From bariatric surgery to instructor of “Insanity” workout

IMG_0607When Marni Gould topped out at 248 pounds, it became evident she needed to make a change.

Dance and exercise had been her passion since high school – and although she had remained active even through her weight struggles, she was finding more and more she couldn’t do it anymore.

At 35, the middle school math teacher was grappling with sky-high blood pressure and a resting heart rate of more than 100 beats per minute. Her knees hurt from carrying too much weight for her frame, and her ankle rolled far too often. She had tried a number of diets and none of them seemed to work.

“I knew I needed help with food. I never knew how to properly eat,” she said, noting cheeseburgers were a particular weakness.

Gould’s two sisters each had had bariatric surgery and after seeing the results, she decided to learn more. After going through a six-month process of medically-supervised weight loss, she still had not lost enough weight. She had the surgery April 2016 and was back at work in two weeks. She almost immediately went back to the gym, doing serious modifications to ease herself back into being active and avoiding core exercises at first to give herself time to heal.

Gould also was strict that first year in particular with her diet – lots of protein shakes and thoughtful meal choices, with PowerCrunch bars to satisfy sweet-tooth cravings. “This just let me reset. Now I know I can eat the right things in balance with the amount of activity I do,” she said.

While Gould’s one sister took up running, Gould gravitated more toward strength.

IMG_5384Four months after her surgery, she started a high-intensity endurance workout called Insanity Live. She modified everything and kept plugging away. She learned to love it.

In a year, her body fat had dropped from 48 percent to 25 percent. By 18 months, she had lost her 100-pound goal. At 138 pounds, she went from a size 22 to a 6/8.

When her instructor moved, Gould couldn’t imagine a Saturday without Insanity Live. She decided to teach it. “At the training, they said, ‘You don’t have to be the best at the moves. You just have to be the most motivating.’ That stuck with me.”

While some instructors bark orders and push students to work at top capacity, Gould remembers the importance of pacing herself. “I really want to pull in people who are scared of it – it’s called Insanity for a reason. I want them in there so they can see how much they change over time. When you start losing and toning, it helps you stay motivated and keep going.”

Gould is so passionate about sharing her transformation, that she regularly attends the TMC Bariatric Support group and manages a Facebook group for local patients, as well as another accountability group for those who need more regular check-ins. “I love inspiring others. I remember early on when I was frustrated with the pace of my weight loss, someone told me, ‘You’re on a trajectory.’ And that changed everything. It’s not about the Right Now. It’s about progress, not perfection.”

“I just want to help others. I feel like I’ve been given this gift – and what good is this gift to me if I am not spreading it and using it to assist others?”

No more blood pressure pills, less pain after weight loss surgery

KelleeKellee Smith didn’t have a history of struggling with weight. She still has the size 2 gown she wore in a Miss Maryland pageant when she was 110 pounds.

But the weight started creeping on after a drunk driver in a large pickup truck slammed into her small car five years ago, shattering her shoulder, detaching her knee cap, severing the tendons in her leg and leaving her with a traumatic brain injury. It took two surgeries and about 18 months of rehabilitative therapy to start rebuilding her life.

She gained weight, in part from the reduced activity, in part as a side effect from the medications she was taking and in part as a result of turning to food as a comfort from the pain and physical limitations.

When her blood pressure medication would no longer control her blood pressure, though, she knew she had to make a change.

“I just wanted to be healthier. I didn’t want to worry about having a cardiac event or having to take more and more medication,” said Smith, a 45-year-old teacher.

Smith had gastric sleeve surgery in summer 2017.

One of the important tools for Smith was a food journal. Surprised to see how much soda she had been drinking, she switched to flavored seltzer water and eventually just switched to water.

Other changes: She adds a low-carb protein shake to iced coffee, giving her the creaminess of a frappucino without the extra sugar and calories. She turns sandwiches into lettuce wraps to eliminate the bread. She’s made spaghetti out of zucchini strings.

“I’m just a lot more conscious about labels and what I’m eating now,” she said. “I can still have the treats that I want, but I just look for ways to make them a healthier alternative.”

Smith said her surgeon told her not to be surprised if it was hard to make some of the transitions in the beginning, and at one point might wonder why she had decided to do it in the first place.

