The gears are finally turning.......but slower and in which direction ? Surgery possible by years end.

[Dub 9,922]

When first making the decision to open up to the tool of bariatric surgery I simply assumed that the sleeve would be the procedure that I preferred.

This was due to having the full run of my plumbing and perceived ability to eat the foods I wanted, but restrict the amounts.

Seemed simple. My younger sister had bypass 15 years ago and I just didn't think that "aggressive" a procedure would be needed for me. After all.....I've lost large amounts of weight in the past through diet and exercise....I just needed a little help......or so I was believing.

My physician who was discussing this with me eased me into the conversation and led me to find my way to the surgeon I've selected.

I've been to his group presentation.....the first required step.

Even after listening to my sister and seeing her progress.......for 15 years......and for secretly thinking in some small way that she took the easy way out.........I didn't "get" it.

That presentation really altered my thinking about restrictive and absorptive restriction.

I realized in that group session my "hero" status as the big brother doing it on his own......over and over again......was a stupid cycle. I needed to get all the help available.....every tool in the toolbox to get the lifelong results I strived for.

Dr Carlson addressed the full room and fielded every question asked. An hour went by....then more.......he'd long since made his informative presentation.....yet stayed to discuss our concerns. A lot of "ah-ha" moments were had.

I heard the lady seated behind me speak to her friend, "The sleeve is what will work best for me".

My wife, seated beside me, was quiet. She reserved her comments until much later when we were driving home.

She proceeded carefully fearing that she knew my mind had already been made up on the sleeve. It was a relief to her when I acknowledged that I felt I needed the bypass.......like my brave little sister did so many years ago.....doing her own research.....as a young woman on her own.......when most folks hadn't heard of such.

One of my issues is reoccurring reflux.

Some nights it can be really bad.

It subsided greatly once I completely cut out alcohol from my intake on April 2, 2015.

Back in early April of this year I'd begun resuming the fight to loose my weight. I'd taken evaluation of my current state of living. I loved to grill out.........really loved it. It is therapeutic. I loved to crack open a cold beer and fire up the coals. More beer throughout the cooking and serving everyone had me relaxed and happy. After dinner, I'd normally get drowsy due to several beers......then it'd be time to hit a couple tequila shooters and another beer......or a rum & diet coke or two.

I'd get my relaxed and happy state back.

It was clear which non-essential calories to drop first......cut out the beer and liquor along with seriously revising the menu on my plate.

Guess what.....these were the nights the reflux was bad. Drinking + spicy food (the only kind off my grill ) = reflux.

I discussed this "revelation" with my wife. She pointed out a few times since when I'd complained of reflux....since I'd cut out alcohol. I realized she was right......it was still occurring but less often.

I have decided that I'd prefer the bypass.......but don't even know yet if I'm approved for it.

The waiting and suspense of insurance is driving me nuts. Don't get me wrong.....I'm glad the procedure isn't something as easy to get as a bad tattoo.......but I wish it was more straightforward from the insurance company standpoint. Down the road the results I get from the bariatric will certainly lessen the costs I'd otherwise pose to them, right ?

Sorry for the rambling. I'm just eagerly impatient and ready to get this ball rolling in the direction that will lead to successful and long lasting health provided I continue to do my part.

I'm checking stuff off the mandatory list at least.....and this website and the folks here are already helping me find answers to the tons of questions I have.

My mandatory checklist:

Attend the group session---done in early June.

Meet with the bariatric program's & surgeon's nurse to review my case and 8 pages of medical Q&A i was to complete--done this past week.

Meet with surgeon on official visit----scheduled for July 1.

Meet with program's nutritional guru----first of the 6 visits is on July 7. This I understand will be the "start" date of the mandatory 6 month timeline to surgery.

Meet with psyche guru----awaiting appointment scheduling now.

Internal scope evaluation of stomach and other plumbing-------to be scheduled after visit with surgeon

I still don't have any type of official indication that bypass is a covered procedure (United Healthcare).

I don't know if I can hang on 6+ months before getting this latest umbilical hernia taken care of.

