NikkiDoc

I live in Pottstown, PA and work in Wilmington, DE. I will be in Elkton, MD at Fair Hill the weekend of Sept 18-20th. I can deliver. I have 2 big totes of clothes I have shrunk out of. They are mostly business casual and some jeans. The pants are mostly 16 short, the tops are XL. There are some 18s, and 2X that slipped through the last purge. There are a some skirts and dresses, some shorts that are likely 18/20, some blazers. Clothes are from Sears, Boscovs, a few are Walmart. I have 2 smaller totes of long sleeve t-shirts and sweaters. These are primarily XL with a few stray XXL or L. I will deliver. I am frequently up in Oley, PA. I can deliver anywhere between Pottstown and Wilmington. I can deliver up to Oley or Reading area. These are free so must take all the clothes. (Totes not included) Please note: smoke free house, all clothes are clean and in good repair. I do have cats and dogs. Flea free house but I can guarantee you will find the occasional pet hair. I will likely be going to Ephrata and Hershey the first weekend in October so could deliver along that corridor during that week- although I would prefer they disappear before then.

OP- I am 47. I was 46 at the time of surgery. I am not a great pill taker. I set a recurring alarm on my cell phone to remind me. I was low Iron prior to the surgery and low D. I take a chewable Multivitamin with iron, a subligual B-12 and a chewable Calcium since my family has a history of osteoporosis. My blood work at 5 months was better after surgery than 1 year before and 1.5 months before. I actually only take my B-12 every couple days instead of daily as it was too high. My surgeon indicated that for the sleeve the most common deficiency is B12 and he prefers subligual pills to injections. Many women have low iron and Vitamin D but that is a problem for many women not just obese or WLS patients. Both my mom and grandmom are very thin and have been their entire lives. My grandmom has broken both her hips due to osteoporosis. I think most if not all women should take Calcium/D to prevent osteoporosis. I spent the majority of my period of being overweight closer to 60-70 pounds overweight. My body was starting to fail- I was pre-Diabetic, high blood pressure, constantly body sore, GERD. My last A1C, about 6 months prior to surgery, was awful. A second one with those results and I would be considered diabetic. Now, no more GERD, better blood results, no more high blood pressure on no meds. I take my Celebrex as needed not daily. I have more energy. My body is no longer failing me. Yes WLS can have risks, so can any surgery. However long term obesity has risks. For me the long term and short term risks of obesity outweighed the slim risks associated with WLS.

I had GERD prior to surgery and was already on Nexium. I had an endoscopy 3 years prior to surgery and did not have a hernia at that time. 2 months prior to the sleeve surgery I did have a hernia. The hernia was repaired when I had the sleeve. I was able to stop the Nexium at my 3 month visit. I have not had any GERD for the last 4 months. My surgeon never even discussed bypass with me. He knew I had GERD and was on Nexium. We didn't find out about the hernia until I was getting my final pre-op medical clearances.

A friend had the lapband. While she has been successful and kept the majority of the weight off for 6 years she does not recommend it at all. My surgeon was doing bands until he retired from bariatrics in July. However he heavily discouraged them and would apparently do them only if the patient really did not want either by-pass or sleeve. I would talk to another bariatric surgeon to see if he/she thinks you are a candidate for the sleeve. If necessary I would postpone the lapband surgery if you need time to see another surgeon. Does you MS doctor have an opinion? What is your current surgeon's concern with the MS medicines and the sleeve? Size, ulcers? Do you need to take NSAIDs or anything with a GI ulcer risk for your MS? Has he consulted with your MS doctor specifically about the drugs you take? If not, why not? I used to have an endocrinologist for my PCOS. There were a few drugs she did not want me to use due to some liver issues I had but refused to talk to my gastroenterologist. When I finally switched endo's the new endo was willing to work with my gastro. The gastro was fine with me taking some of the drugs that the first endo was so concerned about. But she would not pick up the phone or send a letter to the liver specialist to find out she was fine with it. In her effort to be overly conservative I was under treated for 2 years.

