As the holidays approach, many of us will find ourself invited to gatherings where we will be asked/expected to bring along some sort of food/dish.  Veggie trays with a nice dip are a good choice, as are meat/cheese trays.  It is always good to take something that YOU can enjoy too so that you don't worry that there will be nothing you can eat...

The following is a list of dip recipes that I collected via email and conversation threads with other WLS folks.  I didn't save names or such, so if one is yours, please email me and I'll happily give you credit!  Otherwise, please enjoy!

Carrot Hummus

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 10
Serving Size: 1/4 cup

Ingredients

15 ounces can garbanzo beans, drain and rinse
1/2 cup nonfat plain yogurt
1/4 cup water
1 lemon, juice only
1/4 teaspoon garlic powder
1/2 tablespoon ground cumin
1 carrot, peeled and grated

Preparation

Place the beans, 1/4 cup of the yogurt, water, lemon juice and spices into a blender or food processor.
Blend until fine, adding remaining 1/4 cup yogurt. Stir in the grated carrot last.

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Dude Ranch Dip

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 16
Serving Size: 1/2 cup

Ingredients

1/2 cup 1% cottage cheese
1/4 cup plain yogurt
2 teaspoons cider vinegar
1 cup clove garlic, minced
1/4 teaspoon black pepper
2 tablespoons dried minced chives

Preparation

In a food processor, blend all ingredients until smooth. Serve with Cajun chicken fingers and/or raw vegetables.

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Easy Guacamole Dip and Chips

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 4

Ingredients

1 fresh avocado
2/3 cup salsa
8 ounces (approx. 12 chips per oz.) tortilla chips, baked, unsalted

Preparation

Remove peel and seed from avocado; mash flesh with a fork or potato masher.
Combine mashed avocado with salsa, adding more salsa to taste, if necessary.
Serve with baked tortilla chips - 2 ounces per serving.

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Herbed Dip for Veggies

Prep Time: 10 minutes
Cook Time: 5 minutes or less
Serves: 6

Ingredients

1 cup silken tofu
1 cup nonfat sour cream
2 tablespoons fresh chopped parsley
1/4 teaspoon dried thyme
1 teaspoon dried oregano
1 clove garlic, crushed
2 tablespoons chopped green onion
1/4 teaspoon black pepper

Preparation

Place all ingredients into a blender or food processor. Blend until smooth. Refrigerate until ready to use.
Serve this dip with fresh veggies.

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Hummus

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 8
Serving Size: 1/3 cup

Ingredients

1 1/2 cups cooked/canned garbanzo beans, rinsed & drained
1/2 cup nonfat plain yogurt
1 teaspoon minced garlic
1 tablespoon lemon juice
1 teaspoon ground cumin
1 teaspoon sesame oil (optional)

Preparation

Place all ingredients in blender or food processor, blend until smooth. Refrigerate until ready to use.
Serve with raw veggies and baked pita chips.

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Fruit with Peach Dip

Prep Time: 10 minutes
Cook Time: 0 minutes
Serves: 4

Ingredients

4 cups assorted fresh cubed fruit
12 ounces package silken tofu
15 ounces canned peaches in juice, with juice
2 tablespoons sugar
1 teaspoon ground cinnamon
1/2 teaspoon almond extract

Preparation

Prepare the fresh fruit and arrange on a platter. Cover and chill until ready to use.
Place the tofu, peaches with juice, sugar, cinnamon and almond extract in a blender or food processor. Blend until smooth.
Pour into a small serving bowl and chill until ready to serve, at least one hour.

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Italian Vegetable Picks

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 14
Serving Size: 1 pick

Ingredients

16 ounces frozen broccoli, cauliflower and carrots, thawed
1/2 cup pitted medium ripe olives
1/2 cup nonfat italian salad dressing
14 cocktail picks

Preparation

In a medium non-metal bowl, combine vegetables and olives.
Pour salad dressing over vegetable mixture; toss to coat. Cover, refrigerate.
Before serving, arrange vegetables on serving platter; serve with cocktail picks. Makes 14 servings.

