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Hi Everyone... I am having my surgery on 4/9 - I feel so excited - even though it is my last weekend with food. I am a ton of faith in my doctor, he is the head of bariatric surgery at the hospital where I am having my procedure. My pre op diet seems to be different then most. I will be on Optifast shakes and bars for 12 days, then two days of clear liquid. A little nervous but I can loose between 10 and 20 pounds before the surgical date. Is anyone else on a pre op diet like this?

At last year’s annual physical, I asked my primary care physician (PCP) if I would benefit from weight loss surgery. She said, “Yes, weight loss surgery would benefit you. But, not something as drastic as the by-pass due to absorption issues.” Great – that is all I needed to hear. Last summer, I completed the program at my local bariatric center – even though I met insurance criteria, I was immediately denied – both insurance appeals were denied – I got determined – started researching all options - then chose my surgeon in Mexico. (My BMI was 36 and I had a co-morbidity and met the insurance requirement for surgery, but was denied because my hypertension was controlled with two medications.) It never occurred to me to ask my doctor for her “permission” to go to Mexico for surgery nor did I check to see if she would treat me after surgery. She said I would benefit from weight loss surgery, so I was doing it! After surgery in Mexico, I faxed her the surgery notes and she helped me get off all my blood pressure medication. Fast forward to today and this year’s annual exam. This was my first visit to the doctor since surgery in February. Of course my weight is down, my resting heart rate was great, and my blood pressure NORMAL with a normal sized cuff. YES! The appointment started out like normal, she was asking how I was feeling, etc. Told her I felt great, was eating well, exercising, and losing weight after bariatric surgery in February. She said, “Oh yes! I got the surgical notes you sent me…did you REALLY go to Tijuana and have surgery?! I thought you might have been kidding!” It was sort of comical. As I started with the story – here eyes were huge! But, once she understood my surgeon’s credentials, facility certification, what procedure I had, post-surgery follow up, she had a big smile. My PCP said, “You did good! Our medical system is such a mess and everyone watches the doctors & hospitals, but who is watching the insurance companies? Oh, and I would be really interested in talking to your surgeon about how to practice out of the country. We love the Caribbean and I would love to take care of the ex-patriots living there.” She looks at my incisions and said they looked great. For anyone considering Mexico and concerned about what your doctor might think, don’t be. If your doc is on board with weight loss surgery for you, they might be really interested in learning more about medical care outside the US too.

Before my surgery, I had to get an exam done by a bariatric counselor. They talked to me about how I felt about giving things up, or how I plan to succeed. I am a mental health professional so I told them what I knew they wanted to hear bc I wanted the surgery (I know.. I know.) But after surgery, I felt like there was some unresolved issues with food, much like yourself, and so I'm doing the process to go back to the counseling center. Honestly, looking for eating disorder counselors might be a good first step for you.. because overeating is a disorder.. I imagine most people think "eating disorder" and imagine anorexia or bulimia. Which isn't 100% the case. Mood disorders is something completely different. When you talk to a therapist, you get to interview them first. You have to make sure that THEY are a good fit for YOU. Even if it's just to go 1x a month, I bet it'll be helpful. If you don't feel comfortable with them, then ask for a change. You can request a specific gender if you'd like. Look at their credentials and see how long they've been in practice. healthgrades.com is also a good place to get some reviews. Making a call will also help you establish how they'll treat you. Trust your gut with it. I know you've had a bad experience in the past, but that doesn't mean that all experiences will be bad. I had a horrible exp in college with a therapist and swore I'd never go back. Now I've been in therapy for 3 years now and it's changed my life. Good luck!

Hey guys! Bariatric Bro here! As a thank you to everyone who has gone to my blog, read my blog, liked my Facebook page, followed me on Instagram, whatever it may be, I wanted to hold a giveaway as a small token of my appreciation exclusively for BariatricPal members. I'm still a bit early in this journey, but people seem to like Premier Protein a lot. All you have to do is like my Facebook page and then send me a message on there with your BariatricPal forum username. I'll put it into a random generator, have it select a winner, and then send you your favorite case of Premier Protein flavor straight from Amazon. Simple as that! There is another contest running for Facebook users in general, so you can enter twice! Those have different rules though. **As I mentioned before, my site, nor my Facebook page/Twitter/Instagram have any ad-dollars tied to them. It just makes me warm & fuzzy to see people reading my blog posts and wanted to say thank you to you guys. The contest is open to US Residents only 18+. This contest is not sponsored by Premier Protein or any other corporate entity** If this is not in the community guidelines, I can delete the post immediately--just let me know!