I want to get on to eating the foods I'll be living by after the surgery......eat like I've had the surgery......begin accelerated weight loss now......not wait until the surgery. I just want to be sure that I can't lose "too much" on my own that the insurance balks and says, "No way buddy.....you got this.....do it yourself". I can do a lot off by myself.....but I fail to keep it off. I don't want to sabotage my chances for coverage.

So many questions that I'm sure will be resolved and clear in the weeks ahead......it's just right now I want to get going with progress of some type......no matter if it's from bypass or from my jumping onboard with the new plan.

The compelling reasons for the need to get going are probably no different than most other folks here:

I'm having back spasms from reoccurring back injuries due to herniated T-12 vertebrae. Spine surgeon stated that bariatric surgeon can do more for my spine than he could with back surgery. Sounds legit.

Umbilical hernia is driving me nuts. It's worsened when back goes out and my posture and such gets weird.

Knees are shot....ortho doc says I need knee replacements sooner than later....he's saying 5 years tops.....plus hip, too. He also stated that 200 lbs off my frame would push those replacements back a long time. I already feel some benefit in my knees from the initial pounds coming off. Swelling in my ankles is greatly reduced.

Sorry again for the rambling. I'm jittery after finishing up the last day of miracle steroids (4th round with them since April) on my back. The side effects are sleeplessness for me. I get jittery after the 6 day cycles. I'm hoping for a good long sleep later today....tonight.

Aside from dropping the alcohol, fried food and reducing sugar & starch intake (doing these).........what can you advise me to do?

What other dietary-related actions?

Breakfast choices now are oatmeal (made with Water and small amount of salt) vs sausage biscuits and such.

lunch & dinner has me eating lots of salads.

Snacks are nuts, fruits like blueberries and apples and occasional whole grain toast with small amount of health choice butter substitute or Greek Yogurt.

Drinking tons of water.

40oz of coffee every day during the first portion of the day......a lot, I know. I use nonfat Creamer and Splenda or Equal (10 packs for 40oz coffee).

I'm still having 2-3 20oz Diet Mt. Dew's every day. Sounds like a ton....but it's way down over the number I used to drink. I go to one a day on days off....but do poorly during workdays.

No more drive thru's and only salads from fast food restaurants.

What else should I be doing?

Should I order the "Big Book on Bypass" and get started on it ???????

Stir crazy and tired of my 46 years of fat fighting. 5 years ago I burned off 120 and felt like a new man.......still have many of the 2X & 3X clothes. I saved most of them.....refusing to toss them due to that being symbolic of me throwing away my hope of wearing them again.

I lost that weight.....but failed to keep it off. The brief period at that reduced weight was enough of a taste of healthier living that I have craved ever since. Virtually painfree and full of energy. Leaner.......able to wear my old high school letterman's jacket and button it up......too small still, but at least it would button up. Another 100 pounds off that and I feel like i'd be walking around feeling like a Gazillion dollar lottery winner.

I may never get a winning lottery ticket.....but I'll be supremely happy to get 200 lbs off........and MAINTAIN that level.

So ready to get this machine krunk up and in gear and burn some rubber down the track. This waiting is like sitting there with the engine revving up but the parking brake locked in place...........

[Djmohr 6,965]

@@Dub

I am so very very excited for you! You have clearly done a lot of thinking and researching WLS. You are well on your way to a much healthier life already.

I am glad to hear you have kept an open mind about which procedure to pursue. There really is a lot to understand.

I too had my heart set on the sleeve mostly because of all the hype. When I went to my first appointment with the Bariatric doctor and Bariatric nurse, they went over my full history. As we began to discuss the different options the fact that I suffered from Reflux and Gerd came up. At that time they recommended that I consider bypass instead of the sleeve.

I was devastated but decided I would do some research and get a second opinion. The more I researched the more I learned that the sleeve and band can both make reflux worse and in some cases give someone who has never had it, can cause it to happen. In my case I was already on the maxi u dose of reflux medication so if I had a problem with it post sleeve there would be nothing they could do to resolve it besides revise to a bypass. After I saw my gastroenterologist he definfinately recommended bypass and even told me that the bypass would likely cure this disease for good. Well, after that meeting it was a no brainier for me.

