Weight Loss
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Weigh Beyond: Keeping up with Sam and Sara
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Sitting in a dim-lit room – where the only lights are the neon wire lights fading in and out along the black walls and under the desk – Sam, sitting with his back towards Sara’s back, asks, “Are you online?”
Sara replies with an attentive ‘yes’ as she, too, prepares to embark on an online-gaming session that can last hours.
For Sam Mitchell, 37, and Sara Hays, 31, this is not a new scene in their Bowie residence. They’ve been dating for eight years and continue to perfect their gaming skills together. They spend many evenings and weekends doing this because they play on a team. “We have a hard time getting out of the house sometimes,” says Sara, 31. “Sometimes we want to go out to eat, but other online gamers are depending on us to come online so they can also play.”
Although Sara had a very active childhood – playing sports like soccer, basketball and softball all the way through high school – she struggled with her weight, asserting she was always a heavy person. “I grew up with parents who would have meat, a potato and a vegetable for dinner and encouraged me to always clean up my plate,” she says. “That resonated with me for the rest of my life and I think that was part of the problem.”
Sara tried countless diets to no avail, describing the results as a yo-yo effect, where she would lose about 50 pounds and regain 70 pounds soon after.
Sara tried the gym, but didn’t feel comfortable working out in front of others. “I always feel like I’m being looked at or judged,” she says. In an attempt to look for a different alternative, the couple purchased an elliptical to workout at home. The solution lasted for merely a week before the piece of equipment was put away.
The turning point
Weight and self-image is something that has always been on Sara’s and Sam’s mind. But despite their many efforts, nothing seemed to work. They had thought about potentially undergoing surgery, but felt there was a negative stigma attached to this option because others claimed it was ‘cheating’. Their perception changed when one day an opportunity to look at things differently came knocking at their door, literally.
The woman who I met weighing over 300 pounds was now 120 pounds.
“One of our friends came over to talk to us about his wife who had done weight loss surgery,” Sam says, jokingly adding that his friend felt a little jealous because his wife was now getting more attention from others. “We had seen her before and didn’t think it could be that big of a deal. She came to our door two weeks later and when I opened the door, the woman who I met weighing over 300 pounds was now 120 pounds.”
Shocked with the results, Sara and Sam decided to look more into weight loss surgery. “I didn’t even recognize her; she was like a whole new person,” Sara recalls. “I thought to myself, ‘You were my size, how did you do this? What happened?’ She went through the process with us and her feedback was that she wished she had done it 20 years ago. That was the turning point for us.”
The couple started looking up the doctor their neighbor had used after the raving review, but were not fully sold on the idea until they came across Courtney Doyle, MD, general and bariatric surgeon with AAMG Surgical Specialists in Annapolis. After talking to other people who had done the surgery and meeting with Dr. Doyle personally, the couple was ready to move to the next step.
The surgery
The AAMC Weight Loss and Metabolic Surgery Program performs more than 700 bariatric surgeries every year, a steady increase over the last few years. Recent research by the American Society for Metabolic and Bariatric Surgery found that 90 percent of patients were successful in maintaining 50 percent or more of their weight loss after their bariatric surgery.
There are also health benefits that result from this, with data showing remission of Type 2 diabetes in more than 80 percent of patients after undergoing a Roux-en-Y gastric bypass and sleeve gastrectomy. After a gastric sleeve surgery, most patients can expect to lose up to 33 percent of excess weight by three months, 50 percent of excess weight by six months, and up to 70 percent of excess weight after the first year following the procedure.
LEARN MORE: Dr. Courtney Doyle discusses bariatric surgery at AAMC’s Weight Loss and Metabolic Surgery program, and how it can change patients’ lives.
Dr. Doyle first met the couple a few months ago. She recalls Sam was the first one to come in to the office and said he wanted to do this together with Sara. “They felt like they were in a position where they were ready to do well and support each other through the process,” she says.
After attending AAMC’s free bariatric seminar, where Sara and Sam learned about the types of weight loss surgery, program requirements, insurance specifics, and other details to start their weight loss journey, they put a date on their calendar for an official consultation. For Sara, the best option was to opt in for the laparoscopic sleeve gastrectomy.
“This surgery is performed laparoscopically, which is the way most bariatric surgeries are performed these days,” says Dr. Doyle. “This means that we make a few very small incisions as opposed to one very large incision, the way we used to do bariatric surgery.”
The smaller stomach pouch limits how much food a person can eat at one time and in turn, will help Sara to feel full more quickly and for a longer period.
They’re looking for a way to do that and this surgery is a really nice way to help them get to a healthy lifestyle without having to feel every day like they’re constantly on a diet.
