022 Judy Shares About Why It's Important to Talk to Your Doctor

Salam and good evening to you worthy friend! Thanks for dropping by Jimmy Goes Gastric. Today I want to introduce you to a friend of mine. Her name is Judy. Judy and I have known each other since we were kids. We went to school together and played together. I remember the struggles that Judy's family went through when tragedy struck unexpectedly. Judy has been following our story here on Jimmy Goes Gastric and as a result she contacted me the other day to share some of her family's experience with WLS. After talking to her I asked if she would kindly share some of her story with everyone here, and she graciously agreed.

Please keep reading as Judy shares from her own personal experience why it is important to keep an open line of communication between you and your doctor when you are undergoing WLS.

Why It's Important to Talk to Your Doctor

Hi. My name is Judy. My family (two brothers, Mom, & Dad) lived in Fulton, Missouri, for most of my childhood.

My father died when I was just twelve years old. He died because of his obesity. My mother, who was also obese, was worried that she would die soon, as well if she didn't lose weight.

Mom dieted and exercised and still struggled with her weight. It was then that she decided to have gastric bypass. She was thrilled that she was accepted to have the surgery done. I remember her being worried for the actual surgery. She worried she wouldn't survive the procedure, but never worried about what would follow the surgery.

The surgery was a success, and the pounds began to melt away. She lost 150 pounds in no time. But her road was not easy. Everything she ate made her sick. Because I was so young I don't know if her doctors had prepared her for that, or if they had told her what to eat to keep her healthy and she just struggled with it.

I remember her eating cheese sticks all the time because that is all that she was able to keep down. Because she wasn't getting the nutrition she needed her blood sugar would drop and she would go into diabetic comas. Many times my brother called for an ambulance because she was incoherent and didn't know who we were.

The last time she went into a diabetic comma, she didn't wake up. After my mother died I was angry that she had had the surgery, but since I have come to understand that her obesity could have killed just like it had my father. I was blessed to have those six extra years with her.

I know this surgery can be life changing. I have seen many people who have had it done successfully. I would just like to encourage all those who are considering having this done to be well educated about this decision. Keep a close dialogue with your doctor before and after the surgery. Fill your life with people who can support you and help you through this journey. Nothing is more important than that!

Thanks for letting me share my story with you.

Judy

021 Gotta Have Support!

This post is going to stray a little bit back into our chronological storyline and then come back to the present…

Ok, so back to the Dr. Appointment Blitz day. One of the things that was really emphasized to us was the need for support, and I know that we have talked about Making New Friends but here is where the rubber meets the road…

Now jump back to the present. Jimmy and I have been slowly building a great network of people that we can talk to and rely on for support. They have been amazing! Some of them are regular people that we see regularly, others are old friends, and still others have undergone weight loss surgery themselves.

These people have been encouraging us to eat healthy and exercise, but they have taken support a step further than just using their words! On Friday (Nov. 2nd), Jimmy will be starting his two week liquid pre-op diet, but he won't be alone. In order to support and empathize with Jimmy during this time, our support team has taken it upon themselves to arrange a rotation schedule so that at least one of them is doing the liquid diet with Jimmy every SINGLE day!

He will never be alone in his hunger or frustration. He can look at his list and he can see who his "diet buddy" is for the day and he can call them up and talk it out. We are super excited and touched by this amazing outpouring of support and love that Jimmy has specifically received in this area.

A BIG thank you to all our friends and especially to our support team as we prepare to enter the hardest two weeks in our lives to date.

Thanks again,

020 Grieving Jimmy's Lifelong Friend Food

Hey, friends! I am glad to see that you are hanging in there with us. I have been thinking about this blog post for quite a while now but I wanted to wait and write it while my frustration wasn't quite so great.

As you can imagine, the closer we get to the liquid diet and the surgery the harder things become emotionally. It is also a lot harder to stick to our regimen of healthy eating and exercise (we have actually been really bad about this the last week or so). From talking to other people I really knew that I should be expecting this. However, I totally underestimated how hard this stage would be!

Evidently, when you are facing a gastric sleeve surgery you actually grieve FOOD. Ok, please stop rolling your eyes at me. You probably could have told me that you saw that one coming a mile away but let me put my foot down and firmly tell you that IT IS HARD! You really don't get how big a part of your life food is until you look at it and say, "I may never be able to eat this again!"

