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I can't believe I'm even writing this. I had heard great things about Dr. Arif Ahmad and Long Island Laparoscopic but after my various interactions with the office, medical staff and the group meeting, I'm seriously considering looking elsewhere. My initial consultation went wonderfully, I felt comfortable and excited for the next step. Then...the other shoe dropped. I scheduled my first battery of tests (blood work, pulmonary, ultrasound, nutrition and psych evaluation) and off the bat something was wrong. I'd speak to one receptionist/scheduler who would tell me my insurance won't allow me to do everything on the same day so she schedules the tests on various days - then I got a call from someone else who asked why I did it this way and when I said someone in the office had told me to do it that way she said "oh, don't listen to her...she doesn't know anything". I scheduled everything for 10:45am (I had planned other things later in the day), I got a call 3 days prior and was asked to come in at 12:15pm as they had a scheduling issue (I rescheduled the rest of my day). I then show up at 12:15pm and was told everyone had been waiting on me! They rush me into the room for blood work, then into another room for the ultrasound then a 3rd room for a pulmonary test. I'm then told due to a scheduling error (again) I have an hour and a half until my next appointment. The nutritionist, bless her, was a fresh faced college grad who clearly had never struggled with food or weight and spent 20 minutes telling me about sugar free Jell-O. I was then rushed into a meeting with the psychologist (who is not a psychologist but a licensed master social worker - not the same). She spent, at max, 30 minutes with me (10 of which were telling me it's her birthday and then she was fielding calls from her mother) asking if I've ever been suicidal, what diets have I tried and have I decided who is going to drive me home from surgery. I was disheartened and confused -- I have friends who had the surgery with other doctors and who had wonderful pre surgical experiences, that's what I was hoping for. But, I thought "hey, you've already spent the $250 program fee and you have the group meeting tomorrow...it could turn around!". I just left the "support group" and I'm completely disappointed. The "meeting" started with a 30 minute sales pitch from a Bariatric Advantage salesman. We were then "discussed" surgery...by discussed I mean we sat around in a circle, introduced ourselves and talked about how we can't drink after surgery. WHAT? I didn't come here for AA, I came to ask questions and be informed. The "group meeting" was again run by stick thin dietitians, not people who have gone through surgery and could give first hand experiences. Bottom line...I don't feel comfortable. I don't think this is a competent group of people and I don't want to put my life and future into the hands of a bunch of halfwits. I run a business and had been conducting my meetings/schedules (I perform wedding ceremonies) based on the idea that I'd be having surgery in the middle of July, now I have no idea if that's possible and I could have potentially lost hundreds of dollars from clients. Has anyone switched surgeons? Is anyone familiar with Dr. Arif Ahmad? I'm thinking of using Dr. Brathwaite at Winthrop - any tips?

Yes GA Medicaid will cover it. 100 pecrent if you meet the qualifications. You have to find a bariatric center that they approve, do 6 month diet with a nutritionist, a sleep apnea and a psychological exam.

I find it amazing that a Kaiser dietician would make such a ridiculous statement. With a very short list of exceptions, I eat anything I want to eat. The success of the surgery is not about what you can or can't eat. I find it unforgivable for a healthcare "professional" to suggest otherwise. It's about what you choose to eat. Or not eat. Lifestyle changes. Apparently Bariatric Pal should be required reading for bariatric dieticians - for life!

My therapist asked me what food I felt like I could not do without post-op. Pizza was the only thing I could think of. Once you can eat foods - there's some great bariatric friendly pizza recipes. My therapist suggested a portabello mushroom filled with pizza toppings. Stay strong!

