Gastric Wrap Brochure

7/28/2019 Gastric Wrap Brochure

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Gastric Picatio


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Cotets

What s gastc plcatn? 4

What yu can expect afte sugey 5

New eatng habts 6

1st stage iquid diet 6

Sampe meu or iquid diet or 1 da 7 2d stage pure diet 8

Sampe meu or pure diet or 1 da 9

Diet ater the ed o the iquid ad pure stages 10(rom the 6th wee ater surger)

Food pramid 11

Physcal actvty 12

Eercise at east 3 times a wee 13

Move about ever da 13

Aaerobic activities 13

Aerobic activities 14

Combie aerobic eercises with stregtheig oes 14

Yu ntes 15-18

Ntes 19


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3

Pf. MUD. Matn Fed, CSc.Head o Ciic

Dear Mr/Mrs/Miss,

O beha o the whoe team, I woud ie to tha ou or choosig OB iia or ourtreatmet. We are etreme peased about it ad our team o speciaists is read to hepou achieve the desired resuts o treatmet ad improve our quait o ie. We have aidividua approach to ever patiet, which is wh our specic treatmet programme wibe taiored to our heath eeds, ad wi be put together i such a wa that it meets ourepectatios as cose as possibe. OB iia oers ou the eperiece o severa eadigspeciaists obesit phsicias, diabetoogists, pschoogists, utritioa therapists, edo-crioogists, gastroeteroogists, surgeos ad more. The ciic uses the best equipmetad oers care o the highest Europea stadards.However, it shoud be acowedged that surger ad treatmet are just the start o theprocess, the aim o which is to improve our overa heath. To u this goa i the idea wa,it is ecessar or ou to acquire ew eatig habits ad comp with the recommeded

ieste chages. O the oowig pages, we woud ie to itroduce the geera dietarpricipes ad the ecessar phsica activit. We woud aso ie to acquait ou briewith the ature ad course o the treatmet ad the recommeded post-operative regi-me that ou shoud oow. As was metioed i the itroductio, our specic treatmetprogramme wi be taior-made accordig to our eeds. The purpose o the iormatiogive i this brochure is ot to repace the opiios or advice o a quaied medica persoa,but to provide ou with a brie guide and help to complement the medical recommendations. I the evet o a more detaied questios or ucertaities ad probems, ou must awascotact a doctor as soo as possibe.We hope that the iormatio cotaied i this materia wi be useu or ou, ad we trustthat together we ca improve our heath ad chage our ie.


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What is gastric picatio?

The surger is based o decreasig the stomach voume b its wa siig (ig, ivertig)iside the stomach space. The ew shape o the stomach is secured usig o-absorbetstitches or specia sma stapes. The resut o the surger is ot just decreased voume, butaso restricted abiit o the stomach to stretch. It probab aso eads to chage i creatioo digestive hormoes. The advatage o the operatio is that it is ot ecessar to itroduce(impat) a oreig materias or the og term, or is it ecessar to irreversib remove aarge part o a otherwise heath stomach, as is the case, or istace, with a simiar obesi-t operatio the so-caed seeve gastrectom. Ater picatio, the whoe stomach is ept,

which meas a urther beet to this surger, which is the possibiit to retur it to the origi-a state (reversibiit).

Usua, gastric picatio is iteded or peope or whom coservative treatmet has aiedrepeated, ad who have a BMI (bod mass ide) over 40. It is aso or peope with a BMIbetwee 35 ad 40, who suer rom diseases associated with obesit, such as diabetes, highbood pressure, etc.

Reduced space i the stomach

The wa is su (ed, iverted)iside the stomach space

Shrue stomachater picatio


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EnERGy BAlAnCE = EnERGy InTAkEEnERGy ExPEnDITURE

What ou ca epect ater

surgerThe immediate recover period ater surger is reative short. you ma ee ight cotrac-tions in our stomach or nausea and vomiting immediatel ater the operation. These smptomsca be easi reduced with medicatio. your hospita sta wi ot usua be oger tha24-48 hours. Ater goig home, oe o the most importat prerequisites or successu treat-met is the og-term adjustmet o our diet ad ieste. The resuts appear reativequic, ad ou wi usua ose about 30 g i the rst ear ater the surger. However,ou must reaise that the actua weight oss (decrease i iogrammes o weight) is ot the

most importat actor. The aim o obesit treatmet is primari improvig our overaheath ad aso prevetig improvig or u curig certai serious diseases coectedwith obesit. I the rst two ears, ou ca epect udameta improvemets, e.g., or tpe2 diabetes, high bood pressure, icreased choestero, ad seep disorders.

