Losing weight with bariatric surgery is not just about a smaller number on the scale, it's about changing your life for the better. When you commit to taking the first step to a new life, you will have a multidisciplinary support team to back you along the way.
Kristi Fregia-Rucks PT, Aspirus Bariatric Program Coordinator, joins the show to discuss Aspirus Bariatrics. Where you can find support for your success all the way to your goals.
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Aspirus Bariatrics: Support to Help You Achieve Success
Featured Speaker:
Kristi Fregia- Rucks, PT - Aspirus Bariatric Program Coordinator
Kristi obtained her Physical Therapy degree from Mount St. Mary’s University in Los Angeles, Cali., and is the program coordinator of the Bariatrics program at Aspirus Wausau Hospital. Special Interests: Bariatric surgery, weight loss, headaches, and neurological rehabilitation. Transcription:
Aspirus Bariatrics: Support to Help You Achieve Success
Melanie Cole (Host): Losing weight with bariatric surgery is not just about a smaller number on the scale. It’s about changing your life for the better, becoming that person you want to be. When you commit to taking the first step to a new life, you’ll have a multidisciplinary support team at Aspirus to back you along the way. My guest is Kristi Fregia-Rucks. She’s a Physical Therapist at Aspirus Bariatric Program Coordinator. Welcome to the show, Kristi. Tell us about support for bariatrics, and let’s start before, when someone is really considering bariatric surgery, what’s involved in that pre-surgical, pre-decision support?
Kristi Fregia-Rucks (Guest): Great. Well, thank you for having me. It is so exciting to look into bariatric surgery when you first start out. It’s really important to have somebody on your own side, for example, a spouse, a family member, or friend that is going to support you, but then we’re also there to support a person, as well. We mean, we have a support group, we have dieticians, we have a physical therapist, we have a psychology team. It’s all built around that as well as, of course, the support with the surgeon.
Melanie: So then let’s start with some of that pre-counseling because it’s something that most bariatric patients have to go through – if not all. They need some counseling to determine that this is right for them. Along with that counseling, mental health professionals, physical therapists, and nutritionists, what are they doing for this person?
Kristi: I’m glad you mentioned the physical therapy because I forgot to add myself to that original statement. Physical therapy before bariatric surgery is really important because we need to make sure that patients understand what they can do for exercise. A lot of times, people are afraid that they can’t do this or they can’t do that. When I open up their eyes, all of a sudden, they remember oh, I can walk, or I can swim, or I can go to pool aerobics, and we can figure out different ways for them to get their exercise in. It doesn’t have to be all at once. They can do a little bit of exercise at a time.
The dietician is there to support people. They help figure out what works in a person’s diet. Just because I like carrots, doesn’t mean you like carrots. That way, the patient can tailor their pre-op diet and their post-op diet to their own likes and their own dislikes, I suppose. The psychologist’s team works with – I like to say the brain. They want to make sure that our brain is on the right page.
Melanie: What about help navigating insurance because before somebody would consider this type of surgery, they need to know if their insurance company is going to be involved.
Kristi: That’s a really good point. Before surgery, we need to ask our insurance companies if they even cover the surgery themselves. And then we can help the person get the pre-op paperwork or authorizations done – get all those pieces ready to submit to the insurance company. But like I said, the first thing is to find out if the insurance company even does cover the bariatric procedure.
Melanie: Once they’ve been cleared to have the procedure, Kristi, then they have this pretty life-changing procedure. Where does a physical therapist and specifically, a nutritionist, fit into that aftercare? What’s life like for someone who’s just had bariatric surgery?
Kristi: A person that just had bariatric surgery comes back and sees the dietician, and the physical therapist, and the surgeon at their two-week follow-up. At that point, they can be pretty scared about what they can eat with their new, little belly and what types of exercises they can do. They don’t want to hurt anything. One of the most exciting things is they’re probably not going to hurt anything with exercise, so we get them walking right away. In fact, they walk the day of surgery.
With their post-op diet, there are so many different things that they need to learn before surgery, and they have everything all figured out so that after surgery they have all of their ducks in a row, and they have a list of – okay, I can eat this, but I can’t eat that.
Melanie: And what do you tell them about – so, they can take a walk, and they can begin the exercise, but what about things like weight-training, or if they’ve been obese, they might have joint issues, back problems, knee problems, any of those things. Where does physical therapy fit into that picture of trying to rehab some of those things that might have been caused by their obesity?
Kristi: That’s a good question. A lot of times, people are so fearful of all of their ailments – and that’s what’s so great about having a physical therapist as part of the team because I can work with those ailments and say, “Okay. Well, if your knees bother you, try doing this.” And you also mentioned the point that exercise doesn’t include just walking, but we also need to include strength training as part of our program. I always incorporate aerobic exercise, strength training, and even some stretching or yoga activities, as well, so they have a well-rounded program.
Melanie: And how long does that ongoing support last for, Kristi? How long does someone after surgery see a physical therapist, continue to see their nutritionist? Is it until you reach your goals? How long does that go on?
