Las Vegas Bariatrics Health & Wellness Magazine Vol 7 2015

Las VegasBariatrics health & wellness

“Your Leader in Surgical Weight Loss”

EXPERT IN

▪ ▪

Gastric Sleeve Surgery p12 Gastric Band Revision Surgery p14

Health Conditions and Obesity p10 ▪ Up to 80% of Diabetics off medication ▪ Up to 70% Hypertensives off medication Yoga: Find your Center p22

vol. 7

702-384-1160

RICAN SO AME C

Bariatric Surgery

CENTER OF EXCELLENCE

SURGERY

lasvegasbariatrics.com

Y

ETABOLIC A ND RM B FO

RIC AT RI A

Travel: Montreal - Old World Charm and Culture p24

IE T

Fitness: 10-20-30 Training! p27

las vegas

bariatrics

Dr. Hanna Bio As an ASMBS accredited Bariatric Centers of Excellence, Dr. Bernie Hanna, Director of Las Vegas Bariatrics, is a well-respected Las Vegas bariatric surgeon.

Having practiced in the Las Vegas Valley since 2000, Dr. Hanna and Las Vegas Bariatrics strive to create a service-oriented environment focused on quality and commitment.

Dr. Hanna completed his undergraduate work at Barry University in Miami, Florida and graduated from Howard University Medical School and General Surgery residency program.

Dr. Hanna received “Top Surgeon” honors in 2002, 2003, 2011 and achieved the “Top Doctor” award for 2006, 2007, 2012 and 2013.

He is a diplomat of the American Board of Surgeons, a member of The American Society for Metabolic and Bariatric Surgeons, American College of Surgeons, Nevada State Medical Association and the Clark County Medical Society.

Jocelyne Angela Rae Carmen Rose Jeanny Kyra

Medical Assistant Medical Assistant Medical Assistant

Practice Manager Medical Assistant Bariatric Coordinator

Rae

Carmen

Rose

Jeanny Kyra

Medical Assistant

702-384-1160 2

Jocelyne Angela

6140 S. Fort Apache Rd., #100 Las Vegas, NV 89148

Se Habla Español ~ Marunong ng Tagalog website: lasvegasbariatrics.com

Inside

Samantha before & after

LVB magazine

– Testimonial –

“Coming in to see Dr. Hanna was the best decision I’ve ever made in my life!

I was so unhappy with my weight and always covered up.

2 3 4 5 6 8 9 10 11 12 13 14 16 19 20 22 24 27 28 30 31

Bio Contents Editor LVB MediSpa LVB Staff Bariatric Surgery Candidate BMI Health Conditions and Obesity Bariatric Surgery Safe Tool Surgical Procedures Did You Know?

Revision Success Nutrition by Joey Bariatric Surgery FAQs Harsha’s Wellness Yoga Travel Fitness Nutrition Recipe GSS Antireflux LVB Events

graphics & layout by

Studio 3 & me studio3andme3@yahoo.com advertising

graphic design

marketing

“show off your stripes”

Now I love to go out and enjoy simple things like shopping for clothes.”

Best decision ever! Great office staff! Highly recommended!

18

Sleeve 06/23/2014

Quick & Easy Recipe for a Healthy Breakfast

Power Breakfast

28 Harsha’s Wellness YOGA 22 MONTREAL ‘Old World Charm and Culture’ 24

3

from the EDITOR As I sit here immersed in peace and tranquility, deep in the jungles of Costa Rica, I contemplate my next move for serenity. I ask myself ‘Why am I not here?’ And it’s a simple yet unreasonable answer...there are too many things that I have to do, as I am caught up in the rat race of the western world with all my ‘stuff’ ~ things ~, things that I now don’t even know what to do with.

in Costa Rica

I’ve been trying to downsize and rid myself of a lot of unnecessary things that I haven’t even looked at in over a year. So why even have something that you don’t even use or have already forgotten about? Then there are the gadgets, electronics and oh! the infamous cell phone. We’ll get back to this later.

Sitting on a deck in the jungle looking out over the canopy of trees hearing Howler Monkeys in the distance I realize that it doesn’t take much to be happy and content. Why do we need so much stuff? Out here I don’t need much. With limited internet access and poor wi I am forced to be content with nature and a book. We spend our entire lives literally acquiring things with little thought on needs. We live in a society of wanting and getting not for the sake of necessity but only living up to the Joneses. Obviously everyone has their version of peace. You need to nd what suits you best.

Which brings me to this ---- Why is it when I’m out in a restaurant having a meal just scanning the room, the infamous cell phone pops out, or an iPad or Game Boy, they Rule!!! It is overwhelming to see the number of individuals – children, moms, dads, couples, friends and the like simultaneously on their gadgets. I tell you it’s the days of no interaction, no eye contact, no conversation and ultimately No Connection! It’s just sad to see.

The art of conversation is going out the window leaving youngsters with limited interpersonal and communication skills. The need for constant media stimulation is consuming us. To the detriment of a peaceful night of sleep.

We are now introverted, tech savvy, internet minded adults who don’t pay attention to the human spirit which is important for developing relationships with family and friends.

4

The world of social media has consumed some of us!

Facebook, Instagram, Twitter, Pinterest and more. Obviously to do business and be in touch with family, friends and business associates, the internet connection is quite an awesome tool. But balance is The Key. Even traveling has become, for some, a chance to get the best sele. You go to a popular site or attraction to nd a parade of sele sticks blocking your view. Luckily for me I am constantly reminded by my mindful and always present wifey. She keeps me grounded which allows me to take in the sites and enjoy why we are where we are. I am reminded to take a mental picture which at the end of the day is the ultimate pleasure... to be able to close your eyes wherever you are and reect on those precious moments. An actual picture doesn’t even do that justice.

So nd balance, do that which is only necessary and appropriate at the right time. Not every text has to be addressed right away. Take the time to enjoy the moment with family and friends. Stay engaged, show your interest and clear your life of the unnecessary clutter.