I had my bypass on 9/29/2014. I have been off all reflux medications at the 30 day post op mark. I have never ever had a single episode of heartburn, reflux or Gerd. I am down 105lbs and would like to lose another 40 although I look terrific already. I no longer have diabetes, stage 3 kidney disease, knee pain or ankle/foot pain. My sleep apnea has been resolved.

I do still have serious spine issues that have gotten worse but that was because I waited too long to do something about my weight.

I have normal to sometimes lower blood pressure and my cholesterol both good and bad are now all normal.

I feel so lucky that I have a second chance at life!

Your story is so inspiring and I really wish you the absolute best of luck as you go through this process.

In terms of changing some things now, you are asking at a perfect time. I would suggest going after one thing at a time but for starters stop with the soda. You will never be able to have it again post surgery so ween yourself completely off now so it is not such a shock to your body. Then start with coffee.

Practice eating your meals very slowly. Never eat for more than 30 minutes but try to take that whole time to eat your much more normal portions.

Also if up you can, practice eating without drinking 30 minutes before and 30 minutes after. This was the hardest for me to practice before surgery but I have had no problem sticking to it post surgery.

Also if you eat in front of the TV, try really hard to eat without distractions. It helps you pay attention to what your body is telling you.

Good luck and please keep us posted on your progress! I am looking forward to your success! You deserve it and are working hard to get after it.

[The Candidate 3,215]

A year ago I started this process in the exact same frame of mind. I was going to get a sleeve. Period, end of question. I actually have myself on video stating that exact same thing, quite vehemently too, as I had started a video diary for myself early on to track my progress.

I was perhaps halfway through my insurance's mandated pre op classes before I began to wonder if perhaps bypass might be a better choice in my case. I have the occasional reflux too. I also have a wicked sweet tooth, so dumping might not be a bad incentive to have to stay on track.

I'm also older (54), and really don't want to think of the possibility of having to revise to bypass if the sleeve didn't work for me. Not to mention the fact that my insurance has made it very clear that they will only pay for one wls per lifetime. I currently take a huge regimen of Vitamins anyway, so I'm willing to take on both the positive and negative outlets of malabsorption. In all I've come to believe that restriction just might not be enough for me. Hence, the switch.

So here I am, a year later, having completed every single requirement my insurance put in front of me, including losing 10% of my excess weight. I even have undeniable written proof of my insurance's approval in my hands and... I'm still waiting. I carry my phone with me everywhere, waiting for *that* call - the surgical consult. The last step before actual surgery. But because of the high demand and back log, I might not get there for another couple of months. I've resigned myself to the fact. But I know one thing, my resolve that this is the right step for me has never once wavered, and it never will.

There's nothing anyone can say that will make the waiting any easier. It's hell sometimes, I won't lie. But I'll get there and so will you. You've done everything right. Extensive research is the key. You have to know what's right for you, which might be something entirely different than someone else. WLS is definitely not a one size fits all kind of thing, and it's not something to enter into without knowing exactly what you're getting into. You sound like you are well on your way to being monumentally successful. Keep on that path, and you'll suddenly look back one day and realize that it all passed by a lot faster than you thought it did. That's what keeps me going. Good luck on your journey!

[Dub 9,922]

I hank you both so very much for your responses.

My reply is short now....in bed and sleeping.....getting ready for night shift tonight.

My iPad keeps crashing due to being overly full....memory maxed out.

This sight runs very slow on it.

Better response will come later when I can get to laptop or PC.

Thank you.

It's going to go well, I believe.

I'll use my time ahead wisely and educate myself as well as continue to adopt new methods now.

No more diet soda?

No more coffee?

Wow. That is going to take some mental adjustment. More than the sugary Snacks I've been dropping from the menu.

Diet Dew & coffee is like a food group for me. :rofl:

[InspirationMySon 135]

When first making the decision to open up to the tool of bariatric surgery I simply assumed that the sleeve would be the procedure that I preferred.

This was due to having the full run of my plumbing and perceived ability to eat the foods I wanted, but restrict the amounts.

Seemed simple. My younger sister had bypass 15 years ago and I just didn't think that "aggressive" a procedure would be needed for me. After all.....I've lost large amounts of weight in the past through diet and exercise....I just needed a little help......or so I was believing.

My physician who was discussing this with me eased me into the conversation and led me to find my way to the surgeon I've selected.

