stacyrg2

No. Good luck with your surgery!

Just curious . . . why is the thought of taking Vitamins upsetting to you? My thoughts on your question is that you need to do what you believe, in your heart, is the right decision for you. You lost 30lbs and that's great! How many times have you lost before and gained it all back? In my mind, the surgery levels the playing field and gives you a better shot at not gaining it back. Good luck with your decision!!

But is that because you feel that you can't eat in moderation and burn away the calories through exercise - like healthy people do? You feel a chicken wing or a slice of pizza will ruin everything that you worked towards? That you can only have a ton of bad food or no bad food - there is no happy medium? I exercise a ton. I kick box 3 times a week and run an average of 15-20 miles a week and lift weights. The old adage that you can't exercise away a bad diet is true. I can't exercise any more than I already do, nor would I want to. What I'm saying is if rather eat satisfying portions of healthy food than "just a bit" of unhealthy. Yesterday I had a hamburger with mushrooms and Swiss cheese. I ate it without the bun and basically finished the party (4oz). I'd much rather do that than eat a 1/4 of a Big Mac (which I think you stated above). And let's be honest here , I dont know you but I know me. Are you really going to be satisfied with the 1/4 or sliver of a Big Mac? I guess my point is, after surgery real estate is valuable and I'd rather fill it with really flavorful good food than not. Do I eat off plan? You bet, but those days are few and far between. I'm not trying to pick a fight here I'm just saying that you need to decide, for you, what is important. The answer to me in clear. I'll forgo a hamburger bun every single day for my new healthy and active lifestyle. Sent from my iPhone using the BariatricPal App

I agree with what many are telling you. I'm 2 years post op and maintaining a 130 lb loss. I can eat anything and everything. Haven't been sick a single time from food since surgery. The difference is in what I choose to eat. Will I go to a restaurant and order a hamburger? Yep. But I order it without a bun. That way I have more room to eat the nutritionally dense meat rather than 2 bites of a burger with bun. I don't even miss the bun. I'm typing this while eating a salad with salmon. Wait, let me rephrase that. I'm eating a salmon filet with a few bites of salad until in satisfied. I truly think going into this process with an "everything in moderation" mentality is a recipe for disaster. I have a few friends who have tried it and after the first few years, when you can eat crap and lose weight, and the hard times set in, failed. Yes,gained their weight back. I decided for me, there isn't a hamburger bun, or a pizza, or a chicken wing that is worth putting my success at risk. I wish you luck with whatever decision you decide Sent from my iPhone using the BariatricPal App

I'm in the process of deciding if I'm going to convert to a bypass from a sleeve. After my sleeve, I developed significant GERD. It's so bad that, even on maximum dosage, PPIs don't provide me much relief. I swear, breathing air can give me heartburn. I had an endoscopy last week and my surgeon told me my sleeve is anatomically perfect, I was just one of the unlucky few to develop GERD as a result. At this point I may be leaning towards bypass as my Dr. told me it has a 99% chance of curing my GERD and getting me off PPIs as opposed to the non-surgical treatment (Stretta) which only gives me a 50% chance of symptom relief. This is only my opinion, and others who were sleeved with GERD as a preexisting condition have had their problem resolve and would disagree with me, but knowing what I know now, if I had GERD prior to surgery I would not go with the sleeve. The acid is miserable and impacts every part of my life from sleeping (I sleep sitting up or I choke on acid), to exercising (I've had acid come out my nose when I run) to eating. Anyway, if I end up converting, I'm going to miss my sleeve . . . we've grown quite fond of each other. Good luck whatever decision you make! Edited to add, I lost all my weight (130 lbs) with the sleeve and still have amazing restriction, so my decision isn't based on a desire to lose additional weight. Just wanted to make that clear!

