swimbikerun

One, why did you choose this one? Are there any special dietary needs you have other than weight? Two, what is the calorie, Protein, fat, carb, etc. content of this? I couldn't find it. Second that it has whey protein isolates is one thing but why cane sugar, and what are the spices for? Xantham Gum should be a binder, as stevia is a sugar as in cane sugar. I've seen protein items I think had better quality Proteins and the like in them.

Do you have your doctors schedule for how to eat? What to eat first? Do you exercise? I would start there. There is also a 5:2 pouch test that you can try online. Some have gotten good out of that.

I can certainly vouch for a problem with surgeons in the US. When: you ask them to fix their problem, you are not suing them or anything, and other doctors have (AGAIN!) told them that the surgeon was wrong and I did need care educate themselves on complications after surgery ask for a collaborative relationship ask that treatments be made with respect to my values and wallet things like that, and they don't give it, what are you to think? Especially after they spend time trying to "hush up" and tell you they'll respond in writing and never do. That's all the way up to the board and asking do you think this is ethical and they won't answer.

Actually how many lawsuits are there? I don't see or hear of it. I'm looking for the articles that came out recently saying it was getting harder and harder to sue and more people are getting medical bankruptcy. Just because another surgeon comes in behind another one doesn't mean someone is going to sue or have big problems. I don't see a huge increase in people complaining on here about complications. Its more aftercare or the lack/access thereof. I think the issue is a combo of all 4 issues named already but I would bet that lawsuits are what they use to excuse it.

Not in this area at all. I dont know how much of it is the legal agreements between Sentara and Bon Secours or not though. I think the issue on necks may be different than WLS. Different surgeon mentality. It also depends on the $$$ that those surgeons are getting.

I dont think you are talking about elective surgery? You had a surgeon who retired, this is where someone chooses to go to Mexico and pay for their services but they wouldn't pay for the surgeon they are asking to take over care. I don't think its close to the same analogy but again it does give a point to the arrogance and predjudice point quite well. Exactly! I had two vertebrae fused in my neck by surgeon A in Utah. He also did my 3 month followup and X-rays. Then surgeon A retired and I moved to another state so I had surgeon B do my 6 month followup and X-rays. Well surgeon B charged me 3X as much as surgeon A for X-rays (which I filed a complaint against and won because it was discovered that hospital was double billing clients) so I went to surgeon C for my 12 month followup with X-rays and an MRI. I never had any issues finding a doctor to take me as a patient even though they didn't do my surgery. So no, there doesn't seem to be an issue if you take "Mexico" out of the equation, thus my belief the problem is arrogance and prejudice, not necessarily liability and $$$.

I do agree that physicians do have a right to protect themselves, but where does that right end to where patients can't get any local care because not everyone is sue happy? Why is it blanket no no no rather than look at the situation and see? Just because someone didn't do the surgery, if it is to cover some aftercare, its basically saying I didn't get $$$ out of you for the surgery, the main thing, so you are not worth it to me to take on as a patient. I have the problem not just because of the legal non compete agreement, but because with additional issues, no one wants to do anything because they believe the original surgeon should have taken care of it. He just didn't want to be bothered to listen or anything else. I can see why docs have a problem: why should they get dumped on because someone didn't do their job.

All thank you! I do not have followup in the area (the bariatric surgeon did what he threatened to do and that was put a wedge between me and health care providers) but I am in Va. and can't fly. Thank you all for letting others know so if they get the surgery and don't have followup there are options. I wish I had followup in this area but due to non compete agreements between the groups, no one will take others patients. I can't go out of the area due to physical and financial reasons. My big concern is followup because in my case, with problems, its an issue. This is great to hear that not all doctors and hospitals have a $$$ and legal thing first but consider the patient.

You go Becca! For all those who pay their own way to WLS in Mexico, you need to ask your insurance why they won't refund you the dollars you save them by getting surgery! Jerks ... then again, I just had a chat with my insurance because they denied a medication. Between myself and the docs office, we got it approved. Granted for a lower dose but we got it approved.

x

Forget terrified, you will enjoy this side of the losers' bench!