I'm in:. Starting weight 167.2 Goal weight 152

I was 46 when I had my surgery in February. I needed to lose 100 pounds, so right as the cut-off point of your question. I have lost 72 pounds of that in 7 months. I would do it if I was a few years older, I would do it if I had only 65 pounds to lose. I had looked into WLS 6 years ago. I did not qualify since I did not weigh enough and didn't have the right co-morbities for insurance. 5 years later I was now heavy enough to not need the co-morbities but now had those too. I wished I could have had the WLS 6 years ago. I was taking diabetic meds off label for PCOS and was pre-diabetic. No more. I was taking meds for high blood pressure- one week after surgery and no more high blood pressure meds. I was taking Nexium for GERD for years prior to the sleeve. I stopped taking Nexium after my 3 month visit. I am down to Celebrex and I no longer take it daily, just as needed. Only you can make the decision but I would not cancel it 2 weeks out. If you are going to cancel wait until the last moment. Look back over your personal history of weight loss, weight gain, weight loss and decide whether you can take it off and keep it off. Many of us have proven we can take it off but we can't keep it off. Are there things you want to do and can't do because of your weight? Write up a list of pros and cons. Is transitioning to by-pass the worst thing? I don't know. But there are plenty of people on this board that their WLS of choice was by-pass and they are happy with the results. Does anybody want to go through the extra revision? No, of course not. GERD is a real concern. I had it before the surgery. My surgeon fixed my hiatal hernia during my sleever surgery. No more GERD. Losing the weight helped with that too.

Are you on something for stomach acid? Sometimes the hungry feeling is really acid reflux. Sometimes it is head hunger. I was on Nexium when I was discharged and for 3 months after. I was give an anti-nausea, Zofran, just in case. Since Nexium is available OTC I would start with that. I would also talk to your surgeon about the possibility of a stricture. In the meantime go back to Protein shakes, pureed foods, really soft foods like fish, refried Beans, ricotta bake, mashed potatoes with Protein powder in it, Soups etc.... When you do eat make sure your chew really really well and wait a long time between bites. My friend had the band was throwing up and getting things stuck since she was eating too fast. She really had to concentrate on what she was eating, how much she was chewing and how fast she was eating. While they are frustrating stalls are common and can last a couple of weeks. My surgeon has me take the subligual B-12. For fluids try different temperatures. The first 3 weeks I preferred hot or room temp. Now I like it really icy cold. I know most programs do not allow straws. I have been using one since week 4 or 5. I was not able to get in my Fluid otherwise. The straw has never been an issue. When I first started using it I would draw the liquid in my mouth, hold a second or two and then swallow. I was afraid of getting too much air since that was the reason I was told to not use straws. I figure I really did not want to risk dehydration and I just was not getting enough fluid without Mio and without a straw.

Mine was 10 days. 3-4 low-carb Protein shakes, broth, SF Jello, SF popsicles. I started my pre-op diet 4 or 5 days early and just started to slowly replace 2 meals with Protein Shakes. I had one real low carb meal and piece of fruit a day in addition to the protein shakes. I had already weaned off off caffeine a month before. I found easing into the liquid diet helped. I also have a history of high liver enzymes to wanted to really make sure to shrink that liver as mine was likely extra inflammed.

I pay insurance for a living. The NP/PA always bill at the same rate as the doctor and has the same co-pay. Every time there is anesthesia there is a bill for the anesthesiologist that oversees the Certfified Nurse Anesthesiologist. The billed amount is exactly the same amount for each. The fees I see always are based on the procedure code and geographic area not the degree of the person providing the service. The PPO allowed is the same for MD/DO as it is for NP/PA. I am extremely surprised that it is different in your area. The insurance companies and TPA's that I work with are nationwide. I do not believe a doctor/surgeon is doing you a favor. I just understand that when I select a surgeon or physician I select his whole team. That includes the NP/PA, receptionist, billing department, nursing staff. I will and I have left practices if the surgeon is wonderful but a portion of the team sucks. I also don't mind a surgeon that has sucky bedside manners if he has a good team to balance that out. I am paying him for his surgical skills and he be better have a good team for follow-up care and scheduling and billling.

I am 7 months out. I like to cook. (clean-up not so much). I cook things for my husband all the time I don't eat. Mostly I will make carbs as side dishes for him. I make extra vegetables that he won't eat since he is picky. We had his niece's graduation at our house in mid July. I cooked all kinds of stuff not on my diet. Yes, I did have a bite of cake, yes I had 2 bites of a really cool flatbread I made. I don't mind cooking things I can't eat. Will I try something that isn't on my eating plan? Yes. I will have a bite or two. This way I don't feel totally deprived. I also want to taste food I made to decide if I want to make it again and if I need to make changes to spices or other ingredients.

I was thinking about this thread the other day and wish I would have the chutzpa to reply something along the lines of "Your momma didn't do a real good job raising you right, did she?" But I won't say that because my Momma raised me to be polite. I probably would have gone with a condensending look and either "Whatever" or "Really?" and walked away. I just don't want to waste my time with negative people.

