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For treating a regain problem, I prefer the DS as it is stronger metabolically than either the VSG or RNY - the RNY is too close to the VSG in strength to reliably offer a significant improvement in weight loss, from what I have seen over the years. Figure maybe 20lb loss on average - about what one would expect from going through all the intense dieting associated with going through surgery again. (There are some who do significantly better, bit it seems to be more a function of their determination to "make this work" or "not screw it up again" than the actual surgery itself. Call it something like a surgical placebo, lol.) By your surgeons not finding the codes for the DS implies that they are talking about the newer SIPS/SADI/"loop DS" which is a single anastomosis adaptation of the traditional BPD/DS (biliopancreatic diversion) which has been routinely covered by US insurance and Medicare for the past 14-15 years, but is a more complex procedure that relatively few bariatric surgeons perform. Some practices that do the SIPS/SADI use the BPD/DS billing codes which is technically insurance fraud, but if they're comfortable doing it, that's their concern. Revising the VSG to a DS, of either flavor, is straightforward as each use the VSG as its basis (some don't even consider it a revision, more a "completion" of the ultimate configuration.) The strong point of the BPD/DS is its regain resistance - regain is possible as it is with any of these procedures, but it is harder. I know many with the DS who are 10-20 years out (my wife included) who are still maintaining a healthy weight; some are up a bit more and working on losing their "Covid 19" - just like "normal" people but major regains are relatively uncommon. The SIPS/SADI type of DS seems to fall somewhere in between the VSG/RNY and the BPD/DS - I have seen a few in the various forums who have had it and seem to be doing well with it, but it doesn't have as long a history. Any of these procedures - the RNY, DS or SIPS - will be somewhat fussier and less care-free than your VSG when it comes to supplements and follow up; the RNY is maybe a bit less so, but one can get into some serious trouble with any of them if one slacks off. If keeping up with supplements and annual labs is not an issue with you, then any of them should be fine.

I agree with True North, and congrats on your weightloss! You re moving right along. I am moving slower, but in the right direction.lol and I’m prolly a lot older. It’s all good, as they say. I’m just glad I am learning to stop eating before I eat too much and keeping my portion sizes at 1/2 cup. As for your blood work, this really bothers me that you have to wait 6 mos. before they request bloodwork. (Bariatric, I mean) that is way to long to have to wait to find out what’s going on. I’m so glad your PCP requested it for you! I hope my PCP will do that when I go back. I won’t be getting it done for Bariatric til MAY! Hope you get normal results from your blood work tomorrow. Keep up the great work! AWESOME!

Hi everyone! I recently purchased protein smoothie mixes from Bariatric Pal and am wondering if I can mix them with frozen fruit or ice? The consistency is too much like pepto bismol for my taste!!

Every doctor/program is different. Here is what mine was. Stage 1 liquids for two weeks. Stage two, purees for two weeks. Stage 3 was soft foods for 2 weeks. Stage 4 was to reintroduce regular foods. For purees I could have refried beans and ricotta bake. I could eat regular food, but it had to be blended with no chunks. Soft foods could be things like eggs, cottage cheese, etc. Here are some sites I like and use that has recipes for each stage. If you do a search for "bariatric xyz stage" where xyz = liquid or puree or soft you will find lots of information. Just be careful to make sure it fits with your program. If in doubt call your doctor or dietician, that's what they are there for. https://www.bariatricfoodie.com/recipe-index/ https://theworldaccordingtoeggface.blogspot.com https://www.bariatriccookery.com/recipes-2/