Some of these articles can be found online. Others, if you go to a medical library, will let you read them or get a copy. Some links to medical references on general bariatric information: 1) Surgery for weight loss in adults (Review) Colquitt JL, Pickett K, Loveman E, Frampton GK 2) International Journal of Surgery journal homepage: www.theijs.com International Journal of Surgery 8 (2010) 86–89 Review: Bariatric Surgery by S.S. Jaunoo and P.J. Southall 3) The American Journal of Surgery (2011) 201, 266–268 Editorial Opinion Bariatric surgery 4) Bariatric Surgery Outcomes Kristoffel R. Dumon, MDa, Kenric M. Murayama, MDb 5) Complications following Bariatric Surgery Christopher S. Huang, MD, and Francis A. Farraye MD, MSc in Techniques in Gastrointestinal Endocscopy 6) Revisional Bariatric Surgery Todd Andrew Kellogg, MD 7) Surgery for Obesity and Related Diseases (2014) 00–00 Self-report of gastrointestinal side effects after bariatric surgery Q3 Melissa A.Kalarchian,Ph.Da,*, MarshaD.Marcus,Ph.D.b, AnitaP.Courcoulas,M.D.,M.P.H.c, Yu Cheng,Ph.D.b,d, MicheleD.Levine,Ph.D.b 8) Pregnancy After Bariatric Surgery Michelle A. Kominiarek, MD 9) Surgery for Obesity and Related Diseases ] (2014) 00–00 Variation in utilization of acid-reducing medication at 1 year following bariatric surgery:results from the Michigan Bariatric Surgery Collaborative Oliver A.Varban,M.D.a,*, AbdelkaderA.Hawasli,M.D.b, ArthurM.Carlin,M.D.c, Jeffrey A.Genaw,M.D.c, WayneEnglish,M.D.d, JustinB.Dimick,M.D.a, Michael H.Wood,M.D.e, JohnD.Birkmeyer,M.D.a, NancyJ.O.Birkmeyer,Ph.D.a, JonathanF.Finks,M.D.a 10) The American Journal of Surgery (2010) 199, 604–608 The North Pacific Surgical Association Medical Tourism in bariatric surgery Daniel W. Birch, M.D.a,b,*, Lan Vu, M.D.d, Shahzeer Karmali, M.D.a,b, Carlene Johnson Stoklossa, R.D.c, Arya M. Sharma, M.D.c 11) Bariatric Surgery Patients in the ICU Mary Jane Reed, MD, FCCM, FCCPa,*, Jon Gabrielsen, MDb 12) Surgery for Obesity and Related Diseases ] (2014) 00–00 Exploring the impact of bariatric surgery on high density lipoprotein Ali Aminian,M.D.a, AndreaZelisko,M.D.a, JohnP.Kirwan,Ph.D.b, StacyA.Brethauer,M.D.a, Philip R.Schauer,M.D.a, Q1 * 13) Diabetes & Metabolism 40 (2014) 87–94 Review Gastrointestinal changes after bariatric surgery I. Querciaa,d, R. Dutiaa,d, D.P. Kotlerc,d,f, S. Belsleye,f, B. Laferrèrea,b,d,f,∗ available online 14) Nutrition 26 (2010) 1031–1037 Micronutrient deficiencies after bariatric surgery Padmini Shankar Ph.D, R.D., L.D. a,*, Mallory Boylan Ph.D., R.D., L.D. b, Krishnan Sriram M.D., F.R.C.S.©., F.A.C.S. c available online 15) Surgery for Obesity and Related Diseases ] (2014) 00–00 Citation classics:Top 50 cited articles in bariatric and metabolic surgery Ali Aminian,M.D.,Christopher R.Daigle,M.D.,Stacy A.Brethauer,M.D., Philip R.Schauer,M.D.* 16) Nutrition 25 (2009) 1150–1156 Applied nutritional investigation Prevalence of nutrient deficiencies in bariatric patients Seok Yee Toh, M.Sc.a, Nazy Zarshenas, B.Sc., M.Nutr.Diet., A.P.D.b,*, and John Jorgensen, M.B.B.S. (Hons.), FRACS, M.S.c 17) Surgery for Obesity and Related Diseases ] (2014) 00–00 Reproductive health counseling and practices:Across-sectional survey of bariatric surge Julie Chor,M.D.,M.P.H.a,*, PatriciaChico,M.D.b, SubhashiniAyloo,M.D.c, Alicia Roston,M.P.H.a, MichelleA.Kominiarek,M.D.,M.S.d 18) Surgery for Obesity and Related Diseases ] (2014) 00–00 Long-term outcomes of laparoscopic sleeve gastrectomy as a primary bariatric procedure Camilo Boza,M.D.*, DavidDaroch,M.D.,DiegoBarros,M.D.,FelipeLeón,M.D., Ricardo Funke,M.D.,FernandoCrovari,M.D. 19) Surgery for Obesity and Related Diseases 6 (2010) 635–642 Revisional bariatric surgery: who, what, where, and when? John F. Radtka III, M.D.a, Frances J. Puleo, M.D.a, Li Wang, Ph.D.a,b, Robert N. Cooney, M.D.a,* 20) Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after bariatric surgery. Merrouche M, Sabaté JM, Jouet P, Harnois F, Scaringi S, Coffin B, Msika S, . - Obes Surg - ; 17 (7); 894-900