Hi Mare, I have heard of a band being placed after a failed RNY; however, the sleeve wouldn't be an option. I wondered though, have you checked out a procedure called the ROSE procedure? I will copy and paste what I found below: ROSE Procedure, Restorative Obesity Surgery, Endolumenal, obesity surgery, gastric bypass, Albany, Macon, Columbus, Dotham Restorative "Incisionless" Obesity Surgery Even the most successful gastric bypass patients occasionally regain weight [/url]New surgical technology now allows surgeons to treat one of the potential sources of this weight regain. The ROSE procedure (Restorative Obesity Surgery, Endolumenal) provides an incisionless surgical option to restore gastric bypass patients' anatomy to closely match original post-surgery sizes Dr. Bagnato performs the scar-free ROSE Procedure (Restorative Obesity Surgery, Endolumenal) entirely through the mouth without making any external incisions into the body. Eliminating incisions means less risk than traditional open or laparoscopic surgery, minimal post operative pain, fast recovery time and no scarring. Patients generally report minimal or no pain after the procedure and many of them return to work and normal activities the next day. Who is eligible? Patients who originally lost significant weight following gastric bypass but who now find themselves regaining weight may be ideal candidates for this procedure. After an initial screening, you will undergo a series of evaluations including nutritional and dietary counseling, a full medical exam, and endoscopy to determine if you are a good candidate. What does the ROSE procedure entail? The ROSE procedure is performed with the patient under anesthesia using a four-channel tube and special Incisionless Surgery tools. The bariatric surgeon advances the flexible tube and a small endoscope through the patient's mouth, into the stomach pouch. The surgeon will then insert the surgical tools through the channels of the tube. Tissue anchors are used to create multiple tissue folds around the stoma to reduce the diameter. The surgeon will then use the same technique to place anchors in the stomach pouch to reduce its volume. Are there other treatment options available? To perform the initial gastric bypass, the bariatric surgeon creates smaller stomach "pouch" and then bypasses the top portion of the small intestine. The procedure leaves a significant amount of scar tissue behind. This scar tissue makes traditional or "open" revision (performed through an abdominal incision) surgery far riskier than the original surgery. The most feared complication of gastric bypass - a leak, an incomplete tissue connection that allows the stomach contents to spill into the body - is four times more common in revision procedures than in the original bypass. Most surgeons don't perform open revisions today because of the risks. In recent years, many medical device companies have developed new tools that allow surgeons to operate through the mouth. We've chosen a set of tools known as the EndoSurgical Operating SystemTM (EOS) because the system's sutures and tissue anchors distribute holding force across tissue, leading us to believe that they will hold longer than other tissue fasteners. The EOS is also unique because it allows us to reduce the size of both the pouch and the stoma. How long will you need to stay in the hospital? Hospital stay is determined on a case-by-case basis. You may be discharged the same day if the procedure was done early in the morning or Dr. Bagnato may want you to stay overnight. Your surgeon will make the determination following your procedure. What are the benefits of an Incisionless procedure? By eliminating skin incisions, the new procedure may provide important advantages to patients, including reduced risk of infection and associated complications, less post-operative pain, faster recovery time and no abdominal scars. What type of side effects can I expect? It is anticipated that patients will feel little or no discomfort from the procedure. To date, the only noted side effects have been short-term sore throat, swelling of the tongue or lip discomfort from the insertion of the instruments into the mouth. These issues usually go away in one or two days. Is it safe? As with any surgery there is risk involved. This less invasive approach should reduce the likelihood of many of the complications associated with the other open or laparoscopic revision procedures. ROSE is a new procedure, however, and long term outcomes are unknown. What is the success rate? As with any weight loss procedure, results vary with each patient. The ROSE procedure has been well tolerated and most patients immediately lose weight as they eat less - with the return of the early feeling of "fullness" due to the restriction of the new, smaller pouch. The ROSE procedure is new and long-term data are not yet available. What is the recovery process? Typically, patients return to normal activity within a few days of their procedure. Dr. Bagnato will give you specific instructions. In addition, you will be required to follow a post-procedure diet and exercise plan, similar to the regimen prescribed following your initial bypass surgery. This generally means that patients will need to consume only liquids for a day or two after the surgery, and then slowly add soft, pureed foods for about two weeks before resuming a regular diet. To help you on your journey, follow-up appointments with Dr. Bagnato and regular visits with our bariatric support staff will be required. Laparoscopic Bariatric Surgery LAP-BAND System REALIZE Band Advantages of LAP-BAND LAP BAND Adjustments StomaphyX procedure ROSE Procedure Weight Loss Procedure Videos Weight Loss Surgery| Meet Our Team| LAP-BAND System| REALIZE Band| StomaphyX proced

