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Hi, folks. I have not been on this board for a long time. Today, I had a visit to my bariatric surgeon's physician assistant (PA). I am 16 months out from roux en y surgery and have lost a total of 101 pounds. I went there today because I have been experiencing severe abdominal pain, bloating and flatulence at night, every night x 2-3 weeks. I should add that I am an RN and am one semester away from completing my Family Nurse Practitioner Master's degree. The PA gave me some advice, ordered some meds and labs and I checked out--it was about 4:10pm. She had told me to do the labs today, due to the severity of the symptoms I was having. Their office was closing. I went to my PCP's office--which has a lab tech--and they were closing and the lab tech had left. I went downstairs to the outpatient lab and it was closed. The only lab open was the STAT lab on the 2nd floor. Since I was still in the building, I thought I'd just double check that the PA did not want these labs to be drawn STAT. I went back to the office. It was locked. I knocked on the door. I had already heard the cackling and loud voices from 10 ft away. As I got closer, I heard the PA saying "I know, and every time she moved her arms! I couldn't believe it! And she had her teenage son with her!" Needless to say both me and my teenaged son (almost 17) heard this. He drove me today because I wasn't feeling well and he also needs to rack up his driving hours to complete his driver's permit and get his regular license. Just then, the PA, the receptionist and someone from the billing dept emerged from the door. They turned white as ghosts. Their jaws almost hit the floor. Being the classy person that I am, I didn't reference that I overheard them talking about something on my body just then. Their reaction confirmed what I thought I overheard. I asked the PA if she wanted the labs STAT, she said no, and my son and I walked to the elevator. The women huddled back by the door, somehow frozen. The only way to either the stairs or the elevator was toward the direction my son and I walked. Clearly, the women felt ashamed (?)/shook by being overheard body-shaming a patient, violating HIPAA, and being overall terrible people. As we drove home, I was pretty hurt. Most patients at a bariatric surgeon's office are going to have body image issues. Whether they are pre-op or post-op, they have likely experienced some type of negativity about their bodies (either from within or without, or both.) Also, I should add, I am a breast cancer survivor. December 2018 is my five-year anniversary of having stage 2 invasive breast cancer and having a b/l radical mastectomy and subsequent reconstruction, followed by a hysterectomy. One year after my b/l mastectomy, the reality hit me that my GG breasts were now AAs, mutilated and scarred. I felt unattractive, repulsive and beyond depressed. I was thrilled to be alive and that it was caught in time to prevent spreading to my lymph nodes and that by doing a b/l mastectomy, I didn't have to do chemo or radiation. I failed to be able to tolerate Tamoxifen, and had to be put on a cocktail of other meds that resulted in me gaining about 50 pounds to my already Rubenesque 225 lb body. It was a low time. Then, I got my reconstruction. My breast did not, do not, and will not look like "porn star" boobs, or "stripper boobs," although many people have suggested that was the "up side" of breast cancer. See, when you get a radical mastectomy, they hollow you out like a cantaloupe. Then, either at the same time, or at a later surgery, they insert implants (or, in some cases, spacers). Because I was 220 pounds when I got my reconstruction, they put the biggest implants the FDA allows--800 cc. The reconstruction surgeon repaired a lot of the scarring caused by a severe post-op infection from the initial surgery, during which both of my breast turned black and I had to debride the dead tissue myself at home. I was and am thrilled that I had a good reconstruction surgeon and, after recovering, felt a little bit more whole. While I had no breast tissue before, but now, any extra cushion vanished as I lost over 100 pounds. My breasts are skin and implant. It's definitely not a "hot" look. Well, all this cancer talk comes into play because what the women were talking about was my breasts. You see, when you get a breast reconstruction, your breasts don't look like regular breasts. Again, they are hard, stiff, and look like "robot boobs," as I call them. Today, at the office, I was wearing a bamboo material sundress, that was mostly dark teal, but also had other colors tie-dyed into the design. In the front is a "peekaboo" hole. The rest of the dress is just an A-line dress with a full skirt. It is not particularly "sexy." (Including my flabby/flappy wing-like arms!) But because my breasts don't move, there is a tiny bit of "side boob" seen protruding into my armpits. Not regular side boob--because remember, nothing is "soft" anymore. No, it's part of the round, button shape (just imagine an implant covered with skin, literally.) As I reconstructed what the women were saying, I recalled more and more of the beginning. I guess in the moment, in shock, my brain kind of protected me and I somewhat blanked out. Look, we are all human, I get it. We all make mistakes. But for God's sakes, you would think that the staff--including a provider--would be a little more sensitive about yucking it up about patient's bodies while anywhere near the doors/exit. I am posting here in general for support because it just feels yucky. I know I've never done anything like that as an RN, but one never knows how one's words may affect another person. Also, the HIPAA violation bothers me. I work very hard to whisper, even when I am behind closed office doors, because I know how much sound carries in offices. I often tell my patients "I'm sorry I'm kind of talking softly, but these room walls are paper-thin and I want to protect your privacy." I know I won't have the b*lls to tell the office. I feel like somehow they would turn it around on me, even though 3 of them were there and me *AND* my son heard that. And as a mother of a 16 year old son, a 19 year old son, and a 21 year old daughter--it's creepy. The implication that my son--who has seen me go through hell and high water with cancer and this gastric bypass--would even think about looking at my breasts is disgusting. This can only come from a woman with no children. The PA is probably like 35 (I am 44), no wedding ring. Normally, I wouldn't even mention any of that because I fully believe in living my own life and others live theirs but for f*cks sake, please don't foist your sick thoughts on me. I would like some thoughts on how I might handle this. I feel like I won't have the courage to say anything, for fear of being "gaslighted." But, I also feel like there is a lesson for their staff to learn. It occurred to me to write an anonymous letter to the surgeon/head of practice and give a little vague summary of what happened and advise that his staff might want to not be so catty, mean, and to stop violating HIPAA. I don't know. I just know it hurt. I'm hurt. Thanks in advance for any words of wisdom.