B.H.

Las Vegas Medi-Spa

Maintaining A Beautiful You! Elite MPX Laser Treatments Vascular Treatments for Spider Veins Pigmented Lesions (brown/red spots, Rosacea, Melasma) Hair Removal Facial Rejuvination

Las Vegas Medispa Phone: 702.750.1134

www.lasvegasmedispa.ning.com/

□

BOTOX

□

Facials

We carry the IMAGE skin care line that is all organic and suited for all skin types

5

las vegas

– Las Vegas Bariatrics –

bariatrics

Se Habla Español ~ Marunong ng Tagalog Dr. Hanna operates out of an ASMBS accredited Bariatric Center of Excellence. At LVB we have created an environment that is friendly and service oriented. Our staff is always approachable and available to meet your needs.

FOCUS ON QUALITY We are committed to our patients over the long term and follow them indefinitely, which increases your chances of long-term success. In sticking with the program our patients will experience excellent outcomes over time.

OFFICE MANAGER

Carmen

carmen@lasvegasbariatrics.com

As practice manager, Carmen with her many years of experience sees that LVB runs smoothly and efficiently making sure that our patients experience the warm and friendly service that's expected. In addition to being bilingual in English and Spanish, Carmen brings many attributes to the practice to ensure that our patients are given the best in quality care that anyone can provide. Her passion and commitment are tireless, leaving no stone unturned. This sets us apart.

Jeanny

BARIATRIC COORDINATOR As the practice Bariatric coordinator for the past 10 years, Jeanny has seamlessly guided hundreds of clients through the process. Insurance approvals can be challenging and frustrating for clients, which can take several months. Jeanny has experience and passion for the field, and knows what obese individuals face. She gives our practice the personal touch of compassion that patients should expect. Jeanny is bilingual 'English and Tagalog'. Again, this sets us apart.

jeanny@lasvegasbariatrics.com

MEDICAL ASSISTANT Angela is a graduate of Everest College. She is bilingual in English and Spanish. She is Doctor Hanna's right hand and personal assistant when patients come in for their visit. She will greet you and make sure that all of your needs are met during your visit. Her extensive knowledge of the surgical procedures and how our office runs allows her to coordinate patients’ flow from start to finish.

Angela angela@lasvegasbariatrics.com

www.lasvegasbariatrics.com

las vegas

bariatrics

– Staff – SURGERY SCHEDULER & Medical Tourism Specialist Zafiro is a Medical assistant Everest College graduate.

As the Lead Medical Assistant for Las Vegas Bariatrics, Zee wears many hats.

She coordinates our busy surgery schedule in addition to showing our medical tourism clients a seamless and worry free destination surgery experience. She is bilingual in English and Spanish. She also assists Jeanny in coordinating and tracking our Bariatric clients' monthly medical visits to assure that they get through the process in a timely fashion.

Zafiro “Zee”

zafiro@lasvegasbariatrics.com

MEDICAL ASSISTANT Scheduling & Insurance Benefits Rae is a confident and fully qualified medical assistant with 9 years experience in the medical field. She is responsible for verifying insurance coverage and benefits as well as triaging patients during their time of appointment. She is well trained in managing our on-line scheduling and having the knowledge to perform other administrative and clinical tasks to help keep our office running smoothly. Her proper attitude and experience with friendly customer service gives our office a better work environment. Rae is Bilingual in English and Tagalog.

MEDICAL ASSISTANT Clinic Scheduler

Jocelyne

Rae

rae@lasvegasbariatrics.com

Jocelyne is a graduate of Milan Institute. As a Medical Assistant she has the knowledge and skills to provide quality patient care. She is bilingual in English and Spanish. She is the friendly voice on the phone that will schedule your visits and collect the important information required to see Doctor Hanna. During your visit she will be the first one to greet you and ensure that your visit with Las Vegas Bariatrics is a smooth one.

jocelyne@lasvegasbariatrics.com

REGISTERED DIETICIAN

Joey Sjostrom is our Registered Dietitian. After graduating from the University of Nebraska in Lincoln with her Bachelors Degree in Nutritional Science and Dietetics, she completed her Dietetic Internship in Stockton, California.

Joey will work with you closely every step of the way on this journey. You will see Joey before and after surgery and she will give you all the information you need to know to maintain a healthy diet before and after surgery.

www.lasvegasbariatrics.com

Joey

las vegas

bariatrics

Bariatric Surgery is a safe and effective tool for your weight loss

For a long time Weight loss surgery 'Bariatric surgery', had a reputation for being a risky operation. The inherent nature of obesity as a disease increases the chances of complications. However with the implementation of The Center of Excellence Programs like “Las Vegas Bariatrics”, the risks and complications has been dramatically reduced. A mountain of evidence shows bariatric surgery to be the most effective treatment for severe obesity and its safety prole has never been better.

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), the number of surgical weight loss procedures carried out in the U.S. has increased from 13,000 in 1998 to more than 200,000 in 2008.

Bariatric surgery is now one of the most common interventions to which obese individuals turn.

Studies show that Surgery is now the most effective way for patients to lose weight and control their associated diseases. However less than 1% of the population who can benet from this actually utilizes it.

As the table below shows, many of the health conditions can get better or entirely resolve meaning that patients come off their medication. Up to 82% of Diabetics no longer need their medication and up to 70% of patients with hypertension come off their medication.

70

82

For those who have tried medical weight loss, diet and exercise, but just cannot succeed in losing the weight, you may be a candidate for weight loss surgery.