21) Best Practice & Research Clinical Gastroenterology 28 (2014) 741e749 Complications of bariatric surgery: Dumping syndrome, reflux and Vitamin deficiencies Jan Tack, M.D., Ph.D., Professor of Medicine *, Eveline Deloose, M.Sc., Ph.D. fellow 22) The effects of sleeve gastectomy on gastro-esophageal reflux and gastro-esophageal motility. Hayat JO, Wan A, . - Expert Rev Gastroenterol Hepatol - ; 8 (4); 445-52 23) Core Topics in General and Emergency Surgery Complications of bariatric surgery presenting to the general surgeon Simon Paterson-Brown Core Topics in General and Emergency Surgery, 19, 344-358 24) Hindawi Publishing Corporation Journal of Obesity Volume 2013, Article ID 741097, 6 pages http://dx.doi.org/10.1155/2013/741097 Review Article Sleeve Gastrectomy and Gastroesophageal Reflux Disease Michael Laffin,1 Johnny Chau,1 Richdeep S. Gill,1 Daniel W. Birch,2 and Shahzeer Karmali2 25) Hindawi Publishing Corporation Journal of Obesity Volume 2013, Article ID 934653, 6 pages http://dx.doi.org/10.1155/2013/934653 Clinical Study Short- and Midterm Results between Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity Bandar Albeladi, Céline Bourbao-Tournois, and Noel Huten 26) Hindawi Publishing Corporation ISRN Obesity Volume 2013, Article ID 210524, 7 pages http://dx.doi.org/10.1155/2013/210524 Review Article Mechanisms of Weight Regain following Weight Loss Erik Scott Blomain,1 Dara Anne Dirhan,2 Michael Anthony Valentino,1 Gilbert Won Kim,1 and Scott Arthur Waldman1 27) Hindawi Publishing Corporation Journal of Obesity Volume 2013, Article ID 837989, 5 pages http://dx.doi.org/10.1155/2013/837989 Review Article The Impact of Bariatric Surgery on Psychological Health Jeremy F. Kubik,1 Richdeep S. Gill,2 Michael Laffin,2 and Shahzeer Karmali2,3 28) GP Guidance: Management of nutrition following bariatric surgery August 2014 GP Guidance: Management of nutrition following bariatric surgery 29) Hindawi Publishing Corporation Journal of Obesity Volume 2014, Article ID 638203, 7 pages http://dx.doi.org/10.1155/2014/638203 Clinical Study Comparison of the Effectiveness of Four Bariatric Surgery Procedures in Obese Patients with Type 2 Diabetes: A Retrospective Study Sylvie Pham,1 Antoine Gancel,1 Michel Scotte,2 Estelle Houivet,3 Emmanuel Huet,2 Hervé Lefebvre,1,4 Jean-Marc Kuhn,1,4 and Gaetan Prevost1,4 30) Hindawi Publishing Corporation Anesthesiology Research and Practice Volume 2014, Article ID 762432, 2 pages http://dx.doi.org/10.1155/2014/762432 Letter to the Editor Sugammadex and Ideal Body Weight in Bariatric Surgery: The Debate Continues Michele Carron 31) Hindawi Publishing Corporation ISRN Obesity Volume 2014, Article ID 427062, 6 pages http://dx.doi.org/10.1155/2014/427062 The Work behind Weight-Loss Surgery: A Qualitative Analysis of food Intake after the First Two Years Post-Op Angela A. Geraci, Ardith Brunt, and Cindy Marihart 32) Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2013, Article ID 276183, 4 pages http://dx.doi.org/10.1155/2013/276183 Bariatric Surgery in Moderately Obese Patients: A Prospective Study M. Cerci, M. I. Bellini, F. Russo, D. Benavoli,M. Capperucci, A. L. Gaspari, and P. Gentileschi Bariatric Surgery Unit, 33) Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2013, Article ID 528450, 9 pages http://dx.doi.org/10.1155/2013/528450 The Role of Hormonal Factors in Weight Loss and Recidivism after Bariatric Surgery S. D. Pedersen 34) Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2014, Article ID 721095, 6 pages http://dx.doi.org/10.1155/2014/721095 The Anatomy of a Weight Recidivism and Revision Bariatric Surgical Clinic C. J. de Gara1,2 and S. Karmali3 35) BOMSS Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery September 2014 Ms Mary O’Kane, Consultant Dietitian, Leeds Teaching Hospitals NHS Trust Professor Jonathan Pinkney, Professor of Endocrinology and Diabetes, Peninsula Schools of Medicine and Dentistry, Honorary Consultant Plymouth Hospitals NHS Trust Dr Erlend T Aasheim, NIHR Academic Clinical Fellow in Public Health Medicine, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine Dr Julian H Barth, Consultant in Chemical Pathology & Metabolic Medicine, Leeds Teaching Hospitals NHS Trust Dr Rachel L Batterham, Head of the UCLH Centre for Weight Loss, Metabolic & Endocrine Surgery Mr Richard Welbourn, Consultant Surgeon, Taunton and Somerset NHS Foundation Trust 36) Hindawi Publishing Corporation Journal of Obesity Volume 2012, Article ID 837216, 2 pages doi:10.1155/2012/837216 Optimizing Outcomes in Bariatric Surgery: A Primer in Patient Selection Natan Zundel,1 Sayeed Ikramuddin,2 and Raul Rosenthal3 37) The Journal of Emergency Medicine, Vol. 34, No. 