Wiki-wls: Newbies guide to the galaxie - pre-op

Questions to ask your surgeon at your consult: questionstoaskyoursurgeon.html


Link to OHIP forms for OOC:  http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/Fo rmDetail?openform&ENV=WWE&NO=014-1442-84

List of NSAIDS

Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin)
Choline and magnesium salicylates (CMT, Tricosal, Trilisate)
Choline salicylate (Arthropan)
Celecoxib (Celebrex)
Diclofenac potassium (Cataflam)
Diclofenac sodium (Voltaren, Voltaren XR)
Diclofenac sodium with misoprostol (Arthrotec)
Diflunisal (Dolobid)
Etodolac (Lodine, Lodine XL)
Fenoprofen calcium (Nalfon)
Flurbiprofen (Ansaid)
Ibuprofen (Advil, Motrin, Motrin IB, Nuprin)
Indomethacin (Indocin, Indocin SR)
Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)
Magnesium salicylate (Arthritab, Bayer Select, Doan's Pills, Magan, Mobidin, Mobogesic)
Meclofenamate sodium (Meclomen)
Mefenamic acid (Ponstel)
Meloxicam (Mobic)
Nabumetone (Relafen)
Naproxen (Naprosyn, Naprelan*)
Naproxen sodium (Aleve, Anaprox)
Oxaprozin (Daypro)
Piroxicam (Feldene)
Rofecoxib (Vioxx)
Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)
Sodium salicylate (various generics)
Sulindac (Clinoril)
Tolmetin sodium (Tolectin)
Valdecoxib (Bextra)

Benefits of Bariatric Surgery Bariatric Surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective treatments for metabolic diseases and conditions including type 2 Diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea…. (read more (PDF)) Reprinted with the permission of The Cleveland Clinic Center for Medical Art & Photography © 2005-2009. All Rights Reserved

