Many people struggle with weight the majority of their adult life. Sometimes it takes a physician to intervene and suggest bariatric surgery. At 363 pounds, this was the case for Deena. With the help of Dr. Brian Long, Bariatric Surgeon at the Nicholson Clinic, Deena shed 191 pounds.
This is her story.
“Prior to having weight loss surgery with the Nicholson Clinic, I had been severely overweight for the majority of my adult life. I had tried everything to lose weight, but could never get very far,” Deena said. “I gained quite a bit of weight with my pregnancy and was at my heaviest weight of my life at 363 pounds.”
As is true for many patients living with obesity, Deena suffered a number of comorbidities, including joint problems, type 2 diabetes and sleep apnea.
“My body hurt all of the time, I had severe knee problems and had a knee surgery with the surgeon telling me I would need a total knee replacement in the near future,” she said. “I was on several medications for acid reflux, depression, pain, etc. and had been diagnosed with type 2 diabetes and used a CPAP for sleeping.”
But the excess weight wasn’t just a serious health concern for Deena, it also impacted her daily life and prevented her from doing what she loved most — especially playing with her children. Being a parent is a lot of work, and we see many patients, like Deena, who come to us because they simply aren’t able to be as active and involved with their kids as they’d like to be.
“I have 3 children and I wanted to be able to run around and play with them, but I couldn’t. I could not get up and down off the floor with them. I got worn out easily and couldn’t do as much with them as I wanted. It made them sad that Mommy couldn’t play with them like they wanted.”
The primary concern with obesity is that it has been proven to take years off a person’s life. As parents ourselves, we want to be healthy and around our kids for as long as possible, and we want the same for our patients. Thankfully for Deena, her new primary care physician recognized the dire shape she was in, both physically and emotionally, and recommended weight loss surgery as an option to help her lose the weight and reclaim her life.
“After the suggestion from my primary care physician, I contacted the Nicholson Clinic on a referral from a good friend who was a previous patient,” Deena said. “At my initial consult, we discussed all of the options and what I could expect from surgery, including the outcomes.”
“Nicholson Clinic set me up with nutrition and mental health pre-surgical counseling. They really take care of their patients well before the actual surgery, ensuring they are ready for the changes this will bring in their life,” said Deena. “Post-surgery, the Nicholson Clinic and staff have been amazing as well. They have been in touch with me, supporting me throughout recovery and transition to my new life.”
At the recommendation of Nicholson Clinic doctors, Deena selected the gastric bypass procedure and had surgery on November 18, 2018. Just 16 months later, she has lost nearly 200 pounds!
Not all of our patients come to us with a recommendation from their primary care physician, like Deena, but that extra push helps make the decision easier. We encourage our patients to consult with their primary care doctors and/or endocrinologists and we work hand-in-hand with those other healthcare providers to ensure our patients have the best comprehensive team and support system in place before and after surgery.
“I truly do have a new life,” said Deena. “The Nicholson Clinic and this surgery completely changed my life. I am happier overall, I feel great, I feel like I look great. My family is proud of me and I am proud of myself. My kids love that I can run around with them and do anything they want to do. I can jump on our trampoline with them now! I am now off of all medications, and no longer need a CPAP to sleep. I have no more pain in my body, and have not had any more knee troubles. At my heaviest weight, I was 363 pounds. I am now 172 pounds. I am maintaining now, and could not be happier with my life and my health.”
Congratulations to Nicholson Clinic surgeons, Nick Nicholson, MD, Brian Long, MD and Thomas Roshek, MD who have been named among D Magazine’s 2020 Best Doctors in Collin County.
Each year, D Magazine asks physicians in Collin County who
m they would trust to treat themselves or a loved one. Doctors are nominated by their peers, then reviewed and voted on by a panel of esteemed healthcare professionals. “Much like when a respected physician or their family member comes to us for bariatric care, this honor carries the same weight,” says Dr. Nicholson.
