Char

If I'm eating 3/4th of a sandwich, it's usually egg salad or just tomato on Whitewheat bread. Squishy food on regular-size, very soft bread with the crust cut off. It's something I treat myself with on occasion. It's kind of my new version of dessert. I generally stick to whole wheat and even then, I don't eat bread often. I can only eat half of a sandwich with meat when I actually make a real sandwich. Most times, it's just a piece of turkey or chicken lunch meat and some 2% cheese rolled up in a piece of lettuce. When asked about food volume during our orientation, my surgeon told us that after a year or two, most bariatric patients can eat the equivalent of a McDonald's regular hamburger, the one you find in the kid's meals, more if they over eat and stretch out their pouches. Personally, I'm not into that kind of pain and I'd like to keep my tooth enamel, so I eat until I know my stomach is almost, but not full. It takes a while to figure out what that feels like. It's taken me as long as an hour and a half to eat a meal.

I actually do better sticking to my diet plan when I weigh myself daily. I know several other people that do better that way, too. It's an individual preference, but you do have to know and understand the plateaus and even a little weight gain now and then. Water weight gain can be 5 lbs or more. It can happen if you eat too much salt, because of hot weather, as a warning sign that mother nature is about to come calling, or because someone in Thailand sneezed while you were putting on your shoes for that matter. : ) You just have to keep in mind that kind of weight gain will come right back off if you stick to the plan. My scale helps me keep on track. I almost always gain weight when I don't weigh every day.

From what I understand, they're not supposed to cancel your insurance without offering you the opportunity to sign up for temporary insurance under the COBRA laws. You may want to check into that. COBRA insurance isn't the cheapest in the world, but it may allow you to get your surgery sooner. I'd find out what the deductibles will be if you were able to do that. Waiting may be the cheaper option.

The drain line is really long and could still have been the source of your pain. They place the end of it right under the internal incisions made in your stomach because that's where the most drainage occurs. Freakiest feeling in the world having that tube removed. I couldn't believe how long it took to get to the end of the drain line!

Be prepared to experience hunger during the liquid phases of your post-surgical diet. It took a while for me to stop feeling hunger, I assume because my body had to deplete it's grehlin levels and I got more used to the smaller stomach. After a while, you may have trouble making sure you eat enough because you don't get hungry unless you haven't eating for most of the day. It took me a few weeks to get there. If you get all your protien, Vitamins and fluids in, the hunger issue won't be as bad, but you may have trouble getting them all in. A year post-surgery and I still have trouble eating and drinking enough unless I eat and drink practically all day. Don't try to eat solid foods until your doctor says you can or you can cause a leak in the staple line. Hang in there, it will be over soon enough. Pay attention to how you feel when you're eating. If you eat slowly and put some thought into the new sensations in your mouth, sinuses and chest when you're eating, you'll learn when you need to stop eating to keep from vomiting. It goes for both liquid and solid food phases, but especially when you start eating solids. I get a sensation almost like I'm going to sneeze, my gums feel like they're tightening around my teeth, and my mouth, nose and eyes will start watering when I eat too much. Now that I know the warning signs, I know when to stop. You can get those sensations if you eat or drink too fast, too. I get the hiccups when I do that. Hiccups are a good signal to slow down or stop eating or drinking. Most of the time, it doesn't happen immediately after swallowing, it can take a few seconds or more, so pause between bites and sips. You'll learn your cues faster if you pause and take a moment to pay attention to what your body is telling you. Sometimes I'll be chewing another bite when I get my fullness clues. When that happens, I will spit out what's in my mouth, so keep a napkin handy when you're eating until you learn what your intake limit is. If you swallow another bite after your body's told you it's full, you will end up running to the bathroom or the nearest trash can. You definitely don't want that to happen while your staple line is still healing. It will also take a while to figure out how long you have to wait to drink after eating. It hurts like crazy if you drink too soon after eating, even more than if you take one more bite than you should.

I guess that explains why almost a year out from my surgery date, I still can't eat but a half or 3/4 of a small sandwich...even less if there's lots of meat on it. Cool beans!

