Dave_NW

Fred, I think it's unlikely you have stretched your pouch. Unless you're eating too much at a time, or eating too fast, the foods you eat are moving through your pouch within a minute or two. If you are eating slowly and chewing right, things should be moving easily. At only 5cc's in a 14cc band, it's unlikely you have restriction yet, so liquids would also move fairly quickly. Going on liquids wouldn't hurt you, and may help kick-start your weight loss again. You can also do the "five day pouch test" if you're unsure whether you've stretched things. Basically, it's two days on liquids, one day soft foods, one day firm foods, and one day normal food. You can repeat as needed. This is from the website for it: "How often should I do the 5 Day Pouch Test? The 5 Day Pouch Test should be done if you are feeling out of control with your eating, if you have fallen into a slider-carb eating pattern, if you are at a weight loss plateau or have gained weight. It can also be done simply for cleansing and appreciating our weight loss surgery tool. Many patients have successfully done the Five Day Pouch Test and followed the five days by repeating days 4 and 5 over and over. Other patients have elected to include extra days of liquids in their plan. It is perfectly OK to adjust the plan to your specific needs. Patients who do not desire the liquid phase have reported success by doing 3 days of day 3 followed by days 4 and 5." Dave

Ellen, congratulations on your decision. I'm not a woman, and I'm "only" 57, but I am another WA resident, up north of Seattle. I have a coworker who was banded at UW about 18 months ago, and he's had nothing but good things to say about them. It was his success with the band that showed me I might have success too. My insurance led me to Swedish Hospital in Seattle for my surgery, and I'm very pleased. It's been a similarly positive experience for me. Good luck in your journey, and welcome to the forums. There are some amazing people here who are extremely helpful. Every question seems to get a great cross-section of answers, so don't hesitate to ask whatever is on your mind. Dave

Freddy, I know the feelings you're going through. You can definitely reach your goals, but you need to make them as realistic as possible. It's easy to get sidetracked. I set mini-goals of five or ten pounds at a time, and have a mini-celebration when I reach them. It makes it easier to find happiness in an ongoing effort, while still working toward my larger goals. My strongest bit of advice (and the thing that's most helping me win this battle) is to buy a Bodymedia armband. They make several versions, including the Bodybugg, the armband worn by the contestants on The Biggest Loser. This gadget tracks your daily calories burned, steps taken, exercise levels, lets you log your calories eaten, and even records your sleep patterns. By logging your day through their website, and syncing the armband to it, you can see on your computer screen where you stand for the day. If you need more activity, you can go do it. If you eat more calories than you should, you will maintain or gain weight. If you have a caloric deficit each day, after a 3500 calorie deficit you will have lost one pound. It's SO easy, and works so well, I can't say enough good things about it. You can track trends in your weight loss or eating patterns, and get a firm handle on how your weight loss is going. Over time, you can adjust what you're doing to get the best results. Best of all is you can tailor your goals to your current situation. By realistically establishing your activity levels, it will tell you the kind of calories you need to eat daily to maintain your weight, or how much deficit you need daily to lose weight to meet your ultimate goal. I have mine set up to lose 2 pounds a week, which is quite easy for me to manage. The website shows me a graph of my progress based on what I'm doing, and I should reach my goal by Christmas. So far, I'm just a tad ahead of schedule. It's a fantastic tool, and works well with my lifestyle. If you're interested in buying one, do some online searching for the best price. Awhile back Best Buy had them on sale for $30 off. If you get one and need some help, send me a PM. I'll be glad to help you out. Good luck! Dave

It's most likely a coding issue, where the surgeon's insurance coordinator and billing people sent the claim under the wrong billing code. Take it back to them and ask them to straighten it out. If you had approval beforehand, (and you should have some documented proof of that), they should be able to make it right. Good luck! Dave

For me, it's about what I'm eating, and how fast I'm eating it. If I take bites that are larger than they probably should be, don't chew it thoroughly, and/or eat too fast, just about anything gets sort of stuck. I feel the pressure, then put down my fork and wait till I feel the item move through the band. If I force things, it hurts a lot. Patience when eating is the ongoing skill I have to manage to stay comfortable. I've only had one sliming incident (salsa and chips at a Mexican restaurant - ate too fast, didn't chew enough, things got stuck, and I joined the ranks of those who have been slimed... Surprised me a lot, even though I knew what was happening.) I don't want to go back there again, so I'm much more careful. When I slow down and eat properly, I find I can eat anything. If it's a dense Protein like chicken or steak, after about 3-4 ounces, I'm feeling quite full. I went to Olive Garden the other night with friends, and I ordered the "Steak Toscano" with steamed vegetables instead of potatoes. The 12 ounce steak made three meals for me. Worked well, but the trick was taking very small bites. I use the relative size of a dime as the visual queue. Small bites, chew thoroughly, and take my time. It's working for me. Good luck! Dave