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Mock Guacamole

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 8
Serving Size: 1/4 cup

Ingredients

2 cups frozen peas, thawed
1/2 cup chopped green onion
1 tablespoon chopped fresh cilantro
1 ripe avocado
1/8 teaspoon hot pepper sauce, to taste
1 lemon, juice

Preparation

Place peas, onion and cilantro in food processor. Process on high speed until smooth.
Add avocado, hot pepper sauce and lemon and pulse on high until chunky.
Serve immediately with toasted whole-wheat pita triangles or baked tortilla chips.

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Mexican Dip

A traditional crowd pleaser; this Mexican dip is just as satisfying when made with lower-fat ingredients.

Prep Time: 20 minutes
Cook Time: 0 minutes
Serves: 15
Serving Size: 1/2 cup

Ingredients

1 can (14oz/398ml) nonfat refried beans
1/2 cup salsa
2 avocados
2 teaspoons lemon juice
6 small green onions, chopped
1/4 cup nonfat mayonnaise
1 clove garlic, minced
1 1/2 cups light sour cream
1 cup shredded light cheddar cheese
1/4 cup sliced black olives
2 tomatoes, chopped

Preparation

Refried bean layer: In a small mixing bowl, combine the refried beans and the salsa. Spread in a 10-inch (25cm) pie plate.
Guacamole layer: In a food processor, puree avocado and lemon juice.
Add garlic, 3 green onions, and mayonnaise; puree again until smooth.
Spread over refried beans.
Dollop sour cream onto guacamole layer and carefully spread to cover all.
Sprinkle cheddar cheese, tomatoes, remaining green onions, and olives on top in concentric circles or diagonal stripes. Serve with tortilla
chips for dipping.
Variations

For Halloween, cover the dip with grated cheese and use the toppings to make a jack-o-lantern face. For Christmas, make the dip in a
Christmas tree pan with the toppings arranged like garlands.

Dietitian's Message
Serve this healthy party dip with home-baked tortilla chips. They are much more satisfying and have minimal fat content compared to a store-
bought bag of tortilla chips. When choosing refried beans, read the labels carefully. Some refried beans contain lard. Lard is a saturated fat and considered to be heart unhealthy.

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Roasted Eggplant Dip

Prep Time: 10 minutes
Cook Time: 60 minutes
Serves: 6

Ingredients

1 1/2 pounds eggplant
1 medium red bell pepper
1 medium red onion
1 garlic clove
1 tablespoon extra virgin olive oil
1 tablespoon tomato paste, canned, low sodium
1/4 teaspoon salt
1/4 teaspoon black pepper

Preparation

Preheat oven to 350°F.
Wash and peel eggplant and cut into 1-inch cubes. Wash and chop bell pepper and onion. Mince garlic.
Combine eggplant, bell pepper, onion, garlic, and olive oil in a 13x9-inch baking dish lightly coated with cooking spray.
Bake for 1 hour or until vegetables are tender. Cool slightly.
Place cooked vegetables, tomato paste, salt and black pepper in a food processor or blender; process until smooth.
Serve with toasted Italian bread slices or baked pita chips.

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Pineapple Orange Dip

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 8
Serving Size: 1-1/2 tablespoons

Ingredients

1/2 cup nonfat sour cream
1/2 cup light cream cheese
2 tablespoons pineapple juice concentrate
1 orange, zest and juice
1 cup pineapple chunks, drained

Preparation

Place all ingredients in food processor or blender and blend until semi-smooth.
Serve as a dip for whole wheat crackers, fresh fruit and raw vegetables.

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Orange Alaska

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 4

Ingredients

2 large oranges
1 cup nonfat vanilla yogurt

Preparation

Cut oranges in half cross-wise, hollow out with spoon, chop orange into cubes and reserve shells.
Cut a small slice off the bottom of each orange half so it will sit up straight. Combine orange sections with nonfat, flavored yogurt.
Stuff 4 orange halves with orange/yogurt mixture and freeze until slightly firm, about 1 to 2 hours.

