Motivation: Scientific Secrets to Success

Researchers have been trying to figure out what compels us to do something repeatedly we don’t always want to do – like exercise. Here are some scientifically-proven strategies to help your workout motivation:

  • Give Yourself a Real Reward – Give yourself tangible, immediate benefits to working out, such as treating yourself to an episode of your favorite TV show or a healthy smoothie after you exercise. These kinds of rewards are powerful because your brain starts to link the reward to the behavior making it seem worthwhile. Over time, the motivation becomes the workout itself, as the brain begins to associate sweat and pain with the surge of endorphins — those feel-good chemicals released in the brain that are responsible for that exhilarating rush you get after a great exercise session. Once you’ve trained your brain to recognize that the workout itself is the reward, you won’t even need the treat.
  • Sign a Commitment Contract — Research shows we’re more likely to follow through with pledges when we make them in front of friends. You can up the ante even more by signing a contract agreeing to pay a pal $20 every time you skip your planned workout. Studies of people who created contracts found that those who signed longer contracts ended up exercising more than those who agreed to shorter time spans. Once we get past the initial pain and discomfort, it’s much easier to recognize the benefits of sticking to the routine.
  • Rethink Positive Thinking — Believers in the power of positive thinking also believe in the power of positive imaging, where you actual visualize the behavior and the beneficial outcomes of it as well. For example, when deciding whether to get out of bed to go running in the morning, it helps to imagine how the sun will feel on your face as you run. Or visualize your happiness as you see the results of your fitness routine. You can also visualize the obstacles to getting in the workouts you desire. Once you have those images, it’s easier to find solutions to work around the things blocking your wellness path. 
  • Find Your Fitness Tribe — What will ultimately inspire you to get up and start moving is a strong, supportive community. The laughs, high fives, and words of encouragement from the bonds people make are things that can’t be replicated. Find a workout that makes you feel good and surround yourself with people that help build your confidence as much as your strength. 

If you’re in the Las Vegas area and are considering weight-loss surgery, schedule an appointment at VIPSurg. Dr. Tsuda and his team of experts will find the right treatment for you.

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Aging and Obesity: Is Bariatric Surgery an Option for the Elderly Patient?

The good news is that improved life expectancy is allowing baby boomers to enter their golden years in unprecedented numbers. The bad news is that rates of obesity among this aging demographic are climbing in never-before-seen numbers as well, putting this population at risk of developing cancer, heart disease, diabetes, lower extremity arthritis, sleep apnea, and stroke, all of which can lead to disability. Treatment guidelines to lose weight in the elderly have been difficult to define, yet it is very clear that obesity in the elderly contributes to worsening of multiple parameters which along with the metabolic problems mentioned already, include cognition, functionality and quality of life. While ample evidence supports the safety and effectiveness of weight-loss aka bariatric surgery in the general adult population, more information is needed in patients age 60 years and older.

Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; this is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population.

The risk of any surgical intervention increases as one gets older. However, weight-loss surgery is very safe, and the potential benefits routinely outweigh any of the associated risks if there are no other health issues that would dramatically increase the risk of surgery.

Ideally, a comprehensive assessment would focus on psychosocial and functional status in addition to physical data. An excellent support system of family, friends, or caregiver resources is imperative. The selected patient should be capable of engaging in physical interventions focusing on mitigating muscle loss and osteoporosis and of maintaining changes in eating behavior as needed as well. A recommended “pre-habilitation” program may include a physical therapist to assist with strength and endurance training and a nutritionist to aide in enhancing protein intake, vitamin D, and other nutrient sufficiency.

Identifying goals of care, quality of life, and improved function should be considered as primary objectives of undergoing surgery. Goals of the surgery include not only weight loss but also improvements in physiological function, comorbidity, and quality of life, and reduction in institutionalization.

If you live in the Las Vegas area and are considering bariatric surgery, VIPSurg is here to help. Dr. Tsuda and his team of experts can find the best treatment for your unique situation.

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Gallbladder Disease and Symptoms

Unless they’re experiencing bothersome symptoms associated with gallbladder disease, most people don’t give much thought to their gallbladder. However, when there is an issue, it can be quite painful and require immediate action.