Kristi: We consider our patients a patient for life. And I don’t mean that you’re going to be coming to see the physical therapist every week for the rest of your life. Basically, for the first year, we see patients every three months, so it’s pretty spaced out. The nice thing about that is that people are ready for a change every three months in their exercise program, so we’re ready to make those changes and help them make those changes. The same thing with the diet -- every couple of months or three months, it’s time to change that up a little bit and add the new textures or the new foods that you’re supposed to add at those times.
Melanie: Tell us a little bit about Aspirus Bariatrics’ monthly support group, called ALOHA, A Lifetime Of Healthy Achievements. Tell us a little bit.
Kristi: Our support group is run by the dietician and also by the physical therapist. We’ve had extensive training in support group topics, and we have lots of interesting topics for our patients to learn about every month. The other exciting thing is just the patients themselves in the group. Even though we have a topic, there’s always time to talk about other things too, so it depends on who’s at the group, different topics that come up, and it’s just really exciting to have all of the same people – or excuse me, all of the people in the same boat there to support each other. Even if somebody doesn’t have a spouse as a support, but instead, they have a friend, maybe somebody else has a friend there too, and it’s just exciting to be able to see those interactions.
Melanie: So members and friends can also come to this support group?
Kristi: Exactly, family members and friends are encouraged to come to support group because we want to make sure that you always have somebody on your side beside us. We’re a little biased.
Melanie: What if someone’s uncomfortable in a support group in a big group, is there also one-on-one sessions?
Kristi: There’s always an opportunity to talk to us one-on-one with myself, with one of our dieticians, so that’s always an option. It’s really interesting that I have patients that will say, “Oh, I’m afraid to be in a group,” or, “I don’t really like a group setting,” and how much they really enjoy coming to support group. In fact, I’ve had some patients that come to support group, and they listen, and they’ve never said a word, and they keep coming back because they learn so much. It’s really fun.
Melanie: So, how does somebody get started with the Aspirus Bariatric Program and support group?
Kristi: The best way is to give us a phone call. Our phone number is (715) 847-0024. Give us a call, and we can send a packet right out to the house. If you had any specific questions at that time, I could certainly answer those for you. Otherwise, the packet is pretty self-explanatory. You fill it out, you get it back to us, and we get you an appointment to meet with one of our surgeons.
Melanie: So, wrap it up for us, Kristi, what you’d like people to know about Aspirus Bariatrics and the support that goes along with this exciting, but challenging decision.
Kristi: We encourage you if you’ve been thinking about weight loss, or if you’ve been thinking about bariatric surgeries or procedures, to give us a call or even to email us – that’s perfectly fine, too – so that we can get you going in the process. We have such an exciting team to work with, and we just have such a good time together. I hope that you would have fun as well.
Melanie: Thank you so much, Kristi, for that great information. This is Aspirus Health Talk, and for more information on Aspirus Bariatrics, please visit Aspirus.org, that’s Aspirus.org. I’m Melanie Cole. Thanks so much, for listening.
Aspirus Bariatrics: Support to Help You Achieve Success
Melanie Cole (Host): Losing weight with bariatric surgery is not just about a smaller number on the scale. It’s about changing your life for the better, becoming that person you want to be. When you commit to taking the first step to a new life, you’ll have a multidisciplinary support team at Aspirus to back you along the way. My guest is Kristi Fregia-Rucks. She’s a Physical Therapist at Aspirus Bariatric Program Coordinator. Welcome to the show, Kristi. Tell us about support for bariatrics, and let’s start before, when someone is really considering bariatric surgery, what’s involved in that pre-surgical, pre-decision support?
Kristi Fregia-Rucks (Guest): Great. Well, thank you for having me. It is so exciting to look into bariatric surgery when you first start out. It’s really important to have somebody on your own side, for example, a spouse, a family member, or friend that is going to support you, but then we’re also there to support a person, as well. We mean, we have a support group, we have dieticians, we have a physical therapist, we have a psychology team. It’s all built around that as well as, of course, the support with the surgeon.
Melanie: So then let’s start with some of that pre-counseling because it’s something that most bariatric patients have to go through – if not all. They need some counseling to determine that this is right for them. Along with that counseling, mental health professionals, physical therapists, and nutritionists, what are they doing for this person?
Kristi: I’m glad you mentioned the physical therapy because I forgot to add myself to that original statement. Physical therapy before bariatric surgery is really important because we need to make sure that patients understand what they can do for exercise. A lot of times, people are afraid that they can’t do this or they can’t do that. When I open up their eyes, all of a sudden, they remember oh, I can walk, or I can swim, or I can go to pool aerobics, and we can figure out different ways for them to get their exercise in. It doesn’t have to be all at once. They can do a little bit of exercise at a time.
The dietician is there to support people. They help figure out what works in a person’s diet. Just because I like carrots, doesn’t mean you like carrots. That way, the patient can tailor their pre-op diet and their post-op diet to their own likes and their own dislikes, I suppose. The psychologist’s team works with – I like to say the brain. They want to make sure that our brain is on the right page.
