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.

OK I admit it. I’m cheap.  It still bothers me to pay $1.15 for a bottle of water in a vending machine.  I still think water should be free.  Yet I don’t think twice about paying that same amount for a bottle of diet soda which is not good for me.  Go figure!  I need to change my attitude about bottled water and my research on bottled water has helped that. Somewhat!

This month I am continuing the series on water and am including a fun activity for your support group to try. See the article below.

Take a walk down the soft drink aisle of a grocery store and you will see a growing section either at the end or taking up a major portion of an aisle.  It is the bottled water section. Bottled water is increasing in popularity, so much so that in 2002, we spent $7.7 billion on bottled water in this country. If you number among the more than 50% of the population that drinks bottled water, ask yourself why.  Is it because you feel it is purer or safer? Or do you buy it for the taste or the convenience. Be a responsible consumer and find out in the article that follows what you are buying.

Bottled water is regulated by the Food and Drug Administration, well usually! It is true that the FDA sets strict guidelines for bottled water, but those guidelines only apply to bottled water that crosses State borders to be sold, and 60% to 70% of water is sold within its own State.  

Here are the different kinds of bottled water and there really is a difference: 

Spring Water – It really does come from springs, but only if the word “spring” is stated on the bottle.  A spring is an opening in the earth through which water flows naturally. However, the water bottlers are permitted to drill a hole or well to tap into the spring, but the well cannot keep the water from flowing naturally. The “Preserve the Free Flowing Spring advocates” apparently won that battle!

Municipal Water – Guess what, 25% of bottled water is tap water. However, the water must be filtered and processed.  If you see a bottle and it says “purified” water, it is tap water that has been filtered.

Artesian Water – This is water from an artesian well or water that flows above the water table.

Mineral Water – This water must have a minimum proportion of dissolved minerals in it occurring naturally.

Naturally Sparkling – This water must, in fact, be from a natural source that is carbonated.  It cannot have carbonation pumped into it.

Glacial Water – This does not have to come from a glacier.  I guess it can come from anywhere – go figure!

What to watch out for:

	Don’t look at the picture on a bottle.  Pictures are not regulated, only words are. A bottle of municipal water can have a picture of a pure flowing spring on it that has nothing to do with the contents inside. Don’t be fooled.
	Select national brands so they are regulated by the Food and Drug Administration. Only when water crosses State lines do the federal regulations come into play
	Don’t drink a bottle of water and then refill it without cleaning it out well.

Try a taste test in your support group:

Write a category on a slip of paper (mineral water, purified water, spring water, etc.) and have each person buy a bottle or two from that category. That will certainly get people to read labels. Also have someone bring your own local tap water in a bottle. Then have a blind taste test in paper cups and have people vote for their favorite water. Write up the results and have someone email them to me at Barbara@wlscenter.com and I will post the results! You might be surprised.  Many people actually prefer their own tap water because it is what they are accustomed to.

You have had your surgery and are starting to look really good.  You have taken care of yourself on the inside, now it is time to take care of how you look on the outside. It’s time to take care of your skin which is actually the largest organ of the body. 

If you are 35 years old or older, you are probably starting to see lines, scaly or dull skin.  You are feeling better than you have in many years, yet your skin still looks how you used to feel before surgery.

I have been using a fantastic anti-aging skincare product and I mention it to you because I have had so many people comment on how good my skin looks ever since I have started using it. The basic system contains three products, a cleanser, a firming activator and a moisturizer.  Four additional products provide solutions to specific skin problems.

Click on the banner below for more information and to order.  All orders placed through this special website will receive a 20% rebate check through May 15^th.

If you have any questions, call my office at (877) 440-1518.

Question:

Dear Barbara,
I am still pre-op.  The closer I get to the probability of the weight loss surgery really happening, the more concerned I am about morbid complications including death.

I have discussed this with my husband, and with the surgeon. When I mention it in chat rooms I often get rather angry responses, like I "should have" figured that out by now. That is not much help.

I have had several types of surgeries in my lifetime, and waiting for surgery has always been the hardest time.  Concerns about "what if this is the time I don't make it?" surface, big-time. Doctors and counselor have always reassured me that this is normal and I'll get through it. 

Some of my guilt feelings come from having been raised a Christian and how dare I be questioning some of that now?  I also worry about what would happen to my cats if I were gone?