I've been to his group presentation.....the first required step.

Even after listening to my sister and seeing her progress.......for 15 years......and for secretly thinking in some small way that she took the easy way out.........I didn't "get" it.

That presentation really altered my thinking about restrictive and absorptive restriction.

I realized in that group session my "hero" status as the big brother doing it on his own......over and over again......was a stupid cycle. I needed to get all the help available.....every tool in the toolbox to get the lifelong results I strived for.

Dr Carlson addressed the full room and fielded every question asked. An hour went by....then more.......he'd long since made his informative presentation.....yet stayed to discuss our concerns. A lot of "ah-ha" moments were had.

I heard the lady seated behind me speak to her friend, "The sleeve is what will work best for me".

My wife, seated beside me, was quiet. She reserved her comments until much later when we were driving home.

She proceeded carefully fearing that she knew my mind had already been made up on the sleeve. It was a relief to her when I acknowledged that I felt I needed the bypass.......like my brave little sister did so many years ago.....doing her own research.....as a young woman on her own.......when most folks hadn't heard of such.

One of my issues is reoccurring reflux.

Some nights it can be really bad.

It subsided greatly once I completely cut out alcohol from my intake on April 2, 2015.

Back in early April of this year I'd begun resuming the fight to loose my weight. I'd taken evaluation of my current state of living. I loved to grill out.........really loved it. It is therapeutic. I loved to crack open a cold beer and fire up the coals. More beer throughout the cooking and serving everyone had me relaxed and happy. After dinner, I'd normally get drowsy due to several beers......then it'd be time to hit a couple tequila shooters and another beer......or a rum & diet coke or two.

I'd get my relaxed and happy state back.

It was clear which non-essential calories to drop first......cut out the beer and liquor along with seriously revising the menu on my plate.

Guess what.....these were the nights the reflux was bad. Drinking + spicy food (the only kind off my grill ) = reflux.

I discussed this "revelation" with my wife. She pointed out a few times since when I'd complained of reflux....since I'd cut out alcohol. I realized she was right......it was still occurring but less often.

I have decided that I'd prefer the bypass.......but don't even know yet if I'm approved for it.

The waiting and suspense of insurance is driving me nuts. Don't get me wrong.....I'm glad the procedure isn't something as easy to get as a bad tattoo.......but I wish it was more straightforward from the insurance company standpoint. Down the road the results I get from the bariatric will certainly lessen the costs I'd otherwise pose to them, right ?

Sorry for the rambling. I'm just eagerly impatient and ready to get this ball rolling in the direction that will lead to successful and long lasting health provided I continue to do my part.

I'm checking stuff off the mandatory list at least.....and this website and the folks here are already helping me find answers to the tons of questions I have.

My mandatory checklist:

Attend the group session---done in early June.

Meet with the bariatric program's & surgeon's nurse to review my case and 8 pages of medical Q&A i was to complete--done this past week.

Meet with surgeon on official visit----scheduled for July 1.

Meet with program's nutritional guru----first of the 6 visits is on July 7. This I understand will be the "start" date of the mandatory 6 month timeline to surgery.

Meet with psyche guru----awaiting appointment scheduling now.

Internal scope evaluation of stomach and other plumbing-------to be scheduled after visit with surgeon

I still don't have any type of official indication that bypass is a covered procedure (United Healthcare).

I don't know if I can hang on 6+ months before getting this latest umbilical hernia taken care of.

I want to get on to eating the foods I'll be living by after the surgery......eat like I've had the surgery......begin accelerated weight loss now......not wait until the surgery. I just want to be sure that I can't lose "too much" on my own that the insurance balks and says, "No way buddy.....you got this.....do it yourself". I can do a lot off by myself.....but I fail to keep it off. I don't want to sabotage my chances for coverage.

So many questions that I'm sure will be resolved and clear in the weeks ahead......it's just right now I want to get going with progress of some type......no matter if it's from bypass or from my jumping onboard with the new plan.

The compelling reasons for the need to get going are probably no different than most other folks here:

I'm having back spasms from reoccurring back injuries due to herniated T-12 vertebrae. Spine surgeon stated that bariatric surgeon can do more for my spine than he could with back surgery. Sounds legit.