The idea resuts o appear i ou eep to the ieste chages, icudig phsica activitad ew eatig habits.

The most importat step o the path to weight reductio is the chage i our eergbaace. Eerg baace is the ratio betwee the amout o eerg ou tae i ad the

amout o eerg our bod gives out.


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new eatig habits

1st stage iquid diet

you must awas careu measure idividua portios to mae sure the do ot eceed 150 mlper dose.

150 ml f mlk

150 ml f juce

ruit (without pieces o ruit, pup, etc., just cear ruit juice, e.g., appe) vegetabe juices (without pieces o vegetabes, e.g., carrot)

150 ml vegetable/meat bth

strai through a sieve, o dri cear broth without pieces o vegetabes or meat, nlylqud!

150 ml unsweetened plan yghut

without cereas, pieces o ruit, etc.

150 ml pten dnk e.g., nutridri, Prosure, nutricomp, Dr. Sta-Dietlie shae, Modiast shae, dris

made rom whe, nutriie shae, soured dris, er ad soured buttermi

A iquids or driig shoud be o-caoric, o-carboated, ad o-acohoic. Driigwater ad tea is particuar suitabe.The rue or dris is aso a maimum o 150 m o iquid i oe go. you shoud eep to the ruedri more ote ad rom sma gasses. At the begiig dri rom teaspoos, with a straw,or tae sips.you must separate ood (eerg-dese iquids broth, mi, juice, etc.) ad dri (water, tea),to esure the maimum amout o oe portio is 150 m.

you shoud dri ast o-caoric iquids (water, tea) 30 miutes beore ood (broth, mi,juice, etc.). The ou shoud eat, wait 30 miutes, ad the dri ree (water, tea) to esureou driup t 2.5 ltes pe day. Nt me at ths stage!I ou use a MEDICInES reguar, ou must remember to CRUSH a medicies used durigthe iquid stage!Durig this stage IT IS nOT SUITABlE or ou to use other FOOD SUPPlEMEnTS or VITAMInS.Fizz preparatios i particuar are ot suitabe! The ca cause a eeig o uess, auseaad vomitig.

Afte a gastc plcatn, we ecmmend yu keep t ths egmen f 2 weeks.


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Sample meu or iquid diet or 1 da

Beakfast 6am 150 ml f apple juce

7am 75 ml f tea

7.30am 75 ml f tea

8am 75 ml f wate

Snack 9am 150 ml f mlk

10am 75ml f wate

10.30am 75 ml f wate

11am 75 ml f wate

Lunch 12pm 150 ml f clea bth1pm 75 ml f tea

1.30pm 75 ml f tea

2pm 75 ml f wate

Snack 3pm 150 ml f Nutdnk plan

4pm 75 ml f tea

4.30pm 75 ml f wate

5pm 75 ml f wate

Dnne 6pm 150 ml f vegetable juce

7pm 75 ml f wate

7.30pm 75 ml f tea

8pm 75 ml f tea

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Ttal lquds:

1,125 ml

5 meals pe day


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2nd stage pure diet

you must awas careu measure idividua portios to mae sure the do ot eceed150 ml per dose.

you ca repeat oods rom the iquid diet stage, but ou shoud aread epad our meuto icude more ood. However, o with a pured cosistec.

Yu can nclude, f example:

Mashed ptat

Mnced meat mxed nt mashed ptat

Bth (i vegetabe, the iquidised)Vegetable sup (e.g. spiach, vegetabe, lIQUIDISED)Gated apple, mashed banana, chldens fut snacks (without pieces o ruit),steamed fut (nly lqudsed)

Steamed gated cat

Chldens fd (read iquidised oods, e.g., Hami, HiPP)

Avoid oods which cause atuece, such as broccoi, cauiower ad puses. Aso avoid car-

boated dris ad acoho.