List of co-morbidities

1. Diabetes;
2. Neuropathy in feet, ankles, hands and lower arms;
3. Hypertension;
4. Family history of heart disease;
5. Family history of stroke;
6. Family history of Diabetes:
7. Family history of heart attacks;
8. Thickened heart walls due to weight/hypertension;
9. Intracranial hypertension (psudeotumor cerebra);
10. Migraines/Headaches directly related to obesity/cranial hypertension
11. Bells Palsy;
12. Cardiac Arrhythmias;
13. Ocular Hypertension;
14. High Cholesterol (hypercholesteralemia);
15. Elevated Triglycerides;
16. Hypothyroidism;
17. Excess Testosterone;
18. Excess Facial & Body Hair (Hirsutism);
19. Acne;
20. Rashes,
21. Chronic Skin Infections,
22. Excess Sweating,
23. frequent yeast infections;
24. Hormonal Abnormalities;
25. Infertility;
26. Polycystic Ovaries;
27. Dysfunctional uterine bleeding;
28. Amenorrhea related to obesity;
29. Incontinence related to obesity;
30. Lower Back Pain; and muscle spasams (can't stand/work in house for more than five minutes
without pain in lower back)
31. Ankle/knees swelling;
32. Shortness of breath upon exertion;
33. Decreased Exercise Tolerance;
34. Hip pain;
35. Heavy Snoring; (Sleep apnea test suggested by Dr. M. Margolis)
36. Acid Reflux;
37. Lack of Self Esteem;
38. Social Rejection;
39. Loss of Job Potential;
40. Inappropriate Coping Strategies;
41. Anxiety;
42. Severe Depression due to weight, inability to exercise, foot unable to heal properly because of weight, and health-related issues.
43. Fatigue;
44. Fluid retention;
45. Gall Bladder
46. Activity Intolerance; shortness of breath and severe fatigue even with minimal activity
47. Decreased endurance limiting daily activities, including, but not limited to; walking, housework, working, dressing, standing, getting up, bathing, sitting, travel
48. Depression related to difficulty coping with frequent failures at diet attempts
49. Frequent constipation alternating with frequent diarrhea
50. Stress incontinence
51. Fibrocystic breast disease
52. Abdominal gas and frequent nausea
53. Hemorrhoids
54. Personal history of colon polyps
55. Family history of (Fill in the blank)
56. Symptomatic ventral hernia;
57. Congestive Heart failure
58. cardiomyopathy;
59. Heart Attack
60. CPAP
61. Stroke
62. Heel spur surgeries
63. Knee surgeries
64. Osteoarthritis
65. Gout
66. Sleep Apnea
67. Venous stasis disease
68. Chronic leg pain
69. Degenerative Joint disease
70. Recommended joint replacement from specialist
71. Accelerated degenerative joint disease
72. GERD
73. Gall Stones
74. Repeated pneumonia
75. Repeated pleurisy
76. Repeated bronchitis
77. Lung restriction
78. Renal failure
79. End stage renal disease with difficulty dialyzing
80. Hernias
81. Hiatial Hernia
82. Kidney stones
83 Increased risk of certain cancers
84. Fibromyalgia (chronic fatigue syndrome)
85. Hyperlipidemia
86. Extremity edema with ulceration
87. Dyslipidemia
88. Dyspnea
89. Eating Disorder
90. Fatty Liver
91. D.J.D.
92. Coronary artery disease
93. Irregular or Absent periods
94. Skin Tags
95. Traumatic Injuries to Teeth
96. insulin resistance
97. dyslipidema
98. cardiovascular disease
99. stroke
100. Priorsurgical Complications
101. hyperuricemia
102. Sever Acute Biliary and Alcoholic Pancreatitis
103. osteoarthritis
104. Certain cancers are also associated with obesity, including colorectal and prostate cancer in men and endometrial, breast, and gallbladder cancer in women [1-6].
105. binge-eating disorder
106. social stigmatization
107. discrimination
108. impaired psychosocial and physical functioning, causing a negative impact on their quality of life
109. Rheumatoid arthritis
110. Birth Defects Cancers
111. Breast Cancer in Women
112. Breast Cancer in Men
113. Cancers of the Esophagus and Gastric Cardia
114. Colorectal Cancer
115. Endometrial Cancer
116. Renal Cell Cancer
117. Carpal Tunnel Syndrome
118. Chronic Venous Insufficiency
119. Daytime Sleepiness
110. Deep Vein Thrombosis
111. End Stage Renal Disease
112. Heat Disorders
113. Hypertension
114. Impaired Immune Response
115. Impaired Respiratory Function
116. Infections Following Wounds
117. Obstetric and Gynecological Complications
118. Liver Disease
119. Pain

Ontario WLS Support Group info

Please use this link to view an updated list of support groups. Members at all stages of the process are welcome to attend. Many areas also have coffee nights, watch for posts for your area.

http://www.obesityhelp.com/member/fiery/blog/2008/09/19/-pos t/

OMG, this whole thread is wicked awesome!

Dee :D

I second that thought Dee (flowerpower)...it is amazing, i am glad i took a peak.  i will bookmark it and re-visit.

thanks for starting this milaurin!

Ways to make Optifast more palatable (a losing battle?)

Put some instant coffee into it
Add mint flavouring for chocolate or almond extract for vanilla
Mix with crystal light
Make/serve it with lots of ice
Make it with extra water to dilute the taste
Add sugar free syrup
Drink it from a sippy cup so the smell isn't as bad
Plug your nose when drinking it

For variety, make the chocolate with less water so it's the consistency of pudding and then you get to "eat" it.

Here's a great recipe submitted by weightlossdreamer:

one chocolate Optifast
one mug of ho****er
one large tbsp. of decaf coffee dissolved in the ho****er
one drop of vanilla extract (the real stuff!)
one drop of almond (again, the real stuff - don't scrimp if you want the real taste)
one handful of ice cubes

Put the ice and hot coffee into a blender ( I used my Magic Bullet) and blend until some of the ice is crushed.  Add the Opti, vanilla and almond extract and blend until combined.
It's a dirty rotten job, but someone has to do it!

Keep shrinking that liver!!!

