http://www.aspiringbariatrics.co.nz/

Aspiring Bariatrics Laparoscopy and Endoscopy, Suite 7, 72 Newington Avenue, Dunedin (2025)

07/11/2023

Calcium is the most abundant mineral in the human body, although almost all of it is stored in the bones and teeth. Calcium is also used by the body for nerve conduction, blood clotting and other processes. Calcium in our diet comes mainly from dairy products such as milk, cheese and yoghurt, but can also be found in tofu, almonds and broccoli. Some plant milks are fortified with extra calcium.

Because most of the calcium in our body is stored in our bones, when we do not get enough in our diet, our body will ‘borrow’ this out of our bones. Calcium after Weight Loss Surgery
Over the long term this can lead to weakening of the bones (osteoporosis) and an increased risk of fractures.

The American Society of Metabolic and Bariatric Surgery recommends that people get 1200-1500mg per day of elemental calcium in their diet from all sources. People who have had a gastric bypass operation will usually need to take calcium supplements as their ability to absorb calcium is reduced, but calcium supplements may also be needed after sleeve gastrectomy.

Calcium supplements are commonly available in one of two forms, calcium carbonate and calcium citrate. Calcium carbonate is available on prescription but is not as well absorbed after gastric bypass operations, or when people are taking acid suppressing medications like pantoprazole. Calcium carbonate also needs to be taken with meals, and can cause constipation or kidney stones. Calcium citrate is not available on prescription but can be purchased on line including from www.tric.co.nz. It is better absorbed, particularly after gastric bypass operations or when people are taking acid suppressing medications. Calcium citrate also does not need to be taken with meals and has a lower chance of causing constipation or kidney stones as side effects compared with calcium carbonate.

05/11/2023

Avoiding Clexane jabs after weight loss surgery?

Venous thromboembolism (blood clots in the legs or lung) are rare, but still one of the most common serious complications that can happen after bariatric or weight loss surgery. They are also mostly preventable through a combination of early activity, compression stockings and blood thinning medications. Until recently blood thinning medications meant daily injections, usually for 14 days after hospital discharge. We are pleased to report that an alternative protocol has been trialled in the US, where patients are switched from injections to tablets after two or three days, and that this appears to have similar outcomes to the prolonged course of injections.
At Aspiring Bariatrics we are pleased to be able to offer a 28 day course of blood thinning tablets for after people leave hospital, as an alternative to blood thinning injections. As these are not funded in NZ for this indication, there is a small additional cost for this medication.
For more information please contact us.

05/11/2023

It can be really hard to answer questions about weight regain after weight loss surgery, however a recently published study gives us some of the best information we know so far about this question. The study reviewed a large number of Dutch patients undergoing bariatric surgery between 2015 and 2018, who’s outcomes were followed in a national registry. As they were looking at weight regain they firstly excluded all participants who lost less than 20% of their starting body weight during the first year. The groups were matched using a statistical method called propensity scoring that is able to match for other factors that can influence the outcome, so long as they are known and measured. The main outcomes the researchers looked at was the risk of people regaining more than 10% of their lost body weight. What they found was:
* 3.9% of patients undergoing Roux-en-Y gastric bypass and 11.1% of patients undergoing sleeve gastrectomy were excluded due to losing less than 20% of their starting body weight during the first year after surgery.
* Of those that lost at least 20% of their starting body weight, the risk of regaining at least 10% of their lost weight increased with time. i.e. weight after surgery tends to increase slowly with time.
* Of those that lost at least 20% of their starting body weight, 12.7% of people undergoing Roux-en-Y gastric bypass and 22.1% of people undergoing sleeve gastrectomy gained at least 10% of their lost weight by their last follow-up visit, up to five years after their surgery.
Overall this study provides some of the best evidence to date on the rates of weight regain after weight loss surgery. It is important to remember that the researchers were looking for people who gained more than 10% of their lost weight, which is still often a small amount of weight regain overall. Nevertheless this study does support the observation that weight regain after bariatric surgery is probably more common in people who have a sleeve gastrectomy than those who have a Roux-en-Y gastric bypass. Although risk of regaining weight is only one of a number of outcomes that are important to consider when choosing which operation to pick, if it is an important risk for you then please discuss this with your surgeon when making the choice of operation.

