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Since my BMI is less than 40 there is no pre op diet.

My research was last year. Cary Surgical Center $15K for surgery fees, MD fees and overnight stay (doesn't include preop test, x-rays, 3-4 nutrition appointments etc). Dr. Enochs has a great rep there and had insurance not covered it that is where I would go before even considering price. These prices were also based on no significant co morbidities. Duke was about 22k, and Rex was 27k I think. Cary Surgical just merged with Wake Med and was a lot less before they did last fall. I'm surprised it is still that low. They might be doing it at a surgery center verses a hospital which makes the price sky rocket.

I am officially scheduled for 2/18. I am excited and nervous.

What does NSV mean?

orthostatic hypotension. An easy habit is to do some ankle motions or leg kicks, tighten muscles or use your arms to push up from the chair you are sitting on. Anything that will increase your heart rate and blood pressure so that when you do go to stand up it may drop but not as low and thus hopefully you will not have symptoms of dizziness. If you are getting out of bed, sit on the edge of the bed for 30 seconds, do leg/arm motions as well.

I am going to the post op diet class in a few weeks to get the details but wanted to ask if anyone has a chart or schedule for what to eat when, how to schedule vitamins etc. What are the best post op vitamins? liquid or dissolvable?

What surgery are you looking into? Bypass? Sleeve?

How is everyone preparing? Do you already have your vitamins purchased? I go to a preop diet meeting that is 1 week before surgery so I won't have a lot of time to get what I need. I know I will not be required to do any preop diet so I am just worried about the after surgery stuff.

I got insurance approval!!!!! Surgery will be in about 2 weeks (waiting for the scheduler to contact me). I was convinced that insurance wouldn't approve me but they did. So now my emotions are all over the place. Excited but looking forward to getting into March when I would be healed. Guilty that something could go wrong and I am doing this when I don't "have" to. Guilty that I didn't try harder at yet another diet. Worried that I won't lose as much as I should or maintain the weight loss.

I work in the medical field. I always tell my patients to try and return the middle of the week if possible. That way you only have a few days to work, can rest on the weekend before having to go thru 5 straight days. If you can take a week and the second week return on a Wednesday or Thursday that may be a great compromise.

I am preop but have had GERD for over a year now. It came on suddenly. I take the same med/dosage so I am pursuing a bypass vs sleeve. My GI insists that it is a safe medication, has been around for decades etc. I know some other GERD meds have warnings but supposedly Protonix is "safer".

I am preop so I can only tell you my experiences not based on surgery. I had terrible pain under my right shoulder blade due to gallbladder issues and had surgery to remove it. The ultrasound of the gallbladder was fine (no stones) but I had a HIDA test done which showed my gallbladder was barely functioning so off the surgery I went. I don't have the terrible pain anymore but get achy pain in the same area due to reflux.

That sounds like a good plan. I wonder if once your weight loss stabilizes if the gallbladder issues resolved since it seems to be a sudden big weight loss triggers it. Have a great time!!!!!

I am pre WLS but had gallbladder attacks (worse than labor pains) and multiple days per month of a chronic dull ache near my right shoulder blade. I could eat low fat and be miserable and other times eat ice cream and be fine but I did find that high fat usually meant I would be in pain. An ultrasound did not show stones so they did a HIDA scan and it showed the gallbladder functioning at 15%. The GI doc and surgeon said you can put it off but eventually it will need to be removed and probably in an emergency situation. So I decided I would rather have a scheduled procedure when I can choose the surgeon, hospital, date etc verses risking being out of town and have an emergency surgery.

I am surprised it is that much. Maybe that is the cost for going to a sleep center. Can you check if there is a sleep center that lets you use a device at home. I am sure that would be much cheaper and should give nearly as good of results. I had that and it was hundreds not thousands.

So due to the holidays I have gained 2 lbs. I have my final nut visit tomorrow. I plan to wear light weight clothing, plan to take an Epsom bath tonight and tomorrow am and only drink a half of a protein shake in the morning before the appt. I have been eating really clean (low sodium etc.) the past few days, drinking tons of water and limiting to 1100 calories so I am hoping the scale looks better tomorrow. So my question- does insurance look at the weight from the first and last doctor's appointment or the nutritionist? It is at 2 different offices and 2 different scales. My doctor appointment is next week and surely I can lose the 2 pounds by then and be less than my initial appointment. I can't delay either appointment due to insurance number of days requirement. Ugh!! I wish I would have been more mindful over the holidays.