Most insurance companies and 99.99% of the public see weight loss surgery as elective.  So could this be considered by some as a short-circuit suicide if I died?

I know some of that is unreasonable thinking, but it happens.  It is human.  Since this surgery really still is considered high-risk, and, since I still have the stressful job of telling my family, could you please help me (and lots of other readers) how to deal with this whole morbidity/mortality issue with weight loss surgery?  Thanks.

It is okay to use this in your newsletter, if you think it would help others. But please no flaming. Thanks.  Been there, gotten that.

Lauren Merryfield
res0zoyz@verizon.net

Answer:

Dear Lauren,
Absolutely no flaming here! I never do that.  Actually you sound so much like me before my surgery.  I was absolutely terrified, so I can certainly understand how you feel.

What may help is to understand the risks of the surgery through some facts.  In a 2001 study of almost 11,000 patients the International Bariatric Surgery Registry found that 93 % of patients had no complications whatsoever. Of the 7% that had complications, they ranged from minor complications such as dehydration, hernias and ulcers to major complications such as a GI leak, cardiac arrest and respiratory failure. The major complications are often the result of the patient’s health going into the surgery.  A rate of 93% with absolutely no complications is very good indeed.

As for the risk of death, the mortality rate is 1 in 200. The younger and the healthier you are, the less likely you will encounter complications.  So your overall health is a factor.  Another factor is your surgeon’s experience.  Statistically, you are much safer having your surgery performed by a surgeon who has done more that 100 surgeries.  There is definitely a learning curve.

It is not true that the insurance industry considers weight loss surgery elective.  They would never cover it if they did.  The National Institutes of Health endorses the surgery as the only method for those of us who are morbidly obese to be of normal weight. They set the guidelines and the insurance industry follows those guidelines.

Another consideration is how at risk you are staying morbidly obese.  There is an ongoing study being done in Sweden. They reported on the study after 6 years.  It is a huge study involving 2,000 morbidly obese people.  One thousand in the study had weight loss surgery and the other 1,000 dieted.  Of the 1,000 that had surgery, 3 had died after 6 years.  Of the 1,000 that dieted, 27 had died after 6 years. You are much safer being of normal weight than staying morbidly obese.

I hope that these facts have helped you.  I would like to invite people to send you words of encouragement.  And knowing how kind my readers are, I know that no one will flame you!! Take care.

If you would like to offer Lauren some words of advice or encouragement, email her at res0zoyz@verizon.net. She would like to hear from anyone else that can offer her some encouragement. 

If you would like to ask me a question and agree to my sharing it in a future e-newsletter, send it to me at Barbara@wlscenter.com and indicate “E-newsletter Advice” in the subject line and mention that I can use the question in the e-newsletter somewhere in the email.

      Shrimp Dip

Here is a great basic recipe for shrimp dip. I got the idea of dips from David Fouts, the bariatric chef when we did the telephone seminar together called “It’s All About Food.” In the telephone seminar, David mentioned that dips are a great source of edible and really delicious protein from your pureed stage on.

For other great cooking ideas, get a copy of the telephone seminar on CD at http://www.wlscenter.com/Teleseminar/ChefDavid/ChefDavid.htm

Shrimp Dip

1 cup of sour cream
1 package (3 ounces) cream cheese, softened
1 envelope dry onion soup mix
1 can (5 ounces) shrimp drained and chopped very fine
1 Tablespoon chopped pimento (optional)
1 Tablespoon green pepper finely chopped (optional)
Mayonnaise, enough to make the dip and consistency to your liking

Mix all ingredients together and eat with very thin crackers or, better still, with raw vegetables. Use the lite versions of sour cream, cream cheese and mayonnaise to make this a lower fat and lower calorie recipe.

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

I want to offer a special thanks to Marisette Edwards. Here is her story:

Dear Barbara,
It has been just over a year since I had my RNY gastric bypass surgery, so I guess it's time to share my success story with you and your readers.  I can't believe the year has gone so fast!

At the end of April, 2003, as I was thoroughly chewing my ¼ cup of cottage cheese three weeks after my Roux-en-Y gastric bypass surgery, I watched an Oprah show on people who lost significant amounts of weight without surgery (emphasis Oprah’s).  Boy, did that make me feel like a slacker – not much change from the way I’ve felt about myself for much of my life as far as weight was concerned.  I still struggle with the nagging feeling that I should have been able to do this on my own.  But first, here is some history...

