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Surgeon Testimonial

Robert T. Marema M.D.
Dr. Marema took more time with me than I would have expected regardless of what I was paying. He has over 5500 of these surgeries under his belt and I like the fact that he himself has had the surgery.

His office staff is very knowledgeable in handling patients, but I always see the Dr. Marema on every visit regardless of the reason to be there. I have also I dealt with his office in Orlando and found them very accommodating. His head nurse was great about addressing my email prior to surgery, and the hospital staff is encouraging, compassionate and experienced.

The hospital has spent a lot of money to create the right atmosphere and support for Bariatric surgery, and the nursing staff is very experience with barbaric patients. The hospital overall has a great reputation for quality and service.

Dr. Marema answered all my questions and told me all the facts, good and bad. He was the most direct of the many doctors that I attended seminars.

I went to a number of other surgery seminars and felt Bariatric was not for me until I met Dr. Marema. Other seminars I went to, I felt that I was being sold their solution and not told the facts, both good and bad. I am very happy that I found Dr. Marema.

St. Augustine and Flagler Hospital are very fortunate to have a doctor of this skill move his practice from a large city like Orlando and Ft. Lauderdale and come to St. Augustine now has been more than 2 years since my surgery and I have lost over 200 lbs. I could not be happier with the results. I am a new person with the ability to do things I never been able to do before because of my heaviness. I love shopping for close in a normal store and it is even more enjoyable when I fit in the smallest men’s shirt rather than looking for a Big and Tall men’s shop to find the largest, as I did in the past.

Member Interests
  • Theater - Love going to plays and the opera
  • Cards - Don't play computer games but like to play cards with friends
  • Photography - Enjoy Photography when I travel
  • Cruises - 92 of them might have helped put on a few pounds
  • Married - Married for 42 years to a great, understanding wife
  • Adventure - Enjoy all movies, have great DVD collection and now collecting BluRay DVD's
  • Computer and Internet Surfing - Have worked in the Computer industry for 30 years, I am addicted to my laptop

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Welcome to Bill's losing (weight) journey
wmil's Blog
wmil's Blog


8 Months since surgery and I feel like a total new...
on August 8, 2008 9:14 am
Well this week was my 8th month anniversary since my RNY Gastric Bypass Surgery and I feel like a total new person.  I am down from my heaviest weight in the late 90's and early 2000's a total of 165 Lbs.  I now weight less than I did when I got married 42 years ago, and when I graduated High school, a time that I remember I was at my thinnest and healthiest weight in my lifetime.  I went to see my surgeon, Dr. Robert Marema, yesterday and he seems pleased with my progress.  Both he and his wife had made this journey so much easier for me.  It is great to have a surgeon that has gone through the same surgery himself and is such a great example for his patients.  I feel when I talk with him, he has a great understanding of what the challenges are and has most of the answers to help us down the road to success.   I have found the healthy diet requirements come very easy now that I have been working at it for 8 months and even though I am allow more carbs, I just don't want to start back on them much because there were so hard to kick and I still have some pounds to go; not a lot, but enough that I want to make a BMI of 24.9 for once in my lifetime.  This past month I did manage to come down with Gout which is simply too much uric acid in your system and it settles in your feet and causes very painful discomfort in the feet.  I thought the solution was more water, so I bumped my 100 oz of water a day up to about 140 oz of water and found that I was depleting all the sodium (salt) in my system.  Actually, one evening, I got up to go to bed after my wife retired and felt very dizzy and sat back down in the family room and fell asleep in my chair.  About 1:30 Launi came and asked me if I was OK and coming to bed, so I got up, forgetting that I sat down for feeling dizzy and before I got all the way across the room, I passed out and kit my head on the furniture.  I came around very quickly and we checked my blood pressure (77/38) and my pulse (45) and decided that I needed to go tot he emergency room.  We drove back to Flagler Hospital where I had my surgery and where most of my doctors now practice and they admitted me immediately.  I asked to go back on the 8th floor to Bariatrics as I know so many of the staff there from my hospital stay and my attendance at support meeting where so many of them come to help us focus on our future as we lose.  after three days and all kind of tests, I was finally released, loaded up with fluids and with my first weight gain since surgery.  Fortunately it did not stay up there long and I am back on track.  It is hard to believe all the years that I had High blood pressure and a rapid heart rate, along with High Cholesterol and Diabetes that all this can change in such a short period of time and I could actually be low, without any drugs.  I never would have believed that it was possible, but I guess that it does prove all that fat can kill us if we let it.   I am back to a regular schedule now and still working out at the gym.  I have some pain in my arm from an old back injury when I was a teenager, but it is nothing compared to the attaches that I would get from the same injury when I was so much overweight.    We have decided to celebrate my weight loss with a cruise.  I have no concerns about the food temptations as I go out all the time with friends and I just don't eat what I am not suppose to any longer.  I usually just snack off Launi's plate, and I never seem to feel like I am missing anything, as food no longer has the importance it once did in settling stress for me.  I use to turn to food as a tension reliever, but that just not an option.  I use to live to eat and now I have to remind myself to eat to live.  I am looking forward to being able to do tours as the last cruise I did in 2007 was very stressful as I just could not do the walking required on so many of the great tours. Today, that is not an issue and I really look forward to it.
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What a difference 6 months can make; more than...
on June 8, 2008 9:40 am