1, pp. 21–32, 2008 Copyright © 2008 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/08 $–see front matter Clinical Communications: Adults BARIATRIC SURGERY: A REVIEW OF THE AVAILABLE PROCEDURES AND COMPLICATIONS FOR THE EMERGENCY PHYSICIAN Stefanie R. Ellison, MD, FACEP* and Scott D. Ellison, MD, FACS† 38) Hindawi Publishing Corporation Journal of Obesity Volume 2012, Article ID 828737, 9 pages doi:10.1155/2012/828737 Complications, Reoperations, and Nutrient Deficiencies Two Years after Sleeve Gastrectomy Nicole Pech,1 FrankMeyer,2 Hans Lippert,2 ThomasManger,1 and Christine Stroh1 39) Hindawi Publishing Corporation e Scientific World Journal Volume 2014, Article ID 843253, 5 pages http://dx.doi.org/10.1155/2014/843253 Assessment of the Body Composition and the Loss of Fat-Free Mass through Bioelectric Impedance Analysis in Patients Who Underwent Open Gastric Bypass Wilson Rodrigues de Freitas Junior,1 Elias Jirjoss Ilias,1 Paulo Kassab,1 Roberto Cordts,1 Paulo Gustavo Porto,1 Francisco Cesar Martins Rodrigues,1 Mohamed Ibrahim Ali Taha,1 Paulo Carrara,2 Isabella de Carvalho Aguiar,3 Luis Vicente Franco de Oliveira,3 Osvaldo Castro,1 and Carlos AlbertoMalheiros1 40) OBES SURG (2014) 24:1724–1728 DOI 10.1007/s11695-014-1264-4 Analysis of the Five-Year Outcomes of Sleeve Gastrectomy and Mini Gastric Bypass: A Report from the Indian Sub-Continent K. S. Kular & N. Manchanda & R. Rutledge Published online: 8 May 2014 41) Diabetes & Metabolism 35 (2009) 544–557 Medical follow up after bariatric surgery: nutritional and drug issues General recommendations for the prevention and treatment of nutritional deficiencies O. Ziegler a,b,*, MA. Sirveaux a,b, L. Brunauda,c, N. Reibel a,d, D. Quilliot a,b 42) Journal of Visceral Surgery (2010) 147S, e31—e37 Gastric bypass. Principles, complications, and results J.-P. Marmuse∗, L.R. Parenti Hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France 43) e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism 6 (2011) e96ee100 Educational Paper Clinical Nutrition University: Nutritional support after bariatric surgery Anders Thorell* 44) International Journal of Surgery 9 (2011) 29e35 A multidisciplinary approach to post-bariatric plastic surgery Christopher Abela*, Tom Stevens, Marcus Reddy, Mark Soldin 45) GASTROENTEROLOGY 2007;132:2253–2271 Bariatric Surgery: A Review of Procedures and Outcomes KATHERINE A. ELDER and BRUCE M. WOLFE 46) Hindawi Publishing Corporation Journal of Obesity Volume 2011, Article ID 435245, 9 pages doi:10.1155/2011/435245 Tissue-Specific Effects of Bariatric Surgery Including Mitochondrial Function Simon N. Dankel,1, 2 Vidar Staalesen,1 Bodil Bjørndal,1 Rolf K. Berge,1 Gunnar Mellgren,1, 2 and Lena Burri1 47) Hindawi Publishing Corporation Journal of Obesity Volume 2012, Article ID 672162, 5 pages doi:10.1155/2012/672162 Laparoscopic Gastric Sleeve andMicronutrients Supplementation: Our Experience D. Capoccia,1 F. Coccia,1 F. Paradiso,1 F. Abbatini,2 G. Casella,2 N. Basso,2 and F. Leonetti1 48) Hindawi Publishing Corporation Journal of Obesity Volume 2012, Article ID 608534, 8 pages doi:10.1155/2012/608534 The Neurological Complications of Nutritional Deficiency following Bariatric Surgery Danielle A. Becker,1 Laura J. Balcer,1, 2, 3 and Steven L. Galetta1, 2 49) Nutrition 28 (2012) 391–396 Applied nutritional investigation Daily vitamin supplementation and hypovitaminosis after obesity surgery Simara Paganini Donadelli R.D. a, Marcia Varella Morandi Junqueira- Franco Ph.D. a, Carlos Augusto de Mattos Donadelli M.D. b, Wilson Salgado Jr. Ph.D. b, Reginaldo Ceneviva Ph.D. b, Julio Sergio Marchini Ph.D. a, Jose Ernesto Dos Santos Ph.D. a, Carla Barbosa Nonino Ph.D. a,* 50) Clinical update: bariatric surgery www.thelancet.com Vol 370 December 15, 2007 51) Letters to the Editor / Surgery for Obesity and Related Diseases 8 (2012) 655–658 52) Nutrition 25 (2009) 1150–1156 Applied nutritional investigation Prevalence of nutrient deficiencies in bariatric patients Seok Yee Toh, M.Sc.a, Nazy Zarshenas, B.Sc., M.Nutr.Diet., A.P.D.b,*, and John Jorgensen, M.B.B.S. (Hons.), FRACS, M.S.c 53) Nutrition 26 (2010) 1031–1037 Micronutrient deficiencies after bariatric surgery Padmini Shankar Ph.D, R.D., L.D. a,*, Mallory Boylan Ph.D., R.D., L.D. b, Krishnan Sriram M.D., F.R.C.S.