Weight Loss Surgery Directory

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eat and take vitamins on a regular schedule

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Surgeon Testimonial

Raymond G. Washington
From the first time I met Dr. Washington at the 04/12/2010 info session in Asheboro-NC, I knew he was the surgeon for me.

I instantly connected with him, hung on to his every word, and trusted him with my life! My husband was with me and felt the same way.

Over the course of my journey, my respect and appreciation for this Dr. has only improved. He employees a wonderful, thorough, hard-working staff across the board. His work consists of more than bariatric, he performs many types of surgery, and works closely with cancer patients. Washington strictly emphasizes pre-surgery patient eduction as well as post-op aftercare and maintenance. He does not view any office visit, phone call, or concern as silly or non-relevant.

Both surgical competence and bedside manner are phenomenal. I am thankful to Washington for choosing, and his family for supporting, this career path. His work saves lives, prolongs life, heals. He is more than a great person, more than a great surgeon. I am so thankful I found this Doctor.
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for_my_kids's Blog
for_my_kids's Blog


Sometimes, I just have to share...
on March 22, 2013 5:41 pm

I saw this quote on Facebook recently & didn't really give it more than a nod...at first.  Later, the words just kept coming back to me over and over again.  Why had this random thing struck such a chord?  Struck hard enough that I am sitting here tonight, posting about it.

So let's just break this down a little.  Just focusing on the last word "nothing"...this word has vast, deep, and wide ranging definitions.  What IS the "nothing" in this quote?  Emotional nothing, do you know what it feels like to be emotionally deprived?  Physical nothing, do you know what it feels like to be physically deprived?  Deprived of what - basic needs or material wants?  Stay with me, if you will, I'll try not to go through too big of a psychological worm hole.

"...because I know exactly how it feels to have nothing"...wow, powerful statement.  To have nothing:  no love, no shelter, no food, no companionship, or what?  If these words strike a chord in you, what is your "nothing" that you have felt?  I'll answer for myself.

Today -I CHOOSE to be giving, in a pay-it-forward manner (meaning I give to others freely with no hidden agenda in my back pocket), because I can relate to their situation...does not matter the situation...I can relate on some level.  How?...keep reading...

I deeply know real feelings of loneliness, desire for acceptance, the wish to have someone anyone hear my needs and my problems...but have no one to lend an ear...or at least I FELT there was no one to lend anything not even a shoulder.  (Trust me, I could go on & on about just how deeply certain "nothings" resonate within this bariatric body & mind!)

In my past life, I "gave", to fill my own void of emptiness.  In my old lifestyle, the "nothing" would have been defined as my own emptiness.  To the tune of 401-lbs.  Truth.  During this period of my life, I gave & gave & gave to others until there was nothing left to give myself.  I did this as a form of denial, self-rejection, a display of self-sabotage because I believed I was not worthy of self-love.  I was rejecting my emotional & physical needs, demonstrating an underlying belief that:  other people, other situations, were more important than ME - so I gave my attention, my time, my commitment, my loyalty, my heart, my blood-sweat-tears to many other's:  feeding their drama, causes, needs, desires, solving their problems first, above all else.  This self-abuse cycle was not filling any void or providing true gratification, so I turned to food.  Food GAVE me everything I thought I needed...and all the extra weight...right along with that emotional sheepskin.

Fast forward to my life now, the healthy fulfilled life I am rebuilding, and I say:  I CHOOSE to give, not because I have ANYTHING special, but because I know how to EMPATHIZE.  People just want to be heard.  They want and deserve to be validated.  In some ways, "giving" validates me, it still makes me feel good.  Difference is, today, I provide for ME first.  I am worthy.  I am important.  I am worth loving.  When my cup runneth over, there is plenty to share with others!!!

I love & hate this quote at the same time.  My career profession is Customer Service.  I am good at it to.  I spend 8 to 10 hrs a day "giving" to someone in one form or another, doing, pushing, striving to solve issues for other people and departments.  I CHOSE to build a career in Customer Service, so yes, everyday I "give".  But over the years, the WHY I make the choice to give continues to evolve.  No longer am I "giving" to hide from myself.  Today I give (my advice, my knowledge, my time, my silence, my hugs, my attitude, my drive), in hopes that I make a real difference in someone's day or their overall situation.  When I lay my head down at night, I am not filled with emptiness -that dreaded feeling of "nothing" does not loom over me.  I am filled with the knowledge & the belief that I am a good person at my current weight and I was a good person at my highest weight.  My loyalty & my heart now belong to ME, those are things I give to myself.

Well, folks, that's my rambl'n words for this posting.  Watch out for those Facebook "inspirational" quotes...they may very well spark a storm in you!!!

