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Good riddance to bad rubbish. How do you move on and date? In my opinion, very carefully and very slowly. It sounds like you need to grieve and recover from your marriage before jumping back into the dating world. Do you have a good therapist? Have you considered attending a 12 step recovery group like Overeaters Anonymous? Are you attending bariatric support group meetings? Take the time to get to know yourself, recover and heal (physically and emotionally), learn how strong and resilient you are, and focus on health and wellness. Another relationship can wait until you are steady in your own feet. Yes, I am looking into finding a new therapist since I moved away from where I used to live. Hoping to find a good one soon. You're right, no dating for me until I am healed from this pain. Thanks

This is from the Journal of the American Medical Association. It is entitled, "Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery" at http://jama.jamanetwork.com/article.aspx?articleID=1185618

What exactly are you afraid of...I'm getting it done on the 10th of November and I am afraid of nothing but dyin! Bring on the hair loss, bring on the pain just keep me alive. So to soothe my fears I went about doing my own mortality study and here's the facts: new lap band studies as reported by Bariatrics Today indicate that 3 of 16,000 died from Lap Band...all three were injuries to the stomach performed by surgeons who have done less than 20. Further, here's a great number 1 in 100 die of a hip replacement, more than 1 in a 100 die of hernia repair, 1 in 5000 die of simple liposuction! I'm saying this surgery has amazing odds! I'll be scared to death til the minute I'm put under, but I have faith that I'm coming out of it to a far better journey!

A little update...I called my Medical Group and to ask where they send people for bariatric surgery seminars and they said my PCP must submit an authorization and I then I can attend an informational meeting at their Health Center. I see my PCP this morning at 8:30 and will be asking for just that:wink2: Cindy T

Your bariatric report card doesn’t look so good? That might be good news: a wake-up call, with some opportunities for improvement. Back in the olden days, there was a space for teacher comments on the back of my report card. Here my teacher could write comments about areas in which I exceled or (more often) I needed to improve. Mine usually had to do with talking during class too much (except when I shut my mouth because I didn’t know the answer to a question). So, what opportunities for improvement await you this semester? Here’s an example from my own WLS journey. It was an offshoot of my New Year’s resolution, which was to log my food every day. After weeks of living that resolution, I was dissatisfied with its effect on my weight, and suddenly realized that although I’d been faithfully logging my food every day, I hadn't been paying much attention to the resulting nutritional data. In that instance, I had earned an A for effort and an F for achievement. That’s partly because I love keeping logs and journals. I can play with Excel documents 'til long after the cows come home, without any expectation of coming up with useful information. I analyze things just for the fun of analysis, so it’s far too easy for me to overlook the ways in which I might use all that stuff to improve my insight or change my behavior. So if I don’t pay attention to the data in my food log, I can’t evaluate the quality of my food intake. I’d been logging about 1400-1500 calories a day (a calorie goal that accounted for my exercise level and weight loss goal) without taking the time to notice some major inconsistencies in my macronutrients, especially protein. I need to pay attention to my protein intake not just because my body needs good-quality protein to repair the muscles I use during my daily workouts, but because low protein intake often represents maladaptive eating. Rather than slow down and eat carefully so that solid protein doesn’t cause me problems, I take the easy way out and eat the easy stuff, almost always in the form of carbs that don’t offer much satiety value, never mind nutritional value. When I was a clueless little kid, I had to rely on adults to tell me exactly how to improve my school grades, but I’m glad to report that I’m not a clueless little kid any more. I’m an occasionally clueless adult. If my realization about the quality of my food intake had never materialized, eventually I would have asked an expert, like my dietitian or doctor, for guidance. Armed with their suggestions, I would get back on the bandwagon and give that food log another honest try. And (fingers crossed) eventually earn an A for achievement!

Jazsleeve Insurance goes by the BMI at the time of your consultation. If your BMI is over 50, you wont lose so much weight you won't qualify. Your Bariatric Surgeon knows more about the process than your pcp. Stick to the advice they give you. Talk to their insurance specialist. On the other hand, the nutritionist and psycholigist will quickly approve you when they see you have adapted sound eating habits. Focus on your goal. Thank God I had my husband telling me that the entire time. Six months seemed like forever! I just finished my 6 months and am about to be submitted for insurance approval. With God's will, I will start my preop diet in 2 weeks and be sleeved in 4 weeks. I always tell my kids.........lots of people start the race running fast but the one who can endure to the end always wins!

