WLS Center E-Newsletter

A FREE publication from
http://www.wlscenter.com

 

Hosted by Barbara Thompson
Author of:
Weight Loss Surgery:
Finding the Thin Person Hiding Inside You.

Issue #49

June 15, 2004

I arrived home from a week in San Diego and my daughter announced that she likes green beans. As inconsequential as that sounds, I was stunned.  My daughter has an aversion to vegetables that we have dealt with all her life and suddenly, now that the house sitter made them, she likes them. Go figure!  We have a rule in our house.  At dinner, my daughter doesnít have to eat everything on her plate, but she does have to taste everything.  So for 17 years, she has had a single green bean every time I have made them.  Finally, she likes them just as I do.

 

We are profound influences in our childrenís lives. All these years of my eating green beans have been working on my daughter. I eat green beans and now finally she does. We know that in so many ways, our children eventually mimic our good actions as well as our bad.  

What better reason for us to decide to have weight loss surgery than to show our children that we chose health. We are showing that we hold ourselves in enough esteem to want to reach out and grab the best life that we can have. By having surgery, we are not only there for them longer, but we can influence what future paths they may take.  Considering that morbid obesity has a strong genetic component, our decision to have surgery can affect them in ways that we do not at first realize. We can help to influence them to chose health for themselves as well.

In This Issue

 

* Exercise Telephone Seminar Coming Next Week
* Program Fees
* Stalled Weight and Exercise
* ASBS Meeting Report
* Recipe: Multi Bean Salad
* Success Story: Patricia English
* How Do You Maintain Your Weight?

Upcoming Telephone Seminar

 

Exercise:

You Canít Reach Goal without It

Concerned that you are not losing the weight that you want?  Then you absolutely must sign onto the telephone seminar: ďExercise: You Canít Reach Goal without It. 

When: Wednesday June 23rd

Time: 8:00 PM Eastern Time

Cost: $19.95 (Plus phone charges as applicable)

What You Will Learn:

* Starting your exercise program from day one, regardless of your physical condition
* Preventing plateaus
* Getting the motivation to just do it
* Overcoming mental obstacles

And much, much more.  There are a lot of free handouts with this telephone seminar.

Click here to register or to find out more. http://www.wlscenter.com/Teleseminar/Exercise/JonGestl.htm

Program Fees

In the last issue of the e-newsletter I defended having to pay program fees and several of you nicely disagreed with me.  I certainly respect your points of view and find them all very valid.  Here are some of the responses I received.

From Pam Kreinest:

Barbara,

I would like to make a comment about the program fees charged by some of the physicians here in Jacksonville, FL.

My physician charges $6000.00 before surgery!  Another charges only $1000.00.  Why the disparity in prices? It is beyond me since the insurance industry pays the same amount.  I am discouraged that some are outrageous and make it difficult for patients to use their services due to the amount needed up front.  I am ready for surgery but cannot come up with the $6000.00 needed to have it done.  Just a comment...

 

Fram Ana Jarosz of Hobe Sound, FL

I read your June newsletter regarding additional fees charged by surgeon and your response to the woman who was asking if this was possible.  I disagree with part of your answer.

While I realize that managed care companies are reimbursing small amounts to providers, the provider of service has signed a contract stating that they will accept what the insurance company pays them.  If that lady's plan pays at 100%, then she cannot be charged anything by the surgeon for services related to the procedure he already filed a claim with the insurance company for.  I'm sorry, but, itís up to the surgeon to decide whether or not he wishes to participate in a program and if he does, he has to accept those fees and cannot charge the patients.  To do so is in violation of the contract he signed with the insurance company.

I had something similar happen to me with the first and second surgeons I consulted with for my bariatric surgery.  They both wanted $5000 above what the insurance would pay.  My plan had approved me for the surgery and was paying 100%, no deductible, for the procedure and hospitalization.  I went to a third surgeon who stuck by the contract he had signed with my insurance company.  To me, itís a matter of character if the surgeon does not abide by the contract and takes money from the patient.  If they are that lacking in character and ethics, then, I don't want them cutting into my body.  I can't trust them.

 

From Shirley Warren:

Barbara,

I just read the June 1 E-newsletter regarding program fees. Please advise Christina to check with her insurance company regarding the charge of program fees by her physician. In most instances if a physician agrees to accept insurance assignments via their contract, it is not legal for them to charge the patient extra fees beyond the contract fee. If a patient requires follow-up visits past the initial post-op period, these visits should be covered as a regular physician appointment. I know this to be true for my own insurance company and also for the Medicare program. Thank you for your time.   

