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Thanks to both of you. I do hope my body get's use to it too. It feels like my stomach is a wild horse that does not like being lassoed. And yes, the pain is worse at night. I had a 10 cc band put in, so I don't think it could get smaller, correct? No fill, I'm still on full liquids at this point. I am actually afraid of when I am spposed to eat food.

My surgery is scheduled March 17 at 10 am

Since you're confused about malabsorption... malabsorption is what allows bypass patients to lose weight so quickly. Long story short, part of the intestines that absorb nutrients & stuff from food is bypassed, so even though you consume it, you don't get anything from it. It's also why the dumping syndrome bypass patients get can be so severe. Different surgeons are biased in different directions. My surgeon, when asked by another patient, anwered that if one of his family members had to have WLS, he would want them to have the lap-band. To me, as he was my surgeon, learning that said a lot. A very good friend of mine had bypass and lost over 140 lbs in about 8 months. She is maintining at a sz 10. She says "I now understand some of the long term complications"... but she's only 2.5 yrs out. I don't have any details b/c this was in an email, but I'm eager to find out. I know that she does not, and has not for a while, look healthy. She's gaunt, pale... her energy is constantly low, and she has to go in for regular B12 shots. She has not come out and said, "I wish I had gotten the band", but it has been strongly implied in things she has shared with me.

I believe it's just like any time anyone loses. The closer are to your perfect weight goal the slower it comes off. We all know how hard it is to lose the last dreaded 10 pounds.. meaning the less weight you have on your body the harder your body tries to hold on to it. Hence low bmi'ers loses slower

I am 6 days out and the pain is mostly gone. Yesterday I ate some cream of mushroom soup and It tasted so good. I ate more than I should have. About 10 teaspoons and the pain was almost unbearable. I have been eating 5 or 6 teaspoons tops. I couldnt help myself. It felt good and warm going in! lol I was miserable for at least an hour. But I did not throw up! I am having a bit of a problem with my bowel movements and the gas. Only a tablespoon full comes out and soft and chocolate, from my protein shakes. Will they ever be kind of normal again? I am afraid to go out because of the gas and What if its not gas. I have not got the two sorted out yet. Has anyone else had this? My jeans have elastic waist and they go up to where my surgery was and it is uncomfortable. I have been roling them down. I went to my family dr for my first checkup. My sugar was 89 with no medication and my blood pressure was low 80/60. So, we may have to cut out my Lotrel blood pressure medication. I go back in 1 week to see how that is doing. I did not get a b12 shot, but took blood and will call with results to see if they r needed yet. I think I am doing good. I am so blessed with no diabetes medication! So HAPPY! Take care all!