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Spinach Dip for Veggies

Prep Time: 5 minutes or less
Cook Time: 0 minutes
Serves: 8
Serving Size: 1/4 cup

Ingredients

1 cup lowfat cottage cheese
1 cup nonfat plain yogurt
2 cups chopped, washed and dried fresh spinach
3 garlic cloves, crushed
1/8 teaspoon fresh ground black pepper
1/8 teaspoon ground nutmeg

Preparation

Combine all the ingredients in a blender or food processor. Puree until almost smooth.
Serve with an assortment of raw or lightly cooked vegetables, such as: carrot sticks, broccoli florets, jicama sticks, radishes, celery
sticks and bell pepper wedges.

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Veggie Vegetable Dip

Prep Time: 10 minutes
Cook Time: 0 minutes
Serves: 8
Serving Size: 1/4 cup

Ingredients

1 cup plain lowfat yogurt
1/4 cup lowfat mayonnaise
1 teaspoon chopped green onion
1 teaspoon dried oregano
1 tablespoon dried dill leaves
1 teaspoon granulated garlic
1 cup shredded carrots
1 cup shredded zucchini
1/2 teaspoon hot pepper sauce

Preparation

Place all ingredients in a medium-sized bowl and mix well.
Serve with raw vegetables as dippers. Vegetables should be cut into long, thin strips.

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Spinach-Artichoke Dip

Prep Time: 15 minutes
Cook Time: 30 minutes
Serves: 10
Serving Size: 1/3 cup

Ingredients

8 ounces mozzarella cheese, part-skim
1/2 cup fat-free sour cream
1/4 cup fat-free parmesan cheese
1/4 teaspoon black pepper
3 garlic cloves
14 ounces artichoke hearts, fresh, cooked or canned
16 ounces fat-free cream cheese
10 ounces spinach, chopped, frozen

Preparation

Preheat oven to 350°F.
Shred mozzarella and combine 1-1/2 cups (6 ounces) of it with the sour cream, 2 tablespoons of the Parmesan cheese, black pepper,
garlic cloves (crushed), artichoke hearts (drained and chopped), cream cheese, and spinach (thawed, drained, and squeezed dry).
Spoon mixture into a 2-quart baking dish lightly coated with cooking spray.
Sprinkle with remaining 1/2 cup (2 ounces) of mozzarella and 2 tablespoons of Parmesan cheeses.
Bake for 30 minutes or until bubbly and golden brown.
Serve with raw vegetables, baked pita chips, baked tortilla chips, whole wheat Melba toasts, or toasted Italian bread.

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Sunshine Dip

Prep Time: 10 minutes
Cook Time: 0 minutes
Serves: 8
Serving Size: 1/3 cup

Ingredients

2 cups plain lowfat yogurt
2 tablespoons frozen orange juice concentrate
1 cup chopped berries
1 cup chopped bananas

Preparation

Mix all ingredients together in a medium-sized bowl. You can experiment with other fruits and 100% juice concentrates, such as
grape, orange, peach or mixed fruit, for a different flavor.
Use this dip for pieces of raw fruit such as apples, kiwi, melon or berries.
This dip could also be used on pancakes or waffles - top off with fresh fruit and maple syrup.

DRUGS THAT CAN DAMAGE THE POUCH:
Advil
Aleve
Amigesic
Anacin
Anaprox
Ansald
Anthra-G
Arthropan
Ascriptin
Aspirin
Asproject
Azolid
Bextra
Bufferin
Butazolidin
Celebrex
Clinorial
Darvon compounds
Disalcid
Dolobid
Erythromycin
Equagesic
Feldene
Fiorinal
Ibuprofin
Indocin
Ketoprofen
Lodine
Meclomen
Midol
Motrin
Nalfon
Naprosyn
Nayer
Orudis
Oruval
Pamprin-IB
Percodan
Ponstel
Rexolate
Tandearil
Tetracycline
Tolecin
Uracel
Vioxx (off market...not safe for anyone)
Voltaren
ALL "NSAIDS"

DRUGS THAT ARE CONSIDERED SAFE:
Bendaryl
Tylenol
Dimetap
Robitussin
Safetussin
Sudafed
Triaminics (All)
Tylenol (cold products)
Tylenol Ex Strength
Gas-X
Phazyme
Imodium Ad
Colace
Dulcolax-Suppositories
Fleet Enema
Glycerin-Suppositories
Milk of Magnesia
Peri-Colace

FEATURE ARTICLE:

Is Your Brain Making You Eat?
by Katie Jay, MSW, CTA-certified Life Coach
www.nawls.com

According to Dave Krueger, MD, Professional Coach,
www.MentorPath.com, repetition of behavior is comforting because it's secure and familiar, and we like to know what to expect. He says we substitute familiarity for happiness.

