sr910

After being somewhat "on the fence" and experiencing happy/scared feelings, I finally decided, 100%, that I wanted to move forward and get the sleeve! I'm very much in the beginning stages (have only attended the informational seminar and given a copy of my insurance card) but I spoke with my surgeon's insurance specialist and I heard the dreaded words... "you have to complete 6 months of supervised dieting." After failing with medifast, weight watchers, slim fast, etc., I really don't want 6 months of, well, failure! But I just selected a primary care doctor and haven't even seen a doc for 1.5 years so I'm guessing there's no way around it. Anyone else doing the 6 months of supervised dieting? What's it like? Anyone get around the 6 months of supervised dieting? What did your insurance require from you?

Okay, update... Talked to coordinator and have my first appt with nutritionist Aug 22. Called insurance company and found that they do NOT specify any sort of time frame, but just say that I have to have actively participated in non-surgical methods of weight loss and that the doctor must evaluate. Spoke w/ coordinator and told her about insurance not requiring 6 mo diet, and I also told her about my insurance changing to a higher deductible plan in January, so... She said I can just do 3-month diet and get sleeved in December!! First thought: I won't have that looming feeling of failure over a New Year's resolution. Second thought: Surgery -- is this too extreme? Do I really want to do this?? I have a few months to think... =)

Just wanted to share this "Global Fat Scale" from BBC. It calculates your BMI, then tells you which country your health/BMI is closest to. At my current, pre-sleeve weight, my height/weight/BMI is most similar to the country of Tonga. =( Hopefully I'll be changing to a slimmer country soon! http://www.bbc.co.uk/news/health-18770328

Iron and zinc levels also have an impact on hair loss. http://bariatrictimes.com/2008/09/19/the-latest-on-nutrition-and-hair-loss-in-the-bariatric-patient/

I'm guessing that my insurance not showing any bariatric coverage is because it's not just automatically on everyone's plan. Hopefully my surgeon saying it's medically necessary will get me the "ok" from the insurance. My surgeon's coordinator just emailed me a couple days ago to say they'll be calling to set up a nutritionist appt so I can start the 6 months. However... I planned on changing my insurance in January anyway, because I somehow selected a plan where my normal primary care physician isn't covered. No use in going through all the nutrition stuff with one surgeon if I'm going to have to switch and start over. I currently have coverage with Sharp, but will be changing to Scripps. On a positive note there, my friend who went through Scripps didn't have to do 6 months of sup. dieting... We'll see. I'll just continue to lurk here and learn as much as possible! Thanks everyone =)

Marhaba! Hi guys, so this isn't sleeve related, but I just wanted to ask... are you native-born to where you live in the Middle East? If not, what took you to the Middle East -- work, family, etc? I used to work in El Cajon, CA, where there is a very large population of Iraqi refugees. I LOVE the people, the food, the music, and even started learning Arabic! I kind of gave up on Arabic once we got to the writing part, though. I hope to visit one day! My husband wants to go to Abu Dhabi (specifically for Formula 1 racing, of course), but I would love to visit Lebanon.

As a tattoo'd lady myself, I understand why you would want a tattoo now, before goal -- a permanent reminder of how far you've come (so far)! I agree that it is probably best to wait, as you don't want something beautiful and meaningful to morph into a ink splotch. But I also agree that places without as much loose skin (wrist, ankle) would be a smart choice if you can't wait.

Yeah I think the zero calories and zero fat is measured as a spray -- if you take off the sprayer part and pour the butter stuff, I don't believe it can be counted as zero calories and zero fat...

Do you still have your gallbladder? Lower right sounds like gallbladder, and the pain tends to permeate upwards, around, and to the back.

They can keep my stomach, but I'm still annoyed that my oral surgeon did away with my wisdom teeth before I was even awake! He said I couldn't have kept them anyway. Then I had a surgery on my arm where a portion of bone was removed, and I didn't even think about asking for my piece of ulna until months later =( Oh well

I have been looking at shapewear to hold everything in while I shrink -- hoping this will help with the impending saggy skin problem. Has anyone used any sort of shapewear for the upper arm area? I found these... http://www.mytights.com/us/shapewear/arm-shapers/mary-portas-charnos-plain-armery.html ...but I'm hoping someone can make a recommendation or speak from experience.

With my BMI what it is (46 I think) I am def going to exhaust every option. I can also try to supplement my insurance w/ my husband's and see if that helps... Oh well. Might as well sit back and not worry about it too much.