Soooo I've been thinking A LOT lately about a few things....particularly when hearing about people's experiences with some issues post-surgery. Things like acid reflux, nausea, vomiting, SHARTS, dumping syndrome, feelings of being cold, and scars after skin removal.... I'm an acupuncturist and Chinese herbalist, and these are all things that can be treated super effectively using this medical paradigm. I'm kinda considering reaching out to people who have had bariatric surgery in my area to see if acupuncture and herbs could possibly help with these side effects.... All of these issues arise due to the structural change and trauma to our organs, so there's a possibility that acupuncture and herbs won't help at all, but I'm so curious to see if it would! In my clinical and professional opinion, I really think there's a strong possibility it will! Even if acupuncture isn't effective for treating these things in WLS patients, it will DEFINITELY still help with softening scars from skin removal. That is just fact. For those of you that utilize Chinese medicine in your lives...have you heard of any practitioners offering these kinds of services? Have you ever sought out acupuncture or herbs to help treat any post-operative side effects? If so, would you mind sharing your experiences? So this WLS journey of mine is kinda opening up a whole world of what I can specialize in and help people, which is awesome and inspiring and could shape up to be my capstone for my doctorate!

Well, BLOSSOM didn't get the chance to earn my business and I wanted them to. I have MEDICARE and found out earlier this month whenever I inquired with BLOSSOM that they don't take it. Their cash price for the Safe Gastric Sleeve is almost $17,000. I was going to look at buying an INDIVIDUAL health insurance plan the 15TH OF FEBRUARY through BCBS here in Florida, since the market opens back up then, so I looked at them online last night. I called Blossom back today to talk to them about it and they handed me over to one of their insurance professionals. I had previously been told that they bill all of their procedures OUT-OF-NETWORK if your insurance doesn't cover Bariatric surgery. Which is fine. Get this...... Now they tell me that they ONLY ACCEPT Employer health insurance plans. They DO NOT accept INDIVIDUALS health insurance plans. What is up with that? Luckily I had previously found Dr. Shillingford in Boca Raton, Florida that does an All Inclusive Self-Pay Gastric Sleeve for those that insurance doesn't cover of $10,000; and, that includes two (2) days in the hospital. He has done over 5,000 Bariatric procedures over his career and this was my "Plan B". Disappointed in Blossom here. Wanted the experience. As they say, everything aligns for a reason.

re: that article - I've been hanging out on bariatric forums for six years. I've never seen anyone lose 15 lbs a week. Maybe 5 lbs a week for the first two or three months. I never lost that much, though. I was 16 lbs the first month, maybe 12 or 13 for the next two months, and then gradually down from there...

Curious. I have seen a couple of sleevers over the years have that problem, but doe seem to be unusual, particularly compared to acid reflux (isn't it nice to be "special"?) but it doesn't seem to be any more prevalent with us than with the general population. It seems that most anyone can be subject to it on an occasional basis; it's the chronic condition that is problematic, so I guess that you continue to monitor things and see how it goes. There are tests that they can do to determine if this is a chronic thing and if something needs to be done, so keep on them about it if it continues to be a bother. There was one gal a few years ago whos surgeon revised her to an RNY to treat it, which seemed odd given its' predisposition toward it, but it seemed to work (at least initially - like most, she dropped off the forums after a few months) so presumably the surgeon did everything in the RNY toolkit to avoid it. The better approach if things are that bad is to revise it to a DS as that is as good of a cure as one can find (it puts the stomach and bile ducts at near opposite ends of the GI tract, so it's virtually impossible for the two to mix), but most bariatric surgeons don't know how to do that one. Hopefully, you don't need to go so far as a surgical solution. Good luck!

I'm sorry that you have so much to deal with - it sounds miserable, and sending you virtual hugs. I hadn't heard of liver issues being caused by bariatric surgery, like you I'd been told that a fatty liver would be helped by the surgery. But looking at this article here it seems to be a potential outcome from the surgery, and some of the symptoms you mention (pain, nausea) are listed as known signs & symptoms in the article. https://sites.kowsarpub.com/hepatmon/articles/86078.html If your bariatric consultant isn't really taking on board what you're saying about this could you ask for a consultation with a hepatic consultant or find another bariatric consultant, preferably one who is very experienced (as they might have more knowledge of this area) and who would be prepared to consult with hepatologists about your care? Good luck.

