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Allergen: A substance that triggers an allergic reaction.
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Allergic Rhinitis: An allergy affecting the mucus membrane of the nose. Seasonal allergic rhinitis is often called "hay fever."
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Allergist: A doctor that diagnoses, treats, and manages allergy-related conditions.
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Ana-Kit: A device used to inject epinephrine during an anaphylaxis attack.
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Anaphylaxis: A life-threatening allergic reaction that involves the entire body. Anaphylaxis may result in shock or death, and thus requires immediate medical attention
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Animal dander: The small scales or pieces of skin, often containing proteins secreted by oil glands, which are shed by an animal. These proteins are the major causes of allergies to pets.
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Antibiotics: A class of medications used to treat bacterial infections. Certain antibiotics, such as penicillin, may cause an allergic reaction in some people.
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Antibody: A protein in the immune system that recognizes and attacks foreign substances in the body.
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Anticonvulsant: A medication used to prevent or treat seizures. Certain anticonvulsants may cause an allergic reaction in some people.
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Antihistamines: A class of medications used to block the action of histamines in the body and prevent the symptoms of an allergic reaction.
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Asthma: An inflammatory disorder of the airways, causing periodic attacks of wheezing, coughing, chest tightness, and shortness of breath.
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Atopic dermatitis: A chronic skin rash, also known as "eczema," that often appears in the first few years of life.
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Basophil: An immune system cell that attaches to antibodies and circulates through out the blood.
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Beta-blockers: A class of blood pressure medications that ease the heart's pumping action and widen the blood vessels. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock and should not be used during immunotherapy.
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Bronchial tubes: The lower sections of the airway that lead into the lungs.
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Challenge test: A test used to confirm an allergy to specific substance. A doctor will administer small but increasing amounts of a suspected allergen until an allergic response is noticed. Due to the risk of anaphylaxis, this should only be performed under a controlled setting.
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Conjunctivitis: Inflammation of the conjunctiva, or the mucous membrane surrounding the eye. Also known as pinkeye.
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Corticosteroid: An anti-inflammatory medication used to treat the itching and swelling associated with some allergic reactions.
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Cromolym sodium: An anti-inflammatory nasal spray used to treat and sometimes prevent allergic rhinitis.
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Decongestants: A class of medications used for nasal congestion. Decongestants are available in oral doses, nasal sprays, or eye drops (for conjunctivitis).
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Dust mites: A microscopic organism that lives in dust.
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Eczema: See Atopic dermatitis.
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Eosinophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.
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Epinepherine: A medication used for immediate treatment of anaphylaxis by raising blood pressure and heart rate back to normal levels. Epinepherine is also known as adrenaline.
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EpiPen: A device used to inject epinephrine during an anaphylaxis attack.
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Heparin: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.
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Histamine: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.
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Hives: See urticaria.
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Hypertension: High blood pressure. When blood pushes against artery walls harder than normal.
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Immunoglobulin E: A type of antibody responsible for most allergic reactions.
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Immunotherapy: A series of shots that help build up the immune system's tolerance to an allergen.
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Insulin: A hormone that regulates blood sugar levels. Diabetics who take insulin derived from animals may have allergic reactions.
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Intradermal test: A test where an allergen is injected just underneath the skin. Intradermal tests are generally used when results from a skin prick test are unclear.
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Late Phase: The period 4 - 24 hours after exposure to an allergen where tissue damage may occur.
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Leukotrienes: Inflammatory substances that are released by mast cells during an allergic response or asthma attack.
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Lymphocyte: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.
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Mast cell: An immune system cell which attaches to antibodies and is located in the tissue that lines the nose, bronchial tubes, gastrointestinal tract, and the skin
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Neocromil sodium: An inhaled medication used to treat inflammation involved with asthma.
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Neutrophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.
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Radioallergosorbant Test (RAST): A blood test that measures the amount of IgE antibody produced when the sample is mixed with a specific allergen.
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Rhinitis: An inflammation of the nasal passageways, particularly with discharge.
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Sinusitis: An inflammation or infection of one or more sinuses. The sinuses are hollow air spaces located around the nose and eyes.
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Skin prick test: A test where a needle is used to scratch the skin with a small amount of allergen. A response can usually be seen within 15 - 20 minutes.
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Urticaria: Raised areas of the skin that are often red, warm, and itchy. Urticaria is also known as hives.
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Urushiol: An oil found on poison ivy, oak, and sumac.
QUESTION
Is weight loss surgery a cosmetic procedure?
DR. ALAN GREENE
No, weight loss surgery is not considered cosmetic. It is performed to improve
your overall health, not to change or improve your appearance. Most programs
require that you have a BMI over 35 AND medical problems stemming from your
weight (such as high blood pressure, diabetes, abnormal cholesterol levels,
obstructive sleep apnea, gastroesophageal reflux, infertility, some cancers,
or arthritis of weight-bearing joints); OR a BMI over 40, even without medical
problems, if the weight is interfering with daily life AND dietary attempts
at weight control have been ineffective.
In practice, if anyone has a BMI over
30 for more than a year, they will probably show evidence of having medical
problems if they are being evaluated carefully by their health care provider.
Abnormal cholesterol levels, impaired handling of glucose, and fatty liver
changes all occur early in obesity. Although major weight loss may indeed give
you an improved appearance, the reasons for performing these major procedures
are to avoid or reverse the potentially life-threatening complications of obesity.
QUESTION
I'm considering having weight loss surgery before I try to have children.
Is that all right?