If you prefer January you should be able to ask to schedule it for January rather than December. A few reminders- if you have all your pre-op in 2015 you will have met your deductible and part of any out of pocket limit for 2015. Come January that deductible will reset and you will need to meet it again in 2016. Depending on how big of an out of pocket limit you have if you get everything done in 2015 you likely will meet it with the hospital stay and part of the bills will be at 100%. If you split it between 2 policy years then you may not meet it in either year and have to pay more out of pocket. You also risk that upon plan renewal in January your plan could change to eliminate bariatric coverage. (Unlikely) Your deductible and coinsurance could be increased for 2016. So while it is tough to be doing a liquid diet over the holidays you may want to look closely at the financial aspects of spanning 2 policy years for pre-op and surgery. Plus you can say New Year New You and actually be able to meet that New Year's resolution to lose weight.

I second Babb's suggestion of the straw. I spend a minimum of 2 hours per day in the car. I drink 20 oz on my way to work for my hour commute and 20 oz on my way home. I have a double walled 24 oz cup. I prefer my Water with ice. I use Mio or I water down diet Chik Fil A lemonade. I have a double walled 32 oz cup at my desk. I fill that in the morning and sip on it all day. There is no way I could get in my 64 oz water without Mio and without a straw. For food: We have a cafeteria at work. Get up at 5:30am 6 am Leave for work- 1 hour commute- drink 20 oz of water. Refill when I get to work and drink another 6-8 oz before breakfast. At 8:15 I get 1 egg with spinach and tomatoes and a little cheddar. I also get a sausage link. Fill 32 oz water. At about 10:30 I eat another small meal- a slice of cheese & some deli turkey/ham, I eat lunch at 1. Normally chicken, tomato, lettuce, kalamata olives. Or a little chicken salad. Or part of a Boston Market chicken caesar no croutons. or some Soup. At 3:30 I will have nuts or yogurt or low fat cottage cheese. If I don't plan well I stop at Chik Fil A on the way home and get a kids meal with grilled nuggets. You can get no sugar added cinnamon apple sauce or fresh fruit instead of fries. I leave work at 4:15 so maybe at 4:30 I stop at the CFA dinner tends to be late: 8:30 or 9 pm. Grilled chicken or fish, veggies, steal a bite of DH's carb side dish (rice, mac & cheese, potato). Literally one bite so I don't feel deprived. If DH wants burgers I will have one on a wheat Arnold's sandwich thin. I eat it as an open faced burger so wind up only eating half of half since I only eat about 1/2 a burger. The dogs love my left overs. Meatballs and sauce with no Pasta. I do get Dreamfields low carb pasta for DH so I don't feel guilty if I do steal a bite or two of his pasta (I allow myself and extra bite of the low carb pasta). I hate Barilla pasta. I am weird and don't like leftovers. If you don't mind leftover you can do what my friend does. She banded 6 years ago. She cooks a big batch of drumsticks and thighs on Sunday night with a dry rub. (Chicken breast get suck for her). She then brings in chicken and a small salad or broccoli for lunch most days. When her kids were living at home and she was married she would just make sure she cooked a little extra for dinner and bring in the meat and veggies the next day. She cooks her eggs the night before - 1 egg plus some egg whites and heats it in the microwave at work. I find when I slipped back to only 3 meals a day my weight loss slowed. Weekends are tougher since I trail ride for 3 hours at a time. I drink Protein shakes in the AM to make sure I get my protein. Also since I am not used to eating solid food for a good 3 hours after I get up during the week I find that I just can't eat solid food within a couple of hours of waking. I normally get up, shower, get dressed drink Protein shake and am out the door about 1.5 hours after I get up. I bring a soft cooler with me with Protein Bars, water, deli meat and nuts. I drink when I am grooming the horse and when riding. Once the horse are loaded back on the trailer I will snack on one of the protein things I brought with me. If I take a long time at the barn afterwards I may eat another protein thing. Weekends are the toughest for me to get in protein and enough water. Since I am outdoors and sweating I need a lot more than 64 oz on the weekends. I somehow don't like to eat while I ride so I try to fit in in right before I mount or on the trailer ride home. I need things that are portable.

