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On the pre-op diet front, that depends upon the surgeon - many of us do no diet at all other than the day before to empty the GI tract. If you are talking to the same surgeon who did your original surgery, and he normally imposes such diets then you will likely be told to do it again, though one can make a good case that since you are at a reasonable goal weight you don't need to "shrink the liver", assuming that is the rationale that they use for the diet. All you can do is ask. When contemplating a revision, it is always a good idea to get a second (or even third) opinion, as these surgeries are often more complex and their causes more variable. If the cause is a shaping or other structural issue with your sleeve (which can have a big influence on GERD problems) then it may be better to correct the problem with the sleeve rather than replace it. As the sleeve is still relatively new to most bariatric surgeons, they may not really know how to correct a problem with a sleeve and prefer to stick within their comfort zone by converting it to a bypass, which they tend to know very well. A good starting place to look for second opinions on something like this is in the DS community - look for a surgeon who is experienced with the DS, since as that uses the sleeve as its basis, they tend to be more experienced with them than most, and tend to be more comfortable in correcting them when needed. The practice that did my sleeve had been doing them for around twenty years, and that was seven years ago - most bariatric practices at that time had only been doing them for a year or two at best.

Hey! Speaking of bariatric muffins ... that reminds me. I found a protein waffle at the local supermarket. The brand name is Kodiak Cakes. 2 of them have 280 calories and 15g of protein and only a total of 25g of carbs. Very filling an delicious!

LOL! Slow down there ... no love yet but I do like her. She understands the importance of staying focused to achieve weight loss and does med student rounds with a bariatric surgeon. That's why I am excited but have to temper it a little. I don't want to get my hopes up, especially because I am not working yet and still have progress to make. I am starting driving for Schneider National on August 6th. I have to be over 120 days post-op, before Schneider's medical team will clear me.

So many people try starving themselves.....and shoot themselves firmly in the foot. Your body doesn't want to starve to death, and it has a ton of amazing defense mechanisms built in to prevent this from happening....evolutionary coping strategies created by famines and poor hunting season...give our bodies all sorts of hormonal strategies for adjusting metabolism to deal with starvation and NOT LOSE weight. But here's the thing...if your body adjusts your metabolism down to deal with starvation...when you eventually do eat a semi-normal diet someday...it's gonna be a problem. You have a chance to rebuild your metabolism here. You don't want a sluggish metabolism that has learned to cope and survive on 500 calories a day. You want a hot burning furnace that runs all systems at optimal levels and gives you a ton of energy for exercise, burning fat and building muscle....at normal calorie levels as soon as possible. (that is the focus of my group's research...we are encouraged to eat 1000-1200 calories as soon as possible....initial studies support that more calories sooner leads to more sustained weight loss at 5 years post surgery, I'm part of a larger study meant to confirm these results in a larger test group) Bariatrics is an emerging field and there are a lot of ideas about how patients should lose weight post surgically. Old school models are extremely calorie restrictive. There are a lot of folks out there who have lost well on very restrictive plans. Some who have regained, some who have not. Ultimately...there are a lot of ways up this mountain. But, to me...the research makes sense. I want a hot burning metabolism that runs on quality fuel and gives terrific performance. I started eating 1000 calories per day at three weeks. I eat 1200 per day now and am never hungry and have a ton of energy. My weight loss has been steady. (a couple stalls, but par for the course) Another tip....Look up "three week stall"....it's extremely common to hit a stall at three weeks.

I’m three weeks out today , this morning I inadvertently took a huge gulp of water as I was making breakfast and no pain nothing !! For fruits and veggies I’ve heard to stay away from stuff like broccoli and celery. Certain fruits like bananas and watermelon that are high in sugars and can make your pouch feel bloated I will be honest though I’ve had both banana and watermelon and feel fine , I can only eat half of a banana and maybe 1/4 cup of watermelon before I’m full. I have had bad experience with broccoli. I loved them before surgery so on my purée state I tried them and threw everything back up!! I’m no medical doctor though just giving you my personal experience if you have questions call your nutritionist or Bariatric team they will be more than happy to give you medical advice

I'm one-week post-op today. My surgery was a success, even though my hospital experience wasn't. I'm happy for everyone who had successful outcomes all the way around. I feel cheated and still need to vent. I was soooo excited about my big day, so I have that I still fee bitter about the sub-standard CARING I received. Note the word CARING and not CARE. I expected to be treated much differently -- in a more compassionate and CARING way. Instead of being recognized as a chronic pain patient having bariatric surgery, I was treated like someone with ordinary pain. My surgery site was not the source of my pain, but I was treated as though it was. One mg of morphine for me is a Jell-O cup. I was not recognized as a whole person, and when I tried to get relief and mentioned the word GRIEVANCE, everyone turned into SAVE-MY-BUTT mode. There are details that don't give my story a bigger-picture perspective, so just try to imagine feeling dismissed or made to feel as though you had little value and had no right to expect better treatment. Help me release this anger, please! PLEASE!!! It's time for me to get on with my healing. I don't want to think about my grievances with the hospital any longer. I want to celebrate the new and improved me. I want to feel happy. Does anyone have a magic wand?