You're more than welcome. It was such a pain in the tush to get through the Tricare maze, I figured I should share what I discovered so people trying to get a VSG at an MTF can jump through the hoops without the flames I had to endure. I felt quite singed by the time I had my surgery. It's kind of confusing if you don't understand that Tricare has two components, an on base MTF budget and an off-base civilian budget. Basically the VSG is covered by the on-base MTF budget and not covered by the off-base civilian hospital system budget. Both active duty and retired people have access to both Tricare budgets. Both also have to go through the approval process to aquire a referral from their doctors. Neither can have the procedure done at a civilian hospital, both must go to an MTF, so you're not dealing at all with the off-base Tricare people who only approve services paid through the off-base budget. A civilian doctor can do the referral for both active duty and civilian family members. I'm not sure if active duty family members have to have their civilian doctor send the referral to a military doctor or not, but after physician approval, both active duty and civilians seeking a VSG should apply directly through the on-base Tricare system, not the off-base system the civilian doctors access through thier Tricare referral/approval website. Just find out the contact information for the on-base Tricare office (Benefits Management), get the specialty services fax number and contact name and have your civilian doctor fax the referral to the specialty services team for approval. Maybe it will all start making sense to everyone who reads this thread so they know how to work the system and avoid a stress-induced breakdown.

My husband and I call them Tri-2-Care reps.

The Patient Advocacy office is either where you need to go or can tell you where the Benefits Management office is located. Just call them. I did everything over the phone. Of course it took from September 2010 to February 2011 to get a straight answer and figure out exactly who to call. Don't have your civilian PCM send referrals through regular channels. Find out where the Benefits Management team is located and find the people who approve specialty services. I was asked by the Benefits Management team to fax my information directly to the Specialty Services office at Ft. Gordon. If you go through regular civilian channels (the Tricare system the civilian docs enter their referral requests), all you'll get back from Tricare is the MTF isn't taking new patients, which is hogwash. The 1-800# Tricare reps do not know anything about how to get you on base for bariatric surgery they don't cover. Trust me. They don't know. I had to nag my way way up the chain to get someone who knew that their system had an automated response for certain procedural requests and that the auto reject answer from the civilian Tricare system is" the MTF is not accepting new patients." They don't even contact the hospital, it is an automatied, computer-generated response. No humans are involved. You're fighting a machine. Go to the people on base. Patient Advocacy should be able to direct you to the right people if they aren't the ones who process that base's treatment requests.

Just to clarity something in my earlier post, while you do not have to go through the regular retired Tricare system (that crazy 1-800# and a bunch of cluelessness regarding the VSG), you still have to go through the on-base Tricare office. The Benefits Management office on base is the active duty Tricare office. The funding for the base Tricare for services through an MTF is a different pool of funds than the fund pool which pays out for services obtained through a civilian hospital or physician.

I had two bands removed and had horrible scar tissue. My band surgeon said he'd never seen anyone build up scar tissue as much and as fast as I did. It took him a couple of hours to remove and replace my first band as opposed to the 45 minutes to put the first band in. The only thing you'll want to do is make absolutely sure the MTF's surgical team knows you have been warned about your scarring issue. Try and convince them (it should be easy) that you'll need the surgeon with the highest successful number of VSG procedures to perform your surgery because of the scar tissue. I not only had significant internal scarring, I had a deformed upper stomach because of it and still had no problem with sleeve formation. The only complication I experienced was a small bleeder (they missed or improperly sealed off a small blood vessel when they removed my lower stomach). It's a complication that can be experienced with any form of surgery and not specifically associated with bariatric surgery or my scarring issue. I had a 6-day stay in the hospital and a transfusion, but I was well cared for. They did not release me until they knew the internal bleeding had stopped. Just make sure the facility you choose has a good bariatric program that has been in place for a while.

