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Dr. Joshua Long Denver Colorado
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Transcript
00:00Hey friends, I'm Stacey and this is Gorgeously Aging and today we are going to talk about my
00:04gastric sleeve journey. I have had so many of you reach out to me asking me specific questions about
00:09the process leading up to the surgery, insurance benefits, if I self-paid, if I had regrets,
00:16what kind of testing I had, and if I paid out of pocket, and tons of really great questions
00:22that are important to consider before going into a gastric sleeve surgery. In today's video I'm
00:28going to cover everything, all the little teeny tiny details, and if I miss anything you can ask
00:34me in the comment section below. I will always be 100% transparent and honest with you guys,
00:40so don't be afraid to ask. So for those of you finding this video who maybe don't know what a
00:50gastric sleeve surgery is, it's a surgery usually done laparoscopically, sometimes robotically,
00:57that removes a portion of your stomach to assist with weight loss. Now I'm an almost 53-year-old
01:04grandmother of three, mother of four, and a survivor of thyroid cancer. I have a very sluggish
01:10metabolism and I also lost a son to death and that put me into a really severe period of depression
01:16and grief, and during that time I gained a lot of weight. I got to a point that my blood pressure
01:22was really high and I was starting to have signs of being pre-diabetic and I really wanted to take
01:27my health and my life back. Now certainly people can take their life and health back without going
01:33through a gastric sleeve surgery, but for me I felt really strongly that this was going to be
01:39the best option for me after a ton of research. I had been on the diet hamster wheel time and time
01:46again. I had done keto, I had done carnivore, I had done GLP-1 injections, I had done everything,
01:52you name it, I had tried it. For me the weight loss was always very slow and almost impossible
01:58to maintain. In my situation, I've never had a true food addiction. Of course, periodically I
02:03would like comfort foods. I just gain weight very easily and I have a really hard time keeping it
02:09off. I am a post-menopausal woman and I don't have a thyroid. Now I'm not making excuses. I
02:15definitely made some poor choices and during the time that I was grieving the loss of my son,
02:20I was very sedentary. I could barely get out of the bed just to work and provide for my family.
02:25I take full responsibility for the weight that I gained and for the poor choices that I made
02:30during that time. I am giving myself some grace because beating myself up for that is going to do
02:35no good. So getting back to the gastric sleeve, they do remove part of your stomach. It is then
02:40stitched up and you are left with a sleeve-shaped portion of the stomach. The volume of this new
02:46stomach pouch is much less than it was before. This is a big commitment. It is a non-reversible
02:53type of surgery. So once it's done, you don't get your stomach back. There is also a very big
02:58commitment to pre- and post-surgery dietary rules and restrictions. You have to be truly ready to
03:06change your dietary habits and for those with maybe more severe obesity than I was dealing with,
03:11really confronting the food addiction and the emotional component of this is very important.
03:17For me, it was very important as well because I was dealing with a lot of grieving and in that
03:22grieving, I was comfort eating and not taking care of myself or my health. So it all started with a
03:28consultation. I didn't know if I was a candidate for gastric sleeve surgery or what it would cost
03:34via insurance or out of pocket. I pretty much knew that my insurance, which is terrible because
03:39I'm self-employed, would not pay for the surgery. So I knew it would probably be a self-pay situation.
03:45I just didn't know if I had the BMI to qualify, if I would be seen as having enough health risks or
03:53being overweight enough to have a gastric sleeve surgery. So I really needed the expertise of my
03:58surgeon and the advice of that team to lead me in the right direction. In the consultation, it was
04:04determined that with my high blood pressure and some other health issues and my weight that I was
04:09a candidate for the surgery. The cost out of pocket for me was about $13,000 and part of that included
04:16repair of a hiatal hernia. After the consultation, there were some testing that I had to go through
04:21including blood tests, abdominal ultrasound, and an upper endoscopy. And that endoscopy would
04:28determine whether I was a candidate for the gastric sleeve or gastric bypass. I really didn't want to
04:34go the gastric bypass route. In my research for me, I thought the gastric sleeve was a better option.