Here's a post I made a few months back: Sleeve Gastrectomy – Does Size Matter? by Kimberly Taylor on August 21, 2013 · Comments | Weight Loss Surgery The gastric sleeve procedure has quickly become one of the most common types of weight loss surgery, jumping from obscurity to importance in only a few years. Despite it’s newfound popularity among patients and surgeons, there are many technical aspects of the procedure including bougie size that remain controversial. What is a Bougie? The bougie (prounounced BOO-zhee) is a measuring tool in the form of a long, thin, flexible tube. The surgeon uses it as a guide when dividing the stomach. During surgery, the bougie is put into the mouth and pushed down through the esophagus and stomach to the pylorus. The tube creates a bulge inside the stomach that the surgeon uses to guide the stapler when dividing the stomach. After the sleeve is formed, the bougie is removed from the body. Bougies comes in a range of sizes that are identified by a unit of measurement called a French. 1 French is equal to 0.333mm (1/3 mm) and is abbreviated as F, Fr or FR. For reference, a 40F bougie measures about 1/2 inch (40F x 0.333mm = 13.32mm, converted to inches is 1/2″). Standard bougie sizes in the United States range from 32-50F. The bougie size is not the same as stomach size, although it does influence the size of the sleeve. Generally, the smaller the bougie, the smaller the new stomach size, but the same size bougie does not always create the same size stomach. The finished sleeve size is determined by how close the stapler gets to the guide and whether the surgeon oversews the staple line and if so, by how much. While the gastric sleeve is now widely accepted as a primary bariatric procedure, there is not yet unanimous agreement on an ideal bougie size. The decision is trying to find the size that will provide the safest results with the most amount of weight loss. With a smaller bougie size, the smaller the sleeve and greater the restriction, but greater the risk of leak and stricture rate. A stricture is an excessively narrow section that develops when scar tissue grows and interferes with the normal movement of food and liquids into the stomach. It can cause upper abdominal pain after eating and chronic vomiting or regurgitation of undigested food. Symptoms usually start in the first 6 weeks after surgery. Strictures are very uncommon, but surgery is required to remedy the situation. If a larger bougie size is used, the sleeve will be larger and the operation safer, but the concern is that it may not produce enough weight loss. 2008 Study A study in 2008 found that a bougie size of 40F compared with 60F did not result in significantly greater weight loss in the short term. Comparing 40F versus 60F: At 6 months, the excess weight loss was 38.8% versus 40.6%. At 12 months, the excess weight loss was 51.9% versus 45.4%. (Study: Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008 Jul-Aug;4(4):528-33. doi: 10.1016/j.soard.2008.03.245.) 2013 Study In a 2013 study, researchers wanted to find out if there is an ideal bougie size. To do this, they did a search of medical literature published in the last 5 years and analyzed 32 publications involving 4,999 patients. What they found: The use of bougies 40F and larger had a leak rate of 0.92% and excess weight loss of 69.2%. The use of bougies smaller than 40F had a leak rate of 2.67% and excess weight loss of 60.7%. The results show that larger sizing bougies had a lower incidence of leaks with no change in weight loss. The researchers call for further studies before a decision is made on optimal bougies size, but recommend caution in using the smallest bougie possible because the risks may outweigh the benefits. (Study: The Effects of Bougie Caliber on Leaks and Excess Weight Loss Following Laparoscopic Sleeve Gastrectomy. Is There an Ideal Bougie Size? Obes Surg. 2013 Aug 3. [Epub ahead of print]) 2012 Surgeon Survey According to a 2012 survey of surgeons experienced in sleeve gastrectomy, the bougie size used ranged from 32F to 50F, with the most common size being 36F (used by 32% of surgeons surveyed). Studies show that the procedure is relatively safe, but there are still many variations in bougie size. (Study: Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obes Surg. 2013 Aug 4. [Epub ahead of print]) Bougie Size Bougie size is based on patient input, height, weight, and surgeon technique. The bougie size is typically smaller when the procedure is performed as a stand-alone procedure (32-50F) rather than part of the duodenal switch (50-60F). Depending on the bougie size used by the surgeon, the new stomach size will be about 60-80% smaller after surgery. The average stomach holds 30-40 ounces, or roughly 4-6 cups per meal. After surgery, a small meal of 1/2 cup to 1-1/2 cups will fill the new stomach pouch. The sleeve will stretch somewhat from the surgery size, but will get no where near the size of the original stomach. If you are planning to undergo the sleeve gastrectomy procedure, make sure you discuss the bougie size with your surgeon during the pre-op process. It is important that you understand the rationale for your surgeon’s recommendation and to feel comfortable with the size of your post-op stomach. While bougie size is a consideration, healthy weight loss will ultimately depend on following a reduced-calorie, nutrient-rich diet. The sleeve will help reduce hunger and limit food intake, but it is up to you to choose the foods and liquids that you put into your body. I made a quick EXCEL spreadsheet converting the size to mm and inches based upon the formula. Note: Per this article, the surgeon's techniques contribute to the overall size ("...how close the stapler is to the guide...", "...whether they oversew"..., etc.) Bougie Size mm Inches 32 10.66 0.42 33 10.99 0.43 34 11.32 0.45 35 11.66 0.46 36 11.99 0.47 37 12.32 0.49 38 12.65 0.50 39 12.99 0.51 40 13.32 0.52 41 13.65 0.54 42 13.99 0.55 43 14.32 0.56 44 14.65 0.58 45 14.99 0.59 46 15.32 0.60 47 15.65 0.62 48 15.98 0.63 49 16.32 0.64 50 16.65 0.66