Five-Year Study Of Morbidly Obese Finds Significant Benefits Of The LAP-BAND® Procedure Over Laparoscopic Gastric Bypass LAP-BAND® System is less invasive, less risky than laparoscopic gastric bypass, according to a five-year study comparing the two most common weight-loss surgery procedures for the seriously overweight presented at this year's American Society for Bariatric Surgery meeting by Emma Patterson, M.D., the senior investigator of the study and Director of Oregon Weight Loss Surgery, LLC (Portland, OR). "This was one of the first comparative studies of LAP-BAND and laparoscopic gastric bypass patients conducted by a single institution," said Dr. Patterson. "It is significant to note that at the five-year mark there is no difference in the weight-loss results between the LAP-BAND and laparoscopic gastric bypass patients, yet the gastric bypass has a much greater risk of operative complications." The study is an extension of a three-year study conducted by Legacy Health System published two years ago. The study concludes: - LAP-BAND patients have shorter operative time, less blood loss and shorter hospital stay compared with laparoscopic gastric bypass patients - LAP-BAND is less invasive with less perioperative risk to the patient - LAP-BAND patients have decreased complication rates Additional results of the study indicate that patients undergoing laparoscopic gastric bypass had statistically significant greater weight loss up to 4 years, but at 5 years, there was no statistical difference in percent excess weight loss between laparoscopic gastric bypass and LAP-BAND. The study also concluded that laparoscopic gastric bypass patients had significantly more major complications than LAP-BAND patients (10% vs. 5%, respectively). This observation was substantially different from the finding in the 3-year report, where no significant difference in major complications appeared between laparoscopic gastric bypass and LAP-BAND patients. As morbid obesity continues to be a global health problem, bariatric surgery remains the only viable, consistent form of weight loss for this patient population. "With the LAP-BAND System, there is now a safer, less invasive and more acceptable surgical option for patients suffering from the emotional and physical impact of being seriously overweight," added Dr. Patterson. STUDY METHODOLOGY The study compared a consecutive series of patients who underwent LAP- BAND (406) and LRYGB (492) for morbid obesity over a five-year period in a single institution. Most patients were able to choose between the LAP-BAND and laparoscopic gastric bypass procedures unless they were determined to be high risk (higher age, sex, male, super-super- obesity ((BMI greater than or equal to 60 kg/m2)), and presence of significant cardiopulmonary disease). All patients' age, sex, BMI, complications, mortality and excess weight loss (EWL) were examined. The LAP-BAND group had a higher mean preoperative BMI, and the LAP- BAND group had more patients with BMI greater than or equal to 60 kg/m2 (14 vs. 9%; P < 0.05). All patients underwent pre-operative evaluations by a psychologist, nutritionist, sleep study and laboratory evaluation at the Legacy Good Samaritan Obesity Institute. Prior to surgery, patients were instructed to maintain a low-fat, low carbohydrate diet and encouraged to lose at least 5% of their initial body weight. Postoperatively, LAP-BAND patients were seen at three and six weeks, monthly for the first six months, bi-monthly for the next six months, every three months for the second year, and then yearly thereafter. LRYGB patients were seen at three weeks after surgery, then every three months during the first year, every six months during the second year, and yearly thereafter.

Hi I was Banded on Sept 12th and I am like you I can feel it when I eat sugar free pudding or Jello. I also went to Target and bought me these 3oz plastic Solo cups they are like the ones you use in the bathroom for a small drink. Since I use them it helps me know how much Fluid I am putting in my body so that I do not over do it and get to full. I even use it for the jello or the cream of wheat. I have not once been sick or nauseated. I also just went to the doctor for my ten day check up and I lost 10 pounds and have already lowered my blood pressure. I also wanted to tell you about this Protein Drink I bought it is called Pro 5 and it is the best tasting Protein drink I have ever had it also mixes very well with a shaker cup with a cold bottle of Water and there are no clumps. So this is perfect if you are working. I mix it with 6oz of water then I have gotten in 34 grams of protein. You will have to look it up online and find out who distributes it in your area.

Sorry I feel like I'm bombarding the food board today but catching up with the stuff I neglected to post this week. Okay let's be honest, this isn't desert, but it's as close as I'm going to come to it right now, so I decided to enjoy it. Pics here: http://sleevers.wordpress.com/2013/10/02/pumpkin-caramel-bake-high-protein-low-carb-gluten-free/ Fall weather is here in Texas and it’s time to make something with pumpkin that’s still sleeve friendly. I adapted this from eggface’s pumpkin ricotta bake. It would actually make a nice Breakfast dish as well. Ingredients 2 eggs beaten 1 c ricotta cheese 1/2 c pumpkin puree 1 tsp pumpkin pie spice 1/2 c sugar-free Caramel syrup (I used Torani) 1 packet Stevia (optional) Toppings Handful of dried craisins Handful of slivered almonds Method 1. Mix together all ingredients. Pour into greased pan. 2. Sprinkle toppings . 3. Bake at 350 degrees for an hour or until knife inserted into the center comes out clean. Really, does it get simpler than this? 4. Let it cool or eat warm with whipped cream.

