Norma

I would go to Disney tomorrow if I had the opportunity and if I wasn't waiting on knee surgery. I am 10 days out and not having any problems with energy or bathroom issues. I get the protein in by drinking 2 RTD 51 Protein shakes a day that I get at Vitamine SHoppe or at 23 hour fitness. I drink sips of water, crystal light or various other liquids all day long. I am using soups as my two meals. Really--I am doing excellent and would love the opportunity for celebrating my new body at Disneyland.

Dr Aceves didn't use barium as the risk of it leaking into the body if there is a leak. He used Methylene blue and then the fluoscope was used with the x ray hidrosoluble liquid. The taste of the blue stuf was disguised with apple juice in 4 dixie cups that we drank over the period of an hour. The xray hidrosoluble was two gulps that we were encouraged to drink in big gulps. That stuff was bitter but over in a short time.

Dr Aceves states he has had no leaks and no deaths. His care and attention was better than any I have ever received in the United States in my 50 years and 16 various surgeries. I am not expecting to need much face to face follow-up care but I have the same commitment from Dr. Aceves for a year at only $9000. I have already had two contacts from his office and have only been home for a week. I had better customer service from his coordinator than I have from any of my specialists' offices combined. There are excellent surgeons in the world who are not Americans and there are doctors and hospitals in the US that I would not trust with my health as well.

How much money are you talking about? Have you considered going to Mexico where cost are cheaper. Some insurance companies will pay out of network expenses at half price and if the surgery cost way less down there that might be a way of saving money. I was self pay and paid $9000 for mine. I used $5000 of medical flex spend account and was able to save the $4000 by moving in with friends and cutting cost by not eating out, dropped the cable, etc. I saved the $4000 in about 8 months. I was able to borrow for the $5000 as the lender knew the flex spend would be approved immediately after i submitted the bill from the surgery. So I was able to take the flex spend money and pay off the loan within a week of getting the surgery. Some people refinance their home or car loans. hope this gives you some hints.

update-saw dr today. BP -138/80 reduced my Lisinopril. Diabetes-148 took off Lantus and Byetta, reduced Novolog to sliding scale, don't have to test but 4 times a day -down from every 2 hrs, d/c'd Glimiperide , K-Dur, Lasix. I am to crush my Paxil, Mucinex, and Singular and take at different times. Asthma is bronchitis or mild pneumonia-took chest X-ray and put me on liquid Keflex (one of the few antibiotics that I am not allergic too). He thinks that i must have aspirated something into my lungs. Knee-anterior horn of medial meniscus is toast. When he took hold of my ankle and pulled slightly to extend the leg I gasped. If the injury was only the meniscus, that would have relieved pressure and I would have felt better. Thus, surgery is going to be necessary and soon. I got a walker and will be able to get exercise building my endurance at walking with the walker. I have a orth consult for Thursday. Drum roll please-------------------------------weight 280.6 lbs -almst 32 lb lost forever!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Well, I am 8 days out and everyting about being sleeved is great-clear liquids are still going down fine, incisions look good, no head hunger, staying hydrated, and then the bottom falls out of my plans. My meniscus of right knee that I injured about a month ago decided to tear while I was going down the stairs today. :cursing: I can not put any weight on my right leg at all. I have a PCP appt on Monday that was supposed to be to check on my asthma but now looks like I will have to be seeing about scheduling surgery for knee repair. I am bummed because this will delay my getting back to the gym and might slow my weight loss. But, at least it waited till after I got home from Mexicali and for that I am extremely thankful.:001_wub:

You will be fine. I was sleeved by Dr Aceves on the 30th of Oct. Really had minimal pain, nothing that kept me awake or made me want to stay in bed. They give you dissovlable pain pills for the trip home that you just place under your tongue. I kept hydrated by buying a bottle of water after checking into the airport and adding crystal light. We left Mexicali at 7:00 am and I did not get home until 1:30 am the next day due to connecting flights--I was tired but okay. I was able to get electric cart to take me from gate to gate in airport so really had not problem. Breathe easy. Private message me and I will give you my phone number to take with you and will coach you through it if necessary.

Sending healing energy your way!

