Wheetsin

PhatGUrl, if you don't plan on returning to MX for aftercare, you might want to start finding a local surgeon who take care of you now. A lot of people wait until they need it, and them find that no one around them will handle their care, or the costs are more than they anticipated, etc. Knowing who you'll see down the road, when you have your surgery, will save you the stress later on. And on that note, what aftercare is really needed? Staple removal, drain removal -- is there a standard follow-up schedule after that or are you just kind of set loose? (I know it will vary by surgeon, but it's an interesting consideration for out-of-country procedures).

That's a good suggestion. I had not thought too much about the nausea, but knowing the plan up front is great. Especially since I hate surprises and pretty much NEED to know what to expect. Did you have nausea with your other procedures (i.e. is it your reaction to anesthesia, pain...) or is it just with your VSG?

Is it a matter of how the bill needs to be submitted (I ran into this when I had my lap-band because a nurse anesthetist was used and not billed separately, but needed to be -- took me about 6 months to resolve), or that the person's involvement is not covered? Can you paste the exact verbiage in your plan? I'm not completely understanding the problem as you've stated it in your post, but the contract language should help clarify. (I used to work for an insurance company and may be of some help, or if nothing else know some "insiders" I can ask.)

Hi Nohemi - I don't have a sleeve yet but I have a lap-band. Our chewing requirements are similar, and in fact lap-band requirements may be a bit more strict. This is a difficult behavior to change -- it was never apparent how little I chewed, and how much I swallowed at a time, until I had my band and had to pay attention. Until you get the hang of things, I would suggest eating with a baby spoon. SInce you have a 2 y/o, you probably have some of these laying around. The amount of food that a baby spoon holds when it has some room to spare is a good size bite to start with. Also until you get a feel for things, wait 3 - 5 minutes between bites. When we're learning our new feelings & sensations, sometimes we can misinterpret the message and eat a little too much, or a little too quickly. Regardless of your WLS, that's no good to do so soon after surgery. I did OK in the drinking front when learning how to drink more slowly (I was ALWAYS a chugger). It worked for me to take a normal mouthful, but then swallow it over 6 - 7 swallows. I know people who once again turned to their children's tools & used sippy cups with the "slow" restrictor in place. This didn't work for me as well because I had to suck which meant pulling in air, but it worked for them. When you get to a head hunger stage, serve your meals on side plates or saucers. It helps, mentally, to see a "plate full" -- regardless of plate size. HTH!

This recipe reminds me of my Atkins days. "Breading" was either crushed pork rinds or parmesan cheese. I even had a recipe for pork rind pancakes and pork rind french toast. They weren't as horrible as you might think.

Socialized medicine has a lot of pros. The wait lists are not one of them! (Nor are the taxes) I'm a but different since I'll be a revision. Getting my band, I submitted my paperwork around December and had my surgery March 1st. My insurance company at the time did not require a supervised diet for WLS. So the two months was the time it took to get all the pre-op stuff done, and to get a spot on my surgeon's waiting list. This time around, my slip was diagnosed in early June. Last week I had the EGD my current insurance company requires for removal/revision. I don't yet know next steps. My current insurance company DOES require a supervissed diet (6 months) but I have been told that since I am currently living with WLS, and seeking a revision, I will be excluded from that requirement. My surgeon's current wait list is about 3 weeks. He requires 2 months between procedures. I'm hoping removal approval comes through and I can get the band out Aug, and have a sleeve done in Oct. We'll see........

I know one person who went through a "too skinny" stage, but has since been able to get to a healthy weight. A lot of people exceed their target weight, but we tend to set high target weights anyway.