“They want to be active and healthy for the rest of their lives together,” says Dr. Doyle. “They’re looking for a way to do that and this surgery is a really nice way to help them get to a healthy lifestyle without having to feel every day like they’re constantly on a diet.”
Sara underwent surgery in January. While she continues on her successful recovery, Sam has yet to schedule his surgery due to a fractured arm. However, his excitement of being by her side while she recovers is adding to the anticipation. Stay tuned in to the Weigh Beyond series for part 2 as we continue to follow their journey in real-time.
Take the first step on your journey to weight loss. Register today for one of our free seminars to learn more about weight loss surgery (also called bariatric surgery).
Courtney Doyle, MD
Dr. Doyle is a board-certified, fellowship-trained laparoscopic general and bariatric surgeon at Anne Arundel Medical Center. She is an expert in both primary bariatric surgeries and bariatric revision surgery. To schedule a visit with her and explore your personal bariatric journey, call 443-481-6699.
Originally published March 18, 2019. Last updated March 9, 2020.
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General Page Tier 3
Helping children develop healthy snacking habits during COVID-19
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Many of us are still working and learning virtually from home. That’s why this is a good time to take a closer look at your child’s (and your own!) relationship with snacking. A good rule of thumb is to keep it simple. To do that, ask the four ‘w’s’ – why, when, where and, most importantly, what.
Why is your child looking for a snack? Snacks are important to help your child meet nutritional needs for overall health. But, if they are seeking snacks more frequently, it’s fine to ask them if they might be feeling something other than hunger. For example, feelings of stress or anxiety, boredom or loneliness, thirst or fatigue can bring about food cravings. If one is an issue, be sure to address the underlying problem.
When does a snack make sense? Snacks are important to help children meet their nutritional needs. It helps them stay focused and gives them energy to get through a busy day. In general, children and teens need to eat every three to four hours during the day. Younger kids need at least two snacks a day. Older kids/teens need at least one (two or more if they are participating in sports or going through a growth spurt). The timing of snacks is important, too. You want your child to have an appetite for their meals and not get in a habit of grazing throughout the day only to refuse food at mealtime. Consider offering a snack a few hours after one meal ends and an hour or two before the start of the next meal. Offer meals and snacks at predictable times.
Where should you eat a snack? Make snacking an eating event. Have specific areas in your home where snacking takes place. For example, the kitchen table, the counter or a table outside during nice weather. Research shows that when kids snack while doing other things, such as watching TV or studying, it can lead to overeating. And when your child eats all over the house, you’re less likely to be aware of what or how much they are eating.
What to eat as a snack? The nutritional choices you and your children make are crucial. Good nutrition is essential to good health. Parents need to think about food choices as health decisions for their children. Think of snacks as “mini meals.” Try to make 50% of a snack a fruit or vegetable. Add in a high fiber grain, like whole grain cereal or bread. Or add in lean protein, like sliced turkey or peanut butter. This will keep their tummies happy until the next meal or snack.
Additional tips for healthy snacking
Involve your children in age-appropriate meal and snack planning and preparation.
Keep produce in plain sight. For example, a bowl of fruit on the counter or table.
Have cut veggies and fruit in baggies or on a plate in the refrigerator.
Purchase frozen fruit for a quick smoothie.
Prepare small portioned containers of trail mix or dry cereal.
Keep small yogurts and cheese sticks on hand.
Try baked chips with homemade salsa or bean dip.
Roast some chickpeas or kale chips.
Prepare mini bagels with nut butter and a banana.
Your turn! Prepare a yogurt parfait with your child
Set up a yogurt parfait bar. Place all the ingredients on the table and have your children make their own yogurt parfaits. It can be a fun and nutritious snack activity. You will need:
Greek yogurt or non-dairy coconut yogurt
Granola or your favorite dry cereals
Mixed, cut fresh fruit
Pumpkin, sunflower seeds or nuts (for older children)
Start with yogurt in the bottom of the glass or bowl and alternate layers of cereals, fruit, seeds and nuts. Enjoy!
Authors
Ann Caldwell is a nutritionist and registered dietitian at Anne Arundel Medical Center. To reach her, call 443-481-5555.
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Women's Health
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What you need to know about high blood pressure during pregnancy
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Maintaining good health during pregnancy involves more than just watching your weight and taking your prenatal vitamins and folic acid. It also includes managing your blood pressure.
Blood pressure is the force of the blood pushing against the artery walls. The force is created with each heartbeat as blood is pumped from the heart into the blood vessels. If the pressure in your arteries becomes too high, you have high blood pressure, also called hypertension. Sometimes high blood pressure is present before pregnancy. In other cases, high blood pressure develops during pregnancy.