11

HEIGHT

WEIGHT (LBS)

5’0” 5’2” 5’4”

5’6” 5’8” 5’10” 6’0” 6’2” 6’4”

120

23

22

21

19

18

17

16

15

15

130

25

24

22

21

20

19

18

17

16

140

27

26

24

23

21

20

19

18

17

150

29

27

26

24

23

22

20

19

18

160

31

29

28

26

24

23

22

21

20

170

33

31

29

27

26

24

23

22

21

180

35

33

31

29

27

26

24

23

22

190

37

35

33

31

29

27

26

24

23

200

39

37

34

32

30

29

27

26

24

210

41

38

36

34

32

30

29

27

26

220

43

40

38

36

34

32

30

28

27

230

45

42

40

37

35

33

31

30

28

240

47

44

41

39

37

35

33

31

29

250

49

46

43

40

38

36

34

32

30

260

51

48

45

42

40

37

35

33

32

270

53

49

46

44

41

39

37

35

33

280

55

51

48

45

43

40

38

36

34

290

57

53

50

47

44

42

39

37

35

300

59

55

52

49

46

43

41

39

37

310

61

57

53

50

47

44

42

40

38

320

62

59

55

52

49

46

43

41

39

330

64

61

57

53

50

47

45

42

40

340

66

62

58

55

52

49

46

44

41

350

68

64

60

56

53

50

47

45

43

Calculate your Body Mass Index: To nd your BMI locate your Weight on the Left and your Height on the Top. Follow it to the intersection to locate your BMI.

9

las vegas

bariatrics

SURGICAL PROCEDURES

Description

Sleeve Gastrectomy

Reversible

no

The Gastric Sleeve Procedure is The Most Popular procedure. There is no foreign body, and the intestine is not re-routed.

During the sleeve gastrectomy procedure, a thin vertical stomach is created into a narrow tube using a stapling device.

The sleeve is like the size of a banana.

How it works?

Digestion

By creating a smaller stomach pouch, a sleeve gastrectomy limits the amount of food that can be eaten at any one time.

You feel full sooner and stay full longer.

As you eat less food, the body will stop storing excess calories and start using it’s fat supply for energy. We also decrease the number of receptors for the hunger hormone Grehlin which causes a decrease in appetite.

Allows for normal digestion and absorption.

stomach pouch, the Band limits the amount of food that can be eaten at one time, so you feel full sooner and stay full longer.

and absorption.

Food passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body.

Food passes through the digestive tract in the usual order allowing for normal digestion.

Adjustable Gastric The adjustable Gastric Band By creating a smaller Allows for normal digestion Band

Reversible

yes

Gastric Bypass

Reversible 12

no

wraps around the upper part of the stomach, dividing the stomach into a small pouch that holds about ½ cup of food and a larger lower stomach.

The degree of band tightness affects how much food you can eat and the length of time it takes for food to leave the stomach pouch.

As you eat food, your body will stop storing excess calories and start using its fat energy supply.

In this procedure, the surgeon By creating a smaller stomach creates a small stomach pouch, a gastric bypass limits pouch and attaches a section the amount of food that can be of the small intestine directly eaten at one time, so you feel full longer. By bypassing a to the pouch.

This allows food to bypass a portion of the small intestine, it portion of the small intestine. also causes your body to absorb fewer calories.

As you eat less food, your body will stop storing excess calories and start using its fat supply for energy.

Changes the body’s normal digestive process to reduce the number of calories and nutrients that are absorbed.

las vegas

Did You Know...........

bariatrics

That a Kidney Transplant can Change and Save a Life.

More than 26 million adult Americans have Chronic Kidney Disease (CKD).

National Kidney Foundation.

th

Kidney Disease is the 8 leading cause of death in the United States. Centers for Disease Control.

The leading causes of Kidney failure are #1. Diabetes, accounting for 44% of the newly diagnosed kidney failures each year and #2. Hypertension. In The United States there are more than 571,000 individuals with end stage renal disease 'ESRD' on dialysis. National Kidney Foundation.

Many of these patients are either overweight or obese.

In order to qualify for a kidney transplant, a recipient has to have a Body Mass Index 'BMI' of less than 30 to 35. This number is transplant center dependant. Sadly this requirement eliminates two out of three adult individuals for transplant.

With 66% of the U.S. population being overweight or obese the goal of Las Vegas Bariatrics is to put a major dent in this statistic and alleviate the health issues of many of these unfortunate individuals.

Gastric Sleeve

But, there is hope...

At Las Vegas Bariatrics Dr. Hanna has successfully performed Bariatric procedures on quali ied individuals on hemodialysis and even peritoneal dialysis patients.

For patients with ESRD, many of who may have diabetes, hypertension and a host of other illnesses we take them through a very strategic workup process to ensure their safety as a Bariatric surgery candidate. We leave no stone unturned to ensure excellent results. We have protocols in place for patients on peritoneal dialysis undergoing Gastric Sleeve Surgery.

After weight loss surgery, having this tool allows our patients to lose their weight, get below the required BMI and qualify for their kidney transplant. This is the second chance at life that many patients need and hope for.

It is up to our primary care physicians and our kidney specialists 'nephrologists' to take the irst step in educating our patients about the options that Las Vegas Bariatrics has available

Health is Wealth....

B.H.

13

Las Vegas Bariatrics

Revision

weight loss surgery

Is The Gastric Band falling out of favor?

In recent years surgeons have been turning to The Gastric Sleeve as the procedure of choice for weight loss.

For many patients undergoing gastric band surgery the weight loss has been disappointing and unrewarding. Even after having multiple band fills patients have not successfully lost weight or have actually regained weight.

If your gastric band has failed, doctor Hanna has a solution for you.

Patients travel from all over the country and internationally to be under the care of Doctor Hanna.

Doctor Hanna has been voted 'Top Surgeon” by his peers in 2006, 2007 and 2013.

His experience and reputation sets him apart as one of the leading Bariatric surgeons in The Las Vegas area.

As a leading very experienced weight loss surgeon in Las Vegas, and director of Las Vegas Bariatrics Center of Excellence Program, Doctor Hanna will make your experience a truly memorable and pleasant one. We have a fully integrated staff that focuses on your safety.

