WEIGHT LOSS SURGERY MEXICO
A STEP BY STEP GUIDE TO CHANGING YOUR LIFE
INFO@SURGICALWEIGHTLOSS.CO.NZ JBTG : JACKIE BROWN TOUR GROUP
TABLE OF CONTENTS DISCOVER the secrets to transforming your inner and outer world
LEARN how to become the best version of yourself
Nothing tastes as good as being healthy feels.
Introduction: Authors Note Chapter 1: The Mexican Experience, information, admission, videos, kiwi saver Chapter 2: Travel Information Packages, pricing, Electronic visas, carrying money, FAQs Chapter 3: Dietary Guideline three 3 stages (liquid, soft, solids) vitamins
Disclaimer: I am not a health professional, I am an accredited TAANZ bonded travel broker and a qualified tour guide. This book has been compiled from interviews, discussions with surgeons, my own personal experience and readings. https://surgicalweightloss.co.nz/
JBTG Jackie Brown Travel Group
NOTE FROM THE AUTHOR WELCOME TO YOUR NEW ADVENTURE. If you know me you will know that I struggle with my weight. All my life I have yo-yoed. I also do not buy into the fat-acceptance movement, but I don’t intend for that to sound disrespectful to those who do. I just know that for me, being overweight was ruining my life. I lost too many years to longterm coercive control, I don’t want to waste any more. Already I was getting sore knees and pin in my hips, and I was only 28 kgs overweight, my blood test showed prediabetes and my life would have been shortened and what I could do with the time I have left I felt would continue to be severely limited. But isn’t weight loss surgery a bit extreme? Not for me it isn’t. I have lost weight several times in my adult life and always put it back on, plus some. I’m not alone. The statistics show that almost all of those who do lose weight will regain it, and more. So began my journey seriously investigating the pros and cons of sleeve gastrectomy surgery, when a friend told me about her experience of bariatric surgery in Mexico, before you could say "Bibbidi-Bobbidi-Boo" was booked and ready to go on this new
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adventure which I will share with you in this e-book. .
Jackie Brown The day after surgery
CHAPTER
ONE
the Mexico experience www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Body Mass Index So many clients come to me to book their cosmetic surgery, only to have their hopes dashed because their BMI is over 30 (28 in NZ), and find that they are turned down for surgery. What is a ‘BMI’? Over the years, many different ways of calculating a healthy weight have been developed. Most health professionals use the Body Mass Index (BMI) formula to work out whether your weight is within a healthy range. Although this formula isn’t perfect, it is a good estimation of the amount of body fat you have. It is the most useful tool available to help doctors calculate the risk of you experiencing health problems or complications from treatment as a result of your weight. What is a healthy BMI? A healthy BMI measures between 18.5 to 24.9. A BMI of over 24.9 suggests you are overweight. Women with a BMI of over 30 have obesity. This means that their weight has reached a level where it is likely to have a negative effect on their health, increase their risk of some diseases and reduce their life expectancy. Women with a BMI of 40 or more have morbid obesity. Women with a BMI of 35 or more who are experiencing an obesity- related medical condition, such as diabetes or high blood pressure, also have morbid obesity. On average, a BMI of 30 or more reduces life expectancy by about 6 years and a BMI of over 40 reduces life expectancy by about 10 years. Obesity also raises the risk of surgical and anaesthetic complications. Obese individuals thus fare worse than normal weight individuals in surgeries. And so my research began, I wanted to help these men and women who were living with obesity. I do not profess to be a doctor, a nurse or a surgeon, so my research is based on discussions, readings, hours of research and now of course my own gastric sleeve experience. I will bring you the good, the bad and the ugly so that no one is under the illusion that this is "quick fix" .
n w o r B e i k c a J
JBTG www.surgicalweightloss.co.nz
THE EXPERIENCE Three nights in San Diego relaxing by the pool, and of course a little bit f shopping is the perfect time to chill out, remembering of course that you are now on a liquid diet post surgery....but more of that later on. After a few days of chilling and shopping at the famouseLos Americano mall, plus a little excursion to the infamous Walmart, you will enjoy a trolley tour that is a hop on hop off trip that takes you to all the "must see" area including a stop a the famous statue "the kissing sailor" which is next to the USS Midway giving you a once-in-a-lifetime opportunity to explore a historic aircraft carrier, and then maybe a chowder at the world renown "Fish Market" which has the freshest, highest-quality seafood available, simply prepared and served up at a reasonable price. Ensure you do this as "last supper" before going your 2 days of liquids!
courtesy of Steve Brown-Black Diamond Photography
I will help you make the most of your trip, even if it is short, Sea World or San Diego Zoo or the Gaslamp Quarter are the main areas you should consider visiting, especially if you’re only spending two days in San Diego, but remember in my itineraries I bring you back to San Diego post surgery for a few days to either relax, do a San Diego Tour: Hop-on Hop-off Trolley tour or go back for the last minute shopping for the family, or if you feel up to it share an Uber with a few of you and drive up to Disneyland for the day.
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Small tours of six clients
Tours departing 4-5 times per year and price depends on the season you choose to travel (off season, mid season or high season) As an accredited travel agent and airline broker , I have all the airfares and booking engine at my fingertips, however I find the best airline that suites the needs of my clients is Hawaiian airline via Honolulu through to San Diego, with no need of catching trains form LA or dealing with the Los Angeles airport staff. To book your flight I would require a copy of your passport and would require a NON REFUNDABLE booking fee of $2800pp to secure your flight and a placement for surgery with the balance due just one month prior to departure. the cost of the tour includes 3 nights, San Diego, 4 nights Tijuana, additional 3 nights in San Diego, 1 night Hawaii all hotels, airfare, tours and activities prior to your surgery, fully escorted. Your own room throughout. (*please note: The mini bypass and the bypass MAY require an extra day at the hospital , if you have diabetes your would be a candidate for mini or full bypass, but since I book the entire group for 4 nights in Mexico I am around for you.....No man (or woman) gets left behind on my watch!
Jackie Brown Tauranga 0275481004
info@surgicalweightloss.co.nz
San Diego Tour Costs Low season (USA winter) Departure : $6180 NZ pp own room $4930 NZ pp per person share Twin/Double Mid season (USA Spring and autumn) $6400 NZ pp Own room Partner programme (share) $5728NZ per person Twin/Double High Season (USA summer and school holidays) $6972 NZ pp own room $59NZ pp per person share Twin/Double Includes: 1 night Honolulu, (either outbound or homebound, depending on airline schedule) 3 nights San Diego hotel, 4 nights Tijuana, additional 3 nights in San Diego Transfer airport/hotel/airport Transfer to Tijuana (round trip) Trolley tour of San Diego Shopping excursion to Los Americanos mall Excursion to Walmart Surgery is priced in USD (NZD at today’s rate of exchange) These prices covers the hiring of our surgeon and his team plus the hospital operating theatre for the day PROCEDURE Gastric Sleeve Gastric by pass Mini By-Pass Full By-Pass Revision surgery Hernia Repair
USD 4499.00 5600.00 5500.00 5699.00 5700-6200 600.00
NZD (at ROE 0.62USD=$1NZD 7300.00 9125.00 8962.00 9287.00 9288-10,100 (depends on internal tissue/scaring) 977.00 (only if you have a hernia)
Dr. Arias Giovanni
Additional meds $US100-$US200 ($160-$320NZD ) depends on how much pain relief you have over and above the package, this includes anti-coagulants that Pam buys from the pharmacy as they are cheaper there than the hospital)
Remember if your BMI is • over 48-54 the additional cost is 600USD • over 55-59 the additional cost is 1000USD • over 70+ the additional cost is 2000USD (and not recommended for long haul travel)
Jackie Brown with our wonder Mexico co-ordinator Pam Bennett
Additional surgery costs Additional medication which is not compulsory (if you can get the anticoagulants from your GP in NZ) Anticoagulants $60usd Omeprazole $15USD (for 120 tablets)
Gall bladder removal 700USD *Gallbladder removal is not compulsory but recommended since as the body metabolises fat during rapid weight loss, it can cause the liver to secrete extra cholesterol into bile, which can cause gallstones. How much will you need all up, well very little on food and beverage since you will be on a liquid diet for the 2 days prior surgery, and 3-6 weeks prior surgery you will be asked to diet, to decrease the fat around the liver. The only thing the other groups have splashed out on is outlet shopping!!!! The free days in San Diego you could visit: the San Diego Zoo $70USD Sea Word $70USD or you could have a day in Disneyland which is $104 USD, there is a train at 7.10am, takes about 2 hours up the coast and returns 7pm, or get together and book an Uber from $110USD each way (2 hours each way) . I hear you ask how much will I need all up ? I have calculated these at todays rate of exchange into NZD ($1=0.62) GS in NZD $7300 Hernia repair $977NZD (if you don’t have one….more shopping!) Additional meds $150
You are looking at a total of about $13k-$15k NZD compare that to NZ, where you are looking at between $25k-$29K plus consultancy fees
Your driver Brian and his wife Pam
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
After a few nights relaxing, you will be collected by the your chauffer, Brian, the easy going husband of Pam, who is the coordinator of your surgery.