Well this is sort of a confession I suppose. I miss my coffee! It wasn't the taste because I never liked black coffee, can't stand it unless it's calmed down With International Delight, Coffeemate or these days Premier Protein Caramel. I went to half caff, then decaf, I still miss it! You see,when I became allergic to chocolate in all its various forms, I lost a comfort measure, yes even more than food, hard as it is to believe. I 💖cocoa/hot 🍫, that warm milky drink from my Baby-Frustr8-hood And I have nothing to replace it with. When I was going to Kroger's or my health food store I could purchase Carob powder, mix it with my good honey( several relaives have hives) pure vanilla from Watkins and I was temporarily happier. I begged Wal-Mart to start carrying it, begged on my knees, even worked there for 11 years, think they might consider it as a personal favor? No way, last time I humbled myself I was told I wasn't worth trouble. So since I wanted something warm against the slings and arrows of outrageous fortune. Now between my bariatric surgeon and gastrointestinolgist my milky pacifier is gone. GI says it only aggravates my gastritis, bariatric surgeon(ever notice it abbreviated to b.s.?) says may I please have a calm peaceful gastric organ to make my pouch from? So I take religousky my Dexiilant to calm my stomach and. keep Hector my itty bitty ulcer from spreading his glandular wings and perforate. Sniff💦 tea just isn't the same and now anyway I am cursed with decaf forms of that.🍵Cup of peace and tranquility, I miss you!😪

But even though we may not be bariatric diet poster children, look at how well we are doing!

@Sadie24304 did you feel like the Bariatric Pal was coming to get you? 😛From a distance it sounds hilarious but having to clean it up, you weren't giggling too much,were you? There you are , hungry to the point of hangry and the microwave and oatmeal are conspiring against you! This is the kind of thing that will happen to me too.

Good Afternoon, I am having a hard time with this liquid stage and need some help. Tomorrow marks 2 weeks that I have had my gastric sleeve surgery. I purchased some items from the Bariatric Pal Store and IDK what I am doing wrong. Apple Cinnamon Oatmeal - it says to put it in the microwave for 3 mins. After 1 minute it is oozing out the microwave. Strawberry Banana Smoothie - shook it for 30 minutes and still too many clumps. What am I doing wrong?