Does that describe you?

Is Your Neurology in Charge?

You have well worn neural networks in your brain that get triggered. When you see a food that used to be a regular part of your diet, your brain knows what to do with it "without thinking." In fact, Dave Krueger points out that your brain likes not having to make a decision about something every time it comes up. So, without making a decision, your brain automatically says, "Eat it!"

That's right. No need to make a decision -- you have a well-established brain pattern that makes it easy to pick up that food and eat.

Then, of course, your well-worn guilt and shame neural network gets triggered. And your brain knows how to take you down that pathway, too.

The reality is, your brain is not in charge. It is simply following the well-worn path. But hear this! You can change your brain.

Start Digging!

To change how you behave around food, you will need to create new neural networks. That's like digging a new path, instead of allowing yourself to go down the familiar old path.

Digging a new path is hard work. You have to have the right tool (a shovel, not a spoon!). You have to know where you want it to go and you might even have to buy a new map. Of course, you'll probably sweat. It just won't be as much fun as skipping down the old path.

Learn to Accept Change as a Constant

To truly get beyond old eating patterns, you will need to change. Accepting that you need to change is the first step.

Understanding that change will require you to be uncomfortable for awhile is the next step.

To tolerate change, you will develop a neural network that accepts change and welcomes the loss of old patterns.

You can do this using positive self talk. Remind yourself frequently that the discomfort you are feeling is temporary, and that eventually your new pattern will be a well-worn path.

Tolerate Extreme Success

I don't want to weigh anything close to 331 pounds again!

To maintain my goal weight, I have to override all kinds of urges to follow my well-worn path, my "eat-whatever-is-in-front-of-me path."

When I am confronted with an invitation to go down the old path I stop and consider where I want to wind up.

Then, I get out my shovel and start digging. My new path is coming along quite nicely, even if it's the hardest work I've ever done.

Construction Projects Take a Long Time

You're probably thinking 21 days should be enough to change your path. Well, it is not. That amount of time is enough to make a great start. After three weeks, you certainly are getting used to going down the new path. But, the path isn't complete. It's still easy to turn back. The long, well-worn path will take a long time to create.

It's Worth Every Drop of Sweat, Isn't it?

Your goals to be healthy and to live a better life are within reach. You wouldn't have had weight loss surgery if you were not wanting big changes. So, be diligent and keep digging.

Visualize the completed pathway -- with a smooth walkway and many exciting destinations.

You Are not Alone

The nicest thing about this amazing project is you don't have to go through it alone. Many people are in the process of overcoming obesity, and they are available to share your journey, to encourage you, to cheer you on, and to comfort you.

Happy digging this week!

Katie

While my weight has stayed between 219 and 222 for weeks, I measured again today and am down 13 more inches in the last month.  This brings me to a total of 155 inches lost since Sept 13, which does not include the inches lost in the first 2 months of weight loss (about 40 pounds of weight loss).  I have no clue how many inches lost with those first 40 pounds, so I usually just say "over" whatever the total I can document is, so now it's "over 155 inches!" 

The best part of these measurements??  My hips are finally below 50 inches!  They were 49 inches!  That is, however, down from 68 on Sept 13th and they were over 70 at 410 pounds.  That is over 20 inches lost from around my hips alone!

MEASUREMENTS		9/13/2006	10/13/2007
Neck		15	13
Shoulders		57	43
Chest		48.5	35
Bust		55	40
Midriff		46.5	36.5
Waist		49.5	35
Hips		68	49
Thigh/Thigh X 2		35.5	22
Calf/Calf X 2		23.5	17.5
Ankle/Ankle X 2		9.75	9.25
Bicep/Bicep X 2		23	14
Forearm/Forearm X 2		13	10
Wrist/Wrist X 2		7.5	6
TOTAL INCHES		564	409
TOTAL INCHES LOST			155

*These are pretty good and plenty sweet without seeming like you're eating something unhealthy...

wet stuff
1/3 cup oil (I used my rice bran oil)
3/8 cup splenda brown sugar OR 3/4 cup real brown sugar
2 tablespoons honey
1 tsp vanilla
2 eggs

dry stuff
1/2 cup whole wheat flour
1/4 cup as soy flour
1 scoop of Unjury unflavored protein powder
1 tsp cinnamon
1/2 tsp baking powder
1/4 tsp salt

stir-ins
2 cups crisp rice cereal
1 1/2 cups dry oats
and any other stir-ins your choose such as chocolate chips, nuts, sunflower seeds, raisins, etc.