The Main Event!
I suggest you leave your large suitcase at the secure luggage room at our hotel, and just take your hand luggage across the border, as all you will need is your phone, your charger, passport, change of clothes and little else since you will be most dress in the hospital gown. Brian will pick us up between 11am-12 from the hotel lobby pick up your bags from your rooms at around 11am and take them to the lobby Once we have loaded your overnight bags into the vehicle you are swept away for a 30 minute drive, straight through a medical lane at the Mexican border, without even stopping! This is when we meet the wonderful Pam, your coordinator and my soul sister, who oozes personality and makes you feel completely at ease. Along with Brian and Pam you are taken for a lunch at Caesars restaurant famous as the home of the Caesar salad, where you watch the waiters prepare the famous salad, and you are presented with a bowl of Tortilla soup, (and a little taste of the Caesar dressing ) followed by a trip to the colourful ceramics shop. By now it is about 4pm and you are taken to your 4* hotel , for your night prior and your night post hospital stay (you will be in hospital 2 nights) you are given strict instructions not to eat/drink anything after midnight. The reason is that if there is food or liquid in your stomach during your anaesthesia, it could come up into the back of your throat and then go into your lungs. This would cause choking, or serious damage to your lungs.
Pueblo Amigos (Pre-Op )
TIJUANA ACCOMMODATION The Tijuana hotel that welcomes you to the city, strategically located at the entrance from San Ysidro. Just a few steps from the border, This hotel is just 5 minutes from your hospital in a privilege location only a couple of blocks from the Government building, Plaza Rio Mall, Centro Cultural Tijuana and down town. They are one of the best Tijuana hotels, accommodating both business and leisure travellers, there is a Caliente casino inside the property open 24/7, just in case you fancy a dabble on the machines. They also have complementary Wi-Fi and offer all my clients broth and ice blocks as they know that you are their for surgery. If you have a support person with you who does not wish to stay with you at the hospital, I can book them a room at 50% less than the walk prices. . As part of our service for your support person (if you should bring a husband, wife, family member) this hotel has the the well-known El Patio restaurant with its international cuisine or order the room service from as little as $12 NZ or they/you can wander down to the huge supermarket (similar to our Kmart but with food and clothes) which is just a 2 minute walk, or visit the multiple restaurants in the area. Room features Each room is beautifully decorated and includes comforts, such as air conditioning, Sky TV, Netflix, as well as amenities, such as complimentary wireless Internet access, water, coffee machine, and they even give you broth and an ice block for your liquid night.
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Jackie Brown THE HOSPITALS WE USE Dr Arias Giovanni and his team has his own surgery company, since he is a general surgeon as well as a bariatric surgeon therefore his team can contract to a hospital. They are simply independent contractors who have privileges to admit patients and preform procedures at a hospital of our choosing. You will find that in most countries now most surgeons do not work for a hospital. They are simply independent contractors who have privileges to admit patients and preform procedures at hospitals, thus sharing the cost of the overheads. They are not contracted or employed by the hospital. Most surgeon nowadays have no desire to be employed by a hospital.
BLUE MEDICAL TOWER https://hospitalblue.com/en/
We use this hospital if you have a support family member joining you, as they have a couch for you family member. At Blue Hospital, you will find a safe, comfortable and innovative space to care for your health. Offering everything from bariatric to cosmetic surgery. They have operating rooms, devices, personnel and areas at your disposal to meet the surgical needs of specialist doctors. They pride themselves on attracting the best boardcertified specialist surgeons, offering state-of-the-art operating rooms, and becoming the preferred hospital for surgical treatment and care in the region.
HOSPITAL MEDICAL DEL RIO The new Rio Medica Hospital in Tijuana was built in 2019 and is only a few blocks from the San Diego (San Ysidro) border crossing. MBC utilizes the facility for preop CT scans and bariatric and plastic operations – just down the street from Hospital Mi Doctor. Rio Medica is fully stocked with top-quality amenities, medical equipment and accommodates each patient independently according to their health application and doctor’s load management. (but no bed for support person) We fully invest in our patients and utilize modern destinations for the highest bariatric and metabolic surgery possible.
THE HOSPITAL STEP 1
You will be picked up first thing in the morning, along with your luggage, usually between 7am-9am, but Pam keeps in touch and lets you know the evening before. You are then taken by Brian for the 5 minute drive to the hospital (they may even do your pre med test on arrival into Tijuana)
STEP 2
On arrival at the hospital you will fill in the all the documentation, there is a about 5 pages that need signatures, and they will ask for your passport which they will photocopy. This is done by the administration staff, who speaks perfect English (as do most of the staff). This is also the time you pay your account, remember it must be in US Dollars and in cash.
STEP 3
You are now taken to your room which has a fully reclinable bed and a couch for your partner/support person-if you have a partner joining us on the tour. You are now gowned, given compression stockings and taken to the ground floor for your xrays and blood tests .
STEP 4
STEP 5
Once all the pre operative testing has been done you are back to your room where you are now put on a drip and have time to relax before you are whisked down to theatre. The time varies but can be between 9am up to 7pm, depending how many procedures are being done that day. Dr Arias Giovanni will meet you in your room and give you an overview of what to expect for the day. Since every one on the tour is basically "in the same boat" it makes the entire experience more comfortable, you will feel very safe and secure in the knowledge I you are being well looked after. The gastric sleeve procedure is about 60 minutes, the by pass is about 30 minute more, and an additional 15 minutes if you choose to have your gall bladder removed. You are then in recovery for 2 hours, before waking up back in your room.
