Boombalatty

I have a question for those of you who have had plastic surgeries. I have reached my goal and have lost 370+ lbs from my heaviest ever recorded (300+ from when I started the effort that led me to a sleeve gastrectomy). That said, I am a man with extra skin everywhere. I have started meeting with plastic surgeons and have it narrowed down to two. I still have some questions pending with both, but thought I would seek advice on this board before I choose one and have him start the insurance paperwork for whatever I can get covered (likely only pannus, if they will even cover that based on what some doctors said - my skin is all over so the pannus itself may not meet requirements). Both doctors are experienced and I like their attitudes. Their prices for everything I need done are very close, so that's not a factor. The biggest differentiator between the two is how they want to break the procedures into surgeries. The first surgeon wants to do my trunk first - stomach and upper body lift (chest and back) - and then come back in a second surgery and do thighs and arms. The second surgeon wants to do a lower body lift and thighs together then do upper body and arms in a second surgery. Now comes the question. For those who have had multiple procedures, which do you think is better from a recovery standpoint? Trunk, then extremities or lower then upper body? I would think that the upper, then lower might be an easier recovery, but I don't know - they'll both be pretty brutal, I'd bet. I think the first surgeon might be grouping them together like that (trunk, then extremities) because that is the order that they bother me the most and it might give me 'the most bang for my buck' with regards to quantity of skin removed. So, does anyone have any advice? Oh another thing, neither one of these do much of a hospital stay after the surgery. The first said it would be outpatient, but I can't imagine not having at least one day to make sure things are okay before coming home. (One of my follow-up questions for this surgeon - can it be added.) The second mentioned a 23hr hospital stay. Have any of you had such major procedures and not stayed in a hospital afterwards? This would only be my 2nd (& 3rd) surgery ever. My first was the sleeve and I was in the hospital for a day after. Thanks!

Actually, I'm not having surgery today. I did end up scheduling my upper body in Nashville on May 18th with Dr. Brian Tierney. I am waiting on the final costs, but it is approximately $13,000 for this first one. I am having a bilateral male chest reduction, correction to my xiphoid process and arm/forearm lift (I was so large even my forearms have extra skin). The plan is to have the lower body (belt lipectomy and thigh lift, estimate for Dr Tierney was ~$17,000) at the end of the year due to work commitments. In Nashville, I met with Dr Tierney (St Thomas affiliated), Dr Chad Robbins (Centennial affiliated), Dr Bruce Shack (Vanderbilt), and Dr Michael Burgdorf (I have a relative who went to him). Here are my thoughts: Dr Burgdorf - wouldn't try to work with my insurance (but I knew that going in). Really took time to explain things and I liked his manner. However, he wanted to break things into 3 procedures instead of 2. I prefer getting it done in 2 passes. Dr Shack - didn't spend a lot of time talking to me. Seemed to want to rush me out. I guess he knows what he's doing, though. He wanted to do 3 procedures as well. Strangely enough, he was the (slightly) cheapest option even considering 3 procedures...especially if you didn't finance with CareCredit as he had reduced cash and credit prices. Dr Robbins - I really liked him a lot. He spent lots of time going over the procedures. He could do what I wanted done in 2 procedures. It was a very hard choice between him and Dr Tierney, but came down to the fact that I liked Dr Tierney's approach of doing a 360 belt lipectomy with Dr Robbins only doing abdominoplasty. (Dr Robbins wanted to do 360 around my chest and only front on the lower body. Dr Tierney wanted to do mainly front on upper body and 360 on the lower body...it came down to I think I do want the butt lifted a bit, but Dr Robbins didn't think it was necessary as pulling other areas would end up lifting it a bit...but I couldn't see it by pulling skin on my own in front of a mirror. I would bet that either plan would end up giving me a great result beyond my hopes since I've been big since I was 6 years old.) Dr Tierney - I liked him a lot, too. He didn't spend quite as much time going over the procedures as Dr Robbins, but he had an emergency surgery to get to, so I understand. (Unlike Dr Shack who just didn't seem that he cared about my questions.) He did spend enough time that I got a good feeling from him. Both Dr Robbins and Dr Tierney were recommended by the St Thomas Bariatric surgery group when I called them to ask to whom they referred patients. I didn't bother calling the Vanderbilt bariatrics team because I assumed they would refer patients to the Vanderbilt plastic surgeons. For those wondering about Dallas surgeons, I also met with Dr Tittle again before finally choosing to proceed with Dr Tierney. My reservations about Dr Tittle are gone. He spent a lot more time with me on the second visit and really went over things. I would have no doubts about going with either Dr Tittle or Dr Kenkel in Dallas. Dr Tittle did want to do 3 procedures, but I bet my results would be phenomenal with 3 procedures with him the way he talked about being able to go back and touch up areas from the previous surgery.