                                   Sincerely,     

                                 Shirley Warren

 

From Michelle Pfeiff in Massachusets: 

Hi Barbara,

I just read your response to the Program fees question that was posed to you. I have to disagree with a part of the statement.  The physician is getting paid for every after visit you go to following surgery.  Those visits are not part of the surgery fee! And as for other fees, the nutritionist gets paid for every visit too.  They do not share the doctor's fee. They bill their visit themselves, even if it is the same day as the doctor.

I do agree that insurance companies do pay very low prices for such major surgeries, but that is a fight for the doctor's offices to fight. I guess I am lucky that I had my surgery a year ago when this Program fee was not yet in place. And I must say that after a year I am doing great!  I am down 117 pounds and feeling wonderful.

I saw you when you spoke to our support group in Boston and was thrilled to hear you speak.  Way to go! You are quite motivational!  Continue that great work!

Fondly
Michelle Pfeiffer

If you would like to re-read what I wrote on program fees, click here http://www.wlscenter.com/NLArchive/June_1_2004.htm

Research Article:  
Stalled Weight and Exercise
I received the following question from Sheri Heam and thought it might be helpful if Jon Gestl, who is our guest for the upcoming telephone seminar on exercise, would answer her question. :

Hi Barbara,

I am a 35 year old Mom and nurse who had open RNY surgery on April 14th, 2003.  I am thrilled with what has happened thus far but also a little disheartened. My surgical weight was 348 pounds on a 5'2" frame. I was miserable in so many ways. I am currently at 200 pounds and stalled out.

My surgeon had said that in order to get to goal I really had to make exercise a daily part of my day and requested 45 minutes a day 5 days a week.  I have been so good at this. We joined the YMCA and for the past almost 2 months I have been getting up at 4:30 am and doing cardio exercises 5 to 6 days a week followed by weight training every other day.

I have noticed inches coming off and I feel great but my loss has stalled completely. I haven't gained but I haven't lost a pound!!!! I can't help but get a bit concerned and upset that I am not losing anymore weight. I want to lose another 60 pounds.  I know you have the telephone seminar coming up but do you have any words of wisdom?  Thanks for any input you may have for me.

Sheri Hearn, R.N. 

Hi Sheri,
Although you are understandably frustrated, I'm delighted for you.  Believe it or not, you are right on track!

First, the fact that you exercise 5 to 6 days a week (getting up at 4:30AM no less) and have done so regularly for two months is reason enough to celebrate.   Making exercise a daily, habitual part of life is the hardest part of the process.  It is an absolute necessity. Kudos for your persistence!

Second, that you are not seeing dramatic weight loss at this point doesn't surprise me at all.   Having never regularly exercised, it stands to reason that your metabolism is probably slower than average.  Metabolism, or the speed at which your body uses energy, controls the rate of fat burning.  It is affected by genetics, diet patterns, and by the amount of muscle you carry.  

Since fat is burned in the muscle, the more muscle mass you develop (through resistance training) the higher your metabolism will become and the more calories your body will burn, both at rest and during exercise.  However, dramatic change to the metabolism doesn't happen overnight, or even two months, but through consistent effort; you are definitely on the way to increasing your metabolic rate.

Finally, even though you are not experiencing overall weight loss, you state you notice a loss in inches. This indicates that you are indeed losing fat content, but are substituting the weight with muscle.  Muscle is much denser than fat and takes up less room on our frame.  A loss of even 5 pounds of fat and a gain of 5 pounds of muscle mass, even though you can't see it on the scale, will have a noticeable effect on the body.  And, most importantly, it will help to increase your metabolism.

After a year of rapid weight loss, it is certainly frustrating to experience the process slowing down.  But realize that the surgery is just a beginning, helping you to "level the playing field."  As hard as it going to be, the focus for you now needs to be in noticing changes in your overall appearance rather than overall weight loss.  Losing inches, decreasing your clothing size, and increasing your energy level will indicate continued successful progress.  

As your doctor said, exercise needs to become a daily part of your life in order to achieve your goal. Weight loss will continue, just not at the rate experienced in your first year post-op.

Keep up the great work!

Jon

ASBS Meeting Report

The American Society for Bariatric Surgery met in beautiful San Diego, CA June 12th thru the 18th.  There were more than 2200 surgeons, support group leaders, psychologists, dieticians and nurses in attendance.  Every year it grows bigger and bigger. And every year it seems that there is a particular point of controversy.

The first year I attended, the controversy was the introduction of the lap band.  The next year the controversy was about all of the new practices that were jumping onto the bariatric band wagon. One year the controversy was whether the surgery was better done laparoscopically or as an open procedure.  This year the hot topics were the Center of Excellence concept and problems with insurance coverage.

The Centers of Excellence will be those practices that apply to become a Center who are then approved by the American Society for Bariatric Surgery because they meet certain requirements. The requirements include having completed a minimum of 125 cases, have a complete aftercare program, and have proven outcomes.  Patients will ultimately be safer and more successful by having their surgery at a Center because the practice will be experienced and prepared to meet patient needs through a support group and available services such as psychological and nutritional counseling. Insurance coverage should then become easier as well.