Directions:
1) mix wet ingredients together
2) mix dry ingredients together in seperate container
3) add dry mixture to wet mixture and mix well
4) add any stir-ins you like and the cereal and oats
I used 1 bag chocolate and peanut butter chips (Toll House mixed bag), 1/2 cup chopped pecans, and 1/2 cup shelled sunflower seeds.

Preheat oven to 350 degrees.  Spray 9 x 13 glass baking pan with non-stick spray and press the mixture into the pan.  Bake 25 mins for chewy bars.  Cool 10 mins and cut before cooling completely.  Store in sealed container.

The way I made them, they came out like this nutritionally:
1/16th batch (1 bar)
cals: 260
carbs: 27 (2 fiber, 15 sugar)
protein: 7

Suggested changes:
1) Add another scoop of protein powder to bring up the protein numbers.  You could swap a scoop of the whole wheat flour for the protein scoop, but you may not need to as it was probably wet enough to handle this addition.  You could also leave the flour as is and just cut back a bit on the oats...
2) Drop the chocolate/peanut butter chips  as that is almost 100 of the calories per bar!  Just eliminating those would take them to about 165 calories, 16 carbs (2 fiber, 5 sugar) and still about 6 grams protein per bar. 3) You could also look at using raisins instead of chocolate chips if you think they need something of that nature...

I've already lost more than the average adult man weighs!

Your weight loss =

1 pound = a Guinea Pig
1.5 pounds = a dozen Krispy Kreme glazed donuts
2 pounds = a rack of baby back ribs
3 pounds = an average human brain
4 pounds = an ostrich egg
5 pounds = a Chihuahua
6 pounds = a human’s skin
7.5 pounds = an average newborn
8 pounds = a human head
10 pounds= chemical additives an American consumes each year
11 pounds = an average housecat
12 pounds = a Bald Eagle
15 pounds = 10 dozen large eggs
16 pounds = a sperm whale’s brain
20 pounds = an automobile tire
23 pounds = amount of pizza an average American eats in a year
24 pounds = a 3-gallon tub of super premium ice cream
25 pounds = an average 2 year old
30 pounds = amount of cheese an average American eats in a year
33 pounds = a cinder block
36 pounds = a mid-size microwave
40 pounds = a 5-gallon bottle of water or an average human leg
44 pounds = an elephant’s heart
50 pounds = a small bale of hay
55 pounds = a 5000 BTU air conditioner
60 pounds = an elephant’s penis (yep, weights more than his heart!)
66 pounds = fats and oils an average American eats in a year
70 pounds = an Irish Setter
77 pounds = a gold brick
80 pounds = the World’s Largest Ball of Tape
90 pounds = a newborn calf
100 pounds = a 2 month old horse
111 pounds = red meat an average American eats in a year
117 pounds = an average fashion model (and she’s 5’11”)
118 pounds = the complete Encyclopedia Britannica
120 pounds = amount of trash you throw away in a month
130 pounds = a newborn giraffe
138 pounds = potatoes an average American eats in a year
140 pounds = refined sugar an average American eats in a year
144 pounds = an average adult woman (and she’s 5’4”)
150 pounds = the complete Oxford English Dictionary
187 pounds = an average adult man
200 pounds = 2 Bloodhounds
235 pounds = Arnold Schwarzenegger
300 pounds = an average football lineman
400 pounds = a Welsh pony

Well, don't we see THAT word a lot around here--constipation!  I don't talk to many postops who've not dealt with it at some point.  I had been taking FOUR TO SIX generic Colace stool softeners every night at bed time for MONTHS.  Little by little, it seemed to be helping less and I was taking a Correctol about twice a week just to have a bowel movement.  My surgeon says NO to stool softeners and doesn't really want us using laxatives at all either.  He tells us to up the fiber and get more exercise.  While those are both good points (need more fiber and need more exercise), they are sometimes easier said than done!  As I don't do shakes, I get all my protein through food and in order to meet my 80 to 100 grams of protein per day via food alone, I don't have much room for increased veggie intake! And, the Benefiber that his office recommends actually made things worse for me.

