Issue #208 May 15, 2011
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In This Issue

Hernia Surgery + Tummy Tuck

New Feature: Ask the Expert
Back On Track with Barbara
How Much Water Is Enough

Social Networking

Recipe: Crab Papaya Confetti Salad

Success Story: Heather Orosz

Hernia Repair + Tummy Tuck

Dear Barbara,
I had weight loss surgery 8 years ago.  I have been able to keep most of my weight off and fluctuate within a 10 pound range.  I have just been diagnosed with a hernia.  My question is, can I have my hernia repaired and possibly get a tummy tuck done at the same time.   Have others had success with this?

Thanks so much,
Ramona

Hi Ramona,
This was somewhat common a few years ago, but I have not heard of it recently. It was common when most weight loss surgeries were done as open procedures. The long incision would weaken the abdominal muscles and patients would later develop a hernia. The hernia repair was often done by the bariatric surgeon who would also do the abdominoplasty (tummy tuck).  With nearly all bariatric surgeries now being done laparoscopically, hernias closely following bariatric surgeries are no longer a problem.

The satisfactory outcome of a tummy tuck being done the same time as a hernia repair is dependent upon the surgeon.  Plastic surgeons do not repair hernias, so you would need a general surgeon who has some skill in this area.  The obvious advantage of doing this is that a major part of the bill would be covered by insurance as you will be having a hernia repair. This is why patients were often happy when they developed a hernia.

I donít recommend asking any general surgeon to do this, especially if you have a huge amount of skin to be removed. That is a major operation that is not without risk because so much tissue is being removed. For that you would need a plastic surgeon who is accustomed to working with weight loss surgery patients, and a surgery just devoted to that.

The best bet is to talk with your bariatric surgeon about this. They may know a surgeon locally who can do this, or your bariatric surgeon may do it. 

If you have had a tummy tuck done the same time as a hernia repair, please drop me an email at Barbara@WLScenter.com and let me know the details including what kind of surgeon did the surgery, the percentage that was covered by insurance, and how happy you were with the results.

New Feature: Ask the Expert

Join Barbara on Tuesday, May 17th at 8:00 pm Eastern as she talks with Dr. Eric DeMaria in the first of ďAsk the ExpertĒ series.  In this session we will look at:

  How does one define success after WLS?

  What are the success rates of the various surgical procedures?

  How common is it for patients to fail the various surgical procedures?

  When patients are struggling after surgery, what type of evaluation is needed?

  How often do patients who are struggling after WLS need more surgery?

Our focus will be on those of us who are struggling with their weight and through TalkShoe you will be able to type your questions directly to Dr. DeMaria and hear his answers. You can ďAsk the Expert.Ē Mark your calendar and join us!!! 

TalkShoe is a website that allows 2 people to talk while others can listen and type in questions. There is no charge to go to the website. With teleseminars, there is often a long distance phone charge, whereas this is free.

Go to http://www.wlscenter.com/ask_the_expert.htm for more information.

Back on Track with Barbara

Internet Mentoring Program

The Back on Track with Barbara Internet Mentoring Program really concentrates on lifestyle changes. Join our group and receive lessons via the internet and the support of others who are struggling just like you are.

Get Ready for Summertime Fun

Are you suffering from emotional eating and canít stop?
Are you grazing on carbohydrates and canít control it?
Are you lacking inspiration to lose the weight you have regained?
Do you feel that you donít know what to do now that you have had surgery?
Are you dying to be in better shape?

My Back on Track Internet Mentoring Program will give you the
support you need to get your weight under control.

View a FREE Lesson and Listen to a FREE Telephone Seminar by
clicking here and scrolling down to the bottom of the page.

How Much Water Is Enough?

Hi Barbara,
Even though I no longer suffer from diabetes, I still continue to visit with my endocrinologist every 6 months just to monitor my blood sugars and other things.  At my last visit I mentioned that I was a little concerned about an 8 pound weight gain.  He asked me questions about my diet and exercise and then asked me about my water consumption.  He told me that if I was drinking 8 glasses of water a day that I needed to stop.  It is a myth that we need that much water.  Our bodies can't properly disperse the water through our bodies correctly and that it causes our bodies to retain it and thus could be the cause of my weight gain.  I was very taken aback by this comment because from all I have heard and read, the water is vital to weight loss surgery patients.  He said that is completely false, and that I really don't need more than 3 cups at the most a day.

Could you please clear this up for me and suggest some links that I can share with him?  Or, is he right in this thinking.  I must confess, I am very confused.  On the one hand I have a professional telling me one thing and a weight loss surgery expert telling me something else.
Thanks,
Pam 

Hi Pam,
This is a very controversial question and scientists are split.