I use a straw every single day. In fact, I've walked into an appointment with my surgeon drinking a passion fruit iced tea from Starbucks through a straw. He didn't say a single word. In my opinion, if a straw makes things easier for you, drink away Sent from my iPhone using the BariatricPal App

I think it may just be the normal slow down. My loss slowed at that point but I was still losing inches and things were redistributing. I'm positive you're not done!! Hope to see you on 5/12! Sent from my iPhone using the BariatricPal App

Uh -- that's not how I eat 20 months post-op. Yes, I spent the first 6-8-10 months being very disciplined about what I ate, when I ate, how I ate. And in doing so I built some new habits. And, badda boom! Now they're habits. I don't count bites or chews or anything like that now. By working hard to build those new habits, I learned how to eat much more slowly, how to chew my food much better, how to recognize what satiety feels like, how to know when I'm approaching "too full" and to stop before I get there. Trust me, I had some awful bad habits pre-op. I bet you do, too. We can't change those bad habits without some serious attention to our behavior. It's not persuasive to say to you, "Trust me, I don't have an eating disorder." But I don't have an eating disorder. What I have is a new lifestyle. I feel very relaxed in this new lifestyle. There's no anxiety about eating. There's no fear, anger, or other upsetting emotions about food. Isn't that what you want? Y'know -- on the front end it does sound *extreme* to remove 85% of your stomach. But on the back end where I am now, it just all feels normal. I just spent a week hanging with some good friends of mine -- all normal-sized and athletic people my own age. We were both eating at home and eating out, too. Some serious partying occurred, as well. What I notice in those settings is that, nearly two years post-op, I am now living the same kind of eating / exercise life they've been living for a long time. They watch what they eat. Read that again: They watch what they eat. Their watching is not obsessive, but it's attentive. I think there's a range of behaviors between obsessive and attentive, and it's intellectually lazy to equate the two end poles of that range. So don't do that. Actually, the barrier to my maintaining past weight losses wasn't the planning -- it was that my plans were so often blown out of the Water because I'd never built any new eating habits beyond the "diet to lose weight" phase. After you lose all your excess weight, after a year or so you can eat so much more than you could right after surgery. The first week after surgery I averaged probably 500 calories/day, all of it liquid. But over the last 20 months I have gone carefully from phase to phase to phase. I didn't go from Dieting one day to Struggling Not to Gain Weight the next day. (How I did all that is a big subject, and one I won't go into here, but it wouldn't surprise you how I did it.) Yesterday, I ate 3 meals and 2 Snacks -- all real food. I do record most days my menus on My Fitness Pal (it takes me all of 5 minutes -- I'm a data hound). Yesterday I ate 1,805 calories, 103 grams of protein, 189 grams of carbs, 67 grams of fat, 23 grams of insoluble Fiber. Girl, that's how a real person who's eating healthy and maintaining her weight eats! Oh, and yesterday morning I went for a hike up a small mountain with my sister and late yesterday afternoon I spread 20 bags of mulch in some flower beds. And I went shopping. I wasn't wearing my pedometer all the time, so don't know how many steps I got, but it was at least 10,000 I'm sure. Am I obsessive? Or am I attentive? You decide. You can also read this post to your therapist and see what she thinks. Last thought: You should not do this surgery unless and until you are really comfortable that it's the right choice for you. Don't let anyone here talk you into it, including me. Amazing post VSGAnn! I agree, I look at post surgery as a change of mindset. I don't think anyone who sees me eat out now would ever guess I've had surgery. I eat as a normal weight, health conscious person would eat. I make good choices, eat my allotted amount and I'm done. Your post describes post op life for me to a tee (although my calories/carbs are not at your level, I find for me, my plan of 1200-1300 cals a day, 100+grams of protein and the remainder healthy carbs and fats works well. I also agree that no one should go into this surgery until they are fully committed to the lifestyle change. This is not another diet, and I truly believe that mentality will get you in trouble post surgery. This is a lifestyle of eating healthy, well balanced fuel for your body. To the OP, I wish you luck in whatever decision you make!

I agree. What is your total Protein consumption? Total calories? How is your Water intake? It may be the carbs, but it may just be a normal slow down. I know I lost best when I kept my protein over 80g and my carbs under 50g.

In California, once you exhaust your internal appeals with your insurance Company, you can ask for an Independent Medical Review with the Department of Insurance. They take info you submit, as for information from the insurance company and have an independent panel of doctors review the decision. I'm currently going through the process right now. I have Aetna and they denied a non-surgical treatment for severe GERD that occurred after my Sleeve. I've had a few insurance companies and Aetna is by far the worst one to deal with.