A iquids or driig shoud be o-caoric, o-carboated, ad acoho-ree. Water, tea(bac, gree, white or ruit), ersatz coee, water with sugar-ree ruit squash.

The rue or dris is aso a maimum o 150 m o iquid i oe go. you shoud eep to therue dri more ote ad rom sma gasses.

you must separate ood (eerg-dese iquids broth, mi, juice, etc.) ad dri (water, tea)to esure the maimum amout o oe portio is 150 m.

you shoud dri ast o-caoric iquids (water, tea) 30 miutes beore ood. The oushoud eat, wait 30 miutes, ad the dri ree (water, tea) to esure ou driat least2 ltes pe day.

Afte a gastc plcatn, we ecmmend yu keep t ths egmen f 3 weeks.


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Sample meu or pure diet or 1 da

Beakfast 6am 150 ml f apple fut snack

7am 75 ml f tea

7.20am 75 ml f tea

7.40am 75 ml f tea

8am 75 ml f wate

8.20am 75 ml f wate

8.40am 75 ml f wate

Snack 9am 150 ml f plan yghut

10am 75ml f wate

10.20am 75 ml f wate10.40am 75 ml f wate

11am 75 ml f wate



Lunch 12pm 100 ml mashed potato, 50 ml of minced meat mixed into

mashed potato

1pm 75 ml f tea

1.20pm 75 ml f tea

1.40pm 75 ml f wate

2pm 75 ml f wate

2.20pm 75 ml f wate

2.40pm 75 ml f wate

Snack 3pm 150 ml f mlk yghut mlk wthut peces f fut!

4pm 75 ml f tea

4.20pm 75 ml f wate

4.40pm 75 ml f wate

5pm 75 ml f wate

5.20pm 75 ml f wate

5.40pm 75 ml f wate

Dnne 6pm 150 mlf spnach sup

7pm 75 ml f wate

7.20pm 75 ml f tea

7.40pm 75 ml f tea

8pm 75 ml f tea

8.20pm 75 ml f tea

8.40pm 75 ml f tea

9pm 75 ml f wate

Ttal lquds:

2,325 ml

5 meals pe day


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Diet ater the ed o the iquid ad pure stages(rom the 6th wee ater surger)

The trasitio to a orma diet shoud be gradua.

Gradua icude 1 ew ood each da (i.e., oe ou icude ater surger the rst time).Wait uti the et da ad i the ood does ot give ou digestive probems (ausea,heartbur, heav eeig, etc.), ou ca cotiue to icude it.

Do ot use irritatig spices or carboated dris.

you ca icude everthig, but ou must chew ever mouthu eough. Watch out orhard pee, seeds, ad arge mouthus.

Squeeze citrus ruit or 2 moths ater the surger, the ater that ou ca icude thewhoe ruit.

Stic to the pricipes o a reductio diet (avoid ried oods, cream sauces, dumpigs,caes, pies, biscuits, sweet emoades, cream, ad att cheeses; white bread shoud berepaced with whoemea; icude i the meu sh, 1-2 pieces o ruit per da, eoughvegetabes, ow-at dair products, etc.).

keep to a drin diet o 2.5 litres o non-caloric liquids and more (a maximum o 150 ml in one go).

keep a three-hour gap betwee meas.

Have our ast mea 2-3 hours beore goig to bed.

Start to do sports as soo as our doctor aows it.

Mae sure the portio size is 150m!


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Food pramid

The ood pramid shows which oods shoud orm the basis o our diet ad which, o thecotrar, ou shoud avoid.

Fruits and vegetables orm the base o the whole pramid. The are a source o vitamins, mi-

nerals, and fbre. All these elements are benefcial or reducing our weight as well as or our

overall health. you should onl include ruit in the frst hal o the da, then vegetables at an

time o da. Bread, pasta, rice, cereals, and pulses, which orm the second level o the pramid,

are a necessar source o energ and fbre. The should constitute part o our menu ever da.