Thank you so much for those suggestions. I am using the whey powder I bought from Amazon. Also I ordered some items from the Bariatric Pal store and was so excited to finally get something to eat. So the apple cinnamon oatmeal came, opened it up, the directions said place in large bowl for 3 minutes, after 1.5 minutes the whole microwave oozing oatmeal. I am going to reach out to them to see if the directions were wrong. Now I am going to try their strawberry banana smoothie that I have been shaking for 30 minutes now. LOL I am never such a debbie downer but I am hungryyyyy. So far today 4 oz of liquids in. I am running on empty.

My surgeon recommends the sleeve for everyone unless they have significant GE reflux disease. He is one of the bariatric surgery pioneers in Texas and has over 25 years experience.

Never heard of that. I don’t think that is a common belief among bariatric surgeons. I think some surgeons recommend sleeve over bypass because it is an easier surgery for them and takes less time, so their guidance may not actually be what’s best for the patient and instead go with what’s best for them.

My best friend had the sleeve last October and since my surgery is sched for Aug 30th she told me how she got through the liquid period and even gave me samples...based on trying many other products that she couldn't tolerate. Here's what she told me and I hope it helps: She drank a lot of Gatorade G2 Cool Blue with Bariatric Choice drink concentrate BLue Raspberry. She also liked G2 Raspberry Lemonade. The Bariatric Choice drink concentrates are liquid and come in pouches. She also used Crystal Lite Pure in water (no artificial flavors, sweeteners or preservatives): fewer calories. She used Alkaline 88 water because it's PH balanced and is not acidic. She also mixed the whey powder with milk to make a shake (add ice) or hot chocolate made in a milk frother by Bodum that can be purchased from Amazon or Walmart. For protein powder she used Whey powder that she bought at Wallyworld: Vanilla and chocolate. On the huge jar it says Whey Isolate Protein by Integrated Supplements and is way cheaper than other protein powders.

@Starr2015 OMG I feel so weak at work this morning. I had to go with Gatorade low sugar because the regular is just too sweet for me. Its weird because before it lacked sugar lol. I used a protein powder with 60grams of protein. Of course I only used half of it with my herbalife shake formula which I love banana caramel and it tasted horrible as well. I am done with this liquid stage but can't tolerate anything else. I order some things from Bariatric pal to eat for this week and they should arrive to me job today. I cannot wait lol

I’m not in your shoes, I only a year post op and haven’t experienced any regain (yet). Please don’t beat yourself up. Regain is common. Life happens! I think it’s amazing that you’re taking control again! Have you met with a nutritionist or bariatric doctor? I think you need as much support as possible!

Obesity-Related Proteins Several obesity-related proteins are being studied for their role in migraine. Two of the most important are orexin and adipokines. With orexin (which is also considered a hormone), studies in animals and humans indicate that it may be involved in many aspects of migraine. But study results have been inconsistent. Researchers, from Harvard University, now think they may have better luck with drugs that have been fine-tuned to work on orexin. Adipokines are proteins found in fat cells called adipocytes. A few studies have shown that, in some migraine patients, levels of certain adipokines (e.g., adiponectin, leptin, and resistin) are elevated during and between attacks. ------- Currently, migraine is not an appropriate indication to pursue bariatric surgery. But if you qualify for other reasons and have the procedure, three studies suggest that you may end up with fewer and less intense migraine attacks. While these findings are encouraging, more studies are needed to clarify the possible benefits of bariatric surgery in migraine patients. https://americanmigrainefoundation.org/understanding-migraine/the-skinny-on-obesity-and-migraine/ Obesity increases the risk of migraine and this risk increases with increasing obesity status from normal weight to overweight to obese to morbidly obese. Several neurotransmitters, proteins, and molecules that participate in maintaining energy appear to be involved migraine. Aerobic exercise is effective for migraine prevention, and low-fat or ketogenic diets may be effective; while not indicated for migraine alone, bariatric surgery may also be beneficial in reducing attack frequency and severity. Overall, and as for good health in general, it is important for those with migraine to maintain a healthy weight and to maintain healthy lifestyle choices in terms of both diet and exercise.

No, not tested, unless it is part of by bariatric surgery blood workup each year.

Google gastric sleeve bariatric recipes. There are lots of blogs and sites that have excellent recipes and all the nutritional info too. I hate tracking food but it definitely keeps me accountable. And good on you for catching yourself before you slipped into bad habits! Good luck!

