Insight/thoughts for someone considering sleeve surgery

[Veebear 8]

Hey fam,

New here and strongly considering gastric sleeve surgery. I found this site from a helpful youtuber who documented their journey and spoke highly on it. Been looking more into it to be sure my insurance covers or at least will pay for the majority as well. I'm mostly looking for thoughts/suggestions/pointers for those of you who have gone through it. Things you wish you had known before going into it to better mentally prepare myself (or anyone considering ) before making the leap.

Currently, I'm 35 5'3 and a bit over 300lbs struggling with weight most of my life as I know many do. I know my stress eating is something I'll really need to work on prior to also making that leap as I sure do not want to go into this, have it help, and backslide. I'll likely see someone about that before committing to anything in hopes I can jump-start working on myself in that aspect. I have watched a lot of videos and read quite a bit on experiences, but I'm really interested to get more information and absorb as much as I can as you all know, this is life-changing surgery. Also curious for those with so-so insurances if they covered skin removal, not an immediate concern but trying to take in everything. Truthfully, I think after being heavy ones whole life, I think I'd be happier just feeling healthy and being more active over that but this is also why I'd like thoughts.

Any guidance is much appreciated, whether it be before surgery prep, a week, or a year+ after. I read a bunch the other day joining and am looking forward to the wisdom anyone would be willing to share. Thank you!!

[liveaboard15 1,293]

I dont think any insurance will cover skin removal since that is a cosmetic issue. I am just 1 inch taller than you and i was at 317lb when i first started. I am about 5 weeks post op and i have lost about 40lb and its awesome. before surgery i could not stand more than 5 minutes without my back hurting like crazy and i could not walk across a mall. Now i am walking miles a day and have no issues standing. only 5 weeks in and i find it worth it. I cant wait to loose more. Only thing that does suck is well food was a major part of my life as most of us. I miss the going out and grabbing mcdonalds or taco bell or going with friends to random places and pigging out lmao. I was self pay. My insurance did not cover it. After surgery its a huge change with food. so far for the last 5 weeks (since i started on actual food and not liquids ) ive been eating pretty much the same thing and i am starting to get really tired of it. Need to try different things. Make sure you dont have any acid reflux. (doctor will probably order an endoscopy) because if so then the sleeve wont work for you.

[Veebear 8]

Thanks! To clarify, I think I meant panniculectomy which (from what I read...could have changed now) can at times be approved due to it causing back pain ext. That's great progress! I am about 10-15lbs heavier than your starting weight. I've been trying to be more active again the last month or two, but after you don't for so long it is hard getting back into walking and not exhausting yourself. Also not confident enough to do gym memberships or more public things short of us walking around where we live. Our insurance changed this year to one that isn't as good, I feel, but am hopeful if I can find an in-network option, I can move forward if decided. I messaged them today to see what info I could get on it.

Thankfully, I stopped doing fast food a lot over the last few years...but that doesn't mean I don't pick up things that I binge on or that are quick to eat due to general laziness on my part and because I'm too tired after work to cook. Frozen items like pizza have been our go-to off and on weekly. As a stress eater, Snacks are my downfall. Thankfully, never had acid reflux but that's good to know, something I hadn't read or seen!

[LookingForward22 320]

[LookingForward22 320]

I’m a little further down the path than you but I haven’t had my surgery yet, but I did want to share one thing I learned so far. Listen to your instincts and find a program that you feel comfortable with. Don’t be afraid to stop the process at any point if that is what your instincts are telling you.

Back at the end of 2021 I went with a local surgical program I’m familiar with and I had good recommendations for. My husband went to the initial appointment with the dr and we asked our questions. We left not feeling confident about the surgeon or the program but I chalked it up to nerves. Along the way I had more appointments - some went great … some made me feel uneasy with the program, like they were just pushing me through and not addressing my concerns. I met all my requirements, went through the required steps and I had surgery scheduled for early Feb.

I was just two weeks from my surgical date and I canceled. Before I canceled I talked my concerns through with my husband, PCP, endocrinologist and the facilities practice manager. It just wasn’t the right fit for me.

Since then I looked into other area programs, debating if I really should go forward with surgery. This month I found another I think will be a better fit for me. I just started the process but if all goes well I expect to be scheduled this summer - hopefully July or early August. It’s a little frustrating to be starting over again, but I’m much more at ease knowing this program is a better fit and I have been reassured that if I’m not ready at three months (my expected approval plan) they will work with me to make sure that I feel comfortable and confident with the process to have the very best out come for me. If I decide to not have surgery they will refer me to the medically supervised weight loss program as a plan B, if I decide surgery isn’t the right choice at any point.

Although the idea of surgery still scares me somewhat, I feel much more comfortable this time around knowing I have support both outside the program and within - which is more likely to help me be successful.

Best of luck in your journey, no matter what you decide to do.

