Sue40

I started on the Tufts/NEMC program three weeks ago. There are a LOT of requirements including 5 weeks of behavior classes (group therapy basically), 2 nutritionist appointments, 2 physiology appointments, 2 psych appointments, 2 medical consults, 1 surgical consult, 1 "intro" session and now I've learned 2 group physiology classes. It takes a lot of time. They make no effort to bunch appointments together, so I'm spending a lot of time driving to Boston. Here's the reason I'm peeved today. I had my first medical consult. She asked me if I snore. Yes, so? Now she is going to make me stay overnight in their sleep center to determine if I have apnea! I do not have apnea! She made a big deal out of the fact that I wake-up during the night. I have to pee! As I've aged I've lost my ability to hold it that long. All my friends the same age say the same thing! I snore because I have a partially deviated septum, large adenoids and I'm allergic to pretty much everything! She also may make me go for a hematology consult, which takes ages and ages to get. Oh, to top it off, she tried to convince me to switch to gastric bypass. I explained to her that GB is not an option for me because I want to have a child and 42 is the cutoff for IVF, so I don't have time for surgery, healing, and still have successful IVF before I'm 42. She agreed, but thinks the higher weight loss I'll likely achieve with GB is more important. And she insists I need to lose ALL the weight I will lose with LB before I get pregnant. That it would be "very bad". PLEASE. Plenty of people get pregnant with LB, get unfilled if necessary, and then get refilled later. Slowing my weight loss is less of a big deal to me than never having a child. This is a very delicate subject for me and she just didn't seem to get it. She kept talking down to me saying things like, "I do this for a living". I was on the verge of tears driving home. I lost my job (after 10+ years at the same place) in February and they KNOW I need this surgery done before I can look for another job (because there is no way I could do all this with a new job, there are just too many appointments, which they agree with). I had contacted them about the program before I lost my job, I didn't decide to do this because I lost my job. They told me they could put me on a "fast track" since I have no co-morbidities. Except for having a BMI over 40 I'm really healthy, which they acknowledged. Now I don't know what to do. I'm about $300 into it (not including all the travel costs), which isn't that much. I don't know if I should just find an "easy" center. I chose Tufts because they are the pioneer of LB in New England and have had zero erosions. And now I'm questioning my decision to choose LB or GB! Does anyone have any advice? Should I just scrap it and start over somewhere else? The psych doctor, who shepherds you through the program, told me to call him if I have any questions. Should I call him and talk through this with him?

I asked this question at the doctor's and was told I could do cardo within a few days, basicallt as soon as I wanted to. Weights would have to wait a few weeks, abs in 4 or 6 weeks (can't remember which). Can you actually do cardio that quickly?

I didn't even TELL my PCP! My PCP is at Mass General and my LB is being done at Tufts. I totally bypassed (no pun intended) her. She is perfectly nice, and I know no idea how she feels about WLS, and I don't really care. I know my allergist support LB, though. At my last appointment with him he mentioned to me that I might want to consider it (I already was). I wish he was a PCP. Nicest guy, we talk about all kinds of stuff (he also thinks I should get a breast reduction). Mamanmidwife, your PCP is a jerk, and doesn't know the medical facts about obesity. You are better off without her. Maybe one of the weight loss docs can recommend a more WLS friendly PCP?

I can't imagine anyone being there. I may even take the bus into Boston and have DH pick me up later. If I could get away with driving myself there and home I would. It's only a 45 minute surgery. I haven't told many people, partially because I don't like drama. Only DH, father and sister know. It may not be right, but I would tell them surgery is Thursday when it is really Wedneday, and then tell them after the fact that there was a cancellation so you got moved up.