I'm guessing my bariatric surgeon, Dr. Michael Baptista, is getting more and more successful. He's moved from his partnership with another doctor and into his own spiffy new office MUCH more conveniently located for me, in Arlington right off 9A and Monument in the Brooks Rehab Building. Now, I'm not saying his former partner was a bad doctor-- not with that many awards-- but I didn't like the other doctor and that's the honest truth. I'm allowed my opinions, and my two experiences with the former partner were unpleasant. Now I feel much freer to help Dr. Baptista with his newer patients! I'm pleased to say Dr. Baptista asked me to start attending the monthly support group so I can provide cheerfulness and inspiration to a group that has recently begun to focus on negativity in his opinion. One subject he mentioned specifically I could help with was the low carb diet. Many have difficulty in going beyond what's on the face of low-carb living and consider it bland and without joy. Do you think I can change that? Yeah, I can. Especially since it's official-- I lost another 7 lbs, and I'm now within 10 lbs of One-der-land! I can do it! Now the question to ponder is-- what issue with low carb life do people have the most trouble with? I found it easy, so I have no clue where to begin. I need opinions, here!

I have been using Bariatric Advantage chewable vitamins for over 10 months. i also take their Vitamin D gels and their chewable iron. At first I tried the berry flavor (cuz my docotr office sold those) and hated it so bad, I don't know how I got through 180 of them. But I went there (they are close to me) and tried the different flavors, and now I use the Vanilla ones. I love them. So I take all of these mentioned plus B12 sublingual everyday and have no rpoblems or issues with taste. have you tried the Bariatric Advantage or did you have a different brand? They also have a website or can order by phone and they are great to work with.

Carbonation, like straws and other such bariatric urban legends fall into the category that they might cause some discomfort, particularly early on. If they do, skip it and maybe try it again in a few weeks. If it doesn't cause any discomfort, it isn't going to hurt anything. No, it isn't going to cause your stomach to stretch, particularly with an RNY which is an open system (no pyloric valve), but the gas pressure may cause some discomfort as it passes up or down on its way out. The main thing that it could possibly do, with either procedure, is to stress the lower esophageal sphincter which is supposed to keep everything down in the stomach and not flow back up into the esophagus (reflux) making GERD a greater possibility (even with a bypass.)

I can understand your frusteration. I have Tricare prime south . I had 2 other insurnces but after TRICARE said they woiuldnt cover bariatrics if I had other insurance I quit the other two. I saw surgeon who said I am an excellent candidate. EVERYONE in my family has died of diabetes, including my dad at 45 and my son is very brittle t 26.The surgeons office submitted everything and I was denied for not having physician supervised diet, I called Tricare to find out exactly what that meant and I was given the reply of "oh I don't know!" On my own I saw my ob gyn who has it documented since2007 weve discussed weight loss diet exercise weight watchers etc (ive been a member of ww since 2007) the doc wrote me an excellent letter and resubmitted. please cross your fingers.