Melanie: What about help navigating insurance because before somebody would consider this type of surgery, they need to know if their insurance company is going to be involved.
Kristi: That’s a really good point. Before surgery, we need to ask our insurance companies if they even cover the surgery themselves. And then we can help the person get the pre-op paperwork or authorizations done – get all those pieces ready to submit to the insurance company. But like I said, the first thing is to find out if the insurance company even does cover the bariatric procedure.
Melanie: Once they’ve been cleared to have the procedure, Kristi, then they have this pretty life-changing procedure. Where does a physical therapist and specifically, a nutritionist, fit into that aftercare? What’s life like for someone who’s just had bariatric surgery?
Kristi: A person that just had bariatric surgery comes back and sees the dietician, and the physical therapist, and the surgeon at their two-week follow-up. At that point, they can be pretty scared about what they can eat with their new, little belly and what types of exercises they can do. They don’t want to hurt anything. One of the most exciting things is they’re probably not going to hurt anything with exercise, so we get them walking right away. In fact, they walk the day of surgery.
With their post-op diet, there are so many different things that they need to learn before surgery, and they have everything all figured out so that after surgery they have all of their ducks in a row, and they have a list of – okay, I can eat this, but I can’t eat that.
Melanie: And what do you tell them about – so, they can take a walk, and they can begin the exercise, but what about things like weight-training, or if they’ve been obese, they might have joint issues, back problems, knee problems, any of those things. Where does physical therapy fit into that picture of trying to rehab some of those things that might have been caused by their obesity?
Kristi: That’s a good question. A lot of times, people are so fearful of all of their ailments – and that’s what’s so great about having a physical therapist as part of the team because I can work with those ailments and say, “Okay. Well, if your knees bother you, try doing this.” And you also mentioned the point that exercise doesn’t include just walking, but we also need to include strength training as part of our program. I always incorporate aerobic exercise, strength training, and even some stretching or yoga activities, as well, so they have a well-rounded program.
Melanie: And how long does that ongoing support last for, Kristi? How long does someone after surgery see a physical therapist, continue to see their nutritionist? Is it until you reach your goals? How long does that go on?
Kristi: We consider our patients a patient for life. And I don’t mean that you’re going to be coming to see the physical therapist every week for the rest of your life. Basically, for the first year, we see patients every three months, so it’s pretty spaced out. The nice thing about that is that people are ready for a change every three months in their exercise program, so we’re ready to make those changes and help them make those changes. The same thing with the diet -- every couple of months or three months, it’s time to change that up a little bit and add the new textures or the new foods that you’re supposed to add at those times.
Melanie: Tell us a little bit about Aspirus Bariatrics’ monthly support group, called ALOHA, A Lifetime Of Healthy Achievements. Tell us a little bit.
Kristi: Our support group is run by the dietician and also by the physical therapist. We’ve had extensive training in support group topics, and we have lots of interesting topics for our patients to learn about every month. The other exciting thing is just the patients themselves in the group. Even though we have a topic, there’s always time to talk about other things too, so it depends on who’s at the group, different topics that come up, and it’s just really exciting to have all of the same people – or excuse me, all of the people in the same boat there to support each other. Even if somebody doesn’t have a spouse as a support, but instead, they have a friend, maybe somebody else has a friend there too, and it’s just exciting to be able to see those interactions.
Melanie: So members and friends can also come to this support group?
Kristi: Exactly, family members and friends are encouraged to come to support group because we want to make sure that you always have somebody on your side beside us. We’re a little biased.
Melanie: What if someone’s uncomfortable in a support group in a big group, is there also one-on-one sessions?
Kristi: There’s always an opportunity to talk to us one-on-one with myself, with one of our dieticians, so that’s always an option. It’s really interesting that I have patients that will say, “Oh, I’m afraid to be in a group,” or, “I don’t really like a group setting,” and how much they really enjoy coming to support group. In fact, I’ve had some patients that come to support group, and they listen, and they’ve never said a word, and they keep coming back because they learn so much. It’s really fun.
Melanie: So, how does somebody get started with the Aspirus Bariatric Program and support group?
Kristi: The best way is to give us a phone call. Our phone number is (715) 847-0024. Give us a call, and we can send a packet right out to the house. If you had any specific questions at that time, I could certainly answer those for you. Otherwise, the packet is pretty self-explanatory. You fill it out, you get it back to us, and we get you an appointment to meet with one of our surgeons.
Melanie: So, wrap it up for us, Kristi, what you’d like people to know about Aspirus Bariatrics and the support that goes along with this exciting, but challenging decision.
Kristi: We encourage you if you’ve been thinking about weight loss, or if you’ve been thinking about bariatric surgeries or procedures, to give us a call or even to email us – that’s perfectly fine, too – so that we can get you going in the process. We have such an exciting team to work with, and we just have such a good time together. I hope that you would have fun as well.
Melanie: Thank you so much, Kristi, for that great information. This is Aspirus Health Talk, and for more information on Aspirus Bariatrics, please visit Aspirus.org, that’s Aspirus.org. I’m Melanie Cole. Thanks so much, for listening.