Search the Community

Jujube, he is your PCP, not your bariatric surgeon. This is one time I will say ignore your doctor LOL. He is not trained in bariatric procedures and has no business telling you things that he is not an expert in. You will do fine and you know what you need to to do succeed. It's too bad he is not supportive, it makes such a difference. My PCP and his nurse have been very supportive - and curious. My PCP did research on the sleeve so he could treat me properly. I really appreciated that. Now he orders a different range of tests when I see him so he can check my Vitamin levels, Iron, Calcium, etc. in addition to the regular stuff.

For those who haven't been following my story............... I was diagnosed with an eroded band in November of 2011 and had it removed in March of 2012. I had to wait for six months before revising to the gastric sleeve as my surgeon wanted to wait for me to heal completely and do medical tests before confirming that I would be a good candidate for the sleeve. I have complete those tests and he was satisfied that I could have the sleeve. We also found that I had developed another hiatal hernia (the first one was repaired when I had my lap band surgery). My predetermination request for the sleeve surgery was denied. They stated that I needed to complete a six month weight loss program in order for them to consider my request. I asked my surgeon's insurance coordinator to appeal based on the reasoning that this was a repeat surgery for a lap band that had medically failed me and that I shouldn't have to complete the six month medically supervised weight loss program. She filed an appeal but no where in the letter did it address the six month weight loss program so of course they denied me again stating that we still hadn't submitted the records they had requested. Frustrated beyond belief, I took the initiative to write my own appeal letter. I used language from the BCBS-AL bariatric policy regarding repeat surgeries and their rationale for requiring the six month weight loss program and explained how I had met that rationale just by having a lap band for four years and that my waiting for six months before revising to another surgery was not conducive to improving my health. I just got off the phone with BCBS-AL and they have approved my surgery!!!!!! I am actually shocked that I succeeded in my appeal. I fully expected them to deny me and had already started the medically supervised six month weight loss program in preparation for that denial (and have lost 10 lbs over a six week period which is nice). I'm excited, relieved and nervous! I've been through this before so I don't know why but I am. I was very successful with my lap band (losing 94 lbs). I remember how wonderful it felt to be thin and feel good about myself and how I looked and not to be in pain anymore from carrying around all this extra weight (yes I packed the pounds back on after my band was removed). I can't wait to be there again! Yeah me!!!!!!!!!!!!!!!!

I've lost at pretty much the same rate since banding, though it's slowing down considerably now that I reach goal. It was very difficult, but I ate as if I had restriction even when I didn't. I know that doesn't work for everyone. It took me three fills to begin to feel restriction. After that, things got way easier. They have gotten progressively easier since. Well, except for the natural slowdown that has occurred as I've gotten nearer to goal. I have consistently eaten 2-5 oz. lean Protein and 1/2-1 cup nonstarchy veggies for my meals. I use 1-2 protein supplements/day. I journal on Fitday, and aim for 800-900 calories, 80-100 g protein, and <50 g net carb/day (primarily from veggie and legume sources.) I do not eat sugar, or use caffeine any more (important for appetite control, for me). I make sure I get adequate heart-healthy fat (supplementing with omega-3s). I take a good bariatric Multivitamin (and supplemented with zinc and Biotin during the hair loss phase), and take Co Q-10 daily, too. I exercise daily, at least once. For me, each of these components is important. It doesn't mean I don't occasionally indulge, but 99% of the time, I achieve what I set out to do. It's worth it, weight-wise. But mostly, I just FEEL a bazillion times better. Your mileage may vary--not everyone needs to follow the same regimen for success. This is just what works for me.

Did your surgeon not provide a plan or a nutritionist to help you plan your post-op eating plan? I ask because doctors/nutritionists vary quite a bit in what they recommend. @@roundisashape gives a really great plan. But if your doctor/nutritionist did not give you a specific plan, you can do a web search of "gastric sleeve eating phases" and you'll come up with many medical websites so you can see the different recommendations. I'm just concerned that your surgeon would perform a surgery and not give you a list of foods to eat that he/she wants for their plan. This is the link to my surgeon's plan. You can see the different phases and recommended foods and eating times: http://www.360bariatrics.com/360-process/bariatric-diets/

