressants before your weight loss surgery, you should continue to take them after your surgery. You must inform the doctor who prescribed these medications of your surgery and the need for chewable, crushable or liquid forms of the medication prior to surgery. \n \nBariatric surgery is not a fix for your everyday problems. This surgery will allow you to begin to gain control over one aspect in your life: your weight. \n \nAlthough you have elected to have weight loss surgery to resolve your obesity, weight loss also changes the lifestyle you knew so well. Even with its problems and tensions, obesity was comfortable, simply because it was known. Now, that life is gone. When the reality of the new situation confronts you, it is natural to begin a longing for your old way of life.\n\nSigns and Symptoms"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Persistent sadness"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Anxious or “empty” mood"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Loss of interest or pleasure in activities including sex"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Restlessness"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Irritability or excessive crying"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Feelings of guilt, worthlessness, helplessness, and hopelessness"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sleeping too much or too little"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Early morning awakening"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Decreased energy, fatigue, and/or feeling “slowed down.”"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Difficulty remembering, concentrating, and/or making decisions"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n*If you or your loved one begins to have thoughts of suicide, death, self-harm, or the desire to harm others, immediate attention and professional psychological care is needed.\n \n"}]
65fbdf4a-ce03-11e7-9796-067fbe30e3fa | [{"insert": "Getting Out of Bed"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will be asked to get out of bed and walk as soon as possible. After that, you will be required to walk at least "}, {"insert": "four times per day ", "attributes": {"underline": true}}, {"insert": "and to do your breathing exercises hourly. Changing positions in bed, walking, and exercise promote circulation. \n\nGood blood flow discourages the formation of blood clots and enhances healing. Getting up, walking and doing your post-operative exercises will speed up your recovery and minimize complications. Remember, if your procedure is not an overnight stay, that it is imperative that you follow these suggestions and get up and move frequently.\n"}]
65fbdef0-ce03-11e7-9795-067fbe30e3fa | [{"insert": "Breathing Exercises"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "To enhance your recovery your nurse will instruct you in coughing and deep breathing. You will be shown how to use an “"}, {"insert": "incentive spirometer", "attributes": {"underline": true}}, {"insert": "” to help you expand your lungs. Coughing and deep breathing is important so that you will loosen any secretions that may be in your throat or lungs and to help prevent pneumonia. Deep breathing also increases circulation and promotes elimination of anesthesia. \nThe proper way to deeply breathe and cough is to follow these steps:\nInhale as deeply as you can"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hold breath for two seconds"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Exhale completely"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Repeat the above steps three times"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Inhale deeply"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cough. The cough should come from the abdomen, not from your throat. Hold your pillow on your abdomen for support."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbdd42-ce03-11e7-9793-067fbe30e3fa | [{"insert": "Leg Exercises"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Exercising your feet and legs is important for promoting good circulation. \nThe proper way to exercise your feet and legs is to follow these steps:\nPush your toes of both feet towards the end of the bed (as in pressing down on a gas pedal)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pull your toes toward the head of your bed, relax."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Circle each ankle to the right, then to the left."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Repeat three times."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbde78-ce03-11e7-9794-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You may feel pain where the incision was made or from the position your body was in during surgery. Some patients may also experience neck and shoulder pain after the procedure. Most patients have said they experienced more discomfort than actual pain after the surgery.\n\nYour comfort is very important to your medical team. Although there will always be some discomfort after an operation, keeping your discomfort under control is necessary for your recovery. When you are comfortable, you are better able to take part in activities such as walking, deep breathing, and coughing, all of which are imperative in order to recover as quickly as possible.\n"}]
65fbe1fc-ce03-11e7-979b-067fbe30e3fa | [{"insert": "Have staff (desk check in, clinical staff or surgeon) or location verify they went\n"}]
65fbe260-ce03-11e7-979c-067fbe30e3fa | [{"insert": "Register and Check-In\n"}]
9ead9fa6-f48a-11e7-9a08-067fbe30e3fa | [{"insert": "Foods to Eat and Avoid"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Allowed Soft Foods"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Eggs – hard boiled or soft scrambled "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light low fat yogurt "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flakey whitefish "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tuna "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Small shrimp "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Scallops "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crab "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Black bean or soy burgers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lentils "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Beans "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat deli meats thinly sliced "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat cottage cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shredded or soft low-fat cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Wafer texture protein bar"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft cooked vegetables peeled and seeded"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nFoods to Avoid"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Simple carbohydrates "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sticky foods – bread, rice, pasta, macaroni and cheese, peanut butter "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crunchy/fibrous foods – nuts and seeds, popcorn, chips, shredded coconut "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Raw vegetables "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "High fat foods – butters, salad dressings, sour cream, cream cheese, mayo"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tough dry meats (steak, pork chops), use moist preparation methods like stewing, roasting, crockpot "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Rubbery meats – ham, hot dogs, steak"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skins, membranes and seeds of fruits and vegetables "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fibrous vegetables (corn, celery) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fried foods (use added fats conservatively) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Whole milk products (use skim or 1%) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
65fbe30a-ce03-11e7-979e-067fbe30e3fa | [{"insert": "Bring Surgery Bag Packed Yesterday"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "It is recommended to bring only the bare necessities to the hospital. There are a few other things that may make your stay a little more comfortable:\nYour App"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A small overnight bag with toiletries such as toothbrush, toothpaste, soap, shampoo, and lotion"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your eyeglasses and a case"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protective storage case(s) for corrective lenses, dentures, hearing aids, etc."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bathrobe"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your CPAP machine if applicable"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear fluids with protein such as Isopure or Cytomax"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Address and phone book of loved ones"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lip balm"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Comfortable, loose-fitting clothes to wear when you go home. Clothes that are easily removed and easy to slip on are best"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**Do not bring any jewelry or more than $20 cash. You may want to bring an item to comfort you such as a photo of a loved one.\n"}]
65fbe378-ce03-11e7-979f-067fbe30e3fa | [{"insert": "Bring Eyeglasses and Case if Necessary"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Please bring your eye glasses and a case if possible.\n"}]
65fbe3d2-ce03-11e7-97a0-067fbe30e3fa | [{"insert": "Remove Dentures before Surgery"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You may wear dentures, but you will need to remove them just prior to surgery.\n"}]
65fbe486-ce03-11e7-97a2-067fbe30e3fa | [{"insert": "Diet Progression Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Weight loss surgery is an excellent tool to help you limit the amount of food you eat and help you lose weight. For most people, weight loss surgery requires a significant change in diet and lifestyle to safely and healthfully reach your goal. After bariatric surgery, you will likely be losing weight very rapidly. Good nutrition is essential to maintain lean body mass (muscle), hydration, skin elasticity, and to minimize hair loss."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Primary Nutrition Goals"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Consume adequate amounts of protein to minimize loss of lean body mass and help facility healing"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take in adequate amounts of fluid to maintain hydration status"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Obtain adequate nutrients for optimal health through healthy food choices and vitamin and mineral supplementations"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Lifestyle Changes"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Your new lifestyle will include:\nProtein - 60-80g/day (DS 80-100g/day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluids - 64 fl oz/day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vitamins - Lifelong vitamin and mineral supplementation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Exercise - Minimum of 10k steps daily"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Diet Steps"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "After your bariatric surgery, protein and fluid intake are essential to successful recovery. Patients will go home from the hospital on a liquid only diet.\nClear Liquid= Any sugar free, carbonation free liquid that will allow light to pass through. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Remain on clear liquids for the first 48 hours following your surgery"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Full liquid = Any liquids or food that is liquid at room temperature. It includes protein shakes and low fat milk. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin following clear liquids diet, remain on full liquids  for 2 weeks"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Semi-solid = Typically foods that would be eaten with a spoon and are applesauce or pureed consistency. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin following full liquid diet, remain on semi-solids for 1 week"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": " **Between 3 & 4 weeks post-op, you will have a visit with a BSNC registered dietitian"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Soft = Fork tender – able to cut, mash or pull apart with a fork. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin following semi-solids diet, remain on soft foods  for 4 - 8 weeks"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "\nVitamins & Minerals"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "American Society of Metabolic and Bariatric Surgery (ASMBS) recommends that all weight loss surgery patients take a bariatric formulated multivitamin daily.\nAll supplements and medications must be chewable or liquid until 30 days post-op.\n"}, {"insert": "Link to Envision & Bariatric Advantage", "attributes": {"background": "lightgrey"}}, {"insert": "\nB-Complex "}, {"insert": "- ", "attributes": {"bold": true}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1).\nMulti-Vitamin"}, {"insert": " - ", "attributes": {"bold": true}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. We recommend a bariatric formulated multivitamin that contains iron. The multivitamin should be taken without food for increased absorption."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bariatric Advantage Chewable Multi EA (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)\nCelebrate Chewable Multivitamin (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day) \n+ 45mg Iron\nCelebrate Chewable Multi-Complete 60 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)\nCelebrate Chewable Multi-Complete 45 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)\nCelebrate Chewable Multi-Complete 36 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)\nBariatric Fusion Chewable Multivitamin (4 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 30mg Iron\nBariatric Advantage Ultra Multi Capsule with Iron (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)\nAdditional iron is recommended for menstruating women. Consult your surgeon or registered dietitian for more information."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Calcium"}, {"insert": " - ", "attributes": {"bold": true}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. Take calcium supplement doses at least 2 hours before or 2 hours after the multivitamin and iron. Calcium supplements should be spaced throughout the day for increased absorption."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Registered Dietitians"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Link to Bios in Practice Info", "attributes": {"background": "lightgrey"}}, {"insert": "\n\nNutrition FAQs "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Link to FAQs in Practice Info", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65fc5600-ce03-11e7-97d3-067fbe30e3fa | [{"insert": "Balance Paid"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "At this appointment, any outstanding balance as well as your surgery estimate must be paid in full. Your surgery estimate must be paid in full to schedule surgery.\n"}]
65fbe0c6-ce03-11e7-979a-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "The hospital stay for bariatric surgery averages one to two nights. Some patients may need to stay longer if they have complicated medical conditions. This section will help you take steps to a safe and healthy recovery.\n\nRecovering"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "When you return to your room after surgery, you will continue to be closely monitored by your nurses. Along with periodic monitoring of your vital signs (blood pressure, pulse, temperature, respirations), your bariatric nurses will encourage and assist you in performing deep breathing, coughing, leg movement exercises, and getting out of bed after surgery. All of these activities prevent complications. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Be certain to report any symptoms of nausea, anxiety, muscle spasms, increased pain, or shortness of breath to your bariatric nurse. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "To varying degrees, it is normal to experience fatigue, nausea, vomiting, sleeplessness, surgical pain, weakness and light headedness, loss of appetite, gas pain, gas, loose stools, and emotional ups and downs in the early days and weeks after surgery. You may discuss specific medical concerns with your surgeon."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbe42c-ce03-11e7-97a1-067fbe30e3fa | [{"insert": "Shower the Morning of Surgery"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "We recommend that you shower in the morning on the day of surgery, but do not use any moisturizers, creams, lotions, or make-up. Remove your jewelry and do not wear nail polish. \n"}]
65fc151e-ce03-11e7-97a5-067fbe30e3fa | [{"insert": "Recovery Room"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Once the surgery is complete, you will be moved to the recovery room. You will be closely monitored during this period. When your initial recovery is completed and all your vital signs are stable, you will be transported to your room or discharged home depending on you and the procedure you choose. Most patients have very little memory of their stay in the Recovery Room. \n\nIf you are going home from the Recovery Room your family/friend will be given instructions for you to follow.\n"}]
65fc1582-ce03-11e7-97a6-067fbe30e3fa | [{"insert": "Procedure Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Through a laparoscopic approach, the surgeon staples across the stomach, creating a pouch about the size of an egg and then bypassing 25% of the small intestines. The new stomach pouch limits the amount of food patients can consume in one sitting. In bypassing a portion of the intestines, we also limit the time food can mix with digestive juices, this again drives production of hormones that prolong satisfaction with less food.\n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/rgblaparo"}}, {"insert": "\n\n"}, {"insert": "Link to FAQs in Practice Info", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65fc15e6-ce03-11e7-97a7-067fbe30e3fa | [{"insert": "Operating Room"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "During your procedure, specialists using the most modern equipment and techniques will attend to you. This team includes your surgeon, at least one board certified anesthesiologist, a trained surgical assistant, a nurse anesthetist, and nurses that will assist your surgeon.\nOnce you are settled on the operating table, you will be connected to several monitors and an intravenous (IV) catheter. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A quick acting sedative will be given through the IV tubing after you have breathed pure oxygen for a few minutes. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Once you fall asleep, the anesthesiologist will usually slip an endotracheal tube through your mouth into your windpipe to guarantee that your breathing "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " is unimpeded. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "An anesthetic gas and other medications will keep you asleep and pain free. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "At the same time, the anesthesiologist will connect you to monitoring devices."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Most bariatric procedures will last 1 to 2 hours. However, the length of your operation is dependent upon the type of procedure/s performed as well as any other procedures deemed medically necessary by your surgeon."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Once your procedure has been completed, you will be moved to the designated recovery area."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc169a-ce03-11e7-97a9-067fbe30e3fa | [{"insert": "Anesthesia"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "General anesthesia is used to assist in putting you sound asleep for the surgery. During the entire procedure, an anesthesiologist and nurse anesthetist will be observing you, the oxygen level in your blood, the amount of carbon dioxide you breathe out, your heart rate, and your blood pressure. The advanced systems used by the anesthesiology department assist in identifying any issues immediately, reducing your risk significantly. Your anesthesiologist will discuss the specific risks of general anesthesia with you before your surgery. Be sure to ask any questions you may have.\n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/generalanesthesia"}}, {"insert": "\n"}]
65fc16fe-ce03-11e7-97aa-067fbe30e3fa | [{"insert": "At the Hospital"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will begin by registering and checking in. Then you will be escorted to a pre-operative area. You will be asked to change your clothing and put on a hospital gown and slippers. If you wear dentures, corrective lenses or hearing aids, you will be asked to remove them for safety reasons, so it’s best to bring your own container. You will be asked to sign an operative consent form, even though you may already have done so at your surgeon’s office. Your signature indicates that the procedure has been explained to you, that you understand and have no further questions.\n\nYour blood pressure, pulse, respiration, oxygen saturation, temperature, height, and weight will be measured. An intravenous (IV) line will be placed in your forearm to allow fluids and/or medications into your blood stream. You may be given some medicine to help you relax.\n"}]
65fc4f8e-ce03-11e7-97c8-067fbe30e3fa | [{"insert": "Daily Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "2 Bariatric Advantage Shakes per day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "2 Bariatric Advantage bars or crisps per day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 Lean Protein and non-starchy vegetable (see allowable dinner list)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nExample Schedule"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Breakfast - ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Morning - ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Bar or Crisp"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lunch - ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Afternoon- ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Bar or Crisp"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dinner - ", "attributes": {"bold": true}}, {"insert": "Meal: Lean Proteins, Vegetables"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluid - ", "attributes": {"bold": true}}, {"insert": "64oz of fluid throughout the day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " **Please allow 3-4 hours between each me\n"}]
65fc13de-ce03-11e7-97a4-067fbe30e3fa | [{"insert": "\n", "attributes": {"header": 1}}]
aca9cd18-f486-11e7-92ae-067fbe30e3fa | [{"insert": "Sample Meal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Meal"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Start Here - ⅓ cup or 3-4 oz. Lean Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Gradually add these foods as you are able to eat more"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Next - ½ cup non starchy veggies"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Last - ⅓ cup whole grain or starchy veggie"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nSample Schedule"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Breakfast, AM Snack, Lunch, PM Snack, Dinner, Evening Snack"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc1ac8-ce03-11e7-97af-067fbe30e3fa | [{"insert": "Warnings"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "The Bariatric Advantage Liver Reduction Diet may cause significant changes in blood sugar or blood pressue. If you are diabetic, hypoglycemic, or have high blood pressure, it is very important that you are aware of possible changes that may happen during this diet. We advise you to check your blood pressure and blood sugar daily and report any changes to your Primary Care Physician. Call your Primary Care Physician if:\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Blood Pressure"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "If your blood pressure changes by more than 20 mmHg from normal, or if you experience: dizziness, fainting, irregular heartbeat, extreme headache\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Blood Sugar"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "If your blood sugar falls below 70mg/dL or if you experience: cold shaky sweats, rapid heart rate, dizziness confusion or inability \n to concentrate\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Possible Side Effects of Ketosis"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Sensitivity to cold"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dry skin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fatigue"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Diarrhea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Constipation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle cramps"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bad breath"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Irritability"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc1b22-ce03-11e7-97b0-067fbe30e3fa | [{"insert": "Questions"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Regarding the KetogenX Products"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Envision Store 919-234-4907", "attributes": {"background": "lightgrey"}}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Regarding the Liver Reduction Diet"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Link to Patient Portal", "attributes": {"background": "lightgrey"}}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}]
65fc1b86-ce03-11e7-97b1-067fbe30e3fa | [{"insert": "Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Drink lots of water. 64 oz or more per day is ideal. Water is the best thing you can drink."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Get plenty of sleep. Being well rested will ensure you’re not looking for extra energy from food."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Plan your meals in advance. If you stick to a pre-planned shopping list, there is less of a possibility for impulse buying."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc502e-ce03-11e7-97c9-067fbe30e3fa | [{"insert": "Modified Liver Reduction Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will be placed on a 1-4 week liver reduction diet based on your BMI and weight changes prior to surgery. Your surgeon will let you know the length of this program at your Results Visit. The first stage of the program is a modified liver reduction. The week immediately before surgery is all liquids: 5 shakes a day, no solid food.\n"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n"}]
65fc1924-ce03-11e7-97ad-067fbe30e3fa | [{"insert": "Feeling Sick Before"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Should you develop a cold, persistent cough, fever, skin breakdown, or any changes in your condition before your surgery, please notify the surgeon immediately. The surgeon and/or anesthesiologist will need to re- evaluate your surgical readiness. You need to be in the best possible shape for anesthesia. Scheduling can be adjusted to your condition, if necessary.\n"}]
65f37f6c-ce03-11e7-977d-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Weight loss surgery is an excellent tool to help you limit the amount of food you eat and help you lose weight. For most people, weight loss surgery requires a significant change in diet and lifestyle to safely and healthfully reach your goal. After bariatric surgery, you will likely be losing weight very rapidly. Good nutrition is essential to maintain lean body mass (muscle), hydration, skin elasticity, and to minimize hair loss."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n\nPrimary Nutrition Goals"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Consume adequate amounts of protein to minimize loss of lean body mass and help facility healing"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take in adequate amounts of fluid to maintain hydration status"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Obtain adequate nutrients for optimal health through healthy food choices and vitamin and mineral supplementations"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nLifestyle Changes. Your new lifestyle will include:"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Protein - 60-80g/day (DS 80-100g/day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluids - 64 fl oz/day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vitamins - Lifelong vitamin and mineral supplementation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Exercise - Minimum of 10k steps daily"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc18ac-ce03-11e7-97ac-067fbe30e3fa | [{"insert": "Bowel Preparation"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will be given instructions for bowel preparation prior to surgery at your results visit. It is very important that you follow these instructions completely. \nDo not eat or drink anything after 12 midnight the night before your surgery, except medicines that have been previously approved by your surgeon. \nYour stomach must be empty at the start of the procedure to reduce the risk of aspiration.\n"}]
65fc1be0-ce03-11e7-97b2-067fbe30e3fa | [{"insert": "Daily Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Consume 5 protein shakes a day, you should have one every 3-4 hours\n\nExample Schedule"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Breakfast - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Morning - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lunch - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Afternoon - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dinner - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluid - 64oz of fluid throughout the day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add Meal Schedule to Calendar", "attributes": {"background": "lightgrey"}}, {"insert": "\n", "attributes": {"list": "bullet"}}]