 

 

Just 6 short months ago I had RNY Surgery.  I only had one diet last this long, and that was because I went to a Doctor and was hypnotize, and live for 6 months on Liquid Protein. I was in my early thirties, and the diet worked, but at the 6 month point, I was anemic and had to come off the Liquid Protein, as several people on the same diet and died in less then the 6 months that I had been on liquid protein.  It was a red liquid and tasted awful.  The was no transaction period, and despite the fact I had lost 100 lbs back then, I gained 40 lbs in the first third days off the diet.  I tried some other diets, but the weight just keep coming back, and in 8 months I weight 15 lbs more then before I started on the diet.

Well it has been 6 months and this is the first diet that I have learned to eat healthily on.  More importantly, I only take one drug today that I took 6 months ago, and that is for thyroid.  All my diabetic, high blood pressure and cholesterol drugs are long gone, and my blood readings prove that after having Diabetes for 25 years, I no longer have it as my A1C is 5.6, which is that of a normal person.  My Blood Pressure is now 100/55 and my total colestroal is 95!

I had a very close friend I knew for years and watched his kids grow up, but at 58, we lost him to the Diabetes when his kidneys failed and he was to heavy to be able to get on a transplant list.  He had joined me on the Liquid Protein diet and he too had to come off of it, but if this kind of surgery had been there for use 30 years ago, he could still be with us today.  He oldest daughter last year had Lab Band Surgery and has lost nearly all her excess weight.  She has the same determination and comparativeness that her dad always had.  I am glad she was able to learn from his lifestyle and strive to change herself while she was in her thirties.

I have continued to study and learn about the benifets and issues of this kind of surgery.  I have a lot of great people that have had or are planning to have the same surgery that I write daily.  The support is there for anyone that wants to learn more and make their own choice from the many option available today, for those that have failed repeatedly on diets.  One thing I have learned over the years is after each diet, the next one is harder to lose on.  Your body is prepared for you to try it again, and it is just a little smarter in not giving up the weight each and every time you try a new diet.  That is true of this surgery as well.  I have hit many plateaus, and I have kept accurate records day to day on my weight differences.  It some times will more up, but it has never been much more than ½ pound, but when it go into a plateau stage, that some times use to last a week, it can often today hang in there at the same weight for three weeks.  During this long of period for a person dieting would bring discouragement and they often would give up, but there is no giving up with RNY Weight loss surgery.  You can not just start eating more, because you have a pouch that is no larger than a man’s thumb.  You can not eat carbohydrates, sugar or fat, or I should say you can eat it, but because the first third of your small intestine is disconnected with your stomach, and they carry only stomach acid to the last third of the small intestine where they were reconnected to, there is no way to process these foods.  Most likely an RNY patient would just get sick, and if you know that something caused you to get sick, you will not do it too often.  You have to just keep eating three ounces of lean meat, fresh fruits and vegetables, and low fat dairy despite the fact you body has stopped losing.  You also have to keep up with Bariatric vitamins and minerals to supply what your body needs to stay healthy.  Considering the amount of drugs I took, these few vitamins and minerals are a welcome change to a lifestyle of taking one pill to correct the effects of the previous drug.

I have also found from studies that overweight people that have surgery, often trade one addition for another, so while they many adapt a healthy life style in regards to food, they can start drinking, gambling or adapt some other addiction.  I also learned first hand that weight loss can create mode swings, and effect the amount of patience you have with others, and yourself, or allow you to be emotional, even over something as simple as a film or TV movie.