Be careful; I contacted a local bariatric department to see if they would do the aftercare and they told me they would not do it for anyone having surgery abroad. I have since heard that this is common.

Thinking about ordering the unflavored and the peanut butter cup. Looked for reviews on line but couldn't find any, so I'm here for Bariatric Pal input. Anyone put it to the taste test?

This is great information. In my bariatric booklet it says that 6 weeks is an appropriate time. But for someone like me who loves the gym that seems entirely too long. I hope I'm cleared in 3 weeks.

Here is the email I sent out following my surgery to family and friends. Well I finally was released from the hospital on Sunday, Sept 14. I had some issues swallowing the liquid vicodin (way too sweet and thick). I had to wait to come home until I could swallow pills since the liquid wasn't hitting me very well. First of all I have to say that the staff at Blodgett Hospital (in Grand Rapids) on the Bariatric Floor and Dr.'s Foote and Kemmeter (from MMPC Weight Loss Specialists) were awesome!!! The staff on the 4C were amazing. They were helpful in any way they could. They were encouraging and never once made you feel like you were taking the easy way out. Requests for assistance were promptly responded to. I saw Dr. Foote and Kemmeter in the hospital as well and they were also great for support and answering questions. While Dr. Foote was my surgeon, Dr. Kemmeter ended up in the OR with him as well because of some minor issues that came up. The morning of the surgery was a little tense, but I think I was just anxious about getting shots and the full meaning of this surgery. I broke down a little bit in "pre-op" holding because the woman next to me had her blood thinner shot before I did and completely freaked out over it!! Like screaming in agony freaked out...needless to say when the nurse arrived to give me my shot, I was very nervous and broke out in tears. Needles freak me out and after having two kids, I have gotten use to shots, but after hearing her response, I was not looking forward to that particular shot. The nurse was very reassuring and informed that it was a small sting and the sting continued for a slight time after the shot. I calmed down enough and she gave me the shot. I had to stop myself from laughing too loud, because it was a piece of cake. Thankfully it didn't hurt because I had to have the shot twice a day while I was in the hospital. The anestigiolost came in and asked a few questions and then got me ready to take back to the OR about 10:05. My surgery was scheduled for 10:15. I vaguely remember giving Tim and my mom a kiss and then the trip back to OR starting. I don't know if anything else was said, but my doctor's office gives a med in the IV that causes you to "forget" what happens going into OR. I woke up in the recovery room around 4 pm. I dont remember much about that, except that it sounded like they were trying very hard wake me up. They also kept saying "everything is fine..." and I heard a few murmurings about how "she has been through a lot, but she is doing well." They took me up to my room and I talked briefly with Tim and my mom. Tim stayed for a while, but my mom had to leave to go get my kids some dinner. Tim told me a little bit about the surgery including the fact that I ended up with a "Vertical Sleeve Gastrectomy" instead of a Duodenal Switch. I knew this was a possibility and I was okay with that. I took my first walk around the floor around 8:30 and then repeated it every 4 hours. The nursing staff did a great job of trying to time their vital checks so they were right before my walking time. The next morning Dr. Foote came in and explained a little bit more about what happened. It appears that I did need to have my gallbladder out. It was in bad shape and he felt that it would help with my recovery. Then they did the sleeve portion of the surgery, which involved removing a portion of my stomach. They also removed my appendix which is sometimes done in preparation for the Duodenal Switch. After removing the appendix, Dr. Foote noticed that I had something that is sometimes referred to as a "2nd appendix". It really isn't an appendix, but it needed to be removed. After doing this, he measured my intestines to make sure there was enough to perform the "switch". He was a little concerned about the intestines being too tight. While doing the measurements, he found a small mass on the outside of my upper intestine and the bottom of my stomach. At this point, I believe he called Dr. Kemmeter in to the OR for a second opinion. Because of the location of the mass and not knowing the nature, they determined that completing the Switch would not be in my best interest. If I had already had the switch done and then the mass needed to be removed, it may have caused some issues. They decided to just complete the first portion and give me the sleeve only. Because of all of the things they ended up doing, I did end up with a small drain in while I was at the hospital. They did do a biopsy of the mass and sent it to pathology to be tested. On Friday morning, Dr. Foote informed that the mass was benign. He still wants me to see a specialist to monitor it, but he felt confident that it would not need to be removed. I did great with getting around at the hospital. By sunday morning, I really felt like by the time I got home, I would be able to do without the pain meds. However, when they removed the drain tube, I realized that the pain meds would def be a necessity. Unfortunately I have to take 2 to lay down, but when I take 2, I have a harder time sleeping.

