Bariatric Surgery: Life Changing Decision

Friday February 14, 2014 at 6:06 AM | 1 Comment

Nancy Mooers Brown

Nancy Mooers Brown 1982

This is the first in a series that will help you deal with bariatric weight-loss surgery and travel.

Part 1: Bariatric surgery: life changing decision

Part 2: Bariatric lifestyle & nutrition

Part 3: Bariatric support groups & travel

Disclaimer: I am not a doctor, I am a travel writer. You should not consider my bariatric journey as professional medical advice. Consult with your doctor to see if this life changing decision is right for you.

As we discussed my weight gain during my latest doctor appointment I watched nervously as my primary care physician scrawled “consider Bariatric Surgery” on the yellow pad of paper. This was my patient copy, another copy would be entered into my medical records. Yet another weight loss failure I thought to myself as she handed me, what I perceived to be, another nail in my plus-size coffin.

Like most bariatric surgery patients, I have struggled with my weight throughout my entire life. I had a successful dance with a weight loss program in high school, before going off to college (where no one knew me as heavy.) I gained a little weight in college, but not enough to warrant a comment from a fraternity boy to “watch my weight or you’ll end up like one of those fat housewives.”

Three months after meeting with my primary care physician, I got up the courage to make a consultation appointment with a Bariatric surgeon. After a quick step on the dreaded scale in the doctor’s office, my BMI (body mass index) was determined to meet the requirement for this type of weight loss surgery. My BMI, coupled with high blood pressure and high cholesterol, along with my “young” age, qualified me as an ideal candidate for weight loss surgery.

Weight Loss Surgery – is it right for you?

After asking the surgeon how long he had been performing weight loss surgery, I continued down my list of questions.

Q: What is the percentage of complications with bariatric gastric sleeve procedures?
A: Any surgical procedure involves risk. The gastric sleeve procedure results in the best weight loss with the least amount of problems.

Q: Is my hospital (John Muir Medical Center, Concord) a Center of Excellence and certified through ASMBS (American Society for Metabolic and Bariatric surgery)?
A: As of this writing, John Muir Hospital is undergoing the certification process and fully expects to receive certification as the proper programs, support, training and equipment have been in place for years.

Q: What is the cost of the surgery and does my insurance (Blue Shield of California) cover this type of procedure?
A: “If it were my decision,” said Dr. Brian Chin. “I could perform the surgery next week. Depending on your insurance, you will need to meet at least once – sometimes six times- with a registered dietitian, as well as complete a psychological evaluation.” According to Dr. Chin, he views the insurance company requirements as a way to dissuade patients from jumping through the pre-screening hoops and ultimately, opting out of the surgery, resulting in saved money for the insurance company.

Nancy D. Brown

Nancy D. Brown 2013

I had called my insurance provider to confirm that my insurance plan did cover Bariatric Weight Loss Surgery. I was given the wrong information and told that my insurance plan required six months of nutrition counseling.

After my initial nutrition appointment, Blue Shield denied payment noting, “services provided for the diagnosis listed are specifically excluded from coverage under the subscriber’s plan.” I immediately filed a grievance inquiry and began to document every conversation with my insurance carrier. To make a long story short, I learned that my insurance DID NOT require six months of nutrition counseling. I could have had the surgery after one nutrition appointment and the required pre-operative bariatric surgery psychological evaluation.

Due to my insurance carrier’s mistake, I had to wait until February to apply for surgery, requiring me to start a new calendar year with a high deductible policy. Attempting to make lemonade out of lemons, I used these additional months of required nutrition counseling and optional support group meetings as preparation for a complete lifestyle change. After all, my type of surgery is not reversible. Check with your insurance provider to see if bariatric surgery is covered under your insurance plan and prepare to be your own advocate every step of the way on this weight loss journey.

Q: What are the different types of bariatric surgery and which one is right for me?

A: According to my surgeon and the helpful book Weight Loss Surgery for Dummies, there are several types of weight-loss surgeries. The most commonly used surgeries are: gastric bypass surgery, lap band surgery and gastric sleeve procedure.

Q: What are the ramifications if I elect not to have bariatric surgery?

A: Continued weight gain, continued high blood pressure, continued high cholesterol, continued excess weight on joints, continued risk of type II diabetes (adult onset diabetes) as well as possible heart attack or stroke and possible shortened life span.

Q: What are the benefits of bariatric weight-loss surgery?
A: Significant weight loss, high probability of discontinuing prescription medication for weight-related issues; ward off diabetes, less risk of heart attack and stroke, increased longevity, more active lifestyle, healthier eating habits, self acceptance, smaller clothing size.

When I left the surgeon’s office, I was handed a nondescript black folder. Inside the black folder held the steps I would take, should I select bariatric surgery. The next day I scheduled a nutrition consultation. In no way was I convinced that I should have this drastic weight-loss procedure. Read my next post in this series to see what changed my mind.

Related post
Bariatric lifestyle and nutrition

Sage Inn, Provincetown, Massachusetts

Wednesday February 5, 2014 at 8:08 AM | 0 Comments

The patio in front of Sage Inn.

Sage Inn in picturesque Provincetown.

Location, location, location!

Smack in the middle of Commercial Street, Provincetown’s bustling main drag, yet tucked away slightly down a narrow brick alleyway, is the well-situated Sage Inn. Lively bars, boutiques, restaurants, and galleries line Commercial St. in the heart of “Ptown.” And Sage is a relaxing oasis close to it all.