Yep, World According To Eggface is the way to go! Shelley is a WLS person herself, and she has developed TONS of bariatric-friendly recipes that are fantastic! In fact, I just made her Pumpkin Ricotta Praline Bake and I am eating it right now - DELICIOUS!!! Low cal, low carb, high protein - and super good!!

I haven't been on in a while and just see this post regarding surgeons in South Florida. My surgeon is Dr. De La Cruz with University of Miami. I had my surgery Feb. 2014 and have lost 218 lbs! Words will not describe how amazing he and his team truly are. I went to see all, and I mean ALL of the main bariatric surgeons in Miami before I chose Dr. De la Cruz! They have taken EXCELLENT care of me! The hospital staff and nurses are top notch! Please do yourself a favor and schedule a consult and go to their seminar!

If both your doctor and your surgeon say you have reached goal then perhaps it's time to start thinking maintenance instead of weight loss. Sometimes as bariatric patients we have a disconnect with out bodies and what they should look like. There's even a small percentage who start to really like the feeling of losing weight after being overweight for so many years. Some even develop disorders where they go in the opposite direction and start losing more weight than is healthy. Please be careful.

Your Grandma may have given you a hard time, but it looks like she is coming around. Show her some extra love when she gets her knee surgery. A knee replacement is as painful as a surgery can get, the physical therapy is torture and the recovery is long. Maybe Grandma will be convinced now that bariatric surgery would be instrumental in relieving joint pain.

depends on your pickiness. If you have a bullit you can puree almost anything you liked prior to your sleeve. Veggies cooked very well and thinned with some chicken or beef stock is yummy. I particularly liked zucchini that way. Deviled eggs with a little of the unjury powdered chicken broth is really yummy. I didn't not particularly like it made into a broth however but it did make for a really good seasoning for things like deviled eggs and pureed veggies. I added the powder dry to the eggs with a bit of Water to make a paste. It is also good to have some tomato basil Soup, pureed cottage cheese and a little canned fruit pureed into it, Yogurt, go thru some bariatric websites for some great ideas.

I agree it is a long wait. There are so many various requirements which differ depending upon the bariatric center, insurance company, and surgeon. I started the process in January 2008. Between Jan and October 2008, I had to complete many, many, many requirements before I could even meet with the bariatric surgeon. I finally saw the surgeon October 8. I completed the H-pylori on October 10 and completed the upper GI on October 14. All paper work was sent to the insurance company on October 15 and I recieved approval on October 16. Looks like my surgery will be November 11, but I am waiting confirmation. Don't give up hang on. You can do this!:smile:

I have been heavy all my life and just getting heavier. I have been lucky so far as to not have developed any co-morbidities. My husband and I were trying to have another child for the last 3 years. I put $5000 in my flexible spending account for this year and after being told it would be around $20,000 to do invitro with donor eggs - I was looking for other ways to spend my funds. I had been contemplating and researching this for a while. A couple of friends/colleagues had mentioned it a few times as they knew people who had done it and we worked in the medical field so they knew staff and the physicians at the local bariatric center. Once I make a decision, I don't waste time. I went to an info seminar on March 9 and I had surgery last Friday (April 23). I have no regrets and am happy with my decision. I want to be healthy for me and my family to enjoy our lives. I have spent far too long hiding from pictures and situations because of my weight and uncomfortableness. It was time for a change and I'm proud to say I did it.