Went to my surgeon yesterday for a check up. I am not suppose to be eating reg food-got banded Nov 17th,. I thought I could eat in moderation after 10 days. WRONG AGAIN. So far my journey with this band has sucked. I DON’T WANT TO EAT SOUP UNTIL JAN 4TH!! I AM STARVING! CAN ANYONE HEAR M?. I swear if I would have known that I would have to eat like this for 2 months I would never have spent the money. Simply put- If I could eat like this on my own and had the will power, I would not be 5-5 and 206pds. I wanted the bands to fill full faster, not to eat like a vegan! Please help me! I need advice and support. Why am I so resistant to doing this diet? How do all of you do it?

Two solid months of soup is a wee bit harsh in my opinion, but going back to regular eating but only in moderation isn't good either, especially only after 10 days. Your doctor isn't willing to let you go to some mushy stuff like cottage cheese? If not, you can try throwing some hardier soups like bean and bacon in the blender because they will do a better job of filling you up than tomoato. Face it, there are some foods that will likely never sit well again because they're too hard to digest. I'd kill for a nice apple right now but I feel the pain just thinking of it.

I have lost another pound!!!!! I think I MIGHT be on to somthing here!!!??? Iziksmom - I totally got what you were saying in your post. I still watch my calories, carbs and fat. I think I am going to need too in order to feel like I am being honest and giving a 100% of myself to this. I had a high Protein breakfast square and was able to eat it (slowly and chewing!!) with little to no discomfort. I had a piece of lightly fried catfish for lunch 3/4th done I was done!!!! PAIN BURPING PAIN BURPING I pushed it and had that one more bite - as I wanted to get in the protein and calories that I feel this pressure to get in everyday. I am going to be snacking all day long to get this done and done right! I worked out today, burned 350+ calories. I did not work out last night as I came home and crashed after I posted and man did I need it!!! My day starts at 4:15am and I don't crawl in bed until after 10:30 and thats on the early side!! So I was worn out and took the excuse from having seen the doctor and had a fill, as a great one and went to bed at 7pm. Could I be on to something?! Do I have the restriction I need to get me thru the next 20 pounds???

Like a few others, my doc has no restriction on drinking before meals. One thing I do at home occasionally, during and aftermeals, is lick or take one small bite of a popsicle. It helps to cool down my mouth if I've eaten something hot, and it takes away my urge to drink during. Another thing you might try is to swish a teeny tiny bit of water around in your mouth and spit out - make sure you don't swallow any. After time, you'll learn to go without. It's not really an issue for me now, at 10 months since surgery. I just make sure I get enough to drink beforehand. All the best, Karla

I had my sleeve done on June 19, and am also stalled, except for when I actually gain a few ounces. I'm very frustrated, but it has really helped to read this string. I struggle with getting all my water in, and should walk more, so i guess I know what the answer is. Will keep at it!

I was banded on 01-20-2011. I feel I am completely restricted on everything I eat however, I know in a few weeks I will be able to eat once again. I have always craved sweets. I know I will be able to eat some and many other foods I love however; this to me is odd; I have never been able to do this. I know I will need to still monitor what goes into my body. I am really scared that because I have the band I will have the mind set that I can eat what I want. Is there many people out there that have similar issues? Is there many people who have had failure?

Here's a link to the thread I started when I found that study. I think I linked to the actual study abstract in it. It doesn't have long term (> 10 years) results, but those look promising when you consider the result comparisons up to that point.

I was banded on 6/10/08, and I still can not sleep on my tummy. I've always been a belly sleeper, and even laying on my side proped up with pillows has been too painful for me.

