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When I first met my surgeon in April and asked how many sleeves he had done it was 12. He had been doing them just over a year. However he has done over 650 bariatric surgeries, 2/3 of his practice is this. He is specialized in laproscopic surgery and does NO open surgeries. I asked to meet someone in person who had the sleeve and they set me up with a mentor. She thinks she was 5th or 6th of his sleeves. She is now a year out. I am not sure how many sleeves he has done between April and August but my NUT told me no one is going lapband and all want the sleeve now - problem is a lot of insurances still don't cover it. He was asked in support group this month if he had a favorite surgery to perform and he said bypass. He didn't press me to do one surgery over the other and basically let me choose. I didn't have any co-morbidities and my BMI was high 40's. I think experience isn't just in the particular surgery.

I understand your concern. Dr Kim did my sleeve 4 years ago. One thing I know about him is he is VERY thorough prior to surgery. He requires all patients to do cardiac testing and if you have a family history of heart problems he will make you see a cardiologist. If he feels you need a sleep study he will require it. If he wants primary care physician notes on you the office will get them. He has done over 6500 surgeries and has been in bariatrics since 2003. He would not have you go to a outpatient facility if he felt you were high risk and needed to be in a hospital setting. If you meet all criteria to be able to go home, they will allow you to go home. But the criteria is strick. You are in great hands! Dr Kim truly cares about you.

You are doing a great job Zinhaa!! Don't let the silly hunk of metal aka the scale rock your world, like so many things in life it is unreliable LOL!! I see you are from LI, NY, I am from Queens but my doc is on LI. I used NY Bariatric Dr. Holover, who did you use?

Yes agreed with the previous post sme Insurances cover plastics esp after Bariatrics...

every insurance company is different as far as what is required. are you going through your insurance or self-pay? my insurance requires a letter of medical necessity from my PCP, 6 month weight-loss monitored program through PCP, surgeon consult, lap-band seminar, nutritionist consult, and psyc consult. i've done all but the psyc b/c it's hard to find one who does bariatric consultations. i finally found one yesterday and i'm scheduled for next week. i'm nervous though b/c i'm afraid they're going to find a crazy gene or something! :smile: right now i'm taking phentermine briefly before surgery to help with pre-op weight loss. i'm also trying to get the nerves to start these Protein Shakes. i hate milkshakes, so i really will have these... i love smoothies though so i'm going to try to make those instead. :biggrin:

I am not on optifast but bariatric advantage. I cannot have herbal teas :-(. I have 3 shakes, two bars and I can have sugar free jello and Popsicles and one small banana. I just want to start so I can get to the big day! Preop begins tomorrow!

I had a great experience with the hospital and the Bariatric team. My bad experience was with the anesthesia team, and the customer service people afterward. I woke up in recovery and they told me that they chipped my teeth taking the breathing tube out. I was told a dentist would visit me before discharge. That didn't happen. I shouldn't have left the hospital without a plan to get them to commit to the repair(turned out they broke two crowns). Calls in the weeks afterward got me promises to look into it with no return calls. Later the hospital denied there was any problem and even went to far as to engage in lies and cover ups stating the teeth damage were noted in a report prior to anethesia. When I stated common sense would state that if such a thing happened that I would probably have been required to sign this prior to surgery, their tune started to change. After Surgery the surgeon came out and told my wife that this had occured. Next I had my dentist fully document the damage and give detailed records of my visits. I have great dental insurance and take full advantage of it. The damage would have cost $1200 to repair. After continous delays, I finally wrote the hospital a letter stating I needed their decision by a specific date or I would persue other methods of compensation. This finally got them to authorize the work by my own dentist. That was completed in June. The Hospital was great, the Bariatric staff was also great, but I wouldn't trust the administration one bit. I'm glad my wife was with me.

Hi all I had a VSG on 12th August and then developed a volvulus which they tried to fix endoscopically but it failed then ended up being given a bypass on the 21st. So I hadn't read as much about the bypass and all it involves because I had no idea I was going to end up with one The Bariatric nurse rang today and said I need to be on 80g protein a day instead of 60g as with the sleeve. So, my issue is that the protein shakes (slim fast etc) are making me feel really unwell an hour or so after having them and I am guessing it is the high carb count in them even though they are sugar-free. So I am trying to avoid them. Also Vomiting... WHERE HAS IT GONE!? Vomiting is pretty much just a burp and a tiny amount of bile!? I have whey Isolate unflavoured, which I am making up my protein milk with (and some dried skim milk powder) and adding it to some of my drinks too. I will go and read through this forum re: food etc but is anyone making their own fresh soup, adding protein and straining? Cheers