As Jimmy began to grieve food he became moody, angry, emotional, and his thinking was isolated. There were many times when I know he had to be thinking that I couldn't even come close to understanding what he was feeling or thinking because I will still physically be able to eat whatever I want. But he's not alone…

The biggest struggle was trying to support him and encourage him that I do understand his sacrifices in small measure. I wanted him to know that I am with him in this. I eat with him and prepare our meals together. I will be eating the same things he eats--once he gets make to eating solid foods :) I know that he will miss pizza more than me but I am really going to miss pasta.

In the end I know that his sacrifice is way greater than mine but if he gets the fact that I know that his sacrifice is a big deal and I support him--no matter how whiny or angry he gets about losing food--then that is a victory for both of us!

For more information on the process of grieving food, please feel free to visit the resources listed below.  Since our world is revolving around food right now, the next couple of posts will be dealing with Jimmy's Pre-Op diet and preparation for the surgery.

More Resources:

• The 5 Stages of (Food) Grief
• Grieving for Food
• After Gastric Bypass: Some Tough Love on Grieving Food
• Grieving Over the Loss of My Friend Food

019 Jimmy's 3 Week Pre-Op Update

Hi, everyone! Today marks three weeks to the day out from Jimmy's surgery (November 16th). Yesterday Jimmy had to go for a check-up with the cardiologist to get the ok for surgery. Needless to say we had A LOT of waiting at the Cardiologist's office so we decided it would be a great time for Jimmy to record another vlog for you.

Hope you enjoy!

018 Portion Size Matters

Another of the appointments we had during our doctor appointment blitz was with a Nutritionist named Krystal Staggs. Let me tell you right now that Krystal is A-MAZ-ING! I know that she has really helped Jimmy A LOT! So much so that we have even set up additional monthly meetings with her so that Jimmy can talk about ways he can prepare himself for healthier living and what he can be doing now to gradually ease into the new way of eating he will have after the surgery.

The biggest realization that we have come to is that PORTION SIZE MATTERS. I would guess that about 90% of people are regularly overeating and they don't even realize it. It's not because they are "pigging out" necessarily but it is because of an ignorance of portion size. I about cried laughing when Krystal pulled out the little rubber piece of beef that was an ounce portion. It was minuscule compared to what is normally on my plate. When she held it out to us she said, "This is how much Jimmy's stomach will be able to hold right after surgery." Let me tell you that my jaw about dropped to the floor. I mean--come on--I knew that he wouldn't be able to eat a lot but this easily fit into the palm of my hand!

It was in that moment that I truly realized just how much I was overeating without even giving it a second thought. I know that Jimmy must have been thinking the same thing from the look on his face. So in addition, to setting some other realistic goals for ourselves--like not keeping chips or sweets in the house--we also decided to make a conscious effort to actually pay attention to the amount of food and the number of portions we were putting into our mouths.

Because PORTIONS DO MATTER!

017 Jimmy's BIG Dreams

Today you are in for a real treat! Jimmy is writing this post himself. Then at the end I am posting a photo collage of some of the things I dream of us doing after the WLS.

As promised, here is Jimmy's post of his big post surgery dreams…





Losing hundreds of pounds is a good thing. It will make life even more crazy than it already is. Christiana has asked me to write a blog post about things that I look forward to doing once more and more weight comes off. So since I like Top 10 lists, I thought it would be fun to do the:

TOP TEN THINGS I LOOK FORWARD TO DOING AFTER I LOSE WEIGHT OR TTTILFTDAILW for short.

Here we go.

#10. Go to more concerts. I like going to concerts but I don’t like traveling distances and standing for a long time. But losing weight means that I will be able to do both. It will nice to see that a band is playing within driving distance and not working about going to it. Plus this might mean that I will be able to attend some actual music festivals. Such as www.lifelight.org. Its only 5 hours away therefore I will be able to travel to it. Speaking of….

#9. Travel It will nice to not be hindered by being stuck in a vehicle or a plane or a train or a rikshaw uncomfortably as now. It will be nice to take trips to places that are off limits to me know like, I don’t know, apple picking or nascar races. That is the point. I can travel more easily.

#8. Paintball, lazer tag and other such. If I were to go PB or LT now I would be pretty pointless and useless. Serving as a very easy target. But once I become more mobile, quicker, sleeker, sneakier, more spy like, I will be a valuable to a team and more fun. Go ahead and lump Mini Golf in this category too. My wife always wants to go to mini golf. Oh and Picnics. Oh and playing basketball.