Pray and be patient. You had this surgery for change but you must do your part. I had the surgery Dec. 10, 2010. I am not per say hungry but I think the mind and stomach play against one another. When you feel hungry are you hungry or is your mind saying boy im hungry. I try and feel my time working or thinking about other things. I eat my share of sugar free fruit bars they really help. How much have you lost thus far. I weighed in yesterday and I have lost between 9-10lbs.... I'm excited and with results like this I care nothing about food or eating. I know the liquids get old but it's all worth it in the end.... Stay strong you can defeat this ugly monster named hungerB)

Ok here it is, no scrambled eggs, and no kind of potato! I had two episodes of being stuck after months of reading about being stuck, it finally happened to me. I went to Denny's with husband and ordered a veggie omelette after one bite and chewing and chewing with more chewing I swallowed and lord.....I though I was having a heart attack! I could not hardly take a breath and my chest right between my breast felt like something big was "stuck". The scary part was not really being able to breathe, then I started to get hiccups and felt like I was going to throw up. Next episode I think was a few weeks ago I had just one teaspoon of potato salad....same thing I was banded 12-01-2011 and I have a 10cc band. I have had 5 fills, and now have about 7.5cc in band now and I think Im good for a while. Never really experienced untill I had my last fill last month. But the scale has started to move finally...I was losing inches but no pounds. now im losing pounds

Hey momokev, my surgery date is sep. 19 and im scared and unsure. I went to a nutrition class yesterday and in my mind that was going to help me decide if i should do it. I wish I could get excited about it like you are. Chris