Jan. 18, 2013 -- More than 200,000 weight loss surgeries are performed each year in the U.S. Several recent studies have questioned the effectiveness and safety of one type, gastric banding, which has led to a decline in its use as patients choose other surgical options. But the largest and longest study yet of the procedure found that patients followed for up to 15 years maintained significant weight loss -- an average of about 60 pounds. Study: Banding Effective for Weight Loss About half the patients in the study needed additional surgeries to adjust the bands or deal with other complications, but only about 1 in 20 patients opted to have the bands removed. Researcher Paul O’Brien, MD, of Melbourne, Australia’s Monash University, was a pioneer of the Lap-Band procedure, and his latest study was supported by Allergan Inc., which markets the gastric band system. He says gastric banding offers an effective, reversible, long-term solution for weight loss as long as patients get good follow-up care and are willing to carefully control the way they eat. The study is published in the January issue of the Annals of Surgery. “Placing the band is just the first step in the process,” he says. “Compliance and follow-up are critically important. There are plenty of people out there doing this surgery without a follow-up program for their patients, and they are setting them up for failure.” Banding, Bypass, and Sleeve Gastrectomy The Lap-Band procedure is one of several weight loss surgeries performed in the U.S. and the only one that is easily reversible. The band is an inflatable silicone ring that is wrapped around the upper part of thestomach to create a pouch the size of a golf ball, which limits the amount of food that can be eaten. The band can be tightened or loosened to increase or decrease the size of the opening to the lower stomach. The most commonly performed type of gastric bypass surgery also reduces the size of the stomach to that of a golf ball. The surgery also bypasses a section of the small intestine, which limits calorie absorption. The gastric sleeve procedure involves the surgical removal of a portion of the stomach to create a "sleeve" that connects to the small intestine. Just a few years ago, gastric banding was widely seen as less risky, less costly, and less invasive than either of the other surgical options, and about half of weight loss procedures in the U.S. involved banding. But that has changed as the long-term data comparing weight loss surgeries has come in, says Ronald H. Clements, MD, who directs the bariatric surgery program at Vanderbilt University Medical Center in Nashville. Fewer Lap-Band Surgeries Performed Clements says just five of the 360 weight loss surgeries performed at Vanderbilt last year were Lap-Band procedures. “We have essentially stopped doing this operation,” he says. “The sleeve and the bypass are just better for helping people lose weight and keep it off. That’s what we are seeing in our patients and that’s what the data are telling us.” A 2011 study from Belgium found that the bands eroded in 1 in 3 patients, while 60% required additional surgeries. And a study published last year that compared banding to bypass surgery found that bypass patients lost more weight and kept it off over six years and had fewer complications. Four years ago, as many as 40% of weight loss surgeries performed at Lenox Hill Hospital in New York involved gastric banding, says Mitchell Roslin, MD, who is chief of obesity surgery. Today, the figure is closer to 3%. “Last year we took out 80 bands and converted them to other procedures,” he says. “Patients do well in the short term, but they tend to have problems later on.” Banding Good Option for Some American Society for Metabolic & Bariatric Surgery President Jaime Ponce, MD, confirms that fewer Lap-Band surgeries are being performed in the U.S. Allergan’s sales related to its Lap-Band system reportedly fell from close to $300 million in 2011 to about half that figure last year, and last fall the company announced that it was looking to sell its weight loss surgery division. But Ponce says the surgery is still a good option for some patients. “The band is a device that requires a lot of maintenance and multiple adjustments, and one problem is that our insurance system is not set up to pay for this,” he says. He says gastric banding is much more popular and widely performed than gastric bypass in Australia. “In Australia, aftercare is covered by national insurance, so patients don’t have to worry about paying for adjustments,” Ponce says. And there are plenty of gastric banding success stories here in America, including New York Jets head coach Rex Ryan, who lost more than 100 pounds after having the procedure in March of 2010. Ponce says patients who understand that gastric banding will require careful compliance and frequent follow-up visits to their doctor can achieve good results with the gastric banding surgery. “Patients need to be followed, preferably every month or so,” he says. “If your surgeon doesn’t offer this kind of follow up, you need to go somewhere else.” http://www.webmd.com/diet/weight-loss-surgery/news/20130117/lap-band-shown-effective-long-term-weight-loss?page=2

Glad to hear that your recovery is going well! That sharp pain near your sternum could have been from repair to a hiatal hernia which is pretty common for surgeons to fix while performing bariatric surgery. You might ask your surgeon if there was a hernia repair during your procedure. In any case, glad to hear the pain has subsided. I hear you loud and clear on the Protein shakes. No matter how many flavors I had, I dreaded the next shake!! I did find some water-based Protein drinks that really helped as they had different flavors and textures than the shakes. About Time Prohydrate and Isopure were 2 that really helped offer a variety. Also, adding Protein powder to Soup broth was a good alternative. Glad to hear things are going well and welcome to the "other side"!!