You could not find a better facility or doctor anywhere. I was sleeved on Oct 30, 2009 and believe that Dr Aceves and Almater Hospital are the best. I had very little pain; my nausea was controlled as soon as I realized that was what I was experiencing (thought it was gas); all my pre-op emails and questions were answered by Nina within hours of my sending the questions. The hospital was clean. The people were fantastic. I have never been seen so many times by my primary surgeon (3-4 a day) or check on by nurses on a hourly basis in any of my previous surgeries. I would not go to a clinic personally because if I needed ICU or emergency services, they would not have the expertise or equipment available. I have even been contacted since returning home. I honestly could not think of any reason to go to anyone else.

Yeah, you go girl!

Home sweet home! Moxie, my cat, was just pitiful without me. Peter tells me she just roamed the house meowing and slept in the bathtub near his room. Seconds after I arrived home, she jumped into my arms and hasn't left my side since. I am doing well. My insulin has been cut in half since surgery. I have drank 1/2 bottle of Isopuke in past 6 hours. I am keeping it on ice and with a lidded cup so I don't have to smell it. I feel good. I have walked through the house every hour. I plan to take a shower this afternoon and got to the pharmacy to get some bandages and paper tape. I highly recommend using the services of a therapist skilled in hypnosis for pain management. I had very little pain including the torn meniscis (muscle) in my knee that I could not use antiinflammtory meds on. The most amazing thing for me is that I have no sense of being hungry and am satisfied with just sips of my protein drink. Happy Day!

Call your surgeon's office right now and tell them what you are doing. Have a friend or family member monitor your every move around fluids and food. Are you trying to kill yourself? Wake up! I refuse to go easy on you for this behavior--it is suicidal. Stop it now.

Judy, Thank God that your surgeon is looking at the big picture and wants your BP to be stable before the stress of surgery. You wouldn't want a stroke during surgery to cloud your experience. When your surgery happens, it will be the beginning of a new life. I just had mine on Oct 30 and feel wonderful. It was the best decision of my life. I will keep you in my prayers.

I will be coming home tomorrow from Mexicali. Dr Aceves did my surgey on Friday and Dr Campos declared me well with a new smaller stomach this morning. I have lost from 309 starting to 278. Not bad for a start. I am growing tired of apple juice and orange juice but still like tea and broth. My insulin is being adjusted and today I have been around 150 with no insulin. I feel pretty great--have had trouble sleeping but that is usual for me. Today had the peacock blue poop so know that all parts are still connected and working. The entire team here has been wonderful. My hearing loss and lack of spanish has not been a deterrent in the least. I missed the connecting flight because of stormy weather but Nina sent a Frericko to get us. Everything was fine at the hotel and here at the hospital. I met Barb, Ursula, Lisa, and Maria. I am excited and can not say enough about the passion that Dr Aceves and Dr Campos have for what they do. I felt treated with humanity and deep respect. The nurses are great. Sergio is funny and sweet and Arianna is fantastic. Yolanda is professional and a lovely lady. Lucy met me when I finally arrived and was very gracious to have stayed late on Thursday to make my arrival.:thumbup:

Hi, Haley, I am an animal lover too. I have a cat named Moxie and share a cat (Sophie) and a Yorkie named Jazzy. I have never met a stranger when it comes to dogs and cats. I am getting sleeved in two days. I can't wait.

So, thought I'd update everyone. Still doing the pre-op diet. I am 2 days before surgery now. Today I had the best 2 hour massage. My therapist is so good that I would consider marrying him for the massages alone. :frown1: So tonight I am repacking again. I don't want the bag to be too heavy and doubt that I will need much. I have to take my CPAP and am trying to get that in the suitcase as I don't want to have to mess with carrying it separately. I know that I can make do without magazines as long as I have my laptop. I am not taking any make-up or hair styling products-just a couple of pjs, underwear, socks, lightweight robe, my medicines and me. My cat keeps trying to burrow herself into the clothes in the suitcase--I will have to be careful not to pack her. Time is moving oh so slowly the closer it gets. I just can't wait patiently. I want the sleeve now!

It is not available here yet. I have already had the flu shot but not the H1N1. As a severe asthmatic, I am in the high risk category and I work with adolecents and children everday. I have surgery in three days so will not be getting the H1N1 before Mexico. I don't know whether I will have the vacccine later or not. I'd be interested on Dr. Aceves' advice on this topic.

