So what is acid reflux disease? Acid reflux disease is short for gastro esophageal reflux disease often referred to as GERD. Acid reflux occurs when the acid content found in the stomach returns to the esophagus. If this happens several times weeks then you have to deal with this issue which is very common among many individuals of any age today. As a matter of fact, infants and elderly people are prone to having acid reflux and this is particularly due to the diet regime that the individual goes through during the day.

I suffered from this disease not realizing what it was until rushed to the hospital in an ambulance after experiencing a severe case of it while at a client’s home. This client was a registered nurse and she thought I was having a heart attack. At the hospital I went through about 3 days of testing before they determined it was GERD and not a heart attack.

From personal experience I can tell you that GERD can be very painful. While antacids can often bring comfort to a mild case of acid reflux they can also create a worse condition.  The only thing that can be done to attenuate this illness in some way is by following a specific diet avoiding certain foods and drinks that could trigger the acid to form such as citrus, caffeine, alcohol, anything fried or full of fatty substances like onions, garlic and fried potatoes. You know, all of those good things so many of us enjoy.
Not only foods and beverages are to blame for this health issue, but even the kind of lifestyle one chooses to live in. For instance, people who smoke, drink or who are constantly overweight are more prone to suffering the devastating consequences of acid reflux. Following the right change in the lifestyle habits of these individuals could save them from having a burning sensation in the stomach and ease the complications that consequently come out of it.

There are some other activities that one takes for granted too that could bring forth some uneasiness in the esophagus such as lying down after having a meal in the middle of the day, eating big meals all at once instead of pacing it a little at a time. Even bending forward or picking up heavy weights are all acid reflux triggers to pay very particular attention to.

One must also consider the genetic factor which plays a fundamental role. Some individuals belonging to the same family could have the same issues related to this health symptom that if not treated or put under control could worsen and be more serious condition known as heartburn. This is a grave form of acid reflux in which the excruciating pain can be felt in other parts of the body such as in the upper chest area.
After spending several years on medications to control my GERD I had gastric bypass surgery, not because of the acid reflux but because I just could not control my weight with diet. I was told that weight loss surgery helped control GERD, diabetes, high blood pressure, high cholesterol, sleep apnea and a lot of other health problems. Having had my gastric bypass surgery over a year ago now I can tell you that I have not experienced GERD since. Additionally my cholesterol is not completely normal, I no longer use a CPAP machine for sleep apnea, my blood sugar levels are normal and my high blood pressure is completely under control. I may be nearing 70 but I am in better health today than when I was 50.
Am I telling you to have weight loss surgery for your GERD? Absolutely not, weight loss surgery is serious business and not the best way for everyone to lose weight. While I am please that I had the surgery and have experienced so many benefits from it you still want to know all of your options before you go under any type of surgery. Once you do I am sure you will make the best choice for yourself.

As fat people most of us have heard over and over again that learning self control is the best way to control our weight. This is no doubt true yet many of us still have difficulty controlling our weight by self control alone.

For some people there are medical conditions that make self control alone more difficult. I am a true believer that heredity and the environment we grew up in also plays a very big roll in our ease or difficulty in losing weight. Even with these conditions if we are able to maintain self control and eat less we are going to lose some weight and maintain a lower weight.

We can also lose weight by eating more instead of less. The trick here is eating more of the right foods and less of the wrong foods.  By having a better understanding of what we are putting into our mouth and learning to take control we can certainly do a better job of controlling our weight.

Exercise is another way of controlling our weight. With or without weight loss surgery exercise is one of the most important things we can do to improve our health, lose weight and maintain our weight. We need not work out at the gym for 3 hours a day.  Exercise is easy really, just physically do a few of the things that you would use an exercise machine for. Get a push mower instead of a ride on. Wash your dishes by hand instead of using the dishwasher. Walk to McDonalds for your diet coke and Big Mac instead of using the car. [well just skip the Big Mac and fries] Vacuum the house yourself instead of using a maid service. Use the stairs. If you like to go to the gym stop looking for a parking spot next to the front door and instead warm up by walking from a distant space in the parking lot. Avoid the gym and instead take an evening walk after dinner.