I'm much the same way. But once they've got you all hooked up, and you're not looking at yourself, you really don't feel things much. And nothing hurts, so it's not that big of a deal. The trick will be to get yourself tired enough that you can get to sleep at a reasonable hour. Stay away from caffeine and such so you aren't too alert too late. Good luck! Dave

I was banded two days before you. I have also had three fills, and am currently at 8cc in a 14cc band. If I eat dense Protein, like grilled chicken or steak, i do feel restriction after a few ounces. Things can get stuck if I don't eat properly. If I eat slider foods, I can eat till the dish is empty and not feel anything. So what I eat makes a huge difference. As for your weight loss and diet, I'd suggest you analyze what you're eating, how many carbs vs. how much protein, and what those calories are made up of. Too many carbs means you're eating more sugar than you realize, and your body tuns that into fat. If you've been eating oatmeal with fruit every day for three years, how about giving your stomach something else to eat for a change? Change up your meal routine, and eat something else for breakfast for awhile. Have some protein-based meals first thing in the morning - it gives your system something else to work on. It also balances your blood sugars, which can cause peaks and valleys in your energy balances every day. If your blood sugars are more balanced, you won't have cravings, and are less likely to eat something you shouldn't. Evaluate your calories consumed every day. If things are too low, your body could be fighting a starvation mode thing, and you won't lose much weight because it's holding onto every calorie thinking you're starving it. Actually eating more calories can make you lose weight. Weird concept, but it works. If you're exercising, are you doing the same thing every day? Do different things. Are you exercising long enough? It takes 20 to 30 minutes of aerobic activity just to get your system warmed up. Fat burning happens after that. So if you're riding a bike for fifteen minutes a day, for example, guess what? You aren't helping yourself much. And all that can result in slow weight loss, because all you're doing is maintaining your current weight. You've heard about exercise programs that are based on muscular confusion - the concept is to cause your body to not know what's coming next, so it reacts with muscle growth or toning, or whatever you're trying to achieve. Try new stuff, do different exercises, and listen to what your system is telling you. All else being said, if you keep doing exactly what you've been doing, but you increase your activity level, you'll burn more calories, and that will eventually result in weight loss. Good luck! Dave

I was doing the same thing, (saving my fat clothes), till it was pointed out to me that finding larger men's clothes at places like Goodwill is difficult. If you have big clothes you don't expect to wear again, donate them. Someone who needs them will be very grateful, and it's a great incentive for you not to ever need that size again. I finished cleaning out my closet and dressers recently, and took EVERYTHING that was too big to Goodwill. it was amazing to see how much room there was left, and how little room my smaller clothes take up. It was difficult saying Goodbye to certain items I was especially fond of, but if it doesn't fit - out it went! I saved one shirt and one pair of pants as a reminder of where I used to be, and where I never want to go again. Now that I'm wearing more normal-sized clothes again, it's also a pleasure to shop again. No more catalog shopping, or tracking down the closest Casual Male XL store. I was walking through JC Penney the other day, saw a shirt I really liked, and found one on the rack that fit perfectly. I had to check to make sure I wasn't in the Big & Tall section. At the register I didn't have to pay extra for "oversized" clothing. That did wonders for my ego, let me tell you! Dave

Excellent NSV! Thanks! Dave

Welcome the LapBandTalk! Just an FYI, but you're replying to a thread that is over a year old. I have Tricare Prime, and they covered my band surgery 100%. In my experience, Tricare is very easy to work with, and they are very clear on what they will or won't pay for. This is from their website: **************************** Gastric Bypass TRICARE covers gastric bypass, gastric stapling and gastroplasty to include vertical banded gastroplasty and laparoscopic adjustable gastric banding (Lap-Band surgery) is covered only when the beneficiary meets one of the following conditions: Is 100 pounds over ideal weight for height and bone structure and has one of these associated conditions: diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome, hypothalamic disorders or severe arthritis of the weight-bearing joints Is 200 percent or more over ideal weight for height and bone structure Has had intestinal bypass or other surgery for obesity and because of complications, requires another surgery (takedown) TRICARE does not cover: Nonsurgical treatment of obesity, morbid obesity, dietary control or weight reduction Biliopancreatic bypass, gastric bubble or balloon for the treatment of morbid obesity **************************************************** Start with the referal from your PCM to a Weight Loss Surgery center that accepts Tricare (or a military hospital that performs the surgery, if that's more convenient.) Discuss your situation with the weight loss surgeon, and see what they tell you. My understanding is that a lot depends on how they submit the request for surgery approval to Tricare. If they agree you fit the program, you should be approved no problem. Good luck! Dave