And this is not the first time Nicholson Clinic doctors have been named to D Magazine’s Best Doctors in Collin County list. Dr. Nicholson has been recognized nine times. This is the sixth time for Dr. Roshek and the second time for Dr. Long. “We are honored to have received this recognition for so many years and to know peers place such a high level of trust in the care we provide at the Nicholson Clinic,” says Dr. Nicholson.
Nicholson Clinic’s long track record of success and providing top, expert care has been attracting patients from across the U.S. and from around the world. We’ve seen patients from all 50 states and 10 countries travel to Nicholson Clinic for weight loss surgery. Our doctors have treated more than 15,000 patients, and while the majority of these patients are in Texas, more and more patients are making the decision to travel to Nicholson Clinic for weight loss surgery.
Ariel is one patient who opted to have her surgery with Nicholson Clinic, even though that meant traveling to Texas from New Jersey. This is her story.
Life before surgery was a constant battle for Ariel. As many of our patients understand all too well, she tried many times to lose weight, but only found herself gaining even more. “It’s a vicious cycle,” she said.
The tipping point for Ariel came after she met a patient who had undergone weight loss surgery at Nicholson Clinic. “He looked amazing! I couldn’t believe it had only been a couple of months [since surgery],” she said. “He showed me his ‘before’ picture and told me all about the surgery and how quick and easy it’s been for him. I was sold! The next morning, I contacted the Nicholson Clinic!”
Ariel was living in New Jersey at the time, but Nicholson Clinic staff and her Patient Care Advocate worked with her to make the process as easy as possible. “The process of filling out the paperwork needed was very easy, and everything is accessible via email,” she said. “I actually found myself on a beach in Jamaica filling out my forms!”
Not only did Ariel travel from New Jersey to Texas for surgery with Nicholson Clinic, but three of her family members living in New York and Florida chose Nicholson Clinic for their weight loss surgery as well.
“I had my uncle here with me the same day of surgery. We were actually scheduled one after the other. It’s been great to have someone to go through this with, because it is a hell of a ride! Only someone who’s been through this can truly understand and appreciate the journey. My uncle is down to his goal weight and has managed to keep it off. He’s off his diabetes medication and no longer suffers from constant migraines.
His wife and brother also had surgery at the Nicholson Clinic a few months ago. They are doing well on their own path of losing weight and being more active. Both are doing great!”
Ariel has had great success in the year since surgery, as well. “Life has been amazing! I’ve lost 105 pounds, my energy is through the roof, I feel great, I’m completely healthy, my weight and BMI are normal,” she said” “I truly feel as if I bought my life and happiness back! I’m a mother of a 6-year old, and one more child on the way (through surrogacy). And I truly feel blessed that I can be here for my children, who deserve to have a happy, healthy mom.”
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) agree that bariatric surgery can improve outcomes for some patients with diabetes.
The ADA-EASD organizations jointly released a report with recommendations for controlling hyperglycemia in patients with type 2 diabetes. They determined that metabolic bariatric surgery can reduce complications from type 2 diabetes including improved blood-sugar regulation and a better quality of life.
Many advancements in the treatment of diabetes have improved outcomes, however, given the complexity of diabetes, without the proper care and support systems, the complications of poor blood glucose control are progressive and can be devastating.
The ADA found that metabolic surgery, in a qualified bariatric center such as the Nicholson Clinic for Weight Loss Surgery in Texas, is now recommended for patients with type 2 diabetes who are unable to control their blood sugar adequately with other measures and who also need to control their weight.
According to the ADA’s 2018 Standards of Medical Care in diabetes, bariatric surgery is:
- Recommended for any patient with a body mass index (BMI, a ratio of weight to height used to estimate how close a person is to a healthy weight) of 40 or higher, regardless of their A1C.
- Recommended for patients whose BMI falls between 35 and 39 if lifestyle changes and medication alone are unable to control A1C levels.
- Considered an option for people with a BMI between 30 and 34.9 if medications (including insulin) are unable to regulate A1C.
