Dear Friends and Family of Laparoscopic Associates of San Francisco,
to the February edition of our online newsletter. We hope to offer lots
of helpful tips for weight loss surgery patients as well as success
stories and invitations to our events! Please feel free to submit your
tips or your success story with pictures to firstname.lastname@example.org. We
want to see your before and after pictures!!
The Docs of Laparoscopic Associates of San Francisco
SUCCESS STORY : Denise Reclaims Her Life with the RNY Gastric Bypass
I spent over a decade morbidly obese. During that time, I tried almost
every diet, pill and program available but could never seem to lose
more than 50 pounds before I’d come to a screeching halt. I was a
classic yo-yo dieter, but I worked out 3-4 times a week so exercise
wasn’t really an issue for me. I became so discouraged about my
inability to lose weight that I began secretly researching weight loss
surgery for 5 months before gathering the courage to make an
appointment with Dr. Paul Cirangle at Laparoscopic Associates of San
Francisco. In spite of living an hour away from San Francisco, I felt
so comfortable after my first appointment with him; with his knowledge,
thoroughness and compassion that I decided to travel farther to use a
competent surgeon with hundreds of weight loss surgeries under his belt
rather than go see the surgeons in my area that had just begun doing
weight loss surgeries. I felt no shame or awkwardness in discussing my
obesity with Dr. Cirangle, any of the other surgeons at LapSF or his
office staff and that amazed me since I was so filled with shame before
I went in for my first appointment.
From my first appointment with Dr. Cirangle in November 2003
until my surgery in January 2004, I spent the Holidays wondering if I
was about to do the “right” thing. I learned there are several weight
loss surgeries available so based upon how much weight I needed to lose
(120 pounds) I decided to have the RNY procedure. Dr. Cirangle actually
told me I didn’t have that much weight to lose and I still laugh at his
comment because I’d never had a doctor tell me anything like that
before! The procedure itself was surprisingly easy and I discovered I
really didn’t require much pain medication. I now have 5 tiny little
scars that have faded to about 1/4” long each. I eat very differently
now (and a lot less) than before surgery. I try to concentrate first on
getting in enough protein, and I round out my meals with a balance of
carbs and fat. I really don’t want to undergo plastic surgery to reduce
any excess skin which sometimes accompanies major weight loss so I
became very focused on my exercise regime this past year: Thankfully,
good genes and my exercise regime has made it possible for me to
sidestep plastic surgery. I work out 5-6 times a week; walk 18 miles,
and I weight train my upper body as well. I also do Pilates and yoga. I
entered my first 10k race last May and completed the race in a
centipede with fellow LapSF patients. I’ve gone from a size 24 to a
size 6. My family has been very supportive during my transformation
(which really helped). My friends were astonished when I recently
emailed my “before” and “after” pictures – many of them called me to
say they were skeptical of my surgical option for weight loss, but that
after seeing me, they think I made the right choice and that I seem to
radiate good health. It’s kind of cool to now have my teenage daughter
ask to borrow some of my new clothes. My life has changed dramatically
for the better over this past year; problems still come and go, but the
confidence I now have in my body is amazing and something I’ve learned
to accept with grace and humility.
Landmark Study Shows Blockbuster Effects of Bariatric Surgery
A meta-analysis of 136
studies involving 22,094 patients has strongly corroborated the
positive effects of bariatric surgery (Buchwald et al, JAMA
2004;292:1724-1737). Henry Buchwald, MD, PhD, professor of surgery,
University of Minnesota, Minneapolis, and colleagues found the patients
had an average 61.2% excess weight loss. The greatest average
weightloss occurred for biliopancreatic diversion or duodenal switch,
at 70.1% excess weight loss, followed by %68.2 for gastroplasty, 61.6%
for gastric bypass and 47.5% for gastric banding.
The team found an average 30-day postoperative mortality was 0.1%
for the purely restrictive procedures, 0.5% for gastric bypass and 1.1%
for biliopancreatic diversion or duodenal switch. Moreover, 86% of
those with diabetes experienced an improvement or complete resolution
of their disease, while 83.6% of those with obstructive sleep apnea
experienced this salubrious effect, as well as 70% of those with
hyperlipidemia and 78.5% of people with hypertension.
The studies Dr. Buchwald and his colleagues examined in their
meta-analysis consisted of five, randomized, controlled trial; 28
nonrandamized controlled trials or series; and 101 case series without
"This is a landmark paper because of its scope and the thoughtful
review and analysis," said Kenneth MacDonald, Jr., MD, professor or
surgery, East Carolia University Brody School of Medicine, Greenville,
N.C. "It will be refererenced and quoted as a classic, from now on. "
Rosemary Frei, MSC.