That's awesome. I have BCBSIL PPO and the surgery is covered under my employers contract. It has to be deemed medically necessary! Well, I fall within the guidelines of what BCBSIL require >40 and I can see a Master's Degree or higher NUT to say I'm mentally stable and understand what's expected before, during and after surgery. But ... My surgeon, through Cadence Health Bariatric Treatment Program, @ Central Dupage Hospital is having me to meet with my PCP for bloodwork and a letter stating there are no medical contraindications to surgery and a release to exercise, NUT, Pulmonologist, consult with an Exercise Specialist prior to surgery, Gastroenterologist eval or blood test to screen for H.pylori, an ECD and attend at least 1 support group. This along can take months. Is all this needed to help with the approval from the insurance company? These are all things your surgeon requires to ensure a successful outcome. This is major surgery and lifestyle change. You have a surgeon who wants to ensure success.

Hi James, good to have you on here! I'm in Mayo and had a gastric sleeve in the Galway Clinic a little over a week ago. Whereabouts on the bariatric journey are you? HW 365 CW 332 GW 220 Sleeved 6th March 2018

I can't speak for others, but I review requests for bariatric surgery as part of my job. Typically the documentation is included in two places: your psych eval, and your surgeon's note. Some surgeons even use a checklist with the more common diet programs out there. As part of the evaluation process, both the psychologist and the surgeon review previous attempts at weight loss. I actually wrote it all down for my doc in table format, along with how much I'd lost and how long it lasted. I did that as a useful exercise for myself, mainly, but it makes it easier for the surgeon to get a grasp of the big picture. The only time you would need to provide proof is if your health plan requires documentation in a supervised weight-loss program for a specific period of time before you can be approved. I hope this helps!

Any news on your revision nikki2524? Are you feeling any better? That's strange, that nurse telling you since your body wouldn't use the calories to go ahead and eat anything. Doesn't sound like any Bariatric nurse I've ever met. Sent from my VS880PP using BariatricPal mobile app

I was in quite a state last night when I discovered, in just googling Lahey Clinic and one of the surgeries my posting in one of these forums. "Beside myself" comes to mind. To think of all the very personal and generous shares people post in these forums, believing only others considering or having had weight loss surgery could read what they wrote or perhaps see a very personal photo... It never occurred to me that people who I have not told I am going to do bariatric surgery yet could google a hospital and discover my post on the forum without finding the forum to begin with or joining it. I have deleted my photos...and will just use my nickname, mojaleski from here on...and hope to continue participating because it is so valuable to me, although I am still very new. I am feeling confident about the surgery...now hoping to have the sleeve after discussing at length with the nurse practitioner at Lahey. It seems the most prudent option for me, given my age, osteopenia and family medical history...so if my upper GI fluoroscopy is okay that is the direction I will keep heading. I am also a good candidate for the band so it is still an option. Started weight loss plan today too...tracking my food...and will be joining a health club so that I can exercise, in earnest. (argghhh) Hope you all have a wonderful weekend. me

Hi Su. Yeah, I'm not surprised nobody at Dr. Amson's office got back to you. Their office admin is a mess - in fact it's one of the reasons I gave up on having gastric bypass. All worked out in the end, though - I am deliriously happy with my band and soooo glad I didn't go the RNY route, even if I did have to pay for the band myself. Worth every penny! In any case, it's possible that the support group offered specifically for Dr. Amson's patients might not accept patients who have had lapband or bypass done by another doctor (Amson only does RNY). However, there have got to be other, more generic bariatric support groups in your area, and it's just a matter of finding them. Hopefully if you can reach someone at Amson's office they can give you some info on that. Are you aware that there is a bariatric conference going on in Victoria the weekend of March 27-28? First of its kind on the island, apparently. It's called Beyond Bariatrics, I think, and anyone who's had any kind of bariatric surgery can go. Registration fee is $120 and includes dinner Saturday night. I'm attending. Google "beyond bariatrics victoria" and you'll find the link.

