soxaholic

I'm going tomorrow! Yikes! I just called to confirm my surgery (per hospital instructions), and I was told that my surgery was scheduled for 12:45pm. It was supposed to be at 9:30am. I called my doctor's office and was informed that, "Oh yeah, we had to bump you up to the second slot of the day." Not a huge deal in the grand scheme of things, but thank you for letting me know that you changed my surgery time! Ugh, I was totally calm, but now I am a little freaked that I will get there and something will go wrong with the time. Not what I want right now! Ahhh, the joys of a huge "center of excellence" hospital! It's crazy to believe that as of tomorrow, my life and habits will never be the same! Good luck to everyone, both pre-op and post-op!

I am on my last day of the pre-op diet (yay), so trust me, it gets a lot easier. Day one for me was wretched. I had a splitting headache and was starving - trying to survive with SF Jello, apple sauce, SF pops, green veggies, and so on. Nothing I ate made me feel any less hungry. Day two was better and by day three I felt human again. Aside from watching someone eat something I like, I really am not very hungry, nor have I had many cravings. I now have to force myself to drink my shakes or get a yogurt in. I did, however, have insane diarrhea the first few days. I remembered my nutritionist telling me that a lot of people are lactose intolerant and never know it if they're not big milk drinkers. I tolerate cheese okay, but apparently not milk. I switched to Lactaid milk the last few days and I have been fine ever since! Something to think about... As for the Protein drinks, my nutritionist told me to drink Carnation Instant Breakfast for the pre-op diet because it's really low in fat, sugar, calories, and carbs. I tried a few other kinds, but to tell you the truth, I like the CIB a thousand times more than the few other shakes I have tried. The chocolate and strawberry are great mixed with milk. Also, I find that the powder tastes a lot better than the pre-made shakes. I'm sure I'll be itching to try something new fairly soon, but I'll definitely keep the CIB around. Good luck with your diet...you will get through it (with a great weight loss by the way!)

Thanks for the welcome, all! Heidi - Do you know if Dr. V (or her nurses) have fill clinics? At my last appointment, I was telling Dr. L's nurse how I was apprehensive about all of the upcoming appointments because I worked such long hours and getting to Longwood from Cambridge made a "lunch break" a long shot...I didn't see how I could get all that time off and keep it hush, hush (yah, I'm a non-teller). Anyway, she mentioned that Dr. L has fill clinics starting at 7AM. I believe they're weekly (maybe monthly), and no appointment necessary. Maybe Dr. V does something similar? I know you have kids and a long commute, but it might be worth it this time prior to vaca!

Hi Everyone - I just caught up on the last twenty or so pages of this thread, and wanted introduce myself. I'm scheduled for surgery at the Brigham on March 18th with Dr. Lautz! I'm feeling a combination of both excitement and fear; not so much of the actual surgery, but fear that for some reason my liver will be too large. It would just be my luck (and I love my wine, too, which probably increases the chance of it being fatty?). I've only heard of one person on the boards that had a liver problem, so I hope it's a rare thing! I have not started the pre-op diet yet. Natalie told me I could choose to start at two weeks or a week to week and 1/2 because I was "small" (absurd, but thanks, haven't heard that phrase in eight years). I definitely hope to hear it a lot more over the next year :thumbup: I think I will start on Sunday, which would put me about 11 days out. Hopefully that will be long enough. I am not dreading the pre-op diet nearly as much as stage one post-op, but hopefully eating will be the last thing on my mind! It seems only a few of us here don't have Dr. Robinson (I was slightly afraid of him at his info session)! It's crazy how different the process seems depending on the particular doctor. Dr. Lautz was booked very far out (my initial consult was scheduled for April), but his magnificent assistant gave us a great tip at the information session on how to get in via a cancellation, and I was in the next day...surgery date was scheduled the day of the consult...then Psych, Upper GI (ugh), nutrition, a bunch of pokes and prods, a two-day BCBS turnaround, and here I am two weeks away! Thankfully Dr. L doesn't require weight loss prior to surgery (his theory is if we were successful at weight loss, he'd be out of a job :thumbup: because I have been on a eat-everything-I-will-never-be-able-to-have-again-or-have-for-a-very-long-time diet this week! You all are doing so well! I know you veterans will be an amazing resource as us rookies go through this jouney, and I look forward to chatting and eventually meeting you all at support groups!