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
AFTER CARE You will wake up a little ga ga after surgery, however when I had my surgery I had explained to the anesthetist that I have a very unattractive habit of projectile vomiting after anesthetic so they stuck Scopolamine patches behind each ear.....and as you can see from my empty spew tray....nothing! That night I was hooked up to the drip, as you need to receive fluids during the operation to prevent dehydration. This was continued after surgery until the time that you can drink normally. Anti biotics and anti coagulants, anti nausea, pain killers are regularly infused via the canula. Routine post anesthetic observations are taken every 2 hours through the day and night, with one on one nursing care. The cuts (incisions) the doctor made in my belly will probably be sore for several weeks after the surgery. I had steristrip/stitches in the hole where the drain is removed, and the nurses regularly change the dressings. You have regular visits from Pam our coordinator, the surgeon and the anesthetist all come to your room to check on you, Food? well they routinely deliver jelly and juice, but to ne honest I did not feel like eating. Please note if you are taking a support person, they need to buy their own food, which is plentiful in the area, but note that they are not allowed to bring it back to the room for fear of post operative bariatric patients succumbing to eating solids.
STEP ONE Your step by step guide Travelling alone or with a support person? You can choose which date/departure you would like surgery, I will then check if that date is available and then I will look at availability for your flights and the hotel. The Handlrey Hotel/resort stay for your dates. If you would prefer a different hotel that can also be arranged but may be priced differently from my brochure since I have been given special prices at this hotel. The Handlrey is a "family type" hotel. It requires a Uber to get to town, but it is safe (compared to something like Motel6 which was surround by homeless). I used this hotel since it hosts a bar and café and since I run a shopping tour from there it is located with easy access to the airport transfer and to Brian picking you up. Other facilities to be found is: An outdoor pool with sun loungers and pool umbrellas Guest reviews say good things about the bar, overall value and pool The perfect place to chillout (remember you cannot swim after surgery for at least 2 weeks) The itinerary is the same as the group itinerary on the next page.
1
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
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www.bumstumsandgums.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
STEP TWO
2
Wanting to join a tour Tours are run on a minimum of 5 people travelling, maximum 6. It is fully escorted and I am there "holding your hand" from Auckland onwards. I book the flights, the hotels, all the transport, a shopping tour and your surgery. Fully Escorted from/to Auckland Return Flights to San Diego All transfers Total of 6 nights San Diego (own room) 1 night Honolulu 2 nights hospital in Tijuana 2 nights (one before and one after surgery) in 4* hotel Tijuana liquid soup lunch at the famous Caesars restaurant Shopping Tour to outlet mall, trip to Walmart 3 Free days to explore Return chauffeur transfer to Tijuana Return transfer from San Diego airport to Handlery Hotel
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
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3
STEP THREE Are you a candidate for surgery? I will send you a medical form to fill in which I then send on to Pam our programme coordinator in Tijuana. This is a general health form to cover any underlying conditions and past medical history. You will be required to have the following tests done by your local GP about a month prior to surgery: Blood test ECG We would prefer a letter from your GP supporting your decision for bariatric surgery (if your GP is against the idea, let us know and the surgeon will extend your pre diet time. I will never book your flights until you have received confirmation that you are a candidate for surgery since the airfares are non refundable.
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
Me Pre surgery
8 months post surgery
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STEP FOUR
4
Once accepted Now it is "game on", you decide whether you want to fly solo, go with your significant other or join our group of 5 - 6, with me escorting the tour out of Auckland. Once you have confirmed a surgery date, I will then book your flights. I tuse Hawaiian Air to Honolulu for one night then on to San Diego (depending on their schedule it may be on the return segment), as the connections are good, plus they allow us 2 bags at 32kgs per bag PLUS 11Kgs hand luggage and full meal service. Once flights are booked I go ahead and book your flights, the hotel in Honolulu your San Diego hotel, Mexican hotel and surgery. Flights have to be paid for within 1 week of booking and are non refundable and then I send the hospital a surgery deposit to confirm your spot in the theatre (on a group tour we book out the operating theatre and Dr Arias team of 6 staff for the day). The cost of surgery and additional meds , are to be paid in cash to our coordinator at the surgery in US dollars (thus keeping the prices low and without the merchant fees charged by banks and finance companies).
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
STEP FIVE Pre op diet
Losing weight before surgery helps reduce the amount of fat in and around your liver and abdomen. This may allow you to have a laparoscopy rather than open surgery. Laparoscopic surgery is less invasive, requires much less recovery time, and is easier on your body. Losing weight prior to surgery not only keeps you safer during the procedure, but it also helps train you for a new way of eating.
5
Your exact eating plan and pre-op weight loss goal will be determined by the Dr Camelo's nutritionist who will contact you by email. Your eating plan may begin as soon as you’re cleared for the procedure. If sufficient weight loss doesn’t occur, the procedure may be postponed or canceled. For this reason, you should start the diet plan as soon as you can. Guidelines and length of diet will vary from person to person, What does the bariatric pre-op diet consist of? The pre-op diet largely consists of protein shakes and other high-protein, low-calorie foods that are easy to digest. Protein helps bolster and protect muscle tissue. This can help your body burn fat instead of muscle for fuel. Protein also helps keep your body strong, which can speed up recovery. The diet could be anything form 2-6 weeks depending on your BMI.
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Using Kiwisaver for health or surgery –GOOD NEWS FOR WEIGHT LOSS SURGERY
I 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.
One frequent question I am asked is “Can I access my KiwiSaver to pay for weight loss surgery?” On the face of it this is a very good question. According to the Inland Revenue, people contributing to a KiwiSaver scheme may be eligible for a one-off withdrawal to cover the costs of a health related surgery. This withdrawal may be some or all of the funds, and you may continue to keep the fund open and contribute. In order to be entitled to this withdrawal, according to the KiwiSaver Act 2006, you may access the funds because of hardship. (dependent on your kiwi saver provider). In order to start this process, the first step is to check with your provider how much money you are entitled to. Eligible members can withdraw all or some of the funds in a one-off withdrawal. If it is not under hardship you may be able to withdraw if your weight is having an adverse effect of your life or your career. This is information that I have gathered from past clients and each KiwiSaver fund is different, some easier than others, also a letter from a GP always helps recommending weight loss surgery, you don’t have to tell your doctor you are going overseas for it, just ask if he would do a letter for government funding for weight loss surgery. You can apply to withdraw all or some of your KiwiSaver fund balance, specifically: • The total contribution made by you and your employer, but sometime they will only let you withdraw your contributions But you won't be able to withdraw: • The $1,000 KiwiSaver kickstart bonus • Member tax credits (MTC) Also, you may not get everything you ask for. Your KiwiSaver provider will assess your application and may pay all or some of your KiwiSaver balance to you, depending on how they assess your circumstances. Whatever balance is not withdrawn will continue to be invested in the fund and will be available for your retirement and/or any subsequent significant financial hardship application.
