insta keto week is because often what the patient thought

insta keto week is because often what the patient thought they had is different than what they actually had for example we saw a patient who had a sleeve gastrectomy in Mexico a couple weeks ago she had the surgery about a year and a half ago but she's been regaining weight and when we did an upper endoscopy we saw there is no change to her anatomy and it's probably because she didn't actually have a sleeve she probably had what's called the plication where they just sew the stomach to make it thinner but then that tends to fall apart so for patients who've experienced weight regain the first thing we want to do is investigate their Anatomy to see for example sometimes people can have weight gain after gastric bypass if they have an ulcer and they develop a fistula or connection to the old



insta keto diet  stomach and then food goes the same way it always did in terms of the patient who's had a duodenal switch again we'd want to see what was done and investigate you know the patient's eating habits and everything because you don't just do the surgeries and then they work forever magically there has to be behavioral changes there's to be dietary changes there has to be changes the physical activity so there is a lot that can be done even if the anatomy is same you know perfect Anatomy it was at the time of the initial operation and we have another question and I believe you may dress this but they're asking if there he would be able to walk upstairs