We evaluate for band slippage, erosions and device failure.

Having done hundreds of revision procedures, we have the solution.

Band to Sleeve revision surgery is becoming a very popular procedure with great success leading to better weight loss and improved health.

GASTRIC BAND FAILURE?

· · · · ·

14

Gastric Band

·

After having gastric band surgery, some patients can have problems.

Are you having dif iculty with the weight loss?

Are you having frequent bouts of emesis and throwing up?

Are you having dif iculty tolerating certain foods?

Are you only able to tolerate liquids?

Are you having severe Acid Re lux?

Band to Sleeve

Revision

If this sounds like you or someone that you know, then experiencing any of these symptoms can be caused by one of the following: 1.

Device failure

2.

Gastric band slippage or migration

3.

Gastric Band erosion

4.

Gastric Band obstruction

What’s the solution?

At LVB we’ve perfected the art of Revision Surgeries.

On a monthly basis we do several Gastric Revision procedures with amazing success and outcomes.

The options include: 1.

Adjusting the Band

2.

Removing the Band and converting to a Sleeve Gastrectomy

Gastric Sleeve

Why Sleeve? · · · ·

Sleeve Gastrectomy has proven better weight loss.

Has a great safety pro ile.

No maintenance issues like band ills that can be costly.

Better resolution of health problems.

When we do a Band revision, it’s usually a very safe and straight forward procedure. It’s a minimally invasive, laparoscopic procedure. You may be home on the same day.

Most patients after having a Band to Sleeve Revision Surgery do Great!

At LVB we’ve done numerous successful Revision Surgeries with excellent results.

Call now to schedule your visit:

702-384-1160

lasvegasbariatrics.com

15

Las VegasBariatrics Carissa - before

Carissa - after

– Testimonial – “Dr. Hanna saved my life. I was on oxygen suffering from Pulmonary Hypertension among other various illnesses! And with the sleeve surgery I am without oxygen unless I'm traveling or flying.

His staff is amazing! I love you guys for saving my health and my life! Thank you so much.”

Sleeve 05/22/2013

Debi - before

ê ê ê – Testimonial – “This has proved to be an amazing jump start to successful weight loss and to maintain a healthy life style!! It is not the easy way out! It takes work and commitment, dedica on and determina on but nothing worth achieving is easy. I would do it again in a hot minute! Thank you Dr. Hanna for your support and encouragement; special thanks to your staff, I could not have done this without all of you.”

Sleeve 07/31/2013

16

Debi - after

Success Stories John - before

John - after

– Testimonial – “Having Dr. Hanna do this surgery is the best thing I've ever done. Dr. Hanna knows what it takes to lose the weight and always takes the me to work with you to make it happen.

I was 335 pounds with a 48 waist, now 200 pounds and a 34 waist in just over one year.”

Sleeve 05/14/2014

Mark - before

ê ê ê

Mark - after

– Testimonial – “Seeing Dr. Hanna was the best decision I ever made. I was on the wrong track of life.

A�er my surgery my life has never been be er, personal and professionally!”

Sleeve 04/24/2013

17

more.....

Success Stories

Samantha - before

Samantha - after

– Testimonial – “Coming in to see Dr. Hanna was the best decision I’ve ever made in my life!

I was so unhappy with my weight and always covered up. Now I love to go out and enjoy simple things like shopping for clothes.”

Best decision ever! Great office staff! Highly recommended!

Sleeve 06/23/2014

Mark - before

ê ê ê – Testimonial – “Dr. Hanna and his en re staff have been great throughout the en re me of this process.

I am so glad I did this with absolutely no regrets. I feel great, can’t wait to lose more weight and keep it off. Keep up the great work!”

Sleeve 10/17/2014

18

Mark - after

To Eat Gluten or Not to Eat Gluten?

That is the question.........

Years ago those who were diagnosed with Celiac Disease were told to eat gluten free foods but nowadays more and more people who have not been diagnosed with Celiac Disease are ea�ng gluten free. You may wonder if it is healthy even if you don't have Celiac and if you can eat gluten free and s�ll be ge�ng the nutri�on you need to be healthy.

According to the Celiac Disease Founda�on, Celiac disease is defined as an autoimmune disorder that can occur in gene�cally predisposed people, where the inges�on of gluten leads to damage in the small intes�ne. It is es�mated to affect 1 in 100 people worldwide.

Plus, if you already have an autoimmune disease such as Insulin Dependent Diabetes or Thyroid disease this puts you at a high risk for developing Celiac Disease. When someone with Celiac disease eats gluten (protein found in wheat, barley and rye or in their crossbred hybrids like tri�cale) this triggers an immune response that in turn damages the small villi located in the small instes�ne. There are over 200 symptoms that may be involved with celiac disease that range from iron deficiency anemia to severe diarrhea all from inges�ng gluten. For Celiacs (someone who suffers from Celiac disease), ea�ng gluten free is not a choice it is a necessity to prevent further health complica�ons.

Are there people who have symptoms similar to those that have Celiac? Yes. It is called Non-celiac gluten sensi�vity (NCGS).

Research finds about 5% of the popula�on suffers from NCGS and ea�ng gluten does not result in damage to the small intes�ne or interfere with nutrient absorp�on. People who have NCGS eat gluten free because their symptoms (“foggy mind”, fa�gue, joint pain bowel, etc.) typically improve.

You heard that your neighbor is ea�ng gluten free but she doesn't have Celiac Disease. You may wonder if a person who has not been diagnosed Celiac should be ea�ng gluten free products and if it is healthy. People who eat a gluten free diet can eat a healthy diet but it does take work. Gluten free products such as breads, crackers, and cereals are typically replaced with a gluten free ingredient like white rice. White rice is a simple carbohydrates meaning they are rapidly digested which may increase blood sugar levels. You can find high fiber and complex carbohydrate gluten free food by looking at the food label and the ingredient list. Looking for 5 grams of fiber or more per serving in a gluten free food is a great start.

