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I have no idea, there is a questionaire you fill out and when I log into their site it says I am low risk under the assessment, when they callled me they told me I was high risk. I asked them how they figured I was high risk and they couldn't tell me, but added that looking at my records, they couldn't understand why I was high risk either. If you are high risk, you have to meet with one of their surgeons, if you are low risk, you can just go to the center. Like I previously posted, meeting one of their surgeons required a 1000 mile trip. Personally, I thought it was just a way to make more money off of me. And it is not practical. If I wanted to travel 1,000 miles, I would just go back to Mexico and get my fill done for free! I now know that I CAN get a fill somewhere else, even though they try to convey this message that you won't get any support if you got your surgery in Mexico. Also, their prices are higher than the price I will be getting from a bariatric center in my own town, which does fluoro...unlike fill centers usa. Like MySjerriJo said, call around, seach the net, etc. I felt like they were my only opportunity besides going back to Mexico. Believe me, a doctor/hospital near you will be more than happy to take your money :cool:

Hi! I have a consultation in 2 weeks with a bariatric sugeron . Im curious about insurance approvals. Does anyone out there have federal BCBS? What are the requirements? What was the approval process? Im at a BMI of 35.6 and have no comorbities. There is no way I could pay cash for this surgery, so Im just wondering if there is anyone else out there who doubted that insurance would approve the surgery? I just really don't want to get my hopes up. Thanks for any input!

Bariatric pal please fix the metric ticker it can not calculate weight loss it is using pounds when it tells you how many kgs you have lost lol please fix so us non Americans can use it :-) many thanks

My doctor is Mark Shina, an excellent man and a wonderful bariatric surgeon. He could have finished the surgery he said but my blood pressure kept bottoming out, and he was scared he was going to loose me because the scar tissue in my abdomen had to be removed to get to my stomach which would take an extra hour. Apparentally certain types of blood pressure medications interfere with the anesthetic used to put you under. I am going off 1 of my blood pressure meds for two weeks and we are going to do it again the 16th.

Sorry for how long this is- I know that I always appreciate reading detailed posts about the process, so I’m hoping other will find it helpful. I’m just starting the process of getting a VSG. I’ve thought about WLS for a long time, but have always been scared off because of the possible complications. I’m not sure what exactly changed, but, about three weeks ago, I was driving to work and the thought of getting the surgery popped into my head and suddenly I knew it was what I needed to do. Looking at the hard road ahead, I wish I had started this journey earlier in life (I’m 37), but I know I wasn’t ready for it until now. I’m in the DC area, and there are lots of hospitals and surgeons to choose from. I finally settled on Inova Fair Oaks, which is a Bariatric Center of Excellence, has great stats, and has an up-to-date website which let me register for the seminar online. (GWU never contacted me after I filled out their form. Other hospitals had outdated calendars on their websites, or no way to register online, or the websites themselves were unfinished, which I felt didn’t bode well for their programs.) I went to a seminar about two weeks ago, which was mostly basic stuff that I already knew. I had my first visit with the surgeon a few days after the seminar. The surgeon, Rajev Nain, was the same surgeon who did the seminar. He seemed a bit stiff at first, but after a while he seemed to get more comfortable and I felt like we had a good connection. He definitely didn’t come across as the a**hole surgeon stereotype you hear so much about. We first talked about my basic health history, medications, that sort of thing. I don’t have many co-morbidities yet- just hypertension and edema in my left leg. We talked about the various surgeries, and he was fine with me getting the VSG, he didn’t push for the RNY. I’m 5’1” and 355lbs. He said that he could get me to around 205 lbs with the sleeve. He was clearly just basing that on the average amount of excess weight lost with the sleeve, not anything specific to me. I would be overjoyed with 205, even though that would still leave me 100 lbs over my ideal weight. However, I also know that each individual is different, and I feel like I have it in me to go lower. I may not make it to 105, but I think I am determined enough to get myself in the mid-100s. I asked him about his experience- he’s done several hundred VSGs, and even more RNYs. He also has lots of experience with other GI surgeries. While I would have liked him to have done thousands instead of hundreds of VSGs, it is still enough that I feel safe with him. I asked about major complications, and he said that <1% of his VSG patients had had major complications. He has had no mortalities with the VSG, and one mortality with the RNY (the patient died of a pulmonary embolism the day after surgery, even though she was on blood thinners and had had her legs compressed during surgery.) Having lurked on this board for a while, the variance in different surgeons’ pre-op and post-op diet instructions has been a bit puzzling to me, and the materials from the presentation I attended were very authoritative. I will happily follow rules if I understand the reasoning behind them, but I tend to do my own research and come up with my own rules for myself if I feel like the rules I am given aren’t well supported. I was nervous to do it (because of that whole surgeon stereotype), but I told this to my surgeon, noted that his post-op diet (2 weeks Clear liquids, 2 weeks full liquids, 2 weeks purees, 2 weeks mushed-up real food, then finally real food 8 weeks after surgery) was one of the more conservative ones that I had seen, and I asked him what research had gone into making it. He laughed at that, and said that the priority for him and the other surgeons in the group was to have consistent instructions that everyone involved in the practice could refer to, so they just flipped a coin when making them. He said that the part he cared about was that he didn’t want patients going to full liquids until after he examined them at the first post-op appointment. Other than that, I could work with the NUT to come up with a post-op diet plan that worked for me. I then asked him about the 2-week pre-op liquid diet. The pre-op diet that he requires is 900 calories of Protein shakes a day. I told him that I totally understood the reason for the diet (to shrink the liver to make surgery safer), but that I didn’t understand why it had to be all liquid. Why not just 900 calories of low-carb food per day? Again, he laughed and said that there was nothing magical about the liquid part of it, it was just easier for people to stick to the diet when they didn’t have a choice about what to eat. He said that he was fine with me subbing low-carb, high-protein food into the pre-op diet, as long as the NUT approved my substitutions. He seemed to get a kick out of me and my questions. He said he could tell that I took this very seriously and had done my research. I thanked him for not treating me like an idiot, and not having a “do what I say because I am the surgeon” attitude. I have to do 6 months of “nutrition classes” to satisfy my insurance requirements, so surgery won’t be until next spring some time. I’m disappointed to have to wait so long, but I am trying to make the best of the time by really making sure I am ready for this change, and by trying to lose as much weight as I can before the surgery. I started myself on a low-carb diet of my own design, and am doing great on it so far. I’ve done low-carb diets before, and it has always been a struggle with craving carbs while on them, but I haven’t had a carb-craving yet on this one. I’ve cut out all grazing and it has helped immensely. I’m eating 1300-1500 calories a day and not feeling hungry. I know it will get harder, but right now, I’m feeling pretty good about myself.