When you said you read you didn't have to go through Tricare to get a VSG, you were probably reading my post. I did not mean you didn't have to go through one of the Tricare systems, only that you didn't have to go through your regular local channels if you are retired and the MTF is outside of your 99-mile zone of treatment. There are two separate and distinct divisions within Tricare's funding sources. One serves the active-duty, MTF hospital system and the other serves anyone seeking treatment via civilian channels. It's a budget issue. The military hospital system operates on funds the government allots to the military defense budget. Tricare insurance coverage for services off base through civilian facilities reimburses hospitals and physicians is paid out from government funds allotted solely for the purpose of insurance coverage in a non-military environment. So while you do not have to go through the normal Tricare channels if you are retired, you still have to go through the active-duty, on-base Tricare office. Instead of sending your referral to the civilian system you're used to going through, take it directly to the on-base Tricare office. Anyone wanting bariatric surgery at an MTF, active-duty or retired has to go through the Benefits Management's (Tricare) Specialty Services department office on base. The only people you bypass are the people you get stuck talking to on that 1-800# that are pretty much clueless regarding bariatric surgery, especially when it comes to the VSG. Here's how I did it: http://www.verticalsleevetalk.com/topic/12138-tricare-prime-anyone/page__st__40__p__366787#entry366787

Tricare coverage for the VSG will continue to be a hot topic until Tricare approves coverage. I'll share my story again to perhaps make it easier for active and retired military personnel and family members to get a VSG. I'd like to mention first that current coverage refers to vertical banded/sleeve gastroPLASTY, which is entirely different than vertical (or longitudinal) sleeve gastrECTOMY. The difference is with gastroplasty, they are simply stapling off part of your stomach as opposed to gastrectomy, where the majority of the lower portion of the stomach is removed from your body. Gastroplasty is reversible if necessary. Gastrectomy is not. Once your tummy is gone, it's gone, tossed in the bio-hazard bin and burned. As far as I'm concerned, burn, baby, burn! I love my sleeve. The reason you can obtain a VSG on base and can't through an outside surgeon is the MTF's Tricare coverage comes from an entirely different pool of funds than the Tricare coverage paid to outside providers. It's a budgeting issue. The MTF's operate on funds granted to the active military hospital system. Insurance coverage through an outside source operates on funds designated solely for insurance coverage via civilian systems. When it comes to reimbursing for services provided, the two systems do not overlap. OK, so what now? Step 1.) Get your referral. It took months to figure out the maze of retired military vs active military insurance, hospitals, referral processes, etc., but once I did, it's not that difficult. The hardest part is getting the doctors to approve the need for bariatric surgery and getting past the pre-surgical psych evaluation. That's step one. So get started on that if you haven't already. Doesn't matter if it's your civilian or military doctor, although I think it's easier to obtain permission from a civilian doctor. Military doctors can be real snooty about weight management through diet and exercise only. Raspberries.... Once you obtain a referral, you will have to get your VSG at a military facility until Tricare approves the procedure. Since it's new, they want to see the long-term statistics compared to other available options now that the VSG is may be on the way to becoming the procedure of choice for both patients and surgeons. Step 2.) Find an MTF with a surgical bariatric weight-loss program. Some facilities have had bariatric programs for several years now. Others are just starting to perform bariatric surgery. Ask how many bariatric procedures have been performed at that facility and how many the surgeon doing your surgery has done. Ask about their complication rate and if any fatalities have occured. The only one my surgeon experienced was death by Whopper. One of his patients upon discharge had someone drive her from the hospital straight to Burger King, ordered and ate a Whopper, ripped out her staple line and bled out before getting back to the hospital. Please follow your post-bariatric liquid diet. Be prepared to experience hunger and know you're going to have to tough it out...yes, I'm digressing. You may have to do a lot of driving at first, but if you play it smart and get them to combine some of your appointments on the same day, you can cut the expense. We combined my EGD with one of my pre-surgical nutrition sessions and my psych eval with my first meeting with the surgeon. If you are active duty and are traveling outside of your 99 mile treatment zone, you can get reimbursed for travel expenses if your military doctor has approved your surgery. If you are retired military, you're SOL. Start stashing some cash. FYI, obtaining my VSG took 6 or 7 trips to Ft. Gordon. Step 3.) Contact the Benefits Management office at the base where you want to have your surgery. You will need to send your referral directly to that base's Specialty Services department within the Benefits Management office. The names of the offices will probably be different within the various services. The BM/SS office is the Army version of the on-base Tricare management team. The Specialty Services office has to approve your referral before you can see a surgeon on that base. Don't bother trying to go through your normal, local Tricare channels once you get your referral. After 5 months and hours of phone calls, talking to people who had no clue as to what I was trying to do, discovering that the different departments within Tricare have no idea what the other departments do, someone finally admitted that Tricare automatically responds with "this MTF is not accepting new patients at this time" if you are trying to get your surgery done at an MTF outside of your 99-mile treatment zone. I spent weeks calling back and forth with the hospital telling me I have no idea why Tricare is saying we're not accepting patients because we are, then calling Tricare and asking them why they're saying the hospital isn't accepting patients. I'm lucky they didn't cause me to stroke out or rip out all my hair. Another snafu I ran into was my DEERS information was not registered on the Ft. Gordon list of personnel and family members assigned to or being served by the base. I had to contact the I.D. card office and have them register me into the base system. If you are not in that system, the base BM/SS office nor the hospital can access your Tricare eligibility information online. If your information is not accessible on the base internet system, the hospital can't schedule an appointment until they can register you on their online system. This goes for both military and retired personnel and family. Step 4.) At this time, you can contact the nurse in charge of the MTF's bariatric surgery schedule and make your first appointment. Standard procedure will most likely be attending the next informational seminar at that base. After that, you're off and running.