I use teddy Grahams mid-race also. They work really well for me. I also use Clif shot bloks, 1 block every 2 miles. Congratulations on the 1/2! Sent from my iPhone using the BariatricPal App

I developed severe reflux after my Sleeve (my acid level is more than 400% greater than normal). I had an endoscopy and biopsy this week checking for Barrett's. I have two areas of damage on my esophagus from the acid. At this time, I'm considering conversion to bypass to end my GERD. This is completely my opinion, so take it for what it's worth . . . knowing what I know now, if I had severe GERD or the beginnings of Barretts' esophagus I would stay far, far away from the sleeve. I didn't before my surgery and was one of the unlucky few who developed significant GERD post surgery. It's miserable and if I had Barrett's already I would be afraid that the sleeve would exacerbate the problem. Like I said, just my two cents. Hopefully your biopsy doesn't actually show Barrett's. Good luck!

I can't speak to those questions. I would suggest talking to your current doctors. From what I know the surgery should not impact any of your other care Sent from my iPhone using the BariatricPal App

Honestly if you have Barrett's esophagus I wouldn't touch the sleeve with a 10 foot pole. I had an endoscopy earlier this week and if the biopsy shows any signs of Barrett's there is no question I'm converting to bypass. Good luck with your decision. Sent from my iPhone using the BariatricPal App

RNY. I never had reflux prior to my sleeve, but I have it now. I'm on Protonix in the Morning, Dexilant at night and Zantac before bed. Knowing what I know now, if I had reflux/GERD before surgery I never would have been sleeved. I would have gone with RNY without question.

on runs longer than 5 miles, I make sure to fuel during. I tried numerous things and found that Clif shot bloks work best for me. I take 1 blok every 2 miles. Each blok is 33 calories and I find that it leads to a steady stream of energy in my system. When I run 1/2 marathons I add in a mid run snack of either teddy grahams or pretzel sticks (both surgeon and NUT approved) The teddy grahams also deliver a quick jolt of energy since they're mainly carbs, but they do have a few grams of Protein in them. They also basically dissolve in your mouth and are easy to eat. They've never made me sick. I sometimes have trouble with cramping during longer runs, and the pretzel sticks work for me. Again, mainly carb, but the salt helps ME with my runs. I ran the Hollywood Half Marathon this past weekend and brought teddy grahams with me. I wish I had the pretzels because I had a cramping issue after the race. I found it is all finding what works for you. Some people swear by Gu . . . but it makes me want to hurl. I found the main thing is making sure I have a steady stream of energy and liquid during the race so I don't die or dehydrate. I was given permission by my surgeon to ignore the no eating and drinking at the same time rule during a run since the shot bloks need the Water to properly break down in your system. Good luck finding what works for you. Oh, and you can carb load . . . I worked with my surgeon (who is a runner) to develop a plan. I increase my carbs 203 days before a race. I typically stay under 50g a day, but the week of a run, I increase to 80 or so. I don't go crazy eating plate fulls of Pasta or loaves of bread, but I will add in some potato, oats, etc. and I've never had a problem. It doesn't make me crave carbs, nor does it lead to out of control weight gain.

Oh, and my surgeon and NUT both told me on long run/race day I don't have to wait 30 minutes after eating anything to drink. The key is to keep hydrated and you can't do that by following that rule. I follow it religiously at all other times but not during races.

I can't stand Gu, truthfully it makes me want to hurl. I use Clif Shot Bloks (which were recommended by my surgeon, who is a runner). On any run over 4 miles, I eat one blok every 2-2.5 miles. They have the consistency of gummy bears and I can either chew them or let them dissolve slowly in my mouth (followed up with water/gatorade in both instances, which helps to break them down). I really don't vary my eating on long run days. I start my morning with overnight oats, including a half container of greek yogurt, a tablespoon of Peanut Butter, and a 1/3 cup of milk. The oats give me some sustained energy. My surgeon recommended a bonk bar or Quest bar for mid run energy, but they land in my stomach like lead, so I carry a single serving of Teddy Grahams (while I stay away from most processed foods, when discussing training with my NUT and surgeon, they both agreed it was a good option. They have some Protein and are mostly carbs that converts easily into energy, mid run). I also carry a pack of Justin's nut butters. They're easy to get open and suck down on the run. Finally, the week of a long run (actually, not when I'm doing training runs, but only for the race itself) I tend to increase carbs. I usually keep my carbs between 40-50g a day, on a race week, I double that (closer to race day) by eating extra servings of oats, bananas, nut butters, etc. When I stick to that plan, it works for me. I will say, that I've never run a marathon (but have run a handful of 1/2s) so maybe someone with more distance experience can give you a clearer picture. Good luck!

coffee isn't really a diuretic. I'm almost 2 years post surgery and went back to caffeine about 6 month out. I'm now caffeine free again as I'm having a problem with acid reflux. But if you don't have an acid problem, I don't think caffeine will hurt you post op.