Please note I am not a financial advisor -speak to your kiwisaver provider to check your eligibility
Applications take considerable amounts of time to complete, given the details and documentation required. You will need to provide: 1. Evidence of your income for yourself and your partner (i.e. copies of pay slips) 2. Evidence of any benefits you receive (i.e. letters from WINZ detailing payments) 3. Copies of your bank statements for the last month for all bank accounts 4. Copies of any outstanding bills/invoices 5. Copies of statements for credit cards/store cards etc. 6. Copies of correspondence from debt collection agencies 7. If applicable, a copy of the Separation Agreement. 8. Verification of Identity (a copy of a form of ID) 9. A completed hardship application form, which includes your bank account details for any approved payment and confirmation of the exact amount of money you need. 10. A quote showing the amount needed, which I can provide for you, just let me know what month you are considering April, August or October or November, and I can send you a quote (each month varies in price as it is seasonal) You can obtain a form from your KiwiSaver provider, which requires a lot of detail about your financial situation. You will need to pick reason(s) as to why you are in financial hardship (e.g. health/weight loss surgery), as well as provide a lot of detailed annual and monthly wages and expenses information. This may include: (I suggest you type this all up on a spreadsheet) like this example 1. A Personal Financial Position - detailing all of your liabilities (home loans, overdrafts/bank personal loans, credit and store cards, hire purchase), assets (property, bank deposits, cash investments, life insurance, superannuation, vehicles) 2. Personal Income Details, including you and your partner's salary/wages, rental income, business income, child support, working for families, interest, dividends. 3. A summary of your Fixed Monthly Outgoings (mortgage repayments/rent/board, overdrafts and bank personal loans repayments, credit and store cards repayments, hire purchase repayments, rates and water charges, insurance expenses, superannuation contributions, childcare/support maintenance, education expenses, medical expense and anything else). 4. A summary of your Variable Monthly Expenses (monthly food, groceries, clothing and footwear, transport costs, car serving costs, electricity/gas/water/telephone/mobile/internet/Sky, home maintenance and anything else). 5. A summary of your Discretionary Monthly Expenses (holidays, entertainment, takeaways, cafe, bakery, books/newspapers/magazines, videos/DVDs/music, club/gym membership, subscriptions, sports, hobbies, tobacco, alcohol, gambling, vet/pet costs and any other discretionary expenses). Additional requirements • You will also need to explain how the withdrawal of your KiwiSaver money will remedy your situation (i.e. where will the funds be applied), and the implications for you should this application not be approved. • Some KiwiSaver providers require you to answer questions about whether you have considered alternative sources of funding, refinancing or topping-up existing borrowing to resolve the financial hardship situation so be prepared to answer such questions. • You will need to specify any overdue payments on your mortgage, credit card bills, etc. and attach evidence of this. • You may need to have asked your bank and Work and Income for help, and show evidence of this. Note: There is no point in missing out any details on purpose (i.e. lying) - your KiwiSaver provider will have copies of your bank statements and will see everything. Being truthful in every aspect of your application gives you the best chance of having a withdrawal processed. In order to do this you will need to complete a withdrawal request (including a statutory declaration) and provide all of the relevant medical practitioner’s (Surgeon or GP) declaration stating your eligibility. It is important to consider how this withdrawal will impact your retirement savings and it might not suit everyone financially. If you think you need advice around this, it is good to speak to an independent financial advisor around retirement saving. Upon your request, our program co-ordinator in Mexico, along with our surgeon and Bums Tums and Gums is able to provide a letter detailing the cost of surgery for your provider.
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.
CHAPTER TWO
Travel information
www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Anytime is a good time to go to Mexico BETTER BODY, BETTER LIFE.
OUR ESCORTED TRAVEL PACKAGES 12NIGHTS/13DAYS
PACKAGE FOR 2 TRAVELLING TOGETHER FROM $55699 NZD PER PERSON
TWIN/DOUBLE SHARE LOW SEASON, (PRICES INSCREASE DEPENDING ON THE TIME OF YEAR)
ESCORTED GROUPS TOUR (6 SURGERIES )
OWN ROOM FROM LOW SEASON, (PRICES INSCREASE ON THE TIME OF YEAR) ADD $6180 NZD DEPENDING ADDITONAL $800 FOR HIGH SEASON
The tour provides you a set itinerary with major attractions and exclusive facilities included. You will be able to utilise your time wisely and get ample time to enjoy your tour. Group tours are tested, tried and fun. Past clients have recommended the escorted tour and have cited the reasons below (and in no particular order) Security in numbers Safety All transport and accommodation is pre-paid in NZ Corporate group rates Constant updates on travel information As a travel agent all flights are sourced at best prices The pre trip information were sent weekly and I was explained everything required Assistance with USA visa requirements Assistance with information on debit cards Automatically have a bunch of like-minded friends Less chances of getting tricked by locals. Everything is well-organised with precautionary measures Never feel lonely, Never get lost Guide know where everything is (gate numbers at airport, cafes, toilets etc) Organised drivers to meet us at every point Guide knows all the staff Additional information about a place you otherwise might not know Everyone is having surgery at the same time All on the “journey” together
Tijuana
Pam
What is not included in packages : Food and beverage (but remember you are on a liquid diet for the 2-3 days prior to surgery) Entrance fees/Uber fees if you choose to go to an attraction or activities over and above the package inclusions Any medication over and above what is included in your package (between $100USD-$200USD) Hernia Repair Gall Bladder remover (optional)
*35%-40% of patients who undergo bariatric surgery are diagnosed with a hiatal hernia, and the majority of them are diagnosed during surgery. Below are the surcharges for those over 48 BMI and if they find a hernia (they did with me!) BMI BMI BMI GALLBLADDER HERNIA REPAIR*
44%-54% 55%-59% 60% AND ABOVE RECOMMENDED
$600 USD $1000 USD $2,000 USD $700 USD $650
USD
Rapid weight loss after bariatric surgery is associated with gallstone formation,
PACKING LIST Suitcase with 360 degree swivel wheels with extendable handle Comfortable shoes Heat pad (for tummy) available for $35 from chemist warehouse Night dress/PJ's, good to have shoe string straps so you don't have the drip tube running through your sleeve Pashmina/cardi can get chilly in air con Bathers for pool at San Diego (even in Winter its 16c-20c) Minimum clothing, granny knickers, easy fit clothes Jandals for around the pool 2 x 32kgs luggage one carry one (preferable on wheels with handle)
DOCUMENTATION REQUIRED Passport You will need to apply online for an ESTA (Electronic System for Travel Authorization) https://esta.cbp.dhs.gov/ ESTA is an automated system that determines the eligibility of visitors to travel to the United States under the Visa Waiver Program (VWP). The ESTA application collects biographic information and answers to VWP eligibility questions. ESTA applications may be submitted at any time prior to travel, though it is recommended that travellers apply as soon as they begin preparing travel plans or prior to purchasing airline tickets. The cost is NZD$140
if you have a criminal conviction click here https://www.officialesta.com/esta-resources/applying-for-an-esta-with-a-criminalrecord/ Full passport with re-entry visa if not on NZ or Australian passport
WWW.SURGICALWEIGHTLOSS.CO.NZ
MONEY, MONEY, MONEY Wherever you go, "The wise card" card has your back. You can pay with your Wise card almost everywhere debit cards are accepted. You put money on your "Wise Card" which you can then use overseas, both in shops and you can also draw down from an ATM. Remember you have to pay the balance of your surgery account in cash direct to Dr Camelo's administrator. The Wise card takes the worry out of using ATMs abroad. You pay only a super-low fee on withdrawals after the first 350 NZD. Your Wise card comes with default and maximum limits. You can always choose either one in your Wise app or desktop version, or turn off a specific type of payment completely. You can draw down $2700 NZD per day . You can take US dollars with you, but nowadays the bank doesn't provide an exchange service so you need to to go to a bureau de change, there will be one in your area (google it). How to get the Wise card 1. Get a Wise account. Sign up and add your first balance. You’ll be able to add more currencies afterwards. Please note reviewing your application can take them a few days due to verification. Your account and all the currencies on it will be connected to the debit card. As long as you have enough money available in any currency in your balances, you should be able to use the card. 2. To order your card, click on the Cards tab on the website or in Android, or click on Account in iOS, and you’ll see an option to order the card. They will check personal details like your name and address. they might ask you to add money to your balance or pay a small fee for the card. They also need to verify your account. Once everything looks right, they will ship the new card to you.