Umbilical hernia is driving me nuts. It's worsened when back goes out and my posture and such gets weird.

Knees are shot....ortho doc says I need knee replacements sooner than later....he's saying 5 years tops.....plus hip, too. He also stated that 200 lbs off my frame would push those replacements back a long time. I already feel some benefit in my knees from the initial pounds coming off. Swelling in my ankles is greatly reduced.

Sorry again for the rambling. I'm jittery after finishing up the last day of miracle steroids (4th round with them since April) on my back. The side effects are sleeplessness for me. I get jittery after the 6 day cycles. I'm hoping for a good long sleep later today....tonight.

Aside from dropping the alcohol, fried food and reducing sugar & starch intake (doing these).........what can you advise me to do?

What other dietary-related actions?

Breakfast choices now are oatmeal (made with Water and small amount of salt) vs sausage biscuits and such.

lunch & dinner has me eating lots of salads.

Snacks are nuts, fruits like blueberries and apples and occasional whole grain toast with small amount of health choice butter substitute or Greek Yogurt.

Drinking tons of Water.< /p>

40oz of coffee every day during the first portion of the day......a lot, I know. I use nonfat creamer and Splenda or Equal (10 packs for 40oz coffee).

I'm still having 2-3 20oz Diet Mt. Dew's every day. Sounds like a ton....but it's way down over the number I used to drink. I go to one a day on days off....but do poorly during workdays.

No more drive thru's and only salads from fast food restaurants.

What else should I be doing?

Should I order the "Big Book on Bypass" and get started on it ???????

Stir crazy and tired of my 46 years of fat fighting. 5 years ago I burned off 120 and felt like a new man.......still have many of the 2X & 3X clothes. I saved most of them.....refusing to toss them due to that being symbolic of me throwing away my hope of wearing them again.

I lost that weight.....but failed to keep it off. The brief period at that reduced weight was enough of a taste of healthier living that I have craved ever since. Virtually painfree and full of energy. Leaner.......able to wear my old high school letterman's jacket and button it up......too small still, but at least it would button up. Another 100 pounds off that and I feel like i'd be walking around feeling like a Gazillion dollar lottery winner.

I may never get a winning lottery ticket.....but I'll be supremely happy to get 200 lbs off........and MAINTAIN that level.

So ready to get this machine krunk up and in gear and burn some rubber down the track. This waiting is like sitting there with the engine revving up but the parking brake locked in place...........

I think it's great you want to change before the surgery it will only make this whole process easier.

Yes the waiting is terrible!! You should be able to call your insurer and find out specifically if the surgery is covered/what requirements they have of you.

I would also talk to your surgeon about the steroids. After the surgery you cannot take NSAIDs and they really don't like you using steroids due to the risk of bleeding ulcer. I would find out if they believe your need for them will be resolved thru wait loss.

Good luck with your journey! I am 9 months out and couldn't be happier with my choice to get RNY.

[InspirationMySon 135]

I hank you both so very much for your responses.

My reply is short now....in bed and sleeping.....getting ready for night shift tonight.

My iPad keeps crashing due to being overly full....memory maxed out.

This sight runs very slow on it.

Better response will come later when I can get to laptop or PC.

Thank you.

It's going to go well, I believe.

I'll use my time ahead wisely and educate myself as well as continue to adopt new methods now.

No more diet soda?

No more coffee?

Wow. That is going to take some mental adjustment. More than the sugary Snacks I've been dropping from the menu.

Diet Dew & coffee is like a food group for me. :rofl:

The soda is a for sure no go! The carbonation causes a host of problems as well as its ability to push food thru faster.

As for coffee at about 3 months you might be able to have it. It's very irritating to your new & heeling stomach. However you habit would be drastically cut back to about 1 - 8 ounce cup per day. There is a ton of calories in coffee if you say have a latte habit there is about 440 calories in a 12 ounce serving so that's a big dent in your allowed calories for the day.

Oh start tracking your food now. There are tons of apps for your phone & it will shock you to see what you eat & please the nutritionist to see you logging your food.

Be honest with the psych people I think, we'll know I down played my eating in private so my family/friends wouldn't see me eating poorly.

Good luck!!

[Bobbe Schu 53]

I hank you both so very much for your responses.

