Bariatric Life Long Support January Issue: Goals - Kaiser Permanente

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Bellevue BariatricProgramBariatric Life-long SupportWe are pleased to announce the bariatric team now follows our Kaiser member bariatric patients for a lifetime,not just the first five years after surgery.January 2019January Issue: GoalsIntroduction .1SMART Goal Setting .2-5The reason: patients who attend longer term follow-upvisits (annually) may experience better weight loss,maintenance and minimize complications. .Bean Recipes . .6-7The bariatric team provides the special care and management your new anatomy needs (i.e. nutrition, exercise,vitamins, etc.).Bariatric Sound-bites. . 9Weight loss surgery is a tool to help you lose weight andimprove health. Utilizing the tool to its full potential requires hard work on your part and ongoing team care.Bottom line: follow up is key for long term success. TheKaiser bariatric team is here to help you on your path tohealth and weight management.Bariatric Team . .11Daily Vitamins .8Announcements . .9Support Group locations .10Clinic contact Info . .11Quote of the Month:Great things nevercame from comfortzones.

Resolutions to “lose weight” or “exercise more “ are worthy aspirations, butthese statements are vague and too broad. The key to successfully integratinghealthy habits into your life is to be S.M.A.R.T. with your goal setting.S2 2Specific: clearly define the desired resultMMeasurable: quantify the objective toknow when you have achieved itAAchievable: it’s within your scope. Definerealistic ways to attain your objectiveRRealistic: take different constrains into account (resources, environment)TTime-Bound: specify target date forachieving the objective

Answer each question, to refine the stepsneeded to achieve a goal.SpecificMeasurableAchievableRealisticWhat do I want to accomplish?Why is this goal important?Who is involved?What resources or limits are involved?How much?How many?How will I know when it is accomplished?How can I accomplish this goal?How realistic is the goal, based on other constraints?Does this seem worthwhile?Is this the right time?Does this match my other efforts/needs?When do I want to reach this goal?Time-BoundWhat can I do today?What can I do six weeks from now?What can I do six months from now?3

S.M.A.R.T. Goal: ExerciseGoal: “I will start exercising” This is to too broad and not measurable.SMART goal : I will walk 30 minutes every day at lunch42SpecificI will walk 5 days a week at workMeasurableI will walk for 30 minutes at lunch everydayAchievableBring walking shoes , socks, rain jacket &umbrella to keep at work. Plan to walkbuilding hallways when bad weather.RealisticStart with 10-15 minutes walks every dayfor 3 weeksIncrease to 15-25 minutes for 3 weeksGradually increase to walking 30 minuteswalking every day at workTime-BoundTarget: 30 minutes by March 1, 2019

S.M.A.R.T. Goal: 5 servings of Veggies & FruitsA goal of “eating better” cannot be measured.SMART goal : “I will eat 5 veggie & fruit servings every day’”SpecificEat more veggies & fruits(Currently eating 1-3 per day)MeasurableEat a minimum of 5 servings of veggies &fruits serving every day.AchievableMake a shopping list of veggies & fruits toadd for snacks and mealsRealisticEat minimum of 3 servings every day for 2weeks. Add 1 veggie per day for 2 weeks.Once at 4 servings every day, add in 1 fruitserving to my day for a total of 5 servingsevery day.Time-BoundTarget: February 11, 201953

January 6th is National Bean DayBeans (and legumes) are packed with nutrients (fiber, B-vitamins, fiber) and are a goodsource of plant protein. Plant proteins are not a complete protein (containing all 9 essentialamino acids), so as a bariatric patient, think of them as “bonus protein.” Beans are low in fat,calories and fill you up. Average cup of beans are 250 calories & 15 grams of protein.White Chicken ChiliIngredients1 lb. boneless, skinless chicken breast or thighs, chopped1 medium onion, chopped1 Tbsp. olive oil2 garlic cloves2 (14 oz) cans chicken broth1 (4 oz) can green chilies2 teaspoons ground cumin2 teaspoons dried oregano1-2 tsp cayenne pepper3 (14 ½ oz) Great Northern beans, drained & divided1 cup shredded low fat cheddar cheeseSliced jalapeno pepper (optional)Directions1. In a Dutch oven over medium heat, cook chicken and onion in oil until lightlybrowned.2. Add garlic; cook 1 minute longer. Stir in the broth, chilies, cumin, oregano andcayenne; bring to a boil.3. Reduce heat to low. With a potato masher, mash one can of beans until smooth.Add to saucepan.4. Add remaining beans to saucepan.5. Simmer for 20-30 minutes or until chicken is no longer pink and onion is tender.6. Top each serving with cheese and, if desired, jalapeno pepper. Enjoy.64

Spicy Garbanzos & GreensIngredients2 (14 ½ oz can) chickpeas (garbanzo beans)1 tablespoons olive oil1 large onion, diced1 medium carrot, peeled & diced½ lb. spicy chicken sausage, diced2 cloves garlic, minced¼ teaspoon smoked paprika1 teaspoon cumin seeds, lightly toasted and coarsely ground1 lb. kale, washed and cut into ribbonsSalt and pepper2 Tbsp. pine nuts, lightly toasted, optionalDirections1. Put olive oil in a deep, wide skillet over medium-high heat.2. Add the diced onion & carrot, season with salt and pepper, and cook, stirringoccasionally, until softened and lightly browned, about 5 minutes.3. Add the chicken sausage, cook for a few minutes, then turn heat to medium.4. Add the garlic, paprika, and 1/2 teaspoon of the cumin, and stir to coat.5. Add the cooked chickpeas and 1/2 cup broth.6. Bring to a simmer, add the kale and sprinkle with a little salt.7. Stir to allow the greens to wilt. Put on the lid and cook for 4 to 5 minutes, untilgreens are completely cooked. Stir well, taste and adjust seasoning if necessary.8. Serve & enjoy.Smoked Salmon & Black Bean SaladIngredients4 oz. smoked salmon1 (15-oz) can black beans, drained and rinsed1/2 medium avocado, diced1/2 cup cherry tomatoes, halved1 tablespoon freshly squeezed lime juice (from 1/2 medium lime)1 teaspoon olive oil1/4 teaspoon ground cumin1/8 teaspoon kosher saltPinch cayenne pepper (optional)Directions1. Flake the salmon into a medium bowl using a fork or your hands.2. Add the remaining ingredients and gently toss to combine.3. Serve on its own or over salad greens.75