February's Weight Loss Surgery Recipe, ORANGE GLAZED SALMON
ORANGE GLAZED SALMON
1/4 cup fresh orange juice
2 tablespoons balsamic vinegar
1 teaspoon Dijon mustard
1 tablespoon olive oil
1 tablespoon finely minced shallot or onion
1 small clove garlic, peeled and forced through a press or chopped finely
2 teaspoons each finely chopped cilantro, basil and mint or a combination of your favorite herbs.
1/8 teaspoon salt
Freshly ground black pepper to taste
1-1/4 pounds salmon fillet
Place the orange juice, vinegar, mustard, oil, shallot, garlic,
herbs, salt and pepper in a jar or plastic container. Close lid and
shake well to blend.
Place salmon in a foil-lined pan and spoon a little of the
vinaigrette over the fish. Bake in a preheated 450-degree F. oven 12
minutes per inch of thickness, or until cooked through.
Spoon the remaining vinaigrette over each serving of fish.
Yield: 4 servings
Per serving: Calories 276; Protein 26g; Fat 17g; Carbohydrates 4g;
Don't Forget to Get Your Yearly Lab Work Done Early!
We are busy gathering yearly lab statistics from our patients. Believe
it or not, the lab where you get your lab work done takes 3-4 weeks to
get us the results of your complicated one year labs. This means that
you should schedule your one year lab tests at least one month before
your one year appointment. Don't forget to stop taking your vitamins 3
days before your annual lab tests. Please see our website or the link
below for an annual lab form. If you cannot download it, call our
offices and speak to Michelle. We appreciate you getting your labs done
Seminars and Support Group Dates 2005
We have monthly seminars and support groups in 6 different locations.
SAN JOSE: We meet on the third Wednesday of the month at 6pm for
pre-ops and 7pm for post-ops. All meetings are at the Courtyard
Marriott by the San Jose Airport, 1727 Technology Drive in San Jose.
SACRAMENTO: Our support group meeting is on the third Wednesday
of the month at the Sutter Cancer Center at 2800 L Street in Sacramento
at the Buhler Board Room on the 7th Floor. It starts at 7pm, we hope to
see you there!
PETALUMA: Our Petaluma support group meets the third Saturday of
the month at Groverman Hall at Petaluma Valley Hospital on North
McDowell in Petaluma at 10:30am. New patient seminar at 9am. The only
exeption is April, when the support group will be on the 23rd.
EUREKA: Our Eureka support group meets at 7pm on the Thursday
evening that our doctors are seeing patients in Eureka. They meet at
General Hospital, in the Burre Conference Room on the roof. Please call
or check our website to confirm the date.
EAST BAY: Our East Bay support group meets at 745pm on the second
Tuesday of the month at the Mt. Diablo Regional YMCA in Pleasant Hill
at 350 Civic Drive in the Lions Den Room.
SAN FRANCISCO: Our SF support group normally meets the last
Thursday of the month at 6pm at the Cathedral Hill Hotel in San
Francisco, at the corner of Van Ness and Geary. Parking is validated.
Satellite Office Locations
We have office locations
in 6 different Northern California areas. The doctors see patients in
most of these offices once a month. If you live near one of these
locales, feel free to call our main office number to make an
appointment for a satellite clinic day. We'll see you there!
Eureka - 2607 Harrison Street, Suite B Eureka, CA
March 10th and 11th, April 21st and 22nd
Chico - 111 Raley Blvd. Suite 120 Chico, CA
Sacramento - 631 Fulton Ave, Sacramento, CA
March 18th and 25th, April 8th and 22nd
Stockton - 415 East Harding Way, Suite G Stockton, CA
Petaluma - 1456 Professional Drive, Suite 406 Petaluma, CA
March 18th and 23rd and April 8th
San Jose - 3803 South Bascom Ave, Suite 100 Campbell, CA
March 16th and April 20th
Click here for a list of our locations and driving directions.
NOT ALL YOGURT IS BAD YOGURT
There is a company on the east coast named Carb Countdown. Their products have very few carbs and lots of protein.
Now they are starting to bring yogurt to California.
Here are the nutritional values for one 6 oz container of yogurt (that actually tastes good):
Fat Calories 10
Total Fat 1.5g
Sat Fat 1g
Total Carb 4g
Dietart Fiber 0g
If you have tips on good products for weight loss surgery patients, please email them to email@example.com. Thanks!
Thank you for your support to date, see you at the next support group meeting!
Dr. Gregg Jossart ~ Dr. Paul Cirangle
Laparoscopic Associates of San Francisco
2100 Webster Street, Suite 518
San Francisco, CA 94115
866-957-3627/(415) 561-1713 fax
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