Who are you going through for this surgery? Does that dietician work for your surgeon? She full of sh*t. If you're going through some ridiculous weight loss center look up bariatric surgeons in your area and go through one of them.

How did she not know your BMI to begin? Because she's an idiot. The first thing they do at ANY bariatric surgeons office....insurance then BMI. sometimes money is before BMI. but they certainly know what it is prior to you going in there for the consultation so the surgeon doesn't invest his time on someone. After your consultation, most patients do not see their surgeon again until surgery. I would find a different nutritionist because NUT seems to fit this one. She may be qualified, but she is definitely derelict in her performance. It is definitely a blessing in disguise. I wouldn't want her on my "case" if I were a patient there. Either way, a 2nd opinion wouldn't hurt and getting on the right track to finding the time needed to get what you need and deserve.

Geeze I had to say something because I've passed this several times an every time I saw it my heart panicked. I kept reading thinking it said Oldham county. Scary thought! OP, where in KY are you? I know Louisville has quite a few Bariatric programs and there are some in IN that may be worth the drive.

I thought the same thing. I never heard of a bariatric pal house. It sounds pretty interesting.

Howdy, Tamika. You're story sounds really familiar.......as in just like my younger sister's story and like my own. Little Sis was the smart one, though......she had bypass surgery when she was a year or two out of college and went from around 370 down to 140......had all the plastics done and became a new person. It was a transformation like nothing I've ever seen before or since. She then met a really cool guy who I respect and enjoy hanging with. They were married and have had a wonderful marriage and have two of the greatest kids you could ever imagine. Respectful, energetic and really well-rounded. Then.....there is me. 9 years older than her. Football from 6th grade through 12th. Weight lifting and wrestling team to support football......both knees wrecked and surgeries ended football dreams by September of my 12th grade year. College letters of interest ceased immediately. Figured out a way to get to college and somehow graduate.....and had way too much fun along the way. That fun didn't stop after marriage........and it translated over to more weight piling on every year. Still was very active in hunting, golf and fishing. Golf ended in 2011 when I ripped ankle-foot tendon and had to have it repaired. Hurt like a beast being way too heavy and healing after that surgery. A couple hernias from doing stupid stuff in the woods and weight room required a couple surgeries, too. Being heavy during the recovery hurt like crazy. I've lost and regained so much weight over the years that it's incalculable. A heap of it. Lost.....but always found. Battled this way for a long time. Weight and desire to still do all the stuff I enjoy took it's toll on my knees....but ultimately a herniated disc knocked me down for several weeks and I had lots of time to think and reflect. I decided then that doing the same things I'd always done would lead to the same results. I entered a local bariatric plan.....then transferred over to another local bariatric plan....a center of excellence. I was dead certain that I was going to have a bypass. I began all this in June 2015. My BMI was just shy of 60. My new surgeon said that a bypass was not a safe surgery for me in my current state then.....tall and heavy and had a ginormous umbilical hernia that had to be repaired during the surgery. You can see it really well in my profile pics. He was concerned with the repiping done by bypass....routing near the repaired hernia.....stretched due to my height......probability of hernia repair blowing out and involving the already taunt repiped plumbing.......bad juju. He was emphatic that I should have the sleeve. He also was persistent the the sleeve would allow me to continue taking the highly effective NSAID's that help with my knee arthritis. I caved in but was worried that I'd not loose the weight I wanted to lose. He was not yielding and said if I wanted bypass I needed to lose more weight. I'd lost 55 pounds by this point already and knew I was running out of gas......back wasn't healing and it be even harder to lose more in the state I was in. I'd already chosen to self fund the surgery and we agreed on the sleeve and set the date for just 3 weeks from that appointment. He did my upper endoscopy a week later and the next day I started my 2 week pre-op liquid diet. The surgery went really well and he said my sleeve was "textbook" and that my hernia repair was rock solid and should hold well into my old age timeframe. All music to my ears in the recovery room. The weight loss has been steady and it feels freaking great. Every day is a new opportunity to enjoy life and every aspect of it is better. I am very, very grateful for my sleeve and can see how it will be a tool for me to use for the rest of my life. My only regret is not doing so much sooner.......like my wise little sister did 15 years ago.