Wishing, I have not been afraid for even 1 moment about having surgery. I am 50 and all of my fears have been the "what if" kind about not having surgery. My knees are bad. It hurts to walk and doing stairs makes me look like I am 100. Heart disease causing early death runs in my family and I am not ready to die by a long shot. I have had previous surgeries--colon, ears, sinus, knee and so at least I have something to compare this to, but if I would "chicken out" it would be to not pay the money and not have the surgery. I know that I would not live much longer and that the rest of my life would be painful or diminished because of what my body would not allow me to do. Having surgery does take courage and it is not the "easy way out". I will be challenged with the new stomach to think before I eat and drink--to determine what value I place on food and nutrition and if there is some other way to nuture myself. Only you can determine if this surgery is right for you. I can not wait for Oct 30 to get here so that I can begin to live! Good luck with your decision!

I am flying to San Diego on Thursday for Dr Aceves to perform my sleeve on Oct 30. I will be happy to share my experience with you. I am not nervous at all--just raring to get on with my life.

I am 5 days before surgery now. I will fly out of KC early Thursday morning for Houston, then San Diego and finally reach Mexicali for my vacation of surgery--best present ever for me to take care of myself. I am excited and have no worries, no anxiousness and no fears. So glad that I was not able to afford surgery years ago when my choices were limited to gastric bypass and band. I promise to post as soon as I am awake after surgery. Yippee, I am going to be healthy!:thumbup:

I would chose quality of surgeon and number of sleeve procedures and complication rate/leak/# of deaths over proximity.

As a therapist, I would agree that this reaction is common. We do it in part because we have made the idea of "diet" mean that "we will never be able to eat those BAD foods again". This thought of depriving ourselves sets in motion a reaction to eat everything in sight. This is our conditioned response. I have used hypnosis as a way to help block those impulses. I caution the advice to just allow yourself to eat all these last suppers. I have worked at changing my thought patterns out of my "dieting" mode into my "eating for health plan". I chose what foods I want and what portion size will satisfy my body's needs rather than my taste buds needs or head hunger needs. I have been able to follow Dr. Aceves' pre-op diet for 11 days without craving food and without my usual obsessive thoughts of food. I have 5 days left before surgery and after the first 3 days of carb cravings, it has gone easy.

