SummerShadow

My surgery date is November 9, 2017, and my surgeon only requires us to do a ONE week pre-op liquid diet, which begins for me tomorrow. However, to test the waters I started it today instead. I'm HUNGRY, and I can't keep anything straight... grams of this, ounces of that... I'm overwhelmed. All my life I've struggled and fought to have ANY kind of organization, and I usually fail and make things worse when I try, including keeping up with the dietary guidelines. Biggest problem is hunger right now. Ugh. I've 60g-80g of protein, for one thing (on the paperwork), but in our nutrition class she said it was okay to go over a little bit to 100g. So which is it? I've made so many calls to her to clarify things, and I'm still not clear on anything. Sees in order to not go over the protein maximum I have to mostly eat SF jello, popsicles, etc.... which leaves me hungry. This is rough, I have to admit, especially with all the stress from the confusion. I'm having a lot of trouble just keeping up.

I'm estranged from most of my family, all but for my kids and grandkids. My kids know, but I don't talk about it. My husband knows of course, but that's no help, sadly. I don't have a support network other than him, but I'm not telling anyone else I know. It just feels private, you know? Especially to tell people I don't know very well. My life has been nuts till now, kind of still is, so I don't have any real friends. Moved too much, was isolated for many years (long story). And i don't want a ton of negativity coming my way.

Wow, Mellymel... :/ I'm sorry you have to go through that. My surgery is on the 9th and my husband is NO help. That's another talk show that I'll leave for another day. He's my only support network as my kids just look confused (they're grown with kids of their own) when i talk about it. I officially start my liquid diet tomorrow (Nov 2), but I tested the waters a bit today to see how tomorrow would go.. and failed terribly. It's so confusing to me, keeping up with all this stuff, to be honest. SO confusing. :/ Hang in there! I'm sure you'll do just fine! And you already get full from the shakes.. which I found I don't. I'm hungry hungry and can't seem to nip that in the bud. ***hugs***

My surgery date is the day after yours, November 09, 2017. My surgeon only has us on a one week liquid diet, which I start tomorrow. I'm incredibly, INCREDIBLY confused about the diet. Overwhelmed, to be honest. Hope you're handling it better than I am.

I was remarking on the CPAP issue, not the surgery issue.

I was one of those people who ended up with bruising and rashes, etc. on my face from CPAP machine use (tried every mask available and all bruised, leaked, etc). No tolerance whatsoever. My doctor referred me to a dentist who specializes in the oral device, which I have and am using. It's mainly better for someone with mild to moderate sleep apnea and may not be the best treatment for severe SA. If someone is intolerant to the CPAP machine, an oral device may be indicated, but that's up to the doctor of course. My husband had the surgery, which worked for a few years until he gained weight again. Now he's back on a CPAP. Surgery isn't foolproof or long-term, from what my husband was told. I imagine that if someone's insurance requires they use the CPAP machine a bit then it will likely fall into the time frame for doctor supervised diet program so I wouldn't think it would extend the waiting time. Just guesswork on that, of course.. I'm no expert by any stretch.

I agree! I can't get the patient advocate to return my calls, and she's the ONLY one in the office who can tell me if my doctors sent in everything needed. It's frustrating, but that surgery center is the only one even remotely nearby (1 1/2 hours away) that has experienced, qualified surgeons. I was told by a tech who did my stress test that my surgeon has done a ton of the gastric sleeve surgeries and he was a great choice. But I can't even get to the person who can tell me if they received everything required from my doctors. :/ I'm stressed beyond belief right now.

Thank you.

This is what I found online from BC/BS of AL They really don't make it easy at all. And, it still doesn't say how much weight I'm supposed to lose in that 6 months.

Thank you for the input, Middus. BTW, love your avatar. It seems the requirements vary so much from state to state that it's incredibly confusing, overall. But then, that's the way it works anyway... one state vs another.

I will try that, Outside. Thank you for the suggestion. The patient advocate at my surgeon's office, the one who knows the insurance requirements, etc... was the one who told me I had to do the 6 months of dieting. I wish I understood why it's so hard to get approved for this surgery. Can't just be the cost, because there are a lot of approved surgeries that are approved all the time.

I'd been seeing an endocrinologist for pre-diabetes, but now my numbers have slipped a tenth of a point below the cutoff between normal and pre. My Endocrinologist told me to go to my GP to get the process started, and she was one of 3 doctors who suggested I think about getting this surgery. I think my endocrinologist isn't as great as I initially thought.

That's great that they did that for you! I have reflux and sleep apnea, and I still have to jump through all the hoops to get this approved, and that's with a BMI of 48. So glad they did that for you!!!

Wow. You're lucky! Here in AL they require 6 pos of doctor supervised dieting. I thought it was 7 months but found out at my visit with the surgeon that it's 6 months. I didn't realize when I'd already left the appointment... that they didn't tell me how much I had to lose in that 6 months, and I've been trying to reach the person who handles this for about a week and a half now with no return calls. So I'm still pretty much in the dark.