My husband has been against it but has accepted what I am doing. At first he did not want to even come to the hospital. I think he realized that I was determined. One suggestion would to see a therapist who works with bariatric patients. I saw one and was helpful with talking to my husband.

You can find out for sure by doing the cottage cheese test, which is a valid test in the bariatric community... http://www.bsciresourcecenter.com/proddetail.php?prod=A4

Regarding your family who says you don't need to lose weight....doctors figure your 'need' for weight loss based on your BMI (body mass index). (google BMI calculator)....at 4'9" and 235 lbs your BMI is 51....that is classified as "morbidly obese." So, yes, you do need to lose weight. I'm betting you are quite young and look really cute and cuddly right now, especially to your family. But along with obesity eventually comes poor health....we don't retain the cute and cuddly when the health begins to go. Your family loves you like you are, but you love yourself enough to want to be the best you can be in the future and to have a long and happy and healthy life. Dallas is a great place to find an experienced, competent weight loss surgeon....some of the most respected ones are right there - Dr. Wade Barker, Dr. Richard Benevides, Dr. Joseph Cribbins, Dr. Steven Hamm are all very well thought of - as well as others. Methodist Hospital and Presbyterian Hospital are both Centers of Excellence for Bariatric Surgery and have outstanding programs and staff for weight loss surgery. However, none of them work for free....not many people do. You say you don't have insurance or any credit at all....are you on Medicaid by any chance? They cover weight loss surgery. If not, you need to begin trying to establish credit of some sort....just a credit card or a store account with a small limit is a beginning - making payments, never be late in making payments (that's the key) to getting a good rating. I hear your frustration about dieting. It's easy to diet, easy to lose weight - and even eaiser to gain it back ....I 'dieted' myself up to 350 pounds.....so much yoyo dieting that my metabolism went haywire and eventually only went one way - UP- on the scale. I hope you can find a solution to your weight problem soon, whatever it may be. Best wishes to you.......

According to what I was told, Tricare requires the surgeon to be a member of a Bariatric Center of Excellence. To me, it has been great. They have toi adhere to stricter standards and have great follow up.

Right now I think it is still in clinical trials and doesn't have FDA approval. It is a sleeve made of some material (probably a kind of plastic) that a doctor puts in your small intestines and it blocks absorption of nutrients in the duodenum. http://www.gidynamic...er-overview.php http://www.ncbi.nlm....pubmed/19858703 I really hope that one works out, because that is another fairly safe tool for bariatric weight control. In a way you'd assume an endoluminal sleeve combined with a lap band would give the benefits of a roux-en-Y bypass surgery but it would be reversible and have a far lower mortality rate. I have no idea if the surgeries can be combined though, or if you'd even need to do both. The clinical study said a loss of about 19% of excess weight in the first 3 months, but I've also read a 30% drop of excess weight in 6 months, and that can be doubled with something called a flow restrictor to adjust gastric emptying into the intestines (most of the info comes from sites tied to the maker, so no idea how independent they are). http://www.yourbaria...luminal-sleeve/ http://www.wlshelp.c...ndobarrier.html But if I ever do decide to do something for my weight, I want it to be something relatively safe, reversible and affordable. The lap band seems the best idea now but an endoluminal sleeve could be a good idea too when it gets FDA approval.

Appeal. Now. Blue Shield of CA H M O doesn't require six months any longer, and they haven't since July 31, 2015. You should never have been denied in the first place. So long as your surgeon and/or PCP documents your previous attempts to losewweight, that's good enough. Here is the link to Blue Shield's medical policies: https://www.blueshieldca.com/provider/authorizations/clinical-policies/medical-procedures/policy.sp You'll find the policy for bariatric surgery under "B". Your medical group or IPA may be unaware of the change, but they should have looked it up online before denying you. Blue Shield didn't do a good job of letting their groups know of the change. It delayed my process as well. It's your group that did the denial (Blue Shield contracts with them to process authorizations), but appeals are handled by Blue Shield directly. Good luck!