Twice daily (sometimes more often). Yes, I’m obsessive. Yes it can dictate my mood for the day. Stalls can be particularly painful for me. Even when there is a clear hormonal reason why I might be fluctuating up, it can still bum me out. For me, weighing is part of my morning ritual. Its an important reminder every morning to stay on track and be healthy. I have lost weight a million times before bariatric surgery and every time I regained it was because I stopped weighing myself everyday. I do wish I could stop the panicked evening weigh ins though. Once a day should be enough. My family has threatened to hide my scale but I would literally run out and buy a new scale and hide it! i do not recommend that anyone else engage in my insane behaviour!

Hi @ttjmom. It’s a long story. Sleeve has been awesome for many, just not for me. If you care to read it, here you go... 3rd Bariatric Surgery: I realize that most people will probably gloss over this topic...because for most 1 surgery works and is enough and if you fall into this category, please know how fortunate you are. This is not my story I am 5'8. In 2007 I was 273lb's and miserable! I got a Band. Following 13 fills and unfills the best I lost was 60lb's, I never achieved restriction, and unfilled to have 2 kids. All weight returned. In an unrelated accident my port flipped, and in 2015 at 265lb's I was revised to a Gastric Sleeve (Also had my gallbladder taken out, a Haital hernia repaired and the band removed). I lost 60lb's in the first 4 months and then...stopped loosing. At 205lb's I would have been happy with my results, but then, I felt no restriction and started to regain! Fast forward almost 3 years to today...I have developed GERD pretty bad and I've regained most of what I lost back! My stomach feels hungry every hour or two, I could always eat WAY more than my sleeved friends, and once I got myself full, it would not take long for the deep primal hunger to return. I have no relief from hunger. Especially at night, I'm ravenous! I became a grazer! I felt that the Ghrelin was back with an Army to fight me! A 80% international traveling job plus unlimited access to food in the best restaurants around the globe did not help. I have felt dejected, humiliated, like a failure, angry, frustrated and the list goes on for miles, if you are still reading, you probably know how I feel. And indeed, It's not just about how I look...it's about how I feel. Horrible!! My weight is pressing, intrusive and pervasive. There is no time that I am not aware of it. I have sleep Apnea, I can't keep up with my 6 and 7 year old's and the simple things in life are hard again. Completely demoralizing... After almost 3 years, I finally said "Enough" and went back to a new Surgeon. An Endoscopy revealed it has not all been my fault. My Sleeve was cut too big to begin with! My new surgeon reveled he knows the work of the previous surgeon who apparently was not very skilled at the time and making sleeves too big to be successful. A Bougie 42 was was too big to begin with but in my case, even that was very loosely cut. To top it off, my Sleeve was mis-shapen to begin with as well, setting me up for failure and I have a Stricture in the middle, causing me to have an Hourglass shape. Top fills up, stretches, bottom is hungry, then food goes to the bottom and is still there, top is hungry, in short...a hot mess! Miraculously given the Haital Hernia, GERD, Stricture and botched initial surgery, my insurance (that does not cover Bariatrics) has approved a revision to Bypass on Aug 22nd. I've been combing the internet for Sleeve to RNY revision but such information is not as readily available as 1st timers. I am so nervous...so frightened to go through with this. Scared of Anesthesia, scared how I would do, scared of the 3 week post op liquid only phase. Scared that I will fail again, that this will not work. Some Surgeons (like the Pound of Cure guy say you can only expect to loose 10 - 25lbs on a Sleeve to RNY revision, woa?? ) But I have to try...I want to live a full and vibrant life and not just exist like an Amoeba! This is truly Project last chance. My husband is supportive, but my friends, judgmental and not supportive. and if ever I needed some advice, encouragement, support etc...it's now... Nervous but cautiously hopeful, and very much in need of your support... Ellie

I started vitamins months before my surgery and resumed the day after surgery. I take Bariatric multi Vite and Calcium.

@PENGU1N-- It was hard to argue with the facts presented by a bariatric surgeon at the seminar I attended - "Obesity is a disease -- a chronic disease -- a chronic, deadly disease" -- those stark words really hit me between the eyes. Once that sank in, I was totally on board, and 6 months later, am 4 weeks post op and down #30. It starts with being overweight, then maybe you add high BP to it, then high cholesterol, then joint pain, or maybe Type II diabetes, and sleep apnea, and the list goes on and on. It's no magic bullet, but it's the best treatment medical science has to date. If you had cancer or some other disease, wouldn't your spouse want you to get treatment? The general public is slowly coming to terms with the notion of obesity as a disease rather than a self-imposed character flaw. Cancer is also not caused by a character flaw.