#7. Stand Longer. Might seem kind of boring and lame but true. Its annoying sometimes when you get stuck somewhere without a place to sit and you leave. Or having to take a chair to places where you need to be able to sit down. Or just simply to stand longer in the pulpit to preach. Either or. It will be nice to stand for longer period of times.

#6. Easier times at restaurants. There are certain places that we avoid simply because there are no tables, or the chairs are bad or there is limited space. It will be nice because we wont be as limited with this as we are now. Granted its not going to be there over night but it will be an improvement. Of course there will be way less eating out now. LOL.

#5. Discovering other fun activities besides eating out. Maybe hot air ballooning, maybe, maybe archery, perhaps fencing? Any of those and things I haven’t thought of yet. It will be neat to see what kinds of things Christiana will do that we don’t even know yet. I guess that is part of the excitement vs the depressing part of this. I got to focus on the things that I can do now vs the food I cant eat now. BYE BYE Capt. Crunch. (a little veggie tales reference for you)

#4. Going to the Theatre. Christiana and I both love the Theatre. We have only been once since we have been married. Why? Seating mainly. But again, that will be easier. I wont like dressing up but at least….

#3. Dress clothes more often. Do people even realize how expensive clothes for big people are??? Especially dress clothes, if you can even find them. I know that my lovely wife would love for me to dress up for often. Maybe even a dress shirt and tie. MAYBE! But I would love to be more like Corey Matthews of Boy Meets Wold and rock the Sweater vest some!! Again, more options. Clothes are still expensive but some are worth it like….

#2. Buying jerseys and sports clothes!! I always wear shirts and I never get to wear anything to rep my STL Cards or My UCONN Huskies. Well beside hats. I cant wait til I cant get that first Jersey or Uniform. Its going to be awesome. Also a nice plus will be WWE shirts. So I can walk around chanting YES YES YES YES to everyone. (like 3 people will get that. LOL)

#1. Not being embarrassed all the time. Overweight constantly fight self image issues. Since I view this surgery as very PRO ACTIVE it will nice to know that even if I am still a big guy (face it I will never be 150) I will know that something is being done about it and I can feel easier and better about myself.

Christiana's Dream BIG Collage:

016 Dare to Dream BIG

As I mentioned in my last post, we had a Dr. Appointment Blitz on August 10th. If you have no clue what I am talking about then feel free to read my last post “INSERT TITLE & HREF”. One of the appointments Jimmy had that day was with Dr. Taylor who is a local Psychologist who works with the WLS program at Heartland. As a part of Jimmy’s WLS team it’s her job to make sure that Jimmy is mentally prepared for this surgery and the lifestyle changes it will entail.

I think it’s really a no brainer that Jimmy was the most worried about his appointment with Dr. Taylor. I mean--come on--no one wants people to analyze all the things going on in their heads! Thankfully our appointment went really well and Jimmy didn’t have to lay down on any therapy couches :) One thing that we really did take away from our visit with Dr. Taylor was that Jimmy needs to dream big and think about all the things that he really is looking forward to/wants to do/wants to have that he was physically unable to be/do/have before and that this surgery and changing his eating habits will allow him to be/do/have now.

Dr. Taylor made a great point. She said that if he can think about and make a list of all the things that he wants to come as a result of this surgery then it will be easier to follow his doctors instructions and his new healthier lifestyle because he knows what he is doing this for. So when he is really tired and feeling lazy and wants to order a deep dish meat lovers from Pizza Hut instead of giving in he should say/think something like “I am choosing not to have Pizza Hut because I would rather be able to wear a UCONN Jersey.”

If you are planning to have WLS think about what you want to achieve through this surgical experience and make a list. Next time I will be sharing some of the things from Jimmy’s list with you!

Until next time!

015 Dr. Appointment Blitz

After completing the six months of doctor supervised weight loss, Jimmy was scheduled to go in for what we have affectionately deemed the “doctor appointment blitz”! Our blitz was on July 10, 2012. What it entailed were back to back visits with the Surgeon, Dietician, Physical Therapist, and Psychologist. Basically it was everyone you needed and wanted to see to finish getting your insurance approval.

The blitz lasted for approximately five hours. During that time we collected a TON of information, answered a plethora of questions and were given various tests to determine Jimmy’s physical and emotional/mental preparedness for his WLS. The best thing about the whole experience is that this team of blitzers will be helping Jimmy prepare for his surgery, file his insurance paperwork, performing his surgery (ok just the surgeon) and helping him with adjusting to a new diet and exercise program. So it was really great to get a chance to finally meet these people.