I'm just over 2 months out from my VSG, down 58.5 pounds, and am finding myself struggling in 2 areas: Eating Out and Losing Motivation. I've eaten out three times now, and each time I've eaten too much, to the point of feeling uncomfortably full. Are people asking for a to go box right away when they order? I find I keep picking at the food, and of course I've barely made a dent in the huge portions restaurants serve. What are your tips for avoiding overeating in a restaurant? My second problem is that since last Sunday, I have hit kind of a wall with motivation. I've had some significant family stressors crop up that has coincided with an ear infection/pain/loss of hearing in one ear for which I'm seeing the doctor tomorrow, and also a mental funk in that I'm having a hard time wrapping my brain around my new size and the idea of losing more weight. I recently swapped out all my old clothes for clothes 3 sizes smaller. I'm almost halfway to a healthy BMI, but truth be told, I'd be happy with an additional 30 pounds of weight loss (not necessarily another 60 pounds which is almost too much to even imagine). Hopefully this ambivalence and lack of motivation is temporary. I don't have the absolute clear minded focus I had in the early days post-op. I didn't deviate from the recommended eating plan, I was exercising with the frequency recommended by my bariatric clinic; all was going great, and I FELT great. I'm trying to take things moment by moment, day by day, and letting myself have a little down time, focusing on the family stressors and paid work, doing the best I can with following the eating plan, and letting go of exercise for this week, or at least until I can muster the energy to resume. I also have a sense of urgency though in that there is a window during which weight loss happens, and after that window closes, weight loss becomes much more difficult once again. I don't want to waste my window of opportunity. I want my motivation back! Has anyone else experienced this or something similar? Any perspective/advice/words of wisdom to share?

Hi all - i have an insurance-covered VSG scheduled for 6/28 and was curious if anyone had been in the same boat as me. I switched jobs a few weeks ago and was approved under my former job insurance which is active until 6/30. I have new insurance that kicks in on July 1 (after my surgery date). I was curious if anyone had experienced this across two insurances. I’m more concerned how the post-op care is covered or if it would be specifically excluded on my newer policy - especially in any worst case scenario with any post surgical complications etc. Certainly expect to go home the next day, but of course you never know! My new insurance does cover Bariatric, but only when employed by the company for 12 months and onward. Would love to hear others’ experiences here! Thanks in advance.

Hi all! I just found this forum. I had my sleeve on June 1, and have lost just over 20 lbs. I've moved from just protein powder and diabetic Boost to cream soups and yougurt. (Cream of chicken soup never tasted so good!) My problem is I can't get enough calories in or enough water. I should be drinking 5 cups a day, but I can't get in more than 2. Every time I eat anything, or take my suppliments, I'm so full that I can't get even water in without a lot of discomfort. It's like I"m full up to my throat. So I'm great as long as I'm sitting doing nothing, but moving around makes me dizzy and weak. I'm not sure how I'll be able to go back to work if I can't figure this out. Any ideas? I'm having lots of protein powder, incuding a tablespoon in every 1/2 cup of soup, but it isnt enough. Yesterday I managed around 500 calories, but only 49 grams of protein... I just saw my profile on the left - yes, my starting weight in the bariatric program was 310, but I was 285 on surgery day - so 20 lbs lost.

Every time I think there hasn't been something new, something else pops up even in Bariatric Practices Now what is this, what does it entail?