I just learned my surgeon that I have my consultation with on Monday has performed over 1000 bariatric surgeries which includes 100 of those being the sleeve. He comes highly recommended and his facility is a Center of Excellence. He has had no leaks, no deaths, but one stricture. Should I be concern about the one stricture and what questions if any should I ask him about it? Any input would be helpful. Deb

I think there are a lot of unanswered questions still. I did find this review article from 2013. A review article is not the results of a study - instead, they take an expert in the field and ask them to look across everything that is known at that point in time and to summarize it in one report. Review articles tend therefore to be more reliable than a single study. It's not right up to date, but it's fairly current. "Nutrition Care for Patients with Weight Regain after Bariatric Surgery", Carlene Johnson Stoklossa and Suneet Atwal, Gastroenterology Research and Practice, Volume 2013 (2013), Article ID 256145, 7 pages. http://www.hindawi.com/journals/grp/2013/256145/ If you read section 1.3 (Energy Requirements), you will see that they are reporting reductions in resting metabolic rate beyond what can be expected from weight loss alone, in patients having bariatric surgery.

Hi LondonHawke - on the metabolism side of things, I don't think we escape the slowdown - when you look at two factors: Weight loss rates gradually slow, and total weight loss tends to level off with time, at roughly 60% of excess weight lost, on average Patients eat a good deal less than would be expected for a person of their age, sex, height and weight I actually asked the guy who became my surgeon this exact question in one of the pre-surgery group info sessions - is the metabolism permanently slowed, given the above, and does that explain why people stop losing, and why they need to continue eating so little? He didn't really answer - not sure if he didn't know, or if he thought I wouldn't like the answer. I understand that as our weight drops the calories required to operate our body at rest should drop to match the actual calories we consume, but the article seemed to indicate that the TBL contests actually had a change in that their bodies metabolic resting rate was lower than the norm of an individual of the same size ie. their body lowered the resting rate in an attempt to help itself adjust back to its programmed weight. It seems to imply that even if they kept up their rigorous exercise routine they would have regained weight or had to increase the exercise level in order to maintain. My question is that TBL contests would technically have the same amount of grehlin in their body regardless of their existing weight, we don't our chemistry has been altered so will or do we suffer the same consequence. That's correct - metabolism slows during weight loss - this is well established - the body is trying to preserve your weight at your previous equilibrium point. What's new here is just how big the shifts were, and how long they lasted - for these people at least, they appear to be permanent, having lasted 6 years. The subjects had their resting metabolic rates measured repeatedly over the study, and they declined steadily - and yes, far more than the weight loss would be predicted to cause. Now, these people in the study had extremely rapid weight loss, of a very large amount, so bariatric patients won't necessarily be in the same position quantitatively - in fact most bariatric patients maintain most of the weight loss they achieve. However, I am almost certain that the same forces are occurring in us at some level though. That's why weight loss is slowing down over time and levels off normally. As a man of 56 at 6 feet tall and my current weight of 241 pounds with light activity, I should be able to eat 2300 calories per day and maintain weight, according to the calorie calculator at Mayo Clinic: http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calorie-calculator/itt-20084939 ...I can't do that though, and yes, these calculators used to agree very well with my experience. Ghrelin affects hunger, but not metabolism. There is a whole suite of hormones producing the sensation of hunger, because that's critical for survival. The writeup mentions leptin, which causes you to feel satisfied - this declined in the study subjects.

Sure thing! That's the stage I'm most worried about too, so I'll definitely be taking my own advice lol I'm thinking I'll also try some recipes I've found on various bariatric sites for the pureed/blended stage. I"ll attach a file with the ones I've found so far (also include some protein pudding recipes that I want to try) Blended_Pureed Recipes.pdf

Sleeve101, I just read all your posts and learned: * Pre-op, you were anemic (low red blood cell count), and your Mexican surgeon almost didn't do your surgery, but relented and did it anyway. * You may not be measuring or tracking your food (although not sure about that). * You have had a tough time emotionally post-op, but haven't yet sought medical or counseling support for your distress. * You have federal BCBS insurance, which has pretty good insurance coverage. I strongly encourage you to find a counselor or therapist who's familiar with bariatric patients' issues and journeys who will support you through this tough time you're having. As you know you can't get your original stomach back. So it's time to learn how you can move forward with this new lifestyle. Many, many people have done very well post-op. You can, too. You don't have to remain miserable. It's your choice.

