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I know it's not much, but I'm excited to say that I have taken the first step, officially! I spoke to my general family doctor today and asked for a referral to a surgeon. I had already picked out where I wanted to go, based on references from a couple of friends, and research that I had done on my own. But something that I didn't know prior to reading the brochure I was given today, is the surgeon I have chosen, is in a Center of Excellence for Bariatrics! YAY! I was a bit disappointed though, thinking that this would be the first of my 6 month medically supervised diet. Turns out, the bariatric center works closely with a weight management center. So they want all of their patients to go with the weight management center for their diets, and they walk you through the process and all the hoops that the insurance makes you go through. This program though, costs $120, which covers education, materials, and other miscellaneous stuff. Insurance pays for the appointments though. So that's not too bad, but still... ugh. So, I'm on my way! I think I impressed my doctor though. I don't think she was prepared for me to know so much already about the surgery, the options (Lap band VS Bypass), and the lifestyle changes required before and after surgery. Next step is to call the Bariatric Center and get scheduled for a Seminar and follow up appointment! I also got a prescription for Wellbutrin to help me stop smoking. So wish me luck with that! Oh, and I've lost 6 pounds this past month! YAY ME!

Has anyone tried the unjury shakes I keep seeing advertised here on Bariatric Pal?

I have been thinking a lot about how I want not only my stomach size to change, but that i want my dietary habits to completely change for the better. I believe in the power of habits and I need to use this tool to break many or most of mine. I have been thinking about how I eat but also about how my kids eat, age 2 and 5. My son is five and is a very picky eater and very slim. His favorite food is an apple! My daughter is 2 and she is already a little plump, and she will eat anything you put in front of her and is a sweets aholic. I don't want then to have a weight problem one day and suffer the way I have. For a long time I have worried about their diet. We eat family well, mostly whole food without any fast food usually, we don't drink soda and barely ever drink juice We eat out occasionally but mostly eat from home. The meals I make are fairly carb heavy but my kids usually prefer to eat the Protein unless it is spaghetti or pizza. We eat things like stew, chicken Soup, pizza, grilled cheese, tacos, spaghetti, lasagna, hamburgers, eggs, etc. We eat a lot of desert sweets. We love to eat ice cream, cake, Cookies, fudge, candy, etc. we eat tons of it. I want to take refined super totally off our menus and out of our house. I also want to eat only lean protein and whole grain, unprocessed carbs, increase our vegetables and cut out pizza and juice altogether. I don't mind the kids eating wheat bread but I won't post surgery. I'd like to replace the Desserts with fruit or yogurt or take them out entirely- which do you think is better? Is it easier to just go cold turkey and stop doing dessert? I was raised eating desert and I find I am programmed to crave sweets after eating. I was to undo this habit and not give it to my kids. I also want to eat my last meal of the day by 6, 6:30 and be done for the day. I've though about writing out some meal plans for us to follow for the first few months and would love suggestions. Also, my kids take food to to school with them and I need ideas for healthy lunches that don't involve processed carbs. Do you all think this is possible? Any advice? I'm worried my sweets cravings are going to make me miserable. I also found a link to a bariatric food pyramid. Pretty awesome!!! http://www.drsharma.ca/obesity-the-bariatric-food-pyramid.html

I'm so sorry you had to hear that from a friend who you supported in the same situation. Luckily so far, the few friends I have shared that I had surgery with, have been very supportive. I have a lot of friends I went to college with, that have no clue, as I did not tell them, and they live all over the country. I don't plan on the big reveal, until I have met goal, and had the plastics my insurance will cover. Then I'll let the world know. Honestly the harshest and most hurtful comments have come from my 2 younger sisters. I now hear things like... "What are you going to do with all the wrinkles that will appear on your face, when you lose?" (although I don't see any more wrinkles now than I did 145 lbs ago) and "what are you going to do with that big deflated skin flap where your double chin was." (that one was true, it's there. I do exercises to try to help strengthen muscles in the area, it's about all I can do) They both know my insurance won't pay for that kind of cosmetic surgery, and I can't afford face surgery on my own. Why they would even say those things to me, is mean in my opinion. At first they were supportive and the more I lose, the more biting the remarks get. One sister is average sized, and always has been, and the other fluctuates, and is big right now. She cuts me off everytime I want to talk about my progress. I guess it's just a reminder to her that she's ate her way back to almost bigger than me at this point. I can't help that, but I was hoping for more support. We just have to keep doing what we are doing, and know envy and jealousy are things you will come across. My thought would be if you confront her, is remind her how supportive you were of her and her surgery. Yet again, this supports my argument, they just don't give enough help with food addiction issues in these bariatric programs.

