Wheetsin

If it makes you feel any better, what you're describing doesn't sound very much like a shopping addiction to me. It sounds like you're someone "finding themselves," almost as though the "new you" cliche applies. And who is enjoying the freedom that comes with the new sizes, and perhaps the novelty as well. Think of what gives you the joy. Is it the actual purchase? Is it the thrill of buying a size, and having it fit? Is it an affirmation of yes, I really did this? Etc. As for hurting your credit, I don't think so. As long as your accounts were current when they were opened, and were closed by you. Addiction hopping is fairly common. I personally don't fully believe in food addiction (food abuse, yes, actual addicition, no). So I'm not sure that any of us really swap out the addiction. But I think that if food gave you a particular emotional or behavioral reinforcement, that you're not yet able to do without, it'spossible for shopping to do the same. I think we all go a little clothes crazy, because we can. Do you have a therapist as part of your surgical team, that you can see and talk with, to figure out the root of the "compulsions" (not addictions) you're having?

I don't know of any insurance companies that automatically deny, just to make you fight (worked for a very large insurance company for years, and do private consulting with a large handful of others). It may seem like that's what they're doing, but they wouldn't be allowed to be in business if it were the case. It does depend on the MRO reviewing your claim They try to be consistent, but absolutely "Jack" will accept some things that "Jill" will not, and vice versa. There are some cases of absolute consensus, but there's an awful lot of gray area between those points of agreement. So (OP) do I understand correctly that you were denied for sleeve because your BMI wasn't over 50, but you were approved for either the band or the RNY? Have you taken my advice earlier (if not it's fine) and called your insurance company to check on approval of the sleeve as a standalone procedure, or the BMI requirements for the procedures they were willing to cover? What insurance company do you have, if you're comfortable sharing?

Do you feel anything if you lightly press on the area? I don't mean do you have sensation, I mean do you feel anything under the skin? Anything that feels like a little marble, maybe? I'm always surprised at where the pain comes from. It really is the smallest things. Band in, pain came from the weight of my stomach pulling on my port incision. I never really had much pain other than being sore. GB out, pain came from that bee sting belly button incision. Band out, pain came from the massive sore throat I had (throats were NOT designed to handle machinery). Have your healing itchies started yet? If not, then especially at the incision that's causing you discomfort, be extra sure not to scratch.

Aside from the obvious like "myself" or "DH" it would be my Nook. Books, apps, music, email, videos, etc. all in one. In theory I only have to stay 1 night, but I know it will be a long night. I'm taking lots of comfort things, robe and slippers as joiebean mentioned, but those won't help me pass the time. I'll take being cold over being bored. DH is great, but I know that he will not be comfortable if I'm in pain. He will be stressed and awkward, and will probably want to sit & watch TV, and try to help me too much.

I've not had sleeve surgery yet, but I've had 3 laparoscopic abdominal surgeries. This may sound like a silly question, but is the incision that's hurting you the most stapled? (or stitched, or whatever your surgeon used) Sometimes surgeons will leave the smaller incisions open - they're small enough they don't really need a staple. This happened to me and that open one felt pretty much exactly like a constant bee sting for about 6 days. I don't remember when it quit hurting, but at 2 wks I had my staples out and I don't remember it hurting then. Lot of pain for such a tiny little thing (it was seriously like the size of large grain of rice) The numbness may or may not go away. When I had my lapband out (which was my 3rd lap procedure) in Sep of last year an area about the size of two of my palms was left completely numb. Nerves got cut or bumped. Some feeling has come back in some of the area. There's still about a plum sized area that's completely numb. The rest of the area can feel sharper sensations (like if I pinch or prick) but not softer ones like tickling or rubbing. It really bugged me at first but I've gotten used to it now.

Wow, I was really wordy up there. I don't mean to do that. I just give "support" in the form of information or anecdotes, usually, and information takes page space. If it weren't for my progress pics, I would have cognitively distorted my weightloss just as I cognitively distorted my obesity. Only instead of saying things like, "Oh well I blew it today, I'll start my diet tomorrow" I would have been saying, "I'm not smaller, these pants just stretched out a lot." Have you been overweight for a long time? Have you ever lost a significant amount of it before? If yes, and then kinda regardless of answer, you'll probably have body image challenges too. I was constantly asking DH, "Am I her size? Do I look like her?" because I really just had no concept of what my body looked like other than in the mirror. Pictures really helped with perspective. (DH is certified open Water, I'm certified advanced with deep, night & nitrox... you will enjoy being a lot less bouyant!)