Most people make their own gluten free food such as bread and crackers due to the lower cost and they make it according to their tastes.

If you feel you may have Celiac Disease, you can ask your primary care provider or a gastroenterologist for Total serum IgA, An�transglutaminase IgA, An�-endomysial IgA via blood draw.

Those that have a first-degree family member (parent, child, sibling) have a 1 in 10 risk of developing Celiac disease and should consider ge�ng tested. There is another op�on�.Nutrigenomix is a Toronto based company where they test someone's risk of gluten intolerance. The report also provides the client a personalized nutri�on recommenda�ons and resources. One thing to remember is that you may not have outward symptoms such as bowel issues, joint pain or vitamin and mineral deficiencies.

Just because you are not diagnosed Celiac you could s�ll have a reac�on to gluten. Many people experience a decrease in bloa�ng, bowel movements are be�er, iron levels in their blood increase naturally, and they may have more res�ul sleep and perhaps have decreased joint pain.

If you or someone you know have been diagnosed with Celiac Disease or would like start ea�ng a gluten free diet, and don't know where to start. I encourage you to hire a licensed and registered die��an who has a nutri�on degree and experienced in the world of gluten free. They can help and support you on your new journey.

Joey Sjostrom, is licensed die��an and a registered die��an in the state of NV. She has been helping individuals weave through the maze of ea�ng gluten free and also provides Nutrigenomix NGx gluten intolerant tes�ng to see if clients have the gene�c markers.

Call 702-878-Joey (5639) or visit Joey's website: www.nutritionbyjoey.com 19

las vegas

bariatrics

BARIATRIC SURGERY

FAQs What procedure is right for me?

Dr. Hanna will make a recommendation during your evaluation based on your medical conditions and your weight. He will discuss the advantages and disadvantages of each procedure. The final decision is yours to make.

However, the most common procedure that we do now is The Gastric Sleeve procedure.

Does Insurance cover it?

This varies by different health plans. You may check with your insurance provider regarding this.

But for the most part many insurances do cover Bariatric surgery. The staff at Las Vegas Bariatrics are experts at this.

What do I have to do to get approved?

Each insurance has its own criteria. In addition to meeting these criteria, each patient requires a nutrition and psychiatric evaluation. We help you get these evaluations.

Are there any age restrictions for weight loss surgery?

For our program, at least 18 years old, and we look at the overall health of the individual. Patients over 65 may also be good candidates.

Do I have to be on a special diet before surgery?

Depending on your weight, Doctor Hanna may require you to be on a low-calorie diet for a few weeks before surgery.

Do I have to lose weight before surgery?

It is beneficial for all patients to lose some weight 20

prior to surgery because this allows for a safer, easier operation.

How much weight will I lose?

Depending on the procedure, on average one can lose 60-90% of the excess weight. It’s important that you understand how the procedure is supposed to work for you. It is also very important to follow up with your comprehensive Bariatric program to maximize your results.

Will my health problems go away?

There is no guarantee, but the majority of heath problems caused by obesity either improve or resolve.

For example, up to 80% of type 2 diabetes resolves after weight loss surgery and patients come off their diabetic medications.

Will I need to crush my pills after surgery?

It is preferable that all medications be in a crushable or liquid form after surgery. Your pharmacy and your doctor will help you with this.

Can I gain the weight back after surgery?

It’s unlikely but this is always a possibility. Hence it is very important to follow the program as instructed by your surgeon and maintain good dietary habits, exercise and follow-up with your Bariatric team.

What about smoking?

We instruct patients to stop smoking at least 30 days before surgery, since smoking increases risk of complications during and after surgery.

las vegas

bariatrics

BARIATRIC SURGERY

FAQs What procedure is right for me?

Dr. Hanna will make a recommendation during your evaluation based on your medical conditions and your weight. He will discuss the advantages and disadvantages of each procedure. The final decision is yours to make.

However, the most common procedure that we do now is The Gastric Sleeve procedure.

Does Insurance cover it?

This varies by different health plans. You may check with your insurance provider regarding this.

But for the most part many insurances do cover Bariatric surgery. The staff at Las Vegas Bariatrics are experts at this.

What do I have to do to get approved?

Each insurance has its own criteria. In addition to meeting these criteria, each patient requires a nutrition and psychiatric evaluation. We help you get these evaluations.

Are there any age restrictions for weight loss surgery?

For our program, at least 18 years old, and we look at the overall health of the individual. Patients over 65 may also be good candidates.

Do I have to be on a special diet before surgery?

Depending on your weight, Doctor Hanna may require you to be on a low-calorie diet for a few weeks before surgery.

Do I have to lose weight before surgery?

It is beneficial for all patients to lose some weight 20

prior to surgery because this allows for a safer, easier operation.

How much weight will I lose?

Depending on the procedure, on average one can lose 60-90% of the excess weight. It’s important that you understand how the procedure is supposed to work for you. It is also very important to follow up with your comprehensive Bariatric program to maximize your results.

Will my health problems go away?

There is no guarantee, but the majority of heath problems caused by obesity either improve or resolve.

For example, up to 80% of type 2 diabetes resolves after weight loss surgery and patients come off their diabetic medications.

Will I need to crush my pills after surgery?

It is preferable that all medications be in a crushable or liquid form after surgery. Your pharmacy and your doctor will help you with this.

Can I gain the weight back after surgery?

It’s unlikely but this is always a possibility. Hence it is very important to follow the program as instructed by your surgeon and maintain good dietary habits, exercise and follow-up with your Bariatric team.

What about smoking?

We instruct patients to stop smoking at least 30 days before surgery, since smoking increases risk of complications during and after surgery.

Y

oga

find your center

by Harsha

When my husband Dr. Bernie Hanna asked me to write an article on Yoga and it's benefits, I agreed before realizing what a difficult task it is to write “an article” on yoga- about which text books and scriptures have been written.