04:39So I was hoping that everything looked fine in my GI tract and the endoscopy where they stick a camera
04:46down your throat and look at your esophagus and down into your stomach. I was hoping that that
04:51would reveal that everything was okay to proceed. When I had the upper endoscopy, they did discover
04:56that I had the hiatal hernia and that that would need a repair. There were some signs of acid that
05:02had been present in my esophagus, but nothing to the point that it excluded me from having the
05:07gastric sleeve surgery. When having my abdominal ultrasound, they did find a mass on my liver
05:12and after more testing, it was determined that that mass was a hemangioma, which is a non-cancerous
05:19tumor on the liver. It's basically a cluster of blood vessels and so we're just going to keep an
05:24eye on that. From my understanding, it's nothing to worry about. In some cases, insurance will pay for
05:30bariatric surgery. The advantage of that obviously is that they pay for this and you don't have to
05:35worry about the financial burden. The disadvantage is most insurance companies have a very strict
05:40set of guidelines that you have to go through in order to qualify. Because I was going through
05:46self-pay, there were some things my surgeon required me to do, but I didn't have to wait the
05:50year time frame that many insurance companies require. So I did have to participate in a few
05:57group Zoom sessions with other potential bariatric patients and during these sessions we talked about
06:04nutrition, lifestyle, and other aspects of a weight loss journey and how to be successful
06:12post-surgery. I also met one-on-one with a dietician and a psychologist for a psych consult
06:19and they go through a bunch of different things just to determine that you are a good candidate
06:23for the surgery. All these things happened pretty quickly for me because I was doing a self-pay
06:28program. For those who are having insurance pay for the surgery, this is usually stretched out over
06:34a little bit more time, in many cases a full year. The last appointment that I had with my dietician
06:39before surgery was a one-hour Zoom appointment going over the dietary guidelines, they called it
06:46a binder class, going through the whole binder step by step, week by week. The worst thing that
06:51can happen is that somebody comes home from surgery and eats solid food and just completely
06:56ignores the dietary requirements to heal properly. I'll talk a little bit more about that as we get
07:03going into the video about what I ate and drank and what I'm eating now four months later. I'll
07:08also show you guys some before and afters and some things I didn't expect going through this
07:13process. Hang with me in this video because I have a lot of helpful information for you. After the one
07:19hour nutritional appointment, I had a pre-op appointment to go over blood work again. The
07:23surgery date was scheduled and the nurse walked me through what to expect on surgery day. They were
07:29absolutely fantastic. I had my surgery in Denver, Colorado. I'll list my surgeon's name and phone
07:34number in the comments below. So two weeks prior to the surgery was an all-liquid diet. I thought
07:41this would be a lot harder than it was. Basically you're drinking protein shakes. I drank the Fair
07:45Life chocolate shakes pretty much for two weeks. You do drop a little weight then, but the reason
07:50you do that is to repair your body, clean out your system for surgery, and also reduce the size of
07:56your liver. This helps gain better access to the stomach area. It's really important to follow that
08:01liquid diet before surgery. Now every surgeon has different rules and requirements so yours may look
08:07different than mine. Now I won't say that that liquid diet leading up to surgery was easy by
08:12any means. You know you do see other people eating food, you have cravings, but I was so looking
08:18forward to changing my life and being successful with this that I really didn't find it to be
08:24terrible to do the liquid diet. So on surgery day you're going to go in with an empty stomach. Of
08:30course no eating or drinking before surgery for several hours. Every surgeon's a little bit
08:34different. I had a wonderful nurse who kind of walked me through everything. I knew what to
08:38expect but she really put my nerves at ease. She did remind me there was going to be some discomfort
08:44after surgery. She didn't want to sugar coat it and I appreciated that. I knew I was going to wake
08:49up and have some discomfort and so I think going into it knowing that you're doing something that's
08:54pretty major as far as removing a portion of your stomach and there will be some discomfort
09:00following surgery. So immediately after surgery while I was in the hospital they did keep me
09:04comfortable with pain meds through my IV and they also get you sipping water pretty quickly. It's
09:10important for them to see that you can drink an appropriate amount of water or liquids before
09:15going home. In that first 24 hours I only drank clear liquid which was water and chicken broth.