Kind of depends on the surgeon. My surgeon submerges the sleeve in water and looks for bubbles (during surgery), then does a non-barium swallow test post-op. I know another surgeon in the area who does nothing during surgery, but does three separate swallow tests post-op. A sleever I know, who had surgery in MX, had 1, 2, and 3 day post-op barium swallows. Now, that's scary.

Sounds to me like you might be experiencing a stall. Let me qualify that a little by saying that the term stall is abused. A stall is not going four days without losing anything, or 2 weeks. A stall is an extended period of no weightloss, think 3+ months. And not just no weightloss, but no weight and no measurement changes (e.g. you aren't stalling if you're just adding muscle weight to replace fat weight, hence the scale is not moving). I stalled for about 13 - 16 months when I had the lapband. I'm prety sure I was doing everything "right" - or at least I was doing everything textbook. Nothing made a difference and my stats didn't budge. Then, within a span of about 9 days, I went from my stall weight of almost exactly 250 (down from about 385) to 241. I remember that 241 very clearly. I know the whole concept of "burn more calories than you take in and you will lose weight" and that's true in an overarching kind of way, but I know from my own experience there are at least temporary exceptions. I think there's also some truth to the idea that different quality foods burn more or less purely. Here are some things you might want to look at: Cut out any artificial sweetners: crystal light, diet sodas, SF foods, etc. There are some that are obvious, and some that are well hidden so you need to be diligent about food labels. Try to get around 1200 calories a day. Especially during long-term caloric defecits, our bodies find ways of hanging on to what they have. Remember your body doesn't know "dieting," it just knows basic survival. Add healthy fats (oliveoil, avocado, etc.) Try to keep carbs to no more than 20 per day. Try to make the 20 you get come from low glycemic sources. Insulin inhibits fat burning. If you don't already, stop eating about 4 hours before you go to bed. Eating, then sleeping soon after does yucky things to your insulin levels. If you've been doing the same exercise routine, switch it up. If you're still relying on protein shakes, try getting away from them and more toward solid proteins. Check and see if you're in ketosis. Easily done with a pee stick suck as Ketostix. In theory, bariatric patients should be in a sort of perpetual ketosis. You can try a temporary "stall buster" diet, there are many. One of the ones recommended with the Atkins plan would probably be most doable (physicall), like the "Fat Fast" (Atkins). http://www.low-carb.com/atarfatfa.html HTH

Oh, and when a procedure is denied because a BMI is too low, but is still inthe range of the FDA recommendations, denials are most often overturned if you can prove significant comorbidities. I don't mean "regular" comorbidities like joint pain/arthritis, I mean cardiovascular & respiratory comorbidities that can kill you. If you can substantiate not just "medically necessary" but "going to die without" (or more accurately, going to cost you a heckuva lot more without) insurance companies are more flexible in their BMI requirements, usually.

Lots of things kinda weird about this. Start with the CPT codes for all three procedures mentioned. I think they are: VSG: 43843 Band: 43770 RNY: 43644 Then call the customer service # of your insurance provider and ask the person who answers to look through your plan and tell you the BMI requirements for each procedure. I advise doing this to start because usually the BMI requirements are the same (per provider) for all three procedures, and are based on FDA guidelines. I think for all three, it's currently a BMi of 40+, or a BMI of at least 35 with 1+ (or 2+) comorbidities. When they do require higher BMI, it's usually because they aren't yet recognizing the sleeve as a standalone procedure. Do you know if your insurance covers VSG as a standalone bariatric procedure? The other part that's weird is that your surgeon's office, I would hope, would have obtained the insurance requirements and informed you up front if your BMI was sufficient or not. You should not be finding out 6 months later that you never met the criteria to begin with. Or are they considering your weightloss during the last 6 months to be the loss that made you now ineligible? What was your BMI then & now? I was initially denied for the sleeve. I wrote my own appeal, my surgeon's office submitted it, and the procedure was approved about 3 days later. Long story short I ended up having to start over with a completely different provider, totally back to square 1. I just made sure they didn't have a chance to deny me this time.