While medical tourism for cosmetic surgery and other types of elective treatment is becoming increasingly popular, it's still considered risky business to travel insurers. Travel insurance is designed to cover unexpected events, not planned events where the risk is very high. NZ travel insurance companies, have an exclusion for any claims arising from, associated with or related to elective surgery. You're still eligible for all the other benefits of travel insurance – such as cancellation and delay cover, baggage loss or theft and family emergencies - but if you have complications from elective surgery and are not fit to fly home, they will not be able to cover you. This also extends to any overseas medical emergency expenses which arise as a result of the elective surgery. Examples include requiring hospitalisation due to an infection, or if you need to go to the doctor for a follow-up after your surgery. If you’re like me, here’s how you prepare for a big trip: You pack way too much, realise your suitcase won’t close, then start taking stuff out. The snorkel gear, the sarong, that second jacket… you don’t really need those. But there is one thing you definitely, absolutely need to pack: Travel insurance. A lot of people weigh the additional expense and ask, “Is travel insurance worth it even though it DOES NOT COVER ELECTIVE SURGERY?” Most of the time, the answer is an all-caps YES. This is why. Let’s say you pay $7,000 for a once-in-a-lifetime trip for bariatric surgery. The day before flight, your mother suffers a serious fall and ends up in the hospital. When you call the airline and explain what happened, they’re sympathetic — but you’re not getting your money back, your ticket was non-refundable. Situations like these are why travel insurance is a must. When you have travel insurance with trip cancellation benefits, you can get reimbursement for prepaid, nonrefundable trip costs when you must cancel for a covered reason. Covered reasons can include situations like the covered serious illness or injury of the insured person, a travel companion or a family member; the death of the insured traveller, travelling companion or a family member; a natural disaster or other event that renders your destination uninhabitable; etc. Consider this scenario: (this is true example of one of my ladies) You arrive at the hotel, you go down the first morning for breakfast, you are still a bit jet lagged, you don't see the step behind you, you fall and break your hip. When you arrive at the hospital with no insurance the staff just shake their heads. You’ll need to pay up front for treatment — and your medical bills rapidly climb into the tens of thousands. Whereas my client had 4 medics and a doctor come out to the hotel in an ambulance, whisked her off to hospital and within 24 hours she had a titanium hip fitted. When the proverbial hits the fan most Kiwi travellers call the NZ embassy for help — but those travellers are often disappointed to discover that embassy staff’s powers are limited. They can help you replace a stolen passport; contact family or friends in the NZ.; find medical care or legal assistance; communicate with local police; and connect you with various resources. But an embassy cannot pay for your medical care, provide emergency transportation (except during rare, major catastrophes), or otherwise take care of any financial losses you suffer while travelling However I do work with a company in the USA who will consider elective surgery. Please click here to read about their policy http://www.bumstumsandgums.co.nz/about/medical-travel-cover or for travel insurance that you can get here in NZ but does not cover any elective surgery https://www.kiwiholidayinsurance.co.nz/AK45?webLink=220623Mexico
FAQ'S The Good, the bad and the ugly I do not profess to be a health professional. this book has been created from interviews, reading and personal experience. Although it has been plain sailing for me, that is not to say it is all rainbows and lollipops for other people. Here are some of the questions that I had and have been answered When can I go back to work after surgery? After surgery, most patients return to work after two to four weeks. Some may be able to work from home as early as one week after surgery. Because of the significantly reduced calorie intake, many patients have low energy for 1-2 weeks after surgery. However, most patients gain their energy back once they start to have soft food. How bad is the pain after surgery? Most patients have some pain after surgery. . Most patients just need to take oral pain medications for a few days after surgery. The majority of our patients felt that pain was not a major issue during their recovery. When can I start exercising again after surgery? As soon as you totally wake up from anesthesia, They encourage patients to walk. The key is to start slow and listen to your body. If you lift weights or do sports, stay “low impact” for the first month (avoid competition, think participation). If you experience pain or discomfort, stop and relax. Avoid lifting heavy objects for the first 6 weeks. If you swim, your wounds need to be healed over before you get back in the water and always swim slowly at the beginning.
Will bariatric surgery last? Many patients (up to 50%) may regain a small amount of weight (approximately 5 percent) two years or more following their surgery. However, longitudinal studies find that most bariatric surgery patients maintain successful weight-loss long-term. The average excess weight loss is 60%-70% of your excess weight, Studies also have shown that sleeve gastrectomy patients were able to maintain its well-documented weight loss outcome at 5 or more years after surgery, You may also experience health benefits such as reversal of Type 2 diabetes and a decrease in chronic conditions such as high blood pressure and sleep apnea. Do most patients need to have plastic surgery after weight loss? After losing most of the excess weight, most patients may have some loose or sagging skin. For many patients, this might be just temporary. The degree of loose or sagging skin depends upon several things, including how much weight you lose, your age, your genetics and whether or not you exercise or smoke. Generally, many patients can hide loose skin by clothing or compression garments. We generally recommend wait for at least 18 months before having plastic surgery.
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FAQ'S Will I lose hair after bariatric surgery? For the reasons we still don’t fully understand, hair loss after bariatric surgery is common between 3 and 6 months following surgery. However, hair loss is almost always temporary. Adequate intake of protein, vitamins, biotin and minerals will help to ensure hair re-growth, and avoid longer term thinning. I started using Nioxin shampoo which is especially formulated products for fine and thinning hair and a healthy scalp in women and men Do I need to take vitamins and minerals after surgery? You will need to take a multivitamin for life for a gastric by pass. You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You should also have at least yearly lab checks on your blood. Can I eat whatever I wish, or must I control my portion, intake of fats and sugars? Weight loss surgery, no matter which type, is only a tool to help you lose weight and keep it off, if used effectively. After weight loss surgery, almost any type of food is tolerated if chewed well enough, and eaten slowly. There are many exceptions to this:. The Gastric Bypass provides significant weight loss for one to two years, then plateaus. Gastric bypass requires that you greatly reduce your intake of sweets and fats. You will experience physical symptoms such as abdominal cramping, sweating and general weakness when you consume too much fatty food or too many sweets. The Sleeve Gastrectomy results in a banana shaped, or sleeve-like stomach. Similar to the Gastric Band, eating, soft foods, sweets and drinks/ liquid high in calories will cause weight regain, or poor weight loss Can bariatric surgery be reversed? Surgery for weight loss can be reversed, but reversal procedures are usually more dangerous than the original ones. Surgeons would only consider reversing these operations in patients who have significant long term problems from the surgery. It is important to note that anyone who has the operation reversed will regain the weight they lost after the first surgery. Is there anyone who should not have bariatric surgery? Weight loss surgery is a serious step. Patients with psychiatric conditions such as depression, bipolar disease, and/or schizophrenia should be under the care of a psychiatrist before they consider surgery. These conditions can become exaggerated by the body changes that are associated with weight loss. There are some medical conditions which make the surgery too risky to perform. These occur rarely but must be taken into account. What are the risks of bariatric surgery? No surgery is without risks even in NZ. Although Roux-en-Y gastric bypass and gastric sleeve are common bariatric procedures, you may experience some side effects or complications during or after your surgery. Depending on the procedure, you may have bleeding or develop a leak at the staple line, wound infection, Dumping syndrome or GERD (gastroesophageal reflux disease). You can reduce your risk of bariatric surgery complications by following your pre-operative instructions, including good nutrition, diet, exercise, vitamins and supplements, and avoiding the use of all tobacco products. www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Why do I need to make changes in my diet and lose some weight before surgery? The preparation period before surgery provides time for you to practice healthier eating habits and mentally adjust to a different lifestyle. Bariatric surgery involves physical, mental, and emotional changes to be successful in the long term. What is pre-op liquid diet? Two - six weeks before your surgery, you are required to follow a liquid meal replacement diet. The purpose of this diet is to reduce the size of the liver to make surgery safer. This diet includes protein shakes, several “approved” snacks (e.g., sugar-free pudding, yogurt, and sugar-free gelatin), and plenty of clear liquids (water, broth, sugar-free jello and popsicles, etc.). Dr. Camelo's nutritionist will email you the details of this diet once your surgery is scheduled. *Note for patients with diabetes: You will be asked to talk to your doctor or endocrinologist about adjusting your diabetes medications while following the pre-op liquid diet.