Congrats on your sleeve! Once you are back on a solid foods diet, you will begin to feel how much your sleeve restricts the amount of food you can eat. Your other issue is one big old habit that we don't change overnight. The emotional part of this pr ocess, in my opinion, is tougher than the operation. There's lots of tips and tricks you can try to get you started to change your thinking forever about not having to "clean your plate." You'll get lots of ideas here from others. For starters--ditch your big dinner plates. Eat meals from a salad plate and always anything you eat from the smallest dish possible--it tricks your head into thinking you're getting more to eat because the dish is so full. When you eat at restaurants--before you even begin your meal, ask your server to bring the "to go" container and place half (or more) of your meal into the container BEFORE you begin to eat your meal. It's always a good idea to seek help from a bariatric therapist to learn good strategies on how to set up your forever eating and lifestyle plan tailored to YOUR specific situation. There are also a lot of great self-help bariatric books published in the past few years that deal with the emotional stuff.

There is more to this journey than just not being as hungry. There is a very mental side to re- understanding your body's signs for real hunger learning to chose healthy foods and breaking away from the things that got you here to start with. There are a few books that I've found or were suggested to my by my Bariatric psychologist. 1. Eat, Move,Sleep by Tom Rath 2. Lose Weight Easily by Loving Who You Are. Conquering the mental emotional side of losing weight. By S Wharton 3. The Body Book by Cameron Diaz

The Emotional First + Aid Kit: A Practical Guide to Life After Bariatric Surgery, by Cynthia L. Alexander

While my insurance did not require any pre-op stuff, my bariatric team did. I had to attend an information session, then I could make an appointment with my surgeon. Info session in April, first appointment on May 11. My team required 3 months of monitored weight loss, monthly meetings with my nutritionist and nurse practitioner. I had to have an upper GI endoscopy to ensure no hernia needed repair and that there wasn't an ulcer in my stomach, attend one support group meeting, have my psych evaluation, blood work, chest x-ray, clearance by both pulmonary (I'm asthmatic) and cardiology all prior to surgery. My surgery was on August 23. That was just enough time to get all the testing done and all the insurance squared away. (There was also a pre-op class about the 2 week pre-op and the post-op diet.) Success for this is mostly in your head -- you need to have your head in the right place before you're surgery. If it's not, it's not going to work well for you. This is a tool. It's not magic. You need time to learn how to break a lifetime of bad eating patterns and learn how to deal with the issues you have had with food. You need to start getting active. You didn't post any of your stats in your profile, but when I started this journey, I was 271. Today, 5 months post-surgery, I'm 75 pounds lighter, total, 50 pounds since surgery. I wouldn't change a thing. If I had to wait, six months, I would have. This has changed my life in ways I cannot explain.