Aother essetia part o our diet is protei, which orms the third eve o the pramid.Proteis are oud i meat, mi, dair products, egg white, ad sh.you shoud choose ea meats especia (ea bee, ea vea, poutr, sh). you shoud oicude mi ad dair products with a at cotet up to 3 %. you shoud cocetrate osoured dair products. Seect those cheeses which have 30 % at i dr matter. you ca eata maimum o oe whoe egg per da (o ad white), because the o cotais a ot oat ad choestero.

The top o the pramid is made up o oods which are a source o at ad simpe sugars sweet oods. These oods shoud costitute the smaest part o our meu.


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Phsica activit

your weight is sigicat aected b both the ood ou tae (eerg itae) ad theamout o movemet ou mae (eerg epediture). So-caed basa epediture is theeerg which the bod requires to cover basic ie uctios, e.g., eerg used at rest, wi-thout activit. This represets appro. 70 % o the tota dai eerg epediture. For theremaiig 30 % ou ca either mae up with active movemet or sport, thus settig thewhee o metaboism i motio, or ou ca sta with basa metaboism ad ose weight

more sow.I our itae o ood is sudde restricted, ver soo (i the space o wees or moths),our bod wi adapt to the ow eerg itae with reduced basa epediture ad the dietwi become ieective. This process starts ever time the reductio diet is ot accompa-ied b icreased phsica activit. The eect o the reductio diet itse ma ast a mai-mum o 3-6 moths. The o wa ou ca prevet a a i basa epediture is reguarphsica activit.Phsica activit is a importat part o treatmet or ma diseases, ad is aso most ee-ctive or prevetio. The eect o phsica activit is ot just due to weight oss, but aso dueto the chage i bod compositio (the proportio o ea bod mass ad bod at). Actuaphsica activit without eepig to the basic dietar pricipes at east wi ot ead to og-

term weight oss. Whe seectig phsica activit, ou must determie what our mai goais. Whether ou wat to ose weight, improve our phsica coditio, or icrease muscemass. you wi eercise with dieret itesit i ou wish to ose weight, ad with dieret(greater ) itesit i ou wish primari to improve our phsica tess. It is ver importatthat ou seect the id o phsica activit that ou wi ejo, that wi suit ou, ad wicorrespod with our heath (weight, pressure o joits, high bood pressure, diabetes, etc.).you must aso thi about the itesit o the eercise. I ou are uused to eercise, startver careu. Reguarit o movemet is aso ver importat, because it is the o wathat ou wi gradua improve ad phsica activit wi be more eective. The heart rate isa idicator which gives a idea whether our seected activit has a aerobic ature adwhether it breas dow at. For ouger peope, it shoud ot eceed 140 beats/miute, or

midde aged peope 130 beats/miute ad or oder peope, 110 beats/miute.


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Eercise at east 3 times a wee

Eperiece ad epert iterature agree that reguar eercise ever other da is best. I ouhave breas betwee phsica activit oger tha three das, i essece ou are startigrom the begiig. The egth o the phsica activit is just as importat. It is eough orou to eercise aroud 40 to 50 miutes each sessio.At frst ou must extend the time or phsical activit graduall, e.g., b fve minutes each

wee, with a ver low intensit. Onl then is it worth ou increasing the intensit o our

activit.

Move about ever da

Phsica activit does ot just mea sport. This is a our phsica activit per da, which oushoud gradua icrease. A eampe coud be a sufciet og bris wa, as og as oudo ot put too much pressure o joits ad tedos, which is ver eective ad sufcietor our goa. you coud aso tr Ndc walkng.

Aaerobic activities

Aaerobic activit is eercise durig which the bod wors with isufciet oge itae.This is high perormace durig a short period, whe the bods oge reserves are usedup ad a oge debt is created. The activit is ocused o stregth.

Ths ncludes, f example:

eercise at a gm with weightspiatesbod buidigoganot o does aaerobic eercise icrease stregth, but aso stamia. Durig aaerobiceercise, the bod burs carbohdrates primari. It is suitabe as a additioa eercise ordieret tpes o sport. Ad, most o a, ver importat or stregth edurace traiig.