Is your insurance company paying to have the band removed? My surgeon refuses to talk to me about removal of my band even tho I am vomiting for 3-5 days STRAIGHT (no food and unable to take meds) EVERY MONTH. He tells me the band is fine... move on to another idea (like see G.I. doctor which I have done with no solution or even a diagnosis). He also tells me that "the board" wanted to fire me as a patient... basically refuse to treat me or even discuss what might be happening to my body with me. While in the E.R. this same surgeon yelled at me, and my mother, telling me that if I don't get myself under control nobody is going to help me. At this point I've lost my job, had to cash out my 401k with major penalties, and I still don't have a proper diagnosis and none of my doctors have a plan for controlling the monthly vomiting episodes. This bariatric surgeon, after telling me to "move on", then said, "do you want me to talk to your insurance company about taking it out based on your personal preference?" I'm having to apply for disability because a person who is vomiting/retching so hard, to the point of losing bladder function, is not employable. I'm not saying the band is causing this cyclic vomiting/abdominal migraine but I find it really hard to believe that after a year of this my surgeon will not discuss removal of my Lap-Band. It is as if it belongs to him, not me.

My pre-op diet started today 3/18 anc consists of Bariatric Advantage shake for breakfast and lunch. If I want a AM snack it is to be 6 oz tomato juice or low cal vit c fruit juice. At night I can make dinner or some of the low card ww meals, lean cruisine, etc. PM snack can be 1 oz cheese and fruit, or yogurt and nuts, or another protein shake. I was a bit hungry come dinner time tonight but I think this will be liveable. Only 26 more shakes still surgery.

Hi Laney. I don't know if I have much to offer you, as my surgery was 11/29 but my bariatric RN said to wait till Monday to introduce the chewable vitamins. She said one a day for a couple of days then increase as tolerated. She did say break it up in your protein shakes. Maybe that will help? Hope you feel good today. I've been told every day is a little better than the last!🎉

There are many brands of protein shakes and powders and each of them offer many flavors. Just do a google search to see what is out there. The prices varies from reasonable to ridiculously expensive, so shop around. Many can be found at Walmart or ordered online from the manufacturers or Amazon. My clinic recommends these brands (but I've tried many others): Premier Protein Ensure Max Equate High Performance Atkins Plus Musle Milke Genuine, Muscle Milk Light Boost Max Fair Life Core Power There are even high protein soup powders from ProtiDiet and Bariatric Advantage, and others. The variety is vast. Some you will like, some you won't. If you don't like something today, try it again in a week. You can also make your own high protein shakes. There are lots of recipes online, using unflavored whey protein powder mixed with milk or water, like GenePro I prefer plant-based unflavored powder, Like Orgain or Pure Protein. You can add protein powder to just about any liquid, even your coffee or tea or bullion.