The third easy way to lose weight is to worry and fret about it. No, scrap that, but how about setting realistic goals for yourself that you can easily achieve. Do not use huge unachievable steps but little incremental advances to your goal weight. Do not cut out everything at once but break down your goals into daily and weekly things to do. For instance, how about replacing your snack chocolate for a nice healthy apple and going for a 15 minute walk every morning before breakfast. You are the best person to decide on these things but discipline yourself to do it and carry it through. As you succeed at each goal you will gain more confidence and be more assured of success. That is why it is so important to use small achievable goals. Forget about trying for the impossible.

What ever way you choose, just do it and you will be glad that you did!

According to the CDC – Center for Disease Control a person is considered obese when his or her weight is 20% or more above normal weight. The body mass index or BMI is the most common measure of obesity.  A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30. “Morbid obesity” means that a person is either 50%-100% over normal weight, more than 100 pounds over normal weight, has a BMI of 40 or higher, or is sufficiently overweight to severely interfere with health or normal function.

Weight loss surgery from lap-band to gastric bypass continue to grow in popularity. In the United States alone over 200,000 individuals a year are now having bariatric weight loss surgery. While these numbers are big weight loss surgery may or may not be right for you.

There are many factors that each person needs to consider when they are trying to determine if weight loss surgery is right for them. There are also a number of factors that your physician is going to consider to determine if you are a good candidate for this type of surgery.

A major factor is your current weight.  It is extremely common for a bariatric weight loss surgeon to require that their patients be at least eighty pounds overweight and have a BMI equal to or greater than 40. Naturally the same requirements are not going to be in place for the person that is 4’ 9” and the person that is 6’ 9”. If you are not morbidly obese you may not even be able to undergo a weight loss surgery.  That said, not being able to undergo surgery does not mean that you cannot lose weight as surgery is just one of the approaches to weight loss.

To be a good candidate for weight loss surgery you must also be able to demonstrate to your physician and yourself that you can lose some weight by healthy eating, exercise and traditional dieting. While weight loss surgery, like gastric bypass surgery or lap-band surgery, is a valuable tool it is just that and if you are not motivated enough to lose some weight without surgery you are likely not a good candidate for bariatric surgery.

Another factor that you should take into consideration, when determining if weight loss surgery is right for you, is your health.  If you are overweight, have health problems such as diabetes, arthritis, high blood pressure, heart problems, high cholesterol or sleep apnea surgery may be a good choice as is often corrects these health problems. For some individuals with these and other weight associated health problems weight loss surgery may be lifesaving.

The surgery that you would like to undergo is an important consideration in determining whether or not weight loss surgery is your best option. The two most popular surgeries are gastric bypass and lap-band. Both of these surgeries are used to create a smaller stomach. In simple terms gastric bypass surgery requires the stapling of the stomach to create a small pouch, lap-band surgery involves an adjustable or removable band that is placed around the stomach to create a smaller pouch. When deciding which weight loss surgery you should undergo, your decision will need to be made in conjunction with a healthcare professional.

Since weight loss surgeries reduce the stomach pouch size you will be eating a lot less. Failure to eat properly can result in this smaller pouch continuing to get larger and the patient actually regaining much if not all of the lost weight. For that reason, you must be willing and able to follow all instructions.

You will be required to undergo a psychological profile to determine if you will be a good candidate for surgery. Do you become depressed easily and if so how will this affect your success. Following surgery the attitude of most people changes for the best as their image of themselves and the way other people see them improves. For some individuals though psychological problems may result in depression and patients have even been known to become suicidal.

Age is also a consideration for weight loss surgery. Most bariatric surgeons have age requirements covering both those that are too young and those that are too old. I was just a week short of my 67^th birthday when I had gastric bypass surgery. For me it worked out great yet I was at or near an age where many physicians would not have performed the surgery.

Following weight loss surgery, like lap-band surgery or gastric bypass surgery, your healthcare professional will have you on an exercise and healthy eating plan that will usually include a lot of protein.  It is important that you follow all advice given to you. With weight loss surgeries that involve the reduction of the stomach pouch, an over consumption of food can be harmful to your weight loss, as well as dangerous to your health.