Hi all! Finally getting caught up on this thread... I'm getting banded March 18th! Anyone else share that date? I'd love to have a few people within a day or two so we can share updates, track our pain (ugh), progress, and so on. I'm a few days away from the pre-op diet, and I'm not dreading the food as much as giving up the glass (or two) of wine before bed! I'm pretty excited, although the post-op thread just scared the heck out of me, so I'm going to hang out with you all the next couple of weeks :wink: There's a part of me that can't believe I'm actually going through with this! Good luck to melting in March (I combined the two great name suggestions)!

I'm scheduled for surgery in three weeks with Dr. Lautz (yikes). I've been pretty satisfied with the process thus far. I highly recommend going to a bunch of information sessions and hearing the different doctors speak. It will really help with your decision to choose a Dr. I really liked a couple, and others not so much...it's the perfect way see what you like and don't like in a surgeon. Also - Check out the Massachusetts-specific forum - there is a huge thread dedicated to Brigham and Faulkner patients!

While program fees are pretty common, $3,500 is exceptionally high. I'm having my surgery in Boston (where everything is more expensive) and my fee is $550. Most hospitals in the area charge the same. I would definitely shop around; a couple hundred is one thing to come up with, a couple thousand is another! Then again, if you feel completely comfortable with this Dr. and don't mind the fee, go for it. Good luck!

Great Topic! My surgery is scheduled for March 18th (submitting next week to BCBS MA) and I am afraid of SO many things... 1) I guess I should start with not getting approved. I have a date and I am so mentally prepared for this, I would be devastated if the news wasn't good. I meet all of the qualifications, however, so I'm trying to remain optimistic. 2) With PCOS and a lower BMI, what if it just doesn't work for me? 3) Will I REALLY be able to hide this from friends, (some) family, and co-workers? 4) Fear that I will have success, but will just hate the band because of the lifestyle changes. I can deal with counting calories, exercise, and smaller portions. I CANNOT wrap my brain around never being able to eat a sandwich again. The carbonation scares me too, particularly beer. How can I go to Fenway Park and not have a beer? The thought of PBing scares the living daylight out of me! With all that said, I am so excited to get out of this body - to turn heads again, to not be on three prescription medications, to breathe better, to feel like going out with my friends again, to reverse the damage I did to my body over the last seven years, to live the life a 25 year-old should live.

I have to admit, I’m a little bummed and somewhat discouraged after my initial consult with the surgeon. I knew going in that they were going to give it to me straight and prepare me for the risks, but I also expected them to pump the surgery up a little – tell me I’m a great candidate; that so many people are happy after the surgery; if I exercise and eat right, I’ll have a better chance for success, and so on. Maybe I was being naïve. The nurse who first met with me was generally positive, but definitely harped upon the complications. The Doctor, however, kept hinting at the fact that he thought Gastric Bypass would be a better option for me (especially for being in my 20s and concerned about social situations). Further, he said that people with lower BMIs do better with Gastric. He did insist he wasn’t anti-band, but it sure seemed that way to me. He spoke at length about how most people only lose half of their excess body weight and that despite all of my efforts, I might not have success. I know these things are all true, but he almost made me feel as if I should expect this to happen (even though statistically it’s not very common). So – I’m wondering if this is normal. Did anyone else experience this? Do they have to cover their behinds for post-ops who don’t have the results they had hoped for? I was SO excited for this surgery and now I can’t get it out of my mind that there’s a good chance I’ll have to sacrifice a lot for a little. Maybe, without any support from home, I was just hoping for someone to tell me this was a good idea. I don’t know – maybe since the band varies so much from person-to-person (what you can eat, how many fills you need, how much you lose), they have to really try to prepare you for the worst. Any similar (or different) initial consult stories would be great appreciated!