According to the ADA, “Metabolic surgery helps to achieve superior glycemic control and reduction of cardiovascular risk factors.” Even when compared to various changes in lifestyle and medical interventions, metabolic surgery showed improvements in complications, cardiovascular disease and cancer.
Taking steps to lose weight safely and effectively can make a very big difference in reducing complications from type 2 diabetes. Nicholson Clinic is committed to making sure that our patients have a team of professionals at their disposal that will help them achieve their weight loss and health goals one step at a time.
Ready to Learn More?
If you are ready to learn more about the comprehensive weight loss services offered at the Nicholson Clinic, contact us today! Fill out the form below to have a representative contact you to schedule a consultation and/or answer any questions you may have. Or give us a call at (972) 494-3100.
In February 2019, Mike underwent gastric sleeve surgery with Dr. Long. Since his initial consultation just a few months before surgery, Mike has lost more than 125 pounds. This is his story.
Life Before Surgery
“I was always a big kid. I come from a family of large people with a history of heart disease, stroke and diabetes. I was diagnosed 10 years ago with high blood pressure and my last doctor visit prior to surgery, I was borderline diabetic and was about to be put on cholesterol medication.”
As is true for many of our patients, Mike had tried dieting for years, only to lose the weight and gain it back. He tried various diets, including Atkins, low-carb, medifast and just counting calories.
“It worked while I was dedicated, and I lost weight, but as soon as I wasn’t 100 percent with it, the weight continued to creep back up and I would always gain more than when I started.”
At just 43-years-old, Mike experienced pain in his legs from everyday activities, and something as simple as drying his hair would leave him out of breath. “It took me forever to get to work just from parking my car because my legs hurt, causing me to walk very slow.”
Turning Point
“I knew I needed to make the decision to change my life. I had done so many diets before, but I needed something that assisted me to stick to a meal plan allowing me to control my portions, so I decided to go to the Nicholson Clinic for the gastric sleeve.”
The Process
Once he had made his mind up and contacted Nicholson Clinic, the process was quick and smooth.
“I filled out a questionnaire online and got a call to have a consultation. I attended the consultation with Dr. Long, was approved by my insurance and then we set the surgery date.”
Because he had done his research ahead of time, Mike knew the benefits of the gastric sleeve procedure. With his family history of heart disease, stroke, diabetes and his own history of high blood pressure, pre-diabetes and other health conditions that were contributed to his weight, Dr. Long agreed that gastric sleeve would give Mike the best chance at creating change.
Due to his history of dieting, losing and gaining weight, Dr. Long also knew gastric sleeve was the best for for Mike. The gastric sleeve procedure that not only limits food intake by decreasing stomach capacity, but also limits production of the hormone ghrelin, which contributes to hunger.
Mike’s insurance required three visits with a dietitian and a psychological evaluation. Nicholson Clinic helped him receive insurance approval and get scheduled for surgery at Baylor Plano. And the support he received with Nicholson Clinic didn’t stop there.
“Even after surgery everyone has been so helpful and willing to assist in any question, concern and very informative for ongoing changes and success.”
Life After Surgery
“Life is so much better now since surgery. I’m able to live a healthy, active life,” Mike says. I have lost a total or 131 pounds from my heaviest. From this I am no longer pre-diabetic. My glucose is perfect now. My cholesterol has continued to get better and I’m on the lowest dosage for my high blood pressure medication.
I’m so much more confident in myself. I’m much healthier and happier. My end goal was to live a healthy life to have a life of memories with my husband.”
In 2009, Maegan had LAP-BAND surgery. Although she wasn’t severely overweight at the time, Maegan sought help to shed unwanted pounds and jumpstart her weight loss. Unfortunately, the experience was not what she hoped it would be.
“I had an awful time with it,” she said. “I was vomiting all the time, sometimes just from water. When I could eat, I would binge.”
