Rdy2Bthin

It has been six months since I had my sleeve and my nissen reversed. There were no complications from the surgery. I had my hernia repaired again as my nissen was protruding into my chest. There were alot of adhesions from the previous surgery that were causing me problems too. My nissen needed reversal regardless of the sleeve procedure. I had few reflux issues during the first three months but as I begin to eat more solid foods the reflux returned. My doctor doubled my anti acid Meds which have helped. Over the past month this has started to help and the fact that I try very hard not to get too full when eating or drinking. As I loose weight the reflux seems to improve also. I have lost a total of 87 lbs and 66 lbs the past six months. My doctor said the sleeve could be convert to RNY if needed due to severe reflux but I do not believe that will be necessary. As far as insurance paying for the nissen reversal, my paid with no problems. If reversal is medically indicated the insurance company will most likely be required to pay. Good luck with your sleeve.

Hi! Sleeved June 26 in Melbourne Australia.
I've lost 4 kilos which is about 10 lbs, but I'm not worries about weightloss yet. A well healed body is what I want.
I just started puréed food yesterday with pumpkin Soup and roast beef purée (not at the same time)
Still taking 3 resource anyway to make sure I keep the Protein up.
Trying harder with Water now that I'm on purée.

I was sleeved on the 25th also. But I'm definitely not talkin 2 miles a day! lol I was told to wait until 2 weeks post-op for anything that intense. To me, if I sweat, it's working out! (Although, it's 100 degrees in Ohio so I guess walking to my car is working out. ) Prior to surgery I was doing about 8-9 miles a week. I hope to get back there soon; I'm just still dealing with serious fatigue and sleepiness.
About the multivitamin... at the pre-op class they told sleevers to start it 2 weeks post-op. When I went back 7/2 the NUT told me to wait until 4 weeks because VSG patients are more prone to nausea and Vitamins can make it worse. She did tell me to start a sublingual B12 now. If it's that bothersome, I would ask your DR or NUT.

Got sleeved on the 29th. No pain meds today. Just walking and sipping trying to get my liquids in. Just gas right now but it's bearable. Hate these compression socks. How long did y'all wear them? I have to wear until my post op check on thurs with my dr. This is beautiful country in costa rica mountains for my recovery

I am in stage 3 kidney disease. I am so glad to read what you wrote. When I had my blood work done, the nephrologist said my Protein was fine, but my Calcium was up a little and suggested I give up the yogurt for a while. I have lactose intolerance ( so, no real milk products ). So, I gave up the yogurt and only taking calcium supplements, and the test was fine this time.

It's surgery day peeps!!!! On our way to the hospital now. Good luck and best wishes to all of my sleeve twins!!!!

Just popped in to wish everyone a surgery with no complications and a future as bright as the sun.