©., F.A.C.S. c 54) Update: Metabolic and Cardiovascular Consequences of Bariatric Surgery Donald W. Richardson, MDa,*, Mary Elizabeth Mason, MDa, Aaron I. Vinik, MD, PhD, FCP, MACPb 55) Review article: the nutritional and pharmacological consequences of obesity surgery J. Stein*,†, C. Stier†,‡, H. Raab†,‡ & R. Weiner†,‡ 56) Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch1–3 Erlend T Aasheim, Sofia Bjo¨rkman, Torgeir T Søvik, My Engstro¨m, Susanna E Hanvold, Tom Mala, Torsten Olbers, and Thomas Bøhmer 57) Intestinal failure after bariatric surgery Olivier Corcos, Dominique Cazals-Hatem, François Durand, Nathalie Kapel, Marie Guinhut, Carmen Stefanescu, Xavier Treton, Vanessa Bondjemah, Alain Attar, Jean-Pierre Marmuse, Yoram Bouhnik, Francisca Joly 58) e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism 6 (2011) e96ee100 Educational Paper Clinical Nutrition University: Nutritional support after bariatric surgery Anders Thorell* 59) The Journal of Emergency Medicine, Vol. 34, No. 1, pp. 13–20, 2008 Copyright © 2008 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/08 $–see front matter doi:10.1016/j.jemermed.2007.03.017 Original Contributions CARE OF THE BARIATRIC SURGERY PATIENT IN THE EMERGENCY DEPARTMENT Samuel D. Luber, MD, MPH,* David R. Fischer, MD,† and Arvind Venkat, MD‡ 60) Long-term Follow-up After Bariatric Surgery A Systematic Review Nancy Puzziferri, MD, MS; Thomas B. Roshek III, MD; Helen G. Mayo, BS, MLS; Ryan Gallagher, BA; Steven H. Belle, PhD, MScHyg; Edward H. Livingston, MD 61) OBES SURG (2014) 24:1639–1646 DOI 10.1007/s11695-014-1225-y Nutrient Deficiencies Before and After Sleeve Gastrectomy P. W. J. van Rutte & E. O. Aarts & J. F. Smulders & S. W. Nienhuijs 62) Imaging of Bariatric Surgery: Normal Anatomy and Postoperative Complications Marc S. Levine, MD Laura R. Carucci, MD 63) Obesity Research & Clinical Practice (2014) 8, e299—e313 Psychological predictors of weight loss after bariatric surgery: A review of the recent research Cathrine L. Wimmelmanna,∗, Flemming Delab,c, Erik L. Mortensena,c 64) Partial gastrectomy and gastrointestinal reconstruction Author Debrah Wirtzfeld, MD, MSc, FRCSC, FACS Section Editor David I Soybel, MD Deputy Editor Kathryn A Collins, MD, PhD, FACS 65) OBES SURG (2014) 24:1463–1468 DOI 10.1007/s11695-014-1221-2 Taste, Smell and Appetite Change After Roux-en-Y Gastric Bypass Surgery L. Graham & G. Murty & D. J. Bowrey 66) OBES SURG (2014) 24:1436–1441 DOI 10.1007/s11695-014-1222-1 Effect of Sleeve Gastrectomy on Gastroesophageal Reflux Jan S. Burgerhart & Charlotte A. I. Schotborgh & Erik J. Schoon & Johannes F. Smulders & Paul C. van de Meeberg & Peter D. Siersema & André J. P. M. Smout 67) OBES SURG (2014) 24:1090–1093 DOI 10.1007/s11695-014-1199-9 Laparoscopic Sleeve Gastrectomy Using 42-French Versus 32-French Bougie: The First-Year Outcome Hadar Spivak & Moshe Rubin & Eran Sadot & Esther Pollak & Anya Feygin & David Goitein 68) OBES SURG (2014) 24:936–943 DOI 10.1007/s11695-014-1197-y Use of Bariatric Outcomes Longitudinal Database (BOLD) to Study Variability in Patient Success After Bariatric Surgery Stephen C. Benoit & Tina D. Hunter & Diane M. Francis & Nestor De La Cruz-Munoz 69) OBES SURG (2014) 24:1064–1072 DOI 10.1007/s11695-014-1212-3 Keeping the Weight Off: Physical Activity, Sitting Time, and Weight Loss Maintenance in Bariatric Surgery Patients 2 to 16 Years Postsurgery Katya M. Herman & Tamara E. Carver & Nicolas V. Christou & Ross E. Andersen 70) OBES SURG (2014) 24:847–854 DOI 10.1007/s11695-014-1182-5 Validity of Bioelectrical Impedance Analysis for Measuring Changes in Body Water and Percent Fat After Bariatric Surgery Elizabeth M. Widen & Gladys Strain & Wendy C. King & Wenwen Yu & Susan Lin & Bret Goodpaster & John Thornton & Anita Courcoulas & Alfons Pomp & Dympna Gallagher 71) OBES SURG (2014) 24:1481–1486 DOI 10.1007/s11695-014-1198-x Food Quality in the Late Postoperative Period of Bariatric Surgery: An Evaluation Using the Bariatric Food Pyramid Fernando Lucas Soares & Larissa Bissoni de Sousa & Carla Corradi-Perini & Magda Rosa Ramos da Cruz & Mario Gilberto Jesus Nunes & Alcides José Branco-Filho 72) OBES SURG (2014) 24:536–540 DOI 10.1007/s11695-013-1117-6 Improvement of Gastroesophageal Reflux Symptoms After Standardized Laparoscopic Sleeve Gastrectomy Jorge Daes & Manuel E. Jimenez & Nadim Said & Rodolfo Dennis 73) OBES SURG (2014) 24:735–740 DOI 10.1007/s11695-013-1145-2 Lifestyle Modification Parallels to Sleeve Success Dean Keren & Ibrahim Matter & Alexandra Lavy 74) OBES SURG (2014) 24:945–953 DOI 10.1007/s11695-014-1248-4 Measurement of Disordered Eating Following Bariatric Surgery: a Systematic Review of the Literature Katrina Parker & Paul O’Brien & Leah Brennan 75) OBES SURG (2014) 24:647–651 DOI 10.1007/s11695-014-1178-1 Does Patient Compliance with Follow-up Influence Weight Loss After Gastric Bypass Surgery? A Systematic Review and Meta-Analysis Hyun Joon Kim & Aman Madan & Douglas Fenton-Lee 76) OBES SURG (2014) 24:179–183 DOI 10.1007/s11695-013-1094-9 Lack of Adherence to