05/11/2023

Dr Smith is pleased to announce a second location for consulting in Queenstown. For easier access to those travelling from Wānaka, Cromwell and the wider Central Otago and Northern Southland region, Dr Smith is now also offering clinics at The Doctors Whakatipu Shotover Clinic. This is located a 4 Thirteenth Avenue, Shotover, nearby to Southern Cross Hospital and Pacific Radiology.
For those based in Central Queenstown, or from Glenorchy to Arthur’s Point, we continue to offer regular clinics at the Queenstown Medical Centre at 9 Isle Street.
For more information or to schedule an appointment please contact us.

27/10/2022

After a wait of over 30 years, we are pleased to welcome the release of the ASBMS/IFSO guidelines of 2022 to replace the previous NIH guidelines of 1991. These guidelines review all the evidence about benefits and risks of bariatric or metabolic surgery in order to determine who is likely to benefit from this surgery. This has been a huge project due to the major improvements in surgical techniques over the last 30 years, as well as the large amount of evidence now available supporting the outcomes from surgery. The major changes compared with the previous NIH guidelines are:

* Weight loss surgery is now indicated in all people with a body mass index (BMI) over 35 kg/m2, regardless of whether or not they have associated health conditions.
* Weight loss surgery may be indicated in select people with a body mass index (BMI) of between 30 and 35 kg/m2 if they have type 2 diabetes or associated health conditions that have failed to improve despite multiple attempts at weight loss without surgery.

31/10/2021

We are pleased to announce that we are moving our consulting space in Dunedin just along the corridor to Suite 7 at the Marinoto Clinic, Mercy Hospital. This move will give us some more flexibility when it comes to scheduling clinic appointments, and also mean that appointments with Dr Smith and the Nutrition and Life Dietitians are both at the same location.

For people who have not seen Nutrition and Life at Mercy Hospital, Suite 7 is in the main Marinoto Clinic doors and on the left as you come in, just before Pacific Radiology.

06/09/2021

Kia ora koutou.

With Aotearoa moving in to the Covid protection framework/traffic light system as well as the slow spread south of Covid-19 cases we plan to continue to provide a safe service for our community with as little disruption as possible. In order to help us do this and reduce the stress on the health system, please note the following:
* As a health care provider, vaccinations are not required for consultations and we will not be checking vaccine certificates.

* We will be asking patients about their vaccination status and may take options to minimise risk, e.g. booking consultations for before or after a break or offering virtual consultations where appropriate, for people who are not vaccinated.

* Mercy Hospital Dunedin has decided that beginning in 2022, patients will need to have had two doses of the Covid-19 vaccination in order to be admitted for elective surgery. This requirement will also apply to any visitors. Please contact us if you have any concerns about this.

* We will be screening everyone for symptoms and contact locations prior to their appointment via a link in a text message, thank you for taking the time to read this and complete it accurately.

*We are happy to reschedule appointments or use virtual consultations where possible if people are symptomatic or required to isolate for any reason. There will be no additional costs for this.

* Covid-19 delta spreads via the air we breathe out, and lingers in indoor environments. For this reason masks or face coverings are required at all times by patients and visitors in our clinics, including the waiting area. Please do not bring visitors that are unable to wear a face covering, and if you have a medical exemption from wearing a face covering please contact us to ensure appropriate precautions can be taken.

* Thank you for signing in using the Covid-19 tracer app or manual sheets, this is a Government mandated requirement for patients and visitors.

Kia kaha,
Kia pai,
Kia tautoko tatou ia tatou katoa.

Be strong, be kind, and support one another.