Are you sure it is the VSG and not vertical banded gastroplasty? Did they actually remove part of your stomach or did they just run a staple line down it? If you did get the VSG approved through a civilian doctor, please get in touch with Tiffany so she can get all the info she can to pursue TriCare's coverage policies. She would be able to use the fact that ANY sleeve gastrectomy has been paid for in her continuing battle with TriCare and possibly force their hand by taking this information back to a Congressional Representative or Senator.

I just went round and round with TriCare over this same problem. I finally had to have the band removed because it continued slipping so far that it cut off my food supply. When they went in, they discovered not only had it slipped, but had eroded into my liver! Yikes!! I finally got my first appointment at Eisenhower Hospital on Ft. Gordon Army base. It took what seemed like 1000 hours on the phone with TriCare, Eisenhower and the base Managed Care office. Here's what I found out about the approval process that should help a lot of you get the care you are seeking. 1.) First and foremost, you will need to locate an MTF with a bariatric program on your own by calling the base hospitals near you and ask to speak directly to the surgery department, ask that person if they have a bariatric weight-loss surgical program, then asking to speak with the head nurse for that specific surgical team. No one will help you find out what facilities perform bariatric surgery. I'm not sure anyone at any MTF (and certainly not anyone at TriCare!) knows who else is out there from the conversations I've had, especially between service branches. BTW, just because you are AF or Navy, you are not restricted to medical service from that specific branch. If you don't have an AF base near you, look for an Army Post, or nearest military establishment. 2.) Once you've located a facility, contact the office that processes I.D. cards and have them register you into the base/post personnel system. You will need to be registered on base so the people who can help you have access to your TriCare/DEERS information. I was able to find someone to help me over the phone once I explained I was a 3.5 to 4 hour drive away from the post. Some bases may require you to come in to the office, so be prepared to make the drive. I had a minor glitch that you may need to know about. There are two segments to the registration database system. There is a main registrar and one that the hospital system works from. When entered into the main system, it is supposed to automatically update your information into the second segment of the base registrar. If you know you've been entered into the main system and the people at the Managed Care office or hospital can't access your DEERS/TriCare info, call the I.D. office back and let them know to manually update your registration information into the other half of their system so the hospital has access to your info. 3.) If you are retired military and are trying to go through TriCare to get your VSG, YOU DO NOT HAVE TO GO THROUGH TRICARE!! (HALLELUIAH!!) You can go directly to the base or post! First, call the base information desk or get on the internet and find the phone number to the base Benefits/Managed Care office. Explain to the advocate at that office what you are trying to do and that you will need a contact name in the Specialty Care/Medical Management department, the office within the Managed Care office that processes requests for specialty services at the base hospital. The office names may slightly vary from service branch to service branch, so don't quit trying if they tell you they don't have that specific office. Just find out the name of the office that has patient advocates who processe medical services through the active duty TriCare system. Remember, these people can't help you unless they can pull your DEERS/TriCare info from the base registration database. This office has access to some of your civilian TriCare info, but not your medical records. Get contact names from the Managed Care advocate and most importantly, the Specialty Care processor. You'll need a name and fax number so your Primary Care Manager and bariatric surgeon can send a referral to the people who can actually help you. 4.) You may need the Specialty Care advocate to ROFR (Right of First Refusal, pronounced "row-fer") you into the base hospital's insurance system. They had to do that for me because I was outside of the 99 mile service limit. Once you're into the base's DEERS/TriCare system, it's time to get your PCM to send in a referal. You will also want your bariatric surgeon's office to fax in the same referal information. Have them put as much information about your condition on the referal (current weight, BMI, previous surgeries and condition of that surgery if revision surgery is needed, name, address, phone, sponsor ID, your social security number, date of birth, etc., anything they feel may be helpful to obtain on-base approval). Also, make sure the fax has contact information to those doctor offices. The Specialty Care manager will probably need to call back and forth between the offices to get all of the information they need to process your VSG request. I gave all my doctors' contact info to the Specialty Care Manager when I spoke to her in case the contact info wasn't on the fax. Having this info on hand will expedite your paperwork. 5.) FYI, your civilian physicians will not be able to enter a request for services into the TriCare online referal system. So if for some reason you do have to go through TriCare for approval to seek treatment on an MTF, the request will have to be done manually. The Managed Care office will tell you if you need to go through the civilian TriCare system first. If you want to try and go through TriCare first, please note there is a 99 mile service limit. I'll explain more about this later. Explain to your PCM's and surgeon's referal specialist that there is no data entry field for what you are asking to have done on the online TriCare system. Tell them they will need to go onto the TriCare website and download the referal request, fill it out and fax it to the Specialty Care advocate and the bariatric nurse you end up speaking with once you find the MTF (Ask the nurse if he or she wants this faxed to her and get a fax # if he or she wants a copy). Should you go through TriCare Prime or be required to go through them first, in that request, your PCM