The gallbladder is a 4-inch-long organ found under the liver in the upper right area of the abdomen. It stores bile, a compound produced by the liver to digest fat, and helps the body absorb fat-soluble vitamins and nutrients. Unfortunately, when the gallbladder stops working properly or the bile ducts are blocked, it can cause a lot of pain and discomfort.

Some common gallbladder problems include:

  • Gallstones – solid masses of cholesterol. Gallstones occur when high levels of fat and bile cause crystals to form. Over time, these crystals may combine and expand into stones.
  • Inflamed gallbladder, cholecystitis – Acute or sudden cholecystitis occurs when bile can’t leave the gallbladder. This commonly happens when a gallstone blocks the bile duct. Chronic cholecystitis occurs if there are recurrent acute attacks.
  • Perforated gallbladder – If left untreated, gallstones can lead to a perforated gallbladder – in other words, a hole in the wall of the organ can develop. Perforation also occurs as a complication of acute cholecystitis.
  • Porcelain (calcified) gallbladder – a condition where, over time, the muscular walls of the gallbladder develop a buildup of calcium. This makes them stiff, limiting the gallbladder’s function and increasing the risk of gallbladder cancer. With this condition, the organ becomes bluish and brittle.

Symptoms of gallbladder problems include:

  • Pain in the mid- or upper-right section of the abdomen: Gallbladder pain usually comes and goes. Gallbladder pain is often severe and can cause pain in the chest and back as well.
  • Nausea or vomiting: Any gallbladder problem may cause nausea or vomiting.
  • Fever or shaking chill: These are signs of infection in the body. Along with other gallbladder symptoms, fever and chills may point to a gallbladder problem or infection.
  • Changes in bowel movements: Frequent, unexplained diarrhea can signal a chronic gallbladder disease. Light-colored or chalky stools may point to a problem with the bile ducts.
  • Changes in urine: Dark urine may indicate a bile duct block.
  • Jaundice: Yellowing of the skin occurs when liver bile does not successfully reach the intestines. This normally happens due to a problem with the liver or due to a blockage in the bile ducts caused by gallstones.

If you’ve been diagnosed with gallbladder disease in the Las Vegas area or are experiencing these symptoms, schedule an appointment with VIPSurg. Dr. Tsuda is the area’s foremost robotic surgeon specializing in gallbladder, weight-loss/bariatric, and other areas of general surgery. Call for an appointment at (702) 487-6000.The Photo Of Liver On Woman's Body Against Gray Background, Hepatitis, Concept with Healthcare And Medicine

Obesity in America: The Unhealthy Truth

Most Americans are overweight. Most – let that sink in for a minute. The majority of American adults are at least carrying around a few more pounds than is considered healthy. Severe obesity is also on the rise across the country. Unfortunately, these stats tell a story that won’t have a happy ending unless something changes:

  • Nearly 40% of adults and close to 20% of adolescents are obese in America. 
  • A body that is 20% overweight is prone to major health problems. 
  • Life expectancy is greatly reduced in someone who is obese.
  • The obesity problem is growing everywhere, but rural areas tend to have both higher obesity rates and much greater rates of what medical researchers term “severe obesity,” which is a BMI of 40 or more.

The main concern with this alarming trend is that being overweight affects all areas of your health. Carrying around extra weight not only make you feel heavy, but it also contributes to other health problems like sleep apnea, diabetes, high cholesterol, painful joints, and heart disease.

 The good news is that these risk factors can be eliminated by losing weight and maintaining a healthy lifestyle. The bad news is that changing behavior long-term is extremely difficult for all but the most committed. For the very obese, even commitment and willpower often aren’t enough.

Eating the wrong foods, eating too much food, lack of exercise, genetics, stress, emotional eating, and a slow metabolism are the major contributing factors in obesity. Nevertheless, even though we are more aware than ever that nutrition and health value should be playing a bigger role in our selections when it comes to choosing what we eat, most Americans surveyed still listed convenience as their number 1 priority when deciding.

Whatever its causes, believing severe obesity can be managed or eliminated by having a low-fat diet and engaging in exercise is a bit naïve. When a person is 50, 70, or 100+ pounds overweight, it can be difficult to impossible to diet and exercise enough to lose the troublesome weight. 

Unfortunately, diet, exercise, and weight-loss pills are generally ineffective for severely obese people. Studies have demonstrated that when the BMI reaches 40, the chances of success with medical therapy for weight loss are approximately 1%. 

Since 1991, the National Institute of Health has supported bariatric surgery as a treatment for morbid obesity when combined with a healthy diet and exercise.

Surgery can help a person lose weight so that they are able to exercise better to maintain a healthy weight loss. Some obese people need weight-loss surgery because, despite drug therapy, exercise, and behavioral modifications, they still have increased risk of comorbid conditions including heart disease and diabetes. These are the people who are often candidates for bariatric (weight-loss) surgery.  

Obesity is a common and complex medical condition, losing weight isn’t easy to do, and there’s really no magic cure. If it were simple, everyone would be healthy and trim. However, if you are at an unhealthy weight, you must start somewhere. Going it alone into a crash diet isn’t a good idea. You will put the weight back on, and chances are you’ll gain even more than you lost. Checking with your doctor, who can advise you on a plan that is safe and right for you, is a good way to begin your journey to a healthier, happier you.  

If you’ve tried diet and exercise but still aren’t losing the weight you need to lose to be healthy, schedule an appointment with VIPSurg. Dr. Tsuda and his team of experts can help find the right treatment for you.

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Weight-loss Surgery or Diet and Exercise? Long-term Results Can Save Your Life

To maintain a healthy weight medical professionals emphasize that diet and exercise are key. If you want to lose weight, you must control calories and expend more by exercising. This has been the standard approach for decades. Recent research is telling a different story.

A growing number of studies, including one published in Medical News Today, are finding that for those who are obese, weight-loss/bariatric surgery may be more effective at reducing body weight than the old idea of changing habits and watching what you eat. The findings also suggested that bariatric surgery also increased remission rates in obese patients with Type 2 diabetes as well as heart disease.

 Bariatric surgery helps you lose weight and lowers your overall risk of associated medical problems in one of two ways:

  • Restriction. Surgery is used to physically limit the amount of food the stomach can hold, which limits the number of calories you can eat.
  • Limiting the absorption of nutrients including calories. Surgery is used to shorten or bypass part of the small intestine, reducing the amount of nutrients and number of calories the body absorbs.

Some of the more popular weight-loss surgeries are:

  • Gastric bypass – involves the creation of a small pouch in the top of the stomach. The pouch is the only part of the stomach that receives food. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Because food now bypasses a portion of the small intestines, absorption and calories are reduced.
  • Gastric banding – involves placing an inflatable balloon (band) around the top part of the stomach; this creates a small stomach pouch above the band with a narrow opening to the rest of the stomach. A port is then installed under the skin. By injecting or removing fluid, the band/balloon can be inflated or deflated, controlling the amount of food the stomach can hold.
  • Sleeve gastrectomy – In this approach, part of the stomach is separated and removed. The remaining section is formed into a tube-like structure; the smaller stomach cannot hold as much food. It also affects the production of hormones that produce hunger.

Why does bariatric surgery appear to be the preferred option over other weight loss options for those considered obese?

It appears to all come down to the success rates of changing old habits. Unfortunately, only slightly more than 5 percent of people are successful in changing their lifestyles on a long-term basis. Health experts claim that the overall risks associated with obesity which include heart disease, high blood pressure, Type 2 diabetes and other life threatening conditions, outweigh the risks and complications of surgery.

Weight-loss surgery isn’t a magic bullet or an easy fix by any means, but research shows it may be the best answer for many people suffering from severe obesity and the deadly health conditions that often accompany it. If you’re considering bariatric surgery in the Las Vegas area, Dr. Tsuda and his expert team are ready to help you find the best treatment for your unique situation.

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When GERD is the Word – What to Consider when Diagnosed with Gastroesophageal Reflux Disease

Many people experience acid reflux from time to time – that feeling commonly thought of as heartburn or acid indigestion. Gastroesophageal Reflux Disease (GERD) is mild acid reflux that occurs at least twice a week, or moderate to severe acid reflux that occurs at least once a week. While most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications, some people with GERD may need stronger medications or surgery to ease symptoms.

Make an appointment with your doctor if you:

  • Experience severe or frequent GERD symptoms
  • Take over-the-counter medications for heartburn more than twice a week

When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.

If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.

Conditions that can increase your risk of GERD include:

  • Obesity
  • Bulging of the top of the stomach up into the diaphragm (hiatal hernia)
  • Pregnancy
  • Connective tissue disorders, such as scleroderma
  • Delayed stomach emptying

Factors that can aggravate acid reflux include:

  • Smoking
  • Eating large meals or eating late at night
  • Eating certain foods (triggers) such as fatty or fried foods
  • Drinking certain beverages, such as alcohol or coffee
  • Taking certain medications, such as aspirin

Your doctor is likely to recommend that you first try lifestyle modifications and over-the-counter medications. If you don’t experience relief within a few weeks, your doctor might recommend prescription medication or surgery.

The options include:

  • Antacids that neutralize stomach acid 
  • Medications to reduce acid production known as H-2-receptor blockers
  • Medications that block acid production and heal the esophagus known as proton pump inhibitors
  • Medication that helps strengthen the lower esophageal sphincter. 

GERD can usually be controlled with lifestyle changes and medication, but if these don’t help or you wish to avoid long-term medication use, consider the revolutionary LINX device. This device consists of a ring of tiny magnetic beads which is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the junction closed to refluxing acid but weak enough to allow food to pass through when swallowing. The LINX device can be implanted using minimally invasive surgery.

As the first LINX-trained surgeons in Las Vegas and as the first digestive institute in the area to offer the only FDA-approved treatment for GERD, Dr. Shawn Tsuda and Dr. Heidi Ryan at VIPSurg are ready to help you fight back against gastroesophageal reflux disease. Call  702-487-6000 to schedule an appointment. 

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The Family that Plays Together Gets Healthy Together

Even though it gets tougher to find time for ourselves when we become parents, exercise remains just as important as it ever was. In fact, with little ones watching us as an example, exercise becomes even more important. If we as adults wish to create a future full of happy, healthy, disease-free adults for our kids, it’s time we start practicing what we preach.

Our kids model our behavior. If we want our kids to eat well, we need to eat well. If we want them to exercise, we need to exercise.

This modeling creates a culture of wellness in the home. In this environment, children learn that healthy habits are a positive way of life, not punishment for Mom and Dad for eating too much delicious food. One great way to be good exercise role models for your children is to find exercise activities you can do as a family. Here are some suggestions to get you started: 

  • Take a walk. Walking is a wonderful family activity. There are so many benefits to walking, and the whole family can participate (even the baby in her stroller and the family dog too). Whether you head into town or just cruise the neighborhood, building a walk into your daily schedule ensures that it won’t get put off.
  • Jump rope. Jumping rope is a kid-friendly exercise that is great for the whole family. In fact, kids usually dominate at this exercise once they get the hang of it thanks to their lower center of gravity. Just ten minutes of jump rope is enough to get the blood flowing, and with more than one person, it’s fun to learn all kinds of fun jumps.
  • Try structured exercise.There are many types of more structured exercises that can be done as a family. Some families like to take martial arts or yoga classes together. 
  • Try roller blading or biking. Head out as a family unit to try your hand at skating or biking. Both can be great exercise activities that are fun for any active family.
  • Get to work in the garden. Kids are great at digging up dirt, so let them turn over the soil and help you plant new bulbs. Research shows that gardening is as good as weight training when it comes to preventing osteoporosis, and if you’re planting vegetables, it can make them more appetizing to kids. 

When you’re planning your exercise routine, keep in mind that everyone in the family
needs to do this. Try to find activities that are fun and exhilarating for the entire group!

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