ASMBS: Gastric Banding Less Effective than Other Procedures By Charles Bankhead, Staff Writer, MedPage Today Published: July 02, 2009 Reviewed by Zalman S. Agus, MD; Emeritus Professor University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Earn CME/CE credit for reading medical news DALLAS, July 2 -- Patients who underwent laparoscopic adjustable gastric banding achieved less weight loss and less improvement in comorbid conditions than those who had gastric bypass or sleeve gastrectomy. Action Points <LI class=APP>Explain to patients that laparoscopic adjustable gastric banding led to less weight loss compared with two other types of obesity surgery. Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Slightly more than half of gastric banding patients lost more than 50% of excess weight after five years compared with more than 90% of patients who underwent laparoscopic Roux-en-Y gastric bypass, Diego Awruch, MD, reported at the American Society of Metabolic and Bariatric Surgery. Surgical failure, defined as less than 50% excess weight loss, was almost six times more common with gastric banding. "Laparoscopic adjustable gastric banding was associated with fewer complications, but the percent weight loss at one and five years was inferior to laparoscopic Roux-en-Y gastric bypass," said Dr. Awruch, of Pontificia Universidad Catolica in Santiago, Chile. "Surgical failure occurred in more than 40% of patients who underwent gastric banding, and 16% of the patients required surgical revision of the initial procedure," he said. Similar disparities in weight loss occurred in the comparison of gastric banding and sleeve gastrectomy. Across the entire range of body mass index (BMI), laparoscopic sleeve gastrectomy led to greater weight loss, said David Schumacher, MD, of Wright State University in Kettering, Ohio. Dr. Awruch reported outcomes for 91 patients treated with laparoscopic Roux-en-Y surgery and 62 who underwent gastric banding from 2001 to 2003. Five-year follow-up was available for 73.6% of the gastric bypass patients and 91.5% of the gastric banding patients. Comparison of baseline characteristics showed that bypass patients weighed significantly more (106.4 versus 97.6 kg, P<0.001) and had a significantly higher BMI (39 versus 35, P<0.001). Gastric bypass was associated with a higher rate of early complications (14.2% versus 1.6%, P=0.009). In addition, nine bypass patients required reoperation or endoscopic dilatation compared with one patient in the banding group. Late complications occurred in 37.3% of bypass patients compared with 27.4% of gastric banding patients, but the difference did not reach statistical significance. A higher proportion of gastric banding patients required reintervention (23 of 62 versus 20 of 91). Percent weight loss at five years averaged 92.9% with gastric bypass compared with 59.1% with gastric banding (P<0.001). Dyslipidemia, insulin resistance, hypertension, and type 2 diabetes improved or resolved in 80% to 100% of bypass patients compared with 20% to 40% of the gastric banding group. At five years, 94% of bypass patients and 54.4% of gastric banding patients had maintained >50% excess weight loss. Dr. Schumacher reported outcome data for 104 patients who underwent laparoscopic sleeve gastrectomy and 227 who had gastric banding from January 2006 through August 2008. Follow-up data were 99% as of January 2009. Among patients followed for at least 18 months (about half of the total), weight loss averaged 133.82 lb in the sleeve group versus 58.93 lb in the banding group. For the same time interval, excess weight loss averaged 55.54% with sleeve gastrectomy versus 38.65% with banding. Stratification of patients by baseline BMI showed that sleeve patients had a greater excess weight loss in patients with BMI more than 50 (50% versus 33%), 40 to 49 (68% versus 40%), and less than 40 (90% versus 43%). Readmission rates were 6% of sleeve gastrectomy patients and 1.3% with gastric banding. One patient (0.96%) in the sleeve group required reoperation compared with 19 (8.4%) gastric banding patients. "Laparoscopic sleeve gastrectomy appears to allow greater weight loss in all BMI classifications over time with fewer reoperations," said Dr. Schumacher. "The most efficient weight loss occurred in the lowest BMI classification. "Laparoscopic sleeve gastrectomy can be used effectively as a primary operation in any weight classification, achieving a greater than 50% excess weight loss in all BMI subsets." Dr. Awruch and co-investigators reported no disclosures. Dr. Schumacher disclosed a relationship with Ethicon. Primary source: American Society of Metabolic and Bariatric Surgery Source reference: Awruch D, et al "Laparoscopic roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding 5 years follow-up" Surg Obes Relat Dis 2009; 5(3S): Abstract PL-122. Additional source: American Society of Metabolic and Bariatric Surgery Source reference: Schumacher DL, et al "Comparison of gastric sleeve and adjustable gastric band over an extended time frame" Surg Obes Relat Dis 2009; 5(3S): Abstract PL-215.

I am being sleeved by Dr. Aceves on Oct 30. With his permission, I opted for two weeks on the high protein, low fat, under 30 grams of carbs per day diet. The first three days were tough with constant cravings, constant thoughts about food and blood sugars bouncing out of control. I am diabetic and had been taking Glimperide 4 mgs daily, Novolog 15, 15 and 20 units daily and Byetta 10 units twice daily and Lantus 25 units at night. Now I am not on Lantus or Byetta and have reduced the Novolog to 12, 12, 15 and may get told to cut the Glimperide in half. This is all pre-surgery! I am sure that my liver will be in much better shape and that I am doing what I can control to assure that my surgery is safe and with little blood loss. I am also doing hypnosis about pain control, being able to tolerate the liquid phase and having Healing Touch sessions to calm my anxiety and prepare the body for surgery. I have three more days of work and then can focus on packing, relaxing, and keeping my immune system healthy for surgery. Life is good. Has anyone else used hypnosis or massage to prepare them for surgery?

Hi Tonya, Some friends of mine had Dr. Rumbaut do their bands a few years ago. He was very good and they loved him. I hadn't heard he had started doing sleeves. My pre-op diet doesn't have to be clear liquids--just high Protein, low fat and under 30 grams of carbs. I am doing it for 5 days ans feel pretty good. Just a little cranky and ravenously hungry the forst 3 1/2 days till I got past the carb cravings. I see Dr. Aceves on the 29th for sleeve surgery on the 30th. WooHoo, life is going to be good!