I am SO glad to hear your liver is better!!!! Wow! That's a blessing for sure! As for my liver.... my enzymes were elevated, sending me to a specialist. Blood work showed the score for probable NASH, then I was scheduled for biopsy... where they go in through the jugular. Results were NASH with no fibrosis, cirrhosis, nor portal hypertension. I was put on prednisone (was on it a horrid 3 months) because my specialist thought I had/have autoimmune hepatitis, though the biopsy results showed NO interface hepatitis. I really want a second opinion on that as none of it made sense due to the lack of the defining factor (interface hepatitis) and any antibodies in my blood work. There was also no indication whatsoever in the biopsy results that my liver was enlarged and, in fact, said it was normal size. I'm assuming, then, that things will go well. I did read one research paper that said (and I knew this already) that rapid weight loss can cause inflammation, etc. in the liver. One risk vs another, I suppose. What you said makes perfect sense to me, and unless they see something different during the surgery I'm sure everything will be fine. Thank you so much for the info, Patient, and I'm so so SO glad the surgery helped with your liver issues!

It wanted to make sure I understood you. hahaha. I feel like I'm having to do that with my GP. ;p No worries.

jb said.. "Have you thought about going to Mexico for surgery. It's about 4K " No. I'll stick with the US. Insurance will approve me, I'm pretty sure, but it's getting one of my doctor's to understand what's needed from him, paperwork wise. My BMI is 48... I don't think they'll deny me unless I or my doctor screws up the paperwork. Sorry this didn't show up as a quote from you jb. Not sure what happened so put your question in manually.

Hi everyone. Well, I had my first appointment with the surgeon on April 18 and all went well and quickly, which surprised me. The surgeon knows, and we discussed briefly, that I was diagnosed with NASH last year. He was non-plussed and said that would improve with weight loss, mentioned nothing about it posing a problem during or after surgery. However, a co-worker of my husband had the banding done, is having to have it re-done (whatever that means), and he told my husband yesterday that his surgeon told him that if he found a fatty liver that he would terminate the surgery. So then I went online to read about NAFLD and NASH (which is what I have) and gastric sleeve surgery. Confusing confusing confusing information..... A couple of research papers said it helps and doesn't pose too many complications unless the person has cirrhosis and/or portal hypertension. As of my biopsy last year I have neither of those. But other articles, etc say that the liver will "Shred" or "Tear" and bruise due to it's larger size due to the fat. There wasn't any mention by my liver specialist, nor was it in the copies of the biopsy results, that stated my liver was enlarged. BUT... which of the information is true??? Will my liver shred or tear if it's fatty and they try to do this surgery, or.....???? Anyone else have fatty liver, and if so... what was your experience?

Well, after my first appointment it seems I cannot use my endocrinologist at all but my GP, and I have to have a letter from my GP (had two in 3 years time) stating I was overweight, what my BMI was, and listing any co-morbidities. I also have to have a letter from my dentist who fit me for my oral device for sleep apnea, and I have to have clearance from my cardiologist. It's all a giant mess at the moment as one of my GP's doesn't 'get' what I need from him. He mailed me a clearance for surgery letter but didn't include anything about my being overweight etc from when he was my GP (left him due to horrible nurse, that still works for him, and then went back after other GP was a total waste of time to see). Anyway, so the GP who I left actually knew what I needed and it was done, and I was able to speak to a human being at the office. Former and current GP... receptionist keeps putting me through to records, and records can't help me with what I need. *sigh* Now, my surgeon didn't require my losing any weight before my initial visit, and... he didn't tell me exactly how much I was supposed to lose to qualify in that respect either... so I still have to call them and ask. But they didn't require me losing any weight to see him the first time, and I'm suspecting he didn't because they had no idea if I were to qualify through insurance or not prior to that first appointment. I also thought I wouldn't be able to have Gastric Sleeve surgery due to having some reflux. As it turns out... I can, and that most people have improvement of that. So... GS it is if approved. I also read in my paperwork that they don't require a psych eval, and I thought that was pretty standard. But hey, I'm good with one less thing to do beforehand. Oh, and since I have sleep apnea and am being treated for it... my BMI has to be 30 or above. Currently... my BMI is a whopping 48. Yikes.

lol I guess you're just ninja like that. ;p

Well, there's also the hunger factor too, so I'm assuming from what I've read that the bypass helps with that as well. And I mean actual hunger, not appetite.. the latter of which I'm also understanding is a thinking re-set thing. But yeah, slow and steady isn't a bad thing for sure.

Praying for you Keri. Think positive and, as you have already done, allow God to handle it. Please keep us updated.

Unless one is very young this is actually quite common with weight loss. Most people lose weight from their face easily and quickly, so the more you lose the thinner your face, and not being in our 20's or 30's.... gets a bit harder as we age to hold that skin plumpness like when we were young. BUT... skin care can help and we get to have a longer, healthier life. I think that's an okay trade off.

I'm here! But I'm at the beginning of my journey with my first surgeon appointment April 18, 2017. I'm post-menopause at age 56 as well, so this should be interesting.

Guess I'll be starting from scratch. :/ BC/BS of AL requires 7 months. I'm not going to be using my PCP or Endo if I have any say about it. I suppose I'll ask for a bariatric nutritionist from the get-go. Going to be a looooooooooooonnnng 7 months.