During our Dr. Appt. Blitz we also learned that for Jimmy’s safety and a possible transitional weight loss method, Dr. Hornbostel (Jimmy’s surgeon) would like Jimmy to consider doing the gastric sleeve surgery. It will help him to lose weight quickly without the complications of replumbing of the small intestine (on a person Jimmy’s size) that the gastric bypass would include. He is confident that Jimmy will do well with the sleeve and should Jimmy need an additional weight loss push in a year or two the gastric bypass will still be open to him since Dr. Hornbostel will be pursuing the gastric sleeve as a treatment for Jimmy’s acid reflux. The only additional thing we have to do to qualify to have the gastric sleeve as an acid reflux treatment is to have an EGD (esophagogastroduodenoscopy) to prove that Jimmy has a hiatal hernia which is causing his reflux. We even scheduled his EGD for July 17th before we left the office.

All in all, we have nothing about great things to say about Dr. Hornbostel and his team. They really took their time with us and made sure that we understood what we were getting ourselves into. They were realistic with us about the positives and the negatives of the WLS and they are prepared to go through them with us. All in all it was one of the best Dr. Appointments we have ever had.

Over the next several posts I will be talking about some of the specific appointments that Jimmy went through and our experiences through it all.

014 Getting Down to Business

Unless you are still in school, on disability or in between jobs right now you know what it's like to go to work on a regular basis. You probably also know how good or bad employers can be about allowing you to take time off of work. That's why it is important for you to carefully think things through when considering whether or not to do a weight loss surgery (WLS).

WLS effects more than just your body. It effects your emotions, your mind, your family/relationships, your job and so much more. If you are going to do a wls you need to realize that your near future includes many trips to the doctors office along with various medical tests and expenses. You have to be prepared.

One of the biggest areas of preparedness is your job. It's important to know your rights and to keep communication lines open between you and your employer. When I was hired at the St. Joseph News-Press, I was open with my potential employer about the hours that I would be taking off so that I could attend doctors appointments with my husband and the hours I would take off when he finally has his surgery. They were okay with my choices and appreciated my honesty. I know that not everyone has a job like that. That's why it's important for you to know about things like the Family Medical Leave Act (FMLA). Admittedly I don't know how best to explain it but you can learn more by talking to your companies human resources person and/or by visiting The Department of Labor Website.

No matter how easy or difficult your employer is to work with it is important to let them know how much time off you need, when you need it, and what they will be able to expect from you once your doctor clears you to come back to work after surgery. So get down to business and make a visit to your HR department. You need to know what you are getting yourself into before you dive into the deep end!

013 The Wonderful World of Water

Water is literally all around us. It’s in the ground, the air, and our bodies. So what the big deal with water?

In June, Jimmy and I went to Youth Camp. If you don’t know or don’t remember, Jimmy is a youth minister. This was his first ever camp that he planned from the ground up and we were both really excited to see how it was going to turn out. I was personally really excited that the camp had a swimming pool because I hadn’t swam in probably 3+ years. The thing about camp in Missouri during June is that it is HOT and it is HUMID. You just can’t get away from it! So to escape the heat you have to make sure that you are drinking plenty of water, and why not take advantage of that nice cool pool I was just talking about. That’s when it hit me that water is really great for Jimmy and me in two distinct ways.

When it comes to losing weight—especially when you are severely over weight—there are two really great things about water!

#1 Drinking water helps you lose weight. It flushes out your body and keeps you hydrated. Hydration allows your body to function properly and to get rid of toxins and excess water. I know that it seems really backward that you get bloated and hold on to water weight when you aren’t drinking enough water every day but it is true! So it you are interested in shedding the pounds and keeping them off make sure that you are fueling your calorie burning engine (your body) with plenty of H2O!

#2 Water exercises/aerobics are a wonderful way to burn calories that is easy on your back, legs, and joints. When you exercise in water you have the natural resistance that comes with being partially submerged but you also have a buoyancy (lift/floating) that reduces the weight your joints are bearing during the exercise. That means that you can exercise more efficiently with less pain and probably for a longer period of time than if you were to exercise outside of the pool.

Yes, Jimmy and I saw great results from drinking water. We were able to stay hydrated. We didn’t get sick or overheated, and we lost extra weight. Still I have to say that we both enjoyed the benefits of the pool the most. Jimmy got in a few days for about 2.5 hours each time. He had a blast and the next day he told me that he could really feel the difference that exercising in the pool made versus the walking he normally. So it was a great experience all around—even if a dog did run off with one of Jimmy’s water shoes!