63dc6464-f25c-11e7-8af0-067fbe30e3fa | [{"insert": "B-Complex"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter.\nIf not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1).\n\nMulti-Vitamin"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. We recommend a bariatric formulated multivitamin that contains iron. The multivitamin should be taken without food for increased absorption.\nBariatric Advantage Chewable Multi EA (2 a day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multivitamin (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 45mg Iron"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multi-Complete 60 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multi-Complete 45 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multi-Complete 36 (2 a day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Bariatric Fusion Chewable Multivitamin (4 a day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 30mg Iron"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Bariatric Advantage Ultra Multi Capsule with Iron (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Additional iron is recommended for menstruating women. Consult your surgeon or registered dietitian for more information."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nCalcium"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. Take calcium supplement doses at least 2 hours before or 2 hours after the multivitamin and iron. Calcium supplements should be spaced throughout the day for increased absorption.\n"}]
65fc1e38-ce03-11e7-97b6-067fbe30e3fa | [{"insert": "Maintain Good Hygiene"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Don’t forget, good skin integrity is essential for the operative site. It is important to maintain good hygiene, by keeping skin clean and dry, especially in the days before surgery. Skin breakdown could possibly cause your surgery to be delayed.\n"}]
65fc5092-ce03-11e7-97ca-067fbe30e3fa | [{"insert": "Liver Reduction Diet Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Two to four weeks prior to your surgery date, depending on your individual case, you will be required to begin a pre-operative diet intended to alleviate risks associated with an enlarged or fatty liver. This is also known as the Ketogenx diet.\n"}]
65fc5b78-ce03-11e7-97df-067fbe30e3fa | [{"insert": "If you have OSA"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will need CPAP treatment every night when you go to bed. We will contact a company who, through your insurance, will set you up with a machine. Like other diseases, weight loss surgery cures the problem over 50% of the time. \n\nSome patients still have OSA after weight loss surgery, so before you stop using your machine you should be retested. Usually, you can retest 9-12 months after surgery. Remember; use the machine until you are clear of OSA.\n"}]
65fc1d16-ce03-11e7-97b3-067fbe30e3fa | [{"insert": "Rapid Liver Reduction Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You were previously on a modified liver reduction diet based on your BMI and weight changes prior to surgery. The week immediately before surgery is all liquids: 5 shakes a day, no solid food.\n"}]
65fc1e92-ce03-11e7-97b7-067fbe30e3fa | [{"insert": "Prepare Your Household"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Thoughts for Your Living Room"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Are there many steps in your home?"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Is your bedroom upstairs?"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "How accessible is your bathroom? "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nPlease tell your care team about your living environment so they can prepare your going home plan with your specific needs in mind. Nonetheless, a rubber shower head with a detachable hose, long sponge stick (or kitchen tongs), and toilet lift are all useful items.\n\nArrange Someone to Help"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Most patients like to have someone home with them the first few days after surgery for moral and physical support. Due to the nature of abdominal surgery, you may need some help with toileting. Flushable baby wipes tend to be gentler for personal hygiene, as well as a peri-bottle and/or use a small sports-top water bottle. A long sponge stick can also be very helpful.\n"}]
a96f6dce-f238-11e7-8fc4-067fbe30e3fa | [{"insert": "CPAP Questions"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "What if I have a problem with my machine?", "attributes": {"bold": true}}, {"insert": " You will contact the company that set you up with the CPAP machine. They will take care of any equipment issues or mask problems. If you are having a problem, DO NOT STOP TREATMENT."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "What can I expect after using a CPAP?", "attributes": {"bold": true}}, {"insert": " The first couple of nights you may feel funny. You will sleep a lot better, feel more rested, less fatigued during the day, and you won’t wake up the house snoring! "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Can I have Surgery without a CPAP?", "attributes": {"bold": true}}, {"insert": " The answer is no. Anesthesia and pain medications can cause your breathing to slow or stop and can actually worsen OSA. It is dangerous to undergo surgery with OSA. For your safety, you need to have a CPAP and bring it with you to the hospital for after surgery."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc237e-ce03-11e7-97c3-067fbe30e3fa | [{"insert": "o  "}, {"insert": "Questions", "attributes": {"bold": true}}, {"insert": "\n§ Regarding the KetogenX Products\n"}, {"insert": "·     Envision Store 919-234-4907", "attributes": {"background": "lightgrey"}}, {"insert": "\n§ Regarding the Liver Reduction Diet\n·     "}, {"insert": "Link to Patient Portal", "attributes": {"background": "lightgrey"}}, {"insert": "\n"}]
65fc23e2-ce03-11e7-97c4-067fbe30e3fa | [{"insert": " Warnings"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "The Bariatric Advantage Liver Reduction Diet may cause significant changes in blood sugar or blood pressue. If you are diabetic, hypoglycemic, or have high blood pressure, it is very important that you are aware of possible changes that may happen during this diet. We advise you to check your blood pressure and blood sugar daily and report any changes to your Primary Care Physician. Call your Primary Care Physician if:\nIf your "}, {"insert": "blood pressure", "attributes": {"bold": true}}, {"insert": " changes by more than 20 mmHg from normal, or if you experience: dizziness, fainting, irregular heartbeat, extreme headache"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If your "}, {"insert": "blood sugar", "attributes": {"bold": true}}, {"insert": " falls below 70mg/dL or if you experience: cold shaky sweats, rapid heart rate, dizziness confusion or inability to concentrate"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Possible Side Effects of Ketosis"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Sensitivity to cold"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dry skin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fatigue"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Diarrhea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Constipation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle cramps"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bad breath"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Irritability"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc243c-ce03-11e7-97c5-067fbe30e3fa | [{"insert": "Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Drink lots of water. 64 oz or more per day is ideal. Water is the best thing you can drink.\nGet plenty of sleep. Being well rested will ensure you’re not looking for extra energy from food.\nPlan your meals in advance. If you stick to a pre-planned shopping list, there is less of a possibility for impulse buying.\n"}]
65fc248c-ce03-11e7-97c6-067fbe30e3fa | [{"insert": "Diet Do’s and Don’ts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nDo"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Mix your shake with water"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use the allowable foods list to create your lean and green meal and enjoy 1-2 TBSP of added fat "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fill in between meals with plenty of non-carbonated, caffeine free, sugar free liquids."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Enjoy sugar free jello, popsicles, and broths."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Have a shake, bar or crisp every three to four hours."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Rotate your Lean and Green meal (may be consumed at either lunch OR dinner)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nDon’t"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Use milk or milk substitutes to mix your shake "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use fried or breaded and fried meats"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skip shakes, bars or meals "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Go longer than 3-4 hrs between meals and snacks"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc24f0-ce03-11e7-97c7-067fbe30e3fa | [{"insert": "Allowable Foods List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "During your Modified Liver Reduction Diet, you should eat 1 Lean and Green meal per day, 2 Bariatric Advantage High Protein Meal Replacement Shakes, and 2 Bariatric Advantage Ketogenx bars or crisps. \n \n When building your Lean and Green Meal, use the list below. Note: This list is to be used during the Modified Liver Reduction Diet.\n\nVegetables "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Non-Starchy Vegetables"}, {"insert": " - ", "attributes": {"bold": true}}, {"insert": "Recommended Vegetables (3 handfuls per meal)\nAlfalfa sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Artichokes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Asian greens"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Asparagus"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Baby spinach"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bamboo shoots"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bean sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Beets"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bok choy"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Broccoli"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Broccolini"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Brussels sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cabbage"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cauliflower"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Carrots"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Celery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chard"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cucumber"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eggplant"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Endive"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fennel"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Green beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Kale"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Kohlrabi"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Leeks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lettuce – all types"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mushrooms"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Okra"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Olives"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Onions"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Peppers– all types"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Radishes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Radicchio"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Snow peas"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Spinach"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Squash"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tomato"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Turnip"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Water chestnuts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Zucchini"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nProtein"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Recommended Protein (1 palm sized portion per meal)\nBison"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Beef"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cheese - low fat"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chicken"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crab"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Duck"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eggs"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fish"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lamb"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lobster"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mussels"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oysters"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pork- Including low-fat cured meat"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Prawns"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Scallops"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Turkey"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Veal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Venison"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu or Tempeh*"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "*Consume 2 palm portions per meal of Tofu or Tempeh"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nOils to Cook With "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Cook with 1-2 Tbsp. of\nOlive oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sesame oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Walnut oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flax oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Grapeseed oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Macadamia oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sunflower oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avocado Oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nHydration"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "at least 64 oz. of fluid per day \nALL HYDRATION MUST BE: carbonation-free, sugar-free, caffeine-free Water\nSugar-free or diet fruit juice"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free drinks (ex. Crystal Light)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Decaf tea or coffee (no milk, cream, or sugar)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free sports drinks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear, low-sodium broth"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free popsicles"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free gelatin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n \n"}]
65fc559c-ce03-11e7-97d2-067fbe30e3fa | [{"insert": "Liver Reduction Diet Program Length"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will be placed on a 1-4 week liver reduction diet based on your BMI and weight changes prior to surgery. Your surgeon will let you know the length of this program at your Results Visit. The first stage of the program is a modified liver reduction. The week immediately before surgery is all liquids, no solid food.\n"}]
65fc1ef6-ce03-11e7-97b8-067fbe30e3fa | [{"insert": "Preparing for Post-Op Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Pre-Surgery Shopping list"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "New water bottle"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "⅓ and ½ c measuring cups "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Measuring spoons (teaspoon & tablespoon)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Toddler utensils"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp forks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chopsticks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Small food storage containers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Recommended vitamin and mineral supplements"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Buy chewable b-complex"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "A variety of sugar-free/carbonation-free/caffeine-free hydrating fluids"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Water "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Decaf coffee or tea "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Diet or sugar-free "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "clear fruit juices "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Sugar-free Jell-O "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Sugar-free popsicles "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Chicken, beef or "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "vegetable broth "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Crystal Lite "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Sugar-free lemonade "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Vitamin Water Zero "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Fruit"}, {"insert": "2", "attributes": {"script": "sub"}}, {"insert": "O "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Mio "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Dasani Drops"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Ayala’y Herbal Water (Whole Foods) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Metro Mint Water "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Hint Water (Whole Foods) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Skinny Water (Harris Teeter) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Propel"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "3-4 bottles of clear liquid protein (Bring to hospital)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Isopure "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Cocotein"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Healthwise High protein fruit drink"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Healthwise bouillon"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Skim/1 % milk OR milk alternative "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Notebook for food journal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of milky-consistency protein shakes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle Milk "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Premier Protein "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Nectar Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Healthwise High Protein Hot Chocolate "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Bariatric Advantage Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Pure Protein "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Oh Yeah "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Chike Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Met Rx Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Unjury"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "New athletic footwear"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "New athletic socks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crockpot "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Blender"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc5344-ce03-11e7-97cc-067fbe30e3fa | [{"insert": "Hygiene"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Good skin integrity is essential for the operative site. It is important to maintain good hygiene, by keeping skin clean and dry, especially in the days before surgery. Skin breakdown could possibly cause your surgery to be delayed.\n"}]
65fc53bc-ce03-11e7-97cd-067fbe30e3fa | [{"insert": "Diet months before"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Nutrition is a vital part of your success, both before and after surgery and it is vital to understand what is required to optimize your health. Visits and classes with our Registered Dietitians will help you understand what your primary goals should be with hydration, nutrition, and vitamins as you begin and continue your weight loss journey. Our dietitians will guide you as your progress through different stages as you heal and your body changes. Months before surgery start following these tips:\nBegin preparation for post-op liquid diet (protein shakes and hydrating fluids on hand). "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin setting up a weight loss surgery meal plan NOW: plan a meal about every 3-4 hours for about 4-6 small meals each day with a protein at each meal and breakfast with in one hour of waking."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try to increase fluid intake between meals to at least 64oz per day. Begin eliminating carbonated, caffeinated, and sugar containing beverages)                                             "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Practice not drinking with meals (including 30 minutes before and after) and try to establish a habit of sipping on fluids between meals "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Practice mindful eating, try to eliminate distractions during meals, TV, Phone, tablet."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin decreasing high fat/fried and high sugar foods No more than 10g fat or 10g sugar per serving. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try to slow your eating speed, allow about 20-30 minutes to finish a meal."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Practice eating with your non-dominant hand."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Practice chewing foods to an applesauce consistency. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Maintain weight within 2-3 pounds of your current weight or initiate weight loss."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin or continue food journaling to increase mindfulness to food/fluid choices and diet pattern."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc5420-ce03-11e7-97ce-067fbe30e3fa | [{"insert": "Quit Tobacco"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "If you do not smoke, please continue to the next task, by clicking complete task at the bottom of the page.\n\nPatients are asked to stop smoking at least 6 weeks before surgery and to permanently refrain from smoking after surgery. If you feel you will need assistance in quitting, ask your Primary Care Physician for help and/or seek out smoking cessation programs in your area. You can also utilize resources in your area such as Quitline NC.\n\nIf your surgeon finds you are non-compliant, your surgery may be postponed or cancelled.\n\nRisk associated with smoking:"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Hinders proper lung function which can increase the possibility of anesthetic complications. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Reduces circulation to the skin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Impedes healing"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Increases the risk of blood clots in the legs"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Developing cardiopulmonary complications (such as pulmonary embolism and the collapsing of the tiny air sacs in the lungs)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Infections (pneumonia). "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stimulates stomach acid production, leading to possible ulcer formation."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc54e8-ce03-11e7-97d0-067fbe30e3fa | [{"insert": "Begin Exercise Program"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "The best time to begin your exercise program is before your surgery. The sooner you start exercising the easier it will be after you have had surgery. Success with weight loss surgery is all about choosing the right habits, with the support of the surgery to improve your success. We want you to start moving more, but we don’t want you to injure yourself. \n\nWalking on a daily basis improves your circulation and makes breathing easier during your recovery. You will also benefit from having a plan in place, so you don’t have to figure out your exercise routine during your recovery phase. If you are unable to walk daily due to joint pain, then you may want to look into an aquatic program at a local health club. Every town has classes for arthritic or cardiac patients that are held in a safe and clinical environment. Water exercises will condition your breathing, but are not weight bearing and are therefore easier for people who have joint problems.\n30-60 Minutes of intentional activity 4-5x a week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Strength Training 3x a week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "10,000 Steps a day"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc5542-ce03-11e7-97d1-067fbe30e3fa | [{"insert": "Enter Surgery Date & Location", "attributes": {"bold": true, "background": "#bbbbbb"}}, {"insert": "\n"}, {"insert": "If more than 30 days away, additional visits may be required", "attributes": {"background": "#bbbbbb"}}, {"insert": "\n"}]
65fc5830-ce03-11e7-97d6-067fbe30e3fa | [{"insert": "Prepare Questions for Results Visit"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your provider will give you time to ask any questions you have about the day of surgery and go over the benefits and risks associated with your procedure.\n"}]
65fc595c-ce03-11e7-97d9-067fbe30e3fa | [{"insert": "Psychology"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Additionally, all patients are required to have psychological clearance prior to surgery being scheduled. We have found that both the journey that lead you to where you are today as well as the weight loss journey you are about to begin, have great psychological and emotional components. Addressing that component properly is a large factor in your success.\n"}]
65fc59b6-ce03-11e7-97da-067fbe30e3fa | [{"insert": "Pulmonology"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Chest X-Rays", "attributes": {"bold": true}}, {"insert": " will help to show your pulmonary function. During any surgical procedure it is important that the patient has proper lung health.\n"}]
65fc5a10-ce03-11e7-97db-067fbe30e3fa | [{"insert": "Radiology"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "To check your gallbladder for gallstones or sludge, you will have a right upper quadrant "}, {"insert": "ultrasound", "attributes": {"bold": true}}, {"insert": " performed. Should that test indicate that your gallbladder needs to be removed, we can often accommodate both your bariatric procedure and gallbladder removal at once.\n"}]
65fc5b1e-ce03-11e7-97de-067fbe30e3fa | [{"insert": "CPAP Questions"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "What if I have a problem with my machine? "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "You will contact the company that set you up with the CPAP machine. They will take care of any equipment issues or mask problems. If you are having a problem, DO NOT STOP TREATMENT"}, {"insert": ".", "attributes": {"bold": true}}, {"insert": "\n\nWhat can I expect after using a CPAP?"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "The first couple of nights you may feel funny. You will sleep a lot better, feel more rested, less fatigued during the day, and you won’t wake up the house snoring! \n\nCan I have Surgery without a CPAP? "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "The answer is no. Anesthesia and pain medications can cause your breathing to slow or stop and can actually worsen OSA. It is dangerous to undergo surgery with OSA. For your safety, you need to have a CPAP and bring it with you to the hospital for after surgery.\n"}]
65fc5a74-ce03-11e7-97dc-067fbe30e3fa | [{"insert": "Cardiology"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "In order to evaluate your heart, you will be referred to a physician who specialized in cardiology. You will need an EKG to check for any cardiac abnormalities that may be underlying. Many patients have never visited a cardiologist because they have never had a known reason. Our goal is to fully understand your health prior to undergoing surgery.\n"}]
65fc5902-ce03-11e7-97d8-067fbe30e3fa | [{"insert": "Results Visit Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Once your various preoperative tests have been completed, a ", "attributes": {"color": "#333333"}}, {"insert": "Results Visit ", "attributes": {"bold": true, "color": "#333333"}}, {"insert": "will be scheduled to give you and your surgeon a chance to finalize your choices and make sure you are surgery ready.", "attributes": {"color": "#333333"}}, {"insert": "\n\n"}, {"insert": "At this visit you will meet with your surgery scheduler and discuss what your options are for surgery dates. Please have your calendar in mind prior to this appointment and keep in mind your schedule for recovery and plans that may factor into this decision. It is also important to keep in mind, our surgeons have set operating schedules that may not allow for full flexibility with specific day or time requests.", "attributes": {"color": "#333333"}}, {"insert": "\n"}]
65fc589e-ce03-11e7-97d7-067fbe30e3fa | [{"insert": "Review Consent Forms"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "You will sign consent forms associated with the specific procedure chosen and your surgeon will go over the results of all preoperative testing.\n"}]
65fc56e6-ce03-11e7-97d5-067fbe30e3fa | [{"insert": "Gather Everything You Need"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "At your Results visit, we will ask you to provide:", "attributes": {"color": "#333333"}}, {"insert": "\nPhoto ID"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Insurance Card"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Method for paying outstanding balance"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Calendar", "attributes": {"color": "#333333"}}, {"insert": "\n", "attributes": {"list": "bullet"}}]