unjury.com makes and sells a number of products, and they generally taste pretty good. I've got them all. The chicken soup one is okay, but at the time I tried to use it, I was on the three-week all-liquid portion of my post-op diet. I was really tired of only having liquids, so I think my taste buds were a bit tired. I liked the chicken soup before surgery, but after surgery, not so much. Factor in that it can't be heated above 130 degrees F or it clumps up, and you're left with a luke warm chicken soup mix. So for that reason alone, I had to give it an "okay," not a 'good" or "really good." I like my Soups hot, not luke warm. But make note that it didn't taste BAD, it just wasn't warm enough to suit me. If you want a Protein drink with something other than chocolate or vanilla or fruit flavors, it's a nice variation. (P.S. if anyone is in my area and wants the Unjury protein powders i have, they're free for the taking. Nothing wrong with them, I'm just not using them anymore. No sense in wasting them.) Dave

Jim, best of luck with your surgery! You trust your surgeon and his team, so you'll be fine. Let them be the professionals they are. When it's done, you'll be even more relieved. Three things to do for best success: 1. Allow your system time to heal before launching into major diet/activity and concerns about how much weight you've lost. After healing, your system will be ready for the next step. Don't rush it. 2. Listen to your nutritionist about proper eating habits, but don't be afraid to adjust things to suit your particular system. I found the restrictions my NUT gave were too little for me, and my system went into a major plateau for several weeks. I felt it was due to the "starvation mode" thing of not enough calories, so I gradually increased mine. When I hit 1200-1500 calories a day with normal activity, the weight started falling off. It's been a steady loss ever since. 3. Get up and move. When we were younger and thinner, we moved around as a natural course of life. After we got older and put on some pounds, life slowed down for us. If you expect the band to do all the work, you'll have some success, but not enough. If you get up and move, work out, burn extra calories through physical activity and help your band do its job, you'll lose more weight, your body will more easily adapt back to it's earlier form, and you'll feel a whole lot better about all the effort you're putting into things. Good luck! Dave

Awesome, Randi! Way to go! Dave

My family and friends who do know I had surgery say they felt weird at first inviting me out or to dinner at their homes because they didn't know whether I'd be able to eat or enjoy the meal. I told them to not worry about me one little bit - that I'd find something I enjoyed, and would eat what I could. After the first time or two there was no more problem, and everyone relaxed. It soon became a non-issue. For those who don't know, not one has asked why I'm not eating or whatever. I just act as normal, order what I want, and share in the conversation. Life goes on. At work, where I didn't tell many folks at first, it got to be embarrassing when my weight loss became quite noticeable. I started to get the concerned, "Are you sick? You're so thin!" comments. I appreciated the sentiments, but finally decided to tell anyone who was interested what was up. And now everyone knows, because I work at a hospital, and heaven knows, people do love to talk! Now I get "Hey Skinny!" comments, or those who are really paying attention say things like, "You know, Dave, you need to get some tighter pants. Yours are falling off!" I smile right back at them, and tell them I plan to go shopping this weekend. It's a weird kind of bonding thing, but everyone I know (and there are plenty of them) are totally behind me in this. And the very obese ones are really starting to make the "I need to do what you're doing!" comments. It feels great to be the object of positive attention for a change. Relax, enjoy your life, and be as private as you wish. Most folks will accept whatever you decide to tell them. Dave

Closest to home isn't always best. I'd shop around for a different clinic, and compare pricing. I have Tricare Prime, and my out of pocket was only about $100, which included office visit copays and the overnight at the hospital on the day of surgery. Tricare will not pay for nutrition classes or food products, so consider the source - very high profit for the surgeon's office. The Nutritionist at my surgeon's office rolled her fees into the doctors bills, so Tricare ultimately did pay for that. It's all in how it's billed by the clinic. Good luck! Dave