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Potential Complications
All surgery has risks, and as any stomach operation for obesity is considered major surgery, it has significant risks associated with it.
People have died from having operations for morbid obesity. It happens rarely, but the risk can never be removed completely. If you are older, or you already have certain health problems related to your obesity, your risk may rise. Heart attacks after the operation, clots that form in the leg veins which then pass to the lungs, or leakage of the stomach joins can cause death in morbidly obese people after surgery. This risk is less than one in 1000. Thorough precautions are taken during surgery and your hospital stay to minimise these risks, but they cannot be eradicated altogether. Other problems that can occur after gastric bypass surgery include pneumonia, wound infections, and ulceration or narrowing at the joins made between the stomach and the bowel. Some of these are relatively minor and do not have a long-term effect on your recovery. Other complications may be more significant and require a longer hospital stay and recovery period. Antibiotics at time of surgery, deep breathing exercises and early mobilisation after surgery are some of the measures taken to reduce the risks of these complications. After gastric bypass surgery, patients need to take iron, calcium, and vitamin supplements lifelong to prevent complications associated with malnutrition. Sometimes these are best given as an injection. Complications that can occur with gastric bypass surgery are listed below. This list is long, and although most patients have no complications, or minor complications only, please take note and ask your surgeon and team any questions that will help you to understand the risks associated with obesity surgery. During Gastric Bypass Surgery A larger incision may need to be made because of technical difficulty with keyhole approach An injury to the bowel or other organs from insertion of keyhole instruments Bleeding from blood vessels or injured organs Technical difficulty leading to change in operation strategy Complications related to placement of intravenous and arterial lines. This includes bleeding, nerve injury, or pneumothorax (collapsed lung) Nerve or muscle injury, usually temporary, related to positioning during surgery Allergic reactions to medication, anaesthetic agents or prosthetic devices www.surgicalweightloss.co.nz ; Jackie Brown JBTG Jackie Brown Travel Group
Potential Complications continued After Gastric Bypass Surgery Mortality rate less than 1 in 1000 Leak from staple lines or joins. Rate between 1 to 2 in 100. May require further surgery or lead to sepsis Significant bleed. Rate around 1 in 100. May require transfusion or further surgery Infection at keyhole incisions, or deep within the abdomen. A serious infection is often called sepsis. This is uncommon but can lead to further surgery, a longer hospital stay organ failure or death Deep vein thrombosis (blood clot in the leg veins). These can occasionally travel to the lungs (pulmonary embolus). Rate around 1 in 100 Pneumonia or other breathing problems. The worst of these is respiratory failure, which is the inability to breathe adequately after surgery, and may require support of breathing in an intensive care ward Heart attack or abnormal heart rhythm Stroke Pancreatitis Urinary tract infection or injury to the urinary tract from catheter insertion Colitis (inflammation of the colon), usually due to antibiotics used in surgery Constipation Gastric Bypass in the longer term Troublesome symptoms may include abdominal pain, change in bowel pattern, tiredness, bloating, nausea or vomiting ‘Dumping syndrome’. This is an unpleasant feeling after eating sugary foods. Usual symptoms are anxiety, tremor and sweatiness Narrowing or ulcers where the stomach and small bowel join. May require stretching with a balloon or, rarely, surgery Usually because of lack of adequate vitamin intake. Prevented by regular blood tests and supplementation of vitamins, especially B12 Excessive or inadequate weight loss. Rarely requires further surgery Dehydration or imbalance of body salts, usually from inadequate fluid intake, infrequently requires admission to hospital Inflammation of the remaining stomach or oesophagus Gall bladder disease, usually from gallstones that form during rapid weight loss. Can require surgical removal of the gallbladder Hernias at the site of incisions Internal hernias. These can occur inside the abdomen because of rearrangement of the bowel or scarring from surgery. This may block the bowel, and is an ongoing risk that occurs in 1 per cent of patients per year and then requires urgent surgery to correct Psychological problems can include depression, adjustment disorder, relationship difficulties and rarely suicide Liver disease or failure. Can occur if there is underlying liver damage that is worsened by weight loss or surgery Thinning of the bones (osteoporosis) can lead to fractures especially in women. Prevention requires lifelong dietary calcium supplements Hair loss from malnutrition. This usually resolves within a few months of surgery and is usually only noticeable to the patient https://www.webmd.com/connect-to-care/bariatricsurgery/weight-loss-surgery-side-effects
CHAPTER THREE Dietary Guidelines After Bariatric Surgery
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Your new relationship with food Bariatric surgery affects multiple parts of your life. You may feel anxious about comments made to you about your weight loss. It is important to keep yourself involved in support groups and seek counseling when needed. Talk to friends and family for support and join a Face Book forum group.
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Diet Stages after surgery
CLEAR LIQUID Start: 2 days before surgery until 1st day after surgery
FULL LIQUID Start: 2 after surgery for 14-21 days after surgery
SOFT FOOD Start:
SOLID FOOD (Low in sugar and Fat) Start:
Two to three weeks after surgery. Make sure the liquid diet is working well for you before you start eating soft food. 3-6 weeks
Two months after surgery. This is your permanent diet.
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Stage 1 Allowed: Sugar‑free gelatin, sugar‑ free Popsicles, clear protein drinks like Isopure, protein drinks, Gastrorade (no sugar), broth, decaffeinated tea, decaffeinated coffee and water, Atkins protein shake. .
Dumping syndrome Dumping syndrome occurs when your stomach empties its contents into your small intestine too quickly. It doesn’t happen to everyone but is more likely to happen to gastric bypass patients. Dumping syndrome generally occurs right after eating a meal that contains a lot of sugar. Too much sugar causes excess food to be pushed quickly through the intestinal tract. Symptoms include: Diarrhea, sweating, increased heart rate, nausea, dizziness, abdominal cramping.
Stage 1 is started prior to hospital by 2-3 days and after surgery, however when you leave hospital you will be on stage 2 (which is still liquid but need not be clear) Drink in small sips. Eat very slowly. Stop if you feel full or nauseated. Do not feel the need to finish the whole tray. Do not be tempted by anything that is not listed in the column to the left, do not eat those items. They could cause nausea after surgery. Only drink the fluids listed in the What’s Allowed column.
How to prevent: • Choose foods that are low fat and contain no more than 14 grams of sugar per serving. • Avoid high‑sugar foods, such as desserts, fruit juice, jams, honey, syrups, candy, pastries and nondiet soda. • Be careful with condiments, such as barbecue sauce, honey‑mustard dressing, sweet and sour sauce, etc. • In moderation, selectfoods with natural sugars, such as fresh fruit, dairy and vegetables. Choose foods that use artificial sweeteners, such as NutraSweet, stevia and Splenda
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STAGE 2 Aim for 2 ltrs of fluid and 60–80 grams of protein, and track what you eat and drink. Fluid: Aim for 2 litre+ daily. Drink more if your urine (pee) looks dark. Drinking fluids is your top priority. If you are struggling to get enough fluid into your stomach, focus on water intake. Remember, protein shakes and protein waters provide both fluid litres and protein. Protein: Aim for 60–80 grams of protein daily. Choose items with less than 14 grams of sugar and less than 10 grams of fat. Supplements: Start taking your chewable bariatric multivitamin and calcium citrate supplements one week after surgery. You will start taking vitamin B‑12 one month after surgery unless your multivitamin has enough B‑12 in it.