Medscape Medical News from the:
American Society for Metabolic and Bariatric Surgery (ASMBS) 29th Annual Meeting
June 17 - 22, 2012; San Diego, California
http://www.medscape.com/viewarticle/766243?src=nl_topic
http://www.medscape.com/viewcollection/32520
Sleeve Gastrectomy Gets Boost in Push for Insurance Coverage
Kate Johnson
June 22, 2012 (San Diego, California) — With a final decision expected within days from the Centers for Medicare and Medicaid Services, there is now ample evidence supporting the agency's full coverage of laparoscopic sleeve gastrectomy (LSG), researchers asserted here at the American Society for Metabolic and Bariatric Surgery (ASMBS) 29th Annual Meeting.
Reporting the largest series to date, John Morton, MD, from Stanford University in California, said "laparoscopic sleeve gastrectomy is positioned between the band and the bypass for both safety and efficacy."
In a separate, unrelated study, Abraham Fridman, DO, from the Cleveland Clinic Florida in Weston, reported that sleeve gastrectomy showed the lowest morbidity of the 3 procedures.
In March, the Centers for Medicare and Medicaid Services revised its blanket policy of no coverage for LSG by allowing limited coverage of the procedure in randomized controlled trials.
In its so-called "coverage-with-evidence-development proposal," the agency is considering comparative evidence for LSG against other obesity surgeries, with its final decision due on June 27.
"There's considerable amount of evidence now for coverage of the sleeve. It's actually overwhelming, the amount of evidence," said Dr. Morton, who presented a national comparison of LSG vs laparoscopic Roux-en-Y gastric bypass (LRNYGB) and laparoscopic gastric banding (LGB) from the Bariatric Outcomes Longitudinal Database (BOLD) from 2007 to 2010.
The analysis included data on 271,726 patients from 540 hospitals and 1200 surgeons.
Comparing mortality, morbidity, and efficacy outcomes for 117,365 LGBs, 138,222 LRNYGBs, and 16,139 LSGs, the data clearly show that LSG is safe and effective, concluded Dr. Morton.
At 1-year postsurgery, the absolute body mass index [bMI] reduction was 16.6 kg/m2 for bypass patients, 13.4 kg/m2 for sleeve patients, and 7.6 kg/m2 for band patients.
Length of hospital stay was a mean of 2.3 days after bypass, 1.9 days after sleeve, and 0.7 after banding.
Improvement of baseline comorbidities of hypertension, type 2 diabetes, and dyslipidemia was seen after all surgeries, but was most significant in the bypass group, said Dr. Morton.
The bypass group also had the highest 30-day mortality and serious complication rate (0.14% and 1.25%), followed by sleeve gastrectomy (0.08% and 0.96%), and then gastric banding (0.03% and 0.25%).
The readmission and reoperation rates were also highest for bypass patients (4.62% and 2.73%), followed by sleeve patients (3.61% and 1.7%), and then banding patients (1.38% and 0.65%).
Although 30-day follow-up data were "great," Dr. Morton noted that the limitations of the study included poor follow-up beyond this time and lack of information about patients who might have been admitted to other hospitals.
However, he said, the data are convincing for the safety and efficacy of sleeve gastrectomy.
The second study, which included 2433 bariatric procedures, was performed at the Cleveland Clinic Florida between 2005 and 2011, with a mean follow-up of 17 months.
Similar to the BOLD study, this study also showed that BMI loss after the sleeve procedure (11.2 kg/m2) fell between that of bypass (14.8 kg/m2) and banding (5.6 kg/m2).
A total of 1327 bypass, 619 sleeve, and 233 band procedures were included in the analysis, reported Dr. Fridman.
However, looking at readmission and reoperation rates, this study showed that sleeve gastrectomy was superior to both bypass and banding.
Specifically, the average number of readmissions in the sleeve gastrectomy group was the lowest (1.49), followed by the band (1.54), and then the bypass (1.96). Similarly, the rate of reoperations for complications was lowest in the sleeve group (1.8%), followed by bypass (6.6%), and then banding (14.6%).
Asked to comment on the evidence for sleeve gastrectomy, Michel Gagner, MD, told Medscape Medical News, "I think it should be covered [by insurers]."
Dr. Gagner, a Canadian bariatric surgeon, practiced in the United States for 15 years at 3 different centers before returning to his native Montreal at the Hôpital du Sacré-Coeur.
He said he now performs sleeve gastrectomy in 90% of his patients, and "I think the evolution I went through we will see in a lot of practices in the United States," he said.
"Outside the US, sleeve gastrectomy is growing very fast, and there are several countries where it is number one," he said. "In Chile and Japan, it is very popular; in India, it's the number one procedure; and there are many countries in Europe where the number of sleeve gastrectomies has surpassed the number of bandings. This is seen in France and in Belgium, for example."
The BOLD data place sleeve gastrectomy between gastric banding and bypass in terms of morbidity and mortality, he noted. "When surgeons are looking at abandonment of banding, they are looking for a procedure with similar risk ratio, and actually I think that the weight loss and comorbidity resolution with sleeve was better than banding, while the mortality and morbidity rate was slightly higher. So I think it's still an excellent risk–benefit ratio."
In fact, Dr. Gagner said, the BOLD data for sleeve gastrectomy is likely to improve, as the current figures still include a steep learning curve for the new procedure.
"We know it's in the first 100 cases that we get the highest rate of leaks, highest rate of bleeding, and strictures and mortality. Once they go beyond, we're going to see a drop by 2-fold in the leak and major complication rate. So what we're going to see in the database in the future of sleeve gastrectomy is that it's going to be very close to banding, so it's going to be very convincing for surgeons who've been using banding that they could adopt a procedure that has almost the same morbidity and mortality as banding, but yet an increased benefit."
Dr. Morton noted that he is a consultant for Vibrynt and Ethicon. Dr. Fridman has disclosed no relevant financial relationships. Dr. Gagner is a speaker for Covidien, Ethicon and Gore.
American Society for Metabolic and Bariatric Surgery (ASMBS) 29th Annual Meeting: Abstracts PL104, presented June 20, 2012 and PL133, presented June 21, 2012.

Good luck to everyone...see you back here on Thursday

Wow this is it in less than 24 hours my new life will begin. Good luck to all of my sleeve twins!!!!

Im ready for monday too. I fought a horrible migriane today. Nothing was staying down. Its been a tiring journey just to get to the surgery. Im ready for a little rest in the hospital and let someone take care of me for 3 days.

Hamany, I'm a doctor and still took all of my surgeon's advice, and did all the research possible. You cannot use your being a medical student as an excuse for not taking care of your health.
You, of all people, should understand that orange juice does not give you a well balanced diet with Proteins, and will not sustain you. If you can drink liquids, focus on Protein drinks instead.
Crisps and crunchy Snacks are easy for all sleeve patients to eat, because they do not expand in the stomach and slide right through. The sleeve is a TOOL to help us make better food choices, not a quick fix to our obesity. We still have to maintain discipline and be careful with your nutrition.
All the best to you and continue to use this forum to educate yourself about your new sleeve.