Sorry, that I didn't (and won't) do. For me personally, I don't think it would be motivational. Sorry if I derailed onto the wrong topic, I completely thought you meant progress pics. I did take incision pictures, to show people where the cuts had been made without having to actually show them my abdomen.

diverdiva, scuba or board/platform?

Not sleeved yet, but I had a lapband for years so here's what I learned and what I will do differently when I have my sleeve. I was not as diligent as I should have been, and even though it's in the past there are still "records" I wish I had. I had DH take two sets of pictures of me every month. One was nude, the other was in the same outfit. They were full body shots taken head on, and in profile. The nude set so I could see the body changes, and the clothed set so I could see the specific differences in how things were fitting. And scales are rubbish, so this time I'm also going to have him take my measurements. And I'm going to do photos & measurements on the same day, and earmark the photos with that days measurements. Not only will you see the differences that way, but it will serve as a journal. I thought I'd always & forever remember what I weighed in what picture, and what size I was wearing. I managed a few years, but now for the most part the best I can do are guesstimates. I'd like to still have all that forgotten information, with 20/20 hindsight. My advice - if you have a tripod, set it to as close of a head-on angle as you can get, and lock the position. Make sure you place it in the same spot everytime, and make sure you stand in the same spot everytime. Even subtle differences in camera height (we all know how unflattering a bottom-up shot can be) or distance can grossly distort your body. If you don't have a tripod, find something in your home to place the camera on, that doesn't move (like a fireplace mantel, or an armoire). Changes will also be easier to notice if you have a solid something behind you, like a stretch of wall, versus something broken up my doors, windows, or wall decor. (I made this mistake last time and won't do it the next time around). If you don't have that, try to at least use the same photographer each time. When I hit 150 lbs lost, I took the series of pictures and made an animation out of them, so that I could watch my body "shrinking". Day-to-day, it's really hard to see the differences yourself. I tended to just sort of notice, all of a sudden, that a fat roll was gone, or that my bone was sticking out. And looking at pics side-by-side is ok, but there are still differences you won't notice (most people tend to focus on the obvious areas such as stomach, face, and in my case my butt shelf). You don't tend to notice things like your fingers (until one day you're digging apples out of a produce bin and realize your wedding ring has fallen off in there, or go to shake Water off your hands and your ring goes flying across the room), or your ankles (until one day you start walking out of your shoes b/c yes, your feet lose weight too). Collar bones we notice, but not so much the other chest bones (the first time I saw evidence of my sternum it actually freaked me out for a second, because what is that a tumor or something? -- just for a split second. HTH

Hi Holly, I know your post is older but I just noticed the 200+ forum today. In deciding which procedure is going to help you, consider the reasons for your obesity (other than generic overeating/lack of exercise). That's a really important step in selecting the right procedure for you. Just the other day I had a really good conversation with another lady who has elected to get the RNY. We were talking about why. She (like me) was previously banded. Here's the gist of our conversation. Me: did very well with the band, had no problems with a restrictive procedure. Enjoyed ownership of my weightloss. Enjoyed the flexibility of still being able to eat a scoop of ice cream if I wanted, and finding that I was full after that 1 scoop. Have numerous acquaintances with RNY and do not care for their standard of living (what I would call the long term health effects). Also do not care for their regain stats. Her: did not do well with the band. Quickly found which foods she could "eat around" and did. Did not want to have to "work" at it, wanted it to be as auytomatic as possible. Did not trust herself with portion size or good food selections. Did not mind dumping if it meant she would quicky learn to avoid problem/trigger foods (hers were sweets). Granted we're not talking about the band, but it is similar in that the sleeve is a restrictive tool. Some people experience select dumping, and maybe there's a teeny bit of malabsorption, but we still have everything we're supposed to have (just smaller) so it's not in the same league as RNY. So I would suggest looking at what's hard for you. Are you a compliant person? Are you a quantity eater? Are you a behavioral or emotional eater? What kinds of foods are your trigger foods? How is your will power? How much flexibility can you manage, vs. how much will you need something to be more locked down? How much work do you want to put in, versus how much do you want to be a bit more automatic or "handed over"? IT really is a tool, and you need the right tool for the job. Questions such as those should help you start figuring out which tool is right for you. BTW, I weighed about 485 when I had my band. I got down to around 220 and was still dropping until I got knocked up & ultimately my bnad slipped (prolapse). So high weight losses are entirely possible with restrictive-only procedures. Statistics are statistics, and should serve as the generic benchmarks they are. I pimp-slapped them, and so can you.