4717dde6-f6fc-11e7-a5b4-067fbe30e3fa | [{"insert": "Alamance Regional Medical Center"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Grand Oaks Center\n1240 Huffman Mill Rd, Burlington, NC 2721\n"}]
65fc5be6-ce03-11e7-97e0-067fbe30e3fa | [{"insert": "Titration Study "}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Some patients will have shown sleep apnea early during their first test. If so, we will do a CPAP titration the first night (this is called a split night study) This is done by:\nWaking you up"}, {"insert": "\n", "attributes": {"list": "ordered"}}, {"insert": "Hooking up the machine (painless)"}, {"insert": "\n", "attributes": {"list": "ordered"}}, {"insert": "When you are back asleep the pressure will be slowly adjusted until the breathing problem is corrected. "}, {"insert": "\n", "attributes": {"list": "ordered"}}, {"insert": "Not all patients qualify for the titration the first night, because some do not start having problems until late in the night. In that event, you will have to come back for a second night to be titrated on CPAP.\n"}]
65f6b1d2-ce03-11e7-9784-067fbe30e3fa | [{"insert": "Nausea"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Experiencing nausea is common for the first several days to first few weeks after surgery. Nausea may be related to insufficient chewing, fullness, sensitivity to odors, pain medication, not eating, postnasal drip and/or dehydration. For nausea that occurs in the first days after surgery, the nausea can be suppressed with anti-nausea medications. \nIn some cases the nausea can be so severe that it prevents patients from taking in adequate amounts of liquids. If this happens you need to come back to the hospital to receive intravenous fluids. Persistent vomiting can lead to dehydration and electrolyte imbalance, and can cause vitamin deficiencies to occur. \n\nSome advice"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Learn to recognize when you are full. This will not happen immediately, but by eating very slowly, it will become easier."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Should you have difficulty drinking due to nausea, you may want to try peppermint tea, fennel tea, decaffeinated green tea or water with lemon (hot or cold)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If you believe that your pain medication is the cause of your nausea, please call your surgeon’s office to have the prescription changed."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stay hydrated. Fluids should be continuously sipped all day long to prevent dehydration. You need a minimum of 48 to 64 oz. of fluids per day. Increase this amount by 20% if you are sweating."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take your nausea medicine as prescribed by your surgeon."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc5ea2-ce03-11e7-97e5-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "We require all patients undergoing bariatric surgery to first have a sleep study conducted. This is to diagnose or clear you of obstructive sleep apnea (OSA).\n\nOne of the tests we require is a sleep study, or "}, {"insert": "polysomnogram (PSG).", "attributes": {"bold": true}}, {"insert": " There are several reasons this test is required. First, is safety. People who have a BMI of 35 or greater have an 80% risk of obstructive sleep apnea, or OSA. OSA is a potentially lethal condition increasing your risk of stroke, heart attack, or abnormal heart rhythm three hundred percent higher than the average population. Also, OSA can cause or worsen high blood pressure and weight gain, while also causing daytime sleepiness and fatigue. This is a disease that is no different than diabetes or low thyroid and needs to be treated. Most or all weight loss surgical programs mandate evaluation for OSA before surgery.\n"}]
65fc5f06-ce03-11e7-97e6-067fbe30e3fa | [{"insert": "Lab Work"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Specific lab work will be drawn in our office, or by your primary care provider. This blood work is necessary to provide your surgeon and their staff with a picture of your current overall health and nutrition. We do require a fairly extensive screening panel, so please keep in mind that prior lab work may not fulfill all of our requirements.\n"}]
65fc5f60-ce03-11e7-97e7-067fbe30e3fa | [{"insert": "Pre-Op Evaluation & Studies Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "For our patients, much of the pre-operative evaluation remains the same, regardless of which procedure you choose. It is our goal to ensure you are not going into surgery under anesthesia with any unknown or unnecessary risks. We want your health and your weight loss journey to come without and negative surprises along the way, for us or you. Click on the requirements below to learn more about the per-operative evaluation.\n\nPre-Surgery Requirements"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "With any of these pre-operative screenings and test, there may be a necessity for follow-up with the specific specialist. We want to ensure we know everything about your individual health that we can before surgery as well as address any issues that may increase surgical risks.\nLabs"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Radiology exams"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Psychology"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nutrition"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sleep Study"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Gastroenterology"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cardiology"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pulmonology"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Resting Metabolic Rate"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc6834-ce03-11e7-97f7-067fbe30e3fa | [{"insert": "Emotional Concerns"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Bariatric surgery has both physical and psychological effects. Please do not take these changes lightly. In the short term, the immediate sense of loss of food is often a cause for distress. In the long term, you may be experiencing changes in body image and further awareness of the social implications of obesity.\n"}]
65fc5dc6-ce03-11e7-97e3-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A PSG is the gold standard sleep test. You will spend the night in the sleep lab sleeping in a comfortable, secure, climate controlled room while being monitored by one of our sleep technicians. Each room is equipped with a private bathroom and shower. The technician will attach painless monitors that will help us evaluate you for OSA. The exam takes the entire evening and the technician will wake you up in the morning when the exam is over. After that, your exam will be scored by our chief technician and interpreted by Dr. Jon Bruce.\n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/sleepstudy"}}, {"insert": "\nIf sleep apnea is not present you will be required to do nothing else and you will be cleared for surgery from a sleep perspective. If you have OSA, you may have to come back a second night for a titration study.\n"}]
eb2c645e-f24e-11e7-aed5-067fbe30e3fa | [{"insert": "Recovery Room"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Once the surgery is complete, you will be moved to the recovery room. You will be closely monitored during this period. When your initial recovery is completed and all your vital signs are stable, you will be transported to your room or discharged home depending on you and the procedure you choose. Most patients have very little memory of their stay in the Recovery Room. \n\nIf you are going home from the Recovery Room your family/friend will be given instructions for you to follow.\n"}]
51cbd760-f486-11e7-9bcc-067fbe30e3fa | [{"insert": "Transitioning"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Tips for Adding Protein When on a “Regular Diet”:\nAdd eggs, tuna, shrimp, and crab to salads"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Non-fat dry milk powder to smoothies "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add diced meats to soups, salads and sauces "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add low fat cheese to sauces, soups, eggs and salads "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try cottage cheese with green salad or mix into casseroles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use low-fat cheese as a snack "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use peanut on vegetables or in sauces "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add beans to soups, salads and casseroles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Add tofu to soups, salads and smoothies"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc6140-ce03-11e7-97ea-067fbe30e3fa | [{"insert": "Prepare Questions"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will have time with your surgeon to discuss options along with the risks and benefits of each procedure. Your surgeon will also determine if your preferred procedure is medically appropriate for you.\n"}]
65fc6208-ce03-11e7-97ec-067fbe30e3fa | [{"insert": "Review Pre-Op Insurance Requirements"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "At your first appointment, you will meet your Bariatric Case Manager to go over the pre-op insurance requirements, benefits, financials and paperwork.\n"}]
65fc637a-ce03-11e7-97f0-067fbe30e3fa | [{"insert": "Review Your Care Plan"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You are currently on the Roux-en-Gastric Bypass Care Plan. If you want to stay on this care plan, just click complete task below to continue. If you want to update your care plan click the button below. You can always update your care plan by going to the More menu, and selecting settings.\n"}]
65fc62bc-ce03-11e7-97ee-067fbe30e3fa | [{"insert": "Risks"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Risks specific to the gastric bypass include leaks at the staple lines and new connections created during the procedure. A leak could mean an extra few days in the hospital, additional antibiotics or another laparoscopic procedure. Long term risks include an ulcer at the connection between the pouch and the intestine as well as bowel obstructions and internal hernias.\n\nOne attribute specific to the bypass is dumping syndrome, which some patients view as both a positive or negative. Patients who eat too much fat or sugar during a meal may “dump” or experience symptoms of nausea, sweating, fatigue, weakness and diarrhea. It is your body’s way of telling you that you just ate the wrong thing.\nPatients can expect to lose about 60% to 75% of their excess weight within the first year after surgery. Patients can also expect resolution or improvement of medical conditions such as hypertension and diabetes, often within the first few weeks or months after surgery.\n\n"}]
65fc6262-ce03-11e7-97ed-067fbe30e3fa | [{"insert": "Meet Your Care Team"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Surgeon"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Dr. Enochs received his medical degree from the University of South Alabama College of Medicine and completed residency at the University of South Alabama Medical Center. He received additional training at the University of California– San Francisco, the University of Chicago, Carolinas Medical Center, the Medical College of Virginia, and Duke University Medical Center. \n\nDr. Enochs founded Bariatric Specialists of NC, the triangle’s first private weight loss surgery program. Dr. Enochs has performed more Bariatric procedures in the Triangle area than any other surgeon. Additionally, he established programs at Rex Hospital, WakeMed Cary Hospital, and Franklin Regional Medical Center. Dr. Enochs serves on the Board of Directors of Rex Surgery Center of Cary. He has also served terms as the Medical Director of Bariatrics at above hospital programs.\n\nDr. Enochs resides in Cary with his wife and beautiful children. He is active in his church and community and is also heavily involved in funding churches and hospitals in underprivileged areas. \n\nMedical Assistant"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Jana Griffin, RMA\n"}]
65fc61ae-ce03-11e7-97eb-067fbe30e3fa | [{"insert": "Complete Health History Forms"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your surgeon’s Medical Assistant will go over general health history information. Visit the patient portal, by clicking the link below to fill out the forms.\n\n"}]
65fc63ca-ce03-11e7-97f1-067fbe30e3fa | [{"insert": "Support Group"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Patients at all stages of the process are welcomed to and will benefit from attending support group regularly. These are held on a monthly basis and feature speakers from our own bariatric surgeons to personal trainers, plastic surgeons, nutritionists, and more. We aim to provide both opportunity to learn and grow as well as a community environment which allows fellowship and support on a peer to peer basis. We recommend all patients attend at least one support group pre-operatively.\n\nBSNC support groups are held at the following locations and times"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Rex Hospital Raleigh", "attributes": {"bold": true}}, {"insert": "\n"}, {"insert": "Cancer Center Auditorium", "attributes": {"link": "https://goo.gl/maps/dtAWRhqvxSA2"}}, {"insert": "\n"}, {"insert": "4420 Lake Boone Trail, Raleigh, NC 27607", "attributes": {"link": "https://goo.gl/maps/dtAWRhqvxSA2"}}, {"insert": "\n\n"}, {"insert": "Alamance Regional Medical Center", "attributes": {"bold": true}}, {"insert": "\n"}, {"insert": "Grand Oaks Center", "attributes": {"link": "https://goo.gl/maps/hEXYi7qwd742"}}, {"insert": "\n"}, {"insert": "1240 Huffman Mill Rd, Burlington, NC 27215", "attributes": {"link": "https://goo.gl/maps/hEXYi7qwd742"}}, {"insert": "\n\n\n"}]
65fc650a-ce03-11e7-97f2-067fbe30e3fa | [{"insert": "Family & Friends"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You can expect your family and friends to have varying reactions to your surgery and the weight loss that follows. Although you hope your loved ones will be supportive and helpful during your ups and downs, this may not always be the case.\n\nFirst of all, your partner or spouse has become accustomed to you and your obesity. This may result in a resistance to the changes that are happening. You may notice that you and your spouse/partner are having far more disagreements than usual, your spouse/partner may exhibit mood swings, or refusal to support your dietary and/or exercise regimen. Keep the lines of communication open and recognize signs of distress in your partner who is adjusting to the changes in your body and behavior. These changes will require your partner to relate in new ways to you. This takes time, effort and patience.\n\nIf you are experiencing serious ongoing problems in your relationships, some short-term professional counseling may be helpful. You may also experience similar changes in some of your other relationships. Your extended family, co-workers, and friends are all witnessing the changes you are going through and may not have the reaction you expect. \n\nSome of your relationships may change through this process and that is normal. Identify those people who are the most supportive and surround yourself with the love and care you deserve.\n"}]
65fc656e-ce03-11e7-97f3-067fbe30e3fa | [{"insert": "Body Image"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Keep in mind that as your body undergoes changes in weight and size, it is likely you may not see your body as others may view it. It takes time for your mind to catch up with what your body is doing. It is similar to the phantom limb phenomenon, where a person who has lost a limb continues to experience pain or feeling from the missing limb, and in fact, feels they still have the limb. \n\nAs you lose weight, you may actually be surprised when you see your reflection in a store window or mirror. You may not feel like this person is you. It is normal to feel like you are still the same size as you were before surgery, but there are some definite ways to help you work at this.\n\nTalk to your spouse, family doctor, friends, and other patients for support. We are here to support you with personal consultations and support groups. Connect with others that understand your journey by attending support group regularly. If, at any time, you feel overwhelmed or otherwise need more assistance, please contact us. We will be glad to take the necessary steps to find the proper resources for your situation.\n\nCoping with Body Image"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Learn new ways of dealing with the emotions that cause you to eat. In the past, one of the best methods for you to cope with life stress may have been for you to eat. One of the keys to success of this surgery is to learn to replace those comforts with healthy activities. This will take time and you may need some assistance learning new coping methods. Don’t be afraid to ask for help! \n\nTry not to sabotage yourself. The experience of such rapid bodily change will likely be accompanied by many emotional ups and downs.\n\nHere are some additional tips that may help you through the recovery and adjustment period after surgery:\nOne of the most important aspects is the recognition and understanding of the experience of loss."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Expect to have ups and downs as the weeks go by."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If you are feeling teary and depressed, have a good cry. Do not suppress your emotions. They will surface again anyway."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Keep a journal of your experiences and feelings and share them with your doctor, surgeon, and/or counselor."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Adjust your expectations."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Set realistic goals."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stay occupied with work, hobbies and exercise."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc65dc-ce03-11e7-97f4-067fbe30e3fa | [{"insert": "Depression"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Our experience has shown that in the period of stress, starvation, weight loss, and adjustment to lifestyle changes following weight loss surgeries, mild to severe depression is a frequent problem. Unfortunately, most depressed people do not recognize their depression. You and your family need to be aware of the risk of depression and should look for the signs of depression.\n\nEffective psychological treatments for depression are available. Please contact your primary care doctor, psychiatrist, counselor, or the psychologist who helped in your preoperative evaluation to assist you with any depression problems. If you need help contacting a psychologist in your area, please notify the office. \n\nSevere depression cannot be treated with counseling or medication alone. You will need to work with a professional to find the right treat for you. If you have been taking antidepressants before your weight loss surgery, you should continue to take them after your surgery. You must inform the doctor who prescribed these medications of your surgery and the need for chewable, crushable or liquid forms of the medication prior to surgery. \n\nBariatric surgery is not a fix for your everyday problems. This surgery will allow you to begin to gain control over one aspect in your life: your weight. \n\nAlthough you have elected to have weight loss surgery to resolve your obesity, weight loss also changes the lifestyle you knew so well. Even with its problems and tensions, obesity was comfortable, simply because it was known. Now, that life is gone. When the reality of the new situation confronts you, it is natural to begin a longing for your old way of life.\n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/depression"}}, {"insert": "\nSigns and Symptoms"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Persistent sadness"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Anxious or “empty” mood"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Loss of interest or pleasure in activities including sex"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Restlessness"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Irritability or excessive crying"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Feelings of guilt, worthlessness, helplessness, and hopelessness"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sleeping too much or too little"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Early morning awakening"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Decreased energy, fatigue, and/or feeling “slowed down.”"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "·Difficulty remembering, concentrating, and/or making decisions"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}, {"insert": "If you or your loved one begins to have thoughts of suicide, death, self-harm, or the desire to harm others, immediate attention and professional psychological care is needed.", "attributes": {"bold": true}}, {"insert": "\n"}]
65fc6762-ce03-11e7-97f5-067fbe30e3fa | [{"insert": "Counseling"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Occasionally, personal adjustment or relationship problems will persist after surgery. These should be addressed in professional counseling. Emotional counseling may be needed during the phase of adjusting to the new physique and the many changes that follow the surgery for clinically severe obesity. We can help recommend counselors who are qualified and experienced in working with people who have had weight reduction surgery. Do not hesitate to request this. Major changes can cause new problems to emerge or old ones to intensify.\n"}]
65fc67d0-ce03-11e7-97f6-067fbe30e3fa | [{"insert": "Emotional Health"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Take Care of Yourself. Bariatric surgery can do a lot of great things. But it does not create more time in a day. That part is up to you. Make time for you.\n\nChoose Positive Over Negative. If pre-bariatric surgery friends don’t support your new healthy lifestyle, it may be time to let them go. After weight-loss surgery ask yourself: Which relationships are worth holding onto? When you feel bad, you have less energy to try harder at the good things in your life.\n\nBe Respectful and Responsible. Doing what you know is right for your health is not always easy. But the choice is yours alone. Mom is no longer standing over us making us clean our plates. Habits are hard to break and the things we learn as kids are deep-seated. But with dedication, success in bariatric surgery is possible.\n\nTake Credit for Your Successes and Accomplishments. In other words, you have permission to pat yourself on the back for even the smallest of victories. Doing this gives you fuel for doing what it takes to transform your health.\n\nBe Yourself in Relationships. Developing at least one relationship wherein you can relax and be yourself is important to emotional health. Sharing excitement and disappointment is also vital to your mental and physical health.\n\nTalk Positively to Yourself. Your inner voice is very powerful. If it isn’t positive, think about where it got its information from.\n\nHave a Plan for the Future. Whether you are pre- or post-bariatric surgery, having a plan and set of goals for the future are musts. But be sure to work on them one day at a time.\n"}]
65fc688e-ce03-11e7-97f8-067fbe30e3fa | [{"insert": "Bone & Muscle Mass"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "When the body is in a state of stress, and trying to combat starvation and malnutrition, it hoards its precious fat until any other usable fuel has been burned. Practically, the body will prefer to burn muscle mass, before consuming its precious fat. If muscle is not regularly used for exercise, like every day, it will be consumed to meet its energy needs. This concept is similar with calcium stores. Calcium is stored in the bones. Strong bones require calcium, phosphorous, and other nutrients in addition to weight bearing exercise. Obese persons tend to have strong bones because of their obesity. \n\nWhen major, rapid weight loss occurs and adequate mineral supplementation is lacking, osteoporosis is more likely. Loss of muscle mass and osteoporosis are preventable. Follow the nutritional guidelines in the diet section to maintain optimal health bones and muscles. \n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/osteoporosis"}}, {"insert": "\nObese individuals are very strong and powerful–after all, just getting out of bed, you lift more than some people pick up all day long! It would be upsetting to have this muscle power lost, especially when you need it to enjoy life. Save your muscles, keep your energy; eat your protein and EXERCISE!\n"}]
65fc69d8-ce03-11e7-97f9-067fbe30e3fa | [{"insert": "Sexuality & Pregnancy"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You may resume sexual activity when you feel physically and emotionally stable. If you undergo a restrictive only procedure, our surgeons advise that you do not get pregnant for at least one year. For procedures with a malabsorptive component, they advise at least 18 months before becoming pregnant. This will allow you to become healthy and to get your new lifestyle in place before a pregnancy and the added responsibility of child rearing. If you do get pregnant, you will lose the fast rate of weight loss that is experienced during the first year and a half. Patients who become pregnant one or more years after surgery do have healthy pregnancies and healthy babies.\n\nIn the meantime, please use some form of protection against pregnancy. You should use more than one type of contraception to assure that you do not become pregnant. \n\nSome of the medications you are prescribed prior to surgery may decrease the effectiveness of oral contraception. If you are currently taking control pills, please use a mechanical form of birth control as a backup method for one month after your procedure. If you have any individual questions or concerns, please contact your provider’s care team.\n\nIf you want to have a child now, it would be best to postpone the procedure until after the child’s birth, your recovery, and becoming accustomed to your new parenting lifestyle. We recommend using a mechanical form of birth control (condoms, diaphragm, cervical cap, etc.), as fertility may increase with weight loss, and oral contraceptives may not be fully absorbed.\n\nMany severely obese women are considered infertile because the fatty tissue soaks up the normal hormones and makes some of its own as well. This may confuse the ovaries and uterus and causes a lack of ovulation. As weight loss occurs, this situation may change quickly.\n\nYou may start planning a pregnancy after weight loss stabilizes, but it is imperative to keep your OB/GYN and bariatric surgeon informed after your surgery, since we want both you and the baby to be healthy and safe. If you become pregnant, along with extra servings of protein, vitamins, and blood tests, we ask that you arrange for your OB/GYN to contact your surgeon’s office. They will work together to ensure a healthy pregnancy.\n"}]
65fc6a6e-ce03-11e7-97fa-067fbe30e3fa | [{"insert": "Transient Hair Loss"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Hair thinning or loss is expected after rapid weight loss and is temporary. Unfortunately, that does not make it any less disheartening. During the phase of rapid weight loss, calorie intake is much less than the body needs, and protein intake is marginal. \n\nThe body is in a state of starvation and one of the side-effects is hair thinning or hair loss. This is a temporary side effect and resolves itself when nutrition and weight stabilize. \n\nThe hair loss usually occurs anywhere from 3 to 9 months after surgery. You can minimize the loss of hair by taking your multivitamins daily and making sure that you consume at least 75 grams of protein per day. \n\nWe advise patients to avoid hair treatments and permanents – no need to stress your hair from the outside, too. For the same reason, skin texture and appearance may change. It is not uncommon for patients to develop acne or dry skin after surgery. Protein, vitamins, and water intake are also important for healthy skin.\n"}]
65fc6ad2-ce03-11e7-97fb-067fbe30e3fa | [{"insert": "Scars"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Scars are expected after any surgery. The size of the scars depends on the type of procedure, the sutures used, and how your body heals. \n\nScars are a fact of life. But there is a way to make them less visible, should this be a concern. \n\nOnce your incision is fully healed, you may start using silicone pads and scar minimizing creams to make the scars look softer, smoother, flatter, and closer to your skin’s natural color. \nTip: Keep your scars out of the sunlight to help them heal properly.\n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/scars"}}, {"insert": "\n"}]
65fc6b2c-ce03-11e7-97fc-067fbe30e3fa | [{"insert": "Anemia"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Anemia in weight loss surgery patients can be caused by deficiencies in folic acid, iron, and/or B-12. Signs of iron deficiency anemia include: paleness, decreased work performance, weakness, difficulty maintaining body temperature, fatigue, dizziness, and/or shortness of breath.\n\nIron deficiency may also be caused by low Vitamin A. Vitamin A helps to mobilize iron from its storage sites, so a deficiency of Vitamin A limits the body’s ability to use stored iron. Please follow the vitamin and mineral recommendations in the nutrition section of this booklet. If you have any questions or concerns you can always consult your surgeon or nutritionist.\n\n"}, {"insert": {"video": "http://www.swarminteractive.com/vm/index/remote/7382/anemia"}}, {"insert": "\n"}]