This is from the Mayo Clinic website:
ďThe average urine output for adults is about 1.5 liters (6.3 cups) a day. You lose close to an additional liter (about 4 cups) of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace your lost fluids.Ē http://www.mayoclinic.com/health/water/NU00283

However, there are other sites that say that the need to drink 8 to 10 glasses of water a day is a myth. And that we should drink only when thirsty.

Science Daily reported on a study that indicated that how much water we need varies greatly from one person to another. Here is the article: http://www.sciencedaily.com/releases/2004/02/040225071247.htm

Your endocrinologist may be right that drinking 8 to 10 glasses of water is unnecessary and may be harmful, however your bariatric surgeon will probably tell you that 8 to 10 glasses per day is necessary. I can only say that I try to drink as much water as I can, so I still subscribe to the 8 to 10 glasses theory.  I always have something to drink no matter where I go. This is just what works for me.

Sorry I canít be more definitive, but I canít do better than the scientists who are split on this issue.

Social Networking

I am posting on my blog again and my Facebook Group, Weight Loss Surgery and Obesity Concerns, has really taken off. If you would like to join very lively discussions about weight loss surgery and living life afterwards, and concerns about obesity, my Facebook page is where you want to be.

My goal is to get people talking about obesity in general and specifically, weight loss surgery.  The interaction of people from all over is providing education and support to those who have interests and concerns about their weight.

I have always tried to answer my email questions in this newsletter, but I can respond to your questions more quickly by using my blog and Facebook.  

I welcome you to join in on the discussions about obesity and weight loss surgery by joining me on the pages below.  I have also included buttons at the top of this and all future newsletters that will allow you to share my newsletter with your others in your social network.

Barbara Thompson's WLS Private Facebook Group

Start a conversation by making a post.


Barbara Thompson's WLS Blog


You can subscribe to my blog so that you will receive a notification by email when I make a new blog entry.  You can find the subscription box on the right of the blog page.

Send your questions, suggestions, and general input to me at Barbara@WLScenter.com and I will include it in future blog posts as appropriate.

Recipe:
 Crab Papaya Confetti Salad
The following recipe is from Chef David Fouts' cookbook.  You can get this recipe, and many more, by ordering  Chef David's cookbook here.  It is a great salad recipe that provides nearly Ĺ of your protein requirement for the day.

Crab Papaya Confetti Salad

Dressing:
2 tablespoons olive oil
Ĺ teaspoon garlic powder
2 teaspoons Dijon mustard
Ĺ teaspoon black pepper
1 tablespoon lime juice
2 tablespoons fresh parsley, chopped finely

Directions:
Combine dressing ingredients in a bowl. Refrigerate and set aside.

Salad:
1 pound crab meat, canned or in pouch
2 cups mixed salad greens
1 cup canned low-sodium black beans, rinsed and drained
ľ cup canned corn, drained
1 cup canned papaya, chopped

Directions:
1.  In a large bowl mix crab meat, salad greens, black beans, corn and papaya.
2.  Pour dressing over salad; mix and serve.

Serves 4

Nutritional Information per serving:
260 calories, 9 grams fat, 20 grams carbohydrates, 4 grams fiber, 29 grams protein

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

Success Story:
Heather Orosz

I want to offer Heather Orosz a special thank you for sharing her story with us. Here is her story:

Dear Barbara,
My name is Heather Orosz. I am 24 years old and had gastric bypass surgery on February 17, 2010. Here is my story:

My whole life I have been overweight. Some can say it runs in my family, others may say life happened. The first time I can remember being teased because of my weight was in pre-school. I still remember his name. It was Pablo. It was a very tragic time for me, and to this day, 20 years later it still hurts.

The teasing continued whether it was on the bus, in school, at the store, you name it, it happened. At the age of about 10, I went on my first ďdietĒ called Herbalife. I remember the pills and shakes being disgusting, and I couldnít understand why I was the only kid having to do something like this. I canít remember a very big success rate, but from then on I was always on a diet. Nothing seemed to work, and the diets that did, only lasted a few months. If I lost weight, I gained it all back, plus some.

I remember in middle school weighing 225 pounds, and having to weigh myself in front of my classmates. It was very embarrassing. I wondered why I had to be the big girl. Why did I have to feel so trapped in my own skin?

I remember in high school my weight started fitting my body a little better, but I still could barely fit in the desks in school, and I was still teased and laughed at. I started drinking at a very young age, because I wanted to escape the thoughts racing through my mind. I even tried drugs. Nothing seemed to take away the pain I was feeling inside. During high school, I was admitted into the psychiatric ward of our local hospital. I began to cut and burn myself so that I would focus on the pain I was feeling on the outside, rather than the pain on the inside. I felt like dying would be the only way to rid the pain. I could no longer endure the hurtful comments, the laughing, and teasing I had been going through since I was four years old.