The information presented cover many of the facts that you will want to consider in determining if weight loss surgery is right for you. In many communities medical professionals will hold free seminars where these surgeries are discussed. I would strongly encourage each of you considering this surgery to call a bariatric surgeon or surgery center in your local and obtain more information. Once you and your physician have all of the facts it will be much easier to determine if weight loss surgery is right for you.

Next month is my 50^th high school class reunion for Rancho Alamitos High School in Garden Grove, California and I am looking forward to attending. While I certainly won’t be the slimmest person there I will weigh a whole lot less than what I did when I graduated in 1959.

Some of the good news since my weight loss surgery is that I weigh nearly one hundred pounds less than I was at my heaviest weight and feel great.

Before the gastric bypass surgery I had sleep apnea and slept with a CPAP machine. The machine now just collects dust for it is no longer needed.  Where I used to take several medications for high blood pressure I now only take a small dose of medication as a precaution and absolutely no other medications. I used to take a lot of medication for back and neck pain I went off of it a couple of months before my weight loss surgery in order to prepare for the surgery. It has now been over a year since I have had any pain medication not even a Tylenol. Where I used to have a problem with GERD gastroesophageal reflux disease it is no longer a problem and I have not needed any medication for it.

I can now work in the yard, go for a long walk and climb stairs and do not tire easily. I can bend over and tie my shoes and if fact can even look down and see my feet. I can set in a booth at the restaurant or in an airline seat without the embarrassment of asking for a belt extender.

Some people experience side effects after gastric bypass surgery such as nausea, dehydration, food intolerance, Dumping and bowel problems, and depression. I am happy to say that I have not experienced those problems. Where some people fart a lot after gastric bypass surgery and I may be an “Old Fart” I have not experienced an excessive farting problem. (Knock on wood.) While some people experience

My one-year follow up with the doctor will be next week and while I expect to be chastised a bit for not exercising as much as I should or getting those last 25 to 40 pounds off I really do feel good about my self. The thing I am perhaps the most anxious about is wondering how my blood tests turned out. In the mean time I am happy just being chubby instead of morbidly obese.

For those of you not familiar with Bariatric Advantage, they provide a complete line of nutritional supplements that have been specifically formulated to meet the unique demands of both the pre-operative bariatric surgical candidate and the post-operative bariatric surgical candidate. I learned about this company through my own bariatric surgeon prior to surgery in July 2008. I have since use the products and have been extremely pleased.

Thia new assistance program will be administered through a 501(c) (3) accredited foundation(s) or charity(s). Bariatric Advantage expects to be able to serve the vitamin needs of 500-1,000 patient’s in 2009, and expects the program to expand even larger in 2010 and beyond.

Tom Kinder, CEO of Bariatric Advantage stated, “We are grateful to the bariatric surgical and patient marketplace that we have been serving since 2002 and welcome this opportunity to help those patients and programs to “Recover” and to maximize their outcomes from this new lease on life”

The program details including the process required to participate in the “Recover” program will be available by July 20, 2009. If you are interested in learning more CLICK HERE by doing so you can go ahead and submit your information at this time.

The body does not store much thiamine, thus it can be rapidly depleted. Individuals deprived of thiamine will begin to express deficiency symptoms in about a week. Because of the wide-spread presence of thiamine in a varied diet and its general high bioavailability, deficiency — called Beriberi — is rare in the general population. Inadequate intake is typically only seen in underdeveloped countries or areas of famine. In countries where there is endemic malaria, there is some evidence that malarial infection may increase thiamine demand to a great enough degree for deficiency to manifest. Some foods are known to contain anti-thiamine factors (ATFs). These include coffee, black tea, betel nuts, blueberries, cabbage and Brussels sprouts. Rarely are people able to ingest enough ATFs to induce thiamine deficiency. However, if there is high ingestions of ATFs coupled with low food intake or overall low nutrition intake, this has been known to occur.

Alcoholism is the primary cause of thiamine deficiency in the developed world. This is both due to the ability of the ethanol to block thiamine uptake as well as the high correlation of alcoholism with poor nutrient intake. It may also be associated with eating disorders such as anorexia or bulimia nervosa, fad diets, and peritoneal dialysis.