Initially following the procedure, Maegan did experience some weight loss. But it wasn’t long before the number on the scale began to climb again, eventually reaching her heaviest weight of 247 pounds. “I saw the pictures from my son’s first Christmas and hated all of the ones I was in.”
And it wasn’t just about weight gain, Maegan also suffered abdominal pain from the LAP-BAND.
After Christmas, Maegan reached out to Nicholson Clinic’s Dr. Roshek for help. “He answered all of my questions. He talked to me with passion and an understanding of what I was going through,” said Maegan. “In that conversation, Dr. Roshek mentioned doing a revision to the sleeve. I was so against it at first because of my first weight loss surgery experience. But he explained the entire procedure, the outcomes and possibilities.”
Unfortunately, Maegan’s experience with the LAP-BAND is not unique. A decade ago the procedure was one of the most popular bariatric options, but in recent years, LAP-BAND procedures have been on the decline as more options become available that have proven to be more effective for long-term weight loss, with fewer complications.
In some cases, a LAP-BAND patient may simply need a simple office procedure to fill the band. In other cases, the band may have slipped and can be adjusted. But, like Maegan, many patients are looking for a better solution. That’s where bariatric revisional surgery comes into play.
During band-to-sleeve revision surgery, the LAP-BAND is removed and replaced with the gastric sleeve. Like the LAP-BAND procedure, a sleeve gastrectomy is performed laparoscopically, and most patients go home the same day. During this procedure, a large portion of the stomach is divided vertically and removed. This is the non-reversible part of the procedure. The remaining stomach — now reduced to about 25 percent of its original size — is shaped like a banana, and resembles a tube or sleeve.
Gastric sleeve results in gastric restriction, reducing the amount of food volume that can be comfortable ingested. It also removes the portion of the stomach responsible for the production of the hunger hormone, ghrelin. As a result, patients who undergo a band-to-sleeve revision report a reduced appetite, allowing them to lose weight.
Maegan’s story is testimony to the success many of our revision patients experience. Just eight months after surgery, she was down 78 pounds!
“It’s the best decision I’ve ever made. This is nothing like the band,” she said. “It’s amazing, normal and has given me my life back. I can eat normally, in smaller amounts. I can run, literally run a mile without stopping. I can shop at any store I want. I can walk into a room with confidence and run a meeting. Most importantly though, I love every single picture and memory with my son.
As with any bariatric procedure, band-to-sleeve revision is hardly taking the easy way out. Patients are still required to eat right and exercise. “I eat right. I work out. I stay active and enjoy my new life! For this, I will be forever grateful.”
The vast majority of people begin their healthcare journey online, doing a great deal of research before they ever even step foot in a doctor’s office. By the time they come in for an initial consult, they typically already know the benefits of weight loss surgery, the various types of procedures available and which procedure might be a good fit for them.
While it’s wonderful to have so much information at your fingertips, without the input from an experienced bariatric surgeon, it can be confusing to determine what specific route would be the best for you. If you’ve been thinking about weight loss surgery, here are some questions you may want to ask your doctor before you make the decision to have surgery.
1. Is weight loss surgery a good option for me?
Prior to surgery, you should have a consultation with a surgeon, the doctor who would actually be doing your procedure. During this consultation, a thorough medical evaluation should be performed, and any appropriate tests should be ordered so the doctor can determine which procedure might be right for you. The doctor will explain options including how the surgery is performed, how it will help you lose weight, and what to expect during recovery. Your consultation should not feel rushed; it should be thorough, and the recommendation should be personalized to your specific needs.
2. How many procedures have you performed? How many surgeries do you do on a monthly basis?
A surgeon who does just a handful of weight loss surgeries each month simply isn’t as qualified as one who does a high volume consistently over a long period of time. But why does this number really matter? Studies show that the more procedures a surgeon has performed, the better their patients’ outcomes. Similar to mastering any life skill, typically the more a surgeon repeats the procedure, the better he or she becomes. Additionally, the more experience your surgeon has performing bariatric procedures, the more adept they become at monitoring safety and recognizing potential complications and any issues that might arise so they can react quickly and appropriately to provide the most effective outcome to the patient.
