Metabolic Syndrome. How to fix it ? MGB-OAGB procedure?

 Doctor: Yes, Mr. Kapoor tell us when did you get Mini Gastric Bypass (Bariatric )Surgery?

Patient: My surgery was done in July 2019.

Doctor:It is going to be three years to your surgery.

Patient:Yes!

Doctor:How much total weight have you lost?

Patient:I have lost approximately 35-38 Kg.

Doctor:Ok.

Doctor:What problems you had before surgery?

Patient:I had a problem with my foot, which led to difficulty in walking.

Doctor:Yes! you had the foot drop problem.

Patient:I used to feel breathlessness while walking.

Doctor:Ok.

Patient:Yes!

Doctor:You have Spina Bifida since birth.

Patient:Yes!

Doctor:So, being overweight conditions became worse.

Patient:Yes!

Patient:Walking and roaming were difficult.

Patient:More problems were diagnosed like Diabetes Mellitus before surgery.

Doctor:Ok.

Patient:But, I got Bariatric surgery at the right time.

Doctor:Ok.

Doctor:What is the difference in your before and after surgery life?

Patient:Now, I don't feel breathless while walking.

Doctor:Did you feel breathlessness before surgery?

Patient:Yes!

Doctor:Ok.

Patient:Otherwise, I am doing good.

Doctor:How are your blood sugar levels now?

Patient:Blood sugar levels are under control.

Doctor:Is it normal now?

Patient:Yes!

Doctor:Can you eat like a normal person? and do you feel satisfied after eating anything?

Patient:Yes!

Doctor:Have you ever felt that getting MGB done was a wrong decision? and you can't eat properly?

Patient:No.

Doctor:You can eat like a normal person.

Patient:Sometimes I can eat 2 parathas.

Doctor:Ok.

Patient:There is no problem with eating.

Patient:Ok.

Doctor:But take care that you don't eat too much carbs.

Patient:Ok.

Doctor:Don't eat parathas for breakfast.

Doctor:I would say, we should not make parathas for breakfast.

Patient:Ok.

Doctor:Eat a big bowl of fruits in the morning.

Patient:Ok.

Doctor:You can eat any seasonal fruit.

Patient:Ok.

Doctor:Take a variety of fruits and have a whole bowl of curd.

Doctor:Curd contains enough protein and calcium.

Doctor:Don't you eat eggs?

Patient:No.

Doctor:One who eats eggs can eat up to 8 boiled eggs in the morning to fulfill the body's daily requirements.

Patient:Ok.

Doctor:Always thank God, after having breakfast, that we got something to eat.

Think about this, before surgery you were absorbing everything, and you became obese.

Patient:Ok.

Doctor:Before surgery, you were not eating many chapatis at a time.

Patient:No, my diet was the same as now.

Doctor:and you became fat.

Doctor:Many people must have told you to lose weight with diet and exercise, which is not possible.

Patient:Yes!

Doctor:You lost a good amount of weight with surgery but you have to maintain that.

Doctor:The only way to maintain this weight, limit the amount of carbohydrates in your diet.

Patient:Ok.

Doctor:Although you are absorbing less yet body adapts to this surgery after some time.

Doctor:Our system adapts to the new design within some time.

Patient:Ok.

Doctor:You must have noticed that the amount of fat/oil in the stool is lesser as compared to the amount after surgery.

Patient:Yes!

Doctor:This means your body has started absorbing some amount of fats now.

Doctor:But you have 2 benefits, first one is that your pouch is smaller now.

Doctor:If I order pizza or 2 bhaturas, you won't be able to eat all at once.

Patient:Yes!

Doctor:You will feel full after having some amount of food.

Patient:Yes!

Doctor:You need to take care and eat less sugar as it will lead to weight gain in the long run.

Doctor:Drinking alcohol can also lead to weight gain.

Doctor:Whenever you gain some weight, look at what you are eating and control it.

Doctor:This surgery will give you an 80% result and the rest will depend on you, that how you handle it.

Patient:Ok.

Doctor:Combined efforts will give you the best results.

Patient:Get your blood tests done once in 6 months.

Patient:Take multivitamins and 2 tablets of calcium daily.

Doctor:We are more concerned about your bone health, as your bones were already weak and weight loss will make them weaker.

Patient:Ok.

Doctor:You can't do much exercise because of this limitation.

Patient:Yes!

Doctor:The best would be to eat more curd for that take at least 3 bowls of curd daily.

Patient:Ok.

Doctor:The curd contains a lot of good quality calcium which is better than a tablet.

Patient:Ok.

Doctor:Every human needs 1500 mg calcium daily, which is available in 1.5-liter milk or milk products.

Patient:Ok.

Doctor:But we don't eat that much on daily basis.

Doctor:That's why we advise patients to take 2 tablets of calcium daily.

Patient:Ok.

Doctor:But take at least 3 bowls of curd daily.

Patient:Ok.

Doctor:Do some exercise for at least 15-20 minutes in the morning.

Patient:Ok.

Doctor:With some foods, you will feel flatulence and some may be normal.

Patient:Yes!

Doctor:Your food is going directly into the intestine, you will get to know which foods the intestine does not like.

Doctor:Eat more fruits, that will be digested easily and you will feel good.

Doctor:Have your eating behavior changed after surgery?

Patient:Yes!

Doctor:You don't like some foods.

Patient:Liking is not the issue, after eating certain foods I feel the rapid pulsation.

Doctor:Do you feel tachycardia?

Patient:Yes!

Doctor:That tachycardia is because of Dumping.

Patient:Ok.

Doctor:You feel a rapid pulse because of Dumping syndrome.

Patient:Yes!

Doctor:Write down, which foods lead to uneasiness after eating.

Patient:Ok.

Doctor:This means your intestine doesn't like these foods.

Patient:Ok.

Doctor:They may be those foods which we don't need.

Patient:Ok.

Doctor:Like sweet tea or parathas.

Patient:Ok.

Doctor:Put a good amount of sugar in the tea and have cookies with that, firstly you will enjoy that, after some time you will feel uneasy.

Patient:Yes!

Doctor:You need to understand that your intestine doesn't like that.

Patient:Ok.

Doctor:Before surgery, the stomach was like a bag that was welcoming everything.

Patient:Yes!

Doctor:Now, we have made a new pouch and the food is going directly into the intestine.

Patient:Ok.

Doctor:If you feel uneasy, then look at what you are eating.

Doctor:You won't feel uneasy with natural things like fruits.

Patient:Ok.

Doctor:Actually, we should eat boiled or steamed veggies.

Doctor:But Punjabis like to eat tempered vegetables only. You can eat that but use less oil for tempering.

Patient:Ok.

Doctor:Eat less carbs and more vegetables and curd.

Patient:Ok.