The growing popularity of weight loss surgery has created a new axis for thiamine deficiency. While there are few reports in medical literature, thiamine has become a topic of increased interest and suspicion. In the case of weight loss surgery, especially gastric bypass, there may be more than one factor that plays into thiamine deficiency. The greatest risk appears to be in patients who develop vomiting or are unable to consume adequate amounts of food in the early weeks or months following surgery. This is compounded by a generally increased body demand for thiamine with any surgery, decreased food intake, and bypassing of key areas of vitamin uptake. Patients who undergo more rapid or greater than expected weight loss may also be at increased risk. There are reports of chronic deficiency as well, associated with alcohol intake, lack of supplementation and onset of poor eating habits . Subsequent development of anorexia or bulimia following weight loss surgery, would be a significant risk for thiamine deficiency, and has been reported in literature .

Thiamine has many important functions in the body but is especially critical for energy production and nerve transmission. For this reason Beriberi reflects problems related to high-energy need systems (the heart and brain) as well as nerve function. There are three classes of Beriberi: dry, wet and cerebral (Wernicke-Korsakoff Syndrome). Very mild deficiency presents with vague symptoms such as fatigue, weakness, and difficulty concentrating. With dry Beriberi (which is most common), patients may complain of vomiting, loss of appetite, weakness, sleepiness, burning feet, calf and leg pain, abdominal pain, constipation, headache and cramping. Peripherial polyneuropathy is also common, and this is one reason that a presumptive diagnosis of B12 deficiency should not be made in a gastric bypass patient in the absence of supportive lab data. The neuropathy on thiamine deficiency begins with fatigue and loss of sensation, pain, and “heaviness” in the legs. Then pretibial edema develops, along with glove-and-stocking paresthesias and difficulty with tasks such as climbing stairs and standing on one leg . If there is involvement of the brain, mental confusion can be a prominent symptom. While this can be severe enough to include symptoms of delusion, hallucination, or psychosis, more mild symptoms are confabulation, memory impairment, eye dysfunction such as double vision (due to optic neuropathy), inability to walk or stand, or waddling gait. Wet Beriberi presents with symptoms of congestive heart failure. This would be less expected in post-operative weight loss surgery patients as it most often results from excessive over eating of carbohydrate.

Laboratory evaluation of thiamine status should be considered in patients with any suspect axis of deficiency (vomiting, anorexia, etc) or in those presenting with symptoms. Serum thiamin will find moderate to severe deficiency, but is not appropriate to follow treatment as it responds too rapidly to supplementation and will correct before the deficiency itself is corrected. Erythrocyte or whole blood transketolase activity is the most accurate assessment of both deficiency and progress, but may be hard to obtain through some labs. Urinary excretion appears to be relative accurate. Pyruvate levels below 1mg/dL is also considered to be reliable . One may also want to check TSH (to rule out hyperthyroidism as a cause of thiamine deficiency), serum folate (low folate is an indirect cause of thiamine deficiency) and liver enzymes (to rule out occult alcohol abuse).

Generally, thiamine will replete rapidly. Case reports with gastric bypass patients have demonstrated that doses of 100mg IV or IM thiamine for one week, or alternately 100mg tid of an oral thiamine for 2 weeks, together with a multivitamin containing B-complex can correct deficiency . Patients should then be able to maintain with a B-complex or B-complex containing multivitamin assuming that the cause of the deficiency has been addressed.

Bariatric Advantage is pleased to introduce our new 100mg Thiamine capsule. This product is in a small, easy to swallow and digest two-piece capsule (which could also be emptied into liquid or soft foods). All of our Multivitamins contain comprehensive B-complex with 6 mg of thiamine (400% of the RDA)in our chewables and 10mg (667% of the RDA) in our capsules.

Grace DM, Alfieri MA, Leung FY. Alcohol and poor compliance as factors in Wernicke’s encephalopathy diagnosed 13 years after gastric bypass. Can J Surg. 1998 Oct;41(5):389-92.

Bonne OB, Bashi R, Berry EM. Anorexia nervosa following gastroplasty in the male: two cases. Int J Eat Disord. 1996 Jan;19(1):105-8.