For most people, this drug is about as harmless as a drug can be. It wakes you up, keeps you mentally sharp, and even helps you burn a little extra fat. There aren’t many serious health risks, as long as you don’t have too much. For weight loss surgery patients, though, caffeine is a bit of a bigger deal. Find out what it can do to your body, how much is safe to have after surgery, and where to find it. Caffeine and Your Digestive Tract Caffeine is an acid, and it can irritate the lining of your stomach pouch or sleeve. This is true whether you have the lap-band, vertical sleeve gastrectomy, or gastric bypass. One way to prevent symptoms is to make sure you don’t have your caffeine on an empty stomach. However, that’s not really possible when your weight loss surgery diet doesn’t allow you to have beverages at the same time as solid food! Limiting your consumption is the best way to avoid trouble. Caffeine and Acid Reflux Acid reflux occurs when acid from your stomach comes up into your esophagus or throat, causing symptoms like heartburn or an acid taste in your mouth. Acid reflux is considered gastro esophageal reflux disease (GERD) if it persists. Weight loss surgery often helps with GERD, since obesity is one of the main factors. However, you can still get GERD after weight loss surgery, especially if you have the lap-band. What does all this have to do with caffeine? Coffee and other source of caffeine are among the foods beverages that make acid reflux worse. There are plenty of other risky foods, such as citrus fruits, spicy foods, fried foods, and garlic. If you do choose to have caffeine, just be watchful for signs of acid reflux and ask your doctor if you think there may be a connection between caffeine and your symptoms. Does Caffeine Dehydrate You? Staying hydrated is a big deal after weight loss surgery because it’s so important and so tough. It helps keep you full and healthy, and you can only do it if you plan carefully and pay attention to your fluid intake. Coffee and caffeinated diet iced teas and other drinks may seem like a great alternative to water, which can get pretty boring. Unfortunately, caffeine is a diuretic. That means it increases the amount of water your body loses. That means it helps dehydrate you. It’s not a serious problem if you don’t have too much caffeine and if you’re drinking plenty of other liquids, especially water. If you’re already struggling to hit your 8 to 10 cups of water a day, though, you might want to think seriously about skipping the caffeine so you don’t get dehydrated. Caffeine and Your Nutrient Status One of the most serious problems with too much caffeine for bariatric surgery patients is that it interferes with nutrient consumption. This comes at a time when you’re fighting hard to give your body the nutrients it needs through healthy eating and supplements. Caffeine reduces your body’s absorption of two key nutrients: calcium and iron. Miss out on your calcium, and you’re at risk for developing osteoporosis and a high risk for bone fractures later on. Skip the iron, and you could get anemia, making yourself tired and weak. If you do choose to have caffeine, make sure it’s not at the same time you’re taking your nutritional supplements. How Much Caffeine Is Safe? There’s no single recommended amount of caffeine that’s best for everyone. The right amount for you depends on a variety of factors. How it affects you. The type of surgery you have. Your surgeon’s recommendations. A good amount for many bariatric surgery patients who can’t face the thought of quitting might be a cup in the morning to get you awake. Cutting Back on Caffeine If you’re addicted, cutting back on caffeine can be challenging. You can get some headaches, feel groggy and cranky, and get constipated. These symptoms only last a few days, though, and you can use them as motivation to take good care of yourself. That’s because healthy behaviors like getting enough sleep, exercising, and drinking enough water can help reduce withdrawal symptoms. If you’re trying to have less caffeine, it’s helpful to know the sources. Everyone knows about coffee, but there are plenty of other places where you might find caffeine. Hot and iced coffee and coffee drinks. Hot and iced tea. Diet and non-diet energy drinks, including 5-Hour Energy. Some over-the-counter migraine, pain, and cold and flu medications. Caffeine has a lot of uses in everyday life, and it’s not necessarily a bad drug. But, after weight loss surgery, it can be a problem if you have too much. If you love your coffee, ask your surgeon how much you can have to make sure you don’t harm yourself while you’re working so hard to get healthy and fit.

I was just reading what another patient, age about 40, wrote pre-op about her wls goals. She said that she wanted to fall in love and get married. NOT that she wanted to be healthy, or to move better (her pre-op BMI was around 55), or to be able to fit in normal-sized places, or to NOT be pre-judged by strangers based on her obesity, or to be able to go shopping without becoming exhausted or needing a helper, or to NOT base her restaurant choices on which ones had armless chairs, or to be able to go out of town and know that if her luggage was lost she could buy clothes...etc. Nope, she had an adolescent, romantic vision of what wls would do for her. So, after this woman lost a considerable amount of weight and got down to a BMI of 27 or so...and she hadn't found Prince Charming...she picked up drinking as a substitute behavior...and regained to a BMI of 35...so far. I would HOPE that any mental health professional or bariatric surgeon would recognize that having the dream of falling in love and getting married at the top of her list was like a warning flag. This woman doesn't know who she is or what she wants, other than she just wants to be acceptable to a man. WLS does what it does. People who are counting on it to solve all of their problems should be educated on what they can reasonably expect the surgery to do and what needs another approach.

Hi bullwinkle, I "flunked" my MMP and I was told the same thing. They wanted me to take 12 sessions for anger management issues which in my opinion were totally unband related. All of this was really about the shrink's office who was just pissed off that I called a half dozen times after waiting almost a month for test results. I got angry wiht her receptionist since they kept putting me off with no answers and they didnt like me pushing them. I had to find another surgeon since they were tied to a training hospital and I had to meet the criteria even though it wasnt a trial and my insurance was paying. I went to a second shirnk specializing in food disorders who actually interviewed me for two hours instead of taking a test, which was not a requirement for my insurance anyway. She wrote a letter saying that I wasnt insane and although she didnt support bariatric surgery, she felt I knew what i was doing and cleared me on the mental front. I DID on my own go to a therapist post band for almost a year to try to resolve some of my issues. Not anger management, but the other stuff that happens when you lose a lot of weight. I advise everyone who has insurance that will cover therapy to take advantage of that if you can. It didnt solve my problems but it sure helped me to "think" differently. Good luck!!! Babs in TX 334/190 ish 3 1/2 years and counting.... and still insane!!!