I want to say a special thanks for all the great friends that I have that have been so supportive of my efforts, and who have understood that I am trying to maintain the same social lifestyle I had previously without eating and drinking my way back up the scale, and to all the new friends I have met on the this and other web sites.  Each of you brings something special to the table and we learn so much by sharing our experiences with each other.  

I have tried to give you the content from  the past 4 months that I have not been able to find the time to communicate during that period, and I look forward to containing to communicate with as many as I can one on one each and every day as we make this journey

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10 Weeks and Moving On
on February 20, 2008 10:00 am
Now its been 10 weeks since surgery and I had a stall period that lasted longer than I expected, but I stuck to my diet and exercise program, and finally the scale stated to move down again.  I have not lost my 10 week goal of 60 Lbs but I expect in a day or two to be there now that my body has given up the fight to hang on the the fat for the time being and I am again losing weight.  I have never felt better, and a lot of that is because I could never do the proper amount of exercise without running short on breath or just tiring out in a shot period of time.  Now I am able to do 1-1/2 hour per day and some days longer and I work out 6 days a week.  I have a great personal trainer in Walter Sam at the Club at Hammock Beach who is very supportive of my efforts and has taken the time to study what I need to be doing.  I am his first Bariatric student, so he has done a lot of reading.  I work with Walter 4 days a week, and the rest of the time I am on my own.  There is almost no equipment in our gym that he has not had me on, and he has done miracles with me in getting my limbs limber with stretching exercises.  Pilates is the hardest for me to handle, but we spend every Monday working to improve with Pilates.  One day I want to join the spinning classes at the club, as it looks like a lot of fun, but right now, I got a ways to go to be able to take that endurance for as loon as that group works without stopping.  I appreciate all the support from my friends and especially those that have had to have dinner with Launi and I.  I know you all worry about the 3 ounces that I current eat at a meal, but I feel great and really that is all I need and want at a meal.  Thank you to all of you that keep giving me the encouragement and telling me how much better I look.  I can not believe that I am down 6 pants sizes already.  I wish my hips had dropped more, but I know that will come with time.
7 comments | Leave a comment.

Almost two Months and over 50 Lbs lost
on February 4, 2008 11:49 am
In a few days I will have reached the two month mark and lost 55 lbs.  I hit some slowdown, but part of that is from having to take a little more salt in my diet to retain more water, and hopefully the addition of some muscle from working out nearly every day for at least one hour.  I have a personal trainer that I work with two days a week, and adding some group fitness training session now that I can keep up with others in the class better.  I also use the indoor pool at the club, and do some walking.  I got to the point I can cycle 10 miles in an hour, so now I am trying to better that time.  My fitness trainer is working on my upper body conditioning as he feels that I am do a great job on my own with the cycling and the tread mill.  I am starting to get concerned about the sagging skin on my arms, and I know my thighs will follow with the hanging skin soon.  Gravity is taking its toll, but I can always deal with that next year.  Right now I want to get to my weight goal of 200 lbs by the end of the year and 175 by next spring.  That is more than 100 pounds away today, but a lot closer than I was just two months ago.  The diet is not a problem yet, as I don';t have the desire to eat much of anything, but follow the diet laid out for me by my Surgeon, in addition to the vitamins and Minerals that I have to have.  I have dropped 5 diabetic drugs that I use to take.  My blood pressure was so low the other day that I bent over and when I came up, I passed out.  That's is when they decided that I needed more salt to retain a little more water.  My blood pressure has never been better as I average 110 over 60.  My cholesterol total is 95!  So my Cardiologist took me off blood pressure medication and cholesterol medication last Friday.  I see my surgeon this Thursday for a follow-up and expect that he will be happy with my progress.
5 comments | Leave a comment.

6 Weeks and 43 Pounds Gone
on January 21, 2008 6:55 am
Wow!  I just looked at my weight chart (Below) and realized that I had lost nearly 50 Lbs already (well 47 in my first 6 weeks).  I started last week working out at the Gym every day and have Walter who was my personal trainer in the pool to be my personal trainer at the club to make sure that I am doing the correct things and staying up with the proper amount of exercise.  I was concerned for a week or so because my weight loss came to a halt, but I guess my body though I was starving it and way just trying to hang on to what fat it could.  I still am not use to only being able to eat so little.  Right now three to four ounces total is what I can get down for dinner, and I eat less for breakfast and lunch.  I never had had much desire for eating except after work, so dinner has always been my big meal.  I use to snack in the evening after dinner, not because I was hungry, but because it was a habit.  Now I keep that snack to one simple dish of fruit and enjoy it.  Launi, my wife has lost 10 lbs because I do all the cooking.  I feed her three to four times what I eat but I guess it is just eating only the right foods that make a difference.  There not much to snack on around the house any longer so she has to do her snacking when she is out shopping or with friends.  When she is out of her surgery boot on her foot, when will be joining me at the gym some, not that she needs to lose much at 125 Lbs.
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My Story