I decided to bring out all of my yoga texts and write excerpts of my most favorite little parts in some of these books. Hence I start by quoting some experts directly from their texts.

I will end by listing a summary of the current research on yoga and some of its medical benefits.

The word Yoga is derived from the Sanskrit root 'yuj' meaning to bind, join, attach and yoke, to direct and concentrate one's attention on, to use and apply. It also means 'union' or 'communion.'

In the words of B.K.S. Iyengar (renowned teacher of the Iyengar style of yoga) “Yoga is the true union of our will with the will of God”. Taken from B.K.S Iyengar's Light on Yoga.

A further meaning of the word Yoga is “to attain what was previously unattainable.” The starting point for this thought is that there is something that we are today unable to do; when we find the means for bringing that desire into action, that step is yoga. In fact, every change is yoga. When we find a way to bend the body forward and touch our toes, or learn the meaning of the word yoga with the h e l p o f a t ex t , o r g a i n m o r e understanding of ourselves or others through a discussion, we have reached a point where we have never been before. Each of these movements and changes is yoga.

Yoga attempts to create a state in which we are always present- really present- in every action, in every m o m e n t . T h e a dva n t age o f attentiveness is that we perform each task better and at the same time are conscious of our actions.

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The possibility of making mistakes becomes correspondingly smaller the more our attention develops. When we are attentive to our actions, we are not prisoners to our habits; we do not need to do something today simply because we did it yesterday. Instead there is the possibility of considering our actions fresh and so avoiding thoughtless repetition.

The actual practice of Yoga takes each person in a different direction. It is not necessar y to sub scribe to any particular ideas of God in order to follow the yoga path. The practice of yoga only requires us to act and to be attentive to our actions. Where and how does the practice of yoga begin?

Should we always begin on the physical level? I would say that where we begin depends on our personal interests.

There are many ways of practicing yoga, and gradually the interest in one

path will lead to another. So it could be that we begin by studying the Yoga Sutra or by meditating. Or we may instead begin with practicing asanas and so start to understand yoga through the experience of the body.

We can also begin with pranayama, feeling the breath as the movement of our inner being. T here are no prescriptions regarding where and how our practice should begin. Taken from T.K.V. Desikachar's The Heart of Yoga.

No matter who we are or how long we have been entr enched in selfdefeating behaviors, through daily Yoga practice we can become present to our own fundamental goodness and the goodness of others. Rediscovering who we really are at our core opens the way to experiencing our most basic level of connection with others.

This connection lies at the heart of the practice called Yoga.

It is the opening of the heart so that we have the capacity to feel tenderness, joy, and sorrow without shutting down. It is the opening of the mind to an awareness that encompasses rather t h a n e x c l u d e s. A n d i t i s t h e homecoming with and in the body for it is only here that we can do all these things. Taken from Donna Farhi's Bringing Yoga to Life.

This study concluded that yoga exercise improves the cardiovascular risk factors including central obesity and blood pressure in middle-aged and older adults with metabolic syndrome. Siu et al

better regulation of the sympathetic nervous system and hypothalamicpituitary-adrenal system, as well as a decrease in depressive and anxiety symptoms in a range of populations.

·

Those who did mind-body practices had significantly l owe r b o dy m a s s i n d ex , triglyceride levels, and fasting glucose levels. Metabolic syndrome was less common a m o ng i n d iv i d u a l s w h o e ng ag e d i n m i n d - b o d y practices. Younge et al Psychosom

·

The reduction in the fasting and post-prandial blood sugar at three months during yoga was highly significant in the type 2 diabetes group when compared with mean values before yoga. Chimkode et al J Clin

A systematic review of randomized controlled trials examining yoga programs for individuals with heart disease, stroke, and COPD compared with usual care. Compared with usual care, yoga resulted in significant improvements in exercise capacity and a mean improvement in health related quality of life. Yoga programs may be a useful adjunct to formal rehabilitation programs. Desveaux et al

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Clinical studies of health benefits of Yoga

The benefits of yoga have been studied in innumerable disorders ranging from anxiety, depression, chronic pain, high blood pressure, multiple sclerosis, low back pain, schizophrenia, fibromyalgia, chronic fatigue syndrome, Parkinson's and chronic illness.

I want to focus on just a few of these pertaining to the scope of this magazine.

Yoga for High Blood Pressure

Several studies suggested that yoga leads to a significantly greater reduction in blood pressure complementary to various forms of medications. Posadzki et al Complement Ther

Diabetology Metab Syndr. 2015 Apr 30

Med. 2015

Diagn Res. 2015

Med. 2014

Yoga for Metabolic Syndrome, Diabetes, Cardiovascular Disease

Metabolic syndrome is a combination of cardiovascular risk factors, which is associated with obesity, diabetes mellitus and cardiovascular disease.

Systolic and diastolic blood pressure, waist circumference, fasting plasma glucose, triglycerides, and highdensity lipoprotein cholesterol are some of the diagnostic components of metabolic syndrome. · A reduction of the number of diagnostic components for metabolic syndrome was found to be associated with the yoga inter vention. Waist circumference was significantly improved after the 1-year yoga intervention.

A trend towards a decrease in systolic blood pressure was obser ved following yoga intervention.

Yoga for back pain

Mindfulness based stress reduction was effective in reduction of pain severity and the patients who practiced 8 sessions reported significantly lower pain than patients who only received usual medical care.

There was a significant effect on the physical quality of life and mental quality of life. Banth et al Int J Yoga. 2015 Yoga for depression and anxiety

25 randomized control studies provide preliminary evidence to suggest that yoga practice leads to

Pascoe et al J Psychiatr Res. 2015

Yoga for chronic disease

Med Care. 2015

In Summary…

Yoga is an ancient spirit-mind-body practice that aims to help us get in touch with our inner or higher selves and to see our connectedness to the universe and it’s beings.