I got my band last year when I taught at a different school and everyone knew and I didn't care, including my family and close friends but I started teaching at a different school in a different district and since August have lost about 30 more pounds (88 this year) and they have noticed but I belong to a Weight Watchers at Work group and I guess they figure I actually track those stupid points. I just go for the comraderie and healthy food ideas. I am not renewing this month though. When people ask how I am doing it, I tell them I am eating smaller portions (thank you LB), exercising 3-4 times a week (Y-M-C-A, and controlling by blood sugar (my dr is pleased as punch)...it's all the truth....I don't think they need to know

Hello Canadian Band Buddies For those of you that have not heard CIBO Clinic in Toronto has filed for bankruptcy. I received the following email today from Dr. Chris Cobourn at Smartshape (formerly Surgical Weightloss Centre) and he has asked me to post this message. Tom, Toronto Banded July 6 06 Wt. Loss: 156 lbs Hi Tom: We had a meeting at the clinic today and we have come up with the following option for CIBO patients. We will offer them the opportunity to join our follow up program which includes: Initial assessment/consultation with Dr. Cobourn either in person or on the phone Counseling with our team of nurses, coaches and dietitians via email, telephone or in person as necessary Band adjustments as necessary Band adjustments can be performed at our facilities in Mississauga or Downtown Toronto, and with our affiliates across the country Radiologic or endoscopic evaluation as necessary 24/7 access to one of our surgeons if there are concerns or worries after hours Access to weekly webinars by our nurses and dietitian Access to Lap Band Connect – an extensive online support forum for Lap Band patients Access to this comprehensive program is offered to CIBO patients at the cost of $1000 per year and can be renewed annually as the patient wishes. We are not able to offer a fee for individual adjustments because our philosophy of care is that the highest quality Lap Band care is more extensive than simple band adjustments. There was a great deal of empathy for the situation of these patients that are not able to access a follow up program that they have paid for. However there needs to be an understanding that there are real costs associated with the delivery of this extensive follow up and we cannot offer this program without additional cost to the patient. We understand that additional costs may be a burden for these patients and have modified or usual access fee for the CIBO patients. It is important to understand that access to the follow up program does not include the cost of any revision surgery that may be necessary. Revision surgery may include port fixation or placement, as well as band repositioning, replacement or removal. We will develop a schedule of costs for these revision procedures. Please feel free to post this information on the Message Forums that you have access to. You know the quality of the follow up that we provide and we think this is a fair and reasonable option for these patients. SWLC is well known for the quality of care we provide and all patients who join our program will have full access to the post op care we provide to our patients. We want to assure the CIBO patients that we are here to help them if they are interested in our program. Dr. Chris Cobourn | Surgeon and Medical Director SmartShape™ Weight Loss Centre Phone: 905.278.8000 | Toll-free: 1.888.278.7952 | Website: smartshape.ca 1413 Hurontario Street Mississauga ON L5G 3H5