Thanks for your support Daisee68. I met with two surgeons here in Dallas, but I am going to Nashville, TN to have the surgeries, I think. I met with several surgeons in Nashville and it's going to be easier for me to have the surgery there and stay with family for the recovery. Also, the quotes from the Nashville surgeons were much less... almost on par with a quote I got Dr in Mexico (but without the aftercare)... I just worry about going to Mexico and the surgeon I spoke with back-pedalled on things he said previously when I asked extra questions. He also wasn't too confident about how many surgeries would be needed nor some special work I need done that others were confident about fixing. (And he is one that is well regarded on this board. ) I never heard back from my inquery into the BariatricPal associated surgeon's group after an initial 'We got your email' message. In Dallas, I met with Dr Ben Tittle and Dr Jeffrey Kenkel. They both seemed like very good doctors and we're referred by my sleeve surgeon, but Dr Tittle seemed in a hurry and I wanted someone to explain things to me better. Dr Tittle also wanted things broken into 3 surgeries - I think I prefer only going through two. I really liked Dr Jeffrey Kenkel a lot. However, he was very expensive - like 15k-20k more expensive for everything than the two I am considering in Nashville - although he did include 2 nights of aftercare. I'm not pinching pennies at the sake of my health, but that's quite a bit when the Nashville surgeons have bariatric experience and were referred by a bariatric group there. I did look at Dr Fisher's website and considered talking to him, but thought I'd go locally (where family could stay with me) or Nashville (where I could stay with family). I don't know about traveling to San Antonio...how long before you would want to be in a car long enough to drive (or fly) back to Dallas? Sent from my SM-N900T using the BariatricPal App

I find them boring, too. I even think with music, they're boring. I take a tablet and watch TV shows/movies (Amazon instant lets you download episodes to watch offline since my gym doesn't have WiFi) while doing my cardio and switch to music when lifting weights afterwards.

@@Thucydides: Good luck with your upcoming surgery. It's been one of the best decisions I've made and I wish I had done it much sooner. I'm down to 225 now and just feel so much better. I'm hoping to get to 215 before the end of the year and sometime next year see if my insurance will help get rid of (some) of the extra skin. I had to fly to CA for a business trip a few weeks ago (first time in many years because of my size) and it was amazing to be 'normal' for the first time ever on a plane. I could fit in the seat, I didn't need a seatbelt extension and had lots of slack, I could even flip down the tray table and pull out my laptop/notebook and do work on the plane. It was amazing.

If anyone else has been using them and has had labs done, I would be interested in hearing the results as I am considering these - especially when travelling. If you use them, do you still take Calcium supplements on top of them, or just have the calcium that is in them? What about Iron (since they mix calcium and iron in one patch)? Has anyone's NUT said anything about them? I asked mine and she just said 'Try them and we'll check your labs' as only one other person at my surgeon's office has asked about them. For now, I'm still stocked on Celebrate capsules for another couple of months and calcium chews for about 6, but might start using the Patches when I travel or when I run out of the other if they prove convenient and reliable...I just really wonder especially about the calcium since it's hard to tell a deficiency until it's too late since your body will just pull from your bones.

I had a coworker talk me into trying DE a year or two before the surgery. He said that it really helped clean out your intestines and colon like some kinds of Fiber. He also swore that where it helped clean things out, you absorbed minerals better and that it helped his hair, skin and nails a lot. I guess it helped some. Now that I am a year out, I have been thinking about it again as a 'fiber' supplement. I haven't talked to my nutritionist about it, though, as I wonder about a few things. When I did it pre-op, I chugged a cup or so of Water with a tablespoon of the DE in it and then chased it with more water. I can't chug water like that any more, so would I be able to drink it at all? Also, the DE particles are really small. I guess the suture line has healed or is water tight, so it shouldn't work it's way through, but being small hard particles I just wonder if it could erode the suture line...how tightly does that seal?

La Tortilla makes a taco/fajita-sized tortilla with 50 calories (they have a bigger one with more calories). I think it has 5g protein, 10g carbs, but 7g or so is fiber. I've seen them at Kroger, Sprouts, or online at netrition.com

I dug up some old images of me in the past 2 years. The first is before I got seriously motivated about weight loss (10/2013). I was probably around 520lbs, maybe higher. (Highest ever recorded is 585.) Then, in late March 2014, diabetes made me realize that I had to do something about my lifestyle and weight. I started seriously trying to lose weight (again...other times I gained back plus some) and weight loss surgery. On 4/1/2014, I was 515lbs. Then, I had surgery on 9/15/2014 @ 415lbs. Yesterday was my 1 year surgiversary at 233lbs.

I had my first massage ever as a reward for reaching the 300lb mark (or was it at 315 to celebrate losing 200...). I have had one every month since and love it. I actually have one scheduled tonight.

I agree or I did until a week or so ago - if you can use milk. I have found out a way to make powder ones even better. You blend them with ice and some xanthan gum. (I got mine off Amazon.) It makes them almost like a Wendy's Frosty with the right protein powder. (However, I am using Carbmaster milk. For preop, you might need to use water. .. check with your plan. If you have to use water, the Premier might be better but powders allow more flavors. ) I use about an eighth of a teaspoon of the xanthan gum per shake.