09:21Following that for two weeks I drank water, chicken broth, crystal light, and fair life
09:27protein drinks. Small amounts sipping throughout the day about every two hours making sure that
09:33we're focusing on getting enough protein in the system. I didn't find this hard at all because
09:38the stomach is still healing and I didn't want to overload my stomach so I really had no solid
09:44food cravings during that time. But as I get closer to that two week being on liquids post
09:50surgery, mind you I had two weeks before and then two weeks after so that was a month of liquid
09:55basically, by the end of that two week period I was really looking forward to doing pureed foods
10:00and soft foods. So there is a progression you go from liquid to pureed to soft foods and then start
10:06to ease into more normal foods. The discomfort in my stomach lasted for the first week to two weeks
10:12but each day it got better and better. So I noticed it like when I tried to turn in bed or if
10:18I stood up too fast and so I really just took it easy. I did walk around the house a little bit
10:24during that first few weeks to get some exercise and gradually moved that outside but usually had
10:30somebody with me for support. I found for me personally I was a little lightheaded in those
10:34first few weeks so I really wasn't wanting to go outside and walk without somebody with me.
10:39The big reminder is listen to your body. Don't push yourself. If you're not feeling up to a walk
10:45then don't walk. Maybe just walk around the house but do try to get up and move around. Now for me
10:50personally because I followed the diet to the letter I really didn't have much or any nausea.
10:56I had a few waves of nausea here and there but I've never vomited and still to this day four
11:01months later I've been vomited since surgery and I don't have constant bouts of nausea. I make sure
11:06that I'm eating no more than half a cup in one setting and now four months later I can tell if I
11:12overeat even by just a spoonful or more. It's just a full feeling that makes me feel like I want to
11:18burp and so you start to learn your your body's new normal and what is too much for your stomach
11:25size. I had to remind myself in those first two weeks after surgery that it was temporary and my
11:31stomach was still healing. Remember a major organ in your body has been partially removed and so
11:37everything needs to heal inside. Four months later I have no pain or residual side effects from
11:44surgery other than not being able to eat as much. The one exception to that is that the regaining of
11:50energy is a slow process. Your body is metabolizing food differently, you're processing food differently
11:56and you're not consuming as many calories as you used to. So it does take a while for your body to
12:02shift into this new normal and especially when you're having just liquids or period foods you're
12:07definitely not getting many calories at all to fuel you. You start to have more energy as you
12:13shift into eating more solid foods. I found that getting a good night's sleep and doing my best to
12:18make sure I'm sleeping well was super important to my healing and also weight loss. Weight loss
12:24really does require you to get a good night's sleep so focus on sleep if you can. It wasn't
12:30uncommon for me to take a nap in the middle of the day for a couple of hours when I needed it
12:34and sometimes that made all the difference in my mood in the way I felt and when I hit a weight
12:40loss plateau getting those little extra naps in made a difference. It also made a difference to
12:45get a little more movement in my day and after the first six weeks I started lifting weights
12:51not crazy not heavy and not for a long duration but I did start lifting weights and I'm starting
12:58to see the payoff in my arms. So someone asked about resuming intimacy you know there was no
13:03hard and fast rule with my doctor just they said use your best discretion as far as letting things
13:09heal and not being in pain. So I think for me it was maybe like three weeks so for those who want
13:14to know that aspect of it it really from person to person when you're feeling better when you're
13:20not in pain when you feel up to it but definitely check with your doctor. So the dietary progression
13:25starting with your liquids for two weeks and then moving to pureed foods for a week and then soft
13:31foods like cottage cheese, scrambled eggs, things like that that are soft and easy to go into the
13:37stomach and then moving on to introducing more solid foods into the diet. The things that I eat
13:44mostly are pretty repetitive because it's comfortable for me. I eat Greek yogurt, I eat
13:49scrambled eggs, I love chicken breast that's well seasoned sometimes with a side of a vegetable but
13:55I don't like to put too much fibrous vegetables into my system because they'll take up so much
14:00space in the stomach when you really need to focus on the protein. So I always eat the protein first.