Hi folks, I saw your replies so thought I would jump on quickly to answer. The company I went with is called Bariatric Pal, and their package was supposed to include recovery at one of their "luxury condos", or at a hotel. When they pulled up outside that little house I said no, I was supposed to go to a hotel. But they said that they only put people at a hotel if their recovery houses are full. It wasn't a bad house, just not what I expected. When I just couldn't take the heat, they brought me to the Grand Hotel Tijuana, which is brand new. There are two towers, some of which is still under construction. And as I said, the whole 11th floor is a special recovery floor for people who have come here for surgery, whether it be plastics or bariatric. The staff are fantastic! The atmosphere is soothing.. People are helpful. And it's modern with proper a/c! I think if it hadn't been so hot, I would have been OK at the recovery house, because they provide someone there for you to go get you broth or popsicles or whatever you need. But it wasn't what I am used to, and not what I was expecting by their advertising. So, it's true, you just can't tell what you are going to find when you get here. I don't think they did anything wrong, just a little misleading. My surgeon was dr. Ponce de leon. I chose him because of the advertisements on this site, and he seemed to have the most experience. In fact, all the other doctors kind of bow down to him, and refer to him as the "godfather of the sleeve". His assistant, Dr. Garcia is much younger, and speaks very good english (Dr. Ponce doesn't speak english), so it was like I had two doctors. Dr. Garcia was so wonderful, he came to see me in the hospital after the surgery, and prescribed some stronger meds for me since I was having such a hard time, and again before I was released, to explain everything about diet, and to reassure me and answer questions. I even talked to him on the phone the next day, from the hotel, when I still felt awful and started to have panic attacks. It turns out it was withdrawal from one of my regular meds that I had stopped taking. Once I started taking my normal meds again, I turned the corner and started feeling so much better. it's too bad that we ended up at different hotels. But I really love this place, and plan to come back for a vacation once I can eat real food again! I can't praise the staff here on the 11th floor enough! So helpful, so cheerful, really just wonderful people. For anyone thinking of coming here for surgery, I would highly recommend staying at the Grand hotel on the 11th medical floor. There were a lot of people here who went with a company called "a lighter me", and that company always puts it's people up at this hotel. And they didn't pay any more than I did either. And, you can still pick your doctor. It seemed that Dr. Ortiz was the favorite of the people that I met. Out of the dozen folks I met who had the same surgery, there was one man and one woman besides myself that seemed to have a harder time recovering, with more pain and more nausea. But, we all felt better with just a couple more days of walking and sipping. And mixing the juice with Water. And taking the Gex Gel that I mentioned before. In fact, I gave some to each of the other two who were having a tough time, because their package of drugs didn't include that one. Anyway, sorry for the long post. I wish all of you the very best in your recovery. And I hope that my experience and tips will help others who are struggling. And for those of you who are a little hesitant about coming to Tijuana, don't be! The city has changed a lot! It is a thriving metropolis, with part of the old Mexico we come to expect, and a lot of new construction and services. After 9-11, the tourist industry went way down here, so they went all in to the Medical Tourism business, and they did it well. I would not hesitate to come back here for any other procedure I, or my family needed. @@Pejela, try mixing your water half and half with some apple or peach juice. That helped me. I still feel like there is one spot somewhere on the way down that kind of cramps up sometimes if I take a big sip, but it is getting less and less noticeable. And try not drinking it really cold. That might help too. Good night all.

@@jennfred, good for you for insisting on going to the hotel! Really, the Bariatric Pal guys are just fine, and you won't have any problems. @@maggie409 stayed at the recovery house in June, and she liked it. As I mentioned, it might not have been so bad if it hadn't been so darned hot! But the hotel is more what we are accustomed to. Lots of space, all with central air, wonderful staff, and nurses to help if there are medical needs or questions. Plus, my husband went with me, and the Grand is close to all kinds of restaurants, fast food places, grocery stores, etc. so he could go for a walk and pick up some juice, or something to eat for himself without getting out of sight of the hotel. And once I got feeling better, I walked with him over to the Fast & Final grocery store to find some peach juice cuz I was tired of the apple. Just the walk was a challenge, but was so good for me to get outside in the sun and walk on streets and sidewalks and not just in circles around my room. Walk as much as you can. From the minute you wake up from surgery even, if you feel well enough for that. Up and down the hallway in the hospital. Or just back and forth in your hospital room if you need the a/c. INT hospital is not air conditioned in the hallways, just in each room. If it hurts, walk. Seems counter-intuitive, but the walking is what will help the gas to go away (they inflate the stomach area with CO2 so they can see what they are doing during the operation). Trust that you will be fine. Good luck!