I'm sorry to hear that. My doctor's office manager refused to submit my paperwork. I got the insurance commissioner involved, because she was refusing to cooperate with me.
Good luck & I'm sorry that you have been going through this!!!
Little Bits

Hey everyone .... I have been on this site A LOT over the last year through my journey. I spend hours reading inspirational post and tips from others. It has helped me do much in times of need. July 7 will be my one year and so far I'm loving my new self. When I started is was 312. As of a few weeks ago I was 183. I have struggled over the last month with loosing and Im getting frustrated. My goal is 160 .... Sooo close!!

Thank you. I think I have figured it out now. A little bit about me. As I mentioned, I was sleeved on June 12th. Pre Op I lost 97 pounds on my own. Just killing myself with exercise. It took exactly 12 months to lose that much. I'm feeling kind of depressed after the sleeve. I guess I was just expecting to see a bigger difference by now. I know, Im impatient... But thats just me. A classic over acheiver. I find myself not craving anything but missing the texture of chewing on something. My post op visit is on Monday... I hope to see a big weight loss on the scale! I'm posting a full body pic... Its me the day before the surgery.

I just found this site and I'm having surgery on Monday the 25th too. I've been doing the pre-op Protein shakes (New Direction) and am doing well. I'm so ready for some beef broth or something, though.
I'm feeling excited, nervous and ready for Monday! I look forward to looking around this site a bit more and checking in with all of you.
Best wishes to all of us for a safe surgery and speedy recovery!
Having surgery in Lansing, MI with Dr. Mindy Lane.

DR.Garcia recommended that I have the RNY to prevent the reversal of my nissan. He said that as I loose weight my gerd symptoms will most likely go away. My surgery is 8/7/12 and I am going with the sleeve, I am completely against RNY as my sister had it done and had a few complications, plus dumping syndrome NO THANK YOU! He is only charging me an extra 500 to reverse it. I think the risk of not having the sleeve is worse then gerd symptoms that can be treated with some meds. Good luck.

My preop started today! I need all the prayers and positive thoughts you can throw my way! Just the word diet sends my brain into cravings for foods I can't have!

My doctor told me that the sleeve could be converted to an RNY if needed.

What about diabetics? Is the sleeve just as good? I know a lot of people say RNY is better for diabetics. My sister and I are both having surgery and she has chosen RNY because of this. I do not want to try to undo influence her for a sleeve as she might feel unsupported for her RNY. Should I say something? I think the sleeve would be better for her too.

Who could argue with a new grandmother? Congrats!

I'm tracking observations of people's reactions as I lose weight. Curious to see the way different people act.

I read about that in this book about the subject and it really bothered me. I'm a very friendly person and for the most part I talk to people in public and always have conversations with them. But, since I turned 40 (well into 40's now) I noticed the "invisibility factor." I had heard about it and never thought it would happen to me. Sometimes I feel ignored and I know it's not my personality. I do think there is a prejudice against "older" women and heavy people. Yep, I think if I knew--- but how will we??? it would definitely make me angry.
Funny, I almost posted the same thing recently.

I found this very interesting and even though I am less than 3 months out with my sleeve, I am going to try this when I get home! I have always felt like I have a bigger sleeve than most since I have no real issues eating anything and havent from the moment I could eat ice chips in the hospital.
A4 The Cottage cheese Test
So, how do you measure up? Are you accomplishing the feeling of satiety at each meal? Do you know how big your stomach pouch is? Would you like to? Nearly every patient is curious to know just exactly how big their stomach pouch is. The following technique is used by bariatric surgeons and patients to determine the functional size of a patient's stomach pouch.
The idea for this technique began with Dr. E. E. Mason, at one of the Iowa Bariatric Symposia in the early 1980's, who suggested that it might be useful to ask patients to eat cottage cheese, in a structured manner, to attempt to determine their functional meal volume at different times postoperatively.
Dr. Laytham Flanangan (website: Breakfast on that day.

Eat fairly quickly until you feel full (less than five minutes). Note that the small soft curds do not require much chewing. You are eating rapidly so you will fill the pouch before there is time for any food to flow out of it. After eating your "fill" of cottage cheese, you will be left with a partially eaten container that has an empty space where cottage cheese used to be.
Measure the volume of cottage cheese you have eaten by filling a two cup (16 fl.oz.) measuring cup with Water. Pour water into the container of cottage cheese until the water level rises to the original top level of the cottage cheese.
The amount of water poured into the container is the functional size of your pouch.

Dr. Flanagan's research indicates that the average volume of the mature stomach pouch, measured by this method, is 5.5 ounces (163 ml). Additionally, he reached the conclusion that, "sizes ranging up to 9 ounces have NO IMPACT on the person's success in weight loss". This means that unless your pouch holds a greater volume than 9 ounces (267 ml), the exact size of your pouch is not a critical factor in whether or not you can lose excess weight and then manage your weight as time progresses.

I had my surgery April 2 on April 4 my doctor told me I don't need my diabetes meds anymore. My numbers run 97 to 105 great numbers huh that was my main reason for this surgery.