Like many of the people I talk to in my support group, I always struggled with my weight and lost my battle during my pregnancies, gaining 30-50 pounds with each.  I was only able to maintain a low weight in high school and college by forcing myself to eat a very small amount of food (roughly equal to what I eat now post-surgery; only now I have the help of a tiny stomach and don't have to make myself do it).  I’ve spent decades trying to lose weight the “right”, slow, “better life-style” way.  I worked hard at it, such as the 15 months I exercised 6 hours a week until a back injury forced me to quit.  (I had lost 15 pounds during that time, so only another 10 or so years of that would have gotten me to goal).  I found out that I had degenerative joint disease in my back and was told losing weight might slow down the progress of the disease.  Having watched my (normal-weight) father suffer through three back surgeries, I felt it had come to a choice between surgery now or surgery later.  I also felt that my system was a little like the heating system at work – there was no way to tell exactly why it was running hot in spite of lowering the thermostat, but until a cause could be found there were mechanical ways to change the temperature.

I spent months researching weight loss surgery and surgeons to determine who would be most qualified to perform such risky surgery on me.  Then I spent another nine months meeting the criteria set forth by the insurance company and my surgeon.  Like you, Barbara, I decided Dr. Phillip Schauer was the best of the best, and he is exactly as you describe in your book.  By the time I had the surgery, over a year had passed since I admitted to myself that my health was deteriorating and there was nothing more I could do on my own.  Dr. Schauer made it clear to me what risks I was taking as well as the changes in exercise, eating, and vitamin regimen I would need to agree to.  My last comment to him in my pre-op appointment was, “I feel kind of weird doing something this drastic to myself when there’s nothing really wrong with me.”  He replied that the obesity was already doing damage that could be measured in my blood pressure, joint pain, and asthma, and it was most certainly going to cause more problems later.  Having the surgery when I was relatively healthy was ensuring the lowest risk and the highest chance of reversing the damage.  He emphasized that obesity is recognized by the National Institutes of Health as a chronic disease and with 120 pounds to lose I only had a 1% chance of succeeding at losing the weight permanently on my own.

I started out at 266 pounds and size 24.  I’m now below 160 pounds and size 8-10.  I go to the gym regularly – something I couldn’t maintain before because my extra weight caused me to get hurt and end up sidelined, only to regain any weight I had just exercised away.  I can go kayaking with my son now that my butt doesn’t get stuck in the kayak anymore.  I can walk 4-5 miles without pain where before I could only walk 2 before my foot and knee would get unbearably sore.  By the way, I spent most of those 2-mile walks pre-surgery discussing with myself if I should really go for the surgery. I must have looked pretty batty to my neighbors.  My blood pressure is lower without medication, my asthma is much better controlled, my joint pain is improved, and I sleep better than I ever imagined I would again. The only vitamin deficiency I have is an iron level too low to give blood. 

As far as eating, I can now eat just about anything but my old favorite, General Tso's chicken.  It is deep-fried and sweet – a deadly combination for the pouch!  My tummy has trained me to prefer grilled meats, thank you very much.

Now back to that nagging feeling that I should have been able to do this by myself.  The media seem to be having a field day with weight loss surgery.  Either people are trying to have it in spite of not meeting the criteria, or obese people are like smokers, choosing a lifestyle they know is unhealthy and then blaming others for their problems (never mind that one doesn't NEED cigarettes to stay alive).  The media love to point out that we're a nation looking for a quick fix and weight loss surgery is today's answer.  Even though this may be a nation of people looking for a “quick fix,” weight loss surgery is not in that category.  That is sort of like saying having a baby by cesarean section is an easy delivery.

For all the extremes mentioned by the media, there are many more people who agonize over whether to have the surgery and come to the decision only when something happens to drive them over the edge, like being prescribed just one more medication, finding out they have diabetes, or finding themselves letting the weight keep them from doing what they want to do.  These are people who learn about all the risks, learn about the surgery itself, attend the support groups, and do their best to do the right things afterwards to maximize their health.  Oh yes, and we may end up looking better, too – but our main focus is improving our health.

Sincerely,

Marisette L. Edwards
Glenshaw, PA

I’m getting low on success stories, so if you are 1 year or more post op and have a story to share and hopefully before and after pictures, please send your story and pictures to me at Barbara@wlscenter.com so that I can include them in future issues.

Be part of 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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