3. Are you credentialed and do you operate at accredited hospitals? Are you a MBSAQIP Verified Surgeon?
Not every surgeon has the credentials to operate at the top hospitals. Being recognized as a MBSAQIP Verified Surgeon is important because it means your doctor has met the standards of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). The MBSAQUP sets national standards for bariatric surgery centers with the goal of advancing safe and high-quality care for bariatric surgery patients. These standards come from the collaboration of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS). Another benefit of operating at the top hospitals is that your surgeon will have access to the latest technology and the most advanced equipment that not all surgery centers are able to offer.
4. What types of pre-op and post-op support do you offer?
Remember surgery is only part of the weight loss solution. It takes a lifestyle change and commitment to follow a strict diet and exercise program to lose the weight and keep it off. You should not be alone in this journey. Patient support provided by your weight loss clinic should be comprehensive — psychological, nutrition, and fitness support offered by a variety of specialists and in a variety of ways. Patients should have the opportunity to receive one-on-one support and group support, both in-person, and virtually 24/7. Patients should be able to receive support no matter what barriers may exist — geography, time limitations, etc. Your bariatric clinic should be your trusted provider with you all the way, for life — not just in the first year following surgery.
Asking your doctor the right questions can help you make the decision that is best for you and your individual needs.
Perhaps you’ve already had a consultation with another surgeon, but didn’t feel comfortable or get your questions answered. Consider a second opinion. Weight loss surgery is a big decision to make — don’t give up on the chance to have life-changing surgery simply because the first doctor you met with didn’t meet your expectations. You should feel comfortable with your surgeon, their experience, philosophy and bedside manner. You should also feel confident in the support staff and everyone who will be taking care of you before, during and after surgery.
At the Nicholson Clinic, we are internationally recognized as experts in our field and committed to providing the highest level of care to each and every patient. If you are considering weight loss surgery, here are the first steps to take in your journey.
First, take our pre-candidate screening.
Next, watch a free seminar online.
Finally, schedule an appointment for a consultation.
At Nicholson Clinic, we strive to always be the best at what we do. Through innovation and leadership in bariatric surgery, and providing outstanding patient care, it is our goal to be the support system our parents need to reach their health goals.
2019 has been a successful year for our clinic. Not only did we begin using the groundbreaking da Vinci Xi robotic surgery system to benefit our patients in recovery, we have and we are thrilled to announce the addition of three new “Best Doctor” awards to our growing list of awards and recognitions.
In September, Living Magazine recognized Nicholson Clinic in the list of Top Bariatric Surgeon and General Surgeon categories. Dr. Thomas Roshek was named one of the “Best Doctors” in Dallas, by D Magazine, marking the fourth time he has received this recognition. In addition, Dr. Roshek was added to the SuperDoctors® list and named a Texas Super Doctor, a recognition he also received in 2018.
In a growing field of medicine, it is our goal to always stay ahead of the game. We are committed to staying at the forefront of technology, offering the latest advancements in surgical techniques to our patients to improve patient outcomes and ensure safety. If you are considering bariatric surgery, look no further than the Nicholson Clinic. Founded by Dr. Nick Nicholson, one of the country’s leading weight loss surgeons, our clinic offers a variety of options to help you gain control of your weight and reclaim your health.
Patients who chose to undergo bariatric surgery do so for a number of reasons. Though the physical results of weight loss surgery are often the most obvious, the benefits of weight loss as a result of bariatric surgery go far below surface level.
Obesity-related health conditions , including heart disease, high blood pressure, gallbladder disease, sleep apnea, diabetes and even some cancers are a real concern. In patients who have type 2 diabetes, obesity is often the cause of their disease. When you are overweight, the excess body weight causes strain on the pancreas, impacting its ability to produce insulin, resulting in insulin resistance that leads to type 2 diabetes.