You have a really high starting weight (as did I when I had my AGB). It's hard to understand why high losses don't result in size changes. Part of it is math. Think of it not so much as pounds lost, but percentage of excess weight lost. When you weigh 400# and you lose 40#, you've lost 10% of your weight. When you weight 200# and you lose 40#, you've lost 20%. Another part of it is your body, and from where you're losing the fat. I dropped top sizes long before I dropped bottom sizes. Another prt of it is the flab factor, and the nature of your clothes. I'm currenlty down 4 top sizes and 5 bottom sizes from my highest weight. I can still wear the underwear I wore on the day I had surgery, and they aren't loose, but the pants I wore I can fit two of me in. I was banded at about 380 - 385 on 3/1/2006. I could wear a tight 30/32, but even some 30/32 were starting to not fit me. It was easily 50+ lbs before I lost my first size. A lot of anything you lose in youir first month is Fluid. At my lowest pre-op weight I was about 225 (when I got pregnant). At 225 I was a 14/16 top and comfortable 18 bottoms, some 16s. That was two years post-op, but I sat at 250 for seriously about 8 mos - 12 mos. Major stall. Given your slightly higher starting weight than mine, and my best recollection of starting to notice a difference in clothes about 50 lbs in, I'd guess you're right at the brink of really seeing a difference. I noticed that for me, after that initial milestone of the first size, it seemed that a size drop happened about every 30 lbs, and then around every 20 lbs once I had dropped 2 or 3 sizes.

Most restrictive WLS operations come with an ultimate "food as tolerated" guideline. I know some people have a hard time with skins (I know some people with lap-bands for whom this is also true) -- tomato skins, cucumber skins, grape skins, etc. I have heard that extremely fibrous foods, while not outlawed, may be difficult.

Average married sex really doesn't burn that many calories. It might be more related to you feeling better about yourself, and your husbnad picking up on that. "ONederland" is hitting 199.9 on the scale -- weighing in the ONE hundreds. There's also "Twoterville" and I'm forgetting the one people use for 300s.

Not having your surgeries together will be the best thing from a practical standpoint. My parents, a few years after I had it, both decided to get the lap-band surgery. They ("they" meaning my mother) wanted to do their surgeries together, to the point of trying to get them scheduled on the same day. I talked them out of it. It worked out much better for one to be healed/fully mobile/etc. while the other was down. Especially since they have a jumpy dog that can be a little crazy, and have to walk up/down stairs no matter where they enter their house. My mom had a bit of a hard time after her surgery (she went first) and my dad would not have been able to take on the extra care of he was newly post-op too, because it involved more lifting and activity than he would have been allowed.

Your facial hair growth is probably here to stay. Sorry. The hairloss from surgery is not permanent, so even if it did affect your facial hair, it would probably jsut give you enough break that you would hate it even more when it came back. Hehe. If you notice hairloss, it will be from your head (scalp). I think... I was about 200 lbs overweight for a long time, and my mom's side of the family is Greek and my dad's side is Native American. 'nough side, right? I dropped about 175 lbs, and have maintained a loss of about 120 lbs, and have not seen ANY difference in unwanted facial hair. I wax/pluck. I'm seriously considering something called "No! No!" I don't tend to buy things I see on TV, but I have read some really good reviews about that one. A girlfriend of mine had the beard growth. She had RNY, lost all her weightplus about 18 lbs, then gained back about 25 lbs. She shaves in the morning, in the shower. She's single, and we went shopping one day and she was buying a man's razor and facial shaving cream. I was like... wtf??

Why the strong fear? As someone already asked, do you have above average risk factors, or has it happened to someone you know, or...?

Signs of the times, I think. I'd heard that hospitals were really clamping down on payment arrangements. They can't really repossess a missing stomach. Just my 2 cents... experience matters, to a point. I'd take someone who has done 300 sleeves over 12 sleeves any day. But to me, it's not going to make much difference if someone has done 300 vs 500, or 1500 vs 8000. At some point, there's enough experience there, and any more isn't making a huge difference. Perhaps a bad analogy, but -- I don't want to be on the interstate with a first time driver, or even a 1 year driver. But it doesn't matter if I go with someonw ho has 15 years of driving experience or 50. So while I agree that experience is important, can you find a surgeon who has enough experience? If I was right and your "budget" for this is around $10,500 you should be able to find an experienced surgeon in the states in that range. You may even be able to find one near you. What would scare you about going on your own? FOr the part that matters, you'll be unconscious anyway.