Good luck. I agree with the other posts. Read EVERTYTHING you can. That being said, read everything that is valid and reputable. There is a lot of crap out there. When I first started reading and doing research on WLS, I looked at every option and each procedure to see which one was best for how I live. This is a lifestyle change but you still have to account for how you live your day to day life and mesh that with your new habits. This has been a 4 year journey for me and now I will be having surgery next week. 3 and a half of that was me doing some deep thinking, research, and self reflection. The last 6 months has been the required appointments and counseling needed for my insurance and the bariatric center. Think of and ask every question you can, no matter how insignificant or "'dumb" you think they are. I GUARANTEE almost every one in the room has or had the same question at some point. Good luck.

Wow! Thanks y'all! I really appreciate the outpouring of advice here! I got booted off of a male bariatric board for this about a year ago and was hesitant to try again. Winston, I love the advice and your story above. Nut butter were mentioned and I’m down to try those too. Softer foods are definitely better and I do love pasta. I’ve recently started overcooking it to aid the digestion process. Rice is tricky for me. I’ll begin adding in more high calorie filler between meals and work to snack/graze every ½ hour or so. I did undergo Testosterone pelleting and I’m not sure it made any difference outside of “that area” becoming more lifelike (sorry ladies). I have hashimoto’s and I question whether the desiccated thyroid meds are contributing to chronic weight loss. Someone asked where in TX, (sorry I’m not good at stringing replies). I’m in the suburbs between Dallas and Fort Worth. FutureFine Mama mentioned slider foods. Not sure what that is but heading to google to check it out. I was trying to keep it short and not sound like a little baby, so thank you all. I never added that I went from 254 to 120 in less than 8 months and the ride has been terrible since. I really, truly appreciate the replies!!

Okay so I seen a page on Facebook for Bariatrics it works wraps and I don't know if the person I'm talking to has even went through the surgery so what I'm wondering is if there's anyone on here that's used it and what they're doing was only drinking a little amount of water that makes it successful I'm 4 weeks post op and I wanna start at I have six left from a while ago can anybody let me know what they're doing

NO, I used Good Samaritan in San Jose. Here is Doctor McKeen's web site: South Bay Bariatrics & Dr. Robert McKeen

I got my approval! My surgery will be done on March 21, 2011. I'll be going through the Mehta Bariatric Center in NJ and having the surgery done at Somerset Medical Center. Has anybody else used Mehta? He does the surgery with a single incision at the belly button. Now I am nervous. But I am still going to do it! They could have done me in January, but we are going on a vacation in February and my hubby insisted that I wait until after we get back in case there are complications.

I'm not the young studs like you guys are i'm 61 in September but I never in a million years thought that the excess skin would look like this. I think I look terrible without cloths on. But there is no way in the world I will invest the kind of money you have to do to get rid of it. My good friend across the street from me works for a surgeon who specializes in bariatric skin removal procedures. Maybe I can get her to throw me a bone huh?

Just out of curiosity why does bypass scare the crap out of you? I was going to have the sleeve and then because of reflux we decided the better surgery for me was bypass. I was scared to death to because all of the horror stories. I spent some time with both my bariatric team, my gastroenterologist as well as many bypass patients. I was most afraid of the malabsorption component. I then learned very quickly that it actually helps you to lose weight and honestly both bypass and sleeve patients have to have blood work and take Vitamins for life. The biggest thing they warned me about was not going in for yearly nutritional panels and skipping vitamins. As long as you do that which you also have to do with the sleeve as well, you should be good. I am two years post op, have lost all my weight and comorbitities, am very healthy and thank god every day that i went bypass as i have not even had a simple case of heartburn since the day i woke up from surgery. Spend some time and really research so you make the best choice for your health. I have seen way too many sleeve patients then have to revise to bypass anyway. I decided i was only going through this one time in my life. Both surgeries are equally as aggressive. The sleeve removes 90% of your stomach, the bypass reroutes. Just my two cents....take it for what it is worth but don't be afraid, be educated about your choices.