One of the doctors that is part of the LB program I am going through asked me if I ever snore. Ah, yes? I have allergies (and a cat who sleeps on my head), a partially deviated septum and adnoids, of course I snore a little! I always have, when I was a kid, when I was thin, etc. She immediately said I need to be evaluated for sleep apnea. There is a HUGE stretch between a little snoring (which doesn't even disturb DH) and sleep apnea. But this woman is a bull dog and there is no convincing her, so I play along. They schedule the sleep study (wonder how much this is costing my insurance, and what it will cost me?) and they send me a letter beforehand telling me most people sleep fine and many "sleep better than they do at home". Riigghhtt. So I get there and the room STINKS like perfumy laundry detergent. Have they ever heard of ALLERGIES? I had a burning throat and headache within 5 minutes. They turn off the stink machine on the wall for me. The room is roasting hot (I sleep with the room at 57 usually). And then they proceed to glue these things all over my legs, back, upper chest, head (glue in my hair), neck and face. I'm supposed to sleep with this on? It gets better. They want to stick 2 things up my nose. I can't stop sniffling and scratching at my nose. I finally fell asleep at 1:00 am, but they had to keep coming in the room because I kept taking the thing out of my nose. It was like sleeping with plastic straws shoved up there. I woke up (enough to remember) at least 4 times. At 6:00 they woke me up to go home. My face was so puffy I could barely see from my right eye (allergies, likely) and my face was puffy and bright red. I also had a raging headache from sleeping on a rubber wrapped mattress with rubber wrapped pillows. Then I couldn't find my car in the parking garage. I am so POed I could scream. It's now 18 hours later and my face still feels weird (puffy and dry). The tech said if they saw any evidence of apnea they would wake me and give me a mask, which they never did, so I assume no signs of apnea. Aside from a little snoring, I have no apnea symptoms. Thanks for letting me vent. I am getting really aggravated with this program. I've been jumping through hoops with them and I've had it up to "here"! Oh, so what did I do today? I didn't stick to my diet, that's for sure! I was too cranky and upset to deal with just cottage cheese and grapes.

Thanks everyone. I met with the psychologist today and he made me feel better. In the 7 weeks I've been doing the program I have checked off everything on their HUGE to do list. I still have more weight to lose according to their "guidelines", but he said that they will probably present me to be scheduled for surgery at the next weekly meeting. I meet with the surgeon Thursday and need to plead my case with her. I am crossing my fingers that they don't make me redo the sleep study. The technician said it was good that I eventually "settled down", so I hope that means they got what they need!

I currently take a multivitamin, a B12, a folic acid, a weekly vitamin D and an iron. I met with the nutritionist today and she told me post-surgery I will take no vitamins for 2 weeks. After that I will replace the multivitamin with a chewable but will continue to take all the others. She said as long as the pill is smaller than a dime in all directions it can be taken without breaking it or crushing it.

The program I am going through requires everyone to have a sleep study done.

There is definitely a min and max on there. At my height 260 looks exactly the same as 350. I thought my current weight (282) looked too small, so I plugged in a bunch of extremes. I think 260 is the max at 5'6".

Maybe I didn't put this in my original post. After they scheduled my study I learned from others in the program that they have EVERYONE do a sleep study. So her thinking I had apnea was BS, they order it on everyone. Which she should have just told me, I don't appreciate being misled. My quality of sleep is fine. I'm not tired during the day. I do sometimes have trouble falling asleep, but that is a stress thing (lost my 6 figure job and can't look for another one until I no longer have 2-3 doctor's appointments every week, huge mortgage, etc.). The technician was a nice guy, I don't blame him. I just don't like my skin and hair being messed with. And the room was horrible, as I wrote (I felt like I was in a $30 hotel). I now have red skin rashes (and a few bruises) where the electrodes were. No matter how much I schrub with alcohol I can't get the glue off my skin. I know I'm being a little bit of a princess about this, but I've really had it with the hoops they are making me jump through. I have had fifteen appointments already (plus the sleep study) and have yet to meet with the surgeon. This is costing me a damn fortune between copays, parking and gasoline.

I don't expect it to go away. When I was thin I would sweat really bad from my head, just as my father does. When I would workout I would be soaked. I am the same now, 140 pounds heavier. I don't expect it to go away when I lose the weight.

According to the guidelines I was given, I will have to wait 3-4 weeks for mushies. HOWEVER, they classify cottage cheese, yogurt, pudding and scrambled eggs under full liquids - allowed after 1 day of clear liquids. Good thing I love cottage cheese!

Goddess makes a sports bras up to G. I'm out of luck, I wear a J (yes, a J!) and from the research I've done there are no sports bras bigger than H. I wear a Goddess bra that is not specifically a sports bra, but is similar. There are few sports bras bigger than D or DD.

