First Step Letter of Recommendation: Diagnosis: Hiatal Hernia Morbid Obesity. Doctor: We are going to fix your stomach and help you lose weight. You will be able to eat healthier. Me: I am tired of surviving off of starch and I really want an Apple Pecan Salad from Wendys. Can they do breast reduction and Lap Band at the same time? Doctor: NO, you can't eat a salad right now, but there is a possibility you will be able to in the future. No they can't do both surgeries at the same time. Me: Have you looked at me lately? If I lose to much weight, Im going to topple over. Doctor: You will be just fine. "Laughs". Second Step: EGD: Scope of the Stomach. Nothing to eat after midnight. Outpatient procedure. Yes an IV is involved. Yes you are placed in a twilight sleep. Microscope is run down your throat down your esophagus and through your stomach. A mouth guard is used to hold your mouth open during the proceeding. My concerns: Please don't let me slobber on myself during the procedure. Will I get a chance to count backwards from a hundred before I fall asleep? Can I have a print out of my telemetry scan? Wow the sky sure is pretty ( this is my last statement before I fall into a twilight sleep). Third Step: Upper GI. Drink the chalky tasting Barium. Move from one position to the next on the xray machine. Go home. Once again nothing to eat or drink after midnight. My concerns: None. My issues: Got my self tangled up in the hospital gown and walked back into the xray room. Needless to say, after much laughter, it took two people to get me out of the gown. Don't ask. Fourth Step: Pre Surgery Informational. Went as planned. Described what the Lap Band is, how it is placed on the stomach, the financing options available, what results are possible, comparison to other weight loss surgeries, the steps required for submitting your case to insurance, and of course - success stories. Fifth Step: Psych Evaluation. NO right or wrong here. Just be honest with yourself and with the psychiatrist or counselor. My concern: Please give me a good evaluation. The doctors are starving me with this pre op diet. I would like to eat soon. Sixth Step: Talk to the Surgeon. Just questions about expectations, family history, what you have done to lose weight in the past, health issues, and more information on the procedure. My concerns: Will I be able to eat fruit and vegetables without pain. While I am this pre op diet can I have milk? The answer is no. I really want a steak. The answer is no. Why do you not like me? Doctor "laughs" : You will be just fine. Seventh Step: Insurance approval: Took two weeks for an answer. Pre Surgery Diet: 2 Weeks: AdvantEdge Protein Shakes - One every three hours and water in between. NO FOOD. This was by far the hardest part of the process. Especially since It was the fourth of July weekend. Not very happy, Is all I can say. Surgery Day: Urinate in a Cup, IV, Lovenox shot in the belly ( stings ), Patch behind the ears to ward of nausea/After Surgery: Walk twice, urinate, eat a popsicle and keep it down, sent home with discharge instructions, pain medication, nausea medication, and a On Q pump. The patch and the pump are to be removed the third day after surgery. Removing the pump does not hurt BUT you will feel the the tubing moving out of your body as you pull on it ( Ask me and I will explain in more detail.)