LeanDreamsSavannah River Advanced Surgery

Welcome to LeanDreams

Everything you need to hit the ground running, before your first visit.

We are glad you are here. This page walks you through the basics so you feel ready: how to log in to your patient portal, how to track your food, how to join our community, and what to know about your medication and injections. You do not need to finish it all at once. Watch what you can before your onboarding call, and be sure to finish before your visit with the medical provider.

Your first steps

  1. Watch the welcome video
  2. Set up your Charm patient portal
  3. Watch the medication videos
  4. Learn how to give your injection
  5. Download MyFitnessPal to track your food
  6. Join our community on Skool

Onboarding call: our team will schedule a 20 to 30 minute video call with you to go over all of this and answer your questions. Watching these videos first makes that call even better.

Questions? We are here: Text 803-220-1714 Call

1. Welcome to LeanDreams

Start with this short welcome video from our team.

2. Set up your Charm patient portal

Charm is our secure patient portal. This is where you complete your forms, see your appointments, and message the care team.

  1. Look for an invitation email from LeanDreams. Check your spam folder if you do not see it.
  2. Open the invitation link, enter your date of birth, and create your password.
  3. Optional: download the Charm mPHR app and log in with the same username and password.

Using a different phone or a computer? The patient portal also works in any web browser. Use the link in your invitation email. Did not get your invitation? Text or call 803-220-1714.

3. Learn about your medication

Short videos from Dr. Jorge, in the order we suggest. Tap a video to play it. Watch them in any order, and come back anytime. They are also on our YouTube playlist.

1. Understanding the names

2. Difference between semaglutide and tirzepatide

3. How the medications work

4. Medication side effects

5. How to administer the medications

6. How the medications make you feel

7. How to eat while on the medications

8a. How long should I be on the medication?

8b. How much weight loss should I expect?

9. What NOT to do

10. The big picture

4. How to give your injection

Watch this short video, then use the steps below as a checklist the first few times. Your care team will tell you your exact dose and schedule. Always follow the directions on your prescription label.

Measuring your dose

0102030405060708090 Needle Read the dose here Barrel with unit markings (units) Plunger Example: filled to the 30 mark = 30 units = 0.3 mL (100 units = 1 mL) Illustration only. Your syringe may look different. Follow your prescription label. 0102030405060708090100 Needle Read the dosehere Barrel withunit markings Plunger Example: filled to the 30 mark = 30 units = 0.3 mL (100 units = 1 mL) Illustration only. Your syringe may look different.
  • Your prescription may list your dose in milliliters (mL), units, or both. Check the label before you draw up your dose.
  • An insulin syringe holds 1 mL, which is 100 units. A luer-lock syringe holds 1 mL and is marked in mL.
  • Example conversions: 5 units = 0.05 mL, 10 units = 0.1 mL, 20 units = 0.2 mL, 30 units = 0.3 mL.
  • If you are not sure which mark to use, call us before you inject.

Where to inject

Back ofupper arm Abdomen Outerthigh Stay about 2 inches from the belly button (dashed ring).Rotate sites each week. Illustration only.

Medication goes into the fatty layer just under the skin (subcutaneous). Safe areas are:

  • Abdomen: below the waist and above the hip bone, staying about 2 inches away from the belly button.
  • Thigh: the outer middle part of the thigh, halfway between the knee and the hip.
  • Back of the upper arm: halfway between the elbow and the shoulder. This is easier with help from another person.

Rotate to a new spot each week. You should be able to gently pinch 1 to 2 inches of skin.

Step by step

  1. Wash your hands with soap and dry them well.
  2. Open an alcohol wipe and clean the injection area. Let it dry.
  3. Take the cap off the needle by pulling it straight off.
  4. Hold the syringe like a pen or a dart.
  5. Gently pinch the skin. If you can pinch 2 inches, inject straight in at 90 degrees. If you can pinch about 1 inch, inject at 45 degrees.
  6. Insert the needle with a quick, steady motion.
  7. Push the plunger down slowly until the syringe is empty.
  8. Remove the needle at the same angle it went in.
  9. Place the used syringe and needle in a sharps container right away. Never recap or reuse needles.
Sharps disposal. A hard plastic container with a screw-on lid, such as a laundry detergent bottle, works if you do not have a sharps container. Ask your pharmacy or primary care office about local disposal rules.