012 Last Supper Syndrome

Just for you, I cornered Jimmy (well actually we were in the car) and made him make a vlog about what he has been dealing with food before he drove me crazy! So here it is...

011 Waiting is the Hardest

Whether I find myself waiting for a birthday, special event, doctor's appointment or date, I find myself impatient and easily frustrated. Why is it that waiting is so hard and yet we have to do so much of it in life? I truly believe waiting is the hardest.

In this case it was waiting for the six months of doctor supervised weight loss to be over! You get into a routine--eat right, exercise and repeat. Things get boring. There seems to be no end in sight (although you really know that it is only going to take six months). Everything seems to be moving so slowly! What to do?

Well, the answer is NOT to fall off the wagon. HOWEVER, that's where we found ourselves. We started slacking off and caught ourselves thinking more than once "oh we still have months left to…fill in the blank". Then you start to backslide.

In our case this resulted in a stern talking to from Dr. Weiderholt. At first we were a little put off by how forceful she was (especially Jimmy) but looking back on it now I can see that it was exactly what we needed to hear at that moment. If we thought for a second that she was going to call off the supervised weight loss then she knew that we would re-double our efforts to keep going. She knew that we want this more than anything and she had to make us see that even though we still had four or three or two months left to go before all the actual surgery appointments and insurance approval processes could begin that it was still important to stick with it.

Does that mean that we are now perfect and never ever backslide? NO! By no means! We are still human and very prone to ordering pizza when we are feeling tired or lazy but at least we know that are not in this alone and we will be held accountable for our actions and we know that we don't have to wait for that!

010 White Coat Syndrome

Have you ever experienced a severe spike in anxiety and blood pressure when you know you are going to the doctor or at the doctor's office? If so then you might be suffering from white coat syndrome. I personally didn't believe in this at one point and time. BUT then I started going to the doctor with my hubby, Jimmy.

Jimmy doesn't like doctors. He doesn't like needles, and he doesn't like waiting. All these things combined can make for a very stressful doctors visit. Especially when you combine a couple of those elements in the same visit. These things have a very real effect on his blood pressure.

I have been in a doctor's visit where they took Jimmy's blood pressure upon entering the exam room and found it to be high. Then upon his request they would take it after he had time to talk to the nurses and laugh things off and it has been as much as 15 points lower in both numbers.

If you are like Jimmy and the doctor is monitoring your blood pressure closely then you want to make sure that they get an accurate reading. Here are some things that you need to consider to get the most accurate blood pressure reading at the doctor's office:

• Are they using the right size blood pressure cuff?
• Jimmy has large arms because he is over weight so they have to use a thigh sized cuff to get an accurate reading on his upper arm.
• If they attempt to use a cuff that is too small then your readings will be high and vice versa if the cuff is too large.
• Are they taking your blood pressure in the same place each visit?
• Jimmy's blood pressure varies greatly when they take readings in his forearm versus his upper arm.
• Forearm readings (at least in Jimmy's case) are higher approx. 99% of the time.
• Have you considered asking the nurse to take a second blood pressure reading after you have had a few moments to get settled in the exam room?
• Answering the mundane health questions they ask every visit often takes your mind off the anxiety of the visit and helps you calm down.
• You may get a better reading if you have your blood pressure taken at this time.

Please remember that I am not a doctor but these are things that we have found to be true in Jimmy's case. Maybe you can find something in here that can help you too. Rest assured that White Coat Symptom is a very real thing and can drastically effect your blood pressure and heart rate.

Until Next Time,

009 So You Think You Can Dance?

So you think you can dance? No. I am not talking about the TV show. Got you there for a minute though didn’t I. Well I definitely didn’t think that I could dance--that is until the doctor wanted us to add some exercise into our budding healthy lifestyle.

I don’t know if you know this but people who are morbidly obese or just overweight (like me) get more than a little self-conscious when it comes to exercising in public. Go figure! It doesn’t matter if you are walking down the streets in your neighborhood or trying to lift weights at the Y there is inevitably that one person (usually an adult) that says or does something really obnoxious and inappropriate like “Look how big that guy is!” that makes them feel uncomfortable. *Side note: Adults should DEFINITELY KNOW BETTER!!! It still hurts when it’s a child but you have to give them a little grace because they are young. No such excuse for adults!* Whew! Now that I got that out I can move on.