14:05I've had some oatmeal, I like to eat cottage cheese, cheese, really high quality lunch meats and I'll
14:12just put that oftentimes in a piece of cheese and fold it up like a little taco and it's not that
14:17I'm opposed to eating any carbohydrates, I'm just finding the most success when I'm reducing
14:22carbohydrates or making sure the carbohydrates I do eat are vegetables or oatmeal. I'm really not
14:27eating any bread, tortilla, pasta and if I do it's maybe just one bite. When you've been focusing on
14:33protein for a while you don't miss the carbs and sugar at all. You really start to get used to this
14:38new way of eating. If I crave a carb it maybe would be like black beans with some chicken or rice with
14:44some chicken but I don't do it very often. I do really like a hamburger patty with a little bit of
14:51light mayo and ketchup and just focus on eating the hamburger patty with no bun. Certainly you
14:56could add vegetables or lettuce or onions, whatever you like. Pretty much any meat on the grill or any
15:01meat I can eat now that I'm four months in, you know, that's a great way to get protein if you're
15:05not a vegetarian or vegan. I absolutely love my Greek yogurts and so I tend to eat a couple of
15:12those a day. That might be my pre-breakfast followed by two scrambled eggs a few hours later.
15:17I might have some good quality lunch meat folded into a piece of cheese for lunch followed by
15:24another Greek yogurt later in the afternoon and maybe half a chicken breast for dinner.
15:30Periodically I will have a protein drink still but I'm trying to focus on food rather than getting
15:36all my protein and calories from liquids. So somebody asked me about grieving the loss of
15:43that stomach and feeling sadness or depression after surgery. I think this can happen and I had
15:49a few days of sadness but it wasn't grieving eating and it wasn't grieving what might happen
15:55down the road or how my life might be not centered around food or eating the same amount of food as
16:01other people. I think it was just kind of healing from the surgery, feeling a little bit emotional
16:07because I was worried about regaining energy and feeling good again but I assure you after a couple
16:12weeks when things are healed you feel so much better. Not everything is completely healed within
16:16two weeks but that for me was kind of the turning point when things started feeling a lot better. So
16:21I reminded myself that even though I was feeling better you really still have to be careful because
16:26a full healing is going to take a while. So there may be some grieving and mourning the loss of the
16:32stomach and the loss of that old comfort eating especially for someone who has a true food
16:37addiction and that's something to take very seriously. Processing those emotions, those habits,
16:42and that comfort and friendship some people feel, that relationship with food, it's something to
16:47really think about before jumping into this journey. This surgery is a very safe surgery.
16:52In fact, my surgeon said it's no more risky than having your gallbladder removed but it is still
16:59something to really take seriously and consider. It's a surgery. I think for anybody going through
17:03this type of surgery it's important to really be honest with ourselves about a relationship with
17:08food and how we can cope with the things that we're using food to comfort us. How could I cope
17:14with the grief of my son without turning to food as comfort? You know, how can you as someone
17:20considering gastric sleeve surgery cope with the things that you're masking with food? So finding
17:26other ways to cope and finding that comfort in new and healthy ways is so important. So another thing
17:33to consider is the expense of new clothes. So I prepared for this. I did have savings. I paid out
17:38of pocket for my surgery and I repurchased pretty much a whole new wardrobe. I kept a few pieces
17:43that kind of worked for me baggy like some sweatpants that I can still wear around the house
17:48but literally most of my clothes now are not fitting. Four months in I'm down 55 pounds. My
17:53body looks completely different. I'm getting a lot more exercise and I'm feeling so much better. My
17:59blood pressure is completely back to normal. My health has just improved so much I can't even
18:04tell you guys. So there will be that expense but there's also other ways besides rebuying all clothes
18:10you can borrow from people, hit up some great thrift stores, and you know the thing is if you
18:15have a lot of weight to lose you don't want to repurchase a whole wardrobe for every size
18:20because you're going to be moving into new sizes. I think like the first 40 pounds that I lost I
18:25didn't buy anything new. Now that I'm over 50 pounds I've pretty much changed my whole wardrobe
18:31and the other thing is finding your style again. For me during that those two years of grieving the
