Blog moved

Please note that the NoScales blgo, the blog for Dr Hekier and Dr Keilin, has moved to a new website.
The address is http://blog.noscales.com

Oprah fell off the wagon and gained weight.

Don't let it happen to you.
Today Oprah very courageously talked about her continued battle with her weight and how she has had struggles. (Oprah's struggle with weight.)
She points out that she lost the most weight ever on a liquid diet that she stayed on for four months. Yikes, no solid food for four months, that doesn't sound healthy.
She says she celebrated losing weight on her liquid diet by eating, and two days later gained so much weight she couldn't fit into her jeans.
This points out what we have said all along about diets. Diets often don't work because they do nothing to control your hunger.
If you have the Lap Band, you have a great tool. The Lap Band will help you with your hunger. You still need to do a lot of hard work, you need to eat proper foods, and eat a proper portion size. You must exercise appropriately. You have a lot of responsibilities, but you have a great tool to help you reach your weight loss goals.
Don't fall off the wagon. Use the Lap Band, your tool for weight loss.

Lap Band questions

As we approach the new year, we have been contemplating some changes to our blog. We are planning on having regular contributions by the doctors and staff. We realize that for some people there are questions they might have that aren't getting answered elsewhere with regards to Lap Band diet and food choices, or Lap Band post op surgery expectations. We are putting together a list of topics to address in January 2009 so we wanted to hear from you. Leave a comment, what LapBand topic do you want us to talk about?






And here's a bonus. However can first tell us the name of sculpture shown in the picture above and where the original is located, will get a free copy of the book and DVD "Walk Away the Pounds" by Leslie Sansone. Good luck!

Best exercise for weight loss and fitness - Indoor Rowing with Xeno Muller.

Having the Lap Band weight loss surgery helps limit the amount of food you eat. But that is only one piece of the puzzle. You need to exercise to lose weight. Everyone has a different approach.

Many patients try to walk to burn off the calories. The problem with walking is that for many people it just does not burn enough calories. A 200 pound person walking at 3 miles per hour will burn 150 calories in about half an hour. The same person using a rowing machine with light effort can burn 300 calories in just half an hour! And moderate effort on the rowing machine can burn more, 350 - 450 calories per half hour.

Also, many of our patients can't walk far because of arthritis or back pain, knee pain ,or hip pain. A rowing machine is non-impact and easy to use without stress or strain on joints. Let me tell you a personal story:

A few months ago, my father visited us in Texarkana. He had recently had a knee injury playing tennis, and had torn his ACL (anterior cruciate ligament). My dad had not had surgery to fix it yet, and hadn't exercised for some time. I suggested he try the rowing machine I have at home. He got on the machine and rowed for quite some time, working up a sweat because he hadn't been able to exercise in so long. Even with a torn ACL, he had no limitations on the rowing machine and was able to achieve the entire benefit of a rigorous exercise with no knee pain.

Indoor rowing is a fantastic activity that you can do at your own home in all types of weather, so there is no excuse to not do it! It exercises your entire body, enhancing your cardiovascular fitness, leg strength, arm and back strength, and as well as exercising your lower back and abdominal muscles.

While trying to learn more about indoor rowing for exercise I came across Xeno Muller's website at http://www.gorow.com/. (The webpage may be slow to load, you can also try his blog at http://indoor-rowing.blogspot.com/) I ended up getting his training DVDs which I use.

Xeno Muller is a dedicated father, a two-time Olympic medalist in rowing (technically called single man sculling) and now coaches indoor rowing at a gym in Southern California. One of the rowers he recommends is the WaterRower, and if you want to learn more click here: http://web.me.com/xenoralfmuller/Site/WaterRower_Shop.html .

Click on the video on that page, and note that the rower is so quiet that his infant son is watching the TV while he is doing his workout!

Get the exercise machine that you can do indoors and year round for weight loss and fitness!

(Note - I have absolutely no financial ties to Xeno Muller or WaterRower or anything else mentioned on this page! My endorsement is based upon my own personal belief! Get rowing!)

Smart Lipo Laser Liposuction

More patients are asking about SmartLipo and having the procedure done. As you might know, we brought SmartLipo to Texarkana while looking for a solution to touch up small areas of fat remaining in areas such as the chin, arms, or abdomen. We have had several of our Lap Band patients undergo the procedure and also have many new patients. The laser lipolysis achieved by the SmartLipo machine destroys fat cells and allows for skin tightening as well. The ideal candidate is someone close to their ideal weight who wants to have one or more body areas sculpted and it has been popular with both men and women. The procedure is done in the office and you are awake for the entire procedure. So unlike regular liposuction in the hospital or surgery center, you don't need general anesthesia. Many patients go back to work within a day or two after having the procedure done. More information can be found on our site for Texas SmartLipo.

Lap Band nutrition tips, from our Lap Band group in Texarkana, serving Texas, Arkansas, Oklahoma, and Louisiana.