With all the information out in the world about weight and health, you want to make sure you’re getting the facts. As you’re sorting through all of this information, how do you know whether or not what you’re hearing, reading and seeing every day is accurate? This is a common thought of many people who have struggled with their weight and health. To provide you with the best information, the Obesity Action Coalition (OAC) will be in Los Angeles on Saturday, November 7 to host YWMLocal – Los Angeles 2015, a FREE half-day educational event. YWMLocal – Los Angeles 2015 presents safe and proven effective weight management strategies led by the country’s leading experts in weight and health, such as: Cassie I. Story, RD, a dietitian and creator of the food blog www.WLSDailyPlate.com who has been working with bariatric patients for the past 11 years. Deborah Bade Horn, DO, MPH, FASBP, vice president of the American Society for Bariatric Physicians (ASBP), who will be speaking about non-surgical treatment options. Sajani N. Shah, MD, a surgeon and assistant professor at Tufts University School of Medicine who practices minimally invasive surgery, with a focus on bariatric procedures. Our experts will address a variety of topics, such as weight management options, helpful nutrition and dietary guidelines, exercise information and demonstrations, motivational and inspirational messages and more! This free event is open to anyone who wants to learn more about their weight and health, and do so with the guarantee that they’re receiving information driven by science and research. Are you in or near the greater Los Angeles area? Join the OAC on Saturday, November 7, from 8:00 am to noon at the Los Angeles Convention Center and hear from a variety of experts in the fields of weight, health and nutrition. CLICK HERE to register online for the FREE one-day event.

Hello, This is my first post. I have been a lurker for about 9 months now. I have been inspired in my Quest for the VGS by so many of you and your courage. I too have done all the research and feel that the VGS is my best chance for long-term success with the battle of the bulge, and the most safe & effective way for me to get there. I have co-morbidies, along with my current BMI of 38.4, I am eligible for the surgery. I have Bariatric Insurance coverage for Bypass & Band, but I found out today from my surgeons office, no VGS coverage, "to date". Not FDA approved, blah, blah!! I work for a hospital that is a "Bariatric Center of Excellence" and promotes the VGS as a weight loss option, but won't cover it on their insurance for their employees. Ain't that about nothing!! My Bariatric Coordinator is suppose to talk to the Insurance Medical Director tomorrow. Thoughts ~ Should I just submit my paperwork for the VGS with a letter telling them why I feel I should have the surgery (up front type of appeal) OR should I just wait for a denial to do an "official" appeal, OR should I just submit for the bypass. The Band is not an appealing option to me. If I am going to do the Band, I might as well do Atkins another round, or another "diet". I don't want a bandaid this time. If it's not for the "long" haul, I don't want to do a drastic surgery. . .Someone told me a band is better than nothing, though. Thanks in advance. Queenie :001_tt2:

like Ilene says, it does have the rep of being a kind of bariatric mill, and the last two times I've been there I have to wait out in the hall for an hour as there were no seats. that said, the care is excellent. i had my surgical consult with dr. ren this last week, and she was wonderful. i think it may have been the best, most respectful doctor's appointment i've ever had. i almost cried with gratitude at being treated like a human being!

Mexico is a great option. Just make sure you do your homework. Don't just shop price. I wanted a surgeon that does surgery in a hospital and not a clinic. Most importantly look at the surgeons credentials. I had my surgery with Dr. Valencia in Tijuana. The cost was $8,100. He also does surgery in Ensenada for $8000. He is a professor of bariatric surgery at the University of California Los Angeles (UCLA). That was the main that reason that I chose him. When you start eating solid food, if it gets stuck you will PB or throw it up. It sounds worse than it is. You have to take small bites and chew very well. Sometime we forget but you'll learn after a little while.

A lot of people I know including myself bought the premier protein drink premixed . 30 g of protein and 1 g sugar at Walmart. It's a little expensive but I pair that with a bariatric tailored powder protein I bought at the docs office ..you have to make sure it's an isolate. The premix might get you through until you can research the powder you want

Dr. Thomas Umbaugh of Blossom Bariatrics in Henderson...they are off Sunset, near Stephanie

Hello, ol' timer! Here I am 63yrs and heading for skin surgery. For vanity??? Hell no! Those days are gone --along with the Yankees winning season! However, I am having skin removed to save my spine. Go figure, right? My orthopod and my bariatric surgeon agree that removing the loose skin will keep me from having another spinal surgery. So bye, bye skin. AND as long as he's "down there", he will "fix the thighs and lady bits". I'm just glad that at 63yrs I still have "lady bits" that warrant fixing!