I was off work for 2 weeks because I have good insurance. I also work an hour from home so if I start to crash and burn at work I have a long drive home. So with 2 hours of driving, 8 hour day plus 1 hour lunch I am gone 11 hours a day. That said if my job was closer to home I could have gone back after a week. I had surgery on Monday and was in the hospital until Wedsday around lunch. I took my last narcotic Weds night to make sure I had a good night's sleep and after that didn't even need Tylenol. I had plenty of energy. I was actually getting bored by the end of the second week. I was limited in how much weight I could lift as I also had hernia surgery. I was a bit limited in what I could do for chores around the house. I don't watch movies or TV and it was February and cold out. I am used to being active and going to the barn to see my horse. Being idle isn't my thing. On the flip side I had a co-worker who banded and was off three weeks. She found keeping track of what she could eat and when to eat overwhelming at first and said she was glad she did not have to come back to work sooner. Everybody recovers differently.

OP I will address the copay. You likely should not be paying any copay for your 6 week visit. You should be in your post-op day period. Any care that is within the post-op period is considered part of the fee for the surgery. The surgeon should not be charging you a co-pay and should not be billing insurance, nor should the insurance pay for visits during the post-op period. Any major surgery should have a post-op period. It will vary depending on the surgery. The insurance companies use fairly standard guidelines. I think for the sleeve it is 90 days. (If you have a visit with the same surgeon for an issue not related to the surgeon a copay would apply.) The surgery fee is a global fee. I would check with the office and your insurance to verify if you will even have the $50 copay. If not, I would reschedule with the NP/PA. I would not use your PCP for the follow-up. Use your surgeon's practice for follow-up. The surgeon and his staff have the experience with bariatrics, your PCP not so much. If the NP/PA has a question or concern then the surgeon is right there to ask or maybe even pop in the room. If you plan on doing any future follow-ups or if you do have complications and need to go back then your bariatric record is all complete and at your surgeon's office. When I did my follow-ups I also saw the dietician. I would think that your bariatric PA/NP is going to be better versed in the nutritional aspects for a bariatric patient than your PCP will be. (Assuming you don't see a dietician separately). Can you tell that I pay health insurance for a living? 10 years ago I tore my ACL. I used a very good surgeon. He had awful bedside manners but is a great surgeon. I did not mind seeing his PA. His PA was able to spend much more time with me, he was easier to ask questions and gave more detailed answers than the surgeon. I was paying the surgeon for his OR skills. Yes, I paid the higher $40 specialist copay for his PA. But I got more bang for my buck with the PA for the follow-up visits than I would have with the surgeon. I view picking a surgeon as two fold: I am picking his skills as a surgeon and I am picking his program. That program includes his pre-op diet, pre-op testing, post-op diet, post op care and his staff. Like you I was 1 hour 15 minutes from my surgeon's office. I quit an orthopedic doctor's office over his front office staff- they never returned phone calls, never passed messages to the surgeon and let me run out of refills on my medicines even when I started calling for a refill 1.5 weeks before. My PCP recommended him for my husband and I would not let him use that practice. The staff is a very important part of the program. Don't shortchange the NP/PA that your surgeon picked. There is a reason they employ that person. Presumably they trust them for a reason. Like I said if the $50 copay is one of your big sticking points you should verify that you will even owe it for this visit. Maybeing have the visit free will make the drive worth it to you.

I agree the first visit with deep cleaning takes much more time. My housekeeper the first time wiped down the walls (you know that light tan line that is dog height), cleaned the moulding, in addition to the floors, sinks, counters, dusting. She does not do the walls and moulding all the time. She just spot cleans those areas as necessary.

I will say that my program did not tell me that I would not be able to drink anything until after the swallow study the next morning until after I had surgery. Now I had done a ton of research so I knew that well ahead of time. My bariatric nurses said I was the model patient. I kid with them that they tell all their patients that. I would bet there are a few programs that aren't as thorough as they could be about telling all of their patient's what to expect. I saw some of the hand outs from my co-worker's 6 month supervised diet from the dietician. Really bad copies based on the old food pyramid. Not really good nutrition for WLS patients. However it amazes me the number of people that hear what they want to hear and cannot effectively read a couple of paragraphs of information. It amazes me the number of people that don't do any research prior to selecting the program they select. I went to information sessions at multiple places. I read a few blogs, multiple forums and a number of medical websites about various weightloss surgeries before deciding on the surgeon and the sleeve.