Everyone - Thank you so much for responding; it's really nice to hear all of the different points of view. To answer all of the questions and/or clarify some of the points (warning: long!)… As for the surgeon I selected – He absolutely has performed a ton of band procedures (hundreds in fact). He is the Director of Bariatric Surgery at a top Boston (Center for Excellence) Hospital, so I am not concerned about that at all. I did go to a number of information sessions, so I could hear, and speak to, multiple surgeons before I made my decision. I decided to go with this doctor because of his experience, patient reviews, referrals from other doctors, and also the fact that he was the only one to talk about the human/emotional side of obesity. At the info session, he spoke, at length, about improving the quality of life (feeling normal at restaurants, playing with grandchildren, etc.). I loved that – the other surgeons spoke about it from a medical perspective, and that was pretty much it. As for the band vs. bypass – I’m sure, naturally, that doctors who perform both have a preference. They see all of the aftercare, hear the complaints, and so on. However, I think he thought my individual case might be more suited for bypass. I was a little shocked because I have a BMI of 38, I’m in my twenties, and have not had children yet – sounds like a perfect LB candidate if you ask me (and the PA agreed). I think his opinion came from my concerns - I kept expressing that my biggest concern with the band was the unpredictability – how much will be lost, which foods can and cannot be tolerated, restriction levels, success, and so on. My other concerns, which I referred to in my first post as the “social side” – was being 25 and still having an active social life; having a job where I have to travel a lot, attend events frequently, and wine and dine clients on a regular basis; further, I am not planning on telling anyone outside of my immediate family – would I be able to get away with it, or would it be obvious at said social situations? Let me clarify that I know things must change in my life or I'll get the same results, even with the band...I just want be able to lead a somewhat similar life. With that said, I think with those two concerns of mine, he thought bypass would be easier for me – I would definitely lose a lot of weight, I would have more flexibility with what I could eat in social settings (not how much, but what). I also have PCOS, which makes it more difficult to lose weight. I would have to do the research myself, but he said, surprisingly, those with low BMIs (<40) do better with the bypass. He definitely didn’t seem to push it, he just seemed slightly partial…stating the best way to evaluate both is looking at the band to bypass conversions (he said most people were happier with the bypass after-the-fact). But, like I said to him, the more you're willing to risk/give up, the more you get - he agreed. As a medical professional, I understand that it’s his job to lay out both options. He did say my point to not want to re-route my insides was totally common and completely valid. I guess it just bummed me out because I went in not even really considering the bypass – I'm still not - but it made me question whether or not the band would work for me. It certainly wasn’t a tragic experience; I just thought it might be more positive. You know how after you meet with a plastic surgeon and they go over all of the risks, they say something like, “I think you’ll love your results.” I just expected a little something like that. I’ll give his bedside manners a bit of a pass because he was running two hours late because he had a family emergency. Then again, I never think Doctors are as personable as I would like, so I try to focus on their skills! I guess, ultimately, I came out of it more afraid – that even with compliance and exercise, I might not get the results I want (75%+ of excess weight). I see so many people doing cartwheels leading up to surgery, and I’m wondering why I don’t feel quite the same. I’m SO excited to NOT live in this body anymore, but I am terrified of the uncertainty of the results – did anyone else feel this way? Thanks for listening! J

If you're medicated for the high cholesterol, you should be all set. Medication is key, though. Are you in the 35-39 BMI range? If not, you technically don't need co-morbids, although everything helps towards building your case.

Unfortunately, there doesn't seem to be a definitive answer on this one. I have asked four different surgeons, and I have pretty much gotten four different answers. I have heard no - not at all; yes, absolutely; and two sort of in between. You'll hear people speak of the "big co-morbids." I think most insurance companies require a big one (or at least one)...and I think the smaller co-morbids (PCOS, joint pain, GERD) can really support your case. But I'm not quite sure PCOS will stand on its own. I have hypertension and I'm hoping to use PCOS as another reason to approve me. On a side note, it absolutely should be considered a co-morbid - causes high blood pressure, increases risk of diabetes, causes weight gain AND losing weight is the best way to manage it = seems like a no brainer to me.