Here it is, from Amy Carmelli, registered dietician Part 2 of her 3 part series on nutrition.
Vitamins, Minerals, and Water
The forgotten nutrient


We all know we need vitamins, minerals, and water to survive, so why is it that we often forget their importance?

Vitamins are essential, organic substances that we need in our diet for normal function, growth, and maintenance of body tissues. Vitamins are essential in our diet and without them our health can decline. Vitamins are divided into two forms – water soluble and fat soluble. Water soluble vitamins are B-vitamins and vitamin C. Water soluble vitamins taken in excess are excreted from the body in urine. Water soluble vitamins are also destroyed during cooking process. To decrease destruction of water soluble vitamins, it is recommend that we steam, stir-fry, or microwave foods that are high in water soluble vitamins. Fat soluble vitamins are Vitamins A, D, E, K are stored in our bodies so we are less likely to be deficient in these vitamins. Fat soluble vitamins provide a variety of functions in our bodies.
Minerals are divided into two groups – major and trace. Minerals come from plant and animal sources. They are vital to one’s health. Minerals we hear about most often are calcium, sodium, and potassium. Calcium, we all know, is essential to bone health. We need between 1000-1200 mg of calcium per day. Good sources of calcium are milk and milk products, canned fish, and fortified orange juice. Sodium is often associated with hypertension (high blood pressure). Sodium is found in numerous foods – table salt, processed foods, chips, condiments, and sauces. We only need 1200-1500 mg of sodium a day. Many of us take in more than 4000 mg of sodium per day. Recommendations to decrease sodium in your diet include limiting processed foods and chips and using alternative low sodium seasoning when cooking. Potassium is another mineral we often here about. Potassium can be found in various foods – potatoes, tomatoes, beans, bananas, orange juice, milk, meat, and whole grains. Potassium must be balanced in our diet – too much or too little can cause life threatening side effects.
With vitamins and mineral both, the key is not too much and not too little of any one thing. For people who have had a lap band, vitamin/mineral supplementation is necessary due to the decrease portion sizes. Check with your doctor/surgeon or your dietitian if you question if you are taking the right vitamin/mineral supplement.

Water is often the forgotten nutrient. Water is one of the most important nutrients we take in. It helps with sodium-potassium pump, temperature regulation, and removal of waste products. We are often surprised by the amount of water we need versus the amount of water we actual drink. Adequate intake of water for most adults is 9 cups per day (1 cup = 8 ounces). Inadequate water/fluid intake leads to dehydration. Even mild dehydration increases fatigue and impairs performance. The key to help insure adequate fluid intake is to drink water throughout the day. You can not wait till the end of the day to drink 6-8 cups of water. Plan to drink 2 cups between each meal and before bedtime. This will insure adequate hydration.
Don’t forget the forgotten nutrient!
Next month – “Putting it all together to make a health diet”.
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Notes from Dr Ron Hekier for our lap band surgery patients:
1)For vitamins, consider the "Vitaband" from Bariatric Advantage that can be found on the Bariatric Advantage Estore. This vitamin was specially formulated for Lap Band patients.

2)For water intake, be wary of the various vitamin waters and sports fluid replacement drinks. They may have many calories and you might have the unintended result of taking in more calories than you planned on. Plain water is the best, and no need to buy bottled water. Tap water is just as good, and in fact some bottled waters that you buy in a store are simply bottled tap water!

Lap Band fills.

From Dr. Rachael Keilin:

A word about Lap Band fills. When we see patients in our clinic in their routine follow up after Lap Band surgery they are often very interested in fills; how much they have, how much they will get today, how much they can have altogether. Dr. Hekier has said it before, but I think it bears repeating: fills are as individual as shoe size. One size does not fit all. One person can have a single fill and have no hunger between meals. Another person may need three, even five fills after their surgery to get to their “sweet spot.” (See the earlier posts on lap band surgery fills and lap band surgery sweet spot.) And also remember that there are five different sized bands out there and each one takes a different volume of fluid. Weight loss is individual for each person.

There is also a phenomenon we see fairly often, but really can’t explain well. Some people will have a delay in the “tightness” of a fill by as much as two weeks. This is why we won’t fill one day and then fill again three days later. Because there is sometimes a lag in the perception of hunger after a fill (and remember: it’s hunger control we’re aiming for, not bulimia!), we don’t want to end up over-filling patients, especially if they live out of town. Spitting into a cup is just not fun. You're meant to have gradual weight loss with the Lap Band from eating less. You're not meant to be on a liquid diet or pureed food diet. We want to eat more or less a regular diet, just eat a smaller amount of food so that you can lose weight.

While filling the band is certainly important, it is not the only reason we want to see you in the office and it is not the object of every visit. Based on what we hear you telling us about hunger, eating habits, frequency of productive burps (PB’s) and what foods you are-and aren’t-able to take in, we’ll decide whether to fill or not. Remember, sometimes it’s the mind that has to be adjusted, not just the lap band.

Don't forget to visit our site at Texas Lap Band.