Diabetes rates have skyrocketed in America in the last 20 years, according to the Centers for Disease Control, due in part to the spiking obesity rates. More than 100 million adults in America are living with diabetes or prediabetes — and as many as 90 percent of people living with type 2 diabetes are overweight or obese, according to The Obesity Society. Even more startling — the American Diabetes Association estimates that 8.1 million Americans are living with undiagnosed diabetes. Left untreated, high blood sugar resulting from diabetes can cause kidney damage, liver failure and even death.
Weight loss surgery as a treatment for diabetes
There is good news in the fight against type 2 diabetes. Studies show that losing even a small percentage of excess body fat reduces a person’s risk for developing diabetes. For patients who have already been diagnosed with the disease, weight loss can decrease dependency on diabetes medication.
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recognize weight loss surgery as an effective treatment option to reduce complications associated with type 2 diabetes.
The impact of bariatric surgery on diabetes is two-fold. Not only does surgery help a person lose weight; it may also affect hormones that control how the body responds to insulin and blood sugar.
In a 2018 joint report, ADA and EASD recommend recommend bariatric surgery as a means of controlling hyperglycemia (high blood sugar) in patients who have type 2 diabetes. For patients who are unable to control their blood sugar with diet, exercise and medication alone, weight loss surgery can help.
According to the ADA’s 2018 Standards of Medical Care in diabetes, bariatric weight loss surgery is:
● Recommended for any patient with a body mass index (BMI) of 40 or higher, regardless of their A1C.
● Recommended for patients whose BMI falls between 35 and 39 if lifestyle changes and medication alone are unable to control A1C levels.
● Considered an option for people with a BMI between 30 and 34.9 if medications (including insulin) are unable to regulate A1C.
A healthy body weight is essential in both the prevention and treatment of type 2 diabetes. Weight loss surgery may not be a cure for diabetes, but research has shown that diabetic patients who choose bariatric surgery see a marked improvement in blood sugar levels.
If you are overweight or obese and have been diagnosed with diabetes, or you have a family history of diabetes, contact Nicholson Clinic today to learn more about weight loss surgery as an option to reduce your risk.
Did you know you that if you have a Flexible Spending Account (FSA), Health Savings Account (HSA) or Health Reimbursement Account (HRA), you can use those funds to pay for weight loss surgery? If you’ve been considering bariatric surgery, but have been concerned about the cost because your insurance doesn’t cover it, or perhaps you have a high deductible, your FSA, HSA or HRA can help cover the expense — and it’s tax free!
FSA, HSA and HRA funds are taken out of your paycheck pretax, so not only will you not pay taxes on those funds used to cover medical expenses like weight loss surgery, but making a contribution to an FSA/HSA/HRA also lowers your taxable income
FSA: Use It or Lose It
If your employer offers a flexible spending plan for healthcare expenses, you can set aside up to $2,700 (up from $2,650 in 2018), and use this pre-tax income to pay for a variety of healthcare expenses, including weight loss programs and bariatric surgery.
Flexible Spending Accounts are different than Health Savings Accounts in that you must use the funds in your account each year, or you will lose them. Employers are allowed to extend a $500 rollover of FSA funds from one year to the next, or a two-and-a-half month grace period to use the previous year’s FSA dollars (but are not required to offer the rollover or grace period).
If you are unsure how your FSA plan is set up, talk to your employer’s human resources department to find out which, if any, extensions apply to you.
Save Even More at Nicholson Clinic
Nicholson Clinic is dedicated to helping prevent finances from limiting any patient who desires life-changing weight loss surgery. We are proud to offer one of the lowest self-pay prices in town, along with a number of payment options, including cash pay, payment plans and with financing for as low as $248/month.
Few bariatric practices include everything in one low price, from your initial consult to your post-op follow-up visits for life! And our pricing is significantly lower than the national average. (Read more about payments and pricing on our website.)
If you’ve been on the fence about bariatric surgery and your funds expire December 31, it’s not too late to get scheduled for surgery. Contact us today with any questions or to get the process started.