OMG called insurance to see what the specifics of the 6-month diet are and they said I have NO bariatric coverage! Dr. Mueller's coordinator, Monique, said she'd get me set up with Laura but if I don't have any bariatric coverage, might as well stop now! Open enrollment with my employer is coming up in October. I'll just have to do my research at that time and see who to switch to. Lame sauce.

Yes, the statistic is that 95% of dieters will re-gain their lost weight in 1-5 years. And once your weight gets to the obese category, you have an even smaller rate of success for keeping lost weight off.

Esophageal stricture? My whole family has esophageal issues -- my grandma, mom, and myself. I only have a hard time with a couple things, corn tortillas in particular. No matter how small the bite and how much I chew, and attempt to wash down with water, I hiccup and it feels stuck.

From Bariatric Times... (http://bariatrictimes.com/2008/09/19/the-latest-on-nutrition-and-hair-loss-in-the-bariatric-patient/) Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40mg/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemic, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after biliopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high-dose zinc supplementation as a therapeutic agent for related hair loss2 in patients who had undergone vertical banded gastroplasty. The study administered 200mg of zinc sulfate (45mg elemental zinc) three times daily to postoperative patients with hair loss. This was in addition to the Multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus, we cannot definitively say that zinc would prevent hair loss after weight loss surgery, and further study would definitely be needed to make this connection. A further note: The tolerable upper intake level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60mg/day. Information related to this study has made its way to many a support group and chat room—even to doctor’s offices—with the message that “high-dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high-dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen, or prealbumen.3 Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk.4 With surgical reduction of the stomach, hydrochloric acid,5 pepsinogen, and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion rather than malabsorption is responsible for many cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2g of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Biotin Many individuals believe that supplementing with, or topically applying, the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include Vitamin A, inositol, folate, B6, and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS), and is influenced by genetics. Conclusions Hair loss can be distressing to bariatric surgery patients, and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value.

Since the location of the piercing was purposely avoided, I'm assuming it's in a *special* place and I'd say... take it out. Especially if a nurse is going to be inserting a catheter...

And yes, your doctor may very well deny surgery. The purpose of the pre-op diet is to shrink the liver, which kind of sits on top of your stomach. If your liver is normal size, then the doctor may not be able to get to your stomach to do the surgery. http://www.solacedme.com/images/fr7_liver.jpg ^^That shows where the liver sits in the abdominal cavity, covering the stomach

Not to sound harsh, but if you can't follow doctor's orders for a week or two, how are you going to follow the guidelines for this lifestyle change you're attempting to embark on? If you mess up your sleeve, going through the surgery is going to be pointless...

I attended my pre-approval seminar this past Wednesday, and the surgeon said it takes about 3 weeks for the staples to be healed over with scar tissue. I would definitely call the doctor, but know that your staple line should be healed.

Thank you!! I'm not doing it for anyone's viewing pleasure, but I feel like women should get an A for effort instead of "What kind of visual effect are you playing on me?" My intention isn't to deceive anyone, but to just feel comfortable. I haven't been sleeved yet, but once I am, and once the weight comes off and leaves skin (which of course I'm hoping shrinks back), I'm assuming letting it just *hang* there will be pretty uncomfortable...

I have one, brand new, still in the box. I've had it for at least 3 years. Where do you live? I'm thinking I might use it someday, but you can borrow it and see if it's something you really want to purchase. I'm in San Diego...

Queenlylocs, I'm not sure that anyone really *knows* what kind of shapewear is best, or how effective it will be. Just like everyone loses weight differently, people's skin may shrink back (or not shrink back) differently. For me personally, I am looking for something that will have firm enough support to really suck everything in (after the tenderness of the incisions has subsided), and I plan to wear it as much as possible. I probably won't wear spanx because I don't like how they feel on and mine always tend to roll down at the top. I'm sure there isn't really any comfortable shapewear, but there's got to be something I can stand better than spanx... Good luck, all. I'll let you know if I find anything great. I'm going to check out the Gabrialla Breathable Elastic Abdominal Binder for Women that scubadottie found on Amazon...

Pantyhose -- that's smart thinkin'! I tend to wear 3/4 and long sleeves, so my wings should be hidden, but I'm kind of thinking I might be able to "train" the skin to not droop all willy-nilly when I start shrinking.