5. When your medication arrives

Cap Rubber stopper Wipe with alcohol first Label Check name and strength Medication Illustration only
  • Put your medication in the refrigerator immediately, as directed on the label. Do not freeze it.
  • Your medication usually arrives in an insulated mailer or cooler with ice packs. The silver pouch holds your medication. Do not throw it out.
  • If the ice packs are warm or melted when you open the package, tell us right away. Most injectable medication can tolerate short trips, but we want to check.
  • Your vial may look partly empty. Vials are filled with a little extra so you can draw your full dose. Use the dose on your prescription label.
Package marked delivered, but you do not have it?Contact us immediately.
Package arrives warm, without ice packs, or broken?Take a picture and contact us immediately. Do not use the medication until we have checked it.

6. Your medication

Your doctor will choose the medication that fits you. These are short summaries. Your provider will go over your dose, schedule, and any risks with you.

Semaglutide

What it does

A weekly injection that acts like the natural hormone GLP-1. It slows how fast your stomach empties, helps you feel full sooner and longer, and lowers appetite.

Dosing

Starts low and increases slowly as your body adjusts. Weight loss builds over time, along with healthy eating and activity.

Common side effects

NauseaVomitingDiarrheaConstipationStomach pain

They are usually worst when you start or raise a dose.

Good to know

Limit alcohol. It can upset your stomach and can affect blood sugar. Tell your provider about every medication you take, because semaglutide slows the stomach and may change how oral medicines are absorbed.

Tirzepatide

What it does

A weekly injection that works on two hormone pathways, GIP and GLP-1, to reduce appetite and help you feel full.

Dosing

Like semaglutide, it is started at a low dose and increased gradually.

Common side effects

NauseaVomitingDiarrheaConstipationStomach pain

They are usually worst when you start or raise a dose.

Good to know

Limit alcohol. Tirzepatide can make birth control pills less effective, so ask your provider about backup contraception when you start and after each dose increase.

Call or text us right away if you have
  • Vomiting that lasts more than a day
  • Severe stomach pain that does not go away, sometimes moving to the back
  • Signs of dehydration
  • Vision changes
  • Low blood sugar: shakiness, sweating, confusion, or a fast heartbeat
Get emergency help (call 911) for
  • Swelling of the face, lips, tongue, or throat
  • Trouble breathing or swallowing
Do not use these medications if you or your family have a history of medullary thyroid cancer or MEN 2, or if you have had pancreatitis. Tell your provider about these before you start.

7. Track your food with MyFitnessPal

Tracking helps you and your coach see patterns. A free account is enough. Follow these eight steps to get set up.

  1. Download the app (links below) and open it.
  2. Tap Sign Up. Using your email gives you the most control of your account.
  3. Enter your email, password, age, gender, height, and current weight.
  4. Choose your goal and goal weight, and how fast you want to get there (for example, 1 lb per week).
  5. Pick the activity level that fits your lifestyle. Be honest, because this sets your calorie target.
  6. Review your daily calorie plan. You can adjust it later in Settings.
  7. Optional: set dietary preferences (for example low carb or high protein) and macro goals for protein, carbs, and fats.
  8. Finish setup and start logging food, water, and exercise right away.

Turn on notifications
Reminders help you stay consistent.

Log your first meal now
Starting right away builds the habit.

Try barcode scanning
It makes tracking much faster.
Share your login with our dietitian. We encourage you to share your MyFitnessPal login with our registered dietitian. She will log into your dashboard weekly to review your information and give you feedback.

Another type of phone or a computer? MyFitnessPal also works in any web browser at myfitnesspal.com.

8. Join our community on Skool

Take a look inside before you join. Watch the video on the community page and read the description to see what the community is about.

See what the community is about

Get the Skool app:

Another type of phone or a computer? Skool works in any web browser at skool.com.

Already in the paid LeanDreams program? Please do not sign up on the public page. Request your personal invite link from our team. Private community access is complimentary with the paid program.
Step-by-step guide to joining LeanDreams on Skool

Questions? We are here to help.

Text or call our LeanDreams line anytime during business hours.

Need to cancel or reschedule? Please give us at least 24 hours notice.

For educational purposes only. This page is general education and is not medical advice. It does not replace advice from your care team. If you have an emergency, call 911.