It became normal to only be able to shop at one store, Lane Bryant, because no other store had clothes that would fit me. I had gotten up to a size 26/28 shirt and pants. Even those started to feel tight. I began to think to myself that I was in the biggest size there was, and what on earth was I going to do? I realized that something had to be done. 

In February 2009, I found out about weight loss surgery which sounded like it might help me. I called my insurance provider, and unfortunately they didnít want anything to do with the surgery. They even told me if I did end up paying for the surgery out of pocket, and I were to have any complications, they would not cover any of those expenses either.

It was a big let down to me. I wondered why God was making me struggle so much with this. Then I realized that maybe it wasnít the right time. Maybe I needed to get something right in my life. I realized that if anything were to happen, it needed to be on Godís time, not my own.

A year went by, and my Mom discovered that if I were to become a full-time student, I could then be on her insurance. Her insurance covered the surgery. I never thought about going back to school. I always hated school, because of all the teasing I had gone through. I was made fun of my whole life. I was therefore a little iffy at the thought of having to deal with that again. However I quickly enrolled, and in January of 2010 I got on my Momís insurance.

One day as I was leaving work, I noticed that my doctorís office had called. I listened to the message, and couldnít believe it. They had me scheduled for my gastric bypass procedure February 17, 2010. I was shocked. Every emotion I could possibly have raced through my head at the speed of lightening. I was so excited!

I had one month to prep for surgery. I had to quit smoking, something I had been doing since the age of 15. I started on Chantix, and a week later I had quit. Itís amazing what you are capable of doing when you put your mind to it. I had to go on a 2-week liquid diet. I had to see the dietician and the psychotherapist. This was a huge decision that I was making. I was 358 pounds, and sickened with myself by what I had done to become that weight. I was ready to start my life over.

February 17th came. My surgery was scheduled for 7:30 AM. I had never had surgery before, so I was very nervous. I knew I had to suck it up and do this for me, and no one else.

I remember waking up after surgery, in pain, and thirsty. I slept a lot. The next day I had to get out of bed. Whoa, talk about owwy!  I did it though, and took each minute as it came. I slept more, and wasnít in the best of moods, but I think thatís expected. The next day, I finally got to go home. My recovery was slow. I think it was just a huge shock to my body. Also I wasnít eating anything, which made me very weak.

Six weeks later I finally made it back to work. I was still a little sore, but on the road to a wonderful life. The weight was falling off. Although I couldnít see it in the mirror, I was reassured by everyone I came in contact with.

The months went by, and the weight just kept falling off. The beginning of February 2011, I went to bed and felt this really bad pain in my stomach and back. I felt like I was having a heart attack. The next day, I went to work, and the pain came back. I ended up leaving work and going to the emergency room. I explained my symptoms, and they took an ultrasound of my gall bladder which showed multiple gall stones. I was scheduled to have my gall bladder removed on February 16, 2011.

An unexpected emergency came up that my doctor had to take care of. I was waiting in the hospital to go in and prep for my surgery, when a nurse came out and told me that my surgery was cancelled. I was worried, scared, and in pain. I just wanted my gall bladder removed. Luckily, my doctor was able to reschedule my surgery for the next day, which was the one year anniversary of my surgery. I had lost 150 pounds and was ready for my gall bladder to be removed. Everything went well, and I healed nicely.

I am now doing things I never thought I would ever do. I love shopping, and I used to hate it. I am more active than I have ever been. I no longer go home and go to bed after work. I am so thankful that God gave me a second chance at life. And I am so happy that I was blessed with such a great doctor and medical staff. I still have my bad days, but doesnít everyone?

I started at 358 pounds. I have lost 160 pounds in 14 months.  I now weigh 198 pounds. Iíve gone down 6 shirt sizes, and 8 pant sizes. I was in a 26/28 shirt, and now am in a large or medium size. I was in 28 pants, and now Iím in 14ís. Life is so much better.

Heather Orosz
heathero@1stcomm.org

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.

Congratulations Heather

Drink Your Vitamins

Isotonixģ
Supplements

OPC-3ģ, 
CalciumPlus, 
Adv.B-Complex,
Vitamin D,
and more

Chew Your Vitamins

The OAC is the ONLY non profit organization whose sole focus is helping those affected by obesity.  The OAC is a great place to turn if you are looking for a way to get involved and give back to the cause of obesity.

There are a variety of ways you can make a difference, but the first step is to become an OAC Member.  The great thing about OAC Membership is that you can be as involved as you would like.  Simply being a member contributes to the cause of obesity.

 

 

 

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

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