I drink Bariatric Choice drinks bc I’m lactose intolerant. 15 grams of protein. Cut the little pouch open and pour liquid into water. If it’s too sweet add more water 😊 for nausea from anything I use Preggie drops they are a Godsend!

Hi Guy, This is my first post to the forum, but I have been doing a ton of research lately and I am trying to decide whether surgery is right for me and which procedure to go with. I am a 44 year, 5'10" and at my highest weight I was 258. I was always a thin guy up until my late 20's (when I was generally around 185). In my late 20's, I somehow managed to get up 210, then went on diet and started working out and got back down to 185 in a couple of months. Then I got married and got up to 220, then back down to 200, then back up to 241, then down to 215, then back up to 256, then down to 217. Now, I am 44 was back up to 261 of June this year. The pattern is pretty clear and continuing going up and down the scale isn't doing me any favors. I was sort of on the fence about surgery, but last month I was diagnosed with Type 2 diabetes and that freaked the crap out of me. I always knew I was at risk cause I get the fat all in my tummy, but it's one thing to be at risk and another to actually have the disease. I also have high cholesterol, high triglicerides and sleep apnea. At this point, I am really concerned about my health. I am married and I have two young daughters, 2 and 7, and I would like to live to see grand children someday (and live with good health--not with crappy quality of life). My cardiologist referred me to a bariatric surgeon in March, so I have been through the initial seminar, consultation, nutritional counseling and monthly weigh-ins. At that time, I was leaning towards VGS, but that was before I was diagnosed with diabetes. Now, I am thinking maybe RNY is the better option? I would like to be able to consider mini-gastric bypass, but it doesn't seem like any doctors in the NY area perform this procedure (I don't think many in the US do it actually). I am kind of scared about doing this, but more scared about not doing it. Is there any reason why I should go with VGS over RNY??? Thanks in advance for the advice!!!

Had 2 shakes 1 Bariatric pal cream of chicken soup and 25 oz of water. Ready to drink 32 oz the dinner shake and finish with my Greek yogurt

I've attached a PDF of the latest UHC medical policy which does include a 6-month diet requirement: "The individual must also meet the following criteria: o Documentation of a motivated attempt of weight loss through a structured diet program, prior to bariatric surgery, which includes physician or other health care provider notes and/or diet or weight loss logs from a structured weight loss program for a minimum of 6 months;" I've been preaching against these diet programs for many, many years ( "June Gloom" & Bariatric Surgery Insurance Denials ) because there is no evidence showing these delays improve outcomes. They are especially dangerous to start towards the end of the year because of the risk that coverage might change after January 1st. Good luck and I hope this information helps any UHC folks out there! Regards, Walter Lindstrom UHC bariatric-surgery.pdf

Yes, pre op classes lol at least that's what they called them when I had my Lap Band done in 2005. The classes at Tufts NEMC cost $250 each and we had to take three of them. That was also when you had to pay for lap band fills. So a long time ago. I'm asking about Tobey. I was hoping I'd find someone to chat with about their experience with Tobey's bariatric program. Especially if they have had a revision from Lap to something else.

I agree with Matt. Also, as a revision surgery you are likely to not lose as quickly someone who is having a bariatric surgery for the first time. Let your body heal and follow the program and you will see results!

Hi! I'm having my lap-band removed September 13th and once healed I will have the sleeve done. I have been banded for 10 years and I am so nervous. I am nervous that a million things could go wrong and that I might not be able to get the sleeve. My surgeon told me that it would be a two step process so I know its not going to get done in the same day but I am just so worried I would be able to get another bariatric surgery. Before I was banded I weighed 295. My lowest weight with the band was 164. Last Summer I started having issues where my food was getting backed up in my esophagus and making me vomit. My band can no longer take fills. I actually gain weight still with fills. I now weigh 214 pounds. I was hoping maybe somebody is in the same situation as me or have done this as well and can be my support. My family is a great support but obviously they have never had a bariatric surgery before so none of us know what to expect.