65fc6b86-ce03-11e7-97fd-067fbe30e3fa | [{"insert": "Revisional Procedures"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Regardless of what procedure you chose, it is important to remember weight loss surgery is nothing more than a tool. When used appropriately, surgery helps patients lose weight and keep it off. When not used appropriately, patients will lose weight initially and proceed to gain it right back. Most often this occurs when patients do not make the necessary lifestyle and behavioral changes for long term success. \n\nAlthough surgery enables you to eat a small amount of food, experience fullness or satiety after eating, and not get hungry in between meals, it cannot make better choices for you.\n\nDuring the first year after surgery, your tool is the sharpest. This is not only because of the changes made to your anatomy, but also due to the metabolic and hormonal changes that occur in your body immediately after surgery. During the first year, it is vital patients maximize their protein intake, decrease sugar intake, begin bariatric vitamins, establish an exercise program and find a good support system. Remember, having bariatric surgery does not guarantee patients lasting weight loss, unless you actively apply the principles we teach.\n\nThe first step in any revision process is to assess the patient’s lifestyle and behavior. As part of every workup, patients are required to see a registered dietitian and psychologist, as it is extremely important for patients to understand why they may not have been successful with their previous surgery. Insurance also requires documentation of patient compliance to consider covering a revisional procedure.\n\nNext, the anatomical changes from the initial surgery are evaluated. This may require various medical tests, x-ray studies, or an endoscopy to further evaluate the anatomy. It is important to establish what exactly was done during the original procedure, establish if that anatomy has changed, and decide if those changes need to be addressed. \n\nSpecifically, we may find medical or surgical issues have arisen which requires a revisional procedure to fix. For example it’s possible for patients to develop a hiatal hernia or severe reflux, which would be addressed during a non-bariatric procedure. The path to revising a weight loss procedure is dependent upon each patient. Through a very thorough screening, your bariatric team will help identify what if anything is broken and create a plan that is right for you. The most important thing to remember is patients must be medically, physically, and emotionally prepared in order to achieve further and lasting weight loss. The ultimate determination of whether or not you are approved for a revision is the insurance company and the may deny the procedure in the end.\n"}]
65fc813e-ce03-11e7-97fe-067fbe30e3fa | [{"insert": "Specialized Techniques"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nRobotics"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Bariatric Specialists of North Carolina is proud to offer patients the option of robotic weight loss surgery. Robotically assisted surgery represents the latest in technological advancement in the field of bariatrics. Our practice currently performs most types of weight loss surgery utilizing the robotic platform.\n"}]
66d4f7ee-f22f-11e7-a03d-067fbe30e3fa | [{"insert": "PSG Sleep Study"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A PSG is the gold standard sleep test. You will spend the night in the sleep lab sleeping in a comfortable, secure, climate controlled room while being monitored by one of our sleep technicians. Each room is equipped with a private bathroom and shower. The technician will attach painless monitors that will help us evaluate you for OSA. The exam takes the entire evening and the technician will wake you up in the morning when the exam is over. After that, your exam will be scored by our chief technician and interpreted by Dr. Jon Bruce.\n \nIf sleep apnea is not present you will be required to do nothing else and you will be cleared for surgery from a sleep perspective. If you have OSA, you may have to come back a second night for a titration study.\n"}]
17c5b980-f235-11e7-acce-067fbe30e3fa | [{"insert": "Bone & Muscle Mass"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "When the body is in a state of stress, and trying to combat starvation and malnutrition, it hoards its precious fat until any other usable fuel has been burned. Practically, the body will prefer to burn muscle mass, before consuming its precious fat. If muscle is not regularly used for exercise, like every day, it will be consumed to meet its energy needs. This concept is similar with calcium stores. Calcium is stored in the bones. Strong bones require calcium, phosphorous, and other nutrients in addition to weight bearing exercise. Obese persons tend to have strong bones because of their obesity. \n\nWhen major, rapid weight loss occurs and adequate mineral supplementation is lacking, osteoporosis is more likely. Loss of muscle mass and osteoporosis are preventable. Follow the nutritional guidelines in the diet section to maintain optimal health bones and muscles. \n"}]
1d444002-f230-11e7-a564-067fbe30e3fa | [{"insert": "Titration Study"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Some patients will have shown sleep apnea early during their first test. If so, we will do a CPAP titration the first night (this is called a split night study) This is done by:\nWaking you up"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hooking up the machine (painless)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "When you are back asleep the pressure will be slowly adjusted until the breathing problem is corrected. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " **Not all patients qualify for the titration the first night, because some do not start having problems until late in the night. In that event, you will have to come back for a second night to be titrated on CPAP.\n"}]
424eff9a-f230-11e7-8d08-067fbe30e3fa | [{"insert": "What if I have OSA?"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "If you have OSA, you will need CPAP treatment every night when you go to bed. We will contact a company who, through your insurance, will set you up with a machine. Like other diseases, weight loss surgery cures the problem over 50% of the time. \n\nSome patients still have OSA after weight loss surgery, so before you stop using your machine you should be retested. Usually, you can retest 9-12 months after surgery. Remember; use the machine until you are clear of OSA.\n"}]
65fc87b0-ce03-11e7-9805-067fbe30e3fa | [{"insert": "Sign Up for seminar"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Bariatric Specialists of North Carolina offers you free, informational seminars to help you make an informed decision about weight-loss surgery. Dr. Scott Bovard, Dr. Jon Bruce, Dr. Paul Enochs, Dr. Michael Tyner and Dr. David Pilati personally provide important information about Bariatric Surgery and their comprehensive weight loss surgery program. ", "attributes": {"color": "#333333"}}, {"insert": "\nAll patients are required to attend a BSNC informational seminar prior to scheduling their first appointment.\n\nYou have two options for seminar, online or in-person. Follow the links to watch a free online seminar or see upcoming in-person seminars. \n"}]
341d8c92-db57-11e7-ba68-067fbe30e3fa | [{"insert": "If you have Type II Diabetes Read about Effects"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "In regards to type II diabetes specifically, although all procedures may help provide improvement with weight loss, patients may also experience dramatic improvement or resolution due to the metabolic effect of surgery as well. Patients who chose to undergo a procedure with malabsorption (gastric bypass, SIPS, or duodenal switch) may experience these improvements even before losing significant weight. This is because recent studies have shown that by rerouting food around the first portion of the small intestine, a feedback mechanism is created that causes the pancreas to start producing more insulin.\n\nBy causing the pancreas to begin producing more insulin, it helps to improve or resolve the diabetes at its source. As a result while restrictive only procedures may help improve diabetes in several months to a year after significant weight loss has occurred, patients who underwent a combined procedure may see improvement or resolution of their diabetes within the first few weeks of surgery as their own body starts to produce more insulin. This has the potential to lead to a more durable and sustained resolution of their diabetes.\n"}]
65fc8828-ce03-11e7-9806-067fbe30e3fa | [{"insert": "Welcome to BSNC"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Welcome to Bariatric Specialists of North Carolina! Our highly trained surgeons and staff are honored to be a part of your weight loss journey. \n\nBSNC is dedicated to educating the population about the dangers of obesity and equipping them with the surgical and non-surgical tools necessary to begin and continue along their weight loss journey. This is our mission and we hope you will find this is reflected in all that we do.\n\nThis app is an extensive resource where you will find information related to bariatric surgery and the bariatric surgery process. We hope that you will find it useful throughout your journey. You should bring this guide with you to all future appointments.\n\nPlease feel free to contact the members of our staff at any time with questions or concerns. Bariatric surgery is a life long journey, and our staff is here to assist at each and every point along the way.\n\nWe look forward to working with you throughout your journey and are excited to be a part of your future success!\n\nSincerely,\nThe Bariatric Specialists of NC Team\n\n"}]
35d0284c-f259-11e7-9d16-067fbe30e3fa | [{"insert": "Constipation"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Constipation is defined as a lack of bowel movement for 3 to 4 days, or the frequent passage of dry/hard stools that cause excessive straining when you use the bathroom. Constipation is a frequent complaint for weight loss surgery patients. However, constipation can be prevented and effectively managed.\n\nManaging constipation"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Increasing fluids to more than 80 oz. a day or 2 oz. every 15 minutes; this includes the fluid from your protein shakes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fiber supplement, only Benefiber powder that dissolves in liquid; take as directed, too much or too little fiber can be constipating as could other forms of fiber."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use the over the counter product Colace (generic brands are fine), 100mg by mouth 2x daily, if you need it or not. If you wait until you think you need it, chances are you’ve waited too long."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try milk of magnesia only if your constipation is not improving. Follow the directions on the bottle. If you need more than 2-3 doses, call the office."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If your constipation persists please call the office, there may be other options available."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
46bd32b6-e657-11e7-9ad3-067fbe30e3fa | [{"insert": "Pricing"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "This cash, self-pay price includes all costs associated with the day of surgery, facility fees, surgeon fee, anesthesia, overnight stay in a certified surgery center, and five years of follow-up care with your surgeon. Patients must be medically cleared by their surgeon and medical team as well as anesthesia prior to surgery. Self-Pay Pricing – pricing is subject to change. Gastric Bypass starts at $13,995\n"}]
339b85bc-dac6-11e7-86de-067fbe30e3fa | [{"insert": "Obesity & Weight Loss"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "For some, no amount of diet, exercise, or lifestyle changes can help impact severe obesity. It’s a reality that can lead to frustration, depression, and in many cases, serious health issues. Fortunately, for many, weight loss through bariatric surgery may be an option. Determining whether you may be a candidate for bariatric surgery is a process that requires serious discussion with your doctor and your family. It is a decision that cannot and should not be taken lightly. Within this app you will learn more about the choices in bariatric surgery, how they will impact your body and your lifestyle, and what you’ll need to do to help take control of your weight and your life.\n \nObesity is a chronic and progressive disease that can affect the entire body inside and out. People with severe obesity are at risk of disability or premature death. The estimated number of deaths attributable to obesity among U.S. adults is approximately 400,000 each year. At the top of the list are adult onset diabetes and high blood pressure. High blood pressure caused by severe obesity can contribute to heart attacks, congestive heart failure, and/or stroke.\n"}]
fd70700c-f220-11e7-bb8e-067fbe30e3fa | [{"insert": "Anemia in weight loss surgery patients can be caused by deficiencies in folic acid, iron, and/or B-12. Signs of iron deficiency anemia include: paleness, decreased work performance, weakness, difficulty maintaining body temperature, fatigue, dizziness, and/or shortness of breath.\n \nIron deficiency may also be caused by low Vitamin A. Vitamin A helps to mobilize iron from its storage sites, so a deficiency of Vitamin A limits the body’s ability to use stored iron. Please follow the vitamin and mineral recommendations in the nutrition section of this booklet. If you have any questions or concerns you can always consult your surgeon or nutritionist.\n"}]
857589ec-f221-11e7-bb43-067fbe30e3fa | [{"insert": "Emotional Health"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Take Care of Yourself. Bariatric surgery can do a lot of great things. But it does not create more time in a day. That part is up to you. Make time for you.\n \nChoose Positive Over Negative. If pre-bariatric surgery friends don’t support your new healthy lifestyle, it may be time to let them go. After weight-loss surgery ask yourself: Which relationships are worth holding onto? When you feel bad, you have less energy to try harder at the good things in your life.\n \nBe Respectful and Responsible. Doing what you know is right for your health is not always easy. But the choice is yours alone. Mom is no longer standing over us making us clean our plates. Habits are hard to break and the things we learn as kids are deep-seated. But with dedication, success in bariatric surgery is possible.\n \nTake Credit for Your Successes and Accomplishments. In other words, you have permission to pat yourself on the back for even the smallest of victories. Doing this gives you fuel for doing what it takes to transform your health.\n \nBe Yourself in Relationships. Developing at least one relationship wherein you can relax and be yourself is important to emotional health. Sharing excitement and disappointment is also vital to your mental and physical health.\n \nTalk Positively to Yourself. Your inner voice is very powerful. If it isn’t positive, think about where it got its information from.\n \nHave a Plan for the Future. Whether you are pre- or post-bariatric surgery, having a plan and set of goals for the future are musts. But be sure to work on them one day at a time.\n"}]
f3aa44b6-f221-11e7-9ebb-067fbe30e3fa | [{"insert": "Counseling"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Occasionally, personal adjustment or relationship problems will persist after surgery. These should be addressed in professional counseling. Emotional counseling may be needed during the phase of adjusting to the new physique and the many changes that follow the surgery for clinically severe obesity. We can help recommend counselors who are qualified and experienced in working with people who have had weight reduction surgery. Do not hesitate to request this. Major changes can cause new problems to emerge or old ones to intensify.\n"}]
380a1a76-f224-11e7-aa06-067fbe30e3fa | [{"insert": "Body Image"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Keep in mind that as your body undergoes changes in weight and size, it is likely you may not see your body as others may view it. It takes time for your mind to catch up with what your body is doing. It is similar to the phantom limb phenomenon, where a person who has lost a limb continues to experience pain or feeling from the missing limb, and in fact, feels they still have the limb.\n\nAs you lose weight, you may actually be surprised when you see your reflection in a store window or mirror. You may not feel like this person is you. It is normal to feel like you are still the same size as you were before surgery, but there are some definite ways to help you work at this.\n\nTalk to your spouse, family doctor, friends, and other patients for support. We are here to support you with personal consultations and support groups. Connect with others that understand your journey by attending support group regularly. If, at any time, you feel overwhelmed or otherwise need more assistance, please contact us. We will be glad to take the necessary steps to find the proper resources for your situation.\n\nCoping with Body Image"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Learn new ways of dealing with the emotions that cause you to eat. In the past, one of the best methods for you to cope with life stress may have been for you to eat. One of the keys to success of this surgery is to learn to replace those comforts with healthy activities. This will take time and you may need some assistance learning new coping methods. Don’t be afraid to ask for help! \n \nTry not to sabotage yourself. The experience of such rapid bodily change will likely be accompanied by many emotional ups and downs.\n"}]
15fc3324-f229-11e7-800c-067fbe30e3fa | [{"insert": "Family & Friends"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You can expect your family and friends to have varying reactions to your surgery and the weight loss that follows. Although you hope your loved ones will be supportive and helpful during your ups and downs, this may not always be the case.\n \nFirst of all, your partner or spouse has become accustomed to you and your obesity. This may result in a resistance to the changes that are happening. You may notice that you and your spouse/partner are having far more disagreements than usual, your spouse/partner may exhibit mood swings, or refusal to support your dietary and/or exercise regimen. Keep the lines of communication open and recognize signs of distress in your partner who is adjusting to the changes in your body and behavior. These changes will require your partner to relate in new ways to you. This takes time, effort and patience.\n \nIf you are experiencing serious ongoing problems in your relationships, some short-term professional counseling may be helpful. You may also experience similar changes in some of your other relationships. Your extended family, co-workers, and friends are all witnessing the changes you are going through and may not have the reaction you expect. \n \nSome of your relationships may change through this process and that is normal. Identify those people who are the most supportive and surround yourself with the love and care you deserve.\n"}]
1849d05e-f22f-11e7-9b5f-067fbe30e3fa | [{"insert": "OSA"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "OSA, or obstructive sleep apnea is a condition where you stop breathing while you sleep. Basically, your airway or throat collapses while you sleep and you don’t even know this is taking place. Some people we have tested stopped breathing over a hundred times an hour. This can lead to dangerously low levels of oxygen while causing poor sleep and increasing blood pressure. It also negatively affects your metabolism which leads to weight retention and gain. Eight out of 10 patients that we evaluate for weight loss surgery are unaware that they have this condition.\n \nIf you are diagnosed with OSA, you will need to be treated. The most common treatment is CPAP, or continuous positive airway pressure. This is a machine which helps you breathe during the night and reduces your risk of heart attack, stroke, high blood pressure, etc.\n"}]
71c9c176-f229-11e7-9e74-067fbe30e3fa | [{"insert": "Support Group"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Patients at all stages of the process are welcomed to and will benefit from attending support group regularly. These are held on a monthly basis and feature speakers from our own bariatric surgeons to personal trainers, plastic surgeons, nutritionists, and more. We aim to provide both opportunity to learn and grow as well as a community environment which allows fellowship and support on a peer to peer basis. We recommend all patients attend at least one support group pre-operatively. BSNC support groups are held at the following locations and times:\n\nRex Hospital Raleigh"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Cancer Center Auditorium\n4420 Lake Boone Trail, Raleigh, NC 27607\n\n"}]
e802d9d0-f22f-11e7-b3b4-067fbe30e3fa | [{"insert": "Enter Results"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Do you have OSA?\n"}]
65fc5e48-ce03-11e7-97e4-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "We require all patients undergoing bariatric surgery to first have a sleep study conducted. This is to diagnose or clear you of obstructive sleep apnea (OSA).\n \nOne of the tests we require is a sleep study, or "}, {"insert": "polysomnogram (PSG)", "attributes": {"underline": true}}, {"insert": ". There are several reasons this test is required. First, is safety. People who have a BMI of 35 or greater have an 80% risk of obstructive sleep apnea, or OSA. OSA is a potentially lethal condition increasing your risk of stroke, heart attack, or abnormal heart rhythm three hundred percent higher than the average population. Also, OSA can cause or worsen high blood pressure and weight gain, while also causing daytime sleepiness and fatigue. This is a disease that is no different than diabetes or low thyroid and needs to be treated. Most or all weight loss surgical programs mandate evaluation for OSA before surgery.\n"}]
98e15460-f231-11e7-b02a-067fbe30e3fa | [{"insert": "OSA"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "OSA, or obstructive sleep apnea is a condition where you stop breathing while you sleep. Basically, your airway or throat collapses while you sleep and you don’t even know this is taking place. Some people we have tested stopped breathing over a hundred times an hour. This can lead to dangerously low levels of oxygen while causing poor sleep and increasing blood pressure. It also negatively affects your metabolism which leads to weight retention and gain. Eight out of 10 patients that we evaluate for weight loss surgery are unaware that they have this condition.\n \nIf you are diagnosed with OSA, you will need to be treated. The most common treatment is CPAP, or continuous positive airway pressure. This is a machine which helps you breathe during the night and reduces your risk of heart attack, stroke, high blood pressure, etc.\n \n"}]
c58f799c-f231-11e7-9a8b-067fbe30e3fa | [{"insert": "PSG Sleep Study"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A PSG is the gold standard sleep test. You will spend the night in the sleep lab sleeping in a comfortable, secure, climate controlled room while being monitored by one of our sleep technicians. Each room is equipped with a private bathroom and shower. The technician will attach painless monitors that will help us evaluate you for OSA. The exam takes the entire evening and the technician will wake you up in the morning when the exam is over. After that, your exam will be scored by our chief technician and interpreted by Dr. Jon Bruce.\n \nIf sleep apnea is not present you will be required to do nothing else and you will be cleared for surgery from a sleep perspective. If you have OSA, you may have to come back a second night for a titration study.\n"}]
b1c79d26-f232-11e7-9da7-067fbe30e3fa | [{"insert": "Titration Study"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Some patients will have shown sleep apnea early during their first test. If so, we will do a CPAP titration the first night (this is called a split night study) This is done by:\nWaking you up"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hooking up the machine (painless)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "When you are back asleep the pressure will be slowly adjusted until the breathing problem is corrected. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n**Not all patients qualify for the titration the first night, because some do not start having problems until late in the night. In that event, you will have to come back for a second night to be titrated on CPAP.\n"}]
5cad06c6-f234-11e7-90a2-067fbe30e3fa | [{"insert": "Scars"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Scars are expected after any surgery. The size of the scars depends on the type of procedure, the sutures used, and how your body heals. \n \nScars are a fact of life. But there is a way to make them less visible, should this be a concern. \n \nOnce your incision is fully healed, you may start using silicone pads and scar minimizing creams to make the scars look softer, smoother, flatter, and closer to your skin’s natural color. \nTip: Keep your scars out of the sunlight to help them heal properly.\n"}]
c715e410-f234-11e7-9c02-067fbe30e3fa | [{"insert": "Transient Hair Loss"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Hair thinning or loss is expected after rapid weight loss and is temporary. Unfortunately, that does not make it any less disheartening. During the phase of rapid weight loss, calorie intake is much less than the body needs, and protein intake is marginal. \n\nThe body is in a state of starvation and one of the side-effects is hair thinning or hair loss. This is a temporary side effect and resolves itself when nutrition and weight stabilize. \n\nThe hair loss usually occurs anywhere from 3 to 9 months after surgery. You can minimize the loss of hair by taking your multivitamins daily and making sure that you consume at least 75 grams of protein per day. \n\nWe advise patients to avoid hair treatments and permanents – no need to stress your hair from the outside, too. For the same reason, skin texture and appearance may change. It is not uncommon for patients to develop acne or dry skin after surgery. Protein, vitamins, and water intake are also important for healthy skin.\n"}]
65fc5d76-ce03-11e7-97e2-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "We require all patients undergoing bariatric surgery to first have a sleep study conducted. This is to diagnose or clear you of obstructive sleep apnea (OSA).\n \nOne of the tests we require is a sleep study, or "}, {"insert": "polysomnogram (PSG)", "attributes": {"underline": true}}, {"insert": ". There are several reasons this test is required. First, is safety. People who have a BMI of 35 or greater have an 80% risk of obstructive sleep apnea, or OSA. OSA is a potentially lethal condition increasing your risk of stroke, heart attack, or abnormal heart rhythm three hundred percent higher than the average population. Also, OSA can cause or worsen high blood pressure and weight gain, while also causing daytime sleepiness and fatigue. This is a disease that is no different than diabetes or low thyroid and needs to be treated. Most or all weight loss surgical programs mandate evaluation for OSA before surgery.\n"}]
96d9f050-f236-11e7-a6a4-067fbe30e3fa | [{"insert": "OSA"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "OSA, or obstructive sleep apnea is a condition where you stop breathing while you sleep. Basically, your airway or throat collapses while you sleep and you don’t even know this is taking place. Some people we have tested stopped breathing over a hundred times an hour. This can lead to dangerously low levels of oxygen while causing poor sleep and increasing blood pressure. It also negatively affects your metabolism which leads to weight retention and gain. Eight out of 10 patients that we evaluate for weight loss surgery are unaware that they have this condition.\n \nIf you are diagnosed with OSA, you will need to be treated. The most common treatment is CPAP, or continuous positive airway pressure. This is a machine which helps you breathe during the night and reduces your risk of heart attack, stroke, high blood pressure, etc.\n"}]
b1e966c8-f236-11e7-84a8-067fbe30e3fa | [{"insert": "PSG Sleep Study"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A PSG is the gold standard sleep test. You will spend the night in the sleep lab sleeping in a comfortable, secure, climate controlled room while being monitored by one of our sleep technicians. Each room is equipped with a private bathroom and shower. The technician will attach painless monitors that will help us evaluate you for OSA. The exam takes the entire evening and the technician will wake you up in the morning when the exam is over. After that, your exam will be scored by our chief technician and interpreted by Dr. Jon Bruce.\n \nIf sleep apnea is not present you will be required to do nothing else and you will be cleared for surgery from a sleep perspective. If you have OSA, you may have to come back a second night for a titration study.\n"}]
d98048b4-f236-11e7-8099-067fbe30e3fa | [{"insert": "Obese individuals are very strong and powerful – after all, just getting out of bed, you lift more than some people pick up all day long! It would be upsetting to have this muscle power lost, especially when you need it to enjoy life. Save your muscles, keep your energy; eat your protein and EXERCISE!\n"}]