[The Greater Fool 2,024]

Skin removal is not always "cosmetic." For me, it was "reconstructive."

Certain things make it reconstructive. first, a panus that overhangs the pubic area, back-pain, documented constant or repeating infections under the panus. My "reconstructive" tummy-tuck was totally covered by insurance.

My thighs were approve as "reconstructive" for many of the same reasons. Rashes between the legs were additional reasons for "reconstructive." I didn't follow through on this because of a newly discovered clotting issue that killed me during the tummy-tuck.

Keep in mind and prove "reconstructive" and insurance coverage is a new game.

Good luck,

Tek

[redhead_che 824]

Just curious, is there a reason you have landed on the sleeve vs bypass? Bypass does tend to lead to higher weight loss in more obese folks if folks follow their diet plans. I’ve had both now (sleeve to bypass) and wish I would have just done the bypass. But that’s just me! When I did the sleeve I was 225lbs so sleeve made sense, wish I would have given bypass another research though anyway. I ended up in the smaller percent of folks that get GERD and regain after sleeve. So bypass I went.

[liveaboard15 1,293]

3 hours ago, Veebear said:

Thanks! To clarify, I think I meant panniculectomy which (from what I read...could have changed now) can at times be approved due to it causing back pain ext. That's great progress! I am about 10-15lbs heavier than your starting weight. I've been trying to be more active again the last month or two, but after you don't for so long it is hard getting back into walking and not exhausting yourself. Also not confident enough to do gym memberships or more public things short of us walking around where we live. Our insurance changed this year to one that isn't as good, I feel, but am hopeful if I can find an in-network option, I can move forward if decided. I messaged them today to see what info I could get on it.

I am not a fan of gyms. I work out at night. At around sunset I go to an area i like (next to the river) and walk for about an hour or so. before surgery i could not walk for 5 minutes.

[LilaNicole20 252]

17 hours ago, redhead_che said:

Just curious, is there a reason you have landed on the sleeve vs bypass? Bypass does tend to lead to higher weight loss in more obese folks if folks follow their diet plans. I’ve had both now (sleeve to bypass) and wish I would have just done the bypass. But that’s just me! When I did the sleeve I was 225lbs so sleeve made sense, wish I would have given bypass another research though anyway. I ended up in the smaller percent of folks that get GERD and regain after sleeve. So bypass I went.

I just want to echo this post! I went with the bypass the first time for the same reasons. Also, I had researched the number one regret/complaint about the sleeve (or something like that - before finding this forum) and the [loud] answer seemed to be that they wished they had just gone with the bypass. I also had heartburn pretty bad (which fortified consensus with my doctor).

I didn't want to have to wish I had had the big dog (RNY) so I just waited a few more months and had the bypass when a slot opened up.

[Veebear 8]

@LookingForward22

Thank you! This is super helpful. Agreed you should be 100% comfortable with who is doing the surgery. If I move forward. My husband is super supportive and I'm hoping he hops on board if I make this decision and truthfully, he's really good about asking questions and observing where sometimes I am not... Not for lack of care, but sometimes I miss important things where he catches them haha. I think that'll be helpful when it comes to really digging into who we I'll be seeing and talking with. Happy to hear you are comfortable now with the new option and all the best!

@The Greater Fool

Thanks! this is very helpful. I read a bit on how some have been able to prove skin reconstruction can be proved as health required with some insurance but hadn't found too much on the more in-depth what insurances/proving other than back and rash issues. I read the tummy-tucks were more likely covered due to the back issues but not as much on other areas. Appreciate the additional info on this.

@redhead_che

Truthfully, I haven't looked into bypass too much but know someone going for sleeve and also read/head it was a shorter recovery, but as I said, I haven't looked/confirmed this yet since I'm still more in research mode haha. I appreciate the mention, though. I definitely am open to other options to move forward with a healthier lifestyle. Since you have had both, do you happen to have any feedback on recovery, and do you find now that bypass has been more effective in weight loss than the sleeve now?

@LilaNicole20

In addition to my post above, definitely interested in your experience with bypass too with any recovery and after feelings. Will look into videos and posts with experiences as well to help educate myself on both. I currently only have a referral in somewhere as of late last week so waiting to schedule something and talk to a dr about options too but I want to kinda soak up info so I can prepare some questions when I can meet with someone.

Thanks everyone!! ❤️

[LilaNicole20 252]

13 minutes ago, Veebear said:

@LilaNicole20

In addition to my post above, definitely interested in your experience with bypass too with any recovery and after feelings. Will look into videos and posts with experiences as well to help educate myself on both. I currently only have a referral in somewhere as of late last week so waiting to schedule something and talk to a dr about options too but I want to kinda soak up info so I can prepare some questions when I can meet with someone.