will need to put detailed information as to what surgery you are requesting (the VSG), that you are not eligible to have this procedure done at a military treatment facility and you are seeking approval to go to that facility. Again, make sure you get names, phone numbers and fax numbers once you find these people. The speed at which you can get through the system will depend on you. 6.) Important Note: There is a 99 mile point-of-service limit. If the MTF is farther than 99 miles from your location, TriCare will AUTOMATICALLY decline your request for service. The reason they will give for the denial is "MTF is not accepting patients at this time" which is not the real reason they've denied it." The base will tell you they are accepting patients and TriCare will tell you they aren't. Why? Because your TriCare office's computer system is not set up to handle requests outside of your treatment zone. Their solution is to just tell their patients the MTF is not accepting patients when they should be telling you to go directly to the facility and work through the base Managed Care office. (Insert appropriate obscene or derogatory noun here !!!!) You have the right to obtain treatment through an MTF. Just keep trying and don't accept the word NO! The TriCare system for retired personnel works from an entirely different pool of government medical funds than the active duty personnel and MTFs work through. The retired TriCare system does not pay for services obtained at an MTF, the funds are paid out of a separate DOD medical funding account. This is why you are able to entirely bypass the TriCare system. The retired TriCare system actually has NOTHING to do with services obtained on base other than a temporary obstruction to getting your VSG. The post Managed Care advocate explained all of this, not TriCare, so don't expect anyone at TriCare to know what is going on or even why their own system is denying you service due to the MTF not accepting patients. 7.) Once the Specialty Care manager has all of your information, he or she sends your information to the hospital for the first step in obtaining the VSG. If you want to stay on top of things, ask him or her to call you when the office visits are approved by the base Managed Care office, or call that person back to check the referal process to see if there's any missing information you can help them obtain. The hospital should contact you get further information and/or set up your first appointment. My first appointment is February 8th! YAY!!! 8.) While you are working on gaining access to an MTF, have your bariatric surgeon print out all of your medical records regarding your surgery and post-op progress. If you've had any complications, make sure the records contain detailed information about what and how it happened. I happen to have an allergy to the most commonly used anethesia. My anethesiologist had to use an older, less synthetic anethesia to knock me out or I'd have woke up puking like Linda Blair in "The Exorcist." I also had post-operative breathing problems and required breathing treatments. It wasn't fun waking up in the middle of the night surrounded by nurses and screaming monitor equipment and looking somewhat like a Smurf. My body also has the uncanny ability to form massive adhesions which will make my surgery long and complicated. The MTF will definitely want to know these things! Ask your doctor if he can obtain any hospital records (anethesia, hospital records regarding anything the nurses had to help you with, problems with pain management, etc.). If he can't (or won't) go to the hospital and get them yourself. Note: When my first lapband failed, I had to have it replaced 3 months after my first surgery. My doctor told me he'd never seen anyone form adhesions around the band site as heavily and as quickly as I did. He said it took him way longer than expected to remove and replace. When the second band came out, I asked my surgeon to take pictures inside the abdominal cavity so the surgeon at the MTF can get a good look at what to expect once the cutting started. I would recommend asking for photos. Bariatric surgeons tend not to like doing revision surgery on another bariatric surgeon's patients since they are unfamiliar with the patient's history and what may have been done during previous surgeries. 9.) The MTF may or may not ask you to go through all the presurgical appointments with the psychologist and nutritionist. It will likely depend on how far out you are from your previous surgery. When you speak to the head bariatric nurse, ask her about the hospital's pre- and post-surgical procedures and how many appointments to expect. Take all your medical records to this nurse and hand them to her personally. If your psych eval and nutritional counseling are over one year old they're most likely to have you retake the eval and training. Ask about post-op support group requirements, too. I will be required to attend one per month until either 1 year post-op or I meet goal weight (not sure which because I didn't ask...). Since I have to drive so far, I will be allowed to attend a local support group at my previous surgeon's office as long as my current surgeon is willing to provide proof I attended the meetings. If you have nutritional training instructions, paperwork, handouts, etc., it may be helpful in slimming down the number of nutritional counseling appointments. Ask if you can speak with the nutritionist, show her your notebook and see if you can skip some of the nutritional counseling. This will vary from facility to facility. And no...you won't be able to get out of the pre-op endoscopy. 10.) If you currently have a lapband that has slipped, eroded or malfunctioned in some way and require removal surgery, I highly recommend trying to find a surgeon willing to remove the band and do the VSG at the same time. Depending on what they see when they go in, they may or may not be able to do this. If there are too many adhesions, they may need to make you wait until the stomach has time to do a little reformation and stretch out the adhesions at the band site. Because the surgeons consider a slipped or otherwise defective band a hazard to your health, you can probably get onto the surgical schedule faster than someone who's already had to have their band removed. I know this was a lot to read, but hopefully it will help you and others get their VSGs sooner rather than later with fewer headaches than I've had during my battle with the TriCare system.