Ontario Providers of Bariatric Services

St. Joseph’s HealthCare Hamilton
phone number : 905-522-1155 Ext 33240
fax number : 905-521-6152
website : http://www.stjoes.ca

Humber River Regional Hospital
phone number : 416-747-3720
fax number : 416-747-3731

Guelph General Hospital
phone number : 519-837-6440 ext. 2700
fax number : 519-837-6773

The Ottawa Hospital
The Weight Management Clinic
phone number : 613- 761-5101
fax number : 613- 761-5343
website : http://www.weightclinic.ca

Windsor Regional Hospital Regional Bariatric Assessment and Treatment Centre
phone number: 519-971-9206
fax number: 519-971-9566
website: http://www.wrh.on.ca

OHIP Approval Process Info as of December '09

The Out-of-Country Prior Approval Program provides full funding for insured OOC health services when regulatory requirements are satisfied.

Two of these requirements are:
1. the service is generally accepted by the medical profession in Ontario as appropriate for a person in the same medical cir****tances as the insured person;
2. the identical or equivalent service is performed in Ontario but it is necessary that the insured person travel out of Canada to avoid a delay that would result in death or medically significant irreversible tissue damage; Regulation 552 and the OHIP Schedule of Benefits for Physician Services (‘the Schedule’) describe the terms and conditions under which physician services are insured inside Ontario. For services funded through the OOC Program, the Schedule may also provide the ministry with direction with respect to what is generally accepted by the medical profession in Ontario as appropriate for the services that it lists.

Amendments to the Schedule, approved on November 4, 2009 and effective October 1, 2009 include the following section on bariatric surgery: S120 (gastric bypass or partition) and S189 (intestinal bypass) are insured services only when all of the following four criteria are satisfied:

1. Presence of morbid obesity that has persisted for at least the preceding 2 years, defined as:
a. Body Mass Index (BMI) exceeding 40;
or
b. BMI greater than 35 in conjunction with any of the following severe comorbidities:
i. Coronary heart disease;
ii. Diabetes mellitus
iii. Clinically significant obstructive sleep apnea (i.e. patient meets the
criteria for treatment of obstructive sleep apnea);
or
iv. Medically refractory hypertension (blood pressure greater than 140
mmHg systolic and/or 90 mmHg diastolic despite optimal medical
management);

2. The patient’s bone growth is completed (18 years of age or documentation of completion of bone growth);

3. The patient has attempted weight loss in the past without successful long-term weight reduction;
and
4. The patient must either:
a. be recommended for surgery by a multidisciplinary team at a Regional
Assessment and Treatment Centre Ontario;
or
b. participate in a multidisciplinary regimen of at least three months duration where the patient’s participation meets all of the following requirements:
i. Consultation with a dietician or nutritionist;
ii. Reduced-calorie diet program supervised by dietician or nutritionist;
and
iii. The patient’s permanent medical record must contain documentation
of the patient’s participation in the multidisciplinary surgical preparatory
regimen at each visit.

[Commentary: The purpose of the patient’s participation in organized multidisciplinary surgical preparatory regimen is to improve surgical outcomes, reduce the potential for surgical complications, and establish the patient’s ability to comply with post operative medical care and dietary restrictions.]

The Regional Assessment and Treatment Centres (RATCs) mentioned in the Schedule are an integral component of the ministry’s three-year $75 million initiative to increase the number of bariatric surgeries performed in Ontario. Five RATCs are currently operational with others scheduled to open soon. RATCs are staffed by multi-disciplinary bariatric health care teams consisting of physicians, nurses, dieticians, social workers, kinesiologists and mental health workers.

Patients who are determined to be suitable candidates for bariatric surgery will be referred by physicians working in the RATCs to one of 4 Ontario Bariatric Centres of Excellence (comprising 9 surgical centres). Physicians working in RATCs may also submit applications for funding of
OOC bariatric surgery to the OOC Program for adjudication according to the regulations.

With an increase in the number of bariatric surgeries performed in Ontario from 429 in 2008/09 to a projected 1,118 in 2009/10, wait times for this service in Ontario have been significantly reduced and it is anticipated that it will be necessary for relatively few patients to travel OOC to obtain bariatric surgery.