Yep, I was approved in 3 days...I'm Tricare Pirme South as well and they are covering everything EXCEPT for my excercise exam, which is required. So I have to shell out $60 when I go on Monday for my pre op testing. Has any one else heard of this? I am having my surgery done with South West Bariatrics in Austin, TX.The patient advocate said that Tricare doesn't cover the exercise exam, so we have to pay out of pocket up front. No biggie when you consider the whole cost of everything, but still...I wasn't expecting it...you know? :thumbup:

Hi! I hope you are doing well and are making progress towards your weight loss surgery goals, whether they are to get surgery, hit your goal weight, or maintain your new healthy habits. As you know, support is crucial to your success in this journey. BariatricPal is one of the places you can go for support. In-person support groups can be another important factor in your success. When you meet people every week or month, you can look for the following benefits. A greater sense of camaraderie – you’re not in this alone! Accountability – seeing other members in person can be more motivating. Personal growth – opening up in person is much harder and more rewarding than staying anonymous over the internet. Deep friendships – the people you meet in support groups may be the people you call to go walking or just hang out. Most surgeons recognize the value of support groups and many require or ask their patients to attend. Still, not all bariatric surgery patients get enough in-person support. Thousands of pre-op and post-op bariatric surgery patients use BariatricPal’s online forums every day. Now, BariatricPal is providing another way for you to build your support system. BariatricPal Local Chapters is trying to bring face-to-face support groups to your area! Members are the same members of BariatricPal who are there for each other day after day online. Now, you can extend that support into your real life. When Meetings run by your peers in a friendly and helpful atmosphere. In-person support to supplement support from other groups. Members whom you can talk to any time between meetings online at BariatricPal. The same values you get online at BariatricPal. Go to BariatricPal’s Local Chapters page to look for a group in your area. If there is not yet one that is near you and convenient, don’t worry! You can suggest one or start one in the Local Chapters Forum. BariatricPal has plenty of support for anyone who wants to become a Local Chapters Leader – no experience necessary! I hope you will consider joining or starting a BariatricPal Local Chapters group. Please post on the forums or send me a private message to get started. I can’t wait to see what this Local Chapters program can do for our members. Thank you for your support of BariatricPal.

That's a good example of why not to tell...I only told two best friends and one family member, and was supported. I did not want to hear all the "what if"s from others. I did my own research, and it sounds like you did too. As a nurse for over 30 years, I am VERY cautious and researched the medical journals as well as surgeons who do bariatric surgery. My decision to have the sleeve, and which surgeon to use, was based on FACTS, and I also listened to what people said on this forum, some of whom were very biased one way or the other. But I just listened, and then made up my own mind, mostly based on the FACTS that I learned from medical journals and credentials of surgeons. Trust your gut. Don't try to convince or change anyone else's mind or you will become more frustrated. Personally, I would not even discuss the issue with non-supportive persons. Just make up your own mind after you have studied the FACTS, and do what you think is best for YOU. If others approach you with negative comments, just thank them for caring about you, don't prolong the conversation, and proceed on with your plans, what ever they are. We are here to support you, what ever you decide. Keep in touch, read as many posts on this forum and on Obesity Help (where you can find surgeons' credentials), and you will be on the right road!

My primary care doctor told me that there is a very high percentage of bariatric patients who become addicted to alcohol after surgery. He said that basically one drink for us has the same intensity of five drinks for someone without the surgery and that it is easy to become dependent on that. I don't know if he has any studies to back that up. But it seems to make sense to me.

I think nutritionists should ditch the standard advice - if the nutritionist is going to dish out standard advice the patient can as well refer to a high gloss booklet. Costs less money and might be more informative as well in some cases. IMO nutritionists should give out tailored advice. For standard advice: see a booklet. When visiting a nutritionist when it comes to bariatric surgery I demand that the nutritionist is able to do a few things: - different surgeries and the challenges that come with them, this includes supplement advice according to bloodwork - different dietary approaches (e. g. the low carb approach vs. the pound of cure) - being able to advice patients of different cultural backgrounds when it comes to food choices - being able to change gears when one approach obviously doesn't work instead of scolding the patient and telling him to "just try harder" - being able to cater to different dietary preferences of patients (might not be a good idea to advice patients to eat more fish when the thought of eating fish makes the patient want to gag, you maybe also shouldn't advice "lean meats" to a vegetarian) - being able to incorporate the patient's activity level and lifestyle into the dietary advice (e. g. shift workers, patients with high activity levels)

Thank you!! Yes, being consistent with recommendations and staying with the same provider is a key aspect to keep in mind, in the case of bariatric surgery being so personal having the same nutritionist during follow-ups would better help patients.