Follow-Up Visits After Bariatric Surgery: Reasons and Outcome Pablo Vidal & José Manuel Ramón & Alberto Goday & Alejandra Parri & Xènia Crous & Lourdes Trillo & Manuel Pera & Luis Grande 77) OBES SURG (2014) 24:796–805 DOI 10.1007/s11695-013-1166-x The Effect of Bariatric Surgery on Intestinal Absorption and Transit Time Kirstin A. Carswell & Royce P. Vincent & Ajay P. Belgaumkar & Roy A. Sherwood & Stephanie A. Amiel & Ameet G. Patel & CarelW. le Roux 78) OBES SURG (2014) 24:727–734 DOI 10.1007/s11695-013-1130-9 Weight Loss Percentile Charts of Large Representative Series: a Benchmark Defining Sufficient Weight Loss Challenging Current Criteria for Success of Bariatric Surgery Arnold W. J. M. van de Laar & Yair I. Z. Acherman 79) UpToDate, Inc. info@uptodate.com Telephone: 1-800-998-6374 or +1-781-392-2000 Late complications of bariatric surgical operations Official reprint from UpToDate® www.uptodate.com©2014 UpToDate® Print|Back Late complications of bariatric surgical operations Authors Jamie D Adair, MD James C Ellsmere, MD, MSc, FRCSC Section Editor Daniel Jones, MD Deputy Editor Kathryn A Collins, MD, PhD, FACS 80) UpToDate, Inc. info@uptodate.com Telephone: 1-800-998-6374 or +1-781-392-2000 Imaging studies after bariatric surgery Official reprint from UpToDate® www.uptodate.com©2014 UpToDate® Print|Back Imaging studies after bariatric surgery Author Marina Kurian, MD Section Editor Daniel Jones, MD Deputy Editor Kathryn A Collins, MD, PhD, FACS 81) Bariatric Surgery Program at Sunrise Hospital Sleeve Gastrectomy (VSG) 82) Surgery for Obesity and Related Diseases 6 (2010) 115–117 ASMBS position statement American Society for Metabolic and Bariatric Surgery Position Statement on Emergency Care of Patients with Complications Related to Bariatric Surgery Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery 83) This report was derived from the “2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guideline and The Obesity Society” and “Managing Overweight and Obesity in Adults: Systematic Evidence Review from the Obesity Expert Panel, 2013” which were both developed jointly by the AHA, ACC, TOS and the NHLBI. To cite this document: Jensen MD, Ryan DH, Donato KA, Apovian CM, Ard JD, Comuzzie AG, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ. Guidelines (2013) for managing overweight and obesity in adults. Obesity 2014;22(S2):S1-S410. 84) Nutritional Guidelines for Post-Bariatric Patient Pre-operative and Post-operative Concerns Deborah Wong MPH, RD Body By Katzen 85) Surgery for Obesity and Related Diseases 8 (2012) e21–e26 ASMBS online statements/guidelines Updated position statement on sleeve gastrectomy as a bariatric procedure ASMBS Clinical Issues Committee Revised March 14, 2012 86) Hussain and EL-Hasani World Journal of Emergency Surgery 2013, 8:58 http://www.wjes.org/content/8/1/58 Bariatric emergencies: current evidence and strategies of management Abdulzahra Hussain1,2* and Shamsi EL-Hasani1 87) Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient: An Endocrine Society Clinical Practice Guideline 88) ASBS Public/Professional Education Committee - May 23, 2007 Revised February 7, 2008 Bariatric Surgery: Postoperative Concerns 89) PHYSICAL ACTIVITY & EXERCISE STRATEGIES FOR BARIATRIC SURGERY PATIENTS The University of Chicago Hospitals Center for the Surgical Treatment of Obesity 90) Center for Metabolic Health and Bariatric Surgery Weight Loss Surgery at Brigham & Women’s and Faulkner Hospitals Dietary Guidelines for Sleeve Gastrectomy 91) American Journal of Gastroenterology ISSN 0002-9270 C 2007 by Am. Coll. of Gastroenterology doi: 10.1111/j.1572- 0241.2007.01421.x Published by Blackwell Publishing CLINICAL REVIEWS Gastrointestinal and Nutritional Complications After Bariatric Surgery CME G. Anton Decker, M.B.B.Ch., M.R.C.P.,1 James M. Swain, M.D.,2 Michael D. Crowell, Ph.D.,1 and James S. Scolapio, M.D.3 92) Weight Loss Guide: What Are Your Lap Band Conversion Surgery Options? Patrick Domkowski, M.D., Ph.D., FACS Jason M. Radecke, MD 93) International Journal of Surgery Case Reports 4 (2013) 1057– 1060 Contents lists available at ScienceDirect International Journal of Surgery Case Reports jou rnal h omepage: www.casereports.com Laparoscopic sleeve gastrectomy for a two-and half year old morbidly obese childMohammed Al Mohaidlya,∗, Ahmed Sulimana, Horia 94) Gastrointestinal and Nutritional Complications of Bariatric Surgery Matt Cave, MD Luis S. Marsano, MD 2011 95) Bariatric Surgery: Postoperative Concerns ASBS Public/Professional Education Committee - May 23, 2007 96) www.hormone.org Endocrine and Nutritional Management After Bariatric Surgery A Patients Guide Hormone Health Network