ON-Q pumps are an old dying thing. They're often filled with Naropin. They work fine, but now there is Exparel. Which basically works the same as an ON-Q pump, but instead of a giant ball hanging out of your abdomen by ON-Q catheters that you have to carry around. They just inject the exparel into you and it works for 48 to 72 hours just like the ON-Q without all the crap sticking out of and attached to you. We used to use on-qs for every bariatric case and many other cases, now they're almost completely extinct from our hospital. And ON-QS have quite a reputation for falling out and getting removed prematurely. They sometimes would even fall out before patients got out of the operating room

My insurance would not pay for WLS due to low BMI (35), so I decided to go to Mexico for surgery (self-pay). My surgeon in TJ did not recommend VSG because of my longtime history with GERD/acid reflux. Instead, he suggested One Anastomosis Gastric Bypass (aka MGB), which is a type of gastric bypass that is popular outside of USA (i.e. in Mexico, Latin America, Asia, India, Europe). I didn’t expect to get the MGB side effect (low incidence) of bile reflux so did not insist on an RNY instead of an MGB. The good news is that my insurance will pay for revision from MGB to RNY, which is a huge relief. In retrospect, I wish I had the RNY instead of the MGB. If I had to do it all over again, I would go to Mexicali Bariatric Center, which has some of the best WLS surgeons in Mexico, for a Roux-en-Y Gastric Bypass. Note that in spite of my issues with bile reflux, I’ve lost 100 lbs from my highest weight and am currently below goal weight. And I do not have any issues with bowel movements.

I keep hoping everyone stops posting...and then I post again...cause, lets face it....I need all Bariatric Store Rewards Points I can get for my next order of Protien Mighty Muffins. LOLOLOLOLOL....

A good way,go turn your frown upside down. Get,up and go for a walk. Look,around, find one thing that makes you glad you're there. If you're in the country, look around and observe something in nature. If you're in the city, still look at a building, architects and builders made that building so tall and straight, the pieces in a sidewalk, how did they become so square? The cobblestone, did someone fashion it or did it come from a rverbank like that? If you meet someone say Hola, smile, show them they matter and suddenly you may feel like you matter too. Say you meet An old lady with a bucket of water that's almost too heavy, help her with it. Any burden shared becomes much lighter. You miss your mother, you're sad you are in 2 different countries? Take some of the love you shared and pass it on to others, if you can't do it for yourself then do it in her honor. And by making someone else glad, the sad leaves you for a little while and you'll feel glad too. And you always have,Godmothers, brothers and sisters on Bariatric Pal. We have also felt as you feel. Talk to us anytime!😪to😝

The truth is nobody can quite find the negative in a positive like a bariatric patient. It is why I created this...to remind myself of how neurotic I was being regardless of what point I was at...I think a lot of people can relate to this...

it isn't how fast you get there it is where you end up. in my experience 99.9% of people who think they are slow losers are fast losers. I can probably count on my hands in the thousands of disappointed posts how many I would actually describe as slow losers. I considered myself a normal rate loser (not slow, not super fast). I'd wager most people who stress about their rate of loss lost at the same rate or faster than me. it is all a matter of perspective. People need to stop looking for things to critique about themselves. you will always look for and find someone faster and there will always be people slower. One thing I can say about my weight loss, is that I didn't do it on starvation calories and I lost 100% fat and gained muscle along the way according to my dexa scans. That is almost unheard of. Many bariatric patients I know lost at a rate of almost a pound of muscle for every pound of fat...that is not good. If you are losing 25 lbs a month and 12 of that is fat and 13lbs is muscle. and I lose 12 lbs but 13 is fat and I gained a pound of muscle. who is doing better at the end of the day....I am. This is why it is not useful or healthy to compare numbers on a scale with others. Could not recommend dexa scans more highly...it gives the most accurate picture of progress.

if you aren't tracking you need to be. it is the best way to stay accountable. Also, are you making good food choices? You are mistaken if you think it is about restriction. restriction lessens over time as your body adapts, that is normal and expected. most people can eat a whole plate of food by a year post op. it is why food choices and diet are so important and every bariatric program recommends a bariatric diet post op. the hormone grehlin does go away, but for most it does come back (your body is smart and adjusts). if you are experiencing hunger pangs (particularly if it is happening when it shouldn't) there is a possibility it is actually stomach acid and you need to get on a PPI like prevacid. you should talk to your doctor about it. I strongly recommend looking up dr Matthew weiners videos on youtube. he does a very good job explaining in laymans terms why and how bariatric surgery works.

Bariatric Evangelist, thank you so much for your feedback. I must admit I have not been getting as much protein in as I should. I drink plenty of water and I exercise a few days a week. I found myself getting discouraged and started snacking a little bit but quickly stopped that. I just don't understand why my pouch can take in so much.