24cee6b8-f237-11e7-b2f5-067fbe30e3fa | [{"insert": "Sexuality & Pregnancy"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You may resume sexual activity when you feel physically and emotionally stable. If you undergo a restrictive only procedure, our surgeons advise that you do not get pregnant for at least one year. For procedures with a malabsorptive component, they advise at least 18 months before becoming pregnant. This will allow you to become healthy and to get your new lifestyle in place before a pregnancy and the added responsibility of child rearing. If you do get pregnant, you will lose the fast rate of weight loss that is experienced during the first year and a half. Patients who become pregnant one or more years after surgery do have healthy pregnancies and healthy babies.\n\nIn the meantime, please use some form of protection against pregnancy. You should use more than one type of contraception to assure that you do not become pregnant. \n\nSome of the medications you are prescribed prior to surgery may decrease the effectiveness of oral contraception. If you are currently taking control pills, please use a mechanical form of birth control as a backup method for one month after your procedure. If you have any individual questions or concerns, please contact your provider’s care team.\n\nIf you want to have a child now, it would be best to postpone the procedure until after the child’s birth, your recovery, and becoming accustomed to your new parenting lifestyle. We recommend using a mechanical form of birth control (condoms, diaphragm, cervical cap, etc.), as fertility may increase with weight loss, and oral contraceptives may not be fully absorbed.\n\nMany severely obese women are considered infertile because the fatty tissue soaks up the normal hormones and makes some of its own as well. This may confuse the ovaries and uterus and causes a lack of ovulation. As weight loss occurs, this situation may change quickly.\n\nYou may start planning a pregnancy after weight loss stabilizes, but it is imperative to keep your OB/GYN and bariatric surgeon informed after your surgery, since we want both you and the baby to be healthy and safe. If you become pregnant, along with extra servings of protein, vitamins, and blood tests, we ask that you arrange for your OB/GYN to contact your surgeon’s office. They will work together to ensure a healthy pregnancy.\n"}]
64ed2de4-f238-11e7-93b4-067fbe30e3fa | [{"insert": "Titration Study"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Some patients will have shown sleep apnea early during their first test. If so, we will do a CPAP titration the first night (this is called a split night study) This is done by:\nWaking you up"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hooking up the machine (painless)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "When you are back asleep the pressure will be slowly adjusted until the breathing problem is corrected. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n**Not all patients qualify for the titration the first night, because some do not start having problems until late in the night. In that event, you will have to come back for a second night to be titrated on CPAP.\n"}]
65fc856c-ce03-11e7-9801-067fbe30e3fa | [{"insert": "Obesity Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Obesity is very difficult to treat, especially on your own. When other medically supervised methods have failed, bariatric surgery can offer a great option for long-term weight loss and control.\n\nObesity & Weight Loss"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "For some, no amount of diet, exercise, or lifestyle changes can help impact severe obesity. It’s a reality that can lead to frustration, depression, and in many cases, serious health issues. Fortunately, for many, weight loss through bariatric surgery may be an option. Determining whether you may be a candidate for bariatric surgery is a process that requires serious discussion with your doctor and your family. It is a decision that cannot and should not be taken lightly. Within this app you will learn more about the choices in bariatric surgery, how they will impact your body and your lifestyle, and what you’ll need to do to help take control of your weight and your life.\n \nObesity is a chronic and progressive disease that can affect the entire body inside and out. People with severe obesity are at risk of disability or premature death. The estimated number of deaths attributable to obesity among U.S. adults is approximately 400,000 each year. At the top of the list are adult onset diabetes and high blood pressure. High blood pressure caused by severe obesity can contribute to heart attacks, congestive heart failure, and/or stroke.\n"}]
87eb5e2e-f238-11e7-add9-067fbe30e3fa | [{"insert": "What if I have OSA?"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "If you have OSA, you will need CPAP treatment every night when you go to bed. We will contact a company who, through your insurance, will set you up with a machine. Like other diseases, weight loss surgery cures the problem over 50% of the time. \n\nSome patients still have OSA after weight loss surgery, so before you stop using your machine you should be retested. Usually, you can retest 9-12 months after surgery. Remember; use the machine until you are clear of OSA.\n"}]
65fc8422-ce03-11e7-9800-067fbe30e3fa | [{"insert": "Surgical Treatment"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Surgeries we use to promote weight loss use two mechanisms:\n"}, {"insert": "Restricting", "attributes": {"bold": true}}, {"insert": " food intake by making the available size of your stomach smaller.\nInterrupting the digestive processes and incorporating "}, {"insert": "malabsorption", "attributes": {"bold": true}}, {"insert": " as a tool to limit what your body keeps of the food you take in.\n\nWith bariatric surgery, most patients lose weight rapidly and continue to do so for 18-24 months after surgery. Although some patients do regain weight, it is very rare to regain all of your weight, and this depends mostly on your own choices and compliance. \n\nIn conjunction with weight loss, surgery can, and many times does, result in improvement or elimination or most obesity related conditions including:\nHigh cholesterol"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "High blood pressure"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Obstructive sleep apnea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hypertension "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Type II diabetes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cardiovascular disease"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Endocrinology disease"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dyslipidemia"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nWhether a procedure is restrictive or malabsorptive, studies show three to five years after bariatric surgery, regardless of procedure; weight loss can be statistically the same. We know the more mechanisms a procedure utilizes, restriction and malabsorption versus restriction alone, the more effective the surgery is. These mechanisms help patients achieve the lifestyle and behavioral changes that are necessary to lose the weight. A procedure that is purely restrictive, like the LAP-BAND® System or sleeve, will depend more on patient compliance that the mechanism of surgery to be successful. \n\nMore importantly, we have long term data which shows improvement or resolution of health issues associated with obesity. Reflux, depression, sleep apnea, high blood pressure, diabetes and many other medical issues can all be improved with weight loss surgery.\n"}]
65fc81b6-ce03-11e7-97ff-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Whether a procedure is restrictive or malabsorptive, studies show three to five years after bariatric surgery, regardless of procedure; weight loss can be statistically the same. We know the more mechanisms a procedure utilizes, restriction and malabsorption versus restriction alone, the more effective the surgery is. These mechanisms help patients achieve the lifestyle and behavioral changes that are necessary to lose the weight. A procedure that is purely restrictive will depend more on patient compliance that the mechanism of surgery to be successful. \n\nMore importantly, we have long term data which shows improvement or resolution of health issues associated with obesity. Reflux, depression, sleep apnea, high blood pressure, diabetes and many other medical issues can all be improved with weight loss surgery.\n\nBariatric surgery works by several mechanisms, some of which have only recently been understood. The most basic principles include restriction and malabsorption. We are also beginning to understand how these surgeries can also affect major stimuli related to hunger or satisfaction from meals that come by way of nervous and hormonal feedback from your gut to the brain.\n\nThe Roux-en-Y procedure is a c"}, {"insert": "ombination of restrictive and malabsoptive. Watch and read about the normal digestive process and each mechanism below.", "attributes": {"color": "#000000"}}, {"insert": "\n"}]
f9e34a18-f239-11e7-9e8f-067fbe30e3fa | [{"insert": "Normal Digestive Process"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Normally, as food moves along the digestive tract, digestive juices and enzymes meet the food at different points assisting with digestion and absorption of calories and nutrients. After chewing and swallowing, food moves down the esophagus to the stomach, where a strong acid continues the digestive process. When the stomach contents move through the stomach to the duodenum, bile and pancreatic juice speed up digestion. Most of the calcium and iron in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 ft. of small intestine, complete the absorption of calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.\n"}, {"insert": "\n", "attributes": {"header": 2}}]
055efb76-f23a-11e7-b225-067fbe30e3fa | [{"insert": "Restriction"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Purely restrictive procedures such as intragastric balloon and sleeve gastrectomy reduce the amount of food the stomach can hold. By reducing the size of the stomach, meals create earlier increased pressure and nerves tell the brain that you are full. This generally leads to smaller meals and fewer calories, therefore losing weight. These do not interfere with normal digestion or absorption of nutrients.\n"}]
65fc1d84-ce03-11e7-97b4-067fbe30e3fa | [{"insert": "Practice Post-Op Exercises"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "While in the hospital you will be required to perform two types of exercises, breathing and leg exercises, read each and practice to increase lung function and leg agility.\n\nBreathing Exercises"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "To enhance your recovery your nurse will instruct you in coughing and deep breathing. You will be shown how to use an “"}, {"insert": "incentive spirometer", "attributes": {"underline": true}}, {"insert": "” to help you expand your lungs. Coughing and deep breathing is important so that you will loosen any secretions that may be in your throat or lungs and to help prevent pneumonia. Deep breathing also increases circulation and promotes elimination of anesthesia. \nThe proper way to deeply breathe and cough is to follow these steps:"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Inhale as deeply as you can"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Hold breath for two seconds"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Exhale completely"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Repeat the above steps three times"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Inhale deeply"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Cough. The cough should come from the abdomen, not from your throat. Hold your pillow on your abdomen for support."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "\nLeg Exercises"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Exercising your feet and legs is important for promoting good circulation. \nThe proper way to exercise your feet and legs is to follow these steps:"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Push your toes of both feet towards the end of the bed (as in pressing down on a gas pedal)."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Pull your toes toward the head of your bed, relax."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Circle each ankle to the right, then to the left."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Repeat three times."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}]
1a5f9f4e-f23a-11e7-b227-067fbe30e3fa | [{"insert": "Malabsorption"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Procedures such as duodenal switch (a type of intestinal bypass) shortens the useable amount of the digestive tract to limit the amount of nutrients that can be absorbed. Patients lose weight by absorbing fewer nutrients from the food they consume. Taken to an extreme, this can lead to frequent bowel movements and other medical issues.\n\nReducing the size of the stomach or bypassing parts of the intestine can also affect several gut hormones that are important signals to your brain. Removing the upper outer stomach during a sleeve procedure reduces a powerful hunger hormone, ghrelin, leaving patients surprisingly less hungry the day after surgery. By diverting less digested food downstream in the bowel as done with gastric bypass and duodenal switch procedures, the bowel has to work harder to absorb the nutrients. In the process the gut produces hormones that tell the brain that it is busy. This translates into prolonged sense of satisfaction while eating less food. You feel full longer!\n\nOne added benefit to shunting food downstream further with bypass procedures is the bowel increases other hormones that can affect other metabolic issues. Hormones are produced that improve insulin sensitivity and in some cases improve insulin production. This increase can occur very quickly after bypass procedures and have a dramatic effect on control or cure of diabetes.\n"}]
b114db66-f23a-11e7-9fa9-067fbe30e3fa | [{"insert": "Your surgeon controls the robot, by manipulating it’s robotic arms from a console located within the operating room. By allowing for an enhanced 3-D view of the patient’s anatomy, robotic surgery has potential benefits for the patient by shortening hospital stays, decreasing pain, and aiding in a quicker recovery.\n\nIt is important to realize not all patients are candidates for robotic procedures and the standard risks associated with surgery still apply.\n\nRisk"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "It is important to understand there are general risks associated with any type of surgery. These include the risk of general anesthesia, bleeding, infection; injury to other organs, blood clots in the legs and lungs, heart problems, lung problems, and wound problems. \n\nThese risks are the same for gallbladder, hernia, or knee surgery. Weight loss procedures have a lower risk profile than gallbladder surgery; however, it is important to remember any surgery is associated with potential health risks and should not be taken lightly.\n"}]
65fc5ac4-ce03-11e7-97dd-067fbe30e3fa | [{"insert": "Gastroenterology"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "An upper GI or endoscopy by a gastroenterologist will help to indicate if a hiatal hernia or esophageal abnormality may be present. Like the gallbladder, we can often repair a hernia during your bariatric procedure. Any esophageal abnormality may impact which procedure might be the best fit for you or how your surgeon would perform your chosen procedure.\n"}]
65f301a4-ce03-11e7-9743-067fbe30e3fa | [{"insert": "Support Group"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "We recommend all patients attend at least one support group pre-operatively. BSNC support groups are held at the following locations and times:\n\nRex Hospital Raleigh"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Cancer Center Auditorium\n4420 Lake Boone Trail, Raleigh, NC 27607\n"}]
65fc1dde-ce03-11e7-97b5-067fbe30e3fa | [{"insert": "Maintain Exercise Program"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Remember, walking on a daily basis improves your circulation and makes breathing easier during your recovery. Try increasing the time or frequency of your workouts.\n30-60 Minutes of intentional activity 4-5x a week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Strength Training 3x a week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "10,000 Steps a day"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
e632a322-f23b-11e7-bf91-067fbe30e3fa | [{"insert": "Pricing"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "This cash, self-pay price includes all costs associated with the day of surgery, facility fees, surgeon fee, anesthesia, overnight stay in a certified surgery center, and five years of follow-up care with your surgeon. Patients must be medically cleared by their surgeon and medical team as well as anesthesia prior to surgery. Self-Pay Pricing – pricing is subject to change. Gastric Bypass starts at $13,995\n"}]
2878989c-f24e-11e7-ab9f-067fbe30e3fa | [{"insert": "Anesthesia"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "General anesthesia is used to assist in putting you sound asleep for the surgery. During the entire procedure, an anesthesiologist and nurse anesthetist will be observing you, the oxygen level in your blood, the amount of carbon dioxide you breathe out, your heart rate, and your blood pressure. The advanced systems used by the anesthesiology department assist in identifying any issues immediately, reducing your risk significantly. Your anesthesiologist will discuss the specific risks of general anesthesia with you before your surgery. Be sure to ask any questions you may have.\n"}]
5e06bc2a-f23d-11e7-bf27-067fbe30e3fa | [{"insert": "Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Drink lots of water. 64 oz or more per day is ideal. Water is the best thing you can drink."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Get plenty of sleep. Being well rested will ensure you’re not looking for extra energy from food."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Plan your meals in advance. If you stick to a pre-planned shopping list, there is less of a possibility for impulse buying."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
19ff242c-f23d-11e7-a9af-067fbe30e3fa | [{"insert": "Daily Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Consume 5 protein shakes a day, you should have one every 3-4 hours.\n\nExample Schedule"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Breakfast - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Morning - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lunch - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Afternoon - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dinner - Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluid - 64oz of fluid throughout the day"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
76bf1bea-f23d-11e7-a271-067fbe30e3fa | [{"insert": "Warnings"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "The Bariatric Advantage Liver Reduction Diet may cause significant changes in blood sugar or blood pressure. If you are diabetic, hypoglycemic, or have high blood pressure, it is very important that you are aware of possible changes that may happen during this diet. We advise you to check your blood pressure and blood sugar daily and report any changes to your Primary Care Physician. Call your Primary Care Physician if:\n\nBlood Pressure"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "If your blood pressure changes by more than 20 mmHg from normal, or if you experience: dizziness, fainting, irregular heartbeat, extreme headache.\n\nBlood Sugar"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "If your blood sugar falls below 70mg/dL or if you experience: cold shaky sweats, rapid heart rate, dizziness confusion or inability to concentrate.\n\nPossible Side Effects of Ketosis"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Sensitivity to cold"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dry skin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fatigue"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Diarrhea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Constipation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle cramps"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bad breath"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Irritability"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
65fc548e-ce03-11e7-97cf-067fbe30e3fa | [{"insert": "Alcohol Warnings"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Discontinuing the use of alcohol is another factor in you in becoming as healthy as possible for surgery.\n\nAlcohol causes gastric irritation and can cause liver damage. During periods of rapid weight loss, the liver becomes especially vulnerable to toxins such as alcohol. You may find that only a couple of sips of wine can give you unusually quick and strong effects of alcohol intolerance. In addition, alcoholic beverages are high in empty calories an issue for all patients striving for weight loss, which may lead to dumping syndrome in bypass patients. For these reasons, we recommend complete abstinence from alcohol or very infrequent use.\n"}]
65fc50f6-ce03-11e7-97cb-067fbe30e3fa | [{"insert": "Medication & Herbal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your surgeon may ask you to stop taking particular medications for at least 10 days prior to surgery. Medications, especially aspirin and aspirin based medicines, are blood thinners and should not be used 10 days before surgery. Herbal medications such as St. John’s Wort, Gingko Biloba, Garlic, etc, can also contain blood thinning elements and should be discontinued. Other herbal supplements such as Kava and Valerian Root are known to interact with anesthesia and should also be stopped at least 10 days before surgery. Remember to tell your surgeon ALL the medicines and nutritional supplements you are taking. Do not forget to check the label of your multivitamin; many times they can contain herbal supplements as well. Remember to check all labels of over-the-counter medicines, since certain over-the-counter medicines can contain aspirin, which is also a blood thinner. If in doubt, please talk with your pharmacist or your surgeon.\n"}]
ba29df9c-f241-11e7-a46a-067fbe30e3fa | [{"insert": "Modified Liver Reduction Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You will be placed on a 1-4 week liver reduction diet based on your BMI and weight changes prior to surgery. Your surgeon will let you know the length of this program at your Results Visit. The first stage of the program is a modified liver reduction. The week immediately before surgery is all liquids: 5 shakes a day, no solid food.\n"}]
71672728-f242-11e7-8e97-067fbe30e3fa | [{"insert": "Daily Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "2 Bariatric Advantage Shakes per day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "2 Bariatric Advantage bars or crisps per day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 Lean Protein and non-starchy vegetable (see allowable dinner list)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nExample Schedule"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Breakfast - ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Morning - ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Bar or Crisp"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lunch - ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Shake"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mid-Afternoon- ", "attributes": {"bold": true}}, {"insert": "Bariatric Advantage Bar or Crisp"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dinner - ", "attributes": {"bold": true}}, {"insert": "Meal: Lean Proteins, Vegetables"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluid - ", "attributes": {"bold": true}}, {"insert": "64oz of fluid throughout the day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " **Please allow 3-4 hours between each me\n"}]
a938489e-f242-11e7-926f-067fbe30e3fa | [{"insert": "Allowable Foods List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "During your Modified Liver Reduction Diet, you should eat 1 Lean and Green meal per day, 2 Bariatric Advantage High Protein Meal Replacement Shakes, and 2 Bariatric Advantage Ketogenx bars or crisps. \n \n When building your Lean and Green Meal, use the list below. Note: This list is to be used during the Modified Liver Reduction Diet.\n\nVegetables "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Non-Starchy Vegetables"}, {"insert": " - ", "attributes": {"bold": true}}, {"insert": "Recommended Vegetables (3 handfuls per meal)\nAlfalfa sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Artichokes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Asian greens"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Asparagus"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Baby spinach"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bamboo shoots"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bean sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Beets"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bok choy"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Broccoli"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Broccolini"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Brussels sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cabbage"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cauliflower"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Carrots"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Celery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chard"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cucumber"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eggplant"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Endive"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fennel"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Green beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Kale"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Kohlrabi"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Leeks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lettuce – all types"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mushrooms"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Okra"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Olives"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Onions"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Peppers– all types"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Radishes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Radicchio"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Snow peas"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Spinach"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sprouts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Squash"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tomato"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Turnip"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Water chestnuts"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Zucchini"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nProtein"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Recommended Protein (1 palm sized portion per meal)\nBison"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Beef"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cheese - low fat"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chicken"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crab"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Duck"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eggs"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fish"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lamb"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lobster"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mussels"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oysters"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pork- Including low-fat cured meat"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Prawns"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Scallops"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Turkey"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Veal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Venison"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu or Tempeh*"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "*Consume 2 palm portions per meal of Tofu or Tempeh"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nOils to Cook With "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Cook with 1-2 Tbsp. of\nOlive oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sesame oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Walnut oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flax oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Grapeseed oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Macadamia oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sunflower oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avocado Oil"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nHydration"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "at least 64 oz. of fluid per day \nALL HYDRATION MUST BE: carbonation-free, sugar-free, caffeine-free Water\nSugar-free or diet fruit juice"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free drinks (ex. Crystal Light)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Decaf tea or coffee (no milk, cream, or sugar)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free sports drinks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear, low-sodium broth"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free popsicles"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free gelatin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n \n"}]