Well, just came from my PCP's office and I am a fuming!!! He just informed me that he considers my weight loss surgery a miserable failure and he's not going to recommend it to anyone else. I've been hovering between 216/217 For the last few days. Well, I didn't take my normal water pill that I take daily because I don't like to take it until 'm home and near the bathroom. Anyhow, I weighed 220 on his scale this morning which of course I was upset over as well. I was OK until he called me a failure at this WLS and he also said it's ridiculous if you have to keep going for fills and you're still not losing fast enough. Well, I had enough of his negative talk and blasted back that I am not a failure and considering when I first saw him many years ago I was 289. I started my lapband journey at 267 on 12/28/12. I said I've still lost weight and that is what counts. Last time I saw him 3 months ago I wanted to cry because he felt I had not lost weight fast enough (at that point I was down 37 lbs. according to his scale I'm ONLY down 47 lbs and that's not good enough. I should be losing 2 lbs a week, every week according to Dr. "DOOM"! Anyway, I didn't feel like crying this time. This time I wanted to scratch his eyes out. I've still lost 10 lbs in a 12 week period. I still haven't taken my water pill yet but taking that pill makes me lose 4 lbs like in a 12 hr period. Hey, I'm proud of my weight loss and I'm not going to let anyone steal my thunder especially my PCP! I've had many NSV's as well like fitting in smaller clothing, being able to walk more in the stores, etc . If my PCP knew how serious I am with my calories etc., maybe he'd get rid of that negative attitude of his. As far as I'm concerned my PCP is the failure! Not me! I'm still fuming but I'll calm down after awhile. They say 3 strikes and your out. Well, considering the fact he's not a BARIATRIC doctor, I'm giving him one more chance. In Nov. I'll have my 3rd visit with my PCP, if he so much as suggests I'm a failure again, that will be my last visit with him. I already have a new PCP in mind and he's about a mile from my house so I could walk there Just letting everyone considering the lapband, that I love my my band! I may be a slow loser but at least I'm losing. Don't let any doctor talk you out of it. I think all PCP's should all take a course in bariatric medicine before they judge anyone.

Surgery is 3 days and a wakeup away! I am staring to think more and more about it of course. On my liquids I have lost 13.5 pounds. I have "cheated" though and the guilt is killing me. I am not hungry, stomach wise, but my mental hunger is still there. Please tell me someone understands that. I am used to eating even when I am not hungry. This battle is going to be mostly mental for me anyway. I am spending time this week making homemade Soups and pureeing them, then freezing them. I hate how much sodium store bought soups have. I am going to be making homemade popsicles today and homemade chicken broth so I should be set. I haven't had the surgery yet, obviously, but I scared to death of my first fill. My doc does mainly bypasses and sleeves but since he is an insurance provider that is where I needed to go. He does first fills at 2 weeks post op and I am worried about it. We live 3 hours one way away from the doc so I can't just come back in a few days or so if he tries and it doesn't work...especially not with gas prices :-)! The bad thing is walking around WalMart last night is I saw a lot of people just like me, morbidly obese. It is so sad to me that this surgery isn't easier for people to get if they need it. Seeing those folks renewed my wanting to do this. I want to be healthier and I want to look better :tongue2:. My hubby was helping me take off my bra last night cause it was hurting so bad on my shoulders, he saw the bruises the straps had caused and he just said, you need this surgery, you are going to feel so much better very soon. He is a sweetie, said what I needed to hear! Laura

Asking a question is good, but I recommend you do extensive research from major bariatric surgery center of excellence hospitals, JAMA, ASMBS and other respected publications, attend a WLS informational meeting, WLS support group meetings and discuss your findings and concerns with your PCP and surgeon to address your specific medical needs. Good luck.

All plans are different. When in doubt, contact your dietician or look at your bariatric food stage paperwork.

Wow, thank you! I sleep on the couch right now because I am in between beds at the moment. I do not have a recliner but will def check sales! Did you stock up on protein shakes or anything before surgery? Im not sure what to get. They said to buy some now and try it so I would know what I like but I can not afford to just buy a bunch of them. I am planning on getting the bariatric vitamins.

Hi Ladies @Djmohr: That's so amazing to hear that your medical issues are now gone. This is why Bariatric Surgery saves our lives. Thank you for welcoming me. ???? I will definitely take you up on your offer of support. Ahhhhh I'm so excited and scared too. Soooo many things will be happening soon. @Daisee: congratulations on your recent surgery!!! Woohoo!! How are you finding things so soon after? Do you have any pain and how is your eating? My main concern will be lack of Vitamins. I will be making sure to get every Vitamin in me and drink all of my water/liquids. I just met my nurse last week and dietician and it was serious information overload. Lots to do before surgery in October. But I am up for this challenge for sure. Anyways I will let you go for now, I need to finish painting my nails. Hehehehe. Thanks for your messages. ????????????????

you're doing great! my bariatric doctor has a very balanced approach too. how are you feeling with getting some weight off?