Isaiah 40:31 But those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint. Have a Great Day! Love All of You!! Always Have Hope in The Lord He Will Renew Your Strength!!

You can google meal plans for after bariatric surgery. Put together your own plan staying high Protein and low carb. It shouldn't be very hard to do.

Love how you post in the Mens Room and get mostly female answers? Upper GI endoscopy is probably the test. (The tool is an endoscope, the procedure is endoscopy, and upper GI is where they're going.) You'll most likely be in twilight sleep for it, and completely unaware - or maybe slightly aware. I can remember being wheeled into the room. I remember them telling me "We're going to stick this in your mouth" and it looking like a big beige Tylenol with a hole in it (they thread the camera through it), but I don't remember it going in my mouth. I also remember them telling me they were going to spray the stuff that numbs the throat (limits gag reflex) but I don't remember tasting it or anything. I just remember these things as snapshots after the fact. It's truly no where near as horrible as I expected it to be. Usually insurance companies are wanting "documented" weightloss attempts (e.g. those mentioned before, for which you would have a receipt, or log, or weigh-ins, or could somehow verify you really did it). But not always. Write down anything you can think of: what you did, what you lost, etc. In my documentation for my first bariatric surgery (lapband) I included a crazy, but successful diet I did ~1995 where I ate whatever I wanted but no more than 10gm of fat a day. I also documented my Atkins diet attempt, for which I printed out logs I'd kept on an Atkind diet messageboard. DcMak72 - it indeed will be here like *that*. Use the time to get your preparations done - find a few Protein powders you like, start making the behavioral changes you'll need post-op (e.g. chewing everything to goo - breaking bad chewing behaviors is harder than it seems it would be), if you don't yet start ensuring you're taking in 64 oz of Water a day, at least -- if you're going high protein use 64 oz as your base, and add 8 oz for every 25 lbs of weight you need to lose. I had to wait about 6 mos between my band removal and my sleeve (insurance fiasco), and about 1.5 mos between being scheduled and surgery date. At the time it seemed impossibly long, but overall it flew by. Best of luck!

I was cleared for ANY pills, capsules, gel caps etc... one month post surgery. I've been off bariatric Vitamins and back on Silver Centrum since 9/1. I couldn't stand taking the baritrak vits (mixed with 8oz of Water downed in 15 minutes), or the chewable ones, they didn't make me sick, they were just disgusting.

Date Printed: January 5, 2007: 10:48 PM Supplemental Letter for January 9, 2007 January 3, 2007 Dear Review Panel: Presented to you for review is my case for a gastric procedure known as a laproscopic banding procedure or "Lap-Band". In a lower review, BCBSFL did not dispute that I meet the criteria for the Lap-Band procedure. There is no dispute that I would benefit from weight loss surgery and there is no dispute that losing weight would be beneficial to my health. At issue is the coverage of this surgery and the exception I am requesting for this exclusion. Ironically, I received a phone call a few weeks ago from BCBSFL's new Diagnostics Program that offers support to wellness. Through this program, I gained beneficial information in the form of a booklet, catalog and DVD on the very weight loss surgery I am requesting. There is evidence in my medical records that I have tried for years multiple weight loss regimens and used pharmacotherapy for obesity under the supervision of my physician, Dr. Alan Sichelman. For my mental state, it is documented by my therapist, Jane Fenby, that I have a full understanding of what this procedure entails and that it will be a lifetime commitment on my part. There is no indication that I am unstable, misinformed with perceptions of unrealistic expectations; Rather so, that I have pursued this avenue under the direction of my primary care physician and other medical personnel, with cooperation, information and education; That I am laying the course for my surgical event and post surgical life by the compass of these individuals and their combined medical expertise demonstrates I am an individual who very much wishes to be healed. Unquestionably, I am ill and feel I am fighting for my life. As a result of my severe morbid obesity, I suffer from sleep apnea, diabetes, depression, back problems, joint pain, hypertension, migraines, Pictures will show my condition and the severity of my obesity. It is true that my life is endangered. This procedure will prevent the worsening of my condition, alleviate present harmful medical conditions and perhaps cure them. It is the conclusion of my physican(s) and myself that I am in need of this operation. Please authorize my surgery. Additional: As providers of health care coverage, Blue Cross and Blue Shield has historically authorized weight loss surgery. Currently, Blue Cross and Blue Shield of North Carolina cut in half hospital re-admissions "by the twelve surgeons in North Carolina that are designated as centers of excellence for bariatric (obesity) surgery." Additionally, BCBSNC was one of the first insurers in the nation to officially recognize centers of excellence for bariatric surgery. Illinois also follows this model as well as South Dakota, Iowa, Michigan and several other states. In recent publications in the Tampa Bay area, BCBSFL appears to be using bariatric surgery denials as a financial decision rather than one in the best interest of patient care. I must express my concern that with sufficient evidence from their medical providers and informed decisions with which they move forward, it is very troubling that patient/physician decisions of health necessity are disrupted, ignored and denied, superceded by a focus on cost. It is hoped that Florida will soon follow the successful excellence practice as established by Blue Cross and Blue Shield in other states. Patricia Reeves