My reply is short now....in bed and sleeping.....getting ready for night shift tonight.

My iPad keeps crashing due to being overly full....memory maxed out.

This sight runs very slow on it.

Better response will come later when I can get to laptop or PC.

Thank you.

It's going to go well, I believe.

I'll use my time ahead wisely and educate myself as well as continue to adopt new methods now.

No more diet soda?

No more coffee?

Wow. That is going to take some mental adjustment. More than the sugary Snacks I've been dropping from the menu.

Diet Dew & coffee is like a food group for me. :rofl:

If you have UHC, be prepared for possible denial the first, possibly even second time. BUT DO NOT give up! I REPEAT: DO NOT GIVE UP!!! UHC is notorious for denials thinking the insurer will give up! If your policy states WLS is covered, they can not refuse to pay. I am fighting with them now for a revision from band to bypass. I've had to hire Lindstrom Obesity Advocacy to appeal and they are very confident--no promises, mind you, but this is what they do.

Please let me know how it goes and I will keep you posted as well.

[Dub 9,922]

Thanks, everyone!!!!!!

Rest assist that I'll be one persistent patient along the way.

I am really looking forward to the process and the changes and benefits.

I'm making great headway on the diet sodas. Averaging one a day now.......which is down from 6+ per day.

I'll make my July 1 goal of zero per day !!!!!!!!!!!

Stopping at grocery store tonight after work to buy some Stevia for tomorrow's coffee and going to get started soon on 1/2 Decaf blends........

The Stevia is a step to get away from the artificial sweeteners I use for coffee and tea.

Not a bariatric thing so much as something I'd just like to rid myself of.

We'll see. Stuff is expensive but my overall food cost is way down now so there is "room". ????

Amazing how much difference there is in my wallet after quitting the fast food drive throughs before and after work.

More amazing is how much better I feel from eating salads, oatmeal, grilled chicken, turkey some ham, tuna, Oikos Triple Zero, occasional whole grain toast, salmon and a weekly steak.

I'm not starving, either......getting plenty of calories.....too many most likely. The first step was just to move over to the new foods......next step will be to dial it down to below my maintenance level and enjoy what happens when staying in the deficit. Third step is to get into exercise as this suspect back allows.

Edited June 21, 2015 by Dub

[choosehope 233]

Way to go on the diet sodas! I did that and know how tough it is!!

[Brian88ss 59]

Dub,
Sorry I am taking so long to jump into this conversation. I just had my bypass a week ago and was feeling a little bad but I'm back in the saddle now, but dude you pretty much just told my story verbatim. I completely get where your coming from I also have UHC and yes the are a pain in the ass, and I had to go through 6 months of diet and exercise counseling with either a dietitian or my primary care doctor. The whole process for me took almost a year to get to surgery, it sounds like your laying a lot of good ground work and have a great attitude. If you have to do the D&E counseling make sure your doc notes what you are doing as far as calorie intake, amount of exercise, BMI, current weight, and goals. If you'd like I can send you the form we used and submitted I was approved first time through. The 6 months thing is a real downer but I assure you like I did use this time to your advantage, I used the time to do as DJ said practice not drinking 30 min prior to or after eating, try taking much smaller bites, (it might seem silly to you but I went out and bought a baby spoon to make me more aware of the size of the bites I was taking) practice chew, chew, chew, and chew your food some more this will give your new stomach time afer surgery time to tell you I"M FULL. There are other little tips I have heard along the way but any pre surgery retraining of your habits will only help you in a postive way on the other side of the surgery. I am so much like you in the way that I also enjoy to cook out and entertain friends. I full intend to continue to have friends over hangout on the deck grill out go swimming and such I just will have to do so as my new lifestyle will allow. The days of yesterday are gone I am doing this for me and I really don't want to give up hanging out with my friends but somethings gotta give. If things aren't changed my friends could be hanging out with me in a whole different scenario (ie Hospital, Funeral Home you get the picture). So what I'm saying is keep your head high and your definitely moving in a forward motion and if you need any help with what ever forms or resources I have just shoot me a message. NO QUESTION TOWARDS HELPING YOU REACH YOUR GOAL IS OFFLIMITS I will do my best to answer it. Good luck DUB Brian