V.A. Clinic Process

[Bucky0126 37]

I am a veteran and use the VA for all of my medical and primary care. During some clinic visits this fall, I suggested to my doctor that I might be interested in getting Bariatric surgery. She gave me some reading literature and suggested I do some homework prior to making any requests formally. In my 12/26/19 visit, I asked her to make my request official and we started me on the journey. For you fellow Veterans out there, the VA supports weight loss surgery basically as potential long term health for the veteran as well as potential cost savings associated with your health long term.

My process started with getting an appointment referral from my doctor to get an appointment to meet with the Move Program Coordinator and ultimately withe a Move Dietitian and Nutritionist. From there, you must participate in the Move Program for 3 months (easy) and they sent me home with a scale and blood pressure cuff to monitor. The unit has built in wifi and sends your daily weight and blood pressure to the Move Coordinator daily. Ultimately, you must lose approximately 10% of your body weight (or at least show the ability to lose weight) and graduate from the Move program. To help my process, I was prescribed a weight loss supplement, multi Vitamin and Saxenda (injection weight loss medicine). Basically all are to help stimulate your appetite loss, it works! I weighed in this morning (1/21/20) and after 25 days, I am down 15.5 lbs from 351 lbs. My goal weight loss prior to surgery is 35 lbs and am I am on track to graduate the Move program on 3/26/20.

After you graduate the program, your Move Team will then present your case to the Surgery Team (assuming you meet the criteria, graduate and lose the preliminary weight). Once approved, you just need to get on the schedule for surgery. I am not sure what that process entails yet, but I was told to plan on surgery between mid April to mid May.

I will continue to update this process, but I wanted to assure Veterans that we too can get this surgery done within the VA.

[Uomograsso 364]

Thank you for your service and good luck on your journey!

[Bucky0126 37]

Thank you for saying that, I always appreciate it.

You just had your surgery last week? How are you feeling and what kind of diet do they have you on? Tell me what the first 5 days are like...

[Uomograsso 364]

I feel pretty good. First thing after surgery in recovery room was a little rough, but nurses got my pain under control quickly. I think I got 3 or 4 doses of dilaudid via IV for pain the day of and day after surgery, but fter that I mainly used liquid tylenol to control pain. I did take a hit of liquid oxycodone at bedtime to help me sleep. But oral pain meds gave me nausea, but again nurses were quick with anti-nausea meds. Had surgery on Thursday morning and got discharged Saturday morning.

I am on full iquid diet. Protein Shakes, Decaf coffee or tea, sugar free popsicles, smooth Soups (no chunks, meat, nor pasta), skim milk, plain yogurt (can use artificial sweeteners in it), grits, runny oatmeal and sugar free pudding. I am on this for 2 weeks, then onto pureed foods where I can add low fat cottage & ricotta cheese, creamy soups, but no solids. Next 2 weeks is stage 3 soft foods progressing to regular foods. Then stage 4 to start integrating regular foods one at a time back into my diet.

Right now I feel good. Sipping Water to get my 64 oz in daily. I have zero hunger. Just a few little stomach cramps when I sip to fast, but again doctor prescribed levsin for cramps and it seems to be working. Haven't had to take anything for pain since I have been home. My incisions are pretty painless as well I only feel them if I really twist or bend to far. I guess am very lucky in that regard. My daily diet is one Protein Shake first thing which takes me about 2 hours to sip down. Then I do sugar free pudding with Protein Powder added. Just add two scoops to the pudding mix and I mix with Fairlife fat free milk. That gives me about five 4 oz servings with about 15 grams of Protein and 100 calories. I also do a protein water or fruit flavored protein mix in the afternoon to try and get 60 grams of protein each day.

[Bucky0126 37]

Thanks for the snapshot, I haven't really thought about what to expect other than the weight loss and changes I will need to make post op. This gives me a good idea what to look forward to. keep going!

[Tamarita 30]

Thank you for sharing this information! I am a veteran also and completed the MOVE Program last spring. In mid September, the VA approved my referral to Mission Weight Management Center in Asheville, NC. Although my referral was approved at every level, it took Community Care three months to place it (you know how it goes). I had my first appointment and met with my surgeon on 15 January. I have two more appointments (surgical support group and second meeting with my dietitian) before I'm scheduled for surgery. To this point, the process has taken 14 months. Most of that time was waiting for appointments within the VA so I'm sure it would vary greatly depending on which VA facility the veteran is assigned to. My last pre-surgical appointment is 11 Feb so I'm guessing my surgery will be sometime late February or in March.

Best wishes to you and I look forward to your updates!

[Bucky0126 37]

Tamarita - thanks for sharing your story! I sure hope my process doesn't take that long, don't lose hope or the drive to get it done. 14 months in the process will all be worth it once you get the surgery and lose the weight. The upside is a longer and healthier life.

As for me, I just spoke with my Move coordinator and they meet with the surgery team on the 1st Friday of each month and I am on the schedule to be presented April 3rd and with already losing 50% of the pre surgery goal, I would assume to be on track by then as well. My coordinator said we would then be put on the list to schedule the surgery, which could be anywhere between 2-6 weeks (depending on availability). I'm anxiously awaiting April 3rd!!!

[Tamarita 30]

Bucky0126 - Thank you for the encouragement; I’m hanging in there. I actually went out and bought a variety of nutritional shakes today so I could decide which ones I liked before surgery.

I’m glad for your progress in the program. I’m sure you’ll do very well. Are they planning to perform your procedure at the VA hospital? I was referred out.

[Hcat 32]

Bucky0126 & Tamarita - I hope you 2 don't mind me jumping in here. I am a veteran as well, I was reading your posts & I feel better knowing others on here are familiar with the VA system. I am located in IND. I completed the Move prgm & my pcp submitted a referral for wls, Community Care called me the next day to sched with a surgeon of my choice! No outside surgeons would accept the Move prgm & req'd their own 6-9mth wgt loss prgm. Long story short, My Va dietician made some phone calls & I am going to have my wls at Jesse Brown VA Med Ctr in Chicago in 1-2 mths. I am very optimistic this time, because within 30min of speaking to her I was called to sched an apt for my psyc evaluation 3 days later. So the ball in rolling now. Please keep me posted on both your progress & good Luck!

[Tamarita 30]

Hcat - I'm glad things are moving you along for you now! I know the cogs can move slowly within the VA sometimes. I'm glad your team was willing to help you find an alternative to basically starting over again on the weight loss program. I'm fortunate that my surgeon does accept the MOVE program and all the VA testing and labs. I'm so anxious for my appointment on Tuesday because the next step will be scheduling my surgery. I'm so ready! Best of luck with your upcoming appointments and yes, lets stay connected!

[Tamarita 30]

My RNY is scheduled for 3 March... Hang in there!

[Hcat 32]

Thanks for keeping me posted. I am happy for you, I can't wait to hear from you post op! I am progressing in the va system, fairly quickly, I expect to hear from the surgeon this wk, then we'll sched a surg date & any last testing that needs completed. I'll be sending positive thoughts your way & can't wait to hear how your post RNY is going!

[Tamarita 30]

Hcat, I'll post an update when I get home!

[Tamarita 30]

My surgery went well and I'm resting at home. Honestly, I don't feel nearly as bad as I expected I would.

[Hcat 32]

That is fantastic news! Thank you for the optimistic update. Continue to recuperate & keep me posted on your healing & journey forward.