Anyway, as you can imagine when you combine the physical stress of exercising with the emotional stress of what people may say or do towards you, it’s no wonder that overweight people don’t want to exercise! However...it can be done and in the privacy of your own home. One day Jimmy and I were talking about video games and we hit upon a great solution that works for us.

It’s Kinect! If you don’t know, Kinect is a body motion sensor for the Xbox 360 that you can use to play games such as Kinect Adventures and Just Dance 3. You may not think it’s true but let me tell you playing Just Dance 3 IS a workout. By the end of most of those songs your pulse it elevated and you breathing is increased by just putting in a little aerobic exercise. Plus you can judge how much effort you are putting into it by the score you are receiving in the game. Just Dance 3 doesn’t judge on pure perfection--especially set on the lower difficulties but it judges on the amount of movement and the relative timing to the song you are dancing to. So anybody--even a white-y like me--can do it.

Yes, there are other ways to exercise at home but it you are looking for a fun and interactive way to exercise I highly recommend that you try using the Kinect for Xbox360!

008 Our Journey Begins with a Fitness Pal

Our Weight Loss Surgery (WLS) begins...again...in December 2011. We actually visited and got established with Dr. Weiderholt in October but we missed the month of November so we basically had to start our consecutive six months over again in December. So for all practical purposes our WLS Adventure began in December.

Nothing much exciting happened right away. We were just getting established and setting the foundation for the insurance approval. Dr. Weiderholt wanted to know diet history, what our eating and lifestyle habits are like now (we established that pizza is Jimmy’s only recreational drug--the nurses thought it was funny!), and we set some goals for diet and exercise.

One of Dr. Weiderholt’s goals for Jimmy is to log all of the food he consumes using the app My Fitness Pal. Now I really have to sing the praises of this app for a second because I think it has really helped Jimmy to stick with it and get a more accurate picture of the amount and types of food he is eating.

My Fitness Pal has kept Jimmy using it because it is interactive and SUPER easy to use. Yes! We love that you can log foods by simply scanning the barcode on the packaging. I know it sounds lame but it makes entering foods easy and scanning the barcodes is fun. The other bonus is that they are making changes to the app to make it better all the time. So props to whoever invented and programmed the My Fitness Pal app. Keep up the great work!

The doctor also set the guideline that “If you bite it--write it.” Meaning that he should track every single thing that he put into his mouth no matter how big or small we make think it is. It was surprising how quickly all those little bites started to add up. No wonder we consume more calories than we realize!

By using this principle and the My Fitness Pal app, Jimmy is visibly able to see the calories he was consuming. It continues to help him get a grasp on the difference between good food choices and bad food choices that waste calories and leave you feeling empty. Knowing the difference has helped both of to start making healthier lifestyle choices when it comes to food.

If you are serious about being healthy and losing weight I URGE you to start logging your food. It may shock you to realize how many calories you are really consuming everyday. Plus you need to get a grasp on the amount of fuel you are putting into your body so you know how much you need to burn. I’m not trying to sell My Fitness Pal--because it’s FREE!--but honestly it can really help you have an easy and mobile way to track your diet and exercise.

Until next time...

Use MyFitness Pal for free by visiting www.myfitnesspal.com or download the free app.

007 Making New Friends

It's amazing how many new friends Jimmy and I have made since he started talking about having weight loss surgery! Some of them are friends of friends who had weight loss surgery and our mutual friends were like "Hey! You're having weight loss surgery…I know so and so who had weight loss surgery…You should give them a call!" Others have been people we have connected to through the internet, forums, and weight loss support groups.

I want to take this chance to introduce you to one of these awesome peeps. Hey everyone, this is Anna! Anna just had her weight loss surgery this year, and she chronicled her experience in video blogs (vlogs) which she later posted to YouTube where she was discovered by none other than Jimmy Mustion. Anna has graciously answered many of our questions and she has also agreed to allow us to use some of her vlogs on Jimmy Goes Gastric. I am excited to share some of Anna's journey and experience as we share our own.

Please keep in mind that Anna went through a different surgical office/program so some of the things you may see and hear in her vlogs (i.e. diet and exercise prescribed, etc.) may vary from what Jimmy and I are going thru. However, many of the physical and emotional experiences are probably going to be very similar. I say all of this to say that no two programs are exactly the same but it is great to get different experiences and points of view as you go.

I hope you enjoy and learn from Anna as much as Jimmy and I have!

Introducing Anna...