SEE MORE: Are you at risk for high blood pressure? Take this quiz!
While there is no exact cause of hypertension during pregnancy, there are many factors that increase your risk of having it. Your risk may be higher if you’re:
Pregnant for the first time
Overweight or obese
Over 40 years old
African American
Giving birth to multiples
Have a history of hypertension
Hypertension is known as the silent killer because those who have it often do not have symptoms.
“This is why it’s so important to come to all of the prenatal care appointments,” says Laura Merkel, MD, a board-certified obstetrician and gynecologist at Annapolis OB-GYN. “Even if you’re feeling great, we want to see you, measure your blood pressure and check on your baby.”
While many women with high blood pressure deliver healthy babies, hypertension can affect the kidneys and increase your risk of heart disease, kidney disease and stroke. Other complications include:
Fetal growth restriction: High blood pressure can decrease the flow of nutrients to the baby through the placenta. The baby may have growth problems as a result.
Preterm delivery: If the placenta is not providing enough nutrients and oxygen to your baby, your provider may decide that early delivery is better for your baby than allowing the pregnancy to continue.
Placental abruption: This condition, in which the placenta prematurely detaches from the wall of the uterus, is a medical emergency that requires immediate treatment.
Cesarean delivery: Women with hypertension are more likely to have a cesarean delivery than women with normal blood pressure. A cesarean delivery carries risks of infection, injury to internal organs, and bleeding.
Your health care provider may also test your urine for protein because hypertension during pregnancy may lead to preeclampsia. This is the most serious form of hypertension during pregnancy. Along with high blood pressure, there are signs that some organs may not be working properly. Preeclampsia is a serious condition characterized by the following signs and symptoms:
High blood pressure.
Swelling of face/hands.
Protein in urine.
Changes in vision.
Call your doctor if you are experiencing any of these symptoms.
Preventing High Blood Pressure During Pregnancy
There isn’t a magic pill or one single medication that prevents high blood pressure during pregnancy. The good news is there are some simple ways to keep your blood pressure down. You can:
Reduce salt intake.
Limit intake of caffeine.
Avoid tobacco entirely.
Get lots of rest.
Drink at least 10 glasses of water every day.
Do not drink alcohol.
Reduce stress levels.
Elevate your feet when possible.
After the birth of your baby, your care team will closely monitor your blood pressure. Your gynecologist and nurses will watch for any symptoms of preeclampsia. Typically, blood pressure falls back into normal and safe levels within a few weeks of delivery. However, we encourage all new moms to continue monitoring themselves once they’ve arrived home, especially as it relates to high blood pressure. Signs your blood pressure may still be high are:
A headache that won’t go away.
Irregular vision (spots, blurry vision).
Nausea or vomiting.
Very little urine output.
You just don’t feel well overall.
“If you notice any of these symptoms, contact your health care provider right away,” says Dr. Merkel. “Don’t attribute a bad headache to being a normal pregnancy symptom, it could be something more serious.”
Originally published April 4, 2018. Last updated April 26, 2019.
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Behavioral Health
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Former Pathways patient says treatment program changed her life
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Abby Forbes was in drug rehabilitation for the second time when she had to overcome an unexpected hurdle.
By the time she was in her mid-twenties, Abby had been battling addiction for nearly a decade. She began consuming alcohol at 15, drinking to the point of blacking out. She later began experimenting with marijuana and ecstasy before moving on to heroin.
Her addiction led her to Pathways, Anne Arundel Medical Center’s drug and alcohol treatment facility, where she was determined to get clean for good.
But a new obstacle stood in her way. This time, it was in the form of adventure therapy, Pathways’ hands-on outdoor activities course designed to challenge patients’ problem-solving skills.
Abby remembers standing on a wooden platform with about 15 other people. Each person had to climb up a rope and swing to another platform several yards away.
As Abby struggled with the rope, the others tried to help. Still, she was determined to do it herself, insisting to the group that she could handle it despite falling twice.
Mark Sakraida, Pathways’ adventure therapy coordinator, walked over to her. His words remain clear in Abby’s mind, 16 years later.
“How is that like recovery?” he asked her.
It was as if a lightbulb went on in Abby’s mind.
“I learned to ask for help,” she says.
“I couldn’t do it alone”
Abby first came to Pathways in 2000, after her parents had kicked her out of their home.
“I was in a very child-like state,” she recalls. “I wanted what I wanted, when I wanted it.”
She briefly moved in with a boyfriend, living in his family’s basement in squalid conditions. After a few days, she called her parents. They told her she could come back home – as long as she went to rehab.
She remembers having a chip on her shoulder the first day at Pathways, though she felt better after receiving treatment for drug withdrawal symptoms.
