Time Out

I was walking through Norwood Hospital today and passed by a poster that was promoting Hospital Safety Week. One of the key messages was to follow the STAR principle-Stop, Think, Act, Review. This is a particularly appropriate plan for LapBand patients and I will explain more in a minute.

Before every operation, surgeons and staff at Norwood Hospital, and many other fine institutions around the world, pause for what is called "Time Out." Everything in the OR comes to a complete stop while the entire team pauses to insure that we have the correct patient, for the correct procedure, with the correct equipment. We make sure that the patient has been given the correct medications and that we review any special concerns and considerations. This process has proven to consistently and effectively reduce errors and lead to safer surgery.

When LapBand patients prepare to eat, they really need to integrate these two principles in to the process. No meal, no snack, no "food event" should occur without first pausing for a "Time Out" and every event should adhere to the STAR principle. Bandsters need to establish that they are indeed hungry-the ONLY reason to eat, and that what they plan to eat represents "good food choices." Bandsters need to be sure that the appropriate equipment is available-a chair, a table, a small plate, and small utensils and also be sure that the distractions are eliminated-liquids for drinking, TV, reading material, iPhones, Laptops, and Blackberrys- all need to be put away. Eating with a LapBand is a conscious, aware, focused, in-the-moment activity. Eating with the LapBand can NEVER be rushed or thoughtless and it should never be done because you are bored or sad or lonely. Successful bandsters eat to live. They DO NOT live to eat. They also NEVER eat in the car! Car eating is distracted eating and the choices are LOUSY! Remember, you can never eat too slowly and you can never chew too much. Happy and successful bandsters take dice sized bites and chew them 15-20 times.

When a meal concludes, bandsters who have Stopped, Thought, and Acted need to REVIEW. They need to know if they are satisfied (we are getting away from "FULL" imagery.) They need to know if they made good choices, took small bites, chewed carefully, and ate slowly. If the answer is YES to all of the preceeding-Strong Work! You are making beautiful music with your band. If the answer is NO to any of the questions then you need to REVIEW-what went wrong, why did it go wrong, and what can you do differently next time.

Do this EVERY time you interact with food and I promise it will add 37 seconds to the process and increase your odds of successful, satisfying, happy eating by 100%. If you do this you are on your way to becoming a "band maestro." You will be able to lose 1-2 lbs per week and in 18-24 months achieve your goals for weight loss, health, and happiness. Weight loss with the LapBand is NOT a race. It is a PROCESS, a slow steady march toward a goal. NO ONE ever got overweight overnight and no one ever loses weight overnight. Slow and steady really is the key to a successful and rewarding LapBand journey.

HOLD ON TIGHT-sharp turn ahead!

Have you been to Shrinking Closet in Avon. Why not? If you have lost weight and clothes no longer fit, get them out of the house ASAP! You are not going back to those larger sizes-you just aren't! Get the clothes out of the house, bring them to Shrinking Closet, help an other bandster find clothes, and insure that you are NEVER going back to that size.

At night, after dinner, close the kitchen. Clean up, shut out the lights, close the door and do not return till breakfast. If your gap between dinner and bedtime is longer than 3 hours then set out a healthy snack-sugar free jello or pudding, a piece of fruit, some cut vegetables, a protein bar or shake but ABSOLUTELY do not go back in the kitchen to graze.

If the gap between dinner and bedtime is shorter than 3 hours don't even think about eating. As soon as you lay down your pouch is going to empty right back in to your esophagus and you are going to be sick, sick, sick. Don't do it!

Spring is finally here! The days are longer, lighter, warmer. GET OUTSIDE! Breath fresh air! Walk! Jog! Bike! Do something outside. Do something active. Every bit you do, every little bit you do, has benefit. Do not accept stagnation. The dinosaurs once ruled the world. They did not adapt, they did not change, they are extinct! Do not let that be you!

HANG ON! Hairpin turn back the other way!

Julie Cedrone, MSN, FNP-BC has joined our practice. Julie has been a Nurse Practitioner in the Caritas family for years. Some of you may know her from Caritas Foxboro where she worked with Drs. Kearney, Popvic, and Flood. Julie is also on the faculty at Boston College School of Nursing. Julie brings unrivaled enthusiasm and excitement to the practice as well as over a decade of Primary Care experience. For now she will be in the office every Thursday seeing patients, doing fills, and partnering on the journey. In the fall she will likely be even more available. Julie's email is julie@massweightloss.com.

Kittredge White, PA-C has also joined the practice. Kitt comes to us from the Harvard Vanguard/Faulkner Hospital Weight Loss Surgery Program. She is an experienced and talented Physician Assistant. While she has done many things as a PA, especially in Surgery, her primary interest is Weight Loss Surgery. Kitt has cared for hundreds of band patients and done countless fills and adjustments. She will be bringing the practice a fresh and exciting perspective on the journey. Kitt will be in the office Tuesdays and Thursdays. Kitt's email is kittredge@massweightloss.com.

Now that we have added Kitt and Julie, we are able to see people 5 days a week and there are always at least 2 clinicians in the office every day. On Monday Arthur and Adam are in. On Tuesday Arthur and Kit see patients. On Wednesday Arthur and Adam are again here together. Thursday is the Kitt and Julie show. On Friday Jen and Adam have the floor. Jane Sylvestre is here every day to help with Nutrition needs and Gene Newman is in the office Thursday and Friday to support our souls.