Instructions
Choose foods from the Stage 2 foods list. Generally, eat three to five meals a day, no more than four hours apart. If eating solid foods such as yogurt, pudding, eggs or cottage cheese, wait 30 minutes after eating before drinking fluids. Write down what you eat and drink every day, especially protein and fluids. This is your food log. You may use a notebook, a computer program or a smartphone app such as Baritastic or MyFitnessPal
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PLATEAUS You will experience times when your weight loss slows down. This is normal and it is important to remember that everyone loses weight at a different rate. When you are at a plateau (no weight loss or change in measurement for four weeks or more) continue to keep food logs and track your exercise. Don’t panic! If your post-surgery weight loss is stalled, it’s time to take action. Remember you are in the driver’s seat for your weight loss and you are in control. Hints: Take measurement consistently Make dietary adjustments and track your intake Try a new exercise (after 6 weeks) Self care -Health is about more than just calories and measurements. Prioritize holistic health by making time for self care.
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FOOD FULL LIQUIDS
Aim for 60–80 grams of protein every day. Choose food with less than 14 grams of sugar and less than 10 grams of fat. FO O D
AMO U N T
P R OT E I N
C A L O RI E S
Protein shakes (such as Premier Protein) with more than 20 grams of protein, less than 14 grams of sugar and less than 5 grams of fat
226 grams
Varies
Varies
Sugar‑free protein waters such as Isopure Zero, Premier Protein Clear, BiPro or Protein2o
Varies
Varies
Varies
Whey or soy protein powders. You can mix these into milk, nondairy milk and cream soups.
1 scoop
Varies
Varies
Milk (low fat). Choose Lactaid or Fairlife if you are lactose intolerant. You may also choose nondairy milks, such as soy or oat milk.
230grams
Varies
Varies
Protein‑fortified skim milk
250ml
10 grams
100
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Aim for 60–80 grams of protein every day. Choose food with less than 14 grams of sugar and less than 10 grams of fat. P R OT E I N
C A L O RI E S
226 grms
10 grams (more with powder)
190
Nonfat or low‑fat yogurt, Greek or traditional. Plain or low‑sugar (less than 14 grams sugar), such as Yoplait Light, Oikos Triple Zero, Dannon Light & Fit and Fage
About 177ml
Varies
Varies
Sugar‑free pudding (instant or cook & serve)
1/2 cup
2 grams
About 60
Cream of Wheat (made with water or low‑fat milk). Add 1 scoop of protein powder prepared with water.
1/2 cup
About 18 grams
About 165
Fairlife milk
235ml
13 grams
13 grams
FO O D
AMO U N T
Low‑fat, purée‑texture soup, such as low‑fat cream of chicken soup or tomato soup made with milk or unflavored protein powder
"How you love yourself is how you teach others to love you." —Rupi Kaur www.surgicalweightloss.co.nz ; Jackie Brown
STAGE 3-SOFT, GROUND AND MOIST FOODS At least 2ltrs of fluid daily. 60–80 grams of protein daily. Choose items with less than 14 grams sugar and less than 10 grams fat. Chewable bariatric multivitamin and mineral supplement and calcium citrate supplement. If necessary, start taking your vitamin B‑12 supplement on Recommended by NZ surgeons are BN caps, Check out their Bariatric vitamins and supplements. www.https://www.bnhealthy.co. nz
Start introducing soft, moist protein‑rich foods. Moisture is the key to eating comfortably. Use low‑fat or nonfat gravy, sauces or mayonnaise if you need to moisten the protein. Add one new food at a time. Eat small amounts of food and eat very slowly. For example, take a teaspoon‑sized bite and chew it completely. Wait five minutes before taking another bite. Once you’ve met the protein goal, you can add up to a 1/2 cup of non‑protein foods at each meal. Keep your fluids separate from your meals. Wait 30 minutes after a meal to drink any fluids. Do not drink fluids during a meal. Keep writing down everything you eat and drink (food log or food journal).
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WHAT TO AVOID Avoid red meat if it makes you uncomfortable and instead eat chicken, turkey or fish. Red meat means beef, pork, lamb, veal, venison and other game meats. Use sauces and condiments to help moisten foods. The next page has a list of sauces and condiments. Avoid the foods below until about two months after your surgery: Hard, crunchy or high‑fiber foods. This includes raw and crunchy fruits, vegetables, nuts, seeds and popcorn. Fresh or doughy bread, rice and pasta. Very dense protein energy bars, such as those with nuts and seeds. Always avoid drinks with alcohol or carbonation, such as soft drinks, sparkling water or soda. Also avoid foods that are high in fat or sugar. These foods and drinks will not be comfortable for you and can cause bad reactions after bariatric surgery.
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GROCERY LIST FOR STAGE 3 Below are high-protein foods including vegetarian and vegan options. You need to add moisture, such as a sauce or condiment, to most of them. This will make them more comfortable for you to eat. Do not eat dry meat or fish. The texture to aim for during this stage is food easily cut with a fork. Egg (scrambled or with light mayo) Low fat cottage cheese Low fat or non fat yoghurt (regular or Greek) Nonfat (skim) or 1% milk, or low‑fat plain soymilk Fish (fresh, frozen) Shellfish, crab, shrimp (fresh, frozen) Tuna (canned) Smoked salmon Salmon burgers Chicken(ground or cooked, deli, canned) Turkey (ground or cooked, deli) Veggie burgers Veggie sausage or crumbles (such as Boca) դ Tofu Bean dip or hummus Dry or canned beans and legumes(kidney, black, pinto, nonfat refried beans, lentils, split peas, black‑eyed peas)
Use the following to moisten your protein: Low‑fat or nonfat condiments, such as ketchup, mustard or low‑fat mayonnaise Low‑sodium broth Low‑fat salad dressing Lemon or lime juice, vinegars Tomato sauce, salsa (soft) or picante sauce Low‑fat cream soups used as sauce for meats like chicken, fish or turkey Low‑fat plain yogurt or sour cream
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BEGIN TO INCORPORATE THE FOLLOWING FOODS ONCE YOU ARE GETTING 60–80 GRAMS OF PROTEIN A DAY. EAT PROTEIN FIRST. V E G E T A B L E S (BEGIN TO INCORPORATE THE FOLLOWING FOODS ONCE YOU ARE GETTING 60–80 GRAMS OF PROTEIN A DAY. EAT PROTEIN FIRST. V E G E T A B L E S ( B E S T C H O I C E )
Fresh vegetables cooked to soft (such as broccoli or cauliflower) Frozen vegetables (soft, no added sugar or fat) Canned vegetables FRUIT Frozen fruits (soft, no added sugar or fat) such as peaches Canned fruits (soft, no added sugar)such as applesauce or mandarin oranges packed in juice Fresh fruits, such as bananas, pears(soft, ripe; avoid tough peels, skin or seeds) S T AR C HE S ( L IMI T E D ) Crackers Toast Hot cereals Potatoes, sweet or regular (mashed) with no added fat
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FLUID GUIDE Fluids are important to avoid dehydration. Try to drink 2ltrs per day. What to drink: • Water •calorie‑free, sugar‑free, caffeine‑free drinks • Decaffeinated coffee or tea, or herbal tea •Broth — regular or bone broth (Choose low‑sodium broth. Bone broth gives you a small amount of protein.) • Diet Jell‑O (weight watchers or Airplane) •Sugar‑free Popsicle (no more than two or three per day)
Drink fluids throughout the day. Below is an example of roughly when you should drink fluids Avoid drinking fluids during and before 30 minutes after a meal • Before 7 a.m. • 9–10 a.m. • 11:30 a.m.–12:30 p.m. • 2–3 p.m. • 4:30–6 p.m. • 7:30–8:30 p.m. • After 10 p.m.