“I have not once asked why I did this,” Smith said. “I had tried diets and even diet medications. I had gone to gyms. I even had a personal trainer. Nothing was helping me lose the weight and I had really just resigned myself that this was how life was going to be for the rest of my life.”

Instead, six months in, Smith has lost 55 pounds in a safe, steady way. Initially at a size 18/20 pants, she bought herself a pair of size 12 jeans over the Christmas holidays. She’s doing strengthening classes at the gym. Between that conditioning and carrying less weight, she’s experiencing less pain and her balance is steadier than it had been in years.

Importantly, in October, she stopped taking blood pressure medication altogether because she no longer has hypertension.

And she’s strongly considering entering a pageant in fall 2018 to share her accomplishments.

“Weight loss surgery isn’t an easy way out or a cure all, but it is a tool,” Smith said. “Every day, it’s a new commitment. Every day, I choose if I’m going to live an active life and make healthy choices.”

Bariatric support group helps patient stay on track with a healthy weight

MaryannMaryann Webb was once “fired” from a support group for not losing enough weight.

Never mind that she’d shed 100 pounds from her starting weight of 357 pounds after having gastric bypass surgery. It wasn’t fast enough or significant enough to meet the expectations of the other members of her group. So she quit.

She and a friend left another support group so depressed they went out and got a hot fudge sundae.

Then in January 2017 she found the support group at Tucson Medical Center for those who had weight-loss surgery.

The 74-year-old retired personnel trainer never misses one.

“It’s like getting a booster shot every month,” she said. She likes the positivity of the group and the non-judgmental environment.

Webb had a long struggle with weight. Part of it is genetics – a whole passel of her family is just a little shorter and a little heavier than average. And she comes from a long line of family members who comfort and nurture one another with food. If you went to grandma’s for Saturday supper, you knew you were going home with a dozen of her sugar cookies.

When she moved from the family farm and the physical demands associated with it, and took a desk job, she found herself gaining weight pretty quickly.

“I’d tried them all. The cabbage soup diet. The hormone shots. This was a long time ago, but I even tried that approach where they shock you when they show you a photo of food to try to make you repulsed by it. Nothing worked.”

It got worse when she was hit with a triple whammy: A divorce, a change in jobs and a newly empty nest after her daughter went away to college.

By the time she had surgery – this was back in 1999 – she was 55 and having trouble with her kidney function and she had diabetes. She took off 100 pounds pretty quickly and then years later lost more when she went through an unrelated medical condition.

The weight loss support group is offered monthly and provides an opportunity for patients who have had weight-loss surgery to connect with others who are in different stages of their weight-loss journey. Our mission is to provide a safe, supportive environment for patients to build relationships and get education focused on health and well-being for their lifelong journey.

Last year, she underwent surgery to fix a constriction and a hernia on the original bypass. When her surgeon asked her what she wanted from the surgery, she said she just wanted to eat lettuce again.

Unlike the larger incision from the first surgery, technology allowed a laparoscopic procedure this time around, with much less pain and a faster recovery. She stuck to her surgeon’s diet suggestions like gospel, sure it would help her heal faster. And sure enough, she’s eating lettuce again.

She’s also walking three days a week, doing aerobics three days a week and organizing monthly social events with a group of retired friends (including a tour of Tucson’s ethnic restaurants with strict orders to try something they’d never had before.)

“I feel better than I have in years,” Webb said. “It isn’t like the surgeon gets to wave a magic scalpel and suddenly the weight comes off like magic. It’s a tool. But it’s a tool that makes it easier. Plus, now I know myself better. I understand what I have to do to take care of myself. I know I never want to be that sick again. And I’ve learned over the years that it’s OK to be proud of yourself a little bit.”

And that’s also why her self-care toolbox includes the monthly support group held on the TMC campus for those who have had bariatric surgery at TMC.

Webb said she appreciates sharing her tips with others and learning from experiences others share – not to mention it’s often a tasty experience to boot.

A recent class had a series of taste tests for protein bars (she’s rather partial to Power Crunch salted caramel.) In another class, members shared their recipes for protein shakes and made samples. The class learned about vitamins and supplements in another.

“I can actually say that I’ve been to a lot of support groups over the years,” Webb said. “And this is really a support group.”

For more information about weight loss surgery at TMC attend a FREE weight loss surgery seminar.