ece0319c-f242-11e7-9c20-067fbe30e3fa | [{"insert": "Diet Do’s and Don’ts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nDo"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Mix your shake with water"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use the allowable foods list to create your lean and green meal and enjoy 1-2 TBSP of added fat "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fill in between meals with plenty of non-carbonated, caffeine free, sugar free liquids."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Enjoy sugar free jello, popsicles, and broths."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Have a shake, bar or crisp every three to four hours."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Rotate your Lean and Green meal (may be consumed at either lunch OR dinner)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nDon’t"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Use milk or milk substitutes to mix your shake "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Use fried or breaded and fried meats"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skip shakes, bars or meals "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Go longer than 3-4 hrs between meals and snacks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
9357cb4c-f24e-11e7-96df-067fbe30e3fa | [{"insert": "Operating Room"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "During your procedure, specialists using the most modern equipment and techniques will attend to you. This team includes your surgeon, at least one board certified anesthesiologist, a trained surgical assistant, a nurse anesthetist, and nurses that will assist your surgeon.\nOnce you are settled on the operating table, you will be connected to several monitors and an intravenous (IV) catheter. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A quick acting sedative will be given through the IV tubing after you have breathed pure oxygen for a few minutes. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Once you fall asleep, the anesthesiologist will usually slip an endotracheal tube through your mouth into your windpipe to guarantee that your breathing "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " is unimpeded. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "An anesthetic gas and other medications will keep you asleep and pain free. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "At the same time, the anesthesiologist will connect you to monitoring devices."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Most bariatric procedures will last 1 to 2 hours. However, the length of your operation is dependent upon the type of procedure/s performed as well as any other procedures deemed medically necessary by your surgeon."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Once your procedure has been completed, you will be moved to the designated recovery area."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
72799a14-f243-11e7-96b7-067fbe30e3fa | [{"insert": "Tips and Warnings "}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Tips"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Drink lots of water. 64 oz or more per day is ideal. Water is the best thing you can drink.\nGet plenty of sleep. Being well rested will ensure you’re not looking for extra energy from food.\nPlan your meals in advance. If you stick to a pre-planned shopping list, there is less of a possibility for impulse buying.\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Warnings"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "The Bariatric Advantage Liver Reduction Diet may cause significant changes in blood sugar or blood pressue. If you are diabetic, hypoglycemic, or have high blood pressure, it is very important that you are aware of possible changes that may happen during this diet. We advise you to check your blood pressure and blood sugar daily and report any changes to your Primary Care Physician. Call your Primary Care Physician if:\nIf your "}, {"insert": "blood pressure", "attributes": {"bold": true}}, {"insert": " changes by more than 20 mmHg from normal, or if you experience: dizziness, fainting, irregular heartbeat, extreme headache"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If your "}, {"insert": "blood sugar", "attributes": {"bold": true}}, {"insert": " falls below 70mg/dL or if you experience: cold shaky sweats, rapid heart rate, dizziness confusion or inability to concentrate"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Possible Side Effects of Ketosis"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Sensitivity to cold"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dry skin"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fatigue"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Diarrhea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Constipation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle cramps"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bad breath"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Irritability"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
afca3666-f24e-11e7-96e1-067fbe30e3fa | [{"insert": "Procedure Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Through a laparoscopic approach, the surgeon staples across the stomach, creating a pouch about the size of an egg and then bypassing 25% of the small intestines. The new stomach pouch limits the amount of food patients can consume in one sitting. In bypassing a portion of the intestines, we also limit the time food can mix with digestive juices, this again drives production of hormones that prolong satisfaction with less food.\n"}]
65fc6014-ce03-11e7-97e9-067fbe30e3fa | [{"insert": "Gather Everything You Need"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "At your initial consultation, we will ask you to provide:", "attributes": {"color": "#333333"}}, {"insert": "\nPhoto ID"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Insurance Card"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A list of all prescriptions and over-the-counter medications"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your current physician’s names and phone numbers"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Completed New Patient Forms- New Patient Forms are found in your folder you receive while attending the live seminar or in your "}, {"insert": "Patient Portal", "attributes": {"link": "https://847.portal.athenahealth.com/", "color": "windowtext"}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nutrition Forms- Food Frequency and Dietary Recall "}, {"insert": "forms", "attributes": {"link": "http://www.surgerync.com/nutrition-forms.php", "color": "windowtext"}}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Specialist Co-Pay (if applicable)"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
449f21bc-f244-11e7-ab10-067fbe30e3fa | [{"insert": "Questions"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Regarding the KetogenX Products, please call the Envision Store. If you have questions regarding the Liver Reduction Diet, please contact your dietitian or visit the patient portal.\n"}]
65fbdae0-ce03-11e7-978d-067fbe30e3fa | [{"insert": "Discharge"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your date of discharge from the hospital will be determined by your surgeon based on your individual progress. This is the time to ask any questions or concerns you may have before returning home.\n"}]
65fc6320-ce03-11e7-97ef-067fbe30e3fa | [{"insert": "Procedure Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "The roux-en-y gastric bypass was first performed by Dr. Edward Mason over 50 years ago and is still considered the gold standard for weight loss surgery today. Patients who undergo this procedure lose weight by eating smaller meals and having less hunger.\n\nProcedure"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Patients come to the hospital the day of surgery and are put to sleep by anesthesia. Through a laparoscopic approach, the surgeon staples across the stomach, creating a pouch about the size of an egg and then bypassing 25% of the small intestines. The new stomach pouch limits the amount of food patients can consume in one sitting. In bypassing a portion of the intestines, we also limit the time food can mix with digestive juices, this again drives production of hormones that prolong satisfaction with less food.\n\nThe entire procedure usually takes about an hour and a half. The recovery after surgery is essentially the same as the sleeve gastrectomy. Most patients go home in a day or two, once they are walking, breathing and drinking appropriately. Return to work varies between a week and a month based on physical requirements of your job. A few more vitamins are required after surgery compared to a sleeve gastrectomy because of the smaller pouch and the bypassing of some of the small intestine.\n\n"}]
65fc19f6-ce03-11e7-97ae-067fbe30e3fa | [{"insert": "Hospital Preadmission & Registration"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Before you can have your surgery, you will need to follow your hospital’s policy on preadmission testing and registration. Specific instructions will be given to you by your hospital or surgeon’s office.\n"}]
ae6b9eaa-f24d-11e7-9352-067fbe30e3fa | [{"insert": "Personal Preparation"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Shower the morning of surgery "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "We recommend that you shower in the morning on the day of surgery, but do not use any moisturizers, creams, lotions, or make-up. Remove your jewelry and do not wear nail polish. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Remove dentures before surgery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "You may wear dentures, but you will need to remove them just prior to surgery."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bring eyeglasses and case if necessary"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fc1762-ce03-11e7-97ab-067fbe30e3fa | [{"insert": "Packing for Surgery"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "It is recommended to bring only the bare necessities to the hospital. There are a few other things that may make your stay a little more comfortable:\nYour App"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A small overnight bag with toiletries such as toothbrush, toothpaste, soap, shampoo, and lotion"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your eyeglasses and a case"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protective storage case(s) for corrective lenses, dentures, hearing aids, etc."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bathrobe"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your CPAP machine if applicable"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear fluids with protein such as Isopure or Cytomax"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Address and phone book of loved ones"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lip balm"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Comfortable, loose-fitting clothes to wear when you go home. Clothes that are easily removed and easy to slip on are best."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**Do not bring any jewelry or more than $20 cash. You may want to bring an item to comfort you such as a photo of a loved one.\n"}]
0d84b45c-f24f-11e7-af06-067fbe30e3fa | [{"insert": "Visitors Rules"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Depending on the length of your hospital stay, you may have family or loved ones who wish to visit you after your procedure. It is very important for your visitors to be mindful that you and other patients are recovering from surgery and may be experiencing nausea. \n\nStrong odors such as fried foods, perfumes, and scented lotions may increase your level of nausea. You may not be in a private room right after surgery and recovering in a post-op care unit until your room on the floor is ready. All visitors should be considerate to other patients in recovery areas and refrain from bringing in outside food and beverages.\n\nShould your family and loved ones need to eat, we urge them to do so either before or after their visit. Most of the hospitals we operate at have waiting rooms, cafeterias, and coffee shops for family members to visit while you are in surgery, in recovery, or being attended to by hospital staff. \n\nNurses on the floor and in the recovery areas will notify family members when their loved ones will be ready for visitation and usually encourage family and visitors to eat during this time. For visitors coming directly to your room, please encourage them to eat before or after seeing you and avoid bringing outside food into the hospital.\n\nTypically, your stay in the hospital is not more than a day or two, so when possible, you may want to typically your stay in the hospital is not more than a day or two, so when possible, you may want to delay any prolonged or group visiting until you are comfortably home and feel ready. \n"}]
65fc133e-ce03-11e7-97a3-067fbe30e3fa | [{"insert": "Hospital Diet Clear Liquid Diets"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Patients will need to bring clear liquid protein with them to the hospital. Examples of clear liquid proteins:\nIsopure "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cocotein"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise High protein fruit drink"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise bouillon"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "In the hospital you may receive items on your meal tray that are semi-solid like cream of wheat or yogurt. These items are not recommended until three weeks after surgery. If you receive these items on your meal tray please avoid them and focus on drinking the protein fortified nutrition supplements provided.\n\nDehydration"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Dehydration is the primary complication of weight loss surgery. Symptoms of dehydration include:\nFatigue"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nausea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dark or Concentrated Urine"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low Urine Output"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dry Mouth"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "*If you are having difficulty drinking the recommended amount of fluid each day and are suffering any of the above symptoms we recommend that you call the clinic to discuss your intake.\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Hydrating Fluids"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "*NO BUBBLES, SUGAR, OR CAFFEINE\nWater "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Decaf coffee or tea "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Diet or sugar-free "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear fruit juices "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free Jell-O "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free popsicles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chicken, beef or Vegetable broth "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crystal Lite "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free lemonade "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vitamin Water Zero "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fruit"}, {"insert": "2", "attributes": {"script": "sub"}}, {"insert": "O "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mio "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dasani Drops"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ayala’y Herbal Water (Whole Foods) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Metro Mint Water "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hint Water (Whole Foods) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skinny Water (Harris Teeter) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Propel"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drinks can be sweetened with Splenda, Equal, Truvia and Stevia.\n"}]
72b35d42-f24f-11e7-8d9f-067fbe30e3fa | [{"insert": "Diet Phases Overview & Steps"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Weight loss surgery is an excellent tool to help you limit the amount of food you eat and help you lose weight. For most people, weight loss surgery requires a significant change in diet and lifestyle to safely and healthfully reach your goal. After bariatric surgery, you will likely be losing weight very rapidly. Good nutrition is essential to maintain lean body mass (muscle), hydration, skin elasticity, and to minimize hair loss."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\n"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Primary Nutrition Goals"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Consume adequate amounts of protein to minimize loss of lean body mass and help facility healing"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take in adequate amounts of fluid to maintain hydration status"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Obtain adequate nutrients for optimal health through healthy food choices and vitamin and mineral supplementations"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Lifestyle Changes"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Your new lifestyle will include:\nProtein - 60-80g/day (DS 80-100g/day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fluids - 64 fl oz/day"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vitamins - Lifelong vitamin and mineral supplementation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Exercise - Minimum of 10k steps daily"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Diet Steps"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "After your bariatric surgery, protein and fluid intake are essential to successful recovery. Patients will go home from the hospital on a liquid only diet.\nClear Liquid= Any sugar free, carbonation free liquid that will allow light to pass through. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Remain on clear liquids for the first 48 hours following your surgery"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Full liquid = Any liquids or food that is liquid at room temperature. It includes protein shakes and low fat milk. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin following clear liquids diet, remain on full liquids  for 2 weeks"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Semi-solid = Typically foods that would be eaten with a spoon and are applesauce or pureed consistency. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin following full liquid diet, remain on semi-solids for 1 week"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": " **Between 3 & 4 weeks post-op, you will have a visit with a BSNC registered dietitian"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Soft = Fork tender – able to cut, mash or pull apart with a fork. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Begin following semi-solids diet, remain on soft foods  for 4 - 8 weeks"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}]
b1c6f94e-f24f-11e7-8bae-067fbe30e3fa | [{"insert": "Vitamins & Minerals"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "American Society of Metabolic and Bariatric Surgery (ASMBS) recommends that all weight loss surgery patients take a bariatric formulated multivitamin daily.\nAll supplements and medications must be chewable or liquid until 30 days post-op.\nB-Complex "}, {"insert": "- ", "attributes": {"bold": true}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter. If not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Multi-Vitamin"}, {"insert": " - ", "attributes": {"bold": true}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. We recommend a bariatric formulated multivitamin that contains iron. The multivitamin should be taken without food for increased absorption."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bariatric Advantage Chewable Multi EA (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Celebrate Chewable Multivitamin (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "+ 45mg Iron"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Celebrate Chewable Multi-Complete 60 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Celebrate Chewable Multi-Complete 45 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Celebrate Chewable Multi-Complete 36 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Bariatric Fusion Chewable Multivitamin (4 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 30mg Iron"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Bariatric Advantage Ultra Multi Capsule with Iron (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Additional iron is recommended for menstruating women. Consult your surgeon or registered dietitian for more information."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Calcium"}, {"insert": " - ", "attributes": {"bold": true}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. Take calcium supplement doses at least 2 hours before or 2 hours after the multivitamin and iron. Calcium supplements should be spaced throughout the day for increased absorption."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbe06c-ce03-11e7-9799-067fbe30e3fa | [{"insert": "Night of Surgery"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "With the instruction of your bariatric nurse and/or Physical Therapist, you should sit up and dangle your feet the first night of surgery and stand at your bedside. Yes, it will be uncomfortable, but each time you get out of bed it will get easier. Each day you will notice your strength returning, with less and less discomfort. \n"}]
65fbe008-ce03-11e7-9798-067fbe30e3fa | [{"insert": "Clear Liquids (Days 1 & 2)"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Patients will need to bring clear liquid protein with them to the hospital. Examples of clear liquid proteins:\nIsopure "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cocotein"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise High protein fruit drink"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise bouillon"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**In the hospital you may receive items on your meal tray that are semi-solid like cream of wheat or yogurt. These items are not recommended until three weeks after surgery. If you receive these items on your meal tray please avoid them and focus on drinking the protein fortified nutrition supplements provided.\n"}]
11cad0aa-f254-11e7-8f26-067fbe30e3fa | [{"insert": "Dehydration"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Dehydration is the primary complication of weight loss surgery. Symptoms of dehydration include:\nFatigue"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nausea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dark or Concentrated Urine"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low Urine Output"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dry Mouth"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "*If you are having difficulty drinking the recommended amount of fluid each day and are suffering any of the above symptoms we recommend that you call the clinic to discuss your intake.\n\nHydrating Fluids"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "*NO BUBBLES, SUGAR, OR CAFFEINE\nWater "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Decaf coffee or tea "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Diet or sugar-free "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear fruit juices "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free Jell-O "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free popsicles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chicken, beef or Vegetable broth "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crystal Lite "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free lemonade "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vitamin Water Zero "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fruit2O "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mio "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Dasani Drops"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ayala’y Herbal Water (Whole Foods) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Metro Mint Water "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hint Water (Whole Foods) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skinny Water (Harris Teeter) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Propel"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drinks can be sweetened with Splenda, Equal, Truvia and Stevia.\n\n"}]
2dddbaae-f255-11e7-9cfa-067fbe30e3fa | [{"insert": "Pain Meds"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "As soon as you are able to tolerate fluids, your medical team will add oral pain medication. Please remember that you are not bothering the staff if you are asking for pain medicine! \n\nThe risk of becoming addicted to pain medicine is very low when it is used for a specific medical purpose such as surgery. If you have concerns your nurses or surgeon are able to explain this further.\n"}]
56f913c0-f255-11e7-981d-067fbe30e3fa | [{"insert": "Pain Level"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your nurses and doctors will ask you to pick a way that you can describe your pain. This is done to ensure uniform language. Two helpful ways to describe the pain include:\nthe number scale (0 to 10 scale; 0 = no pain; 10 = the worst pain possible) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "the use of words (none, mild, moderate, severe)."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Record pain level every 4 hours\n\n"}]
90e96080-f255-11e7-82a0-067fbe30e3fa | [{"insert": "Helpful Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Tell your nurses and physicians if you are having pain, particularly if it keeps you from moving, taking deep breaths and generally feeling comfortable."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Everyone is different, keep your nurse informed of your pain."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Plan ahead for pain. If you are comfortable lying down, you may still need a pain medication to get up and walk around."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Keep ahead of the pain. Don’t wait for the pain to be at its worst before you push the PCA button or ask for pain medicine. Pain medication works best when used to prevent pain."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f6c8b6-ce03-11e7-9788-067fbe30e3fa | [{"insert": "Recovery Guide"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Days and Weeks after Surgery "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Your medical team cares about your progress. Keep in touch with us; we will do our best to make sure that you receive the best care possible.\nThere are many things you will experience once you are home recovering. When you get home, plan on taking things easy for a while. Your body is still recovering from the stresses of major surgery and weight loss during the recovery period. Your activity will be restricted and you will be required to forego strenuous activity for 3 to 6 weeks after the operation. You may walk and perform light household duties as tolerated upon your return home."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "During the first several weeks after your surgery you may feel weak and tire easily, however, try to be as active as possible. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Refer to the exercise section of this app for instructions on becoming more active after surgery. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid lifting anything heavier than 20 to 30 pounds, or doing push or pull motions such as vacuuming, during the first 6 weeks after your surgery. Avoid heavy work such as lifting, carrying, or pushing heavy loads for the first 3 months after your surgery."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "You will also need to be very aware of your fluid and nutrient intake."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Please review the nutrition section of this app and refer to it often."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "There will be detailed instructions for you to follow after you return home from the hospital. You may resume traveling short distances as soon as you feel strong enough to make the trip. Do not drive a motor vehicle until you are off of the prescription pain medications; this is usually about one week after surgery."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid sitting and standing still for long periods. Change positions frequently and take breaks to walk around. These strategies may help to prevent blood clots from forming in your legs. Climbing stairs is encouraged."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
c2d3eaa0-f257-11e7-9d40-067fbe30e3fa | [{"insert": "Remove Dentures Before Surgery"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": " You may wear dentures, but you will need to remove them just prior to surgery.\n"}]
e24f7e9e-f257-11e7-b4ad-067fbe30e3fa | [{"insert": "Bring Eyeglasses and Case if Necessary"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Please bring your eye glasses and a case if possible.\n"}]
07cf467c-f258-11e7-979d-067fbe30e3fa | [{"insert": "Bring Surgery Bag Packed Yesterday"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "It is recommended to bring only the bare necessities to the hospital. There are a few other things that may make your stay a little more comfortable:\nYour App"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A small overnight bag with toiletries such as toothbrush, toothpaste, soap, shampoo, and lotion"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your eyeglasses and a case"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protective storage case(s) for corrective lenses, dentures, hearing aids, etc."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bathrobe"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your CPAP machine if applicable"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear fluids with protein such as Isopure or Cytomax"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Address and phone book of loved ones"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lip balm"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Comfortable, loose-fitting clothes to wear when you go home. Clothes that are easily removed and easy to slip on are best"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**Do not bring any jewelry or more than $20 cash. You may want to bring an item to comfort you such as a photo of a loved one."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f6c7e4-ce03-11e7-9786-067fbe30e3fa | [{"insert": "Arrange for Someone to Help"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Most patients like to have someone home with them the first few days after surgery for moral and physical support. Due to the nature of abdominal surgery, you may need some help with toileting. Flushable baby wipes tend to be gentler for personal hygiene, as well as a peri-bottle and/or use a small sports-top water bottle. A long sponge stick can also be very helpful.\n"}]
