Bariatric Weight Management Program
Obesity is a complex, multifaceted disease that poses many risks, not just to individuals, but also to society in general.
Those who seek professional help in their weight management need to know that they face a long and involved process of lifestyle adjustments. It could take up to 5 years just to turn around the DISEASE process in your metabolism that has made it virtually impossible to deal with on your own. I congratulate you on taking your first step towards a longer and more comfortable life.
Angelina Surgical has partnered with the Wellness branch of my office in an attempt to help you meet or exceed your own personal goals. Your surgery is the first step. It is a facilitator or a catalyst which will certainly propel you towards your goals. How far you go will depend on you and your ongoing support. When your surgeon has released you to our clinic, the “journey” really is just beginning. We have been trained and certified by Allergan to perform bariatric weight management. Our commitment to you is to make sure you remain healthy during this process, and to offer you an array of options in the form of support that will improve your chances of success. We are more than a filling station. Every patient will have a customized plan. We are all different in how we respond to treatments and changes, and so, in my eyes at least, there should be no such thing as a “cookie cutter” weight reduction plan.
The Initial consultation
We would like to visit with you before your surgery to discuss goals and readiness for ‘The Journey’. Fasting pre-op wellness labs will be drawn on this visit, and arrangements will be made for you to visit with a nutritionist. Other baseline statistics such as pre-op body weight, BMI and body composition analysis will also be recorded. If you have insurance, your visit and lab fees will be covered. We will also discuss your medical conditions and any medications you may be on. If you have a Primary Care Physician (PCP), we will need a referral to our Bariatric Management Program in order to bill your insurance. We will also need to discuss who will be managing your varied medical problems and your medications. As already mentioned, the surgery will necessitate changes (to liquid or chewable versions) and even the possible withdrawal of many of your medications. Feeling healthy already, right!
A signed consent for treatment will be required, if you wish us to manage your medical needs as well. Our team consists of a nutritionist (by appointment), clinical exercise physiologist (also by appointment), personal trainers, as well as our Nurse Practitioner, Laurie Montgomery who is also certified by Allergan to practice Lap Band Management.
We also offer Genetic testing to evaluate a diet and exercise program that is genetically customized for you. (not covered by insurance). We have also partnered with several labs throughout the country which enables us to provide you with the most cost effective and relevant tests available for your journey. These are covered wholly or in part by your insurance, and include Functional Nutritional Evaluations, Markers of wellness, Hormone analysis, Evaluations of various toxicities (keep in mind that most toxins’ are stored in fat, and so, as the fat goes away, the toxin load increases), Cardiac evaluations (to determine ability to safely exercise) and functional aerobic capacity (a measure of fitness) can also be performed. Obviously all these tests are not for everyone, so this is precisely why your treatment by us is truly customized.
You will already have been on supplements on the suggestion of your surgeons, and as you travel further into the program your needs and tolerance to supplements will change. We will guide your regarding these needs and make suggestions accordingly.
We will also spend a lot of time discussing your diet and food preparation. We have also partnered with quality meal providers and these “medical meals” can be provided if desired.
Our Alliance with Angelina Surgical: Total Bariatric Care
You will be under the care and supervision of our team of surgeons until they have cleared you to follow up with our office. This may be just a few weeks in the case of the gastric sleeve, or up to 3 months in the case of the band. Once released by your surgeon, we will be assuming your lap band, nutritional, and wellness care. By this time, you should be on a “regular diet”, and may have had 1 or 2 fills in your Lap Band. On this, first post-op visit by us, we will be repeating all your wellness labs and composition statistics, to see how you have progressed.
Please keep in mind that your surgical procedure is the catalyst for your success. However, everything we do from here on will determine its’ magnitude and duration. It has been estimated that individuals with BMI’s >40 live as much as 15 years less than people of normal weight, and their quality of life in their last 10 years is very poor. As part of YOUR team, we hope to change all of that.
Prior to coming to each visit, we ask that you compose a 24 hour food diary for our review. If a fill is required, you will be asked to remain on clear liquids for 24 hours and then progress to a soft diet for another 2 days (canned tuna or chicken). This protocol will be repeated with each subsequent fill. Please plan on spending at least 30 min on each of these visits, as there is much to document and review. It is advised that you come by 2 weeks prior to your appointment to have your labs drawn so these can be part of the discussion. The purpose of the labs is to track your progress and ensure you remain healthy. On each visit, we will discuss the nature of the metabolic disease that you are fighting and the players that are causing problems. Your lab results provide an excellent learning tool that will provide you with insight and solutions. We will be happy to forward copies of all labs and x-rays to your PCP if you agree. It is my intent to be your “wellness guru” during this process, and not your regular physician. The 2 roles do overlap considerably and your regular physician (if other than myself) will need to be kept informed every step of the way.
These labs and scheduled visits should occur every 3 months in the first year and then every 6 months thereafter. Our team will be at your disposal for support in between these visits if desire. You may schedule an appointment with our nurse practitioner or myself at any time. We can also arrange for extra visits with our support partners, regarding any diet or exercise problems you may be having.
We are in the process of building our website that will enable you to e-mail us and participate in regular “Blogs”. With the Website, we will also be offering suggestions about diets, recipes and activity/exercise programs. We also encourage the buddy system, so that you will have a personal partner that you will call at least weekly and discuss any frustrations or issues. Lets’ face it, life happens to hit us all in different ways.
As I mentioned previously, change is hard. I salute each of you for considering it. Hopefully now, you feel more empowered and ready to proceed with the journey.