My recovery was a blur. I can't tell you how many times I have thought and even said "it doesn't even feel like I had anything done". This, of course, applies after the gas pain passes, you're out of the hospital, etc. I am relatively young (38) and I was extremely healthy and fit prior to these past 3 years where I gained 100lbs. I have had zero issues. Weight is coming off nicely and I'm excited to see how I fare over the summer. I have no experience with any other WLS but this one I am extremely happy with - oh, and no heartburn!! Huge win as I was taking 2 Pepcid AC daily prior to RNY.

Edited May 23, 2022 by LilaNicole20

[redhead_che 824]

Sleeve recovery was easier for me. I was off 3 weeks only because I didn’t have confidence in my ability to meet my Fluid intake goals at a fast paced hospital job until week 4 started. For the bypass, I’m off 3 weeks because it’s needed. I’m still in pain. Bending hurts. Bowels aren’t regular yet. Fluid intake isn’t met yet. It definitely hurts worse and is taking way more of my energy.

Weight loss so far is faster with my bypass. But I am currently in the famous week 3 stall. -25 since 5/6 🤷🏼‍♀️ But I did lose -110lbs with my sleeve so it can be done before GERD and regain.

Keep up the research, I hope it helps you ❤️

[blackcatsandbaddecisions 851]

I think skin removal is possible with insurance but very unlikely. I had insurance cover my surgery but my plan specifically states that no skin removal, regardless of stated medical necessity, will be covered. That’s not an uncommon provision.

Regardless, I’d focus on the weight loss and related surgery at this point. Many people lose the weight and never have skin removed. If I didn’t have the funds for it I wouldn’t stress over it, and I’ve lost almost 180 lbs so I def have extra skin. I’ve posted a pic of me in a swimsuit, however, and even then it’s not that overt.

[Queen ApisM 427]

I agree with what @LookingForward22 said regarding finding the right program. I also switched programs and even though it really extended my timeline, I am so happy I did.

I would also say: research all options (bypass, sleeve) but don't get railroaded or let others convince you of which one is right for you. I always preferred the sleeve, but tried to convince myself that a bypass was better. I was doing all the mental gymnastics for it - it would be faster weight loss (not necessarily true), more weight lost (also not necessarily true) - when in my heart I was not comfortable with re-routing my insides so much and I wanted to still have a pyloric valve. It was so liberating when a surgeon reminded me it is simply a tool and will be as successful as you make it. He wasn't trying to tell me what to do, just to make sure my decision fit my needs and comfort level. That was so important. I personally have no preference for others, just make certain you are an informed recipient of the surgery you get and are 100% on board with the decision and the inherent risks for both (as there are differing risks for each type). Sleeve brings risks of GERD (and is contraindicated for anyone with GERD already) but bypass has other risks. Neither set of risks makes one inherently better or worse - you just need to be aware and ready to accept those risks.

And don't get surgery until you are mentally ready for it. That's just good advice across the board. You need to be in the right mindset to make it work.

Good luck!

[Veebear 8]

@LilaNicole20

Thanks for the additional info! i read that the gas pain can be rough at first but that once that passes, normally, it's not too bad. Glad to hear yours is going well and best of luck with the summer!!

@redhead_che

Thanks, that's good to know. I'm set to have my initial zoom learning session on 7/6. I'm excited to learn more and meet the surgeon and see if it's something I want to move forward with. My SO is also going to join and listen for support. I figure regardless of what I decide if I move forward, I plan to be at home for some time and thankfully, I can have time saved by then or wfh if needed if I'm feeling well enough.

@blackcatsandbaddecisions

Thanks! Didn't know some insurances wrote that in, I'll need to check mine to see if there are any exclusions for it in my current insurance. I found out that my insurance is accepted where I'm considering the surgery, but not sure if they'd block this specific thing. I thought a lot about the extra skin and honestly, I'm not bothered by it and think the health benefits far outweigh extra skin. It's always something I can save for in the future if needed, but to be healthy and comfortable is where I'd like to be.

@Queen ApisM

Thanks! Super helpful as well. I figure after we go through the initial learning session on 7/6 which I think will cover any surgical options they offer, I'll be asking all the questions and trying to also get insight into my body type and what they find to be most successful and safe. I think for me, I want to be sure I'm mentally ready. More so because I am a stress eater which I can admit helped put me where I am today so I know I need to overcome that. I think I'm ready in most ways such as cutting out some things and knowing I need to be more active to help take off and keep the weight off.

More a question for anyone, but for stress eaters, did you see someone to discuss this before or after surgery? I know prior to, you talk with someone about the obvious live changes that any weight loss surgery can do to you, but i'm curious if someone has/is overcoming the stress of eating and what helps you? That's I think my biggest hurdle so i'm hoping for some inspiration. I think once I go through the information zoom call next month, I need to mentally set myself on the path to find more healthy ways to work through those emotions tbh my job is a large cause so I've been working towards that change already.