And another one: Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Gill RS, Birch DW, Shi X, Sharma AM, Karmali S. Source Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. shahzeerkarmali@hotmail.com Abstract BACKGROUND: Existing evidence has suggested that bariatric surgery produces sustainable weight loss and remission or cure of type 2 diabetes mellitus (DM). Laparoscopic sleeve gastrectomy (LSG) has garnered considerable interest as a low morbidity bariatric surgical procedure that leads to effective weight loss and control of co-morbid disease. The objective of the present study was to systematically review the effect of LSG on type 2 DM. METHODS: An electronic data search of MEDLINE, PubMed, Embase, Scopus, Dare, Clinical Evidence, TRIP, Health Technology Database, Conference abstracts, clinical trials, and the Cochrane Library database was completed. The search terms used included LSG, vertical gastrectomy, bariatric surgery, metabolic surgery, and diabetes (DM), type 2 DM, or co-morbidities. All human studies, not limited to those in the English language, that had been reported from 2000 to April 2010 were included. RESULTS: After an initial screen of 3621 titles, 289 abstracts were reviewed, and 28 studies met the inclusion criteria and the full report was assessed. One study was excluded after a careful assessment because the investigators had combined LSG with ileal interposition. A total of 27 studies and 673 patients were analyzed. The baseline mean body mass index for the 673 patients was 47.4 kg/m(2) (range 31.0-53.5). The mean percentage of excess weight loss was 47.3% (range 6.3-74.6%), with a mean follow-up of 13.1 months (range 3-36). DM had resolved in 66.2% of the patients, improved in 26.9%, and remained stable in 13.1%. The mean decrease in blood glucose and hemoglobin A1c after sleeve gastrectomy was -88.2 mg/dL and -1.7%, respectively. CONCLUSION: Most patients with type 2 DM experienced resolution or improvement in DM markers after LSG. LSG might play an important role as a metabolic therapy for patients with type 2 DM. Copyright © 2010 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

I think this surgery pairs with a plant based diet very well. If anything, it helps to be successful on a plant based diet and not terribly hungry all the time. Granted, it will probably be a little tricky getting all your Protein in the beginning. I still haven't fully switched over to full based plant eating but am slowly getting there (90% vegetables/fruits, 10% fish). I lost 150 pounds and got to goal weight after 7 months post op. Even after this successful weight loss, my depression was not cured. However, I am relieved that I no longer have to deal with diabetes and high blood pressure. That, and the fact that I will live a longer and healthier life and be able to raise my son. Dr. Weiner (a bariatric surgeon with many YouTube educational videos) promotes the benefits of the plant based bariatric diet. You can learn about his "Pound of Cure" plant based eating plan at: https://www.youtube.com/watch?v=1M1OUvHM_D4. It is for bariatric and non bariatric patients, so you can even give it a try before surgery.

I have 45 bars left over from my pre-op diet. They all taste very good, but I found I have an allergy to one of the ingredients. For my pre-op diet I was allowed to have 2 of these a day as a snack. Here is the listing on ebay in case you are interested. http://www.ebay.com/itm/Lot-45-Bariatric-Advantage-KetogenX-Snack-Bars-Asorted-Flavors-Metagenics-/280868542722?pt=LH_DefaultDomain_0&hash=item416511d902#ht_500wt_1156 Let me know if you have any questions!

Reading this forum, does make me wonder though how people go about choosing one method of WLS over the other....when I was going for my band, I went to see a doctor who exclusively does band surgery. That was my preference since I had known a few friends and others who had the by pass and suffered medical issues, and complications including death. Since I have met my doctor the first time, there are now other doctors in the Bariatric Practice of the hospital that perform other WLS such as the sleeve, and by pass. From what I understood from the initial meeting with my doctor was that if I was not a "candidate" for the band I would be referred to the other doctors to see if I might be a candidate for their specialty. Which makes me think that there is some standard of measure that makes someone a candidate for one surgery vs. another other the fact that we are all over weight, and I don't think it is solely based on our preference as it was in my case.....but my assumption could be wrong insofar as I have not heard or understood what the metrics consist of that makes someone a better candidate for the band vs. other WLS. Does anyone know if there is such a thing, or if surgery is undertaken based solely on the preference of the patient? Apologies if I’m rambling…I hope this made sense it’s been a rough day J -------------- Good question! -I hear about the benefits of DS ,better Diabetes reduction and quicker/more weight loss. More strict nutritional rules. -RNY to avoid GERD, better Diabetes reduction, mal-absorbtion part of weight loss process.- -Sleeve to avoid mal-absorbtion, ability to use aspirin (this is one reason I got the sleeve, I need aspirin as part of my heart health practice, my Cardio would not approve my surgery without this), can scope the whole existing tract, keep your pylorus, remove most of your Ghrelin producers, only option for Crohn's patients. Can use it as part one of the DS if you don't lose enough weight with just the sleeve. Not as good for Diabetes or GERD. -Band benefits... I would think it might be that it can be reversed and adjusted if you need to? -Don't know much about Plication..... I'm sure there are many more reasons... I really think it is partly what the Doc has experience with, My doc did mostly bands and RNY, I suspect if he had been there at my consultation, I would have ended up with the RNY... he got a new co-Doc who I did my first consult with, he gave me the choice of the sleeve or RNY, I had never heard of the sleeve, looked into it, and it just made good sense to me personally. The sleeve was pretty new as a stan alone procedure when I got it, so the stats are still pretty early out... but people have had their stomachs removed for centuries, and lived through it, and the DS has been around for a while, so I figured nothing completely unsuspected would probably pop up after surgery. I wanted to know everything I could find out about WLS before I got it!