I wouldn't think that the medically supervised diet would need to be redone unless the insurance has a weird requirement that it be done by particular doctors or a different provider type than you used. (Dietician, nutritionist, MD/DO) A medically supervised diet is a medically supervised diet. My particular insurance required that I try a medically supervised diet within the prior 2 years. I had not had that so had to do the 6 months. It did not have to occur while I was covered by that insurance company. My insurance allowed it to be done by dietician, nutritionist or a doctor. I also could have documented 6 months with a program like Medi-fast or Weight Watchers.

I have not used them. I think that is a long time with no contact. I am reasonably close to you and I used Barix Clinic in Langhorne, PA. I would recommend you talk to them. My surgeon is no longer with them but I liked the facility and Dr. Marymor is still there. Dr. Marymore has 13 years of experience as a bariatric surgeon. Barix Clinic was over an hour drive for me. I really liked that they essentially only perform Bariatric Surgery at this facility. I felt that the experience this provided for the surgeon and support staff increased my chances for a complication free recovery. Since they do not have sick patients in the same hospital, using the same radiology, same orderlies etc... I feel that it was less likely that I would get a secondary infection while there. The nurses I had during my 3 days in-patient all had been working together as bariatric nurses for 11+ years. I thought the staffing ratio was great. I would say 2 of the drawbacks on the facility was lack of Wi-Fi and the TVs in the room are really tiny and on those swivel things. I am not a TV watcher so no big deal there. I had a great experience and had a textbook recovery and have had great weightloss.

My surgeon recommended a medical bracelet since with the sleeve you need to be careful with certain medical procedures. I think a stomach tube in particular. If they don't realize you had the sleeve they may accidently puncture your stomach as they expect the pouch there.

My surgeon did not try to sell me on the RNY. I told him I was interested in the sleeve or band and we never even talked about the bypass. I actually saw his original presentation on WLS about 5 years ago but I didn't qualify. He was just starting to perform the sleeve then. He discussed RNY, band and sleeve. I would say he discouraged the band. My stats are not too different than yours. I was 257 and 5'3" as my starting weight. I had a 6 months insurance mandated diet and was at 242 at the start of my 10 day liquid pre op diet. I am 6.5 months out and am at 174. I am still losing, more slowly that when I first sleeved, but still losing. There are plenty of people on this board who have had sleeves and are well below the 180-190 that she quoted to you. If you are not comfortable with what this surgeon is telling you go talk to another one or two. Just because every one else loves her does not mean she is the right one for you. You need to be comfortable with your surgeon and the surgery. If you do decide on the sleeve I would recommend a different surgeon. You want a surgeon that believes in the sleeve and has a program designed for the sleeve not one modified from RNY. You don't want to have a minor stall or complication and feel like she is thinking "Well this wouldn't have happened it you followed my advise and had RNY". You want a surgeon that has done a large number of sleeves not one that does them occasionally, under duress.

At my 6 week appointment my surgeon approved Celebrex but only the low dose. Cox2 inhibitors have a lower GI risk. I find that since I have weight (69 pounds) I need them less.

I am a daily weigher also. I went to the Outer Banks on vacation for a week in May. (I sleeved 2/2/2015). I eventually gave in and went to a YMCA and hopped on a scale on Thursday morning. I tried a raquetball/fitness club first but they didn't have a working scale.

My surgeon allows carbonated beverages at 6 months. I am just past that point. I have not yet tried it. I have had a small sip of my husband's beer. Like a taste, hold it in the mouth and then swallow. Diet Dr. Pepper was such an addiction for me I don't want to start up again. My surgeon does not believe that carbonation will stretch the sleeve. I know somebody that had RNY and she drinks Coke everyday with no problem. I think carbonation tolerance can vary greatly from person to person. You will find that with other foods too. Somebody on one of my Facebook groups is 6 months out and still can't eat lettuce. I have been eating lettuce since maybe 6 or 7 weeks. As long as your surgeon is okay with seltzer Water go ahead and try a little. See how your sleeve likes it. If not at first then try again in a few weeks/months. I have read that some people can drink carbonated but only if they let it get a little flat or if they pour it over ice to release some of the fizz. You may also find that your tastes have changed after surgery and you won't miss it. I don't miss Dr. Pepper at all. I used to have a minimum of two 20 oz bottles per day.

I have a RoadID bracelet. It has 2 emergency contacts plus that I am a verticle sleeve and my surgeon's 800 number. I travel a lot for business and I fox chase with people that know my name but would not know my emergency contact information. I have a few band colors. I am planning on getting more. I am not as good about wearing it every day. I am thinking of getting one of the slim ones for everyday use with the VSG info and 1 emergency contact.