1. You will wake up, believe It! own it! In fact, you may even ask did you have surgery yet because it will feel like you just your eyes! 2. You absolutely will lose weight, believe it! own it! * subtle disclaimer: Do not be surprised if you leave the hospital heavier than when you entered. This is not a failure of anything, it’s just your body retaining the fluids that were given to you. It’s an artificial inflation of your weight so IMHO don’t even bother thinking about it. 3. Loose skin be damned! Even it with it you’ll be smoking hot with a new slimmer silhouette plus renewed confidence (you can fix loose skin later if you even have any) 4. You are likely to have low possibility or no possibility of complications at all (if you look at statistics that are published) And if you have any complications great or small, please immediately contact your doctors ! don’t wait or ask the Internet. 5. Work with your team to make sure you have a pain management schedule put together before you even go into surgery. It’s possible to wake up feeling no pain. These fears are all completely normal, I had the same ones plus a few more, You can do it! Good Luck ❤️

I’m almost 3 years post op and 17 weeks pregnant (it was an oops, did not plan to get pregnant but losing weight and getting healthy can apparently make someone who was never going to get pregnant, get pregnant). Doctors are all much more concerned about my age (39) than my history of gastric bypass (way healthier now than I was 15 years ago), but I am seeing my bariatric surgeon regularly to ensure nutrient levels are good and adjust vitamins. So far age and WLS history just means a bigger team of doctors involved and more appointments. The only differences I’ve found between my experience and friends who haven’t had WLS is the insistence of seeing a Fetal Medicine doctor in conjunction with the OB (due to age and WLS) which has really just meant way more ultrasounds than normal, and I won’t be able to do the typical gestational diabetes testing (sugary drink and blood test) and will have to do two weeks of blood sugar monitoring (finger pricks, ick).

I know this is not really going to get answers but maybe someone might have some insight. I have lifelong chronic illness and disability. A challenge is being sensitive to medications and side effects and having allergic reactions (my list of antibiotics I am allergic to is growing) It started with Umbilical area pain that radiated upward to the right shoulder blade area like spasms. Admittedly I am also dealing with diverticulitis issues, bleeding and pain I'm not sure the source as well as Interstitial cystitis. My gastric bypass surgery inadvertently revealed a form of neurological dysphagia I have difficulty drinking thin liquids. landing in hospital with aspiration pneumonia a day after I got home, I found out that was why. started before surgery but I didnt know why I was having difficulty drinking water. normally i could chug it no issues. For a while I had trouble with eating which turned out to be stricture. I had history of ulcers prior to my gastric bypass surgery. and they found it afterward as well. I had dilations. and eating got a bit easier I just had to be careful what types of foods I ate. But then some weeks back it got really bad I found myself feeling sick just taking nibbles of my lunch. I always meal plan daily and prepare portion control sizes so I know how much calories and protein I am getting and what my portion is so its never too much for my pouch. But Id get partway through nibbling slowly and at times depending what Im eating Id just have to stop. and then feel the need to throw up but cant at times heaving but only a thick mucus comes up. I saw my general practitioner and had a CT scan and bloodwork. I also made some appointments. She told me to see my Bariatric surgeon. I had to wait until just recently to have a Endoscopy. I am just frustrated. because the CT scan showed Hepatic Steatosis. My one liver level is high it was not high when I was losing weight. Only when it was stable already. I did not have fatty liver prior to surgery. But they want to assume I did and that no one told me. But that's something they check for because its a co-morbidity! Also my gallbladder was checked at the time it had to be removed due to chronic inflammation. People have gastric bypass to get rid of fatty liver ... I have only read of maybe a rare case of liver disease post surgery. Anyway. back in June I had a enteroscopy to check the remnant portion of stomach and dilation. no mention of ulcer then. I have trouble with proton pump inhibitors not working and they just seem to deplete my vitamin levels too much. plus trigger my migraines. Ive had ulcers go away without the PPI and gotten ulcers while on them so they just dont seem effective. Then there is carafate. one side effect is constipation and with diverticulitis I cant afford that especially since the CT also showed inflammation and narrowing of my colon ... and I am trying to get iron and even the supposed non constipating kind in my whole foods based multivitamin is throwing my system off. so I had the Endoscopy this month and it showed Jejunal ulcer so the doctor just prescribes proton pump inhibitor and carafate (my insurance decided to not pay for carafate) but what other options are there besides these? and what could be causing the ulcers if Im not taking motrin or similar meds even though I do need them. Ulcer at the junction between the pouch and small intestine can happen in the first months post op and common treatment is PPI and carafate but not nearly two years out. Hard to believe April will be two years ... my gut keeps telling me its issue with my remnant stomach. perhaps even with the staples used. but I dont know how to get answers. I have seen when these things dont work doctors do a surgical revision of some kind. my surgeon is great but yet he seems to address it as it too simply and its not that simple anymore. Also I cant figure out the fatty liver aka hepatic statosis and the high ALT (liver enzymes) they assumed it was high before but no not really. Also I had blood transfusions in June and the levels went down due to the transfusion but then went back up again. so one would assume if it had to do with the weight loss the levels would have stayed down. I cant sort out what move to take next. I kind of sat on this post a while and didnt post it. I still hesitate. I know its probably not something anyone can answer. I am just getting frustrated. I am also retaining fluid in my abdomen along with a lot of pain.