19/08/2021

COVID-19 Vaccinations and Bariatric Surgery

With Covid-19 infections gradually spreading south and the Covid protection framework coming in to place people may be wondering what the requirements for vaccination are around elective surgery. There is very good evidence from overseas that people who contract Covid-19 around the time of surgery have a 4 to 8 times greater chance of dying in the one month after surgery. Covid-19 vaccination therefore is very important to reduce that risk. Also for protection of patients and staff, Mercy Hospital Dunedin has decided that from the beginning of 2022, all patients and visitors over 12-years of age will either need to have had two doses of the Covid-19 vaccination, or an official exemption.

Based on current guidelines from the Royal Australasian College of Surgeons our recommendations for vaccination for people planning to have bariatric or other elective general surgery are:
1. Book in your first dose of the vaccine as soon as you are eligible, only delay this if the gap between vaccination and surgery would be less than two weeks.
2. If you are unable to have your first vaccine dose at least two weeks prior to your surgery then book this in for as soon as possible, but at least two weeks after your surgery date.
3. Book your second vaccine dose for the recommended interval after the first dose, but again book this at least two weeks before or two weeks after your planned surgery date. There is ample evidence that delaying this second dose by a week or two if needed will not reduce its long term effectiveness.

From 2022, Mercy Hospital will require people to have had both their Covid-19 vaccinations or a medical exemption in order to be admitted for surgery. Please contact us if you have any concerns about this.

22/07/2021

Vitamin D is a hormone made by your skin by exposure to sunlight. At higher latitudes, such as here in the southern part of New Zealand, the sunlight is not very strong for much of the year so vitamin D deficiencies are common, particularly during winter. Vitamin D is used to aid calcium absorption from the intestine so people with vitamin D deficiency are at risk for developing weak bones. Vitamin D supplements are available on prescription and are usually taken at a dose of one 50 000 unit capsule once a month. Once vitamin D levels return to normal, ongoing supplementation is not always required, however some people benefit from taking an annual course of vitamin D over the three months of winter.

10/06/2021

Can I use my KiwiSaver to pay for bariatric surgery?

On the face of it this is a very good question. Many people have enough money in their Kiwisaver accounts to pay for weight loss surgery and feel the health benefits from significant weight loss will improve their quality of life in retirement. Also, in the past it has been possible for people with Australian Superannuation to use this to fund weight loss surgery. Unfortunately, in New Zealand things are not so simple. Kiwisaver has been established to allow New Zealanders to fund their retirement over and above whatever NZ Superannuation is able to pay in the future. Aside from the First Home Grant, is is difficult to withdraw money from your Kiwisaver account, until you reach your age of entitlement.

There are however, two possible exceptions that some people may be eligible for. According to the KiwiSaver Act 2006, an application for early withdrawal may be on the grounds of serious illness.

‘Serious illness’ is defined as: an injury, illness or disability that results in your being totally and permanently unable to engage in work for which you are suited by reason of experience, education or training or a combination of those things; or an injury, illness or disability that poses a serious and imminent risk of death.

While the second clause precludes bariatric surgery as an imminent risk of death means that someone is likely to die very soon as a result of their weight. If this were true then almost certainly any elective surgery would not be safe. The first clause however may be applicable to some people, particularly if weight related health complaints prevent you from working in your chosen occupation.

For people who do not meet the serious illness grounds, then KiwiSaver withdrawals may also be available for significant financial hardship.

Significant financial hardship is defined by the KiwiSaver Act as significant financial difficulties that arise because of ... the cost of medial treatment for an illness or injury of a member or a member's dependent.

Here at ABLE we are not financial advisors. We strongly encourage anyone considering applying to access their Kiwisaver on the grounds of serious illness to consider the effect it will have on their retirement savings and discuss this with a registered financial advisor. We also recommend you discuss this with your GP and your KiwiSaver provider, as they are probably the best placed to advise you as to whether your health problems may qualify under the serious illness category, or whether you may be eligible under the significant financial hardship grounds.

Aspiring Bariatrics Laparoscopy and Endoscopy

07/11/2023

05/11/2023

05/11/2023

05/11/2023

27/10/2022

31/10/2021

06/09/2021

19/08/2021

22/07/2021

10/06/2021

Address

Website

Alerts

Contact The Practice

Shortcuts

Share

Category