I think each individual policy is different. I have BCBS of California and my husbands employer included bariatric coverage. Someone else can have BCBS of California and their employer may have chosen to NOT cover that, so it will depend on the policy not necessarily the carrier.

(Permission for this post has been sought and approved by Alex Brecher - the Bariatric Pal founder) http://goo.gl/forms/tzfhG1CzRk Have you had bariatric surgery more than six months ago, and within the last ten years? Research for a Master’s degree at the University of Nottingham would appreciate your help! I am carrying out a research project into barriers to weight loss upon completion of bariatric surgery. There is often little-to-no aftercare provided for bariatric surgery patients, and many people can find it difficult to adjust to their new strict diet and exercise regime without any external help, resulting in a lot of variability in patient outcomes. By taking part in this short questionnaire, you will be contributing to an important field of research that can ultimately help bariatric surgery patients achieve their full potential in their weight loss journey. Above and below is a link to an online survey, where we would like you to provide us with information about your experiences after your surgery. Please click the link and follow the instructions on screen. Please share as much information as you are comfortable with. This study has full ethical clearance from the University of Nottingham, and please be assured that all of the information you provide will be completely anonymised. Thank you for your help. Katie Sutherland Postgraduate Student in MSc Health Psychology, the University of Nottingham. http://goo.gl/forms/tzfhG1CzRk << Click here!

I began attending Bariatric Support Group Meeting. They are generally held once per month and are free. I began walking 30 minutes each day. Walking really helped to make the recovery process go smoothly and quickly. I gave up all caffeine and carbonated beverages. I had a 6 Diet Coke a day habit and making this one change caused me to drop 20 pounds. I had to suffer through a week of withdrawal syndrome because of the caffeine. But it was far better to go through this early then combine it with the recovery process after surgery.

I started on Bariatric Advantage chewable vitamins the day I got home from the hospital. Is having your abdomen cut open in multiple places desirable? A lot of what we have to go through pre and post op isn't desirable, but they're things we have to suck up and deal with. Having to add vitamin crystals to your protein drinks for a few days will be the least of your worries, so I wouldn't waste time obsessing over it. It'll be over and done with before you know it and then you can complain about how bad the chewables taste

I have been stalled over a month, so I feel your frustration completely. For me, it's become especially hard the closer to goal I get. I think all of our bodies go through periods of plateau. The severity and length of said plateaus just depend on the individual. You have lost quite a lot of weight in 6 months, and have a lot to be proud of. Keep mixing up your food and exercise routines and the scale will start moving downward again, you'll see. I agree with the folks above about 65-70% being normal excess weight loss for bariatric patients. I've lost nearly 80% of my excess weight, and I have my sleeve and my determination to thank for that . You will get there with perseverance and patience!

I can tell you from my own experience that the hospital process was incredibly smooth. It was kind of like hanging out. Got a beeper when I checked in. Beeper went off, went to the pre-op room, met with one nurse to go over medical history again. Told her I am a tough person to get an IV going and she called a different IV nurse into the room. Changed into the hospital garb, and then talked to the bariatric coordinator (who had been sleeved herself), until the anesthesiologist came in and put me in happyland. Woke up 3 hours later and it was over. The first week was not a lot of fun...the first full day home was the worst as I now had to get my own fluids in. Only pain I had was at the large incision point, no nausea at all. After a week, pain virtually gone. Averaging about 5 lbs lost per week. You will do fine. Complications are extremely rare in this surgery. My surgeon has done thousands of these operations and has never had a leak. Worst case if you have a leak is they do a bypass...not the end of the world.

January 25th, 2010. Nervous, but I know this is what I have to do. I am going with Dr. Stephen Myers with Fresh Start Bariatrics in Columbus, Ohio. Can't wait!