Chatting With Dr. Ortiz: Episode #3

What’s discussed in this episode with Dr. Elias Ortiz

  • How come you don’t require people to get bloodwork at home? If they do get bloodwork done, what should they get done? (5:29)
  • You wear nice clothes in your pictures, do you actually do surgeries? Do you change your clothes? (6:40)
  • Why should I wait 30 minutes after eating before I drink anything? (7:35)
  • Does having thyroid disease affect your weight loss after surgery? (9:06)
  • How do I resume my medication when I’m on a clear liquid diet? (10:48)

Transcript

Why don’t you require patients to get blood work done at home? What do you want patients to get done before they come here?

Obviously, it’ll be best if they send us their health questionnaire and all their labs. It’s not required, but if patients could send their routine blood work results from their PCP, it’d be easier for us. When patients arrive here, we do a complete routine of blood work, and if we see that someone has issues, we fix them before the surgery.

Why do patients need to wait thirty minutes before drinking anything and thirty minutes after eating? That was always very challenging for me.

Remember, after the sleeve or bypass, the size of the stomach reduces a lot, so there’s no space for liquids and solid foods. If you eat something solid and drink at the same time, the mix in the tiny new stomach will be very uncomfortable. The patient could develop reflux, or, if they’ve had a bypass, they could develop dumping syndrome. You can eat first or drink first, but not both at the same time. With time, people learn how to start eating and drinking at the same time, but in the beginning, it’s just not recommended.

Some patients need to resume their medication the day after surgery. If they’re supposed to be on liquids only, how does that affect taking a pill?

A large percentage of patients in our field have diabetes, and they notice that even during the pre-op diet, their glucose levels go down. After the surgery, some patients don’t need to take any more diabetes medication—only if it’s needed. It’s a bit different with type 1 diabetes, because they’ll always need to take insulin, but the level of insulin they need always decreases. If they have high blood pressure, they need to start their blood pressure medicine again the day after surgery. High blood pressure takes a bit more time to get under control than diabetes; in a few weeks or months, they may notice they don’t need it anymore, but that’s the PCP’s call. Don’t take cholesterol medication anymore, because your cholesterol levels will be lowered, and if you take it you may get a headache. If you take some other type of medication—for a mood disorder, anxiety, depression, sleep aids, whatever—yes, you can take your pills. If they’re big, solid pills, you need to crush them, but if they’re tiny or crushed, there’s no problem at all.

Does having thyroid disease affect your weight loss after the surgery?

If it’s not under control, yes. If a patient has hypothyroidism—low function of the thyroid—associated with obesity, they have to be tested by their PCP before they come here so we know they’re under control, that their levels of Synthroid levothyroxine are good. Sometimes they’ll need to increase or decrease their doses in order to be under control. If a patient comes in with thyroid issues that are not under control or are unsure because they didn’t complete their blood work, their weight loss is going to be slower due to the lower function of the thyroid. Patients should complete another blood test one to three months after the surgery, as sometimes their PCP needs to modify their treatment.

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Dr. Almino Ramos Joins Elias Ortiz & Company

Dr. Almino Ramos is a world famous bariatric surgeon and former president of the IFSO who we are excited to welcome to our team!

CREDENTIALS

Dr. Elías Ortiz, Bariatrics

Professional License Number: 8684409

Federal Taxpayers Registry: OIGJ810323D28

CURP: OIGJ810323HBCRMS08

Qualifications

Undergraduate Degree in Medicine (1999–2004), Faculty of Medicine of the Autonomous University of Baja California
– Overall average: 8.85 / 10

Undergraduate Internship (2004–2005), Regional General Hospital No. 1, IMSS, Tijuana, Baja California, Mexico.
– Overall average: 9.49 / 10

Social Service (2005–2006), Mobile Unit No. 19, SSA, Tijuana, Baja California Mexico.

Graduate Professional XXXI National Aspiring medical residencies
– Place finish in specialty group (Surgery): 32 of 3602.

General Surgery Specialty (2008-2012), Medical Unit of High Specialty, West National Medical Center, Mexican Social Security Institute
– Total Rating: 96.40 / 100.

Certifications

Certificate of Accreditation of Foreign Language Skills: English. April 22, 2006, at the Autonomous University of Baja California, Mexico

Resident Coordinator of General Surgery, generation 2008–2009, Regional General Hospital No. 45, Mexican Social Security Institute, Guadalajara, Jalisco, Mexico.

Chief Resident in General Surgery, 2011–2012 in Medical Unit of High Specialty, West National Medical Center, Mexican Social Security Institute, Guadalajara, Jalisco, Mexico.

Professional Experience

2nd Regional and International Congress on Obesity conducted by the Association for the Study of Obesity and its complications AC.
– May 2004, Tijuana, Baja California, Mexico.

Natural Orifice Transluminal Endoscopic Surgery
– General session speaker
– Regional General Hospital No. 45, May 15, 2008, Guadalajara, Jalisco, Mexico

Natural Orifice Transluminal Endoscopic Surgery
– General session speaker
– Zapopan General Hospital, November 5, 2008, Guadalajara, Jalisco, Mexico

ERCP (endoscopic retrograde cholangiopancreatography)
– General session speaker
– Regional General Hospital No. 45, February 12, 2009, Guadalajara, Jalisco, Mexico.

1stCourse News and Controversies in Surgical GERD
– April 2009, Regional General Hospital No. 45, Guadalajara, Jalisco, Mexico

Laparoscopic Surgery Program in the Regional General Hospital No. 1
– Social Security Institute, April–May 2010, Tijuana, Baja California, Mexico

Laparoscopic Surgery Program in the Regional General Hospital No. 1
– Social Security Institute, June–August 2011, Tijuana, Baja California, Mexico

Gastric Plication Surgery Mini Fellowship
– Hospital Angeles Tijuana, November 2011

Adjustable Gastric Band Surgery Mini Fellowship
– Hospital Angeles Tijuana, December 2011

Bariatric Surgery Program at Hospital Angeles Tijuana
– November–December 2011, Tijuana, Baja California, Mexico

Theoretical and Practical Course XIV of Endoscopic Surgery, AMCE, AC
– Medical Unit of High Specialty, West National Medical Center Gdl, Jal. January–February 2012

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