Hi RJ, If you're serious about losing 250 pounds or so, your money may be better spent on gastric bypass. I say that because even though it's possible to lose 250 with a band, it's going to be slower going, and you'll need to work harder at it. Check out ALL your options before committing to a particular surgery. There are ads along the side of this website that show the surgery prices aren't all that far apart, if you have your surgery in Mexico. If you have it in the USA you're likely to pay much more than that. Definitely research options and shop around. You want the most experienced surgeon possible, at a price you can afford. Having said all that, you may also benefit from some counseling before your surgery so you can come to terms with your food interest/cravings/possible addiction. If you get banded, you can say goodbye to most of those foods you named. (I haven't eaten pizza since November, and before surgery I ate it two or three times a week. I haven't had a carbonated beverage since about the same time, for the same reason.) You're going to miss being able to eat any old thing that appeals to you. The weight loss will be totally worth it, but you'll have to closely manage your eating to be successful. The third thing to really look at is time. Typical bandsters lose weight more slowly than bypass patients. After several years the numbers fairly well equal out, but bypass patients tend to drop weight more quickly at first. So if you're impatient about the speed of your loss, you may find gastric bypass is a better option, because you'd generally lose weight faster. I'd highly recommend you attend a weight loss seminar at a clinic near your home. Most weight loss clinics offer them for free, as a way to get first-hand information out to potential clients. If you have more than one clinic in your area, attend more than one seminar. (I went to three of them, hosted by three different practices, so I could get a cross-section of what each clinic offered.) The more investigation you do, the better informed you'll be, and the better prepared for your decisions. Finally, let me encourage you to follow what works best for your situation. I'm still in the middle of my weight loss journey, and I'm enjoying the rewards of a reasonable weight loss, but I'm anxious to get the rest of the weight gone. It's a daily effort to stay on track, and folow my program to my best advantage. I wouldn't go back for a second, but if I had a choice to do it all over again, I'd take a longer look at how long it all takes. No regrets, but maybe if I had "do overs" I'd make a different surgery choice. Wishing you nothing but good luck, no matter what your decision ends up to be. Dave

I've had two fills since being banded in December. I'm currently at 7.2cc in a 14cc band. I feel some restriction, some of the time. I can still eat anything, and can easily over eat. I only get stuck if I take large bites, eat too fast, and/or if I don't chew thoroughly. I get hungry after three or four hours, but if I eat something small that often, I don't ever get truly hungry. My weight loss is erratic, where I'll go a week or more without losing anything, then I'll drop a pound or two in one day. I had my last fill February 14th, and I've lost only about five pounds since then, but I haven't lost anything in over a week. I have my "100 Days Since Banding" appointment in three days. I'm scheduled for my third fill that day, if I need it. It's a two hour drive to my surgeon's office from my home, and I need to take the day off work to go there, so I want to make it worthwhile. The question I have is, "Do I need that fill?" I'm thinking maybe a small one, like .5cc or so? Most people I've read about say they find they're at good restriction at around 8cc or so in a 14cc band. I know everyone is different, but I'd appreciate some experienced bandster advice. What do you think? Thanks, Dave

I don't have experience with UW, and my insurance paid for my surgery. But I can tell you Swedish treated me most excellent. I felt totally supported all the way through it, and no question went unanswered. I'd recommend them to anyone who was exploring whether to have surgery. I'm still in the post-op followup stage, and I see them monthly. I'm very satisified. You may want to attend one of their free seminars they hold a few evenings a week. If you opt to have surgery there, you'll need to have attended one of them anyway, before you can schedule an office visit. You can meet Dr. McMahon and several of his staff, as well as get a feel for how they operate. Good luck! Dave

Good luck with thngs, and if I can help in some way, just let me know. I sent you a PM with more specific info. Dave

Hi Greg. It can certainly be frustrating till you figure out how your body responds to having the band, and what your system does with the nutrition you give it. After the rush of weight lost in the time before and right after surgery, to have things slow down can really frustrate most people. So you're in good company. For starters, losing four pounds so far this month is actually pretty good. The rule of thumb is 1 to 2 pounds of weight loss per week. If you've lost 4 pounds in 19 days, you're right on schedule. The first six weeks or so after surgery are mainly about healing anyway, so you may be getting slightly ahead of yourself, since you were just banded about a month ago. Having said that, I can say you may want to take a look at the combination of how much nutrition you're getting, how much exercise you're getting, and how much you're sleeping. If your nutrition is too low, your body can go into a "starvation mode" and your weight loss can slow down or even stop. If your exercise isn't active enough, you won't burn any calories. (The combinaiton of not enough nutrition and improper exercise can really frustrate you, since it's a double whammy.) And not sleeping enough can reduce your weight loss too. You should aim for 8 hours a night, if you can do it. My nutritionist said 800 to 1000 calories a day. When I do that, I don't lose weight. If I bump my nutrition up to 1200 to 1500 calories a day, with between 80 and 100 grams of Protein and carbs at 60 or less, I start losing again. So I try to stay in that range. And then there's the mathematics of weight loss: My body needs about 3100 calories a day to maintain my current weight. If I eat and burn only 2100 calories a day, I have a daily deficit of 1000 calories. Since it takes 3500 calories burned to lose one pound of weight, after seven days I have accumulated a 7000 calorie deficit. And that equals a two pound weight loss. Working with numbers like that, I can plan how things go, and basically predict how my weight loss will proceed. I am by no means an expert, but what I'm doing is working for me pretty well. I have the armband by Bodymedia (the same people who make the Bodybugg armband worn by the contestants on The Biggest Loser.) My armband tracks my activity, calories burned, even my sleep patterns. I log my food intake through their website. I can track my day as it's going along, and it makes it SO easy to follow my own routine. The armband costs a couple hundred dollars, but I justified the expense based on the money I'm saving by not overeating anymore. I cannot say enough good things about it, and I most highly recommend it. Bodymedia.com is their website. If you decide to buy one, shop around. Best Buy had them for $30 off awhile back. I hope this gives you some ideas. I'm sure others will offer their tips as well. My biggest lesson after getting my band was finding out everyone is different, and what works on paper sometimes takes more work in real life. You have to do what works best for you. Good luck! Dave

