Dr. Cirangle's Support Group meeting.. Lots of INFO from his meeting

Thank you, thank you, thank you!! The only bad thing about having surgery in Mexico is you don't have the benefit of this kind of aftercare. Thanks again!!

Definitely happy to help.. just remember that this is third hand information and my interpretation/memory from notes.  Hoping some other folks at the meeting will correct anything I got wrong or add to it. :)

well i can definately see where upping some carbs may lead to a road of destruction and catch up with some of us.. especially when they are junky carbs like cake and pie...

Im still fighting to get back down from when my brother inlaw was here in feb, prior to that, it was christmas damage... so yes for me i can definatly see that i certainly am not one of those eat what ever they want type people...

so limiting carbs makes sense to me, but i certainly dont see how we would want to be maintaining and staying constantly in ketosis... most doctors dont recomend doing that long term, so i cant imagine doing it for life at 20g of carbs...

my surgeon told me to stay under 1000 calories for losing but she never told me how many carbs... so i find this interesting   for me the sleeve has always limited my " good carbs" by eating protein first...
I wi**** had that affect on me for the junky ones too but alas it does not seem to...

If you aren't counting green veggies and only counting 20 "other" carbs such as those coming from dairy, splenda, sugar free pudding, etc.. that leaves a lot of room I think?  I think he was saying 20 "other" carbs and that seems to be what Jenn C. interpreted from what he was saying as well.

Seems like he considers green veggies like "free" carbs, so to speak.  I also think people that are on the smaller side and not very active or more insulin resistant might have to be on the low side of the carb scale.

 
Let's just make it clear that Dr.C said staying in Ketosis to long is a "Bad" thing.

I did walk in late on your carb conversation but I did not hear 20grams for life.

I would think 20grams a day would put you in Ketosis..... 

Dr.C also makes it very clear at individual appointments what he thinks is best for you when discussing individual situations. At support we get the broad stroke.

Weight loss period is one thing......follow the program.....it seems to work.

Maintenance is where you find out your tolerances and must be smart enough to flow with the changes.

Note: I for one really benefit from Dr.C running his own support groups..... many here don't get this. But heck.... that's what I paid for.

One thing I want to say to all Dr.C patients..... Is you also paid for individual appointments. If you want/need more individual attention. Guess what.... make an appointment! I don't even want to hear your to far away..... doesn't mean every month.... couple times a year after goal and a few support groups to keep you on track doesn't seem like much!


frisco

Great information Sublimate. As posted, at our group last week the discussion in our area  was mostly about grocery shopping and what restaurants to avoid. Though we did talk alot about the carb and protein stuff at the previous meeting.

All us lapsf patients know our handbook says keep carbs under 40 during weight loss phase. I kept a daily journal and most days mine were more like 20; with quite a few days even less. And it was ok. These days during maintenance I get maybe 50 to 60. The difference is some fruit, occasional oatmeal, and  more nonfat dairy. Plus my daily blob of peanut butter.  Really still eat no bread, pasta, rice or potatoes and I think its just going to have to be that way for me. But I was told by the guru that  the 70 g protein rule is for life and if I get that in there is not much room for carbs so its all good.

My husband has done the Atkins diet and in the induction phase I think the carbs are 20 or less and maybe only 30 or less after that. He refuses to eat green beans when he is doing the induction phase as he considers them too high carb. Jeez. 4 carbs in a half cup. I kind of ignor carbs in green veggies.

Anyway, great summary of valuable information. Americans are so woefully ignorant on nutrition.

Diane

Okay I am finally in the same place as both my computer and my iPad so I can add some stuff from my notes:

On Acid Reflux:
Acid is made in the bottom of the stomach. That's why there isn't a lot of acid when we get the foamies.

Surgery disrupts the fibers at the top of our stomach that keep food out of the esophagus. This is why a lot of people experience reflux early out. It gets better at around 3 months.

While some people say VSG causes reflux, if you look at the stats, at a year out the number who have reflux is much less than the number who had it pre-op. This assumes that any hiatal hernias were repaired though.

On the DS:
Some insurance companies won't injure a surgeon who does the DS no matter how good his complication rate is.

On protein:
The only people who have to limit protein are people with renal failure. They commonly get told not to eat more than 70 g of protein a day. But there are drugs you can take that will allow them to eat more protein and Dr. C likes those patients to have more when early out even if they drop back to 70 g later.

Protein tubes have collagen but that's okay. Meat is a collagen protein too and we benefit from eating it and absorb the protein. He believes we can benefit from the protein in those tubes even if it's not whey or egg or soy protein.

Leaks:
Generally see them at 2-4 weeks out. With the VSG, if you do enough, eventually you'll get a patient who has a leak. Some docs are have 2-5% leak rates. (He didn't say this but I would RUN from such a doc. There are plenty whose leak rate is under 1%.) That's because the sleeve isn't as simple as it appears to do. It's simple in concept but making a really small sleeve with minimal leaks is a real skill.

If you see a patient who is diagnosed with a leak farther than 1 month out, they generally had it earlier but it was misdiagnosed.