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Yes, I am still in the game, 2.5yrs out!
on March 14, 2013 4:38 pm

Not posting alot here...seems the further out you get...the less questions you have and the more time you spend getting out and involved in life again...what I mean is, I have moved away from the research and learning mode.  Now I am in maintenance and sustainability mode.

Year 1 = Honeymoon, losing all the time, loving it.

Year 2 = Adjusting to a new goal, no longer weight loss.  It becomes a goal of NOT gaining.

Year 3 = Living. Making good choices everyday!

Still maintaining a 200+ pound weight loss.  Speak motivationally at Weight Loss Seminars for my Surgical Group.  Have 1 official billboard up in Aberdeen-NC & soon to have 5 more up in other NC cities.  Pretty awesome!

A REALITY CHECK, PLEASE, DO YOURSELF A FAVOR & CLICK THIS LINK:

http://bariatricfoodie.blogspot.com/2013/03/will-i-really-be-able-to-maintain-after.html

 

 

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Bariatric Surgery in North Carolina (NC)
on January 17, 2012 7:26 pm
For those who would be seeking surgery in North Carolina

For those who have had surgery and would be seeking a Doctor to visit

If you live in NC, you need to visit these two sites:
  **1st one is the main hospital website, the link is specifically to patient videos, mine is under Nicole Trembley
  **2nd one is the NEW website just launched, the link is specifically to the patient testimonial page, where my story is published - this is an excellent program with great staff and limitless resources!!!

http://www.firsthealth.org/Specialties%20&%20Services/Bariatric%20Center/hear-from-patients.asp 

http://www.ncweightlosssurgery.org/benefits-and-risks.htm#patient-testimonials 

Check them out!  Good luck to you, or congratulations to you, or welcome aboard, whatever the occasion, I am just happy to see you here!
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Things I Can Do Now...
on November 30, 2011 4:52 pm
 ...that I could not do comfortably...or at all pre-bariatric surgery...

Wear high heel shoes/boots
Sit in any public chair (picture a waiting room)
Take a bath in my own tub
Wear a seat-belt
Wear a belt
Wear a cami (one of my favorites)
Swing in a park
Climb through a jungle gym with my kids
Exercise for 20+ minutes
Sit in a booth
Sit at a picnic table
Sit in the backseat of any vehicle
Ride a horse
Mingle, blend in, at a club or any social event
Register a weight on the dr's office scale
Wrap a bath towel around myself
Push my kids in a stroller without getting winded
Carry my kids in my arms without getting tired
Share a chair (think 2 people in a recliner)
Wear clothes from the Mall (think Express or NY & Co.)
Navigate a public restroom (not one of my favorites)
Shop from the LL Bean catalog (still haven't done that yet, but at least I can!!)

I can do all these things plus a million more unlisted, thanks to a deep drive, will, and commitment to change my life.  Bariatric surgery was the tool, I am the success!!!

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Transitions - 15 months post op
on November 18, 2011 7:40 pm
Lots of things, big and small, have happened since my 1yr milestone.  I have certainly been more socially active, been getting out and about more so now than ever, with my family of course.  And there have been a couple of girls nights out, but nothing too late.  I achieved a promotion at work.  I feel good about myself overall.  I have had a great time, enjoying my new body and energy level!!

The honeymoon phase is definitely over.  The burning question on my mind is:  how do to transition FROM losing massive amounts of weight, TO maintaining what you have left..AND being happy with the situation?  Answer:  Have not figured it out yet.

First 12 months, I lost an average of 13.5lbs per month.
Month 13, I lost 5.5 more pounds.
Month 14, I lost 3.5 more pounds.
Month 15, I lost 2 more pounds.

The path of weight loss is coming to an end, am I ready for that, honestly?  Answer:  I'm not sure.  I want to be ready.  I am happy with my current weight, my current clothing size, my current health status...BUT the scale still drives so much of my "measure of success".  When I stop loosing, will I consider that failure and completely sabotage myself right back to 395+ lbs.  OK, a bit on the extreme side, but can you see my thought process there?

So, how does a bariatric patient transition?  Somebody please send me an owner's manual.  Or am I writing my own everyday, everyday that I wake up and make decisions to eat "right" and exercise and stay positive and keep living the bariatric life?