It totally will depend on how your surgeon explains the need for the revision during the insurance submission and if your insurance requires the waiting period matter what. Call your insurance a d ask where you can find the information on Bariatric revision surgery. If possible ask for it in writing. Also find out if that particular revision procedure is covered. Good Luck ❤️

I think it's definitely the minority. I've been hanging out on bariatric forums for the last six years, and it seems like most people have little to no issues with recovery. I've never watched the youtube videos. It could be related to the fact that people are more apt to reach out to others when they're having negative issues (looking for advice or support) than positive issues, but still, I see way more positive or neutral responses to recovery on here than I do negative.

My recovery has been a bit horrible, but I also didn’t have the best experience due to complications during my surgery which effected my recovery. I was out on leave for 3 weeks (including a hospital stay due to complications), my primary doctor offered a fourth week but I wanted to get back to normal- I really should have taken that 4th week. I also have meet a lot of people who were on their feet the very next day and recovery was a breeze for them. I would strongly encourage you to pick a surgeon local and really look into their after care, that way you can follow up with them directly during recovery and get the support you really need. I made a horrible mistake I went outside my provider care, out of state to a “faster” program and the level of after care is non existent, I didn’t feel supported by them in any way- but thankfully my provider (Kaiser) care has its own bariatric team and I’ve been able to follow up with them and get the support I need for my recovery. Best wishes.

I'm not sure if there's a WLS solution for heartburn in your case since you've already had bypass - that's usually the revision they recommend for sleeve for those sleevers who have severe heartburn (i.e. sleeve to bypass). Although maybe there's some other type of surgery (non-WLS- related) they can do for that?? Not sure. the only "revision" they can do for bypass is tightening the stoma, but I've read mixed reviews of that. And I've heard the same as the above poster - people usually lose about 20 lbs with that. as for insurance coverage, some policies will cover revisions if they're done for medical reasons (GERD is one - but then, you've already had bypass, but again, maybe there's some GERD specific medical treatment out there? Not sure). I don't think many policies, if any, would cover it for weight gain. I'd talk to your PCP or a bariatric surgeon. I don't know what your options are since you've already had bypass. Sorry you're going through this - GERD is awful!!

I had mine here, so no personal experience, but check for reviews on the internet - there are a lot of them. Also, this forum ....and other bariatric forums....are good places to check as well, so kudos to you for checking here. Hopefully you'll get some good responses!