Abby stayed at Pathways for 15 days. She loved the supportive community there, but didn’t know what to expect upon being discharged.
“I was scared,” she says. “I left with knowledge of coping skills. And then it somehow evaporated.”
Abby says she got back in touch with other users, and fell back into her old habits. Seven months later, she returned to Pathways.
This time, she was in a different place mentally.
“I wasn’t as nervous. I was excited about who I was going to meet and learn from,” she says.
Abby had been through adventure therapy when she was at Pathways the first time, when she learned the importance of teamwork.
Yet it wasn’t until she was back for a second round, standing on that platform and working hard to climb up the rope, that the lessons hit home.
“I couldn’t do it alone,” she says.
READ MORE: The benefits of play: Why the playground is essential to a child’s development
The benefits of adventure therapy
Now 42, Abby has been sober since 2001. She works as a peer support specialist with the Anne Arundel County Department of Health, connecting addicts with community resources such as Pathways.
Abby says Pathways gave her a strong foundation that has served as the basis for her successful recovery.
She regularly attends 12-step meetings, where she met her husband. And she’s still not afraid to ask for help when she needs it.
Mark, who has served as adventure therapy coordinator since 1994, cites an ancient Chinese proverb when explaining why adventure therapy works.
“Tell me, I’ll forget. Show me, I’ll remember. Involve me, I’ll understand,” he says. “I tell patients that my job is to take them out of their comfort zone – and I think I do a pretty good job of that.”
More than a decade and a half after leaving Pathways, Abby finally got the chance to thank Mark.
She was at a work meeting at Pathways this summer when she walked past him in the hallway. She stopped and told him how she still thinks about the lessons she learned so many years ago.
“He has a special place in my heart,” Abby says.
Mark says he relishes every chance he gets to give his patients a dose of Vitamin A – “pure adrenaline.”
“Every day I do this is a blessing,” he says.
Ask questions, find resources and learn more at askAAMC.org/HealthyMinds.
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Men's Health, Senior Care, Weight Loss, Women's Health, Wellness
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Seniors and obesity: Weight loss surgery can help
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Aging comes with certain advantages. As we reach retirement, life slows down a little. We have more time to spend with our spouses, our children and our grandchildren. We have the time and funds to take that vacation we never got around to, finish our “to do” lists or pick up that new hobby we always wanted to try.
But aging also comes with certain disadvantages, most notably when it comes to our health. Our joints ache a little more than they used to. Our diabetes requires more and more insulin shots to control. Our hearts start to warn us about those years when we didn’t eat exactly as we should or exercise as much as we might have. Obesity can make these problems significantly worse for seniors.
Obesity is a growing epidemic in the United States in all age groups, and seniors are no different. In fact, the struggle to control weight can be harder for seniors as their metabolism slows down and their activity is limited by the inevitable effects of aging. Before many seniors realize it, they find themselves on handfuls of pills a day to control their blood pressure, cholesterol, diabetes, heartburn and general discomfort.
Many overweight seniors experience frustration and hopelessness with their weight and associated medical conditions. They feel there is no way to stop this slippery slope of health issues. But there are options available to help patients over 65 control their weight, and one of the best tools is bariatric surgery. Bariatric, or weight loss, surgery decreases the size of the stomach and changes the body’s hormonal balance to curb appetite, teach appropriate portion control and help patients manage their weight.
Studies show that obese seniors who undergo weight loss surgery can experience just as much weight loss as younger patients. Also, seniors do not suffer from any significant increases in complications from the surgery, meaning that it is safe even in an older population. Although many older patients have been told that they cannot qualify for this life saving operation because of their age, the truth is there is no age limit for weight loss surgery. Any patient who is healthy enough to undergo the operation is a candidate.
Weight loss surgery can help patients lose more than half of their excess weight. This generally leads to a cure or remission of many medical conditions, or a significant reduction in medications. Because of the obvious health benefits, many insurance companies, including Medicare, pay for the operation.
Maintaining a healthy weight and curing weight-related health conditions could help you live years longer than you might otherwise. You can take that vacation. You can try that new hobby. You can run after your grandchildren with more energy and less pain. You can have a new lease on life after retirement.
AAMC Weight Loss and Metabolic Surgery offers free weight loss surgery seminars in Easton and Annapolis. To learn more about what you can gain with weight loss surgery, visit askAAMC.org/ReadyToGain.
Author
Courtney Doyle, MD
Courtney Jean Doyle,MD, is a bariatric surgeon with AAMC Weight Loss and Metabolic Surgery.
Originally published March 7, 2017. Last updated Sept. 4, 2018.
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