Humber River Hospital Bariatric Surgery Program

1 1 English: This information is important! If you have trouble reading this, ask someone to help : Queste informazoni sono importanti! Se ha difficolt a leggere questo, chieda aiuto a : Esta informaci n es importante! Si tiene dificultad en leer esto, pida que alguien le # 005018 2017_08 REV 2017_11 Surgical ProgramHumber River Hospital Bariatric Surgery ProgramA Resource Book for Patients Having Gastric Bypass SurgeryPlease bring this booklet with you for your River HospitalPage 2 Welcome to the Humber River Hospital (HRH) Bariatric so many other Canadians, you are struggling with your weight.

2 The good news is that you have decided to seek help. Congratulations on making this difficult first step!You are about to begin a journey that could change your entire life. However, success takes hard work. For safety, as well as success, pay close attention to the instructions and guidelines in this book, and follow the advice of your Bariatric the Bariatric Team is here to guide you through each stage of your Surgery , this book will serve as an important reference. You will learn: How to prepare for Surgery What potential nutritional complications can occur from the Surgery How to eat safely after Surgery , and How to begin to make the dietary and behavioural changes you need for long-term Notes:INTRODUCTIONR emember!

3 Bariatric Surgery is just a tool. You will have to make changes to your lifestyle and eating habits to reach your you know?The HRH Bariatric Team has many years of experience. We have received an accreditation from both the Canadian and American Bariatric licensing bureaus, allowing us the distinction of a Bariatric Centre of Excellence. Humber River HospitalPage 3 Introduction ..2 Where do I begin? ..4 The Bariatric Team ..5 Bariatric Surgery Overview ..7 PREPARING FOR SURGERYM aking Lifestyle Changes ..14 Replacing Meals with the Optifast Diet ..34 AFTER YOUR SURGERYE ating Guidelines.

4 37 Protein Requirements ..55 Vitamin and Mineral Supplements ..57 Common Nutritional Problems ..59 Alcohol after Gastric Bypass Surgery ..66 Lifestyle Recommendations ..68 Psychosocial Perspectives ..72 Achieving Long-Term Weight Management Success ..77 Frequently Asked Questions ..80 APPENDICESA ppendix A: Recommended Blood Work ..83 Appendix B: Food Sources of Protein ..84 Appendix C: Food Sources of Fibre ..85 Appendix D: Food Sources of Iron ..88 Appendix E: Gastric Bypass Food Guide Pyramid ..91 Appendix F: My Menu Planner ..92 Appendix G: Low Blood Sugar (Hypoglycemia) after Bariatric Surgery .

5 93 Appendix H: Helpful Resources ..94 TEAR-AWAY SHEETSB ariatric Surgery Support Group .. Life after weight loss Surgery (flyer) ..97 Eating Explored: A Skills and Therapy Based Group (flyer) ..99 Estimated Costs for Bariatric Surgery ..101 Questions for your Bariatric Team ..103 Tracking your Weight Loss Progress ..105My Emotional Food Journal ..107 Sample Menu - 800 Calories ..109 Sample Menu - 1000 Calories ..111 Sample Menu - 1200 Calories ..113 Sample Menu - 1500 Calories ..115 Sample Menu - 1800 Calories ..117 WHAT S INSIDEH umber River HospitalPage 4 The Approval ProcessWHERE DO I BEGIN?

6 Bariatric SurgeryYou attend a pre-screening start Optifast as per the surgeon s instructions (2 to 4 week before Surgery ).You have a 2nd visit with the surgeon - receive Surgery date and buy Optifast .You have an appointment with the medical have an initial assessment or reassessment with the nurse, dietitian, social worker/ Team attend a 3-hour information session and submit assigns you to the Bariatric Centre and meet with the surgeon and have pre-op blood work or nurse practitioner submits a referral to the Ontario Bariatric Network (OBN)You receive appointment dates within 10 to 12 weeks (note: it may take 4 to 6 months until your initial assessments).

7 You are triaged based on your primary care doctor and the patient River HospitalPage 5 Who is part of my Bariatric team?You are the number one member of the team! You have come to us to receive help with losing weight and learning how to live a healthier do I meet my Bariatric team?Before the surgeryYou will first meet with the Bariatric team to help decide if Bariatric Surgery is right for : After you attend the Information Session and decide that you want to proceed with the Surgery , the surgeon is usually the first member of the team you will meet. Your surgeon: Explains the various surgical options available and discuss risks and complications of each.

8 Does a brief medical history. Gives you an overview of how you will proceed through the Nurse ( nurse or RN ): The nurse: Makes sure that you are medically stable and healthy enough to proceed with Surgery . Refers you to the right resources, either within the Hospital or in your community, based on their assessment Works with our medical team and your family doctor to ensure you have a continuity of care as you move through the : This doctor does additional tests to make sure that you are medically stable for Bariatric Surgery . It continues the nurse s medical Dietitian ( dietitian or RD ): The dietitian: Discusses your past attempts at weight loss, and helps you understand why traditional diets have not worked.

9 Asks why you feel this Surgery will work for you. Assesses your current diet by doing a diet history and looking at your relationship with food. Educates you on healthier eating behaviors. Assesses your bloodwork and makes recommendations to your supplements based on the results. Social Worker (SW): The social worker: Spends time getting to know you better, as a person. Asks about support systems, both personal and professional. Looks at your mental health history. Helps you figure out if you are able to afford the miscellaneous costs associated with the Bariatric TEAMR egistered Nurse (RN)Registered Dietitian (RD)Social Worker (SW)PsychiatristSurgeonInternistThe most important member of the team is YOU!

10 For more information on body image and support systems, see Psychosocial Perspectives on page River HospitalPage 6 Psychiatrist: If your social worker feels you would benefit from an assessment by our Program psychiatrist, they can refer you. This referral does not mean that we do not consider you a good candidate for Surgery . It is simply an additional assessment that may help us better prepare you for the lifestyle changes associated with the Surgery After your Surgery , you must attend various follow-up appointments. This is an up to 5-year relationship with your Bariatric team that will help you reach your weight loss goals and keep Bariatric TEAM My Appointments At-a-GlanceWhen do I see NurseRegistered DietitianSocial Worker/ PsychiatristInternist Before Surgery 24 HOURS after Surgery 2 WEEKS after Surgery 1 MONTH after Surgery In class3 MONTHS after Surgery 6 MONTHS after Surgery 9 MONTHS after surgeryAs needed1 YEAR after Surgery Once a year for up to 5 years For information on recommended blood