Rooms are small but many are newly renovated. Rates during the off-season range from $85 for a classic queen room to $130 for the premium guest room with a king-sized bed. Prices jump to $225-$300 during the summer season, when Cape Cod comes alive.

A beautifully landscaped brick patio, (including a living wall) out front is the perfect place to relax with a book on a comfy couch. One of the proprietors has some mad gardening skills.

Travel & Leisure dubbed gay-friendly Provincetown as one of America’s Most Romantic Towns and for good reason. It simply brims with charm and the harbor and beaches are the ultimate in picturesque.

The Sage Lounge is open year round and offers hand-crafted cocktails infused with herbs & fresh fruit as well as small plates ideal for a light dinner or dessert. Think lobster sliders, a meza trio with grilled pita, parmesan fries with truffle oil, or the ubiquitous Cape Cod clam chowder.

Sage is a popular spot for weddings, conferences, and other events like the upcoming Valentine’s Weekend four-course dinner or the hands-on cooking class with Sage’s award-winning chef Lucio Garnica and pastry chef, Alana Garnica.

Sage Inn
336 Commercial St, Provincetown, MA 02657
(508) 487-6424


Healthy Holidays to Get Fit While You Travel

Monday February 3, 2014 at 6:06 AM | 3 Comments

This post is underwritten by First Choice

spa, Sabila Spa

Spa therapy for a healthy holiday

Who doesn’t love a vacation? Yet holidays don’t have to be filled with sinful eating and lounging around like a beached whale.

There are plenty of healthy dining options for travelers on an active adventure vacation. In the spirit of new year’s resolutions I’d like to share five places to travel for a healthy holiday. Who knows, you might have fun and lose a little weight during your vacation!

California spa vacation

I’m a northern California girl, but that doesn’t mean I can’t fly south for the sunshine, or in Ojai’s case, a pink moment sunset. Ojai, California holds a special place in my heart. This mountain community, 83 miles northwest of Los Angeles and east of Santa Barbara, is located in Ventura County. It is also home to Ojai Valley Inn & Spa. There are several spas to choose from in this community; the Ojai Valley Inn & Spa is a luxury retreat offering healthy cuisine, tennis, golf and every spa treatment you can imagine. Read my review of Ojai Valley Inn and Spa here.


buddha, lumeria maui

Experience a yoga retreat at Lumeria Maui in Hawaii

Yoga & meditation retreat in Maui, Hawaii

Lumeria Maui is only a 30 minute drive from Kahului Airport, but it is a world away from all of your worries and stresses. This wellness retreat in upcountry Makawao surrounds guests in a welcoming embrace with its natural beauty, tropical plants, local garden and many buddha statues.

During my visit, I savored the nightly organic and healthy meals prepared by the Lumeria in-house chef and joined in with Hawaiian locals for master yoga classes.

New since my review, Lumeria has added a salt water swimming pool and Jacuzzi. See a detailed review and more photos here.

Horseback riding and Thai massage in BC Canada

When I flew into Kamloops Airport in British Columbia, I wasn’t sure what to expect. This was my first visit to Echo Valley Ranch, a luxury resort owned by English ex-pat Norm Dove and his Thai wife, Nan.
Originally purchased as a retreat for family and friends, the couple kept building on the 160 acre property, resulting in the opening of Echo Valley Ranch in 1995.

ban thai spa, echo valley ranch

Enjoy Thai massage at Echo Valley Ranch

Their executive chef creates fresh and healthy cuisine using plants from their organic garden and cattle, chickens, turkeys and pigs raised on their ranch.

I traveled to Echo Valley Ranch for the horseback riding offered throughout the property and bordering the Marble Range Park. Trail rides offer incredible views of British Columbia’s Fraser Canyon. Little did I know that the ranch is known for its Thai style massage at their Ban Thai Spa.

Drawing from Nan’s Thailand connections, many of the massage therapists specialize in this unique 90 minute Thai massage – a new and wonderful experience for me. See my Echo Valley Ranch review here.

Pico Island, vineards

Pico Island is Portugal’s highest point and offers great hiking

Hiking and riding on Pico Island, Portugal

Europeans love Portugal’s Pico Island for its terrific hiking opportunities. Pico Island holds the unique distinction of being the second largest island in the Azores and is the highest point in all of Portugal.

This was my first trip to the Azores and it was wonderful. If you have a chance to visit this chain of islands, you won’t want to miss Pico Island. In addition to hiking and horseback riding, there is whale watching and there are several museums on the island.

One of the most unique features about the island is the vineyards growing inside basalt rock walls next to the Atlantic Ocean. Crazy! Read my review of things to do on Pico Island here.


flamenco dancer, Esther Vélez

Learn to Flamenco dance in Seville, Spain

Flamingo dancing in Seville, Spain
My daughter had the opportunity to study Spanish in Seville, Spain through her university. I remember my trip to Madrid and Seville, Spain back in 2008. In addition to the beautiful public art and lovely architecture, I was fascinated with the Flamenco dancers and their colorful Flamenco dresses.

There are plenty of places to learn the art of Flamenco dancing in Spain and it is certainly a great way to get exercise. For those not interested in moving your body, the Museum of Flamenco Dance in Seville is a gem of a museum and offers Flamenco dance performances. This photo of Esther Velez was taken by me during a performance at the Museum of Flamenco Dance in Seville.

Do you opt for healthy holidays when you travel? Where do you recommend for an active adventure vacation? For European vacation planning, visit First Choice for all inclusive travel.

Article written by Nancy D. Brown. Photos courtesy Nancy D. Brown.