           

   I'm a 61 year old male and have weighed as much as 385 pounds.  As I approach my gastric bypass surgery date, I’m now down to 326 pounds.  I’ve been overweight all my life, starting in early childhood.  As a child, I ate all the wrong things, as my foster parents had little money and most of our meals consisted of potatoes, pasta, or rice - with very little fresh vegetables, lean meat or fresh fish.

   After high school, I worked full time to pay my way through school at jobs that provided me lots of exercise.  At that time in my life I was a healthy 5’9” and 195 pounds.  I dated slender girls and soon married the love of my live, my current wife for over 40 years, Launi.  She was 80 pounds soaking wet, and still is nearly a perfect weight for her age and height.

   As I moved from labor intensive jobs to behind-the-desk jobs, my eating and exercise habits changed drastically and the weight began to pile on.  By the time I was 26, I’d weighed as much as 300 pounds.  By my 40’s, I’d grown my business to over 300 employees.  Unfortunately, due to my weight and hypertension from work related stress, I had diabetes and was 385 pounds!  In 2000 I decided to sell my company to reduce my stress and focus on my health.  Since then, my blood pressure is under control, my A1C is 6.1 and my total cholesterol is 102.  However, I’ve not been able to get my weight below 300 pounds.

   I’ve tried every diet pill and program on the market.  While they take off some weight, as soon as I try to maintain it, I gain it (plus more) back in less time then it took to lose it in the first place!  My metabolism has become so slow I have to eat less than 1000 calories per day to lose any weight at all.  Unfortunately, this causes me to become anemic due to lack of sufficient nutrients.  The first time this happened my doctor sent me to an oncologist because they were concerned I had cancer due to my extremely low red blood count.  Now, I take iron and other bariatric vitamins and minerals to keep everything in balance. 

   I’ve spent the last few years traveling to Bariatric lectures at various hospitals around Florida to research my options.  I decided on the program offered by US Bariatric and Dr. Marema in Ft. Lauderdale, which has an office in Orlando at Florida Hospital Celebration, about 100 miles from my home.  After consulting with the team, we agreed the RNY Gastric Bypass procedure would be my best option and would be performed by Dr. Marema’s associate, Dr. Kim. 

   My next step was to get approval from my insurance company, United Health Care.  They approved the surgery with some conditions, including additional weight loss.  After I spent 8 months meeting all the insurance requirements, Dr. Marema and US Bariatric opened a new center in St. Augustine at Flagler Hospital , just 25 miles from my home.  We picked a surgery date and notified my insurance company, only to be informed they’d recently changed the policy to exclude Bariatric surgery (regardless of diabetes, heart condition or any other ailments) so my surgery would not be covered!  I hired an attorney but was not able to overturn their decision.  A spokesperson for the insurance company recommended I wait a few years to have the surgery so Medicare could pay for it.  Nevertheless, I decided my health was more important than the money, so I’ve found the best surgeon in the field and will pay for my surgery personally.  To further add to the cost and aggravation, my insurance policy doesn’t cover complications due to the surgery either, so Flagler Hospital will include a complication coverage insurance policy in my fees.

   I realize the magnitude of my condition and my surgery choice.  Therefore, I’ve spent a great deal of time researching weight loss alternatives and understand the pros and cons of several different surgery options.  I’ve found the best doctors to certify I’m physically capable of withstanding the surgery (especially important since I’ve had 5 heart stents since I retired 7 years ago), the best surgeons to perform the surgery, and I’m personally doing all I can to insure it’s success.  In preparation, 4 weeks ago I restocked my home with the proper ingredients and started following the ‘after surgery’ diet and exercise programs created for me by U.S. Bariatric.  Luckily, this along with maintaining 1000 calories per day, has allowed me to lose another 12 pounds!

   This surgery will decrease my long-term treatment, medication and overall heath care costs. However, while United Health Care will benefit greatly from this surgery, they still refuse to participate in any way.  In spite of everything, I’m determined to move forward to better health and a longer life.
 
  Thanks for your support!

--Bill