Take advantage of all the practice has to offer. If you are a regular, great, keep on coming and keep on losing. The more you see of us, the less we'll see of you. If you haven't been in for a while or have fallen off track-what are you waiting for? Get back in!

I look forward to seeing you all again soon, in the office for a visit or at a support group. If you can't get in you can always email, adam@massweightloss.com.

Take care, be well, use your band, lose your weight.

Adam

April showers bring May flowers.

It is going to be a beautiful spring!

Trust me.

Spring and summer are a great time to lose weight and make use of your band. The days are longer and warmer and there is ample opportunity to get outside and exercise. Remember exercise doesn't need to be sophisticated or expensive. You don't need a brand new sweatsuit or a $100 pair of sneakers to get out and walk for 20 minutes. Any activity that you get that is more than your baseline level of activity is valuable and beneficial. Start slowly. Take a 20 minute walk once during the week and once on the weekend. As you get stronger and more comfortable work up to 3 or even 4 days a week. Once you've got that mastered try to extend your walk to 25 and then 30 minutes. Set realistic achievable goals. Nobody plans to fail, they just fail to plan.

Spring and summer are also a time when fruits and vegetables are in season. They are cheaper and more available and in greater variety than at any other time of year. For the most part they are low in calories and you can eat as much of them as you would like. Remember that fresh citrus, corn, celery, and asparagus can be a challenge because of their fibrous nature. Lettuce, cucumbers, peppers, and tomatoes tend to be well tolerated. Steamed green beans and broccoli are also excellent options.

The other day a patient remarked that it seemed like Arthur and I had so much fun together and that they enjoyed seeing a father and son team work so well together. Thank you anonymous patient as you made dad's and my day. We really do enjoy working together and feel blessed to be able to do so. We couldn't have when I was 16 and knew everything but now that I have matured and have teenagers of my own, I know a lot less and I am much more able to benefit from dad's wisdom.

The idea of a "family practice" goes way beyond me and dad. Kathy, Jayne, and Carol have been with us for more than 10 years and are absolutely part of our extended family. Last June, Kathy's daughter Patty joined the practice and has become an integral and beloved part of the team. Nothing brightens a day in the office like when Carol's daughter Gina brings the 3 grandchildren to visit. The gang's artwork beautifully decorates Carol's workspace. Jayne's daughter Tayla is the team hair stylist and keeps us all looking our best from her seat at Easton's swanky Makeover's Salon & Spa. My wife Jordana joined the practice in June and has proved to be as good a business manager and promoter as she is a wife-which is to say the best! Our son Sam designed the whole website and continues to work to update it. Son Ari continues to be the conscience of the practice and is always concerned that we make the sad patients happy and the sick patients well. We try our best. Gene, Jane, and Jen round out our clan and bring deep caring and warmth to the practice and the "family."

We think of you our patients as friends and extended family as well. We are there for you in good times and bad and want to do our best every day to help you be as happy and healthy as you can be. If you are in the office and haven't met a member of the "family" please be sure to go up and introduce yourself.

Patient, friend, and super-successful bandster Gail has developed a phone mentor system and has already recruited fellow patient, friend, and SSB (super-successful bandster) Rosemarie to help. The program works like this: Experienced bandsters call on pre-op bandsters and early post-op bandsters at frequent intervals to check on them, encourage them, coach them, and mentor them. We think it is a fantastic program and will have great benefits for the mentors amd the mentees. If you are new to banding and want a mentor to call you then give the office a shout or send me an email and we'll make sure you get a call. If you are an experienced bandster and would like to help Gail and Rosemarie mentor fellow bandsters then also call the office or send me an email.

If you want a really quick and great read check out Michael Pollan's Food Rules. It is a treasure trove of sensible food advice in a very condensed package. If you want a more in depth analysis and discussion of food check out Michael Pollan's In Defense of Food. If you are tired of the waiting room magazines, let me know what you want and I'll order it and make sure to check out the books in the little black bookcase/end table as there are some good inspirational reads there.

My thoughts on the recently passed health care bill: I am glad it passed as I think it would have been a disaster if it didn't. I wish it was more ambitious and that in general we all weren't so afraid of change. I think that affordable quality healthcare for all is a noble goal and that a country that can afford to wage an 8 year multi-billion dollar war can afford to see that its citizens receive medical services.

My thoughts on the recent purchase of Caritas Healthcare and Norwood Hospital: It is very exciting and ambitious and I hope it lives up to its promise. It absolutely will not affect what we do unless it is for the better. We will continue to do our surgery at Norwood Hospital with the best team to be found anywhere and we will continue to run our office and our practice with one goal in mind-providing the best care and experience possible.

My thoughts on the Red Sox: They present more questions than answers but hope springs eternal especially in the spring. I am looking forward to an exciting and competitive season.

Looking forward to seeing you all in the office or at a support group soon. Never miss an appointment because you don't have childcare! Bring them with you. Everyone here is a parent, grandparent, brother or sister and we are happy to have the "little darlings" accompany you.

Be happy, healthy, and well.

The band is a tool. Use it and lose with it.

Adam