Sewell AR, Recht, LD. Nutritional Neuropathy. http://www.emedicine.com/med/topic221.htm, accessed 25 May 2005.

ibid.

Towbin A, Inge TH, Garcia VF, Roehrig HR, Clements RH, Harmon CM, Daniels SR. Beriberi after gastric bypass surgery in adolescence. J Pediatr. 2004 Aug;145(2):263-7.

All About Thiamine
by Jacqueline Jacques, ND
November 14, 2005

The other day I visited the doctor that performed my gastric bypass surgery. This was my 3-month follow up and I must report that all is going well. Since I started preparing for bariatric surgery I have lost about half of my excess weight. While I am certainly anxious to loose a lot more weight the drop will likely be slower from here on out. My body mass index BMI has dropped about 40 percent from my first visit to the Oregon Weight Loss Clinic. For those that may not be familiar with the BMI scale it works as follows:

BMI Range and Rating

Underweight 16.5-18.5

Normal 18.5-25

Overweight 25-30

Obese Class I 30-35

Obese Class II 35-40

Severely Obese 40-45

Morbidly Obese 45-50

Super Obese 50-80

Hyper Obese above 60

I started out being classified as Morbidly Obese and am now classified as Obese Class II. The important thing for all of us to remember is to try not to get caught up in all of these classifications. As you will see there is not a classification for Terminal Obesity. Terminal Obesity is a term to remind us that many of the diseases caused or exacerbated by obesity lead to early death.

Many people say why don’t they just call us fat instead of all of these gloomy names. The truth is I do not have a good answer for that other than to say that these obnoxious terms can be an incentive for each of us that has a weight problem to loose a few or a lot of pounds.

Speaking for many of us that are either dieting the traditional way or have had weight loss surgery we can get to our goals. We can get to where we are just a bit obese or even normal weight. It may take time but going down is certainly better than going up.

Below are a couple of pictures the one was taken just before my wife passed away due to complications to diabetes. The other picture was just taken and while I am still fat I am pleased at the progress that is being made. I know by site statistics that thousands of people are visiting Terminal Obesity each month though they are not posting. I would love to have you most and am sure that others are tired of hearing about me and would like to here your success stories so please email me with your stories and pictures so that we can share them with others.

It’s not about body mass index or BMI, height and weight charts, or even how much you weigh. At issue here is your outlook concerning weight loss and the problem weight loss surgery can address.

If your hunger and focus on food is constant even when eating then surgery may be for you. Bariatric surgical procedures have been known to quiet the food monster inside many people. We’re talking about folks who, for whatever reason, think about food and have hunger pangs sometimes even when eating. Emotional eaters will need to recognize that food will no longer be available as a source of comfort and this can lead to other problems unrelated to surgical weight loss.

Understand that surgery has its benefits if the grand scheme of things is to lose weight. Many bariatric weight-loss surgery options like lap banding work to shrink your stomach. Some use laparoscopic techniques to place a band around your stomach that constricts the amount of food that you can eat at any one time. This band results in something similar to a figure 8. The top portion of your stomach is much smaller than the lower section, giving you a feeling of fullness with just a few bites of food.

Despite our many of our thinner brethrens claims that obesity is simply a lack of self-control, research has proven time and again that weight gain is much more complex. A person’s weight has as much to do with their emotional state and previous upbringing as it does with what is actually eaten.

Evidence of this can be seen in food selections made by people in highly emotional or stressful situations. It’s almost a cliché that a woman dealing with a recent romantic breakup will reach for chocolate or the proverbial chocolate chip cookie dough ice cream.

No weight-loss surgery can help with this type of emotional eating situation. It will not deal with your weight problem once and for all. Surgery is a tool to help you eat less, though it’s possible to out eat the benefits. Remember that the only true way to lose weight is to eat less and exercise more. This surgery works to help you eat less but it is possible to out eat its benefits. Staying on a strict diet after weight-loss surgery however is much easier to do.

In the end, if you are emotionally prepared to live with food only as a source of fuel then weight loss surgery may be for you. You should be encouraged to continue to do research as any type of weight-loss surgery is a life-changing decision not be to undertaken lightly.