Help Center -Department of Managed Care This I my appeal letter to ask that you reconsider and approve the Sleeve Gastrectomy Weight Loss Surgery that was denied by Anthem Blue Cross because they consider the procedure investigational. I believe this surgery is exactly the tool I need to improve my health and the quality of the rest of my life. I have been told by several of Anthem Blue Cross customer service representatives that 43775 is a covered procedure and that as long as my HMO approved they would pay for the surgery. This is not what I am being told now. I have been getting the runaround on this for two months. I received a letter from my HMO dated 2/6/10(copy enclosed) stating this is not a denial of service but Anthem considers this procedure experimental and has to go to the Utilization Dept for a decision. The number to call this department was on the letter. I called this Dept. a minimum of 5 times and was told they don’t know what I am talking about, this dept. doesn’t handle HMO. So I call my HMO and they say “oh you have to appeal” so I send my appeal letter to Anthem on 2/16 and wait the 30 days for a decision. On the 28th day they inform me that I cannot appeal because I haven’t been denied, oh and the people in the Utilization Dept. don’t know that their department handles this?? So they send it back to the Utilization Dept and now I have officially been denied. This part of this process has taken two months, very frustrating. I. PATIENT BACKGROUND My name is Jeani Xxxxxxx and I am insured under group plan xxxxxxxxxx. My member ID # xxxxxxxxxxxxx. I am now 59 years old. I am 5/5 tall and at this time I weigh 233 lbs. I am seeking approval for weight loss surgery. I have been overweight to one degree or another since I was a young child and was advised by my pediatrician to diet at age 10. I have made numerous efforts at weight loss throughout my teenage years and adult life. I dieted frequently as a teenager and young adult. Numerous times I have lost 40-80 pounds or more but eventually the weight returns. Weight loss programs I tried include juice fasts, traditional calorie counting on quite a few occasions, Weight Watchers, Slim Fast, Nurti-system, the Atkins diet, Cabbage soup, Mayo Clinic diet, the Zone, gym membership, lap swimming, weight training, water aerobics, walking programs, various buddy-system diets and individual, self hypnosis, ”Think yourself Thin” “ Think yourself Thin Automatically, tape you listen to in the car” Dexatrim, Metabalite, Hoodia, Green Tea Extract, and numerous other fad diets. In all cases I lost weight but each time the weight crept back, usually with a little more. Eventually I realized that traditional dieting seemed to actually cause weight gain due to increased hunger that seems to occur after significant weight loss. I believe science is only now beginning to understand the reasons for this phenomenon which is consistently reported by clinically obese people. Studies also show that genetics plays a larger role than once thought and there are morbidly obese people in my family as well as slim people. My co-morbidities include high blood pressure, high triglycerides, low good cholesterol, have had abnormal EKGs, borderline diabetes, and osteoarthritis in my hip, which my doctor said weight loss would help significantly. I have also had sever back pain most of my life. I take hydrochlorothiazide and verapamil for high blood pressure which is effective. I take medicine, Niacin for high triglycerides. I have a family history of cancer as well as strokes, heart disease and severe arthritis. I take nabumetone almost daily and ibuprofen to help with severe leg pain related to arthritis in my hip. I have taken ibuprofin for back pain that i have had most of my life even when I was not overweight. I believe I will need NSAIDS even after WLS which is why I need the sleeve as this is the only WLS that you can still take anti-inflammatory medications. I buy over the counter ibuprofen as I can get 500-200mg pills for $10.00 which last over 6 months, whereas when getting prescription I only get 30 -800 milligrams for a co-payment of $10 which only last a month. My excess weight and other health issues makes everyday activities difficult including housework, shopping, standing, walking significant distances, working and recreation. It effectively makes my world smaller limiting the number of things I can do each day. I have lived with obesity for years and strongly wish to change this aspect of my life. I fear the consequences of my high triglycerides especially considering the family history i have of heart disease. Many members of my family died of heart attack and stroke. I was stunned to learn that my weight is in the obese category but heartened to learn of this newer treatment with fewer side effects and shorter recovery. I am highly motivated to succeed with VSG and understand that food intake will be significantly limited for the rest of my life and that I must continue to exercise to be successful. Before I found out about the arthritis, which is the result of a subtle fracture at some point in my life that affected the curvature and angle of my right hip bone (this was found by an MRI that was done after pain medication didn’t help and physical therapy made the pain worst), I used to walk a minimum of 30-60 minutes a day at least 5 days a week. Since this pain in my leg as a result of the hip arthritis I no longer can do that and I am afraid that the weight will just continue to creep up on me. My particular problem is in volume eating. I eat good food, lots of chicken and turkey, lots of fruits and vegetables, the thing is I am always hungry and I eat until I am full. Having a smaller stomach and feeling full sooner seems like exactly the kind of help I need. I had given up on traditional dieting as it always resulted in failure and am pleased to have found the VSG surgical option which appears to be the only tool offering a realistic possibility of lifelong weight control for me. I believe VSG is the best surgery for me because it offers restriction like the lap-band and the RNY but without the malabsorption of the RNY. The RNY is not an option because I very much need regular doses of nabumetone and ibuprofen for the leg pain related to my hip pain and even once I lose the weight believe I will still need ibuprofen for my back pain which I have suffered with most of my adult life. Tylenol is not effective for me. I am allergic to codeine, vicodin, any pain medication of that type I cannot take. Narcotic pain relievers make my head