Mehta Bariatrics has a monthly support group in New Brunswick, NJ. You can google them to get the information.

"The Emotional First Aid Kit - a Practical guide to life after Bariatric Surgery" by Cynthia Alexander really helped me get my head in the right place to deal with my new life. Let's you know what you can expect through the entire process with suggestions on how to deal. Got it on Kindle.

Hello everyone, I just joined Bariatric Pal. My surgery date is July 20th and I'm excited about sharing my experience others. This website is amazing. I've read many of the testimonials and they are extremely encouraging. Thanks.????

Hello, As I learn more by reading all these posts and doing research into lap-band I am giving serious consideration to having it done. I don't think my cigna insurance will cover the procedure because I have a bmi of 39 and no co-morbidities. I'm a 44 yr old female who lives in central Connecticut. Because I'd need to pay for it myself, I'm considering having the procedure done in Mexico. Perhaps with Dr Ortiz, he seems to have a good reputation. Anyone know of any place that would do fills in CT? Also, if there were complications and I needed a medical attention, would I be turned away by local bariatric doctors? It would be re-assuring if I could get some after-care in Connecticut. Can anyone offer me any advice? Thank you! Susan

Hi ChaCa I'm from Southern Indiana as well. What kind of dog is in your photo? We have 2 maltepoos, Squeakers and Harry. I went to a seminar at Clark beginning of January, have received my letter from PCP, and tomorrow will drop off my packet to the bariatric coordinator.

Here are my recommendations: For multivitamin I use the bariatric support vitamin that the vitamin shoppe (I hope there's one near you) has to offer. It is made by twinlab. For calcium and vitamin D I use Viactiv caramel soft chews. There is some sugar in these chews just FYI. Caltrate also makes chews with slightly less sugar but IMO they aren't as tasty ( vanilla flavor is best). I get my B12 from a once a month injection I do at home ( you need a script from your doc). There are also some good B12 products at the vitamin shoppe or a website called bariatric choice. Good luck on your journey!

My vitamins are from new life bariatric and are in powder form. I add it to my daily protein shake and I am done. You can find them online.

Okay I will definitely be looking y'all up on Facebook! I'm not sure how the whole process works but the bariatric surgery consultant is the one who said that the referral was approved. I still have to get approval from surgeon and psychiatrist and I am praying hard I do. If I don't do something drastic I don't think I will make it past 40 :-(

Hi all, I am still pretty new at posting, but I read on this board everyday. I love the information that is shared. 3 weeks ago I finished up with all of my 'pre req's' I started this process in July with the seminar, then had my consultation, then a group meeting followed by a meeting with the RN.. Then I had my meeting with the psy,nut, and fittness dude. I was told then that the info would be forwarded to my insurance by the end of the next week. I called after the week was up and found out that it had not been sent yet and it would be the next week. i wait a week call my insurance and it had not been submitted yet,, ok so this past monday I call the Doctors office and find out that they were sorry but the paper had not been sent yet, they were very nice but told me that they had 65 new pts and there was a back log. I understand this I really do. but I am more that redy to go.. today I called my ins to see if they had recieved the paper work,, they had not.. so this is so frustrating. I am a very impatient person, and I was really hoping to have this done before my daughter gives birth in Oct. I want to be in good health to do the grandma thing of course. My insurance is one of the better one that approve of bariatric surgery. I feel better now just venting all of this. I guess this is just part of the "journey" But I just keep wanting to know "are we there yet".:sneaky:

Had my surgery back in September and all is well (39 pounds lost). But I have the liquid diet stuff taking up room in my cupboards- would like to sell Vanilla Creme Bariatrix essentials by metagenics - bariatric meal, vanilla advanced protein powder and endura energy and rehydration formula. Each container 1/3 to 1/2 full. Should get you through the liquid phase no problem. $40 for all. Send a message if you are interested. I'm in downtown Toronto, very close to the TLBC centre.

Hi. I am in RI and hope to have surgery in June. I hear that Tufts and MGH are great. Check them out on line under bariatric surgery and make an appt. for a consult. Good luck to you!