“Drinking water is like washing out your insides. The water will cleanse the system, fill you up, decrease your caloric load and improve the function of all your tissues.” www.surgicalweightloss.co.nz ; Jackie Brown
THINGS TO REMEMBER AT STAGE 3 Keep practicing mindful eating. Use smaller plates and baby spoons or chopsticks to help slow down your eating. Continue to separate fluids from foods. Don’t drink with meals or snacks and wait 30 minutes after meals or snacks to drink any fluids. You may need to stop drinking 30 minutes before meals if you are unable to eat enough. You might not be able to eat some solid foods. Add only one new food at a time. A “new food” is a food you have not eaten since having bariatric surgery. Adding one at a time will help you learn which foods you can and cannot eat. Continue writing down everything you eat and drink (food log, food journal).
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STAGE 4 Congratulations, you have reached Stage 4. This is your final stage after bariatric surgery. You will stay on this eating plan for life, unless you need to go back to an earlier stage if you get sick or for other reasons. Email the nutritionist or speak to your doctor if you have any questions about this eating plan, you follow a special diet or have a food intolerance. They can help you adjust the eating plan for your personal needs Take chewable bariatric multivitamin and mineral supplements if possible. I used BN caps which help prevents nutritional deficiency after Bariatric and Weight Loss Surgery. Remember that you are not alone. It is important to stay involved in support groups . The illustration below what your servings will look like on a plate after bariatric surgery. It compares them to servings you might have eaten before surgery. A regular‑size plate is 9 inches across. After bariatric surgery, you might want to use a 7‑inch plate, since you will have less food on it.
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THE HEALTHY PLATE Protein gives you energy,iron and B vitamins. Some protein foods also provide zinc (an important mineral),such as meat, chicken, turkey, and shellfish, such as clams and shrimp. Others, like beans, give you fiber. Some types of fish give you healthy fats. Goal: You need nine to 12 servings of high-protein foods every day. This will give you 60–80 grams of protein. Writing down all the foods you eat will help you meet your goals.
Vegetables give you carbohydrates, fiber, energy and vitamins A and C.
Aim for four to six bariatric servings of vegetables a day, Grains, starchy vegetables and beans give you fiber, energy, Vegetable serving sizes after B vitamins and minerals. bariatric surgery include: Choose foods with more than •1/2 cup raw leafy 3 grams of fiber per serving vegetables, such as spinach •1/4 cup raw vegetables, such and less than 14 grams of sugar. as baby carrots The amount of carbohydrates •1/4 cup cooked vegetables, you can eat is different for each such as peas person. It depends on how •1/2 cup vegetable juice active you are, how much you Goal: exercise, your blood sugar and . weight loss.
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WHEN YOU EAT OUT WHAT TO ORDER order just a entre or It is OK to order children’s portions or serving sizes. However, do not order from the children’s menu. Foods on this menu are usually high in fat and carbohydrates. You may want to order items individually. For example, you may ask for a chicken breast or a side of vegetables instead of a specific dish from the menu. Use the same diet guidelines when you eat out as when you eat at home. HOW TO HAVE YOUR MEAL COOKED Make sure your food is baked or broiled and comes to your table plain. It should not be cooked in heavy oils, butter or cream sauces or covered with condiments such as mayonnaise. KEEPING YOUR SERVINGS SMALL You can split a plate of food with your friend or partner. Ask for a takeout container when your food arrives. Place half of it in the container to eat the next day. Depending on what you order, leftover food can provide enough food for several meals. OTHER TIPS FOR AFTER BARIATRIC SURGERY Remember not to drink fluids with your meal in a restaurant. Carry healthy snacks at all times to avoid stopping for a quick bite to eat when you get hungry. Most convenience foods and fast foods are high in fat or sugar.
www.surgicalweightloss.co.nz ; Jackie Brown
MEET THE AUTHOR JACKIE BROWN
For 22 years I have been a senior lecturer in adult education, I teach entrepreneurship, hotel and tourism management, travel agents and airline staff, and as a professional speaker I also promote the tourism industry by conducting workshops, speak at conferences and escort JBTG groups to Thailand for restorative surgery and Mexico for weight loss surgery. As a qualified travel consultant, a European tour guide and wedding event manager I have worked globally and feel comfortable talking to groups from all cultures and in any location. I also run women's empowerment courses. I have a post grad in "Coaching and Mentoring" from Waikato University, plus I have papers in counselling skills. I personally had restorative surgery in Thailand in 2013. It was always something I knew I would do, It was never a question of if, only when! Seeing a very tired version of my eyes, my neck and face made me realise how much it was affecting me! OK I was in good nick, I was healthy and have always had a positive outlook on like.......but after surgery I felt like I had won lotto. I am also a marriage celebrant so I suddenly saw myself in everyone's photographs, which got more and more uncomfortable, as post menopause the weight started increasing, so in 2022 I went to Tijuana to have a gastric sleeve, its so thrilling to watch my weight go down, and I am now only 10 kgs away from my goal. Everyone has an opinion about surgery, but what I have learnt is that you can't do things to please people, but you must be open to pleasing yourself. I loved the results and so opened my business 12 years as a consultant and tour guide so that I could share my stories, work with clients wanting restorative surgery or bariatric surgery and help meet others needs, at times of transition in their lives. I have worked in the travel industry for 40 years and as the owner of "Bums, Tums and Gums" for cosmetic surgery and Surgical weight loss in Mexico my role is to book your flights and accommodation and then escort you to either Thailand or Mexico. Your Group Surgery Tour is always methodically planned to ensure that each member's specific requirements are catered for both with Travel and Surgery. Our frequent visits to the seaside resort of Pattaya in Thailand or Tijuana in Mexico, and our established partnerships with our Hospital and Surgeons is your assurance that things will all run smoothly. You will have VIP treatment with our Surgeons and Hospitals something not all agencies will be able to offer. Never let what you can’t do interfere with what you can do.
“Shaping your dreams into reality.”
ckie a J wn ro B
HAVE QUESTIONS? 0275481004 BAY OF PLENTY
HTTPS://WWW.FACEBOOK.C OM/GROUPS/100554719040 7978
WWW.SURGICALWEIGH TLOSS.CO.NZ
LET'S CHAT You are welcome to ring me for a chat or email me for more information.
“Look Better. Breathe Better. Sleep Better.”
I take tours to Mexico every 3 months and cosmetic tours to Thailand every 4 months
HAVE QUESTIONS?
2023/2024 January, May, September and
104 Harbour View Road, Omokoroa, Bay of Plenty 3114 info@surgicalweightloss.co.nz
October/November dates TBC
surgicalweightloss.co.nz
INFO@J BTG.CO.NZ
HTTPS://WWW.FACE BOOK.COM/BUMSTU MSANDGUMS
WWW.SURGICALWEIGHT LOSS.CO.NZ
Freedom means the opportunity to be what we never thought we would be.
surgicalweightloss.co.nz| @ JACKIE BROWN JBTG JACKIE BROWN TRAVEL GROUP IATA accredited and fully bonded travel agent and qualified tour tourwith a post grad in tourism and travel, a Bachelor in adult education and post grad in coaching and mentoring