seem fuzzy but do not help with pain. I have the same concern about the lap band. I also understand that as many as 27 percent of lap band patients require band removal and weight loss is often unsatisfactory (I think the number is even higher now). Most importantly, the VSG removal of a large portion of the stomach removes many of the cells that produce the hormone ghrelin which is known to cause hunger and appetite. The RNY and lap band don’t have this advantage. At age 59 I am concerned about the side effects of the RNY and do not want to spend 6 or more months with dumping syndrome and feeling rotten. I also worry about the ability to take and absorb other medications I might need in the future as I age. The VSG appears to offer the fastest recovery, weight loss similar to the RNY and the least amount of side effects. One recent publication, “The Best Bariatric Operation for Older Patients “ by Drs Lee, Cirangle, Taller, Feng and Jossart, 2005, concludes that “These data suggest that the best bariatric operation for older patients may be the laparoscopic VG because it achieves the greatest weight loss with the shortest operative time and the fewest complications”. I have investigated this procedure very thoroughly including attending support groups and talking with others who have had it. I have completed most of the preoperative testing and strongly believe this is the best procedure for my circumstances II. THE VSG SHOULD NO LONGER BE CONSIDERED INVESTIGATIONAL The only stated reason for denying approval for the VSG is that it is investigational and …” current available medical studies do not show that this service improves health outcomes, is as good as or better than standard alternatives, or shows improvement outside the research setting”. It is respectfully submitted that this conclusion is incorrect. The conclusion ignores the 36 studies now available on the effectiveness of VSG which indicate that excess weight loss is similar to the RNY and that complications from surgery are actually lower than RNY. It also ignores the fact that the VSG is now widely performed and is routine for many bariatric surgeons and has long been performed outside the research setting. Anthem’s policy on Surgery for Clinically Severe Obesity is set forth in a document with an effective date of April 22, 2009. This document reviews the various forms of bariatric surgery and explains when weight loss surgery is considered medically necessary. VSG is excluded from ever being medically necessary because it is designated as investigational and that “…there is insufficient convincing evidence in the peer reviewed medical literature, in terms of safety, to support the use of …sleeve gastrectomy…other than biliopancreatic bypass with duodenal switch, in individuals with clinically severe obesity.”. Nevertheless, the lap band and Realize band procedures are approved as medically necessary in this same document based upon what appears to be two three year studies involving 219 and 352 patients respectively. There is now a considerable body of data and studies supporting the safety and effectiveness of the VSG as a primary procedure for weight loss. The June 2009 Supplement to Bariatric Times reporting on the Second International Consensus Summit on Sleeve Gastrectomy (available at www.bariatrictimes.com) includes 10 papers pertaining to the safety and effectiveness of the VSG presented by leading bariatric surgeons. In Reducing Risk in Bariatric Surgery: Rational for Sleeve Gastrectomy, Dr. Eric J. DeMaria concludes that “A growing body of evidence suggests sleeve gastrectomy may be an appropriate primary bariatric surgical procedure primarily due to low risk and ease of surgical revision when required.” In the paper presented by Drs Jossart and Cirangle, four years of data showed a 68% excess weight loss by VSG patients, a figure not largely different than RNY patients of the same time range. Most significantly, in Debates and Consensus: a Summary by Dr. Michael Gagner, important questions concerning the VSG were debated and conclusions reached by the 400 conference participants. Question 6 was as follows: “Question 6: In your opinion, is there currently enough published data to support the sleeve gastrectomy as a primary procedure to treat morbid obesity on par with adjustable gastric banding and Roux-en-Y gastric bypass? Several groups presented cohorts of patients with follow-up periods of 4 to 8 years the day before. Jossart and colleagues in San Francisco presented eight years’ experience including 1,200 cases, whereas at more than four years, weight loss resulted in a similar curve to gastric bypass. At higher BMI (greater than 55kg/m2) a plateau of nearly 40kg/m2 demanded a second stage, but below a BMI of 55, the operation was terrific. Schauer and colleagues assessed the literature from 35 reports, studied more than 3,000 published sleeve gastrectomy cases, and found an extremely low mortality rate (near 0.12%). Results have shown excellent weight loss and co morbidity reduction that is comparable to or exceeds other bariatric operations and that the sleeve gastrectomy is safe and efficacious. Himpens of Belgium analyzed his patients from 2001 through 2002(sic) to attain six-year follow-up. Sixty-five percent of 46 patients were considered a “success” (%EWL greater than 50 ) at two years. At six years the success rate was maintained at 59 percent. Weiner from Frankfurt and MacMahon of Leeds, who started in 2000, also had similar results. *** Certainly, the audience thought there was enough evidence published to support the sleeve gastrectomy as a primary procedure to treat morbid obesity on par with adjustable gastric banding and Roux-en-Y gastric bypass with a yes vote of 77 percent. This is perhaps the strongest contribution to this second consensus conference.” A review article entitled “Systematic Review of Sleeve Gastrectomy as Staging and Primary Bariatric Procedure” was recently posted on the web site of the American Society of Bariatric and Metabolic Surgeons dated May 26, 2009. The authors are Drs Brethaur and Schaur and Jeffrey Hammel M.S. of the Bariatric and Metabolic Institute of the Cleveland Clinic, Cleveland, Ohio. Thirty-six studies involving 2570 patients who had the VSG procedure were analyzed. Their conclusion was: “From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reductions that exceeds , or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been acceptably low. Long-term data are limited but the 3- and 5- year follow up data have demonstrated the durability of the