Hey All! I'm a newbie here, but I've finally decided to start the process and get information about VSG. I feel mentally ready for it and that it's time, as I've been going round and round with the decision for years. I go back to my new PCP on 3/10 of this month to discuss it more and get bloodwork. I gave her a head's up at my initial consult that this was something I wanted, and she said let's see if you are a candidate at your next appointment. I already made my appointment with the weight loss center for the information center on 3/25. They advised they do not need a referral from my PCP, but to have my most recent labs sent over. When I called the weight loss center, I was advised that after the information session, you will be contacted within a week for the actual consult with the surgeon. I've been doing a ton of research so far, and I see a lot of folks have a 6-12 month supervised diet mandate with the insurance. After contacting my insurance company, they sent me the policy and advised that they have lifted their 6 month restriction. My policy states the following is needed for approval. BMI 40 and over or BMI of 35-39 with co-morbidity. Individuals should have documented to respond to conservative measures for weight reduction prior to the consideration of bariatric surgery and these attempts should be reviewed by the practitioner prior to seeking approval for the surgical procedure. HOWEVER, following that statement, it says "As a Result, some centers require active participation in a formal weight reduction program that includes frequent documentation of weight, dietary regimen, and exercise. However there is a lack of evidence on the optimal timing, intensity and duration of non-surgical attempts at weight loss, and whether a medical weight loss program immediately preceding surgery improves outcomes." HELP- what does this mean? Psych consult I'm pretty clear on the other first and last requirement, but the 2nd one has me spinning my wheels slightly. When I called my insurance to ask for clarification, I was advised that a letter of support from my PCP would likely suffice. My only hesitancy is that I just started with a new PCP, and I'm wondering if she will approve me off my BMI alone, or want to try conservative measures first since I am new patient there. If she doesn't provide letter of support, will the nutrition classes that the surgeon will inevitable require satisfy the letter requirement, can he be the one that writes it or does this text indicate that it needs to come from my PCP? I plan on calling the center during their business hours to ask if they've encountered this insurance wise tomorrow, as they were closed today. Any one run into this issue with their insurance policy? Any insight or perspective offered would be awesome.

I am a patient of Dr. Illan also! Im 26yrs old 5'3 and started at 230lbs had surgery on Jan 17th 2014 and i now weigh 210lbs only 12 days later. It was an amazing experience! The doctors were so great and caring even the nurses. Also Omar goes out of his way to take care of you and your guest. I went with my dad who was nervous and against the surgery but once we got there we met two other patients we both felt more comfortable. After my urgery I never felt any pain (except for some gas pain) and I never took any pain meds. Soon as I was out of the hospital we were out shopping and touring TJ, thanks to Omar! I would do it again in a heartbeat. Thanks Baja Bariatrics

Hi all - I had my sleeve done on Thursday afternoon and came home yesterday (fri). I had expected a huge problem from the gas used in surgery as I had a hysterectomy (close to that same procedure for both) and that is what I got, a huge problem. I hardly noticed any pain in my abdomen from the surgery because of the severity of the gas-related pain in my shoulder and back. But feel like the Charco tabs worked far better than gas-x (and my husband lightly whacking my back with cupped hands (what they do for CF but not that hard). This morning most of that is better. 1. I know most all the basics, but some of the details on shaky as I put it all in play! For example: In the liquid stage is there 30 minutes between each drinks (the rules deal with food and liquid that I have seen ca. 2 liquids or 2 actual food items). 2. my surgeon/nutritionist say I can drink up to the point of eating, but I need to wait 30 minutes after eating to drink. The nutritionist for Bariatrics at the hospital, however, said I was better off waiting 30 minutes So I am going with the latter for now. But still, whether due to remaining gas or to reflux or whatever, it feels uncomfortable to eat and drink no matter how small the bites. 3. Another timing issue has happened twice - I started this morning with a protein shake. But about 15m waiting 30 minutes for a food item, I realized that I need to take some meds. I needed some sips to take the pills. Do those few sips mean I begin the counter again? In other words, I am curious about the experience of others on this topic and how you interpreted this (more conservative) rule. 4. In the last hour it feels as if my stomach is growling, as with actual hunger. We will continue to have hunger, but with the increase in acid and gas it much harder to interpret these sensations and feelings.

I did - I had my surgery at St. V's Bariatric Center of Excellence with Dr. Diaz. It went wonderful! Where are you having your surgery done?