On 9/17, I cold-turkey stopped using the Colace and Correctol.  I started taking 3 daily doses of a generic fiber pill from Sam's Club that I'd also bought previously and had okay results with from Walmart.

Member's Mark Fiber Capsules
400 capsules for $9.38
Walmart has a generic fiber pill that is 100 or 120 capsules and like $5.18. 
This product is 100% natural psyllium fiber JUST LIKE the Metamucil fiber supplement capsules.  I was once told at a support group meeting to add 100% natural psyllium fiber to your hot cereal and such if you wanted "your poop to look more like Ss and Ls..."  LOL

Since 9/17, I take 6 capsules in the morning, 3 around lunch, and 6 more at bedtime.  Now I AM taking more pills, but I'm taking fiber, not stool softeners OR laxatives.  And I am writing this now to tell you all that it IS WORKING.  Every morning for the last 3, I have had a regular (S or L shaped!  LOL) bowel movement.  No pain, no pushing, just GO!  SO, I am going to stick to this for a while and see what happens!  This 400 ct bottle will last me 26 days at this dosage level, which breaks down to 38 cents per day for a SMOOTH MOVE!

Yeah, yeah, I know--easier said than done in the postop WLS world!  But, it is worth some effort to let nature help ease your suffering if you CAN eat more of those high-fiber foods...  Here's a list of some high-fiber items from the National Fiber Council website.

Fiber Food Chart

Fiber Content in Common Foods Here is a list of common foods, according to serving size and their fiber content. You may notice slight differences in fiber content on food packages, in reference books or in brochures about food and health. That may be due to how the fiber was determined (there are a few methods), or that serving size varied, etc. Generally, fiber content is approximately the same for most foods. Some sources give the precise fiber content to the decimal (3.2 grams, for instance), while others round up (or down) to the nearest whole number. The numbers in the chart below are rounded, unless they contain less than 1 gram per serving. From time to time we will update the chart, giving you more and more food listings. Printable Version Food Serving Size Grams of Fiber Fruits Apple (with peel) 1 medium 3 Banana 1 medium 3 Blueberries 1 cup 4 Cantaloupe 1 cup 1 Grapefruit 1 medium 3 Orange 1 medium 3 Pear (with peel) 1 medium 4 Pineapple 1 cup 2 Prunes (dried) ½ cup 6 Raspberries 1 cup 8 Vegetables and beans Asparagus (5 medium, cooked) ½ cup 2 Kidney beans (cooked) ½ cup 6 Pinto beans ½ cup 8 Broccoli (cooked) ½ cup 2 Carrots ½ cup 2 Cauliflower (cooked) ½ cup 2 Sweet potato, w. skin (baked) 1 medium 3 White potato, w. skin (baked) 1 medium 5 Spinach, frozen, cooked, drained ½ cup 3 Tomato 1 medium 1 Breads, cereals, grains etc. Rye bread 1 slice 2 White bread 1 slice 1 Whole-wheat bread 1 slice 2 Kellogg’s® All-Bran (original) ½ cup 10 Kellogg’s ® All-Bran Bran Buds 1/3 cup 11 Quaker® Old-Fashioned Oatmeal (cooked) 1 cup 4 Wheat germ, toasted 2 tablespoons 3 Brown rice, cooked ½ cup 2 White rice, cooked ½ cup 0.3 Spaghetti, cooked 1 cup 2 Peanuts, dry-roasted ½ cup 6

Dx E is one of my favorite long-term-postops.  He's over 4 years out now and I pay serious attention to the things he takes time to post.  This one on caffeine after WLS is a good one and gives much relief to folks who just can't live without their full-leaded beverages!
Lea