Ohhh, Groupie, I am right there with you...almost to the T. Over the last five years, I have also fluctuated between 30-36 BMI (though mine has been more of a gradual climb). I finally hit rock bottom a couple of months ago and started seriously considering lap band (you know when you state that you're fat and your friends stop with the automatic, "no you're not!" Yeah, that was my "straw" so to speak.) The only of the big co-morbids that I have is high blood pressure. Over the last year or so, it has consistently been high enough to be considered hypertension. However, I am not yet medicated (my doctor wanted me to try to get it down with diet and weight loss...clearly, no luck). YES, you absolutely need to be on medication for it to be considered hypertension (or high cholesterol, GERD, any of those things). Diagnosed to insurance companies means medication. A couple of Dr. offices confirmed this when I called for consults. Ugh. I also have a ton of smaller co-morbids: Polycystic Ovary Syndrome, joint pain, acid reflux, etc. that I hope to use to beef up the high BP. But I, like you, need that darn hypertension diagnosis. I don't really care for my PCP and I'm fearful that she won't support the surgery as it is. I'm even more fearful to tackle the BP medication thing. Do you tell her you need to go on it to help get the lap band? Or do you take it up as a completely separate issue and hope she doesn't see what you're up to? I don't know...but worst case would be "I think you're looking for the easy way out, and no, I won't medicate you." By BCBS of MA says "one or more of the following..." I think you need either two biggies or one big and a few smaller to back it up. Not fun. Keep me posted, and of course, GOOD luck!

Hi All, I'm 25 years old and have just begun the process to attempt to get banded. I live in Boston, and recently attended an information session held at Brigham and Women’s Hospital. I plan to (hopefully) have my surgery there. I have a BMI of about 36, so needless to say, I’ll likely have a tougher time with the insurance approval process. I have BCBS of MA, which fortunately, the Dr. who led my info session said has one of the easiest approval processes (no six month supervised diet or anything or the sort). I do have to have at least one serious co-morbid in order to be considered. I definitely have high blood pressure – over the last year, and four different Dr. visits, my blood pressure has been high enough to be considered hypertension. However, at my last physical, my PCP told me that she wanted to put me on a diet to try to get the pressure down, and if that didn’t work, she would be forced to put me on meds (I insisted that I do it on my own with Weight Watchers - no luck). The insurance coordinator at the hospital told me that you must be medicated for your insurance company to consider it hypertension. So, my question is, how do I handle this with my PCP? I know, nowadays, you pretty much need a referral from your PCP. I fear the referral process as it is, as I don’t get a very good vibe from her – I feel like she’ll be one to think it’s the easy way out, or I’m not overweight enough to go to such extremes. I’ve also only had her for about a year, so she doesn’t know me or my struggles very well. Do I take the honest approach and tell her what I’m considering having done…and if she seems receptive, ask to be placed on blood pressure meds? Or do I go in and ask to be put on the meds…and mention the weight loss surgery later? My fear is that she will say there is no way I am putting you on medication just to be approved by your insurance. I would agree if I didn’t have high blood pressure, but I do. How should I go about the process? Many people suggest switching to more supportive PCPs, but does it not seem weird walking in on your first physical and saying, “I need you to refer me for lap band?” I would greatly appreciate any help, suggestions, or stories from people in similar situations. I should also mention that I was recently diagnosed with polycystic ovary syndrome, which causes the high blood pressure, makes you twice as likely to get diabetes, and is also a fertility disorder. There is no cure, but the best way to rid yourself of the disease is to get to a healthy weight – I would think this would at least help my referral and/or count as a sub co-morbid. Thanks for reading the long post! :rolleyes2: PS - Considering Dr. Ashley Vernon or David Lautz of B&W, so any opinion on either would be welcome!