SG procedure. “ To date ten thousand patients have had the VSG surgery with good success. Many are going to Mexico or other foreign countries because their insurers refuse to pay for the VSG even though it is less expensive than the RNY procedure, the so called “gold standard” of weight loss surgery which takes several hours and requires a hospital stay of 3 or 4 days. The VSG can be completed in one hour by a skilled surgeon and most patients stay only one night in the hospital. While there is certainly follow up care, the repeated fill and unfill procedures required by gastric banding are unneeded for the VSG. Nutritional supplements are much less of a problem than with the RNY. Many insurance companies are recognizing the value and cost effectiveness of the VSG and have approved the VSG for at least some patients, including BSBC Federal, Tri-west Tri-care Prime, United Healthcare, the Veterans Administration, Aetna, Blue Care Network HMO, Healthnet, Anthem BC of Connecticut, Definity Health/United Healthcare, PPO, Empire Blue Cross Anthem, and UHC. The VSG sleeve gastrectomy is now routinely offered by Kaiser Permanente to all patients that qualify for Weight Loss Surgery and would not do so if this surgery was not proven to work. I don’t think it is fair that if you have five people, one with Kaiser, one with United, one with Aetna, one with Cigna and me with Anthem Blue Cross of California, the other four will be offered the sleeve and I will not. The California Department of Insurance has recognized that VSG is widely accepted by the American Society for Metabolic and Bariatric Surgery as a standard procedure at medical centers for excellence. In Decision #EI09-9645 the physician reviewers reversed the health plan’s denial of the patient’s VSG request and concluded that VSG was the most appropriate option for the patient. The same conclusion was also reached in EI06-5882 though the patient had significantly more co-morbidities. That decision noted the important fact that the VSG is nothing more than the first part of the duodenal switch operation which includes the second step of intestinal modification and as such, the VSG portion has been performed for many years as part of the DS procedure. Some patients have the VSG first as part of a two stage procedure and find that they do not need the second stage. Thus, the VSG is not as new and investigational as Anthem’s conclusions seem to imply. Anthem does cover the DS procedure which includes the VSG as one part. According to an article published in the Detroit Free Press on August 17, 2009, Blue Cross Blue Shield of Michigan, in conjunction with the University of Michigan, has been compiling a large detailed data base on bariatric surgery in order to improve surgical outcomes and provide cost savings. In three years of data collection, it appears that the VSG now accounts for as much as 12% of all bariatric procedures. This percentage indicates that the procedure is far beyond investigational status. This data base indicates that 10,000 VSG procedures are known to have been performed. My Anthem group policy excludes investigational procedures and defines that term as procedures: “ 1) that have progressed to limited use on humans, but which are not generally accepted as proven and effective procedures within the organized medical community; or 2) that do not have final approval from the appropriate governmental regulatory body; or 3) that are not supported by scientific evidence which permits conclusions concerning the effect of the service, drug or device on health outcomes; or 4) that do not improve the health outcome of the patient treated; or 5) that are not as beneficial as any established alternative; or 6) whose results outside the investigational setting cannot be demonstrated or duplicated; or 7) that are not generally approved or used by Physicians in the medical community. It appears that the VSG, based upon the articles cited above, has been performed on thousands of patients, has been accepted by a consensus of participating members of an international conference devoted to this subject, is widely accepted by the ASMBS, does not require FDA or similar government approval, is in fact supported by at least 36 studies analyzed by highly respected physicians, is as effective as the RNY and more effective than gastric banding in terms of percentage of excess weight loss, has fewer complications than the RNY, has as good or better reduction of co morbidities as other procedures, and has results that are similar in studies by both United States and foreign physicians. The VSG therefore no longer falls within the definition of investigational procedures excluded from coverage. The conclusions stated in the previously cited Anthem Policy on Surgery for Clinically Severe Obesity are simply no longer correct and that policy should be updated to include VSG coverage or disregarded. With the VSG patients lose about 68% of excess weight and lower BMI patients like me often do much better. Weight loss will most certainly help my back and hip pain and improve ability to exercise. High triglycerides, high blood pressure, and borderline diabetes are corrected in about 76 percent of WLS cases and I am hoping for this result. It is therefore highly likely that my health will be improved by this procedure and I respectfully ask for your reversal of this denial. I am a mother and soon to be a Grandmother and I want to improve the quality of my life so that I will be healthier and able to help raise my grandchildren and be able to take an active role in their life.Thank you for your review of this matter. I greatly appreciate the fact that the state of California has a procedure to help insured patients who find themselves in disagreement with their insurance companies. I strongly believe this decision will greatly affect the quality of the rest of my life. Thank you for your time. I eagerly await your decision regarding this. I can be reached as indicated below if further information is needed. Enclosed is a copy of my denial letter from Anthem Blue Cross My HMO is Healthcare Partners Primary Care Provider is xxxxxxxxxxxxx Gastric Surgeon xxxxxxxxxxxxx Sports Medicine xxxxxxxxxxxx who ordered MRI and diagnosed arthritis Cardiologist xxxxxxxxxxxxx did my last EKG and stress test All these doctors agree Weight Loss Surgery is a good option for me. Respectfully yours, Jeani Anderson xxxxxxxxxxxxxxx xxxxxxxxxxxxxxx (xxx) xxx-xxxx Work info: xxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxx xxxxxxxxxxx CA 91101 (xxx)xxx-xxxx ext. 244