Three, including the day of surgery.

My surgeon is one of the most awesome human beings I've ever met. I am not exaggerating. To echo VSGAnn2014, my doctor never rushes you, will sit as long as necessary to make you understand and will let you ask as many questions as you need to feel comfortable. Prior to surgery we had a long discussion about procedures . . . he laid everything out clearly and did not push me to a particular proceedure, but made it clear he had definite opinions. After surgery, when I had concerns about my rate of loss, he sat with me and went over food, activity level, etc. At one point, he asked if I understood a point he was making (it was a fairly scientific point) when I said yes, with hesitation, he told me it was his job to sit there all day with me until I understood, so I should be honest with him. He's friends with my primary care doctor and does not hesitate to get her on the phone when issues arise or just to keep her in the loop on my progress. He saw me through my VSG, my gallbladder removal, a blood cholesterol issue and now a fairly significant issue with GERD which may require a revision. He lets me cry on his shoulder when my issues become overwhelming and he cried when I walked into his office at my one year follow up appointment and handed him the medal from my first half marathon which I ran 2 days before. I am thankful every single day that this man is in my life and grateful for the life he helped me to achieve. My one piece of advice to newbies is to find a surgeon you are comfortable with and will give you the level of support YOU need. If your first choice doesn't offer that, find someone else!

This is going to be long, so I apologize. I'm just frustrated. I'm almost 2 years post VSG and have developed a significant case of GERD. It's so severe, and not controlled by medication, that my surgeon feels we can't just let it go. He has recommended that I undergo a procedure called stretta, which seems promising. We submitted for approval to my insurance company which promptly rejected the request (took them all of 3 business days) on the grounds that the procedure is experimental and there are well accepted alternatives, including pharmaceutical therapy and Nissen Fundoplication. Well, I'm not controlled by medication and the only combination that provides any relief Protonix/Dexilant was already rejected by the Company (they won't pay for the Dexilant and at almost $400 a month, the cost is almost prohibitive). Also, given that I no longer have a fundus, a fundoplication isn't available to me (nice going insurance co . . . way to review my medical records). My final option is conversion to bypass, which I really don't want to do. Other than my GERD, I LOVE my sleeve. It's allowed me to lose 130lbs and live an active lifestyle I've only dreamed about. I like having my pyloric valve and not having to worry about dumping, reactive hypoglycemia, etc. Also, the thought of another major surgery is not thrilling me. Anyway, my surgeon gave me the cost for both Stretta ($5,000) and conversion ($100,000). We decided to seek approval for conversion just to have it in our back pocket while we appeal the denial to my state Department of Insurance. Wouldn't you know it, they approved the $100,000 surgery. This is a prime example of what's wrong with the insurance industry. Why would you approve a $100,000 solution to a $5,000 problem???? Just frustrated beyond belief and knew this was a good place to get out my aggression . . . here and in my kickboxing class where I visualize the Ins. co's medical director's face as my target!

Yes, I have PPO. You have the right to request an IMR. The DOI has the right to evaluate whether the claim qualifies for an IMR. If so, they have 30 days from the date they receive a response from the insurance co to rule Sent from my iPhone using the BariatricPal App

I'm in California, but it's not a State rule. It's an internal procedure with my insurance company. For this particular procedure, they are a one look, no right to appeal. That's why my surgeon's request for peer to peer has been denied twice. He keeps trying, going up the chain of command with each request. That's also why I have the request for Independent Medical Review pending with the Department of Insurance. The one look, no appeal is clearly stated in the disclaimer letter and has been confirmed by the stretta people who have faced that position from this insurer before.

Thank you so much! I have an appointment tomorrow with the VP of reimbursement for the company that manufacturers Stretta. They have agreed to partner with me and fight the insurance company through the Dept. of Insurance. This is precisely the type of information I need to present in my appeal Sent from my iPhone using the BariatricPal App