Wheetsin

Ok, it just dawned on me - suture. I was reading it more "ow" than "oo"... sowcher. Suture rejection.

What is a soucher? Trying to understand what would be working its way out but I'm not familiar with that term & don't see it in any of my medical books. It seems like the SILS complication rates are a bit higher, in terms of immediate incision type complications, not things like leaks or strictures. SILS VSG is still fairly rare - please keep us updated on how things progress.

Think of your stomach as a food grinder. That's its principle job - to break up foods (digestion occurs mostly in the small intestine.) Yoiur stomach grinds food up by contracting food downward toward the pylorus/duodenum. Contractions occur about every 20 seconds on a normal stomach. Something like Water doesn't need to be broken up, so it can pretty much go right through , the water is pushed down/through. More dense foods and drinks might need to be ground up, so they are pushed down more slowly. That's generally the "what's really happening" behind whydense foods are so much more filling, and keep you full for so much longer. (That's a really simplified version, but is a good basic idea). Technically you're not holding more water (capacity wise), I wouldn't think, it's just able to pass through almost immediately. Think of a funnel wide open, and a funnel only letting a trickle through. When the funnel is full, it's full -- no more or less capacity between the two. But it will seem like the wide open funnel can hold more since it has constant capacity. HTH

I just started using it. I used to just log things in a spreadsheet but like the portability. I'm (you'll never guess) Wheestin.

It's "cool" (if I can accurately use that word) to see the things self-payers have to think of, that would never even cross my mind (like another Dr handling follow-up). Gene, there is some non-question info I can give you. Dr. Hoehn does most of his procedures either at the Prairie Star clinic (where his office is) or at the SMMC campus. He used to do them at a few other places, but one of those is closed and I'm not sure about the others. I *think* he only does sleeves at Prairie Star or SMMC. Mine was at SMMC because that's what my insurance requires. As self-pay, I'd guess you will be at Prairie Star. Just best guesses, though. Leaving the hospital, unless something weird happens, his standard is Lortab for pain and Omeprazole 20mg (PPI) which he wants you to take 2x daily. I know some other self-payers who got the same Rxs as me, so I don't think it varies too much based on self-pay status. If it 's cheaper, you can just buy the Omeprazole OTC at Sam's or just about anywhere else. (It's cheaper for me through insurance, but more convenient to just buy it on my own since I can buyhowever much I want at a time, so that's what I do). You probably already know this, but he requires an overnight stay. He does not do standard leak tests, but don't freak - I think his leak procedures are actually a better approach. I've only had 1 procedure with him that has required an overnight stay. I think both he and Tim (his PA) did the post-op followup, but I'm not completely sure. I was pretty tired. Your follow-up appointments will be at Prairie Star (1 wk, 2 mo, 6 mo, etc.) Dr. Sabapathy also has a post-op regimine. I didn't realize that at first, but just shcheduled a 6 mo appt for another round of testing. Did you have to go through Dr. Sabapathy as a self pay? Have you met him yet? If not, don't be alarmed. A lot of people think he is "cold" or "uncaring" or even "arrogant." But he's very good. Arrogance is usually an earned trait. When I had my first procedure with him in 2006 I had actually scheduled with someone else and it took a LOT of work to rebook with him, but he weas clearly the better choice. I truly think he's one of the best bariatric surgeons in the country, and he has excellent stats and I can't even begin to describe how much his comprehehsnive program has changed (for the better).

I'm curious what you guys are experiencing in terms of capacity for the different meals throughout the day. I'm able to eat (just recently) more than I thought I'd be able to in the mornings, and not quite as much at lunch, but I'm having a hard time with dinner. I skip it most nights, or just have a drink. I'd really hoped the issue of varying restriction was a thing of the past (from my lapband) but it seems like I'm doomed forever. BTW, had to get weighed yesterday, seem to be in the second week of a stall. But I'm like a stall *****. I tend to lose a lot very quickly, then stall out to a very moderate overall loss.

My surgeon doesn't do a leak test, but he does a submersion test and he fully scopes the sleeve after each procedure. I actually prefer his approach. Lots of leak tests are done with barium (at least). Think about it. If you have a leak, you're going to leak barium. Into your body. Yuck! One of my criteria was "no barium leak test!" I was amazed how many only did barium.