Dx E Northern, MS R. Walker Byars, M.D. RNY (07/03/03) Member Since: 06/19/04 [Latest Posts]

Post Date: 8/26/07 3:55 pm Coffee? Or No Coffee? Many Dr.’s advise against it. I’ve seen this question a number of times- Why No Caffeine? And the responses are incredibly varied. Although Caffeine is a MILD Diuretic, It is often presented without the "Mild," And its powers to dehydrate us are often Overstated. Yes, it does contribute to dehydration but not at A level that is significantly higher Than talking a walk Or being exposed to "Air Conditioned" Air For a prolonged time. (in fact one recent study of Male Athletes, showed NO impact on hydration what-so-ever.) I wanted the "Absolute End All Info" from my surgeon And his explanation was this- "It’s not so much the Dehydration issue that causes me to Advise people to give up caffeine prior to their surgery, but The negative impact it has on Healing and the formation of Scar tissue." Whhhaaaaaaat? Yep, Caffeine constricts the capillaries, Those smallest of the small little Tubes in our circulation system. It is in the capillaries that the exchange between the blood And the cells of the body takes place. Here the blood releases its oxygen and takes on carbon dioxide, Except in the lungs, where the blood picks up oxygen And releases carbon dioxide. In the special capillaries of the kidneys, The blood gives up many waste products In the formation of urine. Capillary "beds" are also the sites where white blood cells Are able to leave the blood And defend the body against harmful invaders. Capillaries are so small That when you look at blood flowing through them Under a microscope, The cells have to pass through in single file. When these capillaries constrict, All of these activities are reduced. Even though Caffeine is a "Vasodilator," (a substance that causes blood vessels, deeper in the body To become wider by relaxing the smooth muscle in the vessel wall) That is only the larger veins and arteries, Caffeine is one of the few Vasodilators, (along with the herb- feverfew) That has the exact opposite effect On the small blood vessels- Capillaries. Since the area of a trauma or cut need extra Blood/oxygen/food exchanges in order to heal the tissue, anything that constricts the capillaries slows the production of new tissue- Healing. It is the same with nicotine. Someone who smokes and consumes even moderate amounts of caffeine, "Heals" or generates new tissue 40% to 60% slower than those who do not. This also accounts for the less elastic and more wrinkled skin or those who smoke and consume caffeine. Doing a little extra internet and library research- There are numerous other bad things about caffeine, such as- A significant association between caffeine and decreased bone mineral density. (however, this is off set by just one serving of milk per day) In Pregnancies, mal-formations in fetus, And prior to becoming pregnant, caffeine reduces fertility rates. (However, these effects have only been seen in rats And no Human studies have ever been sited as conclusive) The list of- "Bad, but not too…." Goes on and on. Caffeine, it seems, is one of the most studied of compounds that we humans take into our bodies and the effects, Other than the Constriction of Capillaries, is marginal and in nearly every study, rides the fence of what could be considered "Significant." Even the constriction of the Capillaries in combination with it’s mild Vasodilator effects, Are a Good Thing, If you are trying to reduce the symptoms of a Migraine headache. Since my Doc is a Bariatric Surgeon, I asked specifics as to how it would effect my Pouch. Once again, it’s a "Fence Sitter." Yes, coffee is a mild irritant to the pouch and should be avoided early on. But, It’s not the caffeine. It’s the tannic acids from coffee that are present even in De-Caf, so switching to De-Caf for it’s benefits on pouch irritation is a little like switching from Bourbon to Scotch so you can Drive home safely from the party. Just some "Food for Thought" about caffeine- It’s the only "psycho-active substance" That We, in fact every country on the planet, Regularly dispenses to children. Cokes, chocolate, etc… Although sites touting the "Benefits of Caffeine" (see below) All include the persuasive fact that it is "Natural" "Occurring in Nature" and some how this makes it "Not a Drug." The THC active ingredient in marijuana Also fits this bill as does nicotine, But we would be hard pressed to think of them as "Safe" because of that fact. There’s an excellent link to-Energy Fiend.- http://www.energyfiend.com/the-caffeine-database/ That tells how much caffeine is in which drinks and foods. And a bit of caffeine as relates to Bariatric Patients at Dame Tooter’s site-- http://www.bariatricbytes.com/caffeine.html And an exceptional source for information about caffeine can be found at- http://coffeefaq.com/caffaq.html It’s sort of a compilation of EVERYTHING- Pro and Con, to be found about caffeine. Are there some benefits of caffeine? Other than the "boost" to the nervous system Often helpful while making a long drive home at night, Other benefits have been touted, ranging from – Lowering incidence in Parkinson's disease, Its association with lowered incidence of Alzheimer's Disease, And, even the reduction of gallstone formation associated with caffeine use. The tannic acid in coffee has great anti-oxidant effects, but can also raise uric acid levels And should be avoided by those with history of kidney stones. The benefits here were all in literature published by The "good people" of Vivarin, a Caffeine tablet, and so The research or at least the "interpretation of it Is a little suspect. Sort of like "The Benefits of Tobacco" As presented by Phillip Morris Co.. Do be on guard and take a "Grain of Salt" with a lot of the "Caffeine Information" to be found on the Web. Such sites as-"Everything You Need to Know About Caffeine" Are publications of the - International Food Information Council (IFIC) Foundation Which is an "informational organization funded by the beverage Industry. Sort of a "Public Lobby Group," that "spins" information In a positive light for those who fund the publications. In other words- Highly specialized advertisement. As to the Metabolic benefits? A study published in this July’s edition of "Neuropsychobiology" – http://content.karger.com/ProdukteDB/produkte.asp?Aktion=Jou rnalHome&ProduktNr=224082 Has found that sustained caffeine use Has No significant enhancing effects on performance Or mood and does not provide a restorative effect after poor sleep. Here’s an Odd One---Caffeine got your tongue? A new study suggests caffeine— Potentially because of how it interacts with neurons in the brain— Might actually hinder your short-term recall of certain words. "tip-of-the-tongue (TOT) phenomenon" where you Know something But the name or fact "escapes you" just for a bit- ""You know! What’s his name! I can believe I can remember it right now." This slip between long-term memory and short term recall May be caused by too much caffeine. Article at- http://www.apa.org/monitor/julaug04/caffeine.html So, It’s clearly not a Black and White issue… But then again few things are. But this long ramble about caffeine? I often see the question about "Why No Coffee?" And I had already gotten in one cup too many today. I guess that the other reason to avoid- You could end up writing yard-long posts on the Board! Best Wishes- Dx