Please don't hate me.... My best friend is looking into wls, and has been involved in the local bariatric clinic for the past year going to her classes etc. She encouraged me to look into wls as well, knowing that I would have to join the clinic and I would be far down the road behind her... Well, I work in the operating room so I asked a surgeon one day if he would accept me as a pt for wls and he said sure he would watch for my referral. Well, surg date was booked within 2 mos of our conversation. Yup, jumped the line. But in my defense I work very hard for my surgeons and they appreciate this fact, and I feel this perk had been a gift from my surgeon for my dedication. Kind of like a Christmas Bonus lol. Now...my friend is pissed. And yes she definitely has a right to be. Things are strained and I feel really bad about it but once the ball started rolling it was really out of my control. I've now been sleeved for almost 2 weeks and I really don't want this guilt to sabotage my weight loss efforts!

Banded June 2010. Rid of 168 pounds! (sorry if this is a repeat for some of you but thought i should post this in this forum too to help/motivate more people) So the truth is the way I had success was to get real with myself. The first year I completely failed my lapband. I lost a little and then gain 30 pounds back. I didn't exercise at all and tried to tell myself walking the dog counted as good cardio. I also didn't count any calories that first year. I ate crap and tried to blame it on my band not working properly. I was very uniformed and thought the band was magically supposed to work. I didn't understand that I needed to get to that "sweet spot". The second year I decided I had to do it and get informed. I read these bariatric pal boards and searched for the secrets to everyone's success. The answer? No big secret, actual real exercise and counting your calories! I got a little cruiser bike and actually rode it 15 miles a day 7 days a week starting the day I bought it. I had always wanted a bike like that and said if I got one i would use it. That day I also started counting my calories religiously...right down to a stick of gum. I stuck with 1200 calories for the first year and then actually had to up my Protein calories once I started doing even more exercise. When it got too cold I tried zumba and fell in love with it and did it 7 days a week. Then I upgraded to twice a day zumba for several months. Then I did the Insanity program and zumba every day for 3 months. I slowly but surely lost steadily that whole time. The majority of my calories was always protein. 90 grams at least. And when my weight was stuck and I exercised more, i upped it to 120 grams of protein and lost even more. With that amount of protein i felt full, and there was only enough calories left for my veggies, then fruit the sometimes some carb foods. My band is a realize band and if i remember correclty it is at 10.2 in an 11cc band. I almost have to have the darn thing closed shut to feel any real restriction. I havn't had a fill in a year. (acutally i had it to 10.7 for a almost a year until this january when i started randomly having really bad night reflux so decided to just get a tiny bit out). I made little goals as I went along.. If I had a trip planned, I would say, ok I just have to lose 10 more pounds by then. Or I just want to weigh what I was when I graduated college, and the what I weighed when I first got married, and then I just wanted to be smaller than my husband ( that was an awesome day the day the scale said I weighed less than him!). And the it was I wanted to be what i was when I was 21, and then the ultimate was what i was when I was in my teens! As for extra skin, yes i look dang good in tight workout clothes but naked is an entirely different story. I will be very honest here and many people here can relate. I struggle daily with my body image. While I may look tiny and muscle packed with clothes on ( I'm at 19% body fat), without clothes my skin is soooo wrinkled. My upper arms are super bad and I am pretty self conscious about them. I wore tank tops last year but vowed not to this summer as i swear all i thought about was people staring at the saggy skin. My upper and lower stomach and pubic region have a huge amount of extra skin that gets in the way when i exercise. I can actually hear it flapping about when I workout dang it! My chest is completely non existent, just flaps of skin which will require a lift and augmentation. My inner thighs and butt are the least saggy out of everything but will require a lift if I really want the complete packed. The good news about some of this is my legs and butt have actually gotten better with working out once I added weight training. I was so overweight for almost 15 years and so i just don't have time (or age) on my side for my skin to shrink back. My goal is to concentrate on reducing my body fat just a little more and have my arms, chest and tummy done this fall as a reward for keeping my weight off for a significant amount of time. The best advice is to get very informed and have a plan. Don't kid yourself, real exercise and a diet plan is the key to success with the band. Exercise is my best friend now. I actually want to be a personal trainer and nutrition counselor. Many people have asked me how I did it and I have to say I was sick of being what I was. You can do this!!!!!