I’m terribly frustrated. When I first went to my surgeon my BMI was over 40. The dietician and bariatric center I went through wanted me to try to lose some weight before my surgery so I was trying very hard to lose some. When the surgeon’s office submitted my paperwork to the insurance company, they denied my surgery because my BMI was 37 with no acceptable comorbidities. I’m pre-diabetic and I do have very bad sleep apnea so the surgeon’s office is trying to submit my sleep study to see if I’ll be approved. To be honest, I’m not holding my breath because they may not take that as well. I’m so angry that had I known my insurance wouldn’t look at the big picture and see my initial weight then I wouldn’t have struggled so very hard to lose those pounds they asked me to. I’m telling you this so you won’t have to deal with what I’m going through right now. My husband said we’ll pay out of pocket for my surgery if we have to since I’ve been working so hard for this for such a long time.

I really am sorry that you are going through this. Your feelings are definitely validated and it was such a traumatic experience for you, for us. You most definitely are not alone, I ended up going through a similar experience last month, ended up being hospitalized after being given 3 surgeries (within 72 hours) and than was told I too may need to have the bypass. It was just a horrible experience and I felt/feel so shamed and guilty to even share it with anyone. fast forward to 6week post op got my crying down to about 3x a week...it was almost everyday. I still think about the risk I went through, and the tears rolling down my husbands face as he drove me to the ER and had to leave me there alone due to covid. It almost feels like grief, and I know this too shall pass. The surgery place I went to has no aftercare post op support other than a FB page, I have been very blessed to be able to follow up with my primary doctor, attend weekly support groups, and access to bariatric medical staff all through my provider. I would encourage you to try to get into a self care regime (things you did before) to help the “good feelings”.

I have no idea why liquid only for 2 days. I honestly expected to go at least a week or two. I do know from reading here that each bariatric practice seems to do things slightly differently. I don't know for sure, of course, but I wonder if your doctor's office will use the weight you started at prior to the liquid diet. They obviously expect that you'd lose some from that.

Water. Joking! I don’t know any new products that are Bariatric friendly but if you see anything low carb for keto it’s a good chance it will have less carbs but not necessarily less calories, however I love Ak-Mak

I live far away from the nearest Trader Joe's, but I'm taking a trip next week that will take me near one on my way home. Because of COVID, I don't want to spend a long time browsing in the store, so I'd like to make a list of items that I can go in and grab without lingering. #1 on my list is the chili lime chicken burgers recommended by @Cheeseburgh on the favorite grocery products post (I hope they have these -- they look delicious!). Please tell me your must-buy bariatric-friendly products at Trader Joe's!

You didn't say if your anxiety was specifically related to your upcoming surgery, but yeah, I think it's pretty normal to be all over the map while you prepare for this. If you're talking about chronic anxiety, then perhaps it's time to talk to your doc or a therapist? All these body changes can mess with our meds/dosages, etc. And I know for me, personally, this process has brought up some issues I didn't expect. I plan to find a therapist who has experience dealing with bariatric patients, both to address issues that might keep me from being successful, but also the things that have surfaced. Take things one minute, one hour, one day at a time!

Hi TaterB, This is the reason why so many come to Mexico. There is nothing to be afraid of as long as you do your research. Thousands of patients come to Tijuana for their surgery and most leave with a very positive experience. Check out Dr. Jalil Illan in Tijuana. He has more experience and accreditations than most US surgeons and is well respected in the Bariatric community. You can learn more about him here: https://hospitalbc.com/dr-jalil-illan/ Please contact me if you have any questions.

At 6 months out since Gastric Bypass, I started my hair loss at the start of December. Currently taking just for hair loss- Collagen, biotin, iron. After talking with my doctor last Tuesday, she told me my iron intake needed to be increased to 50mg up to 100mg per day.and to watch for constipation. We also spoke about meals, currently at about 65-85 grams of protein per day. I add protein to practically every thing I eat. I use Genepro, it can be added to tea and coffee as well as hot and cold foods. It is flavorless and has helped tremendously keeping my protein Intake up. I buy mine on the bariatric pal store. I am due to get some labs this week so I am curious about my vitamin and mineral numbers. Also, I have been discouraged due to the hair loss and the slow down of weight loss. However the doctor told me it is very normal at this stage to slow down losing. That was incredibly reassuring☺️ TLDR;Key takeaways- more protein, more water and check your iron intake. Good luck. ❤️