18:36loss of my son I had always been into fashion and looking nice and I completely let that go
18:41and I lived in comfy clothes and I just really lost my sense of style and so I'm rediscovering
18:47that and that takes time. So I'm buying some pieces that the old thinner me would have loved
18:52but now I'm like not so sure if that's where I want to be with my style. So the expense of
18:58repurchasing a wardrobe but also not going crazy with new clothes until you get to where you really
19:04feel like you can stabilize and make that investment in a smart way. One of the things
19:08that surprised me is that you're going to have so much love and support around you but you're also
19:12going to have haters and people who criticize, people who think that you have no self-control,
19:16people who think it's an easy way out, and let me tell you it's a really huge commitment. My hat's
19:21off and huge love for those who've gone through bariatric surgery and made the changes you needed
19:26to make to take your life back. It is not easy. Like any change in life it takes so much strength,
19:32commitment, and focus to be successful. There are people who have bariatric surgery and gastric
19:37sleeve who lose weight initially but regain the weight back. They haven't dealt with the emotional
19:42connection to food and some people will opt for a revision surgery because they've stretched that
19:47stomach out again. I'm committed to not doing that and to following the guidelines specifically to
19:53avoid weight regain, which is something for me that I'm terrified of. I don't want to put in all
19:58this work, go through a surgery, pay the money, and have the weight come back on. So I think people
20:05think that gastric surgery is a magic bullet or the easy way out but you still have to put in the
20:11work. There will be people out there who are not happy for you, who are jealous of the happiness
20:17that this brings you, the improved health that this brings you, and that you're feeling good
20:20about yourself. There will be people who liked you better that and that's really unfortunate.
20:25In some ways you have to learn to move on and surround yourself with people who support you
20:30and who lift you up and sadly in some cases those people are family members who liked the old you,
20:36who don't want to see you healthy and thriving and thinner. There may be somebody in your life
20:41who has enabled you and you being in that position brought something to their life. Maybe it be the
20:46role of a caretaker or maybe they felt superior to you in some way. I'm not a psychologist so
20:50certainly I can't get into the psychological aspects of all of these relationships that are
20:55surrounding you but definitely consider that and don't let anybody sabotage your success.
21:00Whether you are losing weight naturally or whether you're doing it through the assistance of a
21:05gastric sleeve or bypass surgery, the people who truly love you will support you being healthy
21:12and having the kind of life that you've always craved. Something I'd like to remind you of is
21:16that loving yourself through the entire phase from beginning to end, loving yourself at every weight,
21:23loving yourself at every emotional roadblock. Give yourself grace not just in a weight loss journey
21:30but in general. In most cases people find themselves contemplating weight loss surgery.
21:35It isn't just the love of food. There are other emotional aspects, feeling of self-loathing,
21:42lack of self-esteem and trauma, deep deep trauma in their lives that have brought them to this place.
21:49Giving yourself love and grace and understanding that you're worthy of being your best self.
21:54You're worthy of being healthier and you're worthy of feeling beautiful. All these things are
22:00important and I have to remind myself of them a lot. Just always remember to be good to yourself.
22:05This is not an easy journey. We make mistakes along the way and we get back up, forgive ourselves and
22:12move forward. If I have any other questions come in, I will definitely leave the answers to those
22:17questions in the first pinned comment and like I said feel free to ask any question down in the
22:22comment section below. I'm happy to help. Thank you so very much for watching. If you haven't already
22:27I'd love for you to join the Gorgeously Aged community by subscribing to my channel. You can
22:31keep up to date on my weight loss progress. I'll definitely be posting a lot of before and afters
22:37and a lot of my little mini workouts I do at home which have been so helpful. For me it's not enough
22:42just to lose weight. I definitely want to feel healthy and I want to have longevity and good
22:48health moving through my 50s and into my 60s. Again thank you so much for being here. If you
22:53like this video give it a thumbs up and consider sharing it with a friend. I'll see you guys next
22:58time.

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