JC, Dr. Szomstein is my dr. too! I know it's going to take a long time. I started in July and don't expect surgery till Dec 2003 or Jan 2004. I originally went to US Bariatrics at Holy Cross, but they only want to talk me into RNY. I have about 85 pounds to loose and I don't care if it takes me 2 years to loose it (US Bariatric's big plug for RNY is that you loose it faster and that it's the "gold standard"!) 4-5 lbs a month is fine with me and a less risky, reversible (if necessary) procedure is why I want the band!!!!! Oh Well....in the mean time, I'm waiting! Keep in touch and GO DOLPHINS! Marsha

BCBS has so many different plans - that even have the same names - so you need to just call & ask. My husband works for a tiny company & we have BCBS Texas (not Health Select though) & they told us there is a bariatric surgery rider that the company could add on to the policy, but his company didn't choose it, so I was self-pay. Again, there are tons of different plans even through BCBS & different companies even if someone else has Health Select, so it's best to just call them. Some plans that do cover bariatric surgery only cover the lapband or bypass & not the sleeve too, so it's best to call & see what they say is covered & what hoops you have to jump through to get approval if they do cover it.

I just started using frutis fall fight shampoo and conditioner. So far less strands in my comb. I sure hope this works. It has biotin in it and the bariatric vitamins have 150 per cent of biotin everyday. The vitamins were not working but this shampoo seems to be. Will let everyone know after a few weeks.

If you've selected a surgeon, their insurance staff would have a very good idea how appeals work with your insurance. Since bariatric surgery isn't a standard covered item, they appeal and work with insurance companies every day.

Mindy, I dont nmind helping folks on an individual basis.... I am not interested in educating the "shady coordinators"... I give my work phone number and my work email (and it's my personal as well) so that it IS understood that I am someone that works in this field. Not only that, I feel that if I wanted to be shady I would do a better job at disguises... and use the username msfluffbunny or something non-related.... Oh to address your first question.... I dont work for "a" doctor... I work with several docs in Mexico and the states.... What I do with absolutely no $$ in my pocket, is help people that are having problems...regardless of who did their surgery, help those who DONT have the $$ find a way (in the states and in Mexico), and if someone is just plain scared I dont mind talking with them and encouraging folks.... Not everyone that is here to help... has their hand out. I have come on here more in 2 days then I have in 2 years just defending myself with all of crazy paranoia that seems to be present. I want thank those who sent an email thanking me for the explanations on wanting to help.... I hope maybe... everyone will do things in the way they wish... and allow others to have the freedom to share in the way they are most comfortable. I personally like to help a peron on an individual basis.... That is my choice and if I can be of assistance from someone that NEEDS to share or have questions about any of the bariatric procedures... I am happy to share what I have learned.... Anyone can write to me individually at bandinfo@verizon.net

You are so welcome. I know that when I first started this process I felt completely lost. I am glad I can be here for you. Pacific Bariatrics only does the RNY for Kaiser. I think that by the time you are finished with the classes, they wont have that contract anymore, as Kaiser is performing their own surgeries now. They used to contract with UCLA too for the RNY and Sleeve. They no longer have a contract with them. Kaiser is doing ALL surgeries now.