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Aerobic activities

It is phsica activit durig which the wor o musces ad metaboic processes tae pacewith sufciet oge supp. Aerobic activit is a eercise carried out with ow to medi-um itesit or a oger time ad with icreased heart rate (puse) requec. For eerciseastig oger, the bod begis to use at stores as a source o eerg.

Ths ncludes, f example:

aerobicsjoggigccig

spiigswimmig (eve i warm water)zumbawaignordic waig

Aerobic phsica eercise stregthes the heart ad is most eective or burig at. It isimportat to improve overa heath, ad aso the most suitabe or weight oss.

Combine aerobic exercises with strengthening ones

you ma have aread posed the questio o whether it is possibe to ose weight withoutecessive sports activit. It is possibe, but weight oss wi tae pace reative sow adueve. Eve gete growth o musce mass caused b phsica activit icreases basametaboism (restig eerg epediture). This meas that ou start to use eerg received

rom our ood more quic ad eective. you wi maitai the ower weight obtaiedthrough reguar phsica activit with ease. However, eercise must go had i had with aheath ieste, i.e., with a adjusted diet. you shoud ot just eercise, but eat heathi adreguar. With usuitabe eercise or too much pressure o certai parts o the bod, ou caicur heath probems. you must gradua ad eve icrease our coditio. Sometimesou get ew musce mass through sport, but the at o disappears ver sow. Paradoica-, our weight wi the icrease. A combiatio o aerobic eercise (with a ow to mediumitesit) with stregtheig oes is idea.Ater greater weight oss, ou ma eed cosmetic treatmet, especia aroud the abdome,egs ad arms. The ods o oose hagig si created ca be removed with pastic surgeridividua devised b a pastic surgeo. you ca aso udergo this surger at OB iia.

ruigba games i-ie satig

siiggoorieta dace


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your otes

notes o operatio checs

It is useu to eep otes about the most importat parameters o our heath, i.e., ourweight, bood pressure, ad heart rate. Through them ou wi get a picture o our succes-ses ad progress made. Chec our weight oce a wee. Size o oss o weight depeds ovarious actors, which are iitia weight, geder, metaboic rate, ad voume o musce mass.Bood pressure ad heart rate are the most importat idicators o heath ad we recom-med checig them reguar.

Emegency phne numbe f clents afte peatns: 255 725 125

iNiTiAL STATE BEForE SUrGErY

date o operatio weight beoresurger

bood pressure restig heart rate

15

Weight(g)

loss o weight(g)

Tota osso weight

(g)

Puse requecat rest

moodor

1stwee

2dwee

3rdwee

4thwee

Weight oss ater 4 wees


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Weight(g)

loss o weight(g)

Tota osso weight

(g)

Puse requecat rest

moodor

5thwee

6thwee

7thwee

8thwee


Weight(g)

loss o weight(g)

Tota osso weight

(g)

Puse requecat rest

moodor

9thwee

10thwee

11th

wee

12thwee



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Weight(g)

loss o weight(g)

Tota osso weight

(g)

Puse requecat rest

moodor

13thwee

14thwee

15thwee

16thwee


Weight(g)

loss o weight(g)

Tota osso weight

(g)

Puse requecat rest

moodor

17thwee

18thwee

19th

wee

20thwee



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Weight oss ater 26 wees(6 moths)

Weight oss ater 52 wees(1 ear)

Weight oss ater 78 wees(18 moths)

Weight oss ater 104 wees(2 ears)

FiNAL STATE AFTEr SUrGErY

Date o operatio Weight atersurger

Bood pressure Restig heart rate


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notes


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Wtten by: the OB iia teamPro. MUDr. Marti Fried, CSc., prim. MUDr. Petra rmov, Veroia JiraovCente f the teatment f besty and metablc dsdes

oB klnka a.s.Addess: Pod krejcrem 975, 130 00 Praha 3Phne numbe t eceptn: 255 725 111Emegency phne numbe f clents afte peatns: 255 725 125E-mal: [email protected]

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