One does not need to be “good at yoga” or “flexible” to begin a practice. Being aware of your breath for a minute is Yoga, seeing the beauty of a flower or a sunset is Yoga, closing your eyes for a few minutes and sitting silently is yoga, taking a few deep breaths before reacting to a situation is yoga, and of course doing the physical practice of poses, stretching and movement is yoga.

The health benefits of yoga are multiple, these include physical and psychological benefits like improvement in blood pressure, blood sugar, anxiety, depression, chronic pain and quality of life to name only a few.

So, let's get started… sit still for a few minutes, find a YouTube yoga or meditation or mindfulness video, join a n o n l i n e y o g a class/community/forum, join a yoga s t u d i o, s u b s c r i b e t o a y og a magazine…. whatever is accessible to us.

Let's Get Here to the Present Moment, which is all we have!

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My Travels MONTREAL

I recently traveled to Canada. I visited the City of Montreal, which is in the southwest Province of Quebec. It’s a city of charm and culture where the official language spoken is French. When you think about Canada one doesn’t usually think about America yet this is North America my friends. It was originally called Ville-Marie, or ‘City of Mary’ and is named after Mount Royal which is a triple peaked hill in the heart of the city.

The city is on the Island of Montreal which sits at the confluence of the Saint Lawrence and Ottawa rivers. So surrounded by water there are ports and coastal paths. Montreal is the second largest French speaking city in the world outside of Paris.

Even though French is the official language, more than half of the population speaks English.

So navigating the city makes it easy to communicate.

Montreal has been named a Unesco City of Design along with Buenos Aires and Berlin, and is a commercial capital in Canada. It’s also a leading host city for international association events in North America.

I found this city so enjoyable to walk, explore and dine.

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When to Visit: A great time to visit is late spring, early summer since it’s nice and warm in the day and comfortably cool in the evenings. There’s less rainfall, no snow and lots of sunshine.

Where to Stay: Being such an eclectic city that’s so full of life it really comes down to what appeals to you. I preferred to stay in the heart of “Old Montreal”.

Our hotel was half a block from the popular street “Rue Saint Paul”. This street comes to life in the evenings. It’s lined with art galleries, restaurants, bistros and cafés. There are artists performing music and I’m talking real talent. You may walk upon someone choreographing a beautiful piece

My Travels on a violin or as we did, an accordion. Two blocks away took us down to the Saint Lawrence river where the old port and Quai ‘wharfs’ are fun to walk.

Getting around: Navigating and getting around in the city is quite easy. The STM bus routes and the metro rail system are very efficient and convenient. There is also the public self service bike system ‘BIXI’ which is a coupling of the words Bicycle and taxi.

It’s been very popular in European cities such as Paris, Barcelona and Lyon. You can rent one of over 3000 bikes, ride all around the city and drop off at one of 400 depots.

To Do: Sightseeing and touring neighborhoods are endless in ths city. Beautiful pedestrian streets and markets abound. Even after trekking around the town all day we found ourselves strolling the streets in the evenings. It’s a very different vibe with the town being so alive, there’s always someplace to explore.

You need to select which neighborhood you want to explore since it can take a full day to enjoy.

There’s ‘Little Italy’, ‘Chinatown’, the ‘Latin Quarter’, downtown and more.

Old Montreal ‘Vieux Montréal’ is at the heart of the old port site. There are beautiful squares and the Notre Dame cathedral truly a replica of Notre Dame Paris. Popular here are horse and buggy rides.

Downtown is the epicenter of old-time mansions and heritage buildings.

Here you’ll find business people and students from McGill University sitting in cafés enjoying an espresso, having a good conversation or reading a book. The Musée des Beaux-Arts is a landmark tourist attraction. Ste. Catherine Street is a long boulevard that stretches east to west with boutique shops, and large shopping galleries.

Place des Arts and the performing art complex at the east end is the center for arts and cultural events. The annual jazz festival is a popular event that artists, musicians and writers frequent. Parc du Mont Royal is a large green space with bike trails, ponds, running paths and plant life and an abundance of sidewalk cafés. Cycle alongside the canal de Lachine or take a paddle boat and cruise down the canal leisurely.

Many monuments, churches, and museums are worthy of exploring. Basilica Notre-Dame, Place d’Armes, and Hotel de Ville to name a few.

Musée des Beaux Arts de Montréal houses impressive works of art, sculptures, ancient and modern.

If you’re into sports maybe you can catch a local ice hockey game, Montreal’s most popular sport.

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My Travels Montreal Cuisine: If you love food as I do this is a place to explore the limits of your palate. Restaurants abound from small cafés, quiet bistros, modern hipster pub bars to elegant Michelin star restaurants.

A local favorite if you like adventure is the decadent Poutine {French Fries bathed in warm gravy and cheese then topped with whatever else you choose to put on it like fried egg, grilled chicken or steak}. It’s not the healthiest dish on the planet but when in Rome....eat it....just get one and have everyone in your group have a taste.

Maple Syrup. You can’t go to Canada without getting yours hand on the pure maple.

Markets: Farmers’ markets are one of my favorite to visit and can be very enjoyable. Here you can see a plethora of vendors, butchers, delicatessens and more. Take a visit during lunch hour so you can indulge and partake in the food fare of locally prepared cuisine made from fresh locally grown produce. Make sure you leave room for dessert because the pastries and fresh breads are to die for.

Marche Jean-Talon in Little Italy is a landmark. Also Marché Atwater is another icon that is located in the ‘ Little Burgundy’ area of Montreal. It sits right alongside of the canal Lachine.

Night Life: The evenings are fun and can be what you make of it. One of my favorites is the roof top restaurant bar lounges that overlook the city. There are several in old town near the river that give stunning views of the city and the harbor. You can wine and dine with friends while soaking up the views at sunset.

There are also numerous clubs for music, dance or comedy. Whatever your fancy is you should be able to find it. With so much to do and see at the end of my seven days, I looked back and said ‘jeez’ I barely scratched the surface’.