006 BCBS Pre-Approval Requirements

As I mentioned last post, we have Blue Cross/Blue Shield (BCBS) Insurance. I was going to tag all of this onto the last post and then I decided it would just be too much and more than a little overwhelming. Sorry to make you wait for it but rest assured that now you will get a more thorough answer to the insurance question.

Keep in mind that insurance coverage and requirements vary widely from one policy to the next. However, this is what Jimmy and I have been going through with BCBS. *Side note: I know that I haven’t mentioned this yet but we had considered WLS once before--about two years ago--and we had gone all the way through getting the insurance pre-approval before we backed out (due to circumstances beyond our control). So it was really nice to know basically what was going to be expected of us this time around which is why I think you will appreciate me sharing it with you*

The items below are the minimum necessary for approval of your weight loss surgery:

• BMI of 40 or greater OR...
  a BMI of 35 or greater with at least 2 co-morbidities.
*A Co-Morbidity is a disease that has been caused by excessive weight. Diabetes is one of many examples.

• Primary Care Physician’s Letter
• Active Participation and Documentation of non-surgical methods of weight loss.
• 6 consecutive months of a physician supervised weight loss program.
• 18 years of age (special consideration if under 18 with severe morbid obesity and special circumstances).
• Consult and recommendation from a weight loss surgeon.
• Psychological evaluation
• Nutritional evaluation

Policies Included in Coverage:
Blue cross Kentucky
Blue cross Virginia
Blue cross Wisconsin
Blue cross Ohio
Blue cross California
Blue cross Georgia
Blue cross Missouri
Blue cross New York Empire

Obviously this has all been a long time coming for us since we have had to undergo the six months of supervised weight loss. We will be talking more about this as time goes on, but now you have a better idea of what was required of us and what could possibly be required of you should you choose to pursue a WLS. Keep in mind that all insurance companies are different as is their coverage, but a good weight loss program/center/surgeon should help you collect and file all the insurance paperwork you need.

More Resources:

• Does your insurance policy cover WLS?
• FAQs about Insurance Coverage and Costs
• BMI Calculator

005 Insurance, Money and the Kitchen Sink

Last time we talked about the four main types of weight loss surgery (WLS) available. If you interest has been piqued then I am sure you are starting to wonder how much it’s going to cost you and what you may or may not have to do to get insurance coverage for a WLS. I can only answer these questions from our perspective and give you tips on how you can find out how these things are going to apply to you.

Let’s just go ahead and get the easy question out of the way...

Q: How much will a WLS cost me?

A: No one has an exact amount. It varies from person to person and hospital to hospital. However, for an estimate of the cost you will incur you should contact the WLS program/center/doctor you are planning to use. They should have a pretty good idea of how the money will come out in the end because they do this all the time.

Keep in mind that there are many factor that will determine the cost of your WLS:

• Surgeon performing the surgery
• Time spent recovering in the hospital
• Complications or lack of complications
• Number of care providers overseeing your case

Q: Will my medical insurance cover WLS?

A: Each insurance carrier is unique. Be sure to check with your insurance provider before undergoing surgery as the types of surgery covered and the requirements for coverage vary widely from one provider to the next. A good surgery program should help you to file your insurance paperwork and receive pre-authorization of coverage for your surgery before you ever schedule your operating room time.

Q: What are some common insurance requirements for WLS coverage?

A: I can’t tell you for sure about your insurance company but I can tell you about ours. But I am not going to do that until next time...

So stay tuned.

004 What kinds of Weight Loss Surgery (WLS) are Available?

WLS is pretty self-explanatory. It is a surgery that is a tool designed to help an individual lose weight. But you may be wondering what kinds of surgeries are out there. I am going to give you a brief explanation of the four surgeries that I am aware of, but remember that I am not a doctor. If you have any medical questions or concerns please consult your doctor.

WLS Option #1: Lap-Band

Lap-Band reduces the amount of food you are able to consume in one setting without removal of any part of the stomach. This is accomplished through the insertion of a band around the top part of the stomach which creates a smaller stomach pouch for food. This makes you feel full faster and longer as the band also restricts how quickly food can progress from your stomach to the rest of your digestive system. For more information about the Lap-Band please visit Lapband.com.

WLS Option #2: Gastric Bypass (Roux-En-Y Gastric Bypass)

Gastric Bypass surgery reduces the size of the stomach through the surgical removal of a large portion of the stomach. It also involves a redirection of the small intestine which bypasses the upper portion of the small intestine. In addition to reducing the stomach size the surgical removal of the stomach reduces the production of the “hunger hormone” which controls appetite. This helps you to feel full longer and to process food longer. For more information about Gastric Bypass please visit Roux-En-Y Gastric Bypass on Webmd.com.