My grocery list is still the same as what I posted before, I have added a few carb based options into my diet:
Kashi TLC Chewy Granola Bars (6g or more of protein & 6g or less of sugar varieties)
Kashi Snack Crackers (cheese & honey sesame varieties but never a whole serving)
The occasional bottom piece of a mcmuffin from McDonald's (only half of that bottom though)
100 calorie bag of popcorn (rarely indulge, but it's on my grocery list now)

Another question:  Now that most of my excess weight is gone, do I need more calories in a day just to maintain a healthy energy level?  During my 1st 12 months I barely hit 900 calories a day.  Now I can consume 1200 to 1500 in a day no problem.  I know one cannot survive forever on 900 calories a day, but I can't seem to be OK with eating more than that just yet.  In my mind, anything over 900 calories = weight gain.  So far, I've had no weight gain, but certainly a drop in weight loss.  Is it the calorie intake or is it the fact that I don't have much more to physically loose.  My body can't burn off much more fat, is that why I require more calories now?  Any of this resonating with you, are the feelings mutual?

I know how to eat, that part I am not completely obsessing about.  Can I eat more now, yes.  Do I want eat out of boredom, yes.  Do I eat out of boredom, sometimes if I am being honest.  Am I still focusing on protein at each meal, yes.  Am I still drinking 2 protein shakes a day, yes Mon-Fri.  Do I still eat 5 times a day, yes & sometimes 6 if I stay up late.  Has the hunger sensation come back yet, yes-if I am bored, no-if I am busy.

My success now is based on how I manage day to day:  calorie intake vs physical activity vs quality of food vs enough water.
No longer is my success based mostly on malabsorption and restriction of volume.  In essence, did I really learn how to manage food and life during those crucial 12 months of rapid loss?  Answer:  I know the rules, so yes I did learn, but nothing could have prepared me for this part, the ending of the weight loss.

I am not doing anything wrong these days, I'm just no longer loosing 10+ pounds a month and I am struggling with how to measure success now, if not in most recent pounds lost then what?  What will I be happy with measuring this year?

I am still exercising.  I have worked up to a 6 day/week routine, roughly 30 to 45 minutes a session, using a new at home DVD program.  Recently, say the last 2 months, I have cut back to 5 days/week, never less than 4 days/week.

And today, I had to finally take time to update the wardrobe.  My career clothes are just entirely too big at this point, again.  Went to a discount store and hit the motherload, not only in prices, but in realization of sizes as well.  I put on 12's & 10's!  Depending on the material.  Brought home 2 pair of size 10 blue jeans.  Brought home a hodgepodge of career pants for work anywhere from 8/10 to 10/12.  Can I get a WHHOO HHOOO?!?!?!  Retail therapy is always a great morale booster.

As I end this day in my life, I can truly say that I am happy with my food choices today, I am happy with my new found clothing treasures today, I am not happy that I missed out on exercising today, I am not happy that I just ate a few crackers and some cheese this late at night, I am happy that the scale is still moving downward - even if at a snails pace.  Notice that I am speaking only of current events - one of my daily goals is not to focus on what didn't happen in the past (which is done & gone), and not to focus on small details of tomorrow (which is not here yet), but instead to focus on this moment and the decisions made in this moment (that ultimately affects your future, which ends up becoming your past).  Isn't that how we stay on track, by making the right decisions now, by having the right attitude now.  My family doctor says that we stay on track one meal at a time, not one day at a time.

If my success, in my head, truly is measured on the scale then I know what to do:  exercise all 6 days a week, cut out all carbs except for fruit, and only eat 5 times a day - not 6 no matter what.  But that sounds like another "diet method" to me.  I am maintaining healthy choices everyday, I am not making extreme choices that put my past attempts at weight loss on a path to self destruction.  No, I like me now, and if 173 to 175 on the scale is where I float then so be it.  I will have to find a way to work through this transition phase without relying on the scale.

Bariatric surgery is a cycle of continuous change an evolution.  I regularly speak publicly about my experience to groups seeking to enter the program and the 1st thing I tell them, after stating/celebrating that I have lost over 220lbs, is that I am an imperfect person who has to decide daily if this is still the life I want.  Then I tell them that life post op may look easy but it can be just as hard as the life they live sitting there in an overweight body.  The Bariatric life requires motivation, dedication, commitment, willingness to change, and a deep drive to finally do something different.

At 15 months post op, these words are what's on my mind.  I am in transition mode, a chapter that is proving to be a bit of a challenge.  I want to be successful for more than just the 1st year. 

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My Story

Name:  Nicole
Age:  30
Married:  Yes, happily
Kids:  (2) - Girl & Boy, born 11 months apart
Career:  Yes, Business/Marketing/Customer Service
Overweight since:  1988
Reason:  Poor life circumstances during childhood, Poor personal choices as an adult
Decision to have WLS:  Investigated January to April 2010, pursued April to August 2010, chose RNY

And so my WLS journey began...all these entries were requirements from my Insurance Company and my Bariatric Surgeon.