Yep. I did get more followup with the surgeon, but some of that was due to the complications. His manner was something else. He blamed me for the problems. I had the psychologist who cleared me for surgery call my house and leave a message about in the 5th month after surgery. I told my counselor because I was mad. My counselor went back and checked with the office. The surgeon called me, said it was all in my head and "I DID IT. I CALLED THEM". He didn't ask me, check with me, just did it. I don't know but I've seen other people get mad when a doctor does that. The fact I turned up with physical problems explaining a number of issues, the HIPAA issue, etc. didn't help the issues.

One other thing missed: the competition between surgeons. I won't go into it, but suffice it to say I've had surgeons get more catty about each other than women at that time of the month, all unmarried at age 35, and a billionaire single man in the room. I had one comment made that I remember to this day and I'm like ... children ... its like the My Dad Can Beat Up Your Dad school yard routine. LOL

I think there are good and bad, just like there are here in America. I also have to wonder about the $$$ factor. The sources I have say that bariatric practices are high money makers and surgeons are the high RVU people. They have a vested interest in keeping people here in America. While I am sure some doctors bring up credible points, I have to wonder how much of it is patient concern and how much is the surgeon missing in lost opportunities. If say 10 people go to Mexico, and figure $25K for each surgery, that is 1/4 of a million bucks getting lost, not to mention pre op billing and after care visits. Bariatric practices were mentioned in one article I saw regarding propping up losing areas of hospitals, like ER's. I doubt you will see many surgeons' saying this. Btw, it isn't just America. Canadians do it because of the 3-4 or more years wait for surgery.