65f6c67c-ce03-11e7-9785-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your wound needs minimal care. If sutures were used, they will dissolve. You may notice some tape on your wound. This tape is called steri-strips. They will fall off on their own. If surgical staples were used, they will have to be removed, usually around your 10th post-op day. The removal of surgical staples is painless. Leaving the wound open to air, whenever possible, helps prevent suture infection.\nNo matter how your wound was closed, it is important to keep the wound clean and dry to promote faster healing. \n\nYou may shower, but pat dry the incision area. After about 3 weeks, the incision is usually ready for immersion. Ask your surgeon for the official go ahead before bathing or swimming. Despite the greatest care, any wound can become infected. If your wound becomes extremely red, swollen, leaks pus, has red streaks, has yellow/green oozing odorous drainage, feels increasingly sore or you have a fever above 100° F, you must report to your surgeon right away.\n"}]
8460506e-f258-11e7-bbd7-067fbe30e3fa | [{"insert": "Wound Care Tips"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Please do not use any antibiotic ointment, peroxide, or other bandages or ointments that would prevent your wound from getting air. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "The bottom line, (unless otherwise prescribed) shower, wash with soap, rinse and pat dry thoroughly."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If wound is oozing or catching on clothing, you may cover with a very light dressing, otherwise leave open to air."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drainage from surgical wounds is not unusual. A clear or pale yellow drainage is not unusual after surgery. Anything other than this should be reported to your surgeon. Bloody drainage or thick cloudy (pus) drainage should be reported to your surgeon."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
9c44ac34-f258-11e7-acfc-067fbe30e3fa | [{"insert": "Urgent Wounds Concerns"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Even though we do not expect you to have any serious problems after your surgery, some symptoms that you may experience need to be addressed immediately. If you experience any of the following symptoms, contact your surgeon right away:\nFever of 100.5˚F or above"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Redness, swelling, increased pain, and/or pus-like drainage from your wound"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chest pain and/or shortness of breath"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nausea and/or vomiting that lasts more than 12 hours"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pain, redness, and/or swelling in your legs"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Urine output less than 4 times in 24 hours "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pain that is unrelieved by pain medication"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nNormal Wounds Symptoms"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Moderate swelling and bruising is normal after any surgery. (Note: Severe swelling and bruising may indicate bleeding or possible infection)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mild to moderate discomfort or pain is also typical. Note: If the pain becomes severe and is not relieved by pain medication, please contact your surgeon."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "You may also experience numbness. Small sensory nerves to the skin are occasionally cut when the incision is made undermining the skin. The sensation in those areas usually returns within 2 to 3 months as the nerve endings heal. (Note: Be especially careful not to burn yourself when applying heating pads to the area that may have some post-operative numbness)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Itching and occasional small shooting electrical sensations within the skin frequently occur as the nerve endings heal. These symptoms are common during the recovery period. Note: Ice, skin moisturizers, vitamin E oil and massage are often helpful."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "All new scars are red, dark pink, or purple. The scars take about one year to fade. Note: We recommend that you protect your scars from the sun for a year after your surgery. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear a sunscreen with a skin-protection factor (SPF) of at least 15 when out in sunny weather."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbe2b0-ce03-11e7-979d-067fbe30e3fa | [{"insert": "Bring Surgery Bag Packed Yesterday"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "It is recommended to bring only the bare necessities to the hospital. There are a few other things that may make your stay a little more comfortable:\nYour App"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A small overnight bag with toiletries such as toothbrush, toothpaste, soap, shampoo, and lotion"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your eyeglasses and a case"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protective storage case(s) for corrective lenses, dentures, hearing aids, etc."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bathrobe"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Your CPAP machine if applicable"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Clear fluids with protein such as Isopure or Cytomax"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Address and phone book of loved ones"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lip balm"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Comfortable, loose-fitting clothes to wear when you go home. Clothes that are easily removed and easy to slip on are best"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**Do not bring any jewelry or more than $20 cash. You may want to bring an item to comfort you such as a photo of a loved one."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
de0e02e6-f258-11e7-aafe-067fbe30e3fa | [{"insert": "Vomiting"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Vomiting is often associated with eating inappropriately. It is very difficult to gauge in the beginning how little food will satisfy your hunger. \n\nChew your food well, keep it moist and eat only half of what you anticipate eating. If there is still space, and you still feel hungry, then you can always eat more. Chances are that you are going to feel full with very little. A couple of teaspoons may be all that you can take in at one time. If you overeat after surgery, you may vomit. Sometimes fullness occurs quickly. Allow yourself time to recognize the feeling of fullness. \n\nTypically, with gastric bypass, a profound feeling of satisfaction follows the fullness within a few minutes, and makes further eating a matter of indifference. \n"}]
f0542890-f258-11e7-a632-067fbe30e3fa | [{"insert": "Causes & prevention"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Possible causes of vomiting:"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Eating too fast"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Not chewing food properly"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eating food that is too dry"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eating too much at once"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eating solid foods too soon after surgery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drinking liquids with meals or immediately after meals"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drinking with a straw, "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lying down right after a meal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nPossible ways to prevent vomiting:"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Chew food thoroughly"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Keep food moist"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eat only half of what you anticipate eating, you can always come back later "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Follow your post-operative diet"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If you begin vomiting and it continues throughout the day, stop eating solid foods and sip clear liquids (clear and very diluted juice, broth and herbal tea). Should you have difficulty swallowing foods or keeping foods down, please call your surgeon. Vomiting may indicate that the stomach pouch is blocked. If vomiting continues for more than 24 hours, contact your surgeon, since vomiting can lead to severe dehydration, a situation that needs to be taken seriously."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
65f68590-ce03-11e7-9783-067fbe30e3fa | [{"insert": "Bowels "}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "It is normal for you to have one to three bowel movements of soft stool per day. It may be foul smelling and associated with flatulence. Most of these changes resolve as your body heals and you adapt to changes. Please call your surgeon, should you have persistent diarrhea because this can lead to dehydration.\n\nAfter restrictive surgery, the amount of food consumed is greatly reduced, and the quantity of fiber or roughage consumed may be much smaller. Correspondingly, the amount of bowel movements will be diminished, causing less frequent bowel activity and sometimes constipation.\n"}]
65fbda04-ce03-11e7-978b-067fbe30e3fa | [{"insert": "Returning Home Instructions"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You may take showers as normal, but you must avoid baths, hot tubs, oceans, lakes and swimming pools for I month."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Remember: wash and dry wounds well. No lotions, ointments, salves, creams, antibiotics, or any type of topical product other than soap and water."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Continue your regular walks, moving regularly, and your incentive spirometer as you did in the hospital."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If you have been diagnosed with osa, continue your use of cpap machine."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Do not lift anything greater than ten pounds (i.e., a gallon of milk) for at least four weeks if you had a laparoscopic procedure, or at least 4- 6 weeks if you had an open procedure."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Most individuals can drive as long as they are not in pain and not taking medication for pain. You can expect to be away from work for about 2-4 weeks."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Check with your surgeon before taking any medication. Do not take any long-acting (sustained release/extended release) medications"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Drink at least 64-80 ounces of fluids each day (for example: water, crystal light, or protein shakes). You must work to get in about 800-1000 kcals and 60-80 grams of protein."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid carbonated beverages, Non-steroidal anti-inflammatory drugs, tobacco and caffeine. Stay away from \"baby food.\" "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "No motrin, advll, ibuprofen, alleve, naprosyn, naproxen, celebrex, indomethacin, relafennoltaren, bc powders, goody powders"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "In general, Tylenol products are ok."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Continue your post-operative diet instructions per dietician."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Contact the office with any questions/concerns"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
4e4d891e-f259-11e7-b571-067fbe30e3fa | [{"insert": "Flatulence "}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Everyone has gas in the digestive tract. Bariatric patients have a shortened bowel, which can cause gas to be more odorous and expelled more forcefully.\n\nGas comes from two main sources: swallowed air and normal breakdown of certain foods by harmless bacteria that are naturally present in the large intestines. \n\nFoods high in carbohydrates cause gas; those high in fat and protein cause very little. The foods that are known to cause more gas are beans, veggies, some fruits, soft drinks, whole grains/wheat and bran, cows’ milk and cows’ milk products, foods containing sorbitol and dietetic products.\n\nHere are some things you can do to help prevent flatulence:\nEat your meals more slowly, chewing food thoroughly."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lactose intolerance is generally the culprit of gas, so discontinue eating all cow milk products. Yogurt is okay."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid eating chewing gum and hard candy."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid drinking with a straw."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eliminate carbonated beverages. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "If you are looking for some gas relief, please consult your surgeon before trying any herbal or over-the-counter remedies."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
65fc8756-ce03-11e7-9804-067fbe30e3fa | [{"insert": "Insurance "}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Generally speaking, if you have bariatric benefits as part of your policy, a weight loss surgery procedure will be covered by insurance. Our team will help you verify your insurance benefits prior to meeting with one of our providers. We encourage you to check your own benefits as well by calling your insurance provider and asking if you have coverage for E66.01. You can also check with your employer for specific information about your policy. Costs of the procedure or surgery will vary depending on the site where the surgery occurs, the type of procedure, and how long you are required to stay in the hospital. During your initial appointment, your Case Manager will go over procedure coverage with you and estimated out of pocket expenses. \n"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\nAs of January 2017, our practice is unable to accept the following for bariatric procedures: \nBlue Local"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cigna Connect"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "United Healthcare GHI"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Medicaid"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65fbd784-ce03-11e7-9789-067fbe30e3fa | [{"insert": "When Should I Call?"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Call immediately and/or report to the ER for any of the following:"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vomiting that does not go away and/ or you are unable to keep clear liquids down for greater than 4 hours."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Abdominal pain which does not get better after taking your prescribed pain medicine."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Redness, swelling, drainage, or foul odor at incision site."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Fever greater than 101 degrees."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "If your incision opens or pulls apart."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Chest pain/shortness of breath."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Calf pain and/or swelling."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Anything you consider \"abnormal for you.\""}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "If you pass out, dial 911 and report to closest ER. It is never \"normal\" to lose consciousness and the ER can get in touch with your surgeon as need be."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Most individuals can drive as long as they are not in pain and not taking medication for pain. You can expect to be away from work for about 2-4 weeks."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Check with your surgeon before taking any medication. Do not take any long-acting (sustained release/extended release) medications"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Drink at least 64-80 ounces of fluids each day (for example: water, crystal light, or protein shakes). You must work to get in about 800-1000 kcals and 60-80 grams of protein."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Avoid carbonated beverages, non-steroidal anti-inflammatory drugs, tobacco and caffeine. Stay away from \"baby food.\" No"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "No motrin, advll, ibuprofen, alleve, naprosyn, naproxen, celebrex, indomethacin, relafennoltaren, bc powders, goody powders"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "In general, tylenol products are ok."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Continue your post-operative diet as per bariatric guidebook and instructions per dietician."}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Contact the office with any questions/concerns"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}]
65f39970-ce03-11e7-9781-067fbe30e3fa | [{"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "You are already aware that bariatric surgery is merely a tool to weight loss. Of course, this means that in order to receive the maximum benefits from your surgery, you must incorporate exercise into your daily routine. Patients and researchers report that exercise is a key factor in the ability to maintain weight. If you want to feel good and maintain and build muscle mass, you must exercise. Exercise helps you lose weight and stimulates the production of “the good feeling” hormones called endorphins. Exercise also helps to keep your bone tissue dense and strong, increases strength and balance, boosts energy, and improves quality of life.\n\nResearch has shown that patients who exercise 3 or more times per week for a minimum of 30 minutes lost an additional 12% of their excess weight in 6 months. Patients who work hard on exercise soon after surgery find it very rewarding. As the weight falls off, the capacity for exercise improves dramatically, with significant improvements on a week-by-week basis. Do not cheat your body of this important aspect of weight loss. Make a long-term commitment to exercising! \n\nYes, exercise is hard. It is difficult to stay motivated. It is not easy to find an exercise that you may like. Try to look into forms of exercise that you may have never tried before. Explore yoga, dancing, roller skating, tai-chi, etc. Exercise does not mean that you have to be in a gym for hours a day. If it has been some time since you have exercised regularly, then it is best to start slowly. Begin with as little as 5 minutes a day and add 5 more minutes a week until you can stay active for 45 minutes per day. We recommend that you make exercise part of your daily routine. Just being an active person is not enough exercise to be able to lose the weight and keep it off.\n"}]
e7008080-f259-11e7-9c88-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Hydrating Fluids + Protein Shakes = 64oz fluid\n\nDrink fluids in no more than 2oz or ⅓ cup portions every 15 minutes and sip on this fluid over 10-15 minutes. Try to drink about 2oz of protein fortified fluid each hour then sip on 6oz of hydrating fluids, totaling 1 cup or 8oz total each hour. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sip slowly, do not gulp, and do not use straws, sippy cups, or sports bottle tops. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Some people experience taste changes after surgery, therefore choose a variety of fluids to keep hydrated and provide a source of protein (examples provided on the following pages). "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "You may be sensitive to very hot and very cold fluids initially. Start drinking fluids that are room temperature and then gradually make them colder and warmer as tolerated. This is usually a temporary side effect and will resolve for most people in several to a few weeks."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
f1d979ee-f259-11e7-b0d7-067fbe30e3fa | [{"insert": "Exercise Types"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "There are three forms of exercise that you should incorporate into your new life: cardiovascular, strength-building or training, and flexibility.\n\nCardiovascular"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Cardiovascular exercise is also known as aerobic exercise. Aerobic exercise uses your large muscles and can be continued for long periods. For example, walking, jogging, swimming, and cycling are aerobic activities. These types of exercises drive your body to use oxygen more efficiently and deliver maximum benefits to your heart, lungs, and circulatory system. A simple definition of cardiovascular exercise is any exercise that raises your heart rate to a level where you can still talk, but you start to breathe harder. Your goal is to lose weight; you will need to do some form of cardiovascular exercise for 5 or more days week for 30-45 minutes.\n\nStrength Training"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Strength-building exercises are known as anaerobic exercise. Anaerobic exercise does not have cardio vascular benefits, but it makes your muscles and bones stronger. Strength-building exercises require short, intense effort. People who lift weights or use any type of equipment that requires weights are doing strength building exercise.\n\nStrength-building exercise makes your muscles and bones stronger and increases your metabolism. Your muscles use calories for energy even when your body is at rest. So, by increasing your muscle mass, you are burning more calories all of the time. If you strength train regularly, you will find that your body looks leaner and you will lose fat. Strength building exercises should be performed 2 to3 times a week for best results. Always warm up your muscles for 5 to 10 minute before you begin lifting any type of weight or before performing any resistance exercises.\n\nStretching & Flexibility"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Flexibility exercises, which are also anaerobic, tone your muscles through stretching and can prevent muscle and joint problems later in life. A well balanced exercise program should include some type of each exercise from each category.\n"}]
18e63c0c-f25a-11e7-affe-067fbe30e3fa | [{"insert": "Exercise Plan Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\n"}, {"insert": "Treat exercise like a prescription", "attributes": {"bold": true}}, {"insert": "\nYou do not have to like exercise, but you need to do it in order to stay healthy. You also have to do it in order to lose weight. No miracles here. If you have a condition that requires a medication every day, you are going to take this medicine every day. Your body needs exercise every day, so you have to give it what it needs.\n\n"}, {"insert": "Research", "attributes": {"bold": true}}, {"insert": "\nFind out what types of classes your local gym is offering. Does your hospital offer water exercise classes for people with arthritis? Is there a gentle yoga class offered at the community center? You have a greater likelihood of continuing with an exercise that is tailored to your needs and that you enjoy. Explore new types of exercise. \n\n"}, {"insert": "Change your routine", "attributes": {"bold": true}}, {"insert": "\nSo you love to walk, but you are bored with it. Sometimes, just changing the direction of your route can make all the difference. Find new places to go walking, change the time of day, or offer to walk your neighbor’s dog.\n\n"}, {"insert": "Find a workout buddy", "attributes": {"bold": true}}, {"insert": "\nLet’s face it, without a coach most athletes would not be where they are now. Why should you be any different? We all need someone to nudge us and make us go the extra mile, especially when it comes to exercise. Find a friend, a neighbor, or personal trainer to meet you at the gym or in the park.\n\n"}, {"insert": "Find your rhythm", "attributes": {"bold": true}}, {"insert": "\nListen to music or books on tape or meditation while you exercise. 15 minutes on the bike can seem like an eternity without music, but with the right music to occupy your brain, it will not seem so long.\n\n"}, {"insert": "Try group activities or sports", "attributes": {"bold": true}}, {"insert": "\nYou don’t need to join the soccer team, but participating in a group activity increases the chance that you will stick to it. Choose water exercise, yoga, or stretching classes. Choose places and times where there are other people who are actively involved in exercise.\n\n"}, {"insert": "Know your weakness", "attributes": {"bold": true}}, {"insert": "\nKnow what makes you give up the program. If going on vacation throws you off your fitness plan, try incorporating exercise into your vacation. If boredom makes you give up, stay interested by changing different types of exercise and times.\n\n"}, {"insert": "Make a schedule", "attributes": {"bold": true}}, {"insert": "\nIf you don’t put exercise into your daily schedule, most likely you will do everything but exercise. Schedule specific activities on specific days, like walking 20 minutes on Monday, yoga class on Tuesday, etc.\n\n"}, {"insert": "Keep a workout log", "attributes": {"bold": true}}, {"insert": "\nWrite down the exercises you do and see how you have improved. Just like weight loss, sometimes one does not see the scale drop, but the inches seem to melt away. It is difficult to keep up with exercise when you do not see the results. Write down the number of repetitions, the weight used, the length of walk, the time, etc.\n\n"}, {"insert": "Just keep moving", "attributes": {"bold": true}}, {"insert": "\nWalk as much as possible between workouts. Park your car farther away. Get off the bus a couple of stops early. Always keep a good pair of walking shoes in your car, should you have unexpected time to take a walk.\n"}]
2f016b2e-f25a-11e7-ae32-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Full Liquid Protein (start post-op Day 3) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle Milk "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Premier Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nectar Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise High Protein Hot Chocolate "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bariatric Advantage Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pure Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oh Yeah "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chike Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Met Rx Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Unjury"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
c3ba147c-f25b-11e7-8337-067fbe30e3fa | [{"insert": "Diet Phases"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "After your bariatric surgery, protein and fluid intake are essential to successful recovery. Patients will go home from the hospital on a liquid only diet.\n\nClear Liquid"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Any sugar free, carbonation free liquid that will allow light to pass through."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\nRemain on clear liquids for the first 48 hours following your surgery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nFull Liquid"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Any liquids or food that is liquid at room temperature. It includes protein shakes and low fat milk. \nBegin following clear liquids diet, remain on full liquids  for 2 weeks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nSemi-Solid "}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Typically foods that would be eaten with a spoon and are applesauce or pureed consistency."}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\nBegin following full liquid diet, remain on semi-solids for 1 week"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "**Between 3 & 4 weeks post-op, you will have a visit with a BSNC registered dietitian"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nSoft"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Fork tender – able to cut, mash or pull apart with a fork. \nBegin following semi-solids diet, remain on soft foods  for 4 - 8 weeks"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
6b56692a-f25b-11e7-a2e9-067fbe30e3fa | [{"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review meal plan created pre-surgery"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eat every 3-4 hours (4-6 times daily)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Breakfast 1 hour of waking and last meal at least 2 hours before bed"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "Schedule "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "12 – 1-2oz Protein Drink"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "3 – 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "6 – 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "9 – 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 2}}, {"insert": "\nUse the above schedule to make sure that you get enough hydration. \n\nTry to sip on 2oz of fluid over 15 minutes. Drinking too quickly or gulping may cause pain or discomfort. Always measure your fluids – do not sip from large cups.\n"}]