UPDATE MAY 2013:  As I re-read this entry, I re-live every moment on this timeline, and realize THIS period of time (the "clearance" phase) is the MOST stressful.  If you can survive the stress of ALL THIS, and loose a few pounds, you are going to do GREAT post-op!!

APRIL:

*04/12/10 - attended Bariatric surgery info session in Asheboro-NC with Dr. Washington (once you document this attendance with the surgeon, you can NOT gain any weight)

*04/20/10 - appt. with primary care physician for obesity assessment, labs to get baseline bloodwork panel established, check thyroid, and obtain letter of medical necessity (if your PCP is not on board, in NC, you are dead in the water for WLS)

MAY:

*05/04/10 - appt. with bariatric surgeon for initial consultation, identify pre-operative clearances that are needed and set forth a plan of action, check weight against seminar reportings

*05/04/10 - patient education class, held at bariatric surgeon's office by bariatric nutritionist, 4-hour class explaining everything you ever wanted (or didn't want) to know about the various WLS procedures as well as your life changes before-during-after surgery

JUNE:

*06/07/10 - appt. with bariatric psychologist for initial assessment, verbal face-to-face session

*06/14/10 - appt. with bariatric psychologist for 2nd assessment, written personality exam

*06/28/10 - appt. with bariatric surgeon for 2nd consultation, verify current progress, verify psyc clearance, set additional goals, identify any remaining clearances required, check weight against last visit

*06/28/10 - appt. with bariatric nutritionist for initial assessment, pre-surgery eating plan as well as post-op discussions

JULY:

*07/14/10 - appt. with cardiologist (heart dr) for initial consultation and to identify what procedure will be done, obtain a baseline EKG

*07/20/10 - appt. with cardiologist for echocardiogram, heart ultrasound, to obtain cardiac clearance for surgery

*07/22/10 - outpatient surgical process, EGD, scope down the throat into stomach to look for ulcers and take a biopsy to test for the presence of H-pylori bacteria which is the bacteria that causes ulcers

*07/22/10 - appt. with cardiologist for follow-up, obtain results from ECHO, (this is a biggie - clearance or no clearance? a pivotal moment)

*07/22/10 - appt. with pulmonary (lung) dr for initial consultation and to identify what procedures are needed, I ended up wearing a sleep apnea machine home "ApneaLink" as an initial assessment for possible sleep/breathing disorders

*07/26/10 - appt. with pulmonary dr for 2nd consultation, obtain results from ApneaLink, schedule further tests

*07/29/10 - appt. with bariatric surgeon for 3rd consultation, petition insurance company for surgery approval, verify if lung clearance is truly needed (answer was yes because this is an elective surgery, and everyone needs to know if a patient is a risk during the recovery phase of the surgery, with regards to breathing or need to be resuscitated), check weight against last visit, obtain information about how/when to begin liquid pre-op diet

AUGUST:

*08/03/10 - begin liquid protein pre-op diet, to shrink liver prior to surgery, also to demonstrate ability to follow post-op eating plan

*08/04/10 - sleep study, ordered by pulmonary dr & required by bariatric surgeon

*08/09/10 - appt. with pulmonary dr for follow-up, obtain results from sleep study, (this is also pivotal - if results show sleep apnea then patient has to be on a c-pap/bi-pap machine for 2 to 4 weeks prior to surgery, if results show no disorder then patient is cleared)

*08/16/10 - appt. with bariatric surgeon for 4th and final consultation, verify all clearances are received, verify insurance approval received, obtain all prescriptions needed before & after surgery, tie up any remaining loose ends, check weight against last visit - this verifies if you are following the pre-op liquid diet, complete remaining pre-op tasks:  chest x-ray, bloodwork, hospital registration, payment due in full to all parties involved

*08/19/10 - drink solution to flush your body prior to surgery.  Yesterday was the last day of solid foods for a long time.  Only clear liquids today until noon or so.  Then the flush.  If you ever want to back track and live the "old" way again, try to remember what this stuff tastes like, then re-think self-sabotage!

*08/20/10 - SURGERY DATE, RNY

**Post-Surgery has brought on a few gliches.  I was re-admitted to hospital for pneumonia on 08/24 and now have gallbladder removal scheduled for 10/20.  Both conditions are very common for post-op bariatric patients.  I was not surprised either time, learned all about it in the patient education class!!

**Life on the other side is as challenging as life on the pre-surgery side.  Getting in enough liquid, protein, frutis/veggies, and vitamins proves to be very hard work and takes some planning/fine tuning.  Good luck to you all!  Pray for my success.