How does this prove anything to the nutritionist? Unless she follows you around day and night how does she know what you are eating? The hospital I am going through requires a 10% weight drop and they suggest what is basically a low-glycemic index diet.

I get heartburn from the lemonade flavored drinks, but not the iced tea. In fact, I'm drinking Crystal Light iced tea right not. I've never heard of aspartame causing fluid retention. I can tell when I am retaining fluids (the ankles show it), and there is nothing there. Carbs DO cause fluid retention for me (nutritionist agreed with me, not sure why it happens though).

Before I started all this I thought I was 5'7", but the docs say it is closer to 5'6". At that height my weight should be 115-160. That is a pretty wide spread. I weighed 160 in my 20s and wore a size 10-12 on the bottom. But I am built a little odd. I build muscle very easily (at 160 I looked like a sprinter, all big butt and thights, but solid and no fat). My goal is to get to a BMI of 35 and then try to get pregnant. After that (fingers crossed) I will worry about getting in the range of 150-180.

I was told I had to lose 10% of my weight, a requirement for all patients in the program even if their BMI is close to 40 (they submit the starting BMI to insurance). I started at 299 according to their scale and have lose 15 pounds in 5 weeks. So I have about another 15 to go.

I am going through the program at Tufts/NEMC, the most experienced LB program in New England, so they have a lot of experience. They said that once your BMI is about 50 and up their experience shows you are more likely to be successful with gastric bypass. They also said that both surgeries have the same percentage of complications, but the complications you get wirh gastric bypass are the worse type (leakage, for example). In terms of loss, they said people in both groups tend to lose the same amount of weight, but it takes LB patients about 3 years and gastric bypass about a year. And then both groups trend upwards, with a regain of about 20-30% (if I recall correctly). Continuous follow-up is vital to limit the regain.

My doctor doesn't require any special pre-op diet. However they do require that you lose TEN PERCENT of your body weight before surgery. I would rather do the liquids for a week! That's 7 days of suffering instead of 2-4 months.

Just curious, why the need to sleep in a recliner? We don't even have a recliner.

I am going through Tufts/NEMC and asked this question at my orientation. He said Lap-Band is done outpatient, which I was happy about. I prefer to sleep in my own bed, next to my husband rather than some person I don't know. And I am germaphobic about hospitals. I imagine if there is any type of complicating factor they keep you overnight. I can't have morphine (or Percocets, etc.) so pain pumps aren't a factor for me. Nausea IS, so I'll make sure to ask for anti-nausea medication before I leave.

The program I am going through is pretty strict, but I was surprised the psych eval wasn't longer. The program coordinator sees you every 6 weeks and he is a psychologist. We already spent about an hour just talking about their program, what is expected of me, my medical history (uneventful), reasons for weight gain, history of weight loss, what my expectations are re: surgery, etc. I also did a quick fill in the circles thing. I've never had depression, bulimia, etc. (I can't make myself throwup if I try, which I told him). I don't drink or do drugs and never have. Food is my vice! Also, due to my profession, I am very good at "selling" myself. He gave me a list of everything I have to do before they schedule surgery, and other than "check in" meetings with him, there are no more psych eval. Maybe if they see certain things they dig deeper?

I keep reading here about how someone has X size band and Y amount of fill. Can someone explain the different band sizes to me and why one size is used over another. And if there are any advanatages to certain band sizes. Thanks.

When I met with the psychologist for my initial consult he said something that really applies here. He asked me if my husband was supportive, and I said he was, that he knows how impossible it was for me to keep weight off. I asked if that was an issue for some people and he said it was, that thinner (but not necessarily thin) spouses or family members who attend the sessions with the patient sometimes have the attitude that the person isn't trying hard enough, that they just need to exercise more and eat less, etc. He tells them to try losing just 15 pounds and keep it off for one year if they think it is so easy. The next time they come in he asks how much they lost. They always have some excuse. I was actually surprised when he told me it took courage to take this step. He said most people who need it more than me never take that step, and he thinks criticism from others is a big part of that. If I know I am doing the right thing I don't care what others think.

I lost 70+ pounds when I was in my twenties and my skin bounced right back. I don't expect that to happen now. I'm 40, and my lower stomach is very saggy (sorry for the graphic image:ohmy:). I expect I'll need a tummy tuck eventually.