WIth the lap-band, the rule serves three purposes. Surgeons tend to tell you about two of them. 1. Keep from flusing food through the band 2. Avoid the discomfort that can come from drinking too soon (on a full pouch) 3. Allow solids enough time to activate the "full" sensation, and keep them in the pouch longer (related to #1). I don't know if these are the same reasons given for the sleeve or not, other than the pouch obviously wouldn't be. Of those above I found that #2 was the biggest. There was never a difference in how much I ate when I didn't drink vs. when I did. But there was a world of pain if I drank too soon! (I'm not a rule follower, but I did find that over time, drinking with meals become easy to avoid. Stick with it, and make them unavailable during meals if it helps.) I'm also assuming that if your "meal" takes you, say, 4 hours to finish, taking a drink during those 4 hours doesn't count. Our guidelines averaged about 30 mins before to an hour after. If I grazed on something, I tended to wait a few mins.

CT Fats - I kinda see two different conversations going on. I'm assuming your question is about body/physical attraction and not about emotional connection. Is that right? You're not talking about emotional fidelity, or whether or not women love their husbands & would still love them if they gained weight... but purely whether or not that instinctual level of raw physical attraction would be there if they were obese...?

Do you by any chance wear 36x36 - 42x36 pants or 2XL shirts? I have boxes of them that I need to get rid of (hubby's). I haven't lost any sizes in the last 2 years... haven't gone up either though. I did the "new qwardrobe per size" thing. It was costly, but a good investment for affirmation. A few strategies you can use, 'cuz we're all going to need smaller sizes at some point before we're completely done. - Focus on basics. A pair of black slacks, and a brown-toned pair - solid or print. Completely interchangeable with any career wear. WHen rapidly changing sizes, I became completely hooked on the camisole (LB style stretchy tank) and cardigan sweaters. I now wear their canisoles layered with something else almost every day. They go on sale for about $9 -- the cheapest way to completely change the look of a shirt. - For casual, a single pair of jeans can also be cuffed up for island capris. - Shop clearance for upcoming sizes. I just got back from buying some summer clearance. I don't expect to lose any sizes this summer so I just got my current size, but since empire waist cross dresses were on sale for $9 I'd have bought the next size down if I did. If I had any clue what size I'd be wearing next summer I would have bought it too. - I can find really fun and unique things at Marshall's and TJ Maxx (saw someone else mentioned them too). - Have a local support group? Me and about 6 other ladies from mine all had surgery a few months apart, and all started around the same size. Usually when one of us was getting out of a size, another was going into it. This worked really well, except for pants (I'm about 4" taller than the next tallest) - Pants can be reasonably taken down about 2 sizes before they start too look really weird (IME, anyway). Most dresses can be worked for about three sizes if you tuck the waist - same with skirts. (I know the dress & skirt tips probably don't help OP too much, but most subsequent responses were from females)

I never needed a stress test (the treadmill thing). My appointment was just an EKG. Done in the hospital, in a side room with a recliner, while I went over a pre-op questionnaire with a nurse. Did it in my regular clothes (pulled shirt up) and all.

When I ifrst started looking into VSG (about 3 years ago, but in a really serious sense - for about a year now) one of my larger concerns was the idea of permanance. I kept thinking, "But they'll be taking out 85% of my stomach, and it can't ever be put back." That's actually not a major concern of mine any longer. I've come to realize -- so what? It's not like I'm at super high risk for some terrible medical complication 40 years from now, where -- darnit -- if I just had that other 85% of my stomach still, I'd be ok.

That is the whole point if a payment plan. Like when you get a car, unless you pay in full you arrange payments (installment loan). You're still able to start driving the car, even though you don't own it yet and are still making payments. But you will have to talk to the hospital/surgeon and see what they allow. There's a difference between a large emergency bill, or setting up payments for the amount insurance wouldn't cover, and setting up payments for an entire charge ahead of time. (A good friend of mine is a doctor - the hospital she is at now will work with patients, the one she recently transferred from would not, so it does vary.)

