James Marusek

Find a copy of your insurance plan or go online and find one and look up the part that discusses bariatric surgery. Many health insurance plans are similar. This is what my plan says: •Surgical treatment of obesity (bariatric surgery) is covered only if: - eligible enrollee is 18 of age or over - clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following: • Type II diabetes mellitus (by American Diabetes Association diagnostic criteria). • Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications. • Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications). • Obesity–induced cardiomyopathy. • Clinically significant obstructive sleep apnea. • Severe arthopathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity. - Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration. Since you have GERD, it would be wise to focus on RNY gastric bypass surgery, because sleeve surgery will only make this condition worse.

I am 3 years post-op RNY gastric bypass surgery. I hit a couple bouts of severe constipation along the way. What worked for me was eating an apple a day just before bedtime. But it was very important to eat the skins also. One of the things that can cause constipation is dehydration. So if you are not getting in enough fluids then increase your uptake. Constipation come up often on this board. Here are some of the past recommendations: Smooth Move Herbal Tea Prune juice (warmed) Prunes (4 in the morning and 4 at night) Magnesium citrate Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). Haribo sugar free Gummy Bears (be careful with this one because it can lead to diarrhea) Aerobic Magnesium 07 Ground Flax Seeds (but don’t try to grind it yourself). Use 2 tablespoons per glass of Water every night before going to bed. Low Fat Bran Muffin (recipe). 80 calories each 1 cup flour 2 teaspoons baking powder ½ teaspoon baking soda ½ teaspoon cinnamon 2 cups bran Cereal 1 ¼ cups milk 1 egg ½ tablespoon applesauce optional: banana, berries, mini chocolate chips Bake 400° F for 22 minutes

Congratulations.

One of the main reasons why I had RNY gastric bypass surgery was because I had diabetes. I was on two forms of medication and even that wasn't controlling the diabetes and my primary physician wanted me to transition to insulin shots. My mother had diabetes and I helped to care for her. She developed a diabetic ulcer on her foot. With diabetes these wounds simply do not heal. She had it for years and if it was not constantly cared for it, could easily lead to a major infection and a foot amputation. So seeing what she went through, I resolved not to go down the same path. The interesting thing is how quick you can end diabetes forever. The day I left the hospital, two days after my surgery, I was off all my diabetes medicine. I haven't taken any meds since. I am 3 years post-op and diabetes is still in remission. I test my blood sugar levels periodically and they are fine, actually far better than when I was on my meds prior to surgery. Also gone is my high blood pressure, sleep apnea and GERD.

It is my understanding that most insurances use the weight at your first check-in.

Sounds normal. After my RNY gastric bypass, I transitioned from full liquids to pureed foods to solids over the coarse of 2 months. Most foods tasted very drab. When I finally reached the solid stage, it was difficult because solid foods were hard on the stomach. But I noticed that mixing foods together helped restore some of the flavor. So I primarily used soft foods, home-made high Protein chili and Soups once I reached the solid phase. Also I completely lost my hunger. It took about a year but it finally returned but not at the same intensity as pre-surgery.

Good luck on your surgery and check back with us when you are on the other side and let us know how it went.

After my RNY surgery, I was restrict to Full liquids for the first 4 weeks and pureed Foods for the next 4 weeks. It was only until Week 9, that I was allowed to transition to solid food. Since you had surgery on 8/23 that would put you at the 3 1/2 week mark. This is a little too soon to make the transition to solids. So I recommend that you take your time in this transition because it can be difficult. I found that softer foods such as chili and Soups went down much easier than solid food such as steak and chicken, so therefore I relied on these to a large extent. They also had a lot of flavor. I have included recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf

I am 3 years post-op RNY gastric bypass surgery. I choose RNY because I had severe acid reflux prior to surgery. The sleeve will only make this condition worse. Also RNY gastric bypass is almost the gold standard. It has been around a long time and most of the bugs have been worked out.