Does anyone know how far back bariatric Dr's will look at medical history? I met with a nut about a year ago and have been through 4 weight loss programs since 2008. I already was diagnosed with sleep Apnea so I feel like all I need to do now it see a psychologist, but not sure if they will accept me seeing the nut a year ago? Anyone else? Thanks Jen Sent from my iPhone using the BariatricPal App

I haven't tried the K20, but if you are looking for a real bang for your protein buck, Worldwide Protein Shakes are great. They have 35g of protein, 1g sugar, 3g carbs, 1g fat (0.5g sat/fat)and 160 to 170 calories. It comes in Chocolate Cream, Vanilla Cream, Strawberry Cream, Banana Cream, and Cookies 'n Cream (tastes like Oreos). They are sold in Vitamin Shoppe for $2.75 individually and $27.99 for a 12 pack which is about $2.33 each. Worldwide calls it a protein supplement, and says not for use in weight reduction, but I have been drinking them for over a year (I saw a link here once to Brigham Womens Hospital Bariatric Program, and these shakes were on their list of protein drinks for patients). They also come in 29g drinks but I have only seen them at Trader Joe in Vanilla and Chocolate. They were $1.69, and the Vanilla and Chocolate 35's were $2.29. GNC has the 35s in Vanilla and Chocolate but they are $2.99 a can. Vitamin Shoppe (and GNC) also sell them online and sometimes you can get a free shipping deal depending on how much you buy. I really like them.

Thanks so much Stephanie. That really helped out. I actually talked to the rn of the bariatric department. She said I should be fine and not to worry about it at all. I have to wait until Wednesday for their decision I have so many things going on at once, moving, working two jobs, back in school. Smh I pray Wednesday gets here fast.

Ok, so I said I would put more up about this last night, but with the kids, getting ready for bed....I just didn't have time. The article is called "The Easier Way to Diet" by Martha Beck She talks about a five-step plan to help master your "beastie brain" and "relax the weight off." She makes four key points about our brains and how there are several layers to our brains. Basically, the "wanting to be thin" (cyberbrain) part of the brain is always at war with the "feed me now" brain (beastie). This also relates to the nervous system that goes back and forth between "fight or flight" and "rest and relaxation." Obviously, when the cyberbrain is in control you naturally restrict your intake. Repeated dieting and constant negative thoughts theoretically rev up your fight or flight/beastie brain. She has come up with five steps to combat the issue and calls it SO FAR: S - Stop - feeling anxious, hating yourself, just ate a ton? Stop and shout "Nature break!" O - Open - once you are by yourself work to get back to that "rest and relaxation" part of your brain by Opening up. Relax your body by opening your lungs, your eyes and stretch your muscles. F - Forgive - She says this is the most important step. You must forgive yourself and your body. Make a list of things that you've done right, don't just focus on having eaten those 10 Cookies (yeah, I used to be able to do that! No MORE though!). She says that eventually, you will reach self-forgiveness and the "calm observer" part of the brain will become more active. A - Accept - Once you can forgive yourself, it's time to allow things to happen as they do. (sounds sort of like the AA mantra - "accept the things I cannot control") R - Renew - From that place of "stillness, openness, forgiveness and acceptance, you can Renew your commitment to any eating plan you like." Is it over simplified? Sure. But I like the idea of forgiving myself for being overweight, for choosing poorly that day, past days and past years. I want to accept myself now and enjoy my new body as it begins to change through this process. Good luck to all of us! I look forward to our weigh ins on Friday. We have SO FAR to go in our journey, but at the same time, we really have come SO FAR...Thanks for reading...

I also think the band sounds better when you don't have too much to lose. I don't know how tall you are but I would imagine you have less than 100 pounds to lose to get to a normal BMI. It is so much less stress on the body. Another way to look at it is by reviewing your eating habits. If you are a chronic overeater at meal times, banding may be the best choice. If you are a sweetaholic or primarily eat junk food, then R&Y might have the added benefit of the "dumping" syndrome which might cause you to lose the desire to eat sweets if you get exceedingly sick when you do. Also keep in mind that doctors have their preferences as well. Some doctors favor one surgery over the other in most cases. Your doctor could be biased one way or the other and it is helpful to keep this in mind. Ask your doctor why they prefer one over the other in your particular case to see if it makes sense to you . . . after all, it is your ultimate decision. If you can get cardiac clearance and bariatric surgery would be considered relatively safe from your doctors perspective, I think you would still benefit from taking off the weight. Any excess weight is a strain on your heart. Weight loss with a healthy diet and doctor approved exercise may prolong and enhance your life considerably.