I have BCBS of Michigan and my recent sleeve surgery was my 2nd bariatric procedure under the same insurance plan. The first being lap band in 2005. I haven't read the actual language of the policy, but when I went for my initial consult the doctor's staff came in prepared with it all printed out. They told me that the insurance required a 6 month medically supervised diet. It's also possible that there were BMI requirements. What I've seen is that they set a threshold for minimum BMI with and without co-morbid conditions. All other pre-operative tests seemed very routine to prove medical necessity and/or to make sure you were healthy enough to go through surgery: blood work, upper GI, psych testing, sleep study, chest x-ray, cardiac clearance, etc. both times the doctor's insurance staff asked me to write a letter about why I needed the surgery. Basically, I just explained my struggles with weight loss and tried to show that without it I would have more health problems. By the way, doing this really helped me put things into perspective and I learned that I seem to have a "set point" where my weight keeps landing. Both times, I got approved right away. Honestly, I had more trouble with insurance when I had the lap band removed in 2009. They denied and I had to go through a really messy appeals process that took so long the doctor/hospital started threatening me with collection.

Here are some good informative videos from a bariatric center I ran across on You Tube, if you haven't seen them already. Sometimes when you go to the sessions at your own facility you may miss things, these are helpful reminder or may help you develop questions for your own team. https://www.youtube.com/user/BariatricKC/videos

I am post op sleeve 3 years . I am in lake city fla. Had surgery at uf Gainesville fla with Dr Georgio rosdidis.i now see Dr Fredrick Lord I forget his last name sorry Dr tissue is moved on oh Jeffery Friedman whew. That's my new vsg care bariatric dr. Sent from my SM-S727VL using BariatricPal mobile app

@Fallinfast Does that mean I do 10 days on commercial protein shakes? My concern is that once I start eating more normally I would regain some weight? Have you tried the reset? I guess the answer is to be more patient. There are a lot of threads with people who are three week post op complaining about a stall lasting a few days. I resist the urge to roll my eyes but I’m not that different despite being nearly a veteran. However, because I have lost so much weight and I’m approaching the one year mark, I’m seriously concerned that this is it for me. My body is just done losing. When I met my bariatric surgeon, he said I would get to 110kg and that would be it. I applaud him for not selling me a bunch of insane expectations but in a way, I felt limited. Only when I found bariatric pal did I start to think I could smash my surgeon’s expectations and define my own goal. I saw people here determined to do amazing things. In spite of having a starting BMI of 50+, I felt like I could still go for it. Losing a little weight puts me at Onederland, gets me in the 80s (kg wise) and takes my BMI to merely overweight rather than obese. It would mean everything to get there. I hate this stall.

Made me laugh out loud. I think this is like...every bariatric patient ever. LOL:)

I have had a very interesting journey and it continues. I had s lap band done in 2008 in Tijuana Mx by Dr Corvala. That experience was better than the ones I’ve had in the states. I am a nurse, so when I say it was very impressive, it was one where I would consider having other procedure in the future. Over 7 years I had fills and un-fills because I could not tolerate a lot of fills and it got to where I had no fill for a couple of years... needless to say, I could no longer tolerate the fills anymore and went through my next surgery in 2014, through my insurance where I had my lap band removed and a VGS done. I only lost 50lbs in 6 months, despite my working out (I found a love for spinning) and eating small meals and drinking my Premier Protein shakes. My weigh got down to 195lbs from my surgery weight of 252 lbs... today I am 4 years post VSG. I weigh 252lbs gaining my weight back. I went to my insurance and asked to be evaluated for surgery to add the malabsorption to my VSG, I asked to see my surgeon that did my VSG because in my initial consultation we discussed doing a lap band removal and a gastric bypass. He talked me in to the VSG say that if needs to add the malabsorption to my VSG by converting to a Gastric bypass or DS. Long story short, I had a UGI series recently showed her I have not stretched my sleeve and he recommends me going back to square diet wise to loose the weight. So I have gained weight because, I had to stop working out due to chronic plantar fasciitis and a new diagnosis of fibromyalgia... I still eat mostly Proteins because it makes my stomach feel so much better. I need to go back to drinking more Water, but I feel like a failure despite my efforts. I do 5k walk runs when I can(I have very active friends and I enjoy doing these with them) but now these days, it’s very difficult.. now my planter fascitiis is better, I am having problems with my knees and having to get shots in them... So I believe if I had that malabsorption component to my surgery, as a tool: it would help me loose weight and keep it off so I can work out.. I am feeling like I do not want to deal with the bureaucratic issues with my insurance , so I’m thinking about going back to Mexico. I am researching currently a surgeon who can do the 2nd stage Duodenal Switch. I see people talking about Dr Illano but I don’t get the impression that he does a lot of these. There is a Dr Ungson in Mexicali who did them more often than most bariatric surgeon, but no longer works for the bariatric center, due to him taking on a job with the government. I heard Dr. Esquerra in Mexicali learned under Dr Ungson does them just as often. Has anyone had a duodenal switch or VSG revision with any of these physicians I just mentioned?