The SMMC bariatric program has a scheduled support meeting, unfortunately the time slot for sleeved patients is during the middle of the workday, around 2:30 or 3:30 IIRC. I don't know what they are like now, but they used to be pretty bad. It was a mix of all surgeries so only some of what you were hearing or discussing was relevant to you. There were a lot of politics brought in, and one of the ladies who used to run them (I don't think she's employed by them any longer, but I don't know for sure) was just absolutely miserable. I think they actually bring in people now to talk about relevant topics, but they didn't used to. It used to be... let's just say really bad, in a lot of different ways. I haven't been in years, so in all fairness they could now be wonderful meetings. Several of "us" (their more tenured patients, because when I say "used to be" I'm talking 6 years ago) started doing our own thing. Meeting up for dinner once a month, or an afternoon brunch, or coffee, clothing swaps, "bariatric potlucks," whatever. We'd found a more generic bariatric support group that met at one of the libraries, but I think they sort of disbanded about 2 yrs ago. For a while there were 8 of us who met up somewhat regularly. Most of us participated in a patient consortium sponsored by Allergan in Vegas and were able to meet about 15 other KC area people, but after Vegas we sort of dropped back to our smaller groups, which is too bad, because the larger group had so much more experience (one of the girls even back then was still about 10 yrs out from her surgery). I don't know of any local groups, formal or otherwise currently meeting. If you guys are interested I can send some emails and see what I can find out. I know a few of the ppl who used to run some of the more localized groups - they may know of something more generic going on. BTW I'm in NE KC, near Liberty/Gladstone and I work near Olathe. I've been told that Dr. Malley's support groups are open to the public, but I've never gone so I can't say for sure.

You are using the same surgeon I did. I've actually had 4 surgeries with him between 2006 and now, so if you have any questions I can help with, please feel free to ask. I was a revision (from lap-band) so my questions were mainly around the specifics of revision, rather than generic sleeve questions. I did ask him things like: Bougie size (tailored or standard) Process of checking for leaks (his is not standard, but I like it) What complications he would expect due to... (in this case a revision, but it could be anything) During the info seminar, I was told a few things and I didn't know if they were accurate or not (I'd been told them for previous surgeries too, and they never happened, so I wanted to know if they really would or not). Things like catheters, drains, etc. His personal sleeve stats compared to other potential revision surgeries. What the long-term follow-up plan looked like (comprehensively - for him as well as Dr. Sabapathy, Tim, etc.) I knew a lot going in - I'd been looking (lightly, but still) at the sleeve as a revision option for years, knowing I'd probably need something different one of these days. I also already knew a lot about his surgical procedure, aftercare, "how things work," etc. from being a repeat customer.

About 5 months the first time, then about 2 days (after my wrath when I figured out what the delay was). It will depend on how busy the coordinator(s) is/are, usually. You can ask them what their turnaround time runs. For your particular office, that's where you'll get the best info.

I have not, but it does happen. "Unfortunate" reactions to anesthesia are fairly common.

Generally STD is an employer-paid benefit, though it can be offered as an employee-paid benefit, or a hybrid of the two. (E.g. the employer will pay for a certain % of income coverage, but you can purchase higher on your own.) Contractors generally do not have STD benefits unless through a very large contracting firm (think along the scale of gov't contractors, I know several of the very large govt's contractors have pretty good STDLTD benefits... or at least used to before things tanked so much). Though it's not unheard of... VERY few companies offer (at least they used to, they may not anymore) offer individual STD coverage, and when they do, it's really expensive. Usually the only way to get it is through a group plan.

I don't go to church & have never had communion, but I know that back in the Atkins days people used to freak out about the carbs in the little wafer thing and/or the wine. They went so far as to measure everything out and drill it down to the nearest half carb. So don't forget you have to factor them into your weekly carb counts, I guess. (If it doesn't fill you up, just head over to the Sam's Club buffet after church, where I can be annoyed b/c you're blocking the aisle.)