abc2c31e-f25b-11e7-ac90-067fbe30e3fa | [{"insert": "Shopping List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review and purchase any missing items\nNew water bottle"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "⅓ and ½ c measuring cups "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Measuring spoons (teaspoon & tablespoon)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Toddler utensils"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp forks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chopsticks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Small food storage containers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Recommended vitamin and mineral supplements"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of sugar-free/carbonation-free/caffeine-free hydrating fluids"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "3-4 bottles of clear liquid protein (Bring to hospital)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skim/1 % milk OR milk alternative "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Notebook for food journal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of milky-consistency protein shakes "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "New athletic footwear"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "New athletic socks"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Crockpot "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Blender"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vegetable steamer "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-sodium chicken or vegetable broth"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free jello"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free popsicles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Smaller “saucer” like plates"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
28ebd4d4-f25c-11e7-891d-067fbe30e3fa | [{"insert": "Vitamins & Minerals"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "American Society of Metabolic and Bariatric Surgery (ASMBS) recommends that all weight loss surgery patients take a bariatric formulated multivitamin daily.\n All supplements and medications must be chewable or liquid until 30 days post-op.\n"}]
75943402-f25c-11e7-a43b-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Click "}, {"insert": "here", "attributes": {"link": "http://www.surgerync.com/nutrition-portal/bariatric-bistro-recipes.php"}}, {"insert": " for bariatric bistro recipes.\n"}]
65f379cc-ce03-11e7-9770-067fbe30e3fa | [{"insert": "Create a Food Journal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Create a food journal and add to it every day.\n"}]
c29251a0-f47b-11e7-8e37-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Week Hydrating Fluids + Protein Shakes + Semi-Solid Foods\nDo not drink fluids while eating semi-solids. Stop drinking fluids 30 minutes before a mini-meal and do not start drinking fluids until 30 minutes after finishing a semi-solid meal."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "All liquids from weeks one and two are allowed with the addition of some semi-solid foods."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Semi-solid foods are those that would normally be eaten with a spoon and are applesauce consistency. Avoid skins, seeds, and chunks."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try no more than ⅓ cup of semi-solid food at a time, plan on consuming a semi-solid mini meal every 3-4 hours."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "As you begin to add semi-solids you may begin to feel fullness. For most people fullness after weight loss surgery feels like a gentle tightness, pressure or heaviness right below the breast bone."}, {"insert": "\n", "attributes": {"list": "bullet"}}]
efd52962-f47b-11e7-a5f0-067fbe30e3fa | [{"insert": "Blending Tips"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Cook all vegetables until fork tender"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cut food into thumbnail sized pieces then place in a blender with enough broth, water or low-fat milk to cover the blades"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Blend until the food has reached an applesauce like consistency"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Strain out any lumps, seeds or stringy pieces that do not blend completely"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
11267ae4-f47c-11e7-948b-067fbe30e3fa | [{"insert": "Fortifying with Protein"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Try adding unflavored protein powders (such as GenPro, Nectar, or Unjury) or non-fat dry milk powder to pureed vegetables, pudding and hot cereals to improve the protein content of food. \n\nProtein sources"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "1/3 cup cottage cheese – 9g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup hummus or pureed cooked beans – 4g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup plain low-fat Greek yogurt – 8.7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup Snack Pack pudding + (Genepro) – 21.3g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup low-fat ricotta cheese – 9.3g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup protein fortified soup (Healthwise) 5-7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
3bf65668-f47c-11e7-bd67-067fbe30e3fa | [{"insert": "Foods to Eat and Avoid"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "\nAllowed Semi-Solids"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Strained soups, broth and low fat cream based soups "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat yogurt "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat or 1% ricotta cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hummus "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat or 1% cottage cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protein fortified cooked, mashed or pureed non-gas forming vegetables like: carrots, squash, green beans, or peas "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pureed black, pinto or navy beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fat free refried beans "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protein fortified sugar free and fat free pudding"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nSemi-Solids to Avoid"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Any soup with meat, rice or noodles "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Full fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Yogurt with seeds or fruit "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oatmeal "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Full fat cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Regular refried beans or cook beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Full fat, sugar containing puddings"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
f3c5857c-f47f-11e7-9389-067fbe30e3fa | [{"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Add semi-solid meal times to your calendar (for one week)\nAdditional Info: Sample Schedule - Shaded Boxes indicate Protein fortified semi-solid foods and/or fluids "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Un-shaded boxes indicate fluid for hydration "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "No more than 2-4 oz fluid or ⅓-½ cup of semisolid at a time. Times with a star (*) indicate a semi-solid food "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "0 – no food or fluid at these times "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fullness: As you begin to add semi-solids you may begin to feel fullness. For most people fullness feels like a pressure, tightness or heaviness in the center of your abdomen near the breast bone. "}, {"insert": "\n", "attributes": {"list": "bullet"}}]
65f377ba-ce03-11e7-976d-067fbe30e3fa | [{"insert": "Continue Full Liquid Diet"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "This is your final week on the full-liquid diet, starting next week you will be able to start a semi-solid diet. For your final week please review key concepts, protein sources and sample schedule.\n"}]
33216a9c-f480-11e7-8ea3-067fbe30e3fa | [{"insert": "Shopping List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review and purchase any missing items\nLow fat soups (strained cream-based soups)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light/low-fat almond, soy or lactaid milk"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skim or 1 % milk"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light or low-fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low fat cottage or ricotta cheese "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free pudding"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "A variety of canned beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hummus"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat/fat-free refried beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sugar-free Jello"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Flavorless protein powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned/fresh/frozen non-gassy veggies (carrots, squash, green beans or peas)"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
63fd0d88-f480-11e7-bb89-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Hydrating Fluids + Protein Shakes = 64oz fluid\nDrink fluids in no more than 2oz or ⅓ cup portions every 15 minutes and sip on this fluid over 10-15 minutes. Try to drink about 2oz of protein fortified fluid each hour then sip on 6oz of hydrating fluids, totaling 1 cup or 8oz total each hour. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Sip slowly, do not gulp, and do not use straws, sippy cups, or sports bottle tops. "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Some people experience taste changes after surgery, therefore choose a variety of fluids to keep hydrated and provide a source of protein (examples provided on the following pages). "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "You may be sensitive to very hot and very cold fluids initially. Start drinking fluids that are room temperature and then gradually make them colder and warmer as tolerated. This is usually a temporary side effect and will resolve for most people in several to a few weeks."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
e3c62464-f480-11e7-954c-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Full Liquid Protein (start post-op Day 3) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Muscle Milk "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Premier Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Nectar Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Healthwise High Protein Hot Chocolate "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Bariatric Advantage Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pure Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Oh Yeah "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chike Protein Powder "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Met Rx Meal Replacement "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Unjury"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
032f32a0-f481-11e7-8afd-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Click "}, {"insert": "here", "attributes": {"link": "http://www.surgerync.com/nutrition-portal/bariatric-bistro-recipes.php"}}, {"insert": " to view recipes.\n"}]
8cc00aa0-f489-11e7-a6d9-067fbe30e3fa | [{"insert": "Guidelines"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Advancing the diet"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Start with no more than 2 ounces of ⅓ cup of protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Mini-meals should be every 3-4 hours "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Try only one new food at a time "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Do not consume liquids with meals (30 minutes before or after) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Always eat protein first "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid extremes in temperature "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop eating when feeling full "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chew food to applesauce consistency "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Allow a minimum of 20-30 minutes to finish your meals "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take thumbnail sized bites"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Reintroduce meat in the following order"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Flaky fish and seafood "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft cooked eggs "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ground or tender cooked beef, pork, poultry "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
c4abc9de-f481-11e7-a2a6-067fbe30e3fa | [{"insert": "Sample Schedule"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review meal plan created pre-surgery\nEat every 3-4 hours (4-6 times daily)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Breakfast 1 hour of waking and last meal at least 2 hours before bed"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Schedule "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "12 ", "attributes": {"bold": true}}, {"insert": "– 1-2oz Protein Drink"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "3 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "6 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "9 ", "attributes": {"bold": true}}, {"insert": "– 1-2 oz Fluid for Hydration"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Use the above schedule to make sure that you get enough hydration. \nTry to sip on 2oz of fluid over 15 minutes. Drinking too quickly or gulping may cause pain or discomfort. Always measure your fluids – do not sip from large cups.\n"}]
18d22dc8-f482-11e7-ae0d-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Click "}, {"insert": "here", "attributes": {"link": "http://www.surgerync.com/nutrition-portal/bariatric-bistro-recipes.php"}}, {"insert": " for bariatric bistro recipes.\n"}]
65f37594-ce03-11e7-9767-067fbe30e3fa | [{"insert": "Continue Taking Chewable B-Complex"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter. If not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1). Call the Envision store or visit Bariatric Advantage by using the buttons below.\n"}]
65f374a4-ce03-11e7-9765-067fbe30e3fa | [{"insert": "Continue to Get Your Daily Walks"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your activity level will be restricted activity for three weeks after the operation. You may walk and perform light household duties as tolerated upon your return home but nothing else. Usually, frequent walks of short duration are tolerated better than one or two long walks that go to or past the point of fatigue. Increase the distance that you walk gradually. \n"}]
0091218c-f483-11e7-aeb1-067fbe30e3fa | [{"insert": "Continue Taking Chewable B-Complex"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter. If not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1). Call the Envision store or visit Bariatric Advantage by using the buttons below.\n"}]
47978062-f483-11e7-bc20-067fbe30e3fa | [{"insert": "Continue to Get Your Daily Walks"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Your activity level will be restricted activity for three weeks after the operation. You may walk and perform light household duties as tolerated upon your return home but nothing else. Usually, frequent walks of short duration are tolerated better than one or two long walks that go to or past the point of fatigue. Increase the distance that you walk gradually. \n"}]
d8df4c96-f486-11e7-9f62-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Click "}, {"insert": "here", "attributes": {"link": "http://www.surgerync.com/nutrition-portal/bariatric-bistro-recipes.php"}}, {"insert": " to view recipes.\n"}]
fa39dbde-f488-11e7-8f99-067fbe30e3fa | [{"insert": "Key Concepts"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "4-8 Weeks: Fork Tender Foods\nFluid (decaffeinated, non-carbonated & sugar free) = 64oz daily "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Protein = 60-80 grams daily, 80-100 grams daily for duodenal switch"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\nFour weeks after surgery you will receive instruction the dietitian to learn how to safely and healthfully reintroduce soft foods, meal plan, and make proper food choices to aid in continued weight loss and healing.\n\nDue to change in size and function of your stomach after surgery, there are foods and fluids that should be limited or avoided for the first 2-3 months after surgery.\n\nAt your 2 or 3 month follow-up visit with your surgeon, you will be given clearance to reintroduce regular consistency of foods.\n"}]
6d7b43a8-f489-11e7-be7a-067fbe30e3fa | [{"insert": "Transitioning"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "How To Make Your Transition to Solid Food A Success\n"}, {"insert": "Try one new food at a time.", "attributes": {"bold": true}}, {"insert": " This helps you to identify those foods you tolerate well and those that you don’t tolerate quite as well initially."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Eat slowly and be aware of when you feel full.", "attributes": {"bold": true}}, {"insert": " Your new stomach is very small and will fill very quickly. Try to take at least 20-30 minutes to finish your meal."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chew well.", "attributes": {"bold": true}}, {"insert": " Your new stomach has decreased ability to mechanically and chemically digest food. Help your stomach by chewing well (bout 20-30 times with each bite) to ensure your food will digest easily."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Take small bites. ", "attributes": {"bold": true}}, {"insert": "Small bites are necessary to avoid filling your stomach too quickly which may cause abdominal pain, cramping, or nausea and vomiting."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Do not drink fluid with your meals.", "attributes": {"bold": true}}, {"insert": " It is important to save the room in your new stomach for nutritious food. Drinking with meals may limit your ability to take adequate amounts of nutrition in the early months after surgery. Drinking with meals may also cause food to empty from your stomach more rapidly and cause stomach cramping and other unpleasant side effects."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid sticky foods.", "attributes": {"bold": true}}, {"insert": " Soft white bread, rolls, buns, pasta (especially if overcooked and large pieces), rice that clumps together, macaroni and cheese are some foods that may cause nausea, stomach cramping and sometimes vomiting."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid crunchy, hard to digest foods for the first 2-3 months.", "attributes": {"bold": true}}, {"insert": " Crunchy and hard to digest foods include: raw vegetables, nuts, popcorn, chips, coconut, olives, pickles, tough fruit/vegetable skins (such as apple, cucumber skin), dried fruit, corn, iceberg lettuce. Some people may tolerate these foods after graduation to regular consistency foods at about 2-3 months post-op if eaten slowly and chewed very well."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid tough or rubbery meats.", "attributes": {"bold": true}}, {"insert": " Avoid steak, pork chops, ham, and other tough meats for the first few months. Meat is a great source of protein, but it is easier to digest when prepared moist and tender, and chewed well. Try a slow cooking method to make your meat tender, such as a crock-pot, boiling or cooking at a low temperature over a long period of time."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Avoid extreme temperatures in foods and beverages.", "attributes": {"bold": true}}, {"insert": " Very hot and very cold foods may cause cramping and pain. We suggest that all foods and fluids be introduced at a moderate temperature to establish tolerance. Sensitivity to temperature is usually temporary and will usually resolve within several weeks."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Limit high fat and high sugar foods. ", "attributes": {"bold": true}}, {"insert": "All patients should consume 10 grams or less of total fat per servings and 10 grams or less of sugar per serving. After Roux-en-Y gastric bypass, sweets, desserts, fried, greasy, and rich foods are likely to cause a side effect called dumping syndrome."}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
cc7f8a2a-f48a-11e7-b79c-067fbe30e3fa | [{"insert": "Protein Sources"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "1/3 cup beans – 4g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup steamed soybeans/edamame – 5g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 string cheese – 7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1 egg – 7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup tuna, fish, seafood – 10g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup imitation crab – 3g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup chicken, turkey – 13g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup lean beef or pork – 13g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 soy patter – low fat – 6g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "1/3 cup tofu – 7g"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
a20b5b7e-f48b-11e7-bc2d-067fbe30e3fa | [{"insert": "Shopping List"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Review and purchase any missing items\nEgg Beaters"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Light or low-fat yogurt"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Boneless/skinless chicken breast"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Ground or tender beef/pork/poultry (lean)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen/fresh flaky fish"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned tuna/salmon"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned chopped chicken"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Canned beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fat-free refried beans"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shredded light cheese"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Tofu"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen vegetable steamers"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat/light mayonnaise "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Low-fat deli meats"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft lettuces (bib, boston, red or baby spinach)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen broccoli/cauliflower "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft vegetables fresh/frozen/canned "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Lentils "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen soy patties "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Frozen black bean burgers "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "High-protein/Low-fat cheeses (i.e. parmesan or mozzarella) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Wafer cookie texture protein bar"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Shrimp/scallops/crab"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "PB2 peanut butter powder"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft vegetables: Green beans, carrots, cauliflower, baby spinach, broccoli (fresh/frozen)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Soft fruits: Pears, peaches, mandarin oranges (sugar-free frozen or fresh)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "\n"}]
d12fe41a-f48b-11e7-9532-067fbe30e3fa | [{"insert": "Recipes"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Click "}, {"insert": "here", "attributes": {"link": "http://www.surgerync.com/nutrition-portal/bariatric-bistro-recipes.php"}}, {"insert": " for bariatric bistro recipes.\n"}]
65f31356-ce03-11e7-974e-067fbe30e3fa | [{"insert": "Begin Taking Multi-Vitamin"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Begin 4 weeks after surgery when you start soft foods. We recommend a bariatric formulated multivitamin that contains iron. The multivitamin should be taken without food for increased absorption.\n\nApproved mulit-vitamins"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Bariatric Advantage Chewable Multi EA (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multivitamin (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "+ 45mg Iron"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multi-Complete 60 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multi-Complete 45 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Celebrate Chewable Multi-Complete 36 (2 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Bariatric Fusion Chewable Multivitamin (4 a day)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": " + 30mg Iron"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Bariatric Advantage Ultra Multi Capsule with Iron (3 a day) "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "+ 500mg Calcium Chew (3 a day)"}, {"insert": "\n", "attributes": {"list": "bullet", "indent": 1}}, {"insert": "Additional iron is recommended for menstruating women. Consult your surgeon or registered dietitian for more information.\n\nCall the Envision store or visit Bariatric Advantage by following the buttons below.\n\n"}]
eab7eba2-f48c-11e7-b7f0-067fbe30e3fa | [{"insert": "Continue Taking B-Complex"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "A B-complex vitamin is recommended for the first month after surgery, but is optional thereafter. After the fourth week post-op you can switch to a capsule.\n\nIf not purchased through the Envision Nutricenter, please ensure your B-complex contains 50 mg of thiamin (vitamin B1).Until fourth week is complete, after this point you can switch to a capsule, continuing to take after fourth week is optional. Links to call the Envision Store or visit Bariatric Advantage are below.\n"}]
6488d70e-f48b-11e7-9746-067fbe30e3fa | [{"insert": "Sample Meal"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Plate Meal"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Start Here - ⅓ cup or 3-4 oz. Lean Protein "}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Gradually add these foods as you are able to eat more"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Next - ½ cup non startchy veggies"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Stop Here Last - ⅓ cup whole grain or starchy veggie"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
707ef342-dac6-11e7-8112-067fbe30e3fa | [{"insert": "Conditions Associated with Obesity "}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Breathing Related Conditions\nObstructive sleep apnea"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Obesity hypoventilation syndrome"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Asthma/reactive airway disease"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Vascular Conditions\nAtherosclerosis (thickening of the arteries)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Digestive conditions\nGallbladder disease"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "GERD (recurrent heartburn)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Recurrent ventral hernias"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Fatty liver disease"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hormonal and Insulin Related Conditions\nDiabetes"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hirsutism (excessive hair in women)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hyperlipidemia"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Hypercholesterolemia"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Urinary and Reproductive Conditions\nFrequent urinary tract infections (UTIs)"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Urinary incontinence"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Menstrual irregularity or infertility"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Joint and Skeletal Conditions\nDegeneration of knees and hips"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Disc herniation"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Chronic non-surgical low back pain"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Skin Disorders\nYeast infections between skin folds"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Cancers\nBreast"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Uterine"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Prostate"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Renal"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Colon"}, {"insert": "\n", "attributes": {"list": "bullet"}}, {"insert": "Pancreatic"}, {"insert": "\n", "attributes": {"list": "bullet"}}]
c2652154-f23b-11e7-8488-067fbe30e3fa | [{"insert": "Self-Pay Program"}, {"insert": "\n", "attributes": {"header": 1}}, {"insert": "Overview"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "For patients with a bariatric exclusion in their policy, those who do not have insurance, and those who are seeking surgery outside the constraints of their insurance company, we offer many self-funded options for Bariatric Surgery. We have cash-pay programs for many different types of weight loss surgery as well as secondary, or revisional procedures.\n"}, {"insert": " ", "attributes": {"bold": true}}, {"insert": "\nOur surgeons and staff work diligently with patients to provide the best outcome while helping to keep out of pocket expenses down. As one of the busiest practices on the East Coast with over 50 years of bariatric surgery experience, our practice is well equipped to work with local and out of state patients.\n\nPricing is subject to change dependent on, but not limited to, medical conditions and BMI. Patients may not qualify due to medical conditions, and patients are also subject to BMI criteria. Please call our office if you have any questions.\n"}]
aac54bfc-f64e-11e7-bdd1-067fbe30e3fa | [{"insert": "Continue to Food Journal"}, {"insert": "\n", "attributes": {"header": 1}}]
25761e24-f6e7-11e7-802b-067fbe30e3fa | [{"insert": "Alamance Regional Medical Center"}, {"insert": "\n", "attributes": {"header": 2}}, {"insert": "Grand Oaks Center\n1240 Huffman Mill Rd, Burlington, NC 2721\n"}]
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