It's very hard for people to relate to things they can't relate to. I have never smoked, and though I understand that my smoker friends have addictions, it's still hard for me to conceive of why they can't just not smoke. But that's an addiction, and I do not think that obesity is a food addiction. I don't see it meeting the medical criteria. It does produce an effect similar to addictions, but without some pretty key requirements. So I'm not even sure the smoker/drinker/drug abuser/etc. analogies are accurate. I think it's closer to a cognitive disorder where people could change if they absolutely had to, but it would come with great distress -- more like OCD. The unspoken bias isn't toward WLS surgery, really. It is, but not in a direct sense. For one, there's a bias against "elective surgery." And I know that technically most WLS are deemed "medically necessary" but they are not medically necessary in the way that an aortic aneurysm repair or a surgery to remove pressure on the brain or an emergency c-section is "medically necessary." I'm not going to say "no" fat people are fat because of a medical reason, but it's exceptionally rare. Same with people who are fat because of true hunger (which at that point would have to be a disorder, or "medical reason). Most fat people are fat because of their cognition. There IS a solution other than surgery, it's just usually not a sustainable solution. (It COULD be a sustainable solution, but that would require extremes, and see below on extremes...) We CAN lose weight. We all have. We just can't keep it off very well. And when we do, we're usually sacrificing something else to make it happen. Because it is humanly possible for us to lose the weight off & keep it off (meaning -- it's not outside the laws of physics, or medicine, or...) most people see WLS as elective and an unfavorable solution. They think it's EXTREME to, for example, volunteer (and we are all kinda volunteering in a way... no one is knocking us out while we walk down the street to do this) to have 85% of your stomach cut out instead of just eatling less. Most things in extreme become taboo. (Money/wealth is one of the only exceptions I can think of.)

I was allowed to use sugar free ones. Some people have reported stalls related to use of sugar free products (espsecially ones containing sorbitol and maltitol, both of which can also be hard for some people to process) but it has never seemed to have that effect on me. That I know of. When I was going strong with Protein drinks, I regularly used SF Khalua, Peanut Butter, Caramel, Egg Nog, White chocolate, Cookie Dough, and Orange syrups. I did Protein Drinks in lieu of at least 1 meal and 1 snack for about 3 years, so I had enough time to develop a good relationship with them.

The amounts you're talking about are not going to hurt you, but too much Protein (and only protein) can basically posion you. It takes extremes to get there. Higher than average protein intakes should up Water to help flush things out. While upping protein won't hurt, it may not help, and more than you can use (of anything) isn't ideal. I've been trying to find conclusive information on how much protein the body can actually absorb - at a time, or in a day. Lots of different ideas. Years ago they used to advise bariatric patients to really bulk up on their protein and go for 40 - 60 gms per meal, with 3 or 4 meals per day. A friend of mine who had RNY in 2004 was told to use double scoops of a sugar free Protein powder and try to get at least 80gm per meal. The most generic consensus I can find right now is that the body can absorb/use about 30gm per meal.

There's not much you can do, as long as it isn't because of some other reason (a reason other than liquid in, liquid out). Don't take the diarrhea meds. They really just sort of paralyze you. Your body is trying to expel, so let it expel. If it starts to hurt, either fro content or too much wiping, you can "hose off" (in the shower) in lieu of wiping. I had to use that tactic after my daughter was born (I had a stage 4 tear and NOTHING other than the epi foam could touch me). Mushies should help, especially ones with Fiber. That may seem counterintuitive, but fiber without adequate Water will actually block you up.

You really need to do your day of liquids (I assume SF liquids). It's to reduce the size of your liver, which will make your surgery much more doable. An elarged liver, or liver that is not sufficiently shrunk, can cause your surgery to be postponed. Kind of. They have to cut you open & get in there before they know. So if you have to go through it anyway, just buck up, do oe single day of liquids, and don't risk it. (Kinda late telling you this at 3:30 pm though). If I were you, I would call my surgoen's office and let them know. Then at least there's a chance of avoiding a "surprise" tomorrow. The surgeon can better work with things when they are expected. You've undoubtedly been giving some fasting instructions too, should be for at least 12 hours prior. This one is important, too.