WLS Option #3: Gastric Sleeve *Jimmy's Surgery*

Gastric Sleeve surgery removes a large portion of the stomach but leaves all of the small intestine intact as is. This still reduces the production of the “hunger hormone” and creates a smaller holding area for food entering the stomach but it causes fewer nutrient absorption issues because the small intestine remains fully intact. For more information about Gastric Sleeve please visit Gastric Sleeve Surgery on thebariatricsurgeryresource.com.

WLS Option #4: Gastric Bypass with a Doudenal Switch
(Biliopancreatic Diversion with Duodenal Switch)

The Doudenal Switch is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. The restrictive portion of the surgery involves removing approximately 70% of the stomach along the greater curvature. The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel. The common channel is the portion of small intestine, usually 75-150 centimeters long, in which the contents of the digestive path mix with the bile from the biliopancreatic loop before emptying into the large intestine. The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat. As a result, following surgery, these patients only absorb approximately 20% of the fat they intake. This is copied directly from Wikipedia as I didn’t know how to summarize it myself. For more information about Duodenal Switch please visit Doudenal Switch on Wikipedia.org.

I hope this helps to make you aware of the kinds of Weight Loss Surgeries available. Please consult your doctor if you are considering WLS.

003 Let's Go Back...

I realized when I was looking back at my last post that I talked about why obese people in general consider Weight Loss Surgery (WLS) but I didn’t talk specifically about Jimmy and me. So I wanted to stop and take you back...

Jimmy is 36 years old. He is 6’3” and a BIG guy. Many people can pinpoint the cause of their weight gain to a specific event or series of events in their lives. Jimmy once told me that he doesn’t remember a time when he wasn’t the “Big Kid”. I don’t think that could be easy on anyone.

Jimmy doesn’t believe there were any specific things in his life that caused him to gain weight (and of course there is the continuing genetics debate about weight) but that doesn’t mean his life was easy. He was raised by his amazingly wonderful grandparents--Grampy and Grammy--who lived in Boonville, MO.

Grampy and Grammy did their best to help Jimmy be healthy and active. He participated in just about every sport he was eligible to play. They made sure he ate his veggies (however few of them he may enjoy), and they took him to the doctor in the third grade when they were still concerned about his size. Nothing any of them did seemed to change the weight.

Jimmy says that it wasn’t until he had free reign over his diet and he could eat whatever he wanted that his weight truly escalated. Like most people in America, Jimmy didn’t make very healthy choices when it came to eating. By the time he really realized he had a real and serious weight problem things seemed hopeless to change.

I can attest from personal experience that when you can’t see a way out of your bad circumstances you often choose to continue in them instead of trying to make a way. So here we are now. It’s been 18 years since Jimmy left home to go to college and the spiral began and we are just now really, seriously trying to fight out way out of the pit. It’s going to be a long hard journey but we know in the end it will be worth all the blood, sweat, and tears.

002 Why Consider Weight Loss Surgery (WLS)?

I would hazard a guess that if you are reading this then you may have either had or be considering some kind of WLS. Therefore you are not the person that says “They can’t lose the weight because they are lazy” or “Why do surgery when you can lose it naturally” or “They are just looking for a ‘magic’ fix to their problem”. Those people DRIVE ME CRAZY! In some cases their questions might be valid but in the vast majority they are just wrong and their questions are inappropriate. Let me explain...

Most people are not aware that there have been medical studies conducted that have concluded that most morbidly obese people (anyone with a BMI 40+) are physically incapable of losing their weight naturally and keeping it off long term. These studies are the reason that insurance companies have decided to provide coverage for WLS surgeries such as the gastric bypass and Lap-Band. They realize that many of the people they insure will never be able to lose their excess weight without surgical assistance.

However, surgery never has and probably never will be an easy or magical fix. You MUST WORK to change your eating and exercise habits in order to receive the benefits of the surgery. “Failed” surgeries are the cause of many of the snide and demeaning comments like the examples I gave above. Really it is not the surgery that has failed but the people who have failed to commit to a lifestyle change that have failed to receive the results they were hoping to achieve. More on this later.

Jimmy and I decided to consider WLS because we realized that he needs help to achieve his weight loss goals. We are committed to making lifestyle changes that will make us healthier and will help to achieve and maintain long-term health and weight management. We are ready and willing to start putting in the work it will take to make those dreams happen. Join us!

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