I did not experience any hair loss but some patients do. Generally hair loss occurs during the weight loss phase and once you transition into the maintenance phase, it slows down and recovers.

Here are three things to do while waiting for surgery. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. Since you have a mobility issue, you might try another form of exercise to prepare for the surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

I will pray for you and a successful operation.

I am 3 years post-op RNY and I am not experiencing this.

I had RNY gastric bypass surgery over 3 years ago. It was a great decision. It took care of many health issues including high blood pressure, diabetes, sleep apnea and GERD.

There are two phases to RNY gastric bypass surgery. These are the "Weight Loss" phase and the "Maintenance" phase. Each phase is different and require a different approach. This is the approach that I used in the "Maintenance" phase. http://www.breadandbutterscience.com/Surgery2.pdf

Things to do: 1. Take a good before photograph so that you have something to compare it with after surgery. Many people, like myself, fail to actually see how obese we really are. Then after surgery, we question how effective surgery was. I have enclosed my before and 6 month after photo as an example below. 2. Walk 30 minutes each and every day before surgery, walk every 2 hours after surgery and walk every day for the first year after surgery. This will help the recovery process go smoothly and reduce the pain from surgery. 3. Give up all caffeine and carbonated beverages now if you haven't already. Six months prior to surgery, I went cold turkey on by 6 diet coke a day habit. I lost 20 pounds pre-op on that change alone. But after I went cold turkey, I suffered from a week of severe withdrawal (severe headaches and body aches). Since you have to give this up prior to surgery, it is best to do it now so that you do not compound the effects of your surgery with caffeine withdrawal.

I have a major sweet tooth. That was why I was overweight in the first place. Quest Protein bars do not trigger my sweet tooth. They contain very little sugar. But some Protein Bars are more like a version of a candy bar. They contain significant sugar (and trivial amounts of protein). Important to stay away from these.

I use Quest bars mostly when I am up and about. It is hard to drag along a blender to mix up my Protein shakes. They have a number of different and interesting flavors, such as Cookies and cream. So if you use this product, I would suggest that you buy several different types and try them in order to select the one you most like. Then order them by the box over the internet (Amazon) to get the best price. Using cookies and cream as an example, it has 21 grams of protein, less than 1 gram of sugar, and 9 grams of fat. It also has quite a bit of dietary fiber 14 grams. This is important to me because I suffered from bouts of constipation.

Transitioning to hard foods can be difficult. meats are especially difficult for me. So I relied on softer foods such as chili and Soups.

Many health insurance plans require a 6 month medically supervised weight loss and exercise program. In my case I contacted a doctor specializing in weight loss and met with her to begin the process. I attended monthly Bariatric Surgery Support Group Meetings. I monitored my daily caloric intake. I went cold turkey on my 6 diet coke a day habit. I kept a food journal. I did 30 minutes of exercise (walking) daily. I met with the doctor monthly, was weighed and discussed my nutrition, exercise and progress in weight reduction. At the end of the six months, the doctor forwarded a letter documenting my program and results. This went in with the package that the surgeon's office forwarded to my insurance company requesting surgery approval.

Congratulations.

Congratulations.

Stepped on a scorpion. That doesn't sound like any fun. By the way, how do you treat a scorpion sting. Is it like a major bee sting but many times worse. I have found that if you smash an aspirin and add a little Water turning it into a paste and apply it to the sting, it helps in removing the pain, stopping the swelling and the itch afterwards. But you have to apply it very quickly, say within 5 minutes. I wonder if this approach works with scorpion stings.

Goal weight is somewhat of an artificial number. I think 3 years ago my surgeon and I discussed goal weight and came up with 190 pounds. In the end I dropped to near 140 pounds. Your body will determine how much you will lose and your weight loss will naturally tapper off and you will slide into the Maintenance phase. I slid into maintenance around 7 months post-op. A good goal is the upper side of normal BMI weight category.

A little confused here. Nurse Practitioners do not perform bariatric surgery. So how does your surgeon and hospital rate? John Hopkins is a top rated hospital, isn't it!