The following list of questions to ask potential surgeons was gathered from a conversation on the GastricBypass-InfoCentral group at YahooGroups.

1) How many cms of intestine will you bypass???

2) How much common channel will I have?

3) Do you transect the stomach?  Do you remove the remnant stomach?  IF NOT--Will you transect if I have or revert to an Open vs. lap surgery???

4) How common are staple line disruptions?

5) How common are ulcers around the stoma?

6) How many surgeries of this type have you done???

7) How many deaths are on your record??? (Please keep in mind that the more experienced the surgeon is and the more complicated cases he takes on the higher this number can be so you need all of the facts to make a determination.)

8) Will I wake up with an naso-gastric tube or JP drains in???

9) Will I go straight to a regular room if there are no complications or
wake up in ICU???

10) What will I do if I have complications and you are unavailable (i.e.
sick, on vacation, away from the office, etc.)? Is there a partner or other
doctor who knows as much about RNY that can help me. (It's been my
experience that docs that practice with another surgeon or surgeons is
better when and if you have complications and your surgeon is unavailable.  It's hard to find a surgeon willing to take on complications of a different surgeon outside of their practice.)

11) How long will you follow up with me??

12) What kind of aftercare program do you offer and what kinds of
information and help will I receive during the weight loss process?

13) How often do I need labs done?  Will you agree to order the lab tests necessary to keep me in good health?

14) How many supplements should I take? (protein and vitamins both)

15) How big is the pouch you create?

16) How do you feel about milk in the diet?  sugar?  fats?

17) How long am I off foods?

18) How strict a "diet" will I still be on?

19) If I am still sick/nauseated/vomiting after 3 weeks, what will you do for me?

19) Of my excess weight, what percentage can I expect to lose?

20) Of the weight that I lose, what percentage can I expect to keep off long-term?