Daily Vitamins for the Bariatric PatientYou need to take these vitamins DAILY and for the REST OF YOUR LIFE.Gastric Bypass (RNY) & Sleeve GastrectomyVitamins & SupplementsServings per Day*Bariatric formulated multivitamin-mineral with18 - 60 mg iron and 500 mcg Vitamin B121 servingVitamin B complex (with 50 mg thiamin)1 servingCalcium Citrate with Vitamin D3(total 1200 - 1500 mg daily)2 servings of 600 mg per serving3 servings of 400 or 500 mg per servingProbiotic1 serving*Serving sizes vary with different brands, READ THE LABEL Bellevue Pharmacy is now carrying Bariatric Advantage & Celebrate Vitamins. Buy them at your convenience after the Bariatric Education class or your follow up visits! They’re also available online. Bariatric Advantage has a special offer for Kaiser patients. Receive Kaiser member pricing ofroughly 20% discount & free shipping with validation code: KAISER.For a full list of our recommended vitamins: bariatric/meds.pdf 8

WelcomeWe are pleased to welcome Liam Malpass, RN, our new Clinical Operations Manager (COM).Liam will take over the reins for Anna Withee, RN, who has been a huge advocate for bariatricsover the years. Thank you Anna for your vision and support of our bariatric patients and program.Bariatric Sound-bitesAdvice, Ideas, & Tips from your Bariatric Team.The #1 piece of advice I give patients is THOROUGHLY CHEW YOUR FOOD. Eat slowly andmindfully; only what you can in 15 to 20 minutes aiming for the right amount and type of food.Often patients eat too fast and /or too much. They need to learn the difference betweenfeeling full, feeling over full and eating the right amount of food. I often hear patients say“I know I’ve had enough when it feels like it’s about to come back up.” This is an example ofeating too much and experiencing food reflux or regurgitation. Instead, aim for the rightamount of food.Remember your stomach has been dramatically reduced in size. For the first 3-6 months postop it’s roughly the size of a shot glass. After six months - 1 year its not much bigger unless youstretch it out by over eating often. This requires you to keep your meals small; eating mindfully, slowly and chewing thoroughly. If you don’t chew it well enough you'll be giving it back orregurgitate. by William Young, PA-C9

Bariatric Support Group LocationsBellevueKaiser Permanente Bellevue Medical Clinic, Room E101/105Held quarterly, the 3rd Wednesday of the monthJanuary, April, July & October, 6:00 - 8:00 pmJanuary 16th at 6:00 pmPlease call 425-502-3454 for more information.Overlake Bariatric Support GroupHeld twice monthly: 2nd Thursday; 6:00 - 8:00 pm and 4th Saturday; 10:00 - 12:00 pmOverlake Medical Center - PACCAR Education CenterInsight Conference Room1035 116th Ave. NE, Bellevue, WA 98004Please call (425) 467-3957 for more information.TacomaMultiCare Center for Weight Loss and Wellness in TacomaHeld on the 4th Monday of every month, 5:30 - 6:30 pm2202 S Cedar St. Suite 300 Tacoma WA 98405Please call (253) 301-5280 for more information.Sumner (led by MultiCare Center WLW staff)YMCA in SumnerHeld on the 2nd Wednesday of every month, 5:30 - 6:30 pm16101 64th St E Sumner WA 98390Please call (253) 301-5280 for more information.10

We want to hear from YOU! What do you want included in themonthly newsletter?Send us your ideas to:bariatricpatients@kp.orgBariatric TeamBariatric Surgeon: Dr. Gupta MD, FRCSC,FACS,FASMBSDiplomate, American Board of SurgeryDiplomate, American Board of Obesity MedicineKaiser Permanente Bellevue BariatricProgram DirectorContact UsNurse: 425-502-3454Listen to the Prompts.Press 3.Routine Appointments:425-502-3454Listen to the Prompts.Press 1Consulting Nurse:1-800-297-6877*Call the Consulting Nurse lineif after 4:00 and weekends, withany symptoms/concerns.Bariatric PAs: Kat Cozza, PA-C Lynda Crescenzi, PA-C Travis Sears, PA-C Heather Vincent, PA-C William Young, PA-CBariatric ARNP: Bariatric RN: Lisa Stariha, RDN, MA ABSMedical Assistant: *For specific questions regardingyour health, please email usthrough Kaiser’s MyChart to ensure privacy.Sarah Chan, BSN, RNBariatric Dietitian: Bariatric Team Email:bariatricpatients@kp.orgLori Gokee, ARNPKaren Kucera, MA-CClinical Operation Manager: Liam Malpass, RN11

Bellevue Bariatric Program January 2019 Bariatric Life-long Support We are pleased to announce the bariatric team now fol-lows our Kaiser member bariatric patients for a lifetime, . Weight loss surgery is a tool to help you lose weight and improve health. Utilizing the tool to its full potential re-

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