My highest weight was 585 (several years ago). I got serious about weight loss surgery at about 515 in April 2014. At surgery in Sept 2014, I was about 415. I am now 235 and still losing (hopefully. ..I am away from home and haven't checked this week). KcHelper as for satisfaction from food, it will get better, but sometimes it's better if it doesn't, if you know what I mean. However, I learned a while ago that food always seems better in my head than it ends up being (I realized this even before surgery while still overeating... it didn't seem to stop me from trying to prove it wrong, though. ☺) OP, as for the preop diet, just stick with it. I know it's hard, but it is important to avoid complications. Are you allowed broth or bouillon? That helped me with something savory. Also, check with your surgeon, but I was allowed a few small-medium dill pickles (and mustard) a day up until a few days before surgery (when everything had to be liquid). Good luck. You can do this. Just stick with it. After all the hard work you will feel so much better and live a better, and longer, life.

What I did for my birthday was a shake made with birthday cake flavored protein powder... that's as close as I got to a birthday cake.

Proudgrammy, my doctor believes to get your Protein from solid food instead of shakes because shakes won't keep you full for long since they are liquid. He thinks that if you drink them that you'll still eat solid food later to get full, thus consuming more calories than you need. I kinda understand that, but I still drink them on some days, especially if I do some strength training. He also thinks it's some kind of dangerous precedent, drinking a liquid with calories. I just look at it that he deals with all sorts of people and comes up with rules 'for the masses' and puts them out there without worrying if people have any common sense about what they are doing... so sometimes I apply common sense (and other advice from this board - since he doesn't give protein gram requirements, either) and not necessarily the letter of his rules.

Just a warning on those Protein shots. One of my nutritionists told me about this and I did some research on them (going so far as to make a spreadsheet that calculates the PDCAAS) but they are not complete. Most shots use Gelatin based protein that do not contain enough of all the essential amino acids to really count as a full amount of protein. Search about PDCAAS. It's a digestibility score for protein based on the amounts of the essential amino acids in a product. If you actually calculate it out (I have) those protein shots only give you the equivalent of a few grams of protein. Now, if you mix the shots with other protein sources that have an abundance of what the shots are deficient in (if I remember right, the shots I looked at were deficient in tryptophan), then you can count it all, but don't rely on those shots alone as you will be deficient in some amino acids and thus the 'whole' protein you need. (You can get the amino acids breakdown on product labels or websites for supplements, typically, but only plugging it into an equation will tell you how much it really counts.)

Well, I didn't mention Protein pancakes because it's only recently that I've had those. I've tried several recipes, but my favorite was the simplest - mash (I blend) a medium to large banana, 2 eggs, 2 tablespoons of Protein powder and about 1/8 teaspoon of baking powder then cook on a griddle or pan. They come out thin, but are great and so sweet because of the banana (and protein powder, if flavored) that I don't want syrup. I wrap them around small breakfast meats. It's only recently that I wanted to add the carbs (banana), though. Be careful of what your plan allows.

At a month out, I think I was still on purees. I remember eating Greek yogurt and a LOT of cottage cheese. I had cottage cheese mixed with touches of hot sauce, tomato sauce, etc. I also ate canned chicken or tuna (mashed really fine or even blended early on) mixed with fat-free mayo and maybe some chicken broth to thin it. I am also one of those that ate baby food early on in purees. I wasn't allowed eggs until solids and at that point I ate a lot of eggs. Only recently (I'm almost a year out), have I done something other than eggs or a Protein bar for Breakfast since I was allowed solids.

One thing I've done since my sleeve surgery is to make chicken-crust pizza. Some recipes just said to pound out chicken breast, but I followed another to get more flavor. I took some raw chicken, threw it in a food processor with an egg, some garlic, herbs and a little parmesan cheese and processed it. Then scooped it onto a (foil covered) cookie sheet and pressed it flat and baked it for a while, flipped it over and baked it some more (drying some of the juices with a paper towel). Then topped it with my sauce and toppings and cooked until done. It was really good and lots of Protein. Another option I've seen is a cauliflower (and cheese) crust, but it uses a lot of cheese, so I haven't tried it yet.

If I can find a good 'before' picture, I might post, but I abhored pictures at my large size. All I have is a short video from someone messing around with my phone when I bought it about 2 years ago. Luckily, I didn't delete it.

Yeah, King Size runs bigger than some other places. Just look at their sizing charts. I could fit in one of their 3x before something off the rack at Walmart, for instance. Another place I've gotten some stuff is from Goodwill after I got in 4x and below. Your luck may vary with that, though, as it all depends on your area....but you can't beat a $1.50 (or so) for a shirt if you can find it. The 4x were rare, 3x uncommon, 2x and smaller are easier to find.

Well, my month to month numbers came from the app I use - My Weight Tracker. I log it once a week on Sunday, but the app has a view that shows change by month (which you can expand to show all your entries that month). I like the app as it also shows a moving average and trend line on the graph with a projected time to goal. I also use a spreadsheet for occasional measurements and MyFitnessPal for spot checking calories. (I was religious for a while, but only check occasionally now...I probably should start back to logging more.)

I used to buy most of my stuff off kingsizedirect.com However, unless they have something on clearance, the price is comparable to Casual Male, I think.