Patient support at TMC Bariatric Center

Bariatric SurgeryRegardless of a person’s background, lifestyle or motivation – weight-loss is challenging. What approach works for one person might not work for another. Patients who choose weight loss surgery have the best outcomes with access to the right information and support. Fulfilling that crucial need is Rachel Deal, the TMC metabolic and bariatric coordinator.

“The TMC Bariatric Center is nationally accredited as a comprehensive center,” said Deal. “We provide education and assistance at every stage, from a patient’s first questions through years after a procedure – a patient is never in this alone.”

Getting started

Patients considering weight-loss procedures have questions about their unique factors and options. With a dizzying amount of information available on the web, it can be difficult to know where to start.

“With a quick phone call or email, we can get you started with information or a consultation with a bariatric specialist,” said Deal. “TMC also offers a monthly seminar on the second Tuesday of every month – It’s a great way to learn more about weight loss surgery in a comfortable and informal setting.”

 Personalized program

Weight loss procedures are often thought of as one particular surgery. In fact, there are many options available to meet the unique health factors, experiences and goals of each patient.

“Bariatric procedures are not a one-size fits all – everything in the program is personalized,” explained Deal. “We work as a team and take the time to make sure each patient has received all the information about their options and health, so they can make the most informed decision.”

Deal said this careful, custom and vital process can take months, but has an important side-effect that supports a successful outcome. “Patients say they feel empowered – the information gives them the control and authority to make an active decision about their health.”

Confident and prepared

Preparing for a medical procedure is not a common experience, and patients can rely on Ms. Deal to provide the support and help to feel confident and prepared.

“We help educate for pre-op and post-op, so patients understand the dos and don’ts and know what to expect,” says Deal. “In addition, we facilitate resources for aftercare, and make exercise, diet and action plans for the first year after surgery.

More than medicine

The TMC Bariatric Center was designed to be a comprehensive program, assisting patients with all aspects that affect weight loss.

“There are many factors that contribute to successful weight loss,” Deal said. “That’s why the TMC program also provides a dietitian, exercise physiologist and psychologist.”

Weight-loss surgery patients also have the opportunity to participate in a monthly support group, and discuss triumphs and challenges with individuals who are having like-experiences.

“We also have insurance specialists available to assist with information about coverage and payment options – we want to leave no stone unturned.”

Success

Deal says the TMC Bariatric Center has combined medical, clinical and professional support with one focus. “Patient success is our goal – we hope to be each patient’s partner here after.”

If new weight loss challenges arise after surgery, Deal explained her role is to help keep patients motivated, determine new plans and provide needed information or referral resources. “Our patient partnerships are meant to last a lifetime – not just for the first or second year after surgery.”

Deal also explained why patient success is so important to her. “It’s amazing to see the bliss and happiness when patients reach their goals – and not all successes involve the scale.”

Success can mean being healthy enough to walk up the stairs unassisted, or being fit enough to comfortable take family on a trip to Disneyland.

“Mostly, I hear patients say they never could have imagined life being this good.

Rachel Deal has a degree in dietetics and nutrition. She has a passion for patient care and has worked in bariatric medicine for several years. When time allows, Ms. Deal enjoys sampling healthy dishes at Tucson’s diverse restaurants and traveling with her husband and young son.

For more information about Tucson Medical Center’s Bariatric Center of Excellence and to sign up for a FREE seminar see our website or call (520) 900-1842 today.

 

 

 

Have you talked with your primary care provider about your weight? National Obesity Care Week

TMC offers surgical and non surgical scientifically based programs to support you achieve a healthy weight. The American Medical Association in 2013 recognized obesity as a disease, and in doing so took critical steps towards supporting those affected to access science-based healthcare.

The misperceptions and stigma surrounding the causes of obesity often negatively affect an individual’s ability to access the care they need. The more than 90 million adult Americans affected by obesity are at increased risk for a variety of health conditions, including type 2 diabetes, high blood pressure, and sleep apnea.

Despite the significant health impacts of obesity, many of us struggle to talk with our primary care provider about our weight and how a science-based approach can help us to achieve a healthy weight.

Tucson Medical Center offers safe and effective weight-loss programs with both surgical and non-surgical options. We know everyone faces unique challenges to achieving a weight-loss goal. Our team of medical professionals can help you choose the path that’s right for you.