– So keep your trekking shoes handy –

Safe Travels!

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Can exercise that is intense be fun?

There are those of us who love the gym, being in a structured class and being around others to motivate them.

Then there are those that love the alone time and getting their workout done in a more tranquil zone of solitude. The key is to find your zone. Know what works best for you.

There's no way to know unless you try.

FITNESS

You only get results when you do it!

One of the things I love to do is getting outdoors. Just being outside, seeing and being around nature, breathing the fresh air is what it's about.

So how can we attain optimum fitness and health.

There are several theories. But in a recent article I read in the New York Times health section [July 29th, 2015 by Gretchen Reynolds] titled 'A Way to Get Fit and Also Have Fun', talked about interval training. I found this interesting and fascinating.

Studies done by Jens Bangsbo, a professor of physiology at the University of Copenhagen in Denmark confirm that h igh-intensity exercise, usually in the form of short bursts of very arduous intervals interspersed with rest, has shown that even a few minutes of these intervals can substantially improve health and cardiovascular itness.

Repeated hard interval training 'HIT' has almost invariably made people fitter, faster and healthier.

The goal was to create a workout that could be employed by everyone, from the non-experienced person to the elite athlete.

It's called 10-20-30 Training.

The essentials of 10-20-30 training are simple. Run, ride or perhaps row on a rowing machine gently for 30 seconds, accelerate to a moderate pace for 20 seconds, then sprint as hard as you can for 10 seconds (It should be called 30-20-10 training, obviously, but that is not as catchy.) then you Repeat the interval.

If you wish to try 10-20-30 training, Dr. Bangsbo recommends starting by replacing one or two of your normal weekly workouts with a 10-20-30 session.

Warm up with an easy jog (or pedaling or rowing), then ease into the intervals. The 30-second portion should feel relaxed; the next 20 seconds moderately hard; and the final 10 seconds a full gallop. “The aim is to cover as much distance as possible in those 10 seconds,” Dr. Bangsbo said.

Do five of the 10-20-30 intervals in a row without pause, then rest for two minutes by standing or very slowly walking about. Repeat the five consecutive intervals one more time, cool down, and you are done. The whole session, minus warm-up and cooldown, will have lasted 12 minutes.

This can be done easily outside basically a fast paced walk followed by a slow jog followed by a faster jog.

For our bariatric patients and people who are heavier and can't run obviously the key is just alter your stride and pace intermittently to achieve the same effect.

It has become one of my favorite interval programs.

The world is yours. Explore!

So GET OUTDOORS and MAKE IT FUN!

by Bernie Hanna 27

Las VegasBariatrics

S e a l l p a m d i S

Ingredients:

Dressing to your liking:

Chopped Organic Field Greens

Virgin Olive Oil

Grilled Corn

Salt

Fresh Field Tomatoes

Pepper

Apple

Balsamic Vinegar

Hummus ‘Protein’

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A Healthy You

Find the word in the puzzle.

Words ca n go in a ny direction. Words ca n s ha re letters a s they cros s over ea ch other.

alcohol appetite balanced calories carbohydrates cycling dairy

diabetes diet disease energy exercise fat fiber

fitness friendship glucose happiness health jogging leisure

lifestyle muscles oxygen posture protein relaxation sleep

strength sugar training vegetables yoga

GENERAL SURGERY SOLUTIONS

ANTI REFLUX / HIATAL HERNIA SURGERY Minimally Invasive Surgery

WHAT IS A HIATAL HERNIA? A Hiatal Hernia is a space in the diaphragm. Your diaphragm is the muscle that separates the chest and belly. Your stomach may bulge through this hole into your chest and this can make Acid Reflux symptoms worse.

WHAT IS GERD? GERD is a condition that allows food or stomach acid to move from the stomach up to the esophagus. This is called reflux. It can cause discomfort in the chest called heartburn. This happens because there is a weakness in the muscle between the esophagus and the stomach.

WHAT ARE THE SYMPTOMS? Burning and heartburn in the stomach, chest and throat especially after meals.

CAUSES: The cause can be due to several factors. Increasing age, obesity, and smoking are known risk factors in adults.

HOW IS GERD TREATED? This is usually treated medically with diet modifcation cessation of tobacco and alco hol and with weight reduction.

WHEN IS SURGERY INDICATED? When medical treatment fails. Usually patients are on medication for a long period of time and the medication doesn’t control the symptoms anymore. You may develop aspiration pneumonia, hoarseness or chronic cough.

WHAT IS ANTIREFLUX SURGERY? The surgery for GERD is called a Nissen Fundoplication. It is a procedure that tightens the junction between the esophagus and the stomach. This is a minimally invasive surgery that takes about an hour to perform. Usually a Hiatal Hernia Repair is performed in conjunction with the fundoplication. Patients can go home the same day of surgery depending on your overall health.

HIATAL HERNIA

OVERALL PROGNOSIS Anti-refux surgery repair is a safe operation. Heartburn and other symptoms should improve after surgery. There may still be some residual refLux symptoms that will require you to still take antireflux medication after surgery.

There is a possibility of recurrence which means that some people will need another operation in the future to treat new reflux symptoms. This may happen if the stomach was wrapped around the esophagus too tightly, the wrap loosens, or a new hiatal hernia develops.

Possible complications of surgery include difficulty swallowing (dysphagia), difficulty belching if the wrap is too tight and inability to eat certain foods in the future.

ANTI REFLUX SURGERY

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45 minute Out Patient Surgery You can go home on the same day

702-384-1160

Events □

Seminars Monthly

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Support Groups Monthly

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Health Walks Monthly ...Lots of fun to get outside and enjoy

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Meeting locations are frequently updated on our social media sites FB

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Las Vegas Bariatrics

website: lasvegasbariatrics.com

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LIFE’S CHOICES......

Be Happy and Free!

B.H.