I was just told by my surgeon that they will be removing my band on 11/18 because this is my second band and they do not give their patients a third band. The first band failed within two weeks of my surgical date. I kept trying to tell my doctor that the protien supplements he insisted on me using were making me sick and making me throw up. He decided I was just being a whiney baby and pretty much told me to keep doing what I was told to do and not question him. The current band (my second) recently slipped. I ate some undercooked Pasta and it continued to absorb Fluid after I ate it. Since it was really gummy, it formed a plug and I wasn't able to eat or drink for four days. On the fourth day, I tried to flush it through with a bunch of Water and ended up ripping the band out of place and throwing up the gummy pasta plug. You'll probably ask why I didn't go to my doctor and have him unfill the band. Here's some background info. In a presurgical seminar, I was asking some questions about things I've read here on Lapband Talk. I was trying to ask him what typically caused stoma blockage, but he interrupted me thinking I was asking about what to do if mine got blocked. He told me and the rest of the people in the room that if any of his lapband patients got stuff stuck in their band, "don't come running to me, I won't unfill your band and you can just suffer the consequences of not following my instructions, maybe you'll learn something and not do it again." Frankly, I wanted to bolt from the room and find another surgeon, but the procedure deposit was non-refundable and I was just stuck with him. Two weeks after the pasta incident, I had an myleogram. The guy who did it also did lapband fills. He told me it had slipped and he contacted my doctor's office. Instead of calling me in, my doc just looked at the pictures and told me he'd put it in at an angle for whatever reason he had when he did the first revision. Since I wasn't having any eating problems, I didn't argue with him (not that this guy is open to any kind of opinion that differs from his). I started noticing my meds were getting stuck and started forcing the pills through the band. After three more weeks, I was unable to eat or drink anything without having to force it through the band and was aspirating stomach fluids in my sleep. So, now I am only given the option of a bypass or band removal. I'm quite torn as to what to do. I'm asking for feedback. Should I just let them remove it and try to maintain the weight I've lost (108 lbs in the last 20 months) or should I find another doctor and give it one more try? All opinions are welcome, even if you agree with the doctor. Thanks for any input, Charlotte