Oh my. I was 210 at surgery time. Went from 251 to 248 down to that just before surgery. Around that number 210/213 any way. I'm about your height also. Jeez ... if the person wants RNY, let them have RNY. Why does it matter? They may have their own reasons for it. Gracious. I support your RNY. Hope it works out for you. I attended a WL group meeting and as I walked into the room, a teen aged girl was there waiting with her mother. I heard her say OMG! and then laughter. I believed (but can't swear) that it was stated towards me. I am 5' 2" tall and weigh 215. All of the others before me were really huge ppl. I have type2, HBP, High chol, and arthritic pain in my knees. The nurse that took my weight and vitals said " I know you're having your band removed, but why are you having RNY?. You're not that big. Why don't you just get the sleeve". Well, for number one, my Dr. feels that I would have the same symptoms/ results as with the band. And number two, My insurance won't pay for it. I know the health problems I have, but ppl make me feel as though I'm crazy for thinking RNY.

I agree. The problem will come when the doctor doesn't want to do followup bloodwork. I've found some do and some don't. They will tell you to go back to the original surgeon. The problem is waiting months for a PCP and then finding out they aren't what was expected, its having to wait another few months to find another. I am not sure on the ER's. I've seen them miss some major stuff. The other problem you miss out on? Some one I know who doesn't live a "traditional" lifestyle, when she mentions it, that's when the stuff hits the fan. I can understand the point of not saying anything, but at least you develop a relationship with someone who approves of you and your choices. I know another person who has problems also away from the surgeon. They had my surgeon and moved away. They couldn't find a doctor and have gotten at least a couple of ER visits and those aren't cheap. Its a catch 22. This surgery is as safe as hip replacement, but you also don't know who knows what in the ER. Sometimes you are getting residents, etc. and they may not have the level of expertise as another. I once got a trainee PA.

Same here. I have to admit though, I am sorry for people that arent in the driving area having to go to Mexico. It would have been very very tough on me to do that and then fly out. I don't know how people do it, but they do. I support people having the ability to look themselves in the face and say I can do this and show the fortitude to do it. Takes guts. Takes character. I think people who research their options and choose a good one - and it seems a number have - really, I can't see why people can't support this. Especially when they don't have insurance. Its us against obesity right? Not the country. Not each other. Its us trying to improve our health.

I saw this and had to comment, it just makes me feel so sad for those who aren't covered by their insurance for a surgery that can really help. Then again, most insurances don't cover nutritional visits unless you are diabetic. Maybe if they did, they wouldn't get diabetic in the first place! At least the surgery gives people a chance at getting healthier. Simply insane. I can understand why people go to Mexico. I am pretty sure the issue is liability. In the case of my area, there are non compete agreements between the 2 major providers, legal agreements I was told, so you are stuck when you have a problem. The only thing I would want is for people to make sure they do have care when they come back. Or at least have the surgeon work with the doctors to help.

You can't always count on the stomach being empty at that point. Plus the items would be still digesting in the intestines.

Thanks for giving back to the community.

What about going back to the basics? You have gained 4 pounds but you were on vacation. What about just getting back into the swing of things of what you did to lose in the beginning? Things like portion control, exercise, etc.?

Interesting thought.

Would you consider the trainer again or what about the above of using the machines to help and then doing the free area? Or how about doing the free area on a less used time? Maybe Saturday afternoon, that tends to be a good time at the gyms I've been in.