KarenLR75

I had gastric bypass in July of 2019. Highest weight was 400 before losing a bit on my own. Current weight varies from 167 to 173. I still feel some restriction to this day. My meals are usually small although I know we can all 'eat around' the restriction by eating smaller, but continuous meals and this was a slippery slope I fought back against. About 2 yrs ago, I started having right sided pain. It felt like the pain I used to feel when I ovulated so I assumed it was ovarian. Saw OB & had 2 ultrasounds and they couldn't even see right ovary (and the left was fine. Since they couldn't 'see' the right one, they said that was good since there was no obvious signs of..I don't know tumors, growths? The pain continued to worsen & I finally had gall bladder taken out 1.5 yrs ago. I adjusted diet again to deal with gal bladder being gone and things seemed ok. A few months after that the right sided pain returned. About 4 mos ago, the pain got so bad at times I'd be in a ball on my bed considering going to ER (which I HATE doing). Went back to primary got CT scan. CT came up with no findings. Then he referred me to GI doctor for colonoscopy & upper GI. I thought finally 'this was it, we've ruled out most other things'. I also had seen blood in my stools and it was old blood, like coffee grounds so I thought ok, not hemorrhoids? Just got back home from colonoscopy & upper GI. I thought doing prep was bad yrs ago, but much harder having had bypass surgery. Good news is no polyps or other concerning things. Bad news is main finding was on bypass "Patient's surgical anastomosis noted to be widely dilated, raising possibility of Dumping Syndrome as a cause". OK, most know what dumping is. I thought it was post surgery when we ate food (i.e. sugar, high fat) that processed too fast, etc. and you had dumping. Is the type of dumping they are alluding to different from our post surgery dumping? They recommended I see gastric bypass revision specialist. Has anyone else had revision NOT due to 1st bariatric surgery not being successful but for a "medical reason" like this (other than GERD, heartburn). I'm not even sure insurance will pay, but I have 2 yrs worth of history on this pain. Even it if does pay, I dread what this means for me - more hair loss? If I do this, will I need another revision in 5 yrs again at which point I'll be getting up there in age. I also still feel restriction kick in although yes, nothing like 1st 2 years My highest right now hovers at 173. I hoped I'd get to 150 but closest I've come is 167-168. Is revision another 'nuclear detonation option'? I've also wondered with the CT scan, etc. is there any chance of some straggler/stone from my gallbladder surgery 1.5 yrs ago that should be considered? Should I post this in the revision group instead? I read through some and was unsure. Are we allowed to cross-post? Any input would be appreciated. This is causing issues on my job as the pain hits out of nowhere (not X amount of time before OR after a meal, that I have been able to discern. Thank you!

oh my gosh...I was on the edge of my sofa reading your story! Your reply as to whether it was the plane trip or your surgeon just cracked me up! I had to quote it! One thing I wasn't clear on and this is where I'm also afraid of getting surgery done 'out of the US/out of country) is if there is some sort of issue/medical emergency like you had, will my insurance refuse for me to be treated so I will be forced to make an unplanned trip out of the country to figