Obalon Pre-Procedure Meds

obalon pillThe Obalon swallowable gastric balloon is unique in that treatment is gradual, and the balloons are filled with nitrogen gas which makes them float on top of the gastric contents.  These are the primary reasons that Obalon patients tend to have much less nausea and vomiting than patients receiving traditional saline-filled balloons.  Although symptoms are usually minimal, we highly recommend a pre-procedure medication regimen that will reduce symptoms even further.

It is recommended to start this regimen THE DAY BEFORE each scheduled balloon swallow:

  • Zofran (generic ondansetron) – 4mg sublingual tablets
    • Dissolve one tablet under your tongue every 6 hours.
    • Start the morning before each balloon swallow and continue until your appointment.
    • Continue for 24 hours after then use as needed.
  • Levbid (generic hyoscamine) – .375mg tablets:
    • Take one tablet every 12 hours by mouth with a sip of water.
    • Start the morning before each balloon swallow and continue until your appointment.
    • Continue for 24 hours after then use as needed.

These medications can be ePrescribed for you, so if you have not yet given us your pharmacy information please call us with the pharmacy name and full address (with zip code).

It is required to have liquids only on the day of the balloon swallow, with minimal intake for two hours immediately prior to the appointment to ensure that the stomach is fairly empty.

After the swallow you must do clear liquids only for the next 24 hours, pureed food for 24 hours after that, then you can transition to solids on the 3rd day.

 

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Obalon Placebo Swallow

The Obalon “Swallowable” Gastric Balloon is a unique new treatment for obesity.  Since the capsule itself is slightly bigger than a large multivitamin capsule, we need to make sure the patient can swallow it adequately beforehand.   We do this with what is called an “Obalon placebo swallow.”

Obalon supplies us with dissolvable capsules that are the exact same size as the balloon capsule itself, so the patient can swallow this in the office so that we can observe the patient.  In the rare event that it doesn’t go down, it will dissolve within a few minutes and pass into the stomach.

We do two back-to-back placebo swallows, just to make sure and give the patient confidence that they won’t have any trouble on the day of their Obalon swallow!  No special preparation is required, but it is best to not eat any solid food for a couple hours prior to your appointment.

Dr. from New Jersey demonstrates how easy this is in this YouTube video:

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Obalon “Swallowable” Gastric Balloon in Cincinnati, Ohio

In Cincinnati, Ohio our physicians at JourneyLite have done many ReShape and Orbera insertions over the years.  Gastric balloons have been a significant breakthrough in the field of non-surgical weight loss, and now a new device, the Obalon “swallowable” gastric balloon is out.

Overall, advantages of gastric balloons include:

  • lower risk than surgery
  • lower cost than surgery
  • faster recovery than surgery
  • does not permanently alter the patient’s anatomy
  • can be a great kickstart for a patient who is not a candidate for surgery to make a lifestyle change

Up until now, in the US at least, a gastric balloon has required two procedures:  one endoscopy (with anesthesia) to insert the balloon, and then one endoscopy (also with anesthesia) to remove it 6 months later.  The Obalon gastric balloon changes this equation for the better, as it can easily be placed in the office with no anesthesia and no downtime.

Both ReShape and Orbera gastric balloons have more similarities than differences.  Both of them require two endoscopies, both of them are filled with saline, and both of them have a reasonably high rate (8%-16%) of intolerance, which requires early removal of the device.  See Table 1 below for a list of similarities and differences between these devices.

Obalon is a definite game-changer in the gastric balloon world.  Obalon patients receive a total of 3 smaller balloons over a total of 8 weeks.  Each balloon insertion is a simple process:  the patient comes into the office, stands in front of an xray machine, and swallows a capsule with a tiny catheter attached to it.  The physician uses xray to confirm that the capsule is in the stomach, and then it is inflated with a special cannister of gas up to 250cc.  The patient comes back then every 4 weeks until all 3 balloons have been placed.

Obalon Uninflated & Inflated

obalon gastric balloon
This technique has some major advantages over traditional gastric balloons.  Most importantly, increasing the total balloon volume gradually over time results in much better tolerance than inserting an Orbera or ReShape and immediately inflating it up to 900cc’s.  This results in much less nausea and vomiting upon each balloon placement, allowing most patients to return to work the next day.

Their initial trial, SMART, showed excellent safety profile with no balloon leaks or early removal.  Weight loss was roughly double that of the control group.

The development of less-invasive treatments such as Obalon will hopefully allow physicians to attack the disease of obesity much earlier, avoiding major disease like type 2 diabetes and sleep apnea.

Click here to schedule an Obalon “swallowable” gastric balloon consultation!

 

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Our First Virtual Support Group!

Join us on VHPGO!

Virtual+Live Support Group

Wednesday January 24th, 6:30-7:30 pm

Topic: Goal Setting

Join us on Wednesday, January 24th at 6:30pm for our first ever virtual support group through our new VHPGO app!  Rebecca Erdman RD/LD will discuss strategies on successful goal setting towards achieving your healthy weight.  This will be a great way to start off the new year!

In order to participate you must have an active VHPGO membership.  You can learn more or sign up at LoseWeightCincy/VHPGO

Any active VHPGO membership will work, but the best value is definitely the $99/year flat access.

VHPGO will also give you the ability to do virtual visits with our dietitians right on your phone, which will greatly reduce your office wait times!

You can also attend the support group live, at the usual place in our Cincinnati office (10475 Reading Road).

We are excited about this new technology and would like to encourage everyone to participate.  We are offering this at our cost with no markup as I feel strongly that it will improve weight loss outcomes!

Go to LoseWeightCincy.com/VHPGO and sign up now!

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What is Lovenox? Why do I need it and how do I do the injections?

Blood clots after surgery are a risk for any patient, and being overweight can increase the risk significantly. Lovenox is a short-acting, injectable blood thinner that is frequently used after surgery to prevent deep vein thrombosis (DVT).  Some surgeons use it in 100% of patients, and others use it selectively based on the patients risk.  In any case, if your doctor prescribed Lovenox for you either before or after surgery, it is IMPORTANT that you use the medication as directed by your physician!

DVT’s can be serious after surgery as sometimes they can travel to the lungs, which is called a pulmonary embolism (PE).  In addition to blood thinners such as Lovenox, frequent walking after surgery will also reduce the risk of DVT.

Lovenox is dispensed in pre-filled syringes matching the dosage your doctor wants you to have.  Injecting is pretty simple and causes minimal discomfort.  Please view the information below from the Lovenox® web site to learn more about how to do your injections properly. Note that significant black-and-blue bruising can occur around injection sites, this is normal. If you have any signs of significant bleeding please call your doctor immediately!


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The Importance of Screening For Sleep Apnea

Sleep apnea affects nearly 25 million adults in America by many estimates.  Undiagnosed sleep apnea can be risky to your health, and can increase the risk of pulmonary issues after surgery.  For this reason, we screen all our surgical patients for sleep apnea and test those who are at moderate or high risk.  We will ask you to complete a STOP BANG sleep apnea survey and possibly an Epworth Sleepiness Scale.  If indicated, we will set you up for a sleep test in your own home using a WatchPAT device.

WatchPAT is an FDA-approved portable diagnostic device that uses the most innovative technology to ensure the accurate screening, detection, and follow-up of sleep apnea. Its ease of use is unparalleled in the marketplace and it is greatly complemented by the fact that WatchPAT testing is done in the comfort of your own bedroom; an environment that best reflects the pattern of your sleep habits!

Please return your device to us within 24 hours of completing your testing so that we can transmit your results to our board-certified sleep physicians for interpretation.

Please watch the two videos below to better understand the disease of sleep apnea, and how to properly use your WatchPAT device to obtain an accurate sleep test in your very own bed!

Why sleep apnea testing is important to your health!

How to use your WatchPAT device

Note:  Acryllic nails or dark nail polish may interfere with the accuracy of WathPAT testing.

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