DR. ALAN GREENE
If you are obese, it's an excellent idea to try to get yourself in optimal
health prior to conceiving a baby. If you do undergo weight loss surgery, however,
you should not try to get pregnant during the period of time directly after
surgery when you will be experiencing the greatest rate of weight loss. This
period of time is usually 12-18 months after the operation. You should plan
on using reliable birth control throughout this period of time. Before you
become pregnant, it's a good idea to visit the healthcare provider you'll use
for your pregnancy to discuss your health history and to have a pre-pregnancy
check-up.
QUESTION
What will my diet be like after weight loss surgery?
DR. ALAN GREENE
Carefully following the prescribed diet after surgery is essential both to
protect your body and to ensure weight loss. Typically, for the first 1 - 3
days after surgery the diet is clear liquids only (water, broth, high protein
fruit drinks, or other clear liquids). After the initial liquid-only period,
the diet should consist of pureed or blended foods (yogurt, pudding, cream
soup, liquid supplements). After a week or so of this, soft foods are very
gradually added -- about 1 ounce of a new soft food every 2 or 3 days:
- After 1 week: scrambled eggs, cottage cheese, low-fat refried beans, mashed
potatoes, hot cereal
- After 3 weeks: tuna salad, ground turkey, baked fish, canned vegetables,
bananas, seedless watermelon or cantaloupe
One month after surgery, some normal foods can be a regular part of the diet,
although limiting food selections may be a permanent part of the new diet.
For example, you might need to avoid steaks and chops, apple skins, citrus
fruit membranes, incompletely chewed raw or fibrous vegetables, and fresh bread
(because of the tendency to form a solid "bread ball" in the stomach pouch
-- toasting may prevent this problem).
Although each person is different, and there are different recommendations
depending on the specific type of weight loss surgery you have, some of the
basic recommendations are as follows:
- You will need to adjust portion sizes. In general, a small stomach pouch
will hold only about 2 ounces of food at a sitting.
- Food choices will need to be blended, soft, or easily chewed. Limit foods
that are dry (turkey, roast beef), sticky (peanut butter), gummy (fresh bread),
or stringy (fibrous fruits or vegetables).
- Eat a balanced diet that is low in fat, high in protein. Protein is important
for healing directly after surgery, and it's also important during weight
loss in order to help you preserve muscle mass. About 60 g of protein is
recommended daily.
- Avoid foods that contain sugar, especially if you've had gastric bypass
surgery. Eating foods containing concentrated amounts of sugar may cause
an uncomfortable reaction called dumping syndrome (sweating, low blood pressure,
dizziness, abdominal cramping).
- Don't drink fluids just before or with your meals. Drink well before or
at least 30 minutes afterwards.
- Eat slowly (at least 20 minutes per meal), and chew your food very thoroughly.
QUESTION
Will I need nutritional supplements after surgery?
DR. ALAN GREENE
Actually, you'll need to use nutritional supplements permanently after you
have weight loss surgery. You'll need to take both a multivitamin with iron
and a calcium supplement daily. You may need additional calcium and/or iron
supplements. You may also need vitamin B12 shots. Your healthcare provider
will perform regular blood tests to monitor your body's levels of micronutrients.
QUESTION
Will I have a lot of extra skin after I lose weight?
DR. ALAN GREENE
Excess skin can be a problem for some people. Because everyone feels differently
about these kinds of things, and because there are individual differences with
regard to the elasticity of skin, it's not easy to predict what will happen
with your skin after major weight loss. Exercise seems to be helpful, although
some people are still troubled by the extra skin, and may even choose to have
plastic surgery to remove loose skin. If you are considering plastic surgery,
however, you should wait about two years after weight loss surgery, so that
your weight has stabilized before any procedure to remove excess skin.
QUESTION
Are there any medications that I can't take after weight loss surgery?
DR. ALAN GREENE
You won't be able to use nonsteroidal anti-inflammatory medications (such
as ibuprofen, naproxen, aspirin) after weight loss surgery, because they may
cause ulcers (shallow, irritated pits) in the lining of your stomach pouch.
You should also avoid diuretic medications. Their use, in conjunction with
changes in the way your body absorbs potassium and other nutrients after surgery,
may result in a serious potassium deficiency.
QUESTION
Will I be able to return to my usual level of activity after weight loss surgery?
DR. ALAN GREENE
Actually, it's hoped that you'll be able to increase your activity comfortably
and happily after weight loss surgery. With less weight to carry around, you
should notice improvements in your respiratory capacity and your stamina. With
less weight and stress on your joints, any problems with arthritis should also
improve.
REFERENCES
Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B-12 and folate deficiency
clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–442.
Guidelines for laparoscopic and open surgical treatment of morbid obesity. Obesity
Surgery. 2000 August;104):378-379. Document adopted by both the American
Society for Bariatric Surgery and the Society of American Gastrointestinal
Endoscopic Surgeons, June 2000.
Marcason W. What are the dietary guidelines following bariatric surgery? J
Am Dietet Assoc. 2004;104:487–488.
Naslund E, Kral JG. Patient selection and the physiology of gastrointestinal
anti-obesity operations. Surgical Clinics of North America. 2005 August;85(4):725-740.
National Institutes of Health Consensus Development Panel, Gastrointestinal
surgery for severe obesity. Ann Int Med. 1991;115:956–961.
Stocker DJ. Management of the bariatric surgery patient. Endocrinol Metab
Clin N Am. 2003;32;437–45.
Stumbo P, Hemingway D, Haynes WG. Dietary and medical therapy of obesity. Surgical
Clinics of North America. 2005 August;85(4):703-723.
Review Date: 12/21/2006
Reviewed By: Alan Greene, M.D., F.A.A.P., Stanford University School of Medicine;
Chief Medical Officer, A.D.A.M., Inc.
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A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