Weight-Loss Counseling Program

Our registered dietitians and exercise physiologists will work with you to create a personalized plan you can live with, so you can lose weight and keep it off. The 12-week program includes: • Nutrition, fitness and general wellness assessments • Reliable advice that you can use • Tracking of weight and estimated body composition • Development of personalized nutrition and fitness plans • Strategies to promote long-term weight-loss success

The program is individualized for you and so you can begin at any time. For more details, please contact TMC Wellness, (520) 324-4163 or Wellness@tmcaz.com.

Weight-Loss Surgery from the TMC Bariatric Center of Excellence

At the TMC Bariatric Center, we offer a comprehensive approach to help those who qualify for weight loss surgery. For most people to qualify you must:

  1. BMI ≥ 40, or more than 100 pounds overweight
  2. BMI ≥35 and at least one or more obesity-related co-morbidities such as type 2 diabetes, hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease
  3. Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts

Our program guides you every step of the way on your weight-loss journey, starting with free seminars to discover if a surgical option is right for you; to pre-surgery counseling and evaluations; post-op care that includes nutritional counseling; psychological support; instruction on incorporated exercises into your lifestyle; and discussion groups where you can build relationships with others who have had bariatric surgery at TMC to help you achieve your goals.

 

The TMC Bariatric Center of Excellence is accredited as a comprehensive center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

The American Society for Metabolic and Bariatric Surgery (ASMBS) Center of Excellence was started in 2004 to advance the safety and efficiency of bariatric and metabolic surgical care. Surgical Review Corporation administers the program on behalf of the ASMBS.

No matter what method you have used to lose weight, sticking to your new good habits and keeping the weight off can be a challenge. Don’t try to tackle it alone, talk to your primary care provider, talk to us, together we can take on the challenge of obesity and its complex nature and help you be a healthier you.

This week is National Obesity Care Week where the goal is to advance an evidence-based understanding of obesity and widespread access to respectful, comprehensive and appropriate care.

Measuring success at the first-ever bariatric clothing exchange

Tucson Bariatric patients at The Teal Saguaro's first-ever Celebrate Weight Loss Clothing Exchange

Tucson Bariatric patients at The Teal Saguaro’s first-ever Celebrate Weight Loss Clothing Exchange

Drs. Jeff Monash and Scott Welle from Tucson Bariatric, along with the TMC Auxiliary, recently held the first-ever Celebrate Weight Loss Clothing Exchange.  The event marked the kick-off to an ongoing bariatric clothing exchange at  The Teal Saguaro, TMC Auxiliary’s new resale boutique.  Bariatric patients often lose weight so quickly that it can be difficult for them to find clothes to fit every time they drop a size.

Patients who have undergone weight loss surgery at Tucson Bariatric are invited to drop off their too-large, gently used clothing and shoes  (maximum five pieces/pairs of shoes please) to either The Teal Saguaro, 5395 E. Erickson Rd., or Tucson Bariatric, 4715 E. Camp Lowell Dr. in the Swan Corporate Center.  In return, they will receive a voucher to get the same number of items in their current size. 

Tucson Bariatric employee Binda Tatro with patient Nancy Killian

Tucson Bariatric employee Binda Tatro
with patient Nancy Killian

More than two dozen patients attended the event, and were thrilled to be able to swap their too-big items for things they can wear NOW.  “The patients expressed how grateful they were to be able to find fashionable clothes in their current size at The Teal Saguaro.  We absolutely accomplished our goal of providing this service to our patients while making it fun for them.  Most left with full shopping bags, some exchanged phone numbers, and everyone was thrilled to be there,” said Dr. Monash.

There were giveaways, healthy refreshments, and friendly help.  The bariatric clothing exchange is ongoing at The Teal Saguaro for the patients of Drs. Monash and Welle.  Vouchers can be redeemed for up to one year.  The Teal Saguaro’s clothing selection always includes plus size garments and remains a great community shopping resource for everyone on a weight loss journey.

Special thanks to Jessica Monash for organizing the event, furnishing the refreshments and decorating the shopping bags.

Since 2011, TMC has been a Bariatric Center of Excellence, an accreditation from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.  Bariatric surgeries performed at TMC are minimally invasive, and some are even done using the da Vinci surgical robot.  For more information about TMC’s Bariatric Program, please call De Anna Elliott at (520) 324-3766.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461