Protein drinks are kind of like shoes. You can try a lot, and maybe they're horrible or maybe they're OK but most people eventually find that "just right" one for them. You can disguise - heavily - the Protein Drinks as well. The only time I drink them straight is if I'm doing one for Breakfast. I'll drink a Premiere protein in the car if I don't think I'll have time for breakfast when I get to work. They're not the best, they dry my mouth out and have a horrible long-term aftertaste, and unless I wipe my mouth off they leave little flaky crunchy things on my lips (dried drink, maybe, but I don't think I'm that messy of a drinker). Other than that, it's SF syrups, PB2, etc. out the wazoo. A little vanilla powder, some Splenda, low sugar/acid OJ, ice, and vanilla pudding and you're got a virtual clone of an Orange Julius. DaVinci and Torani have an amazing amount of SF syrups out there. Some are pretty sucky and others are amazing (sucky = chocolate, amazing = salted caramel). I've tried a lot and my favorite so far are EAS Carb AdvantEdge (powder & RTD). I'm going to try the Isopure Fruit Drinks as soon as I can make it to GNC. Isopure powder tastes like rotten ass, but I've seen several people saying the fruit drinks are pretty good. You can bake with protein powder, lots of people don't realize that. About 6 years ago when I first got my lapband there were two other ladies who lived in my area that I met who were also banded and we'd do little protein potluck things - make different protein ice creams, protein "cookies" (modeled on an old Atkins treat - they're not really Cookies, but you can freeze them and tell yourself that). Protein brownies, etc. If you're on required shakes that won't help much, but if you're just trying to meet a base protein level - get creative. You can add protein to just about anything. Be wary of protein "shots", protein jellos, 1 or 2 oz concetrates, any protein that looks like a test tube, etc. They are usually made of gelatin/collagen Proteins and are pretty much crap. (All proteins are NOT created equal).

I was given a fairly large pill to take (Sucralfate, definitely one I'd classify as a horse pill), and my surgeon told me I should be able to just take it. I wasn't so sure, so I would bite it into thirds (hate crushing meds) and swallow a third at a time. From being lapbanded, I was SOOO used to not being able to do pills at all, really. It was such a mental challenge. I finally took the pill whole about 5 days post-op and had no problems EXCEPT I couldn't take a big enough drink of Water to keep it from sticking down my throat (that dang pill acted like a sponge, kinda like zinc and folic acid do), so I'd have to quickly take a few more and sort of force swallow. But the stomach part of it was just fine. I also had Omeprazole and prednisone to take. I could take both of those no problem. To this day it's still bizarre to think that I can take a pill when I need to.

Just teasing. Tell the nurse to back off - they'd really like me, I gain about 13# with TOM. And somehow my surgeon's office misrecorded my weights, and had 286 as my sleeve weight (it was actually what I weighed when my band was taken out, over 6 months prior) and they couldn't figure out how I had gone from 286 to 302 in the 4 weeks since getting my sleeve. "You have a really good loss of... uh... (flipping pages)... this can't be right..." In all fairness, it's nice (strange, but nice) that they're keeping close tabs on you. It's always nice to see a program that is that "into" its patients and so involved in the more everyday things. That's pretty rare, anymore.

I only weigh when required for a Dr. visit. For now, anyway. Not seeing much change in clothing so I suspect I am not moving much right now. I have some things that are tight enough that a small change should register. scales suck.

Tons of info on companies, coverage, requirements, etc. is archived in the Insurance & financing forum: Link here What companies cover, what don't, differing requirements, state requirements, etc. All of it will be there. HTH

Ugh if you mean the actual surgery, it was VSG. But that doesn't mean VSG surgery is bad. GB surgery was just that much of a breeze. Day after GB I was back to normal, no pain, never needed meds, etc. VSG had an incision that tweaked for a while, and I had some energy issues.

Call your surgeon's office and tell them you need more time - yes, they can extend it. The surgeon recommends the time off, STD rarely fights it unless it's preposterous. I was given 4 weeks off without question. You probably won't get an extension for loose stool, but tell your surgeon about the discomfort you're having.

And our regain stats beat up their regain stats all week long.

Here it is, you'll find more info to help: http://www.verticalsleevetalk.com/topic/37685-what-were-your-restrictions-after-surgery/

I could start when I was off pain meds. Which was pretty much the next day. I actually started when I could comfortably turn to check the lanes around me. B/c of the painful incision on the left side I think it was just under 2 weeks. I just answered this exact question in another thread so I know a search will yield some results.

They really are negligible. And even looking at the capacity difference from say 32 to 60, it's stil negligible. I mean, about a tsp. Wtf cares about a tsp. A tsp of food never made anyone obese, or kept them from reaching goal weight. IMO, the most important factor around bougie size (and do keep in mind the sizing is always a bit arbitrary... I doubt any two bougie patients have the same exact capacity and if they do it's a fluke) is stricture rates. Surgeons are favoring the 34 over the 32 because of the lower stricture rate (I don't remember the s but it was significant), while %EWL and other weightloss stats are virtually identical.