Thanks for the encouragement. I went today and was down 2.5 lbs. so that's good. Now I just have to make sure I stay at this weight for the MD appt. next week. I found out they are submitting my info . to insurance today and "should" hear back in 15 business days. So fingers crossed. I am still expecting for it not to be covered since I don't' use a c-pap as I have a diagnosis of "mild" sleep apnea without any other comorbidities.

I would recommend going to a physical therapist before you look into medications or a nerve block. I would bet you would have pain relief with certain exercises and they can also use things like ultrasound or a TENS unit for pain. Have you tried heat or a cold pack. That wont make the pain go away but could at least decrease it. The PT could also work on your posture or give you advise about how you sit in a chair or your car to help ease the pain.

I still have to go to my 3rd Nut. visit, see the surgeon and then a diet class. The office put me down tentatively for Feb 18. I am still thinking insurance will not approve it since I don't need a CPAP and diagnosed with only "mild apnea", no diabetes and BMI of 36. I am trying to talk hubby into just a cash procedure. A different surgeon said it would be 15k. That's a lot of money but what scares me more is if their is a complication and I am a cash patient that insurance wont cover issues.

I am preop so I can only tell you just from the gallbladder issue. I had terrible pain under my right shoulder blade and nausea. I had several episodes and considering going to the ER it was that bad. I had an ultrasound done- GB was "fine". Then I had the HIDA test done and the gallbladder was not functioning well so I had surgery. I still have almost phantom pain but continue to take reflux meds and its more annoying than painful. It is now just reflux issues. Prior to the gallbladder surgery I would have to stop driving and pull over and try to concentrate on deep breathing as if I was in labor. It was horrible. So that being said the gallbladder can cause a lot of pain, aches, and nausea. fingers crossed you feel much better when it's out.

I just came across an article that said that restrictions after bypass was walking only for 30 days. Then maybe add swimming but no weight lifting/strength training for 4 months and no high impact for a year. That seemed conservative so I wanted to see what others were told. I have not had the final meeting with my surgeon so I don't have his specific recommendations.

So I'm guessing re timing of bypass surgery regarding insurance approval etc. My extended family is planning a trip and it would be a minimum 6 weeks probably 8 weeks post op. Would that be crazy? We would end up eating out a lot. I'm guessing I could just take a protein shake and not order food at restaurants and just have cottage cheese snacks etc at the condo as my meals. Will I be up to normal activity ie walking, maybe swimming? Would I be able to go to an amusement park?

I had read somewhere (not sure how accurate it was) that the bypass procedure was actually meant to treat reflux not weight loss initially. Someone please correct me if I am wrong. Other research I came across showed stats like 20-30% of sleeve patients have reflux issues post surgery. Not sure if this is long term, severe etc. verse the study I read said bypass patients only a small percent reported new or worse reflux symptoms but most reported improvement.

I will finish my 90 day preop visits in Jan. When I met the surgeon in October he asked what surgery I was considering. I said the bypass due to my 1 year history with significant reflux (I have to take meds or I am miserable, I have cut out caffeine and carbonated drinks as well.). I also have a history of DM in my family (not me yet but I am prediabetic and bypass is supposed to decrease DM more than the sleeve. However now that surgery is getting closer I'm getting cold feet about the bypass and thinking maybe I should just get the sleeve. It freaks me out about malnutrition and increased side effects etc. Then I think about how I have researched about relfux being an issue after sleeve and bypass surgery actually helps reflux. Has anyone here had reflux prior or post surgery?

I haven't had that done but here's some advise since I am a health care worker. Set up as much as you can before hand. Get a wedge pillow so that you can sleep semi reclined. That will be easier to get in and out of bed without having to use your arms to push up. Be strict about using compression garments the doctor orders. Have things ie pots/pans sitting on the counter so you don't have to bend and reach for them. Go to the dollar store or shop Amazon and get a sponge on a stick and a reacher. I would also have a sturdy step stool so if you do need to reach something high you can stand on the step stool to avoid lifting your arms too much. Also get some button front shirts. You may want a step stool at the edge of your bed if it is high. That way you can stand against the bed and step onto the stool to get on the edge of the bed easier. If your legs are really sore you can use a long belt, scarf, or dog leash, the belt you put thru to make a tiny 10 inch waist- that's where you stick your foot thru the loop and you can use your arms to help slide your leg on the bed if needed. You could buy a leg lifter device but a belt works ok. I think it's better to have all of the modifications ready and if you don't need it great. Also if you use gallons of milk or water, switch or have someone else pour them in smaller, lighter containers. I recommend getting the spray dry shampoo since you won't be able to wash your hair for a while. Dove makes a good one. If you use a recliner with a lever put a piece of PVC pipe over the lever so it's easier to pull and recline the chair.