Have you heard anything? I called BCBSIL today. The Customer Care Agent said they did receive it today (I was told Monday when I called that it could take two days for it to show up in their system). My surgeon's office said they didn't get it out and will be faxing it on Tuesday. BCBS agent said there are no notes on it yet, and it's before the medical review. She told me there was about 28 pages that they received from my doctor. She said they are told to tell people that there could be up to 30 days to review and has had many other people calling in the past regarding bariatric services.. I asked her when I should call again, she said maybe about 7 days. I told her I'll probably call back on Monday, she said no problem.

Hi All, I have the Sleeve about 16 months ago and had an overall good result, lost about 55% of my excess weight. I was pretty surprised though that I really never had much feeling of restriction after the surgery, never got sick, never felt overly stuffed, and my hunger only decreased moderately. I kinda felt like most of my weight loss was really attributable to the lifestyle changes I made associated with the surgery, although it definitely helped some. I recently was diagnosed with an inflammatory spine disease for which the only real treatment is aggressive weight loss and moderation of inflammation. I'm considering having a revision of the sleeve or conversion to a bypass and would really like to find someone great in the Los Angeles area. My previous surgeon was fine operatively but didn't really listen to me and I'd be hesitant to discuss my current situation in that setting as this feels like a really big decision given my recent diagnoses. I'm considering Dr. Feiz and Dr. Dorwaiswamy. Any other great people I should consider who are great surgeons but also willing to spend a minute listening to concerns?

Around 20 years ago my dad died. My mom was a home body. His death affected her greatly and I was concerned she might decide to follow him soon. I told my mom to join some clubs because she needed contact in the outside world. She followed my advice and joined a book club and a church club. This helped her and allowed her to make some friends that followed her throughout the rest of her life. The second thing I did was to send my youngest daughter to live with her for the summer. My youngest daughter wanted to become a doctor and I figured the best approach was to have her work as a volunteer at a hospital during the summer so she could get some experience. She was in her early teens at the time and couldn't drive. And the hospital was close to my mom's house. So I felt it was killing 2 birds with one stone. My daughter would get some experience that could someday help in her career. My mom would get companionship, she would get purpose (driving my daughter to and from the hospital). It worked well that summer so we repeated it the next summer also. My daughter is a medical doctor today, in part because of this. So if I offer some advice, it is to get involved in some club or group. To begin with are you attending Bariatric Surgery Support Group Meetings? Generally they are free and are held once per month. But there are a variety of groups out there such as computer group meetings. Sometimes groups hold their meetings at libraries. That might be one place to look.

Holy hell! this is a long thread. Some people for plastics, others not so much. I looked into it, I just can't afford them. No one here has to apologize or justify the reasons they choose to have a medical procedure. Dang, how many of us have been judged for having bariatric surgery? The only thing I want to leave here for newbies..... Is the loose skin is not as bad for me as being obese. it's livable. If your fortunate to be able to have insurance coverage or afford them. Go for it if it makes you feel better about your situation.

Honestly, they can't force you to see this internist. I would keep going to your endocrinologist (I'm sure that you are), and I would find another bariatric internist recommended by other patients and let the bariatric surgeon know that is where you'll be doing your follow-up care. Are you also seeing a registered dietitian (RD) who specializes in bariatric patients? If not, I would definitely find one. I am a slow loser also and my RD is really my most important post-op coach. I don't know what I would do without her. Diet is about 75% of what will make or break our success, and it takes on even greater importance when you are limited in the exercise that you can do as you are, so I would see if there are any tweaks that you can do to help there. Obviously I know that you are working very hard and your weight loss isn't a reflection of that, but at the same time, there is always room for all of us to tweak and optimize what we can. I would really, really focus on getting at least 60 to 80 g of Protein, even if you have to do more shakes, and try to drink at least 100 oz of Water. An RD will have lots of specific ideas for you that work for you, your lifestyle, and the particular preferences of your sleeve.

Between Friday and Saturday I almost talked myself out of this but today I feel a lot better The bariatric Group that will be doing my surgery said that they are not members or providers under my insurance and well according to my insurace in black and white yes they are the letter I got from the bariatric Group said I woul;d be responsible for what the insurance will not pay but according to my insurance as long as they are in my HMO paln and they all are that I will never see a claim and I will not have to pay out anything other than my co payment for the hospital well after reading that letter i just got depressed for I don't have 3500.00 so I have to wait until tomorrow to clear this all up and all I have been doing is crying and not eating