Dr. Tracy Martínez

Biography

RN,BSN,CBN; Director Wittgrove Bariatric Center, Del Mar, California, Estados Unidos; Chair. Intergrated Health Committee. International Federation for the Surgery of Obesity (IFSO); Nurse consultatnt Cardiometabolic Disease Team, West Healt; Past President, Integrated Health, American Society For Metabolic And Bariatric Surgery.

Publications

Selected publications from PubMed

Laparoscopic gastric bypass in patients 60 years and older: early postoperative morbidity and resolution of comorbidities.

Wittgrove AC, Martinez T

Obes Surg. 2009 Nov;19(11):1472-6 doi: 10.1007/s11695-009-9929-0.

Featured in

1h 3min

2nd I.H. IFSO Online Symposium: The role of physical exercise in pre and post-bariatric surgery

Bariatric surgery has proved to be an effective treatment in patients suffering from morbid obesity, with more than 50% excess weight loss at ten years. However, the variability in patients’ outcomes is significant, with several factors being related to the maintenance of weight loss and the resolution of comorbidities. It has been suggested that physical activity has a substantial impact on the prognosis of morbidly obese operated patients, by improving physiological and psychological health. More specifically, active patients enjoy an improved quality of life and lean towards maintaining the long-term surgical benefits. By contrast, inactivity induces loss of muscle mass and development of abdominal adiposity, which may stimulate insulin resistance, atherosclerosis, and tumorigenesis. The reason why many patients who undergo bariatric surgery limit physical exercise is multiple: some attribute it to a lack of time, others to physical limitations, but in the majority this is due to a lack of motivation. The role of the physician is to help the patient overcome barriers and promote activity, with a particular focus on making them part of the decision-making process and increasing their motivation. The design of individualized programs, recording daily tasks and realistic objectives, being mindful of diet and physical limitations, learning about the benefits of exercise, and dealing with the lack of energy are some of the necessary steps. In addition to the importance that physical activity has for treated obese patients, exercise training has been shown to be of utmost relevance in the preoperatory population. Prehabilitation encompasses the concept of optimizing the pre-surgical patient, by promoting exercise, nutritional supplementation, and anxiety management. Several trials have reported a decreased rate of postoperative complications after prehabilitation, suggesting that it should be performed in the majority of patients who undergo major abdominal surgery. In this video, Dr. Cristina Aquino discusses the role of physical activity before and after bariatric surgery. Dr. Tracy Martinez moderates the session in which Drs. Dale S. Bond, Scott Jamieson, and Marcos Morales also participate.

Published

Nov 2018

1h 8min

Necessary Supplements Following Bariatric and Metabolic Surgery

Clinical Case Obese patients present with preoperative nutrient deficiencies , decreased postoperative caloric intake , lower contact of food with intestinal enzymes and an altered absorption due to intestinal bypass, associated with avoidance of nutrient rich foods and non compliance with prescribed supplementation that can lead to nutritional deficits causing significant morbidity . This health issues range from anemia, neuropathy, cognitive dysfunction, visual loss or bone loss to anemia and weight regain. Silvia Leite from the Department of Nutrition at the University of Brasilia explains the differences between the patients compliant with the prescribed multivitamin supplementation and non-compliant patients. A thorough review of physiological intestinal absorption of nutrients and the expected deficiencies for each type of bariatric procedure (laparoscopic adjustable gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, single anastomosis gastric bypass and duodenal switch) is provided. Recommendations on prevention, screening and treatment of nutritional deficiencies after bariatric procedures are explained for each possible deficiency. An interesting debate between IFSO experts S. Leite, T. Martinez, S.S. Dagan, M. O’Kane and J. Parrott on important issues in prevention and treatment of nutritional deficiencies after bariatric surgery follows. [Image]