Although there is a certain amount of competitiveness going on with practices and vendors, this professional association is very proactive in dealing with issues facing the field.  The Centers of Excellence will help to ensure that patients are receiving the highest quality of care and the opportunity for the greatest amount of success.  You will no doubt be hearing a lot more regarding the Centers of Excellence in the months to come.

Recipe:

      Multi Bean Salad

I would like to thank Karen Perna from Chandler, AZ for the following recipe.  This is a great summer salad.

 

Karenís Multi-Bean Salad                              

1 16 oz. package frozen shelled edamame (soybeans)-cook lightly, drain, let cool
OR 1 16 oz. can of soy beans, drained
1 16 oz. can cut green beans, drained
1 16 oz. can red kidney beans, drained
1 16 oz. can garbanzo beans, drained
1 medium sweet onion, cut into strips
1 large green pepper, cut into slices

Combine the following ingredients for the marinade:
3/4 cup Splenda
1/3 cup canola oil
2/3 cup white vinegar
1 1/2 tsp. salt
1 tsp. ground black pepper

Put all the vegetables in a large bowl, pour marinade over, toss lightly, cover tightly and refrigerate for 10-12 hours (mix, turn over or lightly toss occasionally to distribute the marinade). 

Note: Other beans may also be added but try to avoid beans that are very soft.  I pick which beans to use based on their protein value....and what is on sale :-)

If you have a recipe that you would like to share in a future issue of this newsletter, please send it to me at Barbara@wlscenter.com

 
Success Story:  
  Patricia English

I want to offer a special thanks to Patricia English of Louisiana. Here is her story: 

Barbara,
I really enjoy receiving your newsletter. You have many inspirational stories, wonderful articles, and lots of recipes. It was through researching weight loss surgery that I found your site and was led to Dr. Hargroder in Baton Rouge Louisiana.

My highest weight was 241 pounds. I had high blood pressure, painful joints in my back, hips, and knees, and high cholesterol and was taking medicine daily for these conditions. I had been on numerous diets to lose weight only to regain it plus some. My dad's father died of a heart attack in his early 40's. My dad also has high cholesterol and high blood pressure, and my dad's mother has high cholesterol, high blood pressure, and heart problems. My uncle had a heart attack while I was having my surgery so that made me that much happier I had made this decision to go through this surgery.

My motherís weight is 350 pounds and has high cholesterol/ high blood pressure, diabetes, arthritis, renal problems and, heart problems. And the list goes on and on.  I could see myself in the same shoes as my Mother in a few more years. I did not want to go through what she is going through now. I have 2 children and a husband and I want to spend a few more years being able to do things with them. It was seeing my mother like this that led me to my decision to have a laparascopic RNY on October 9th, 2002.

I went into the surgery apprehensively and thinking "Do I really want to give up this lifestyle of sweets and high fat foods?" My decision of course was yes and it was the best decision I have ever made in my life. If you ask me if I'd do it again, I'd say YES!!.

After the first 6 weeks post-op my cholesterol was down from over 350 to 201. I went down to 141 pounds after 8 months and lost another 6 pounds after I had to have a hysterectomy 2 months ago and I am now down to 135 pounds. I have lost a total of 106 pounds. YEAH!!  I am down to the weight I was in high school and can still not believe it.  

I feel better than I have felt in several years. I enjoy doing more things. I am active with riding with my husband on his motorcycle, something that I hated riding on before because I was so big.

I would like to thank you for your encouraging newsletter that led me to make the best decision of my life. Again, thank you and God bless you!! You are doing a great service to all the people that have had weight loss surgery or who are considering it.

Sincerely, 
Patricia English 

I love good news.  If you have good news, a success story to share, or inspiration, please send it to me at Barbara@wlscenter.com so that I can include it in future issues.

I am again low on success stories, so if you are 1 or more years post op and have a story to share, please do so.  And please email before and after pictures.

How Do You Maintain Your Weight Loss?

More Success Stories Needed for My Next Book

Are you 2 or more years post-op? If so, I need to know what your secret is for maintaining your weight. I will be using your story in my next book on maintaining your weight loss long term. You must write at least 1 full page. Anything less than 1 page will not be useable. I also need your before and after pictures sent via email. I need to know how you eat, what you do for exercise, and any tips that you have to offer. This will be a tremendous help to people who are having the common problem of weight gain following surgery, or are struggling to maintain their weight loss.

Send your stories to Barbara@wlscenter.com

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Reprinted from Barbara Thompsonís free e-newsletter featuring helpful information and research material to help patients succeed following weight loss surgery.
Subscribe at http://www.barbarathompsonnewsletter.com/

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