You need to have the referral from your PCM to the weight loss surgeon before you can do anything. I asked for, and got mine directly to Dr. Ross McMahon, who is head of bariatric surgery at Swedish Hospital. Once you have the referral, Swedish requires you to attend one of their free weight loss seminars (they have them a couple nights a week) before making your consult appointment. They do that so you'll know whether you want to have surgery. After the seminar (which I found informative, and only about 90 minutes long) you make the consult appointment. At the consult, they do a kind of "marathon" thing. I had four appointments back to back on the same day. I met with the psych, a physician, a nutritionist, and the surgeon. I also talked with their Insurance Coordinator, to make sure they had me approved through my insurance. (Tricare Prime is easy, but they're very specific of how they want it handled. Swedish's bariatric insurance coordinator is awesome. She had me vetted in no time.) After they'd each given their recommendation for me to move forward, I was given a pile of blood work lab slips (they need a zillion tests to make sure things are good for me to have surgery) and an endoscopy appointment. Within two weeks I'd had all the blood work and the endoscopy done. Following that, they submitted to Tricare to approve me for surgery, and I had my approval three working days later. It really was that easy. The program is ongoing, and after surgery there are scheduled followup appointments. Yes, they also do my fills. I've had three so far, and currently am at 8cc in a 14cc band. The staff is great, and very supportive. I can't say enough good things about them. You should review their website, at swedish.org. You can see the info on the staff. They're easy to work with. I wonder if your friend who is attending classes is requird to do so because she's doing it at Madigan? Tricare doesn't require classes, but maybe Madigan does? Not sure what that is about. I live north of Seattle, so going to Swedish was actually closer for me than going all the way to Madigan. (If you do go to Swedish, tell them I referred you. They'd like that.) Hope this helps a bit. Good luck! Dave

It may be how Tricare was billed. For example, they don't pay for Nutritionists, even if they work for the surgeon. If you had a NUT who billed Tricare directly for services, it may be disallowed. You need to review the claim itself on the Tricare website - it will break down the specifics of the claim, so you can see what it was for. If it was billed in error, the surgeon's office needs to resubmit the bill with the right billing code. If it was billed correctly but is for a non-covered service, you may be stuck paying it. I have Tricare Prime, and I haven't paid for anything more than a few office visit copays and the overnight in the hospital. You need to look closer at things. Good luck! Dave

Insurance Coordinators are supposed to be on top of the regulations. If this person isn't up to date, you definitely should bring it to the attention of someone who can change that. My experience with Tricare was that they are very specific about what they require, and what they will approve. In my case, it ws three days between date of submission, and when I was approved for surgery. No six month diet required. If other thngs aren't stacking up, don't hesitate to move to a different clinic. You need to have confidence in your surgeon's team. Good luck! Dave

Tricare does not have a six month diet requirement. Go to the Triwest website and search the database for the exact wording of what they will and won't pay for. Having said that, your surgeon may have a requirement. You'd need to ask them about it if it concerns you. Dave

Steven, here's a bit of motivation to help you make it through: After my surgery, my surgeon had me on liquid diet for THREE WEEKS!!! No pudding, nothing creamed, mushed, or pureed. It was either "liquid you can see through" or Protein shakes without anything added to it. Three longgg weeks of liquid misery. Absolute hell. You don't need to ask me how that first "real" meal tasted when I was finally able to move ahead! LOL! Hang tough, guy. You'll get there. Dave