Dave, the gastric sleeve that you're talking about is the one where they actually remove part of the stomach and suture the rest of it into a tube-like structure, right? I just checked. My insurance company does cover that. And it looks like I won't have to put up much of a fight for it since I've already had two band surgeries. They will cover a different procedure if you've already tried a less invasive method and it didn't work for you. Now just to convince the hubby and find a doctor who'll do the procedure. I'm going to call my doctor's office on Monday to discuss this option, see if they're willing to do the procedure or whether they'll need to refer me to another surgeon. They don't list that as a procedure they do, but I know one of the surgeons has done them in the past. As far as finding another doctor, this surgeon is the best bariatric surgeon in the region as far as his skill in the O.R. There are nurses that come all the way from Columbia University Hospital, a two hour drive just so this guy can do their bypasses. It's his bedside manner that sucks. He does have a new surgeon in his practice that I like a lot. I know the newer patients opting for the band are not being treated with the same disrespect as I have been now that the new doctor is here. I wouldn't mind if the (insert foul word here) does the surgery as long as my post op care is with the other guy. Off on a road trip. Will be back tomorrow to read any further posts! Thanks so much!!

Thanks Dave. I've got 85 more pounds to lose. I've had my current band for almost two years. The first one was replaced four months after the first one. That one wouldn't have slipped if my doctor would have helped me find options to replace the whey protien supplements during the clear liquid post-surgical phase. I did finally find that a mixture of whey and soy protiens work best for me and don't make me barf my guts out. Too bad he didn't help me make that discovery before it was too late. If my doctor hadn't told me not to call him if anything got stuck, the band would not have slipped this time. Had I been able to call, go in and get it unfilled to clear the blockage, I wouldn't be in the situation I'm in now. If it weren't for those two occurances, I'd just let them take it out without considering a third band. I'm just wondering if I'd had better support from my doctor, perhaps neither of the bands would have slipped. As far as the vertical banding, I've been reading about it on the forum today. It sounds like it would be a good option to try if my insurance would cover it (which it does not) and my doctor hadn't discontinued using that procedure. If I could find a doctor that still did VB surgery and would be willing to duke it out with the insurance company to see if they'd pay since the band didn't work for me, I'd still need to find another doctor. The insurance company might make an exception since we've already tried an alternative method. If my insurance company is willing to pay, my guess is that they'd want it done at the same time the band comes out. So then the question becomes, should I bother or just let them take the band out?

Your best bet is to get some really small plates and bowls. I ate out of 6 or 8 oz little bowls for a long time while in the adjustment phase you're in. If you've got someone in the house who can put the leftovers away instead of doing it yourself, I highly recommend having someone do it. I know you're not supposed to drink anything for 30 minutes before and after a meal, but you may be able to take some very small sips of some warm chicken broth with your meal. I found the warmth flowing into the stomach below the pouch helped relieve that missing feeling of weight in your stomach. I think that feeling of weight after eating may be what you're missing the most on a psychological level. Eventually, you do get used to not having the weight of food in the lower stomach. Hang in there until you do. Another thing that helped with the hunger was the addition of protien supplements to my meal plan. 20 grams of protiens twice a day between meals along with some really good Vitamins, extra Calcium and B-12 did help. I do notice a difference in my hunger levels when I stop taking them.