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            WLS Center E-Newsletter 
            
            A 
            FREE publication fromhttp://www.wlscenter.com
 
              
            
            Hosted by 
            Barbara ThompsonAuthor of:
 Weight Loss Surgery:
 Finding the Thin Person Hiding Inside You.
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             | 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 doesn’t 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 children’s 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. 
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            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?
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              |  | 
              
              Upcoming 
              Telephone Seminar   
              
              Exercise: 
              You Can’t Reach Goal without It
               |  
              | Concerned that you are not losing the weight 
              that you want?  Then you absolutely must sign onto the 
              telephone seminar: 
              “Exercise: You Can’t 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, it’s 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, it’s 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! 
              FondlyMichelle 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
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                    |  | 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. 
            
             
            Karen’s 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 |  
       
        
        
          
            |  |  |  
            | 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 mother’s 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 |  
       
        
        
          
            | Permission to 
            Reprint |  
            | You may reprint any items from this newsletter in your own print or 
            electronic newsletter. But please include the following paragraph: 
            Reprinted 
            from Barbara Thompson’s 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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