Ok! So I received my packet today from Kaiser. It comes with a 23 page booklet about the whole process. Also a Bariatric Pre-Program questionnaire. Im a bit worried from some of the stuff I have read in the booklet. For example, they want me to show proof I have been on a program for at least 6 months in the last 10 years. Well years ago my old doctor put me on Medifast and I went to some support meetings for it. I was able to lose weight over a course of 8 months but I gained it all back. They charted our success at the meetings, but I wasn't given any documentation on letterhead or anything like that. Ive also done HMR supplements last year and lost 25 lbs and gained it back. I'm worried I don't have the proper documents they are looking for. Also im a bit nervous with this questionnaire. I'm afraid if i answer wrong ill get turned down. It also says a BMI of 50 or 40 with 2 morbiditys. Im 38BMI and I have hypertention but it is not severe, and the booklet says severe. I do have gerd, sleep apena and joint and back pain. And some depression from my weight. Any advice you can give me if you have filled this out for kaiser before would be helpful. Id like to know what happens when I bring this in. I feel like its my only chance and I dont want to mess it up.

hi andre... welcome. i'm relatively new to this site and to being banded myself. actually just had surgery on monday, so i'm not even a week out. so far so good. the soreness is subsiding and i'm headed out soon for another walk. i'm in nyc too and might head over to central park or to the historical society. as for finding a doctor. checkout the sites for nyu (thinforlife.med.nyu.edu) and for lennox hill (LHH/MMIBS :: Home). others here have highly recc'ed dr. murian and dr. fielding at nyu. i met with dr. kruian, but ultimately went with dr. roslin over at lennox hill. as you embark on your own research, you'll find that bariatric surgeons are a relatively small community in nyc and many have worked with and for one another at some point in their career. i went with roslin and lennox hill partly because of his experience and his straightforward style. also, i appreciated that his office was convenient for me to get to from my home and my office. plus, several friends of mine had other procedures at lennox hill and i liked that it was a somewhat smaller hospital and very focused on patient care. at any rate, do yourself a favor and comparison shop. you're making a lifetime purchase, commitment and quite possibly forming a lifetime relationship with your medical team. also, pick-up "weight loss surgery for dummies." it's a helpful primer and will help you think of and ask the right questions. good luck with your decision and your quest for a healthier lifestyle.

I started reading Before & After a few days ago. The author had RNY but I am finding it a good read and many applicable tips. She went on to start the site www.bariatriceating.com and opened a bariatric store in Florida. I'm going to have to pick up the other recommended book. I ordered mine at barnes & noble, the one I stopped at didn't have it on the shelves.

I am so sorry to hear this, remember many insurances will deny you. According to the American Society of Bariatric Surgeons, insurance companies will do this in hopes that you give up. They will find errors in paperwork or errors in filing etc. to deny you. This is an expensive surgery and if they can get a few people to say "forget it or I'm done" that's money in their pocket. So don't give up file an appeal, don't let them win.

Your feelings are normal. I'm 5 months out and was 65 when I had the surgery with gall bladder removal and hiatal hernia repair!! Believe me, it is not easy but... The rules/ guidelines are for your safety!!! Every stage my daughter, a doctor, who had the sleeve also kept saying" you only have to do this once. I'm the lowest I've been in over 20 years, and now training with the Bariatric group for a 5 k walk/run! You can do this and use the tool. One day at a time!!! Hour if you need to. Enjoy the journey and we all are with you! Carol

I have UHC too. What you need to do is call them and ask them if they cover for bariatric surgery. Ask them if there are any restrictions or exclusions on your policy. They should be able to read it straitght up to you and tell you if you have coverage. Every policy is different. Looks like mine covers. Good luck!!:cursing:

From what I understand being Allergan/Inamed (allergan is the new name) certified to place the band is not state by state. It's one time. You can call Allergan and ask them if your surgeon is certified. The website is lapband.com and you should be able to find a link to look him up. What is his name, BTW? You can look him up on obesityhelp.com and on tha American Society of Bariatric Surgeons (asbs.org) to see if he's a member. Please do these things, or PM me the name or post it here and we'll see what we can find out about him to see how much experience he has.