I am down to 216 from 235 in one week! 19 pounds gone! I have not weighed this in years. My husband has never seen me this small, I love it! The doctor said everything was good and then I had to talk to the nutritionist. she said to start taking some vitamins and start my protein shake.

Yes! It only took about 10 days. My doctor submitted the paperwork on Jan 3rd and got approved on Jan 13th.

So I wanted to update everyone. I am actually 29 years old. Great guesses out there!! The reason I asked, is because my entire life people have always thought I was at least 10-15 years older than I am. Since I have lost weight, I get a lot of the opposite, which is an entirely new feeling. Thank you so much for playing <3 So about a year ago, I posted on a few different forums asking how old people thought I was. Now I am 9 months post op, I wonder how I look age - wise now. If you know my age, please don't spoil it. I will post my age after I get an idea from people. Thanks for playing. Be honest. <br><br> Sorry it is sideways. I have no idea why it does that.

I think about 95% of people some sort of stall. I never had a true stall (14 days without an ounce lost), but the closer I got to goal, my loss slowed down. I didn't experience a stall for the first 6 months, and then I was a few pounds from goal and hit a 10 day stall, then BAM dropped those pounds plus 2 to drop me below goal. If you follow your post-op dietary guidelines, push Protein and fluids, the weight loss will continue, plus working out, building muscle mass can slow down your loss, but you'll be losing inches. A pound is a pound be it a pound of fat or muscle. Fat is lumpy and takes up space, muscle mass is lean, and takes up less space in our bodies so when we build muscle, it burns the fat, and we trim down even though the scale may not be moving. I recommend taking your measurements at your neck, breasts/chest, upper arms, upper thighs, waist, hips and calves. Your clothes might fit differently even if the scale isn't moving much because you're muscles are growing, and the lumpy, bumpy fat is melting away. Mentally prepare for a stall by realizing that your body can not continue to lose a pound a day for a year. Take your measurements, and document your progress in pictures so you can physically see the changes. If you hit a stall, analyze your intake and make sure you're staying on course food wise. Stalls happen, the rapid weight loss can't last forever, but you can continue to lose at a good rate by sticking to the rules. I dropped 115lbs in 6.5 months so it's possible to lose all your weight, and keep a steady loss going.

Thanks for all the good information. I am getting sleeved on 01/10/2011 with Dr. Kelly, and I am getting super excited right now.