Hmm, my H-M-O's above have been filtered out. Guess the board doesn't like them, either. But *** is supposed to be H-M-O.

1. Call your surgeon's office and get the current CPT code for the sleeve (I have it, but not with me) 2. Call your insurance company and ask if your policy has an exclusion for that CPT code, either from your company or from the primary's employer. You ca, also get employer exclusion info from HR, or you can pour through your SPD, but the insurance company should be able to tell you. 3. If you have neither an employer nor provider enforced exclusion for the procedure (CPT code), call your surgeon and make sure he/she takes your insurance. The rest depends on the type of insurance you have. ***? PPO? Open ***? PPO+? The "how to go about it" changes accordingly. For example, a traditional *** will likely want a referral/letter of recommendation from a primary care physician. I had my lapband with a PPO sp I didn't need anything from a primary care physician (I don't even have to have a primary are physician), I just selected the surgeon I wanted and went from there. Find the surgeon you think you want, and just call and ask them what kind of insurance you have, and what you should do first. They have coordinators whose job it is to manage the insurance process for you (with some help from you, of course).

The risk for complication goes way up when both removal & revision are performed in the same procedure. I just read statistics over this a few weeks ago and it was something like < 1% for "virgin" stomachs, 3% for revisions with a waiting period, and 32% for 2-in-1 procedures. My surgeon requires two months between procedures. Unfortunately thanks to an insurance run around, my "2 months" is now going to be 6. (I first got a denial, which I appealed and won - but by the time all that happened there wasn't time to schedule me in before my insurance changed, so I had to start over in January...)

ellendeete - your experiences sound like a textbook slip. Being too tight for a prolonged amount of time does not normally just come on out of nowhere. It can cause similar symptoms, but periods of extreme tightness are usually acute, not recurring. Hopefully your unfill will take care of it, but if you don'tget any more fill and continue to have symptoms, even if they have a slow onset, consider pursuing a total unfill for a few weeks. The reflux was my main symptom that read slip. My body "tolerated" my slip in that I still had restriction, could still eat/drink, etc. It started off just a bit of reflux now and then. But I knew when I would have it. You know how our bands give us those weird pressure feelings, and over time you learn to know what they mean? I had one that meant, "If you go to sleep now, you will reflux." I really can't think of how else to describe it other than - it wasn't my "full" pressure, and it wasn't my "uh oh" pressure. It didn't hurt. I'm not even sure I'd say it was uncomfortable. But it was persistent. If I could clear it before I went to bed I would be fine. Usually the only way I could do this was to drink a fair amount of something extremely cold, like a slushy frozen drink. Anything else would just cause more discomfort. And sometimes I would have a referred pain in my hip, like where your hand sits if you put your hand on your hip, and it would last for 2 or 3 days. But my band was a referred pain junkie, so that never seemed unusual for me. At first the reflux was just a time or two at night, a tiny amount, and only if I was laying on my right side. Then it started to be several times. Then both sides. Then flat and propped up (it even happened if I dozed off sitting up). Then it started happening every time I would doze off. Twice I aspirated it and got aspiration pneumonia. I was started to have concern for the integrity of my esophagus. About 4 nights before my band was coming out DH and I had had some popcorn after dinner. I refluxed popcorn hulls. And the taste/experience of reflux already gets me on the verge of losing it (I gag easily)... so try now having to fish out popcorn hulls that you ate 6 hours ago. That was the night I officially wanted it the "F" out of me. My other symptom that had me start thinking slip was that when I would irp something back up, which happened very rarely my last few years of banding (actually outside of my first year, it rarely happened at all), I would taste stomach acid. This is part of why I tend to harp on bandsters not to use "vomit" for their symtpoms unless they are actually vomiting (as in, brining up stomach contents which includes acid & partially digested foods). What we did was not stomach contents, it was a bit of food in foamy or non-foamy egg white saliva, right? So if someone says "I vomited" and someone says "I irped up something that looked like shampoo lather" -- totally different experiences. Moral of the story -- if you ever irp and taste stomach acid, go have your band checked. If you ever irp and then actually have the urge to vomit, go have your band checked. If you irp and actually vomit after/during, go have your band checked. If you irp something that looks weird, like coffee grounds, go have your band checked. WHen I had my band put in I hoped it would last forever, but I'm not impetuous enough to believe it would so I was already considering my Plan B. About 3 years ago, that started seriously looking like the sleeve. So when the time came, I didn't have to scramble and figure out what to do. I already knew the CPT code, so I already knew my insurance covered it. I already knew what it would involve. I'd already lurked here and read all I could on band-to-sleeve differences. Etc. I don't mean all of that to say "look how great & prepared I am," I mean it to say that you're doing the absolute right thing by thinking about it now. Probably your band will have to come out some day (hopefully it won't, but I don't know very many people banded for say 5+ years who are still banded), and you'll be that much ahead of the game if your Plan B is in place.

Why do I type things like, "... and his them going about 45"? On what planet does that make sense? Apparently the one my fingers come from...

On the AGB counterpart to this board, I was once asked why "super sized" members felt they needed a separate area than "regular" members, because aren't we all after the same goal? My response was something to the effect of, "When my GOAL weight is your STARTING weight, no, we aren't after the same goal."

I haven't read every response so I'm sorry if I'm duplicating. And I thought I read you were going for a cosolidated list, so I'm putting it all in here. If that's not the case, ignore as appropriate. My sleeve next month will be my 4th abdominal lap procedure and 2nd bariatric procedure, and based on my lessons learned here's what I suggest: For hospital: Wear somethong with no waistband, preferred. Like a house dress. Inevitably I've had an incision EXACTLY where my waistbands fall. And I'ev also had a few incisions that were intentionally left unclosed. Those hurt the worst, even though they're the smallest, and also tend to be right where my pants hit. If you must have a waistband, try to find one without elastic (e.g. drawstring) so you can fully adjust the tightness. When I had my band out I wore one of those velvety track suit things, mine has a drawstring waist. Perfect. Wear slip-on shoes if you have them. Socks are hard to get on when you can't bend comfortably, and I don't like other people putting socks on me. Flip flops, or those fugly plastic clog shoes (forgetting the name), or a ballet flat or something like that. If youdon't have or can't get, then when you take off your sneakers pre-op, leave the laces all loose so you can just slip them on later. Nook or Kindle or book or whatever. My sleeve will be the first procedure that requires me to stay overnight, and post-op I've een either asleep or prepping to go home, but pre-op? I played Boggle on my iphone for almost 2 hours pre-op. Was glad to have it. DH was there but is always more nervous than I am and wasn't a great talker. I always bring a small hair clip. You can't do anything but wash/rinse your hair the day of, and you're probably (technically) not allowed to shower the night of. I have curly hair that gets bushy if I can't put some kind of product on it while it's still wet. So I always bring a clip to at least pull the hair back from my eyes. I prefer to bring my own slippers (they have memory foam soles). I bring my own robe. I haven't been able to wear it (IV lines, etc.) but hospital blankets are cold. Even the warm ones get cold too quickly. My robe is warm. And it can double as an extra pillow, because those flat jokes in the hospital aren't cutting it. Chapstick, deodorant, my own toothbrush, skin lotion and hand sanitzier. (I put all of the above in my purse). If my face or hands are dry, I will not be able to focus on much else. Pillow, for supporting your stomach. Especially if you have a large pannus, this will help. When I had my lapband put in, it took me about 3 days of walking completely hunched over like an ancient lady until I realized that the majority of the pain was coming from my pannus "pulling" down on my incisions. As soon as I started to support my pannus with my arm, it was like night and day. LIttle nicer doing it with a pillow than your forearm, but hey, I was desperate. I will also help to apply steadying pressure when you go over potholes on the ride home. (About 4 days post-op DH drove me to visit my parents. He took a route that goes over a train crossing. He had a "theory" that the faster he went, the less I would feel the bumps so he gunned his truck and his them going about 45. Our marriage almost didn't make it to the next block.) When I had my lapband out, I had the most horrible sore throat from all the gear using my mouth as enter/exit. Truly it was far worse than strep, and easily the single worst pain I had after surgery. I didn't have any eating/drinking restrictions so I used Chloraseptic. If you can have some type of analgesic lozenge or something, go for it. Electric razor. Let's just say I'm 1/4 Greek and would be a good candidate for laser facial hair removal if everyone hadn't told me it feels like exacto knives slicing your face repeatedly. This isn't required, but I need it for comfort level. For drive home: I haven't yet had anesthetic make me nauseous, but it can make a lot of people sick for a while. I drove my mother home from a bariatric surgery she had and we kept having to stop on the interstae so she could chuck on the side of the road. So the REAL suggestion here is get a driver who doesn't get queasy when she hears others chuck. Second suggestion is to bring some type of a barf bag (those blue emi-sleeves the hospitals have are great) if you know or suspect the anesthesia will affect you. There's something about car rides that seems to make it worse, even if you've been "fine" for a while. Keep said pillow with you. Either to support your abdomen, or to nap, or both. (If your procedure is outpatient, you'll probably still be nap ready by the time you're released) Keep a blanket in your car. I'm always freezing cold after surgery, for a day or two. And DH is not, so it's nice to able to limit the use of the heater - for his sake. (BTW, when people lose weight, especially quickly, they tend to discover they're perpetually cold - you might want to just keep a blanket in your car long term). At home: I have DH bring one of the recliners up from his theater room and station it in the living room. From there I have same-floor access to the door, kitchen, a half bathroom, etc. This recliner becomes my docking station for at least 3 days until I can comfortably lay in bed. And on that note, I'd suggest getting some extra pillows. When I CAN lay in bed, I do best if I'm VERY propped up. I suspect this will be true with sleeve surgery, especially until my acid production drops off. Don't wait until you're out of surgery to try and find supplements you like. Have them selected before hand, and have a few options. Things will probably start tasting different. Have cold & room temp Water ready. Not all bariatric stomachs tolerate all temperatures. When I had by AGB surgery DH bought a little apartment fridge to keep in the LR so I didn't have to walk into the kitchen. That was overkill. But if somehow being able to stay on the same floor as the fridge weren't possible, it would've been awful handy. I'm queuing up movies & shows to watch on Netflix. Daytime tv sucks monkey butts. Also holding off on getting a few books I really want to read, so that I can have something to do until I can comforably move around. If you have someone who can help you around the house for a few days, do it. Think about kids if you have 'em, pets... and how may up/downs it is just for an hour or two. I don't like to take my hydrocodone any longer than I have to, so I use liquid Tylenol and try to have a few bottles on hand. Gas-X never did a thing for me other than taste bad. The gas that Gas-X works on (I say "works"lightly) is not surgical gas, i.e. the piercing ache you might feel around your collarbone/shoulder area... so don't buy it thinking it will bring relief. Surgical gas, and intenstinal gas, are two wholly different things. As an addendum to what I just said - I just remembered that an RNY friend dumped on liquid tylenol. For VSG it might be better to wait and see if you can tolerate it, unless your surgeon gives you the OK ahead of time. If your shower hyas a stationery head, I suggest getting one of the kind of tubing that you can move around. Especially for ladies out there. Bending and twisting is gonna smart, and let's face it. Some things in life require us to bend and twist, or be able to hit it with some water. I'm just sayin'... When I had my AGB and the graduated diet, I made sure to buy everything a few days prior to my surgery so that I didn't have to go to the store if I didn't want to. Ends up I wanted to, the next day, just to walk around a bit. But having the option is nice. Since my AGB both of my parents have had bariatric procedures. I've made each of them a large gift basket and brought it to the hospital. Here's what I try to include: small plates (cocktail size) toddler utensils refillable water bottle that will fit into a car drink holder, and has ounces hashed so they could track water intake liquid Tylenol Wet wipes/hand sanitizer Snap-up robe (belt can be uncomfortable) SF Jello Mio or Crystal Light (was allowed with their surgeon) liquid breath freshener Sudafed dissolvable strips corn bags (cloth bags filled with field corn, I think they're far superior to heating pads, and caln also be frozen) Book, crossword puzzles, Sudoku, etc.

Glad to see this thread. I was just getting ready to check out the 200+ forum. Most of my time here so far has been spent in the band revision area. I weighed about 385 when I got my band. Dropped to about 220. Back up to 275 during a pregnancy. Band removed September 2011. At my post-op for the removal I weighed about 310. I haven't weighed since then but I'm probably in the neighborhood of 330 now. Scheduled for sleeve surgery late March. Hopefully I won't gain ALL my weight before then, and will probably be looking to lose around 175 lbs (again) with the sleeve. I see it, along with the lapband, most often used by people with "only" about 100 lbs to lose. And yes, 100 lbs to lose is significant, but it's not 200 or 300 and it is a much different "journey" with different circumstances. But I really really don't want RNY.

Here are the actual requirements: To be eligible for the Pre-Existing Condition Insurance Plan: For children under age 19 or persons who live in Massachusetts or Vermont: You must have been quoted a premium of 200% or more of the Pre-Existing Condition Insurance Plan premium for the Standard Option in your state. You must be a citizen or national of the United States or lawfully present in the United States. You must have been uninsured for at least the last six months. You must have a pre-existing condition. To prove this, you will be asked as part of the application process to submit one of the following documents dated within the past 12 months: A letter from a doctor, physician assistant or nurse practitioner stating that you have or had a medical condition, disability or illness. This letter must include your name and medical condition, disability or illness, and the name, license number, state of licensure and signature of the doctor, physician assistant or nurse practitioner. A denial letter from an insurance company licensed in your state for individual insurance coverage. Or you may provide a letter from an insurance agent or broker licensed in your state that shows you aren’t eligible for individual insurance coverage from one or more insurance companies because of your medical condition. An offer of individual insurance coverage that you did not accept from an insurance company licensed in your state for individual insurance coverage. This offer of coverage has a rider that says your medical condition won’t be covered if you accept the offer. My understanding of PCIP was that it is intended to provide insurance for people denied group or personal insurance because of a pre-existing condition. i don't think it functions as "insurance on an as-needed basis," where you can opt not to have insurance until something is wrong, then pick up the coverage just to get the treatment you're after. If that were the case, everyone could just wait until they needed something, then pay a few months' worth of premium and get extraordinarily reduced healthcare coverage, regardless of physical condition. But I'm not a PCIP administrator, so this is just IMU/IMO. The Pre-Existing Condition Insurance Plan (PCIP) was created as part of the nation's new health insurance law, the Affordable Care Act. The PCIP program was designed to make health insurance available to you if you have been denied coverage by private insurance companies because of a pre-existing condition. Sorry for the weirdness above, quote tags aren't working and I get "error on page" when I try to quote through the GUI controls.

Keep in mind the Water guidelines on Atkins. 64oz base plus an additional 8oz per 25# of excess weight. I think that's the current recommendation (it used to be half your body weight in oz of water). Also much sure you don't exceed your target Protein intake by a lot for a sustained period. Even protein will store as fat if you're getting too much of it. Otherwise, it's just following a standard post-op diet of 60 - 70gm protein, protein first. Main difference is that on Atkins, the MORE fat/protein you eat, the better. Obviously sleeve will reduce that. I did a modified Atkins induction for about 2 years. Lots a ton of weight. No more than 20g carbs per day regardless of source. On sleeve portions, that would probably be... 5g? Atkins fats don't have to come from meat. Olive oil is a great fat. I used to mix it into my tuna salad (always looking for ways to up the healthy fat content on Atkins).

Ok so I'm not sleeved yet, but I've been through bariatrics before. These are guesstimates that vary from person to person, but you'll get the idea. So, a couple of things to keep in mind... For the first 3 - 5 weeks, about 50% of what you lose is going to be fluids. About 50% is going to be fat. Part of it will be the "natural" dehydration. Part of it will be your body letting loose its liquid stores (e.g. glycogen) because it's freaking out. Part of it will be your body trying to find equilibrium, etc. Aside from that, I think I had lost in the neighborhood of 45 - 60 lbs before I could see any real difference in my pants. I didn't really notice "getting looser," either. I went from "fit" to "falling off" seemingly overnight. Next is where you lose weight. Abdominal/torso weight tends to come off later. Face/shoulder/upper body weight tends to come off quicker. That's a horribly generic blanket statement, but for the most part it's accurate. I see tons of people who haven't really lost that must weight in terms of %EWL, but have mad collar bones. My tops went down two sizes before my pants even got noticeably too big. Your face may be way slimmer, and maybe that's why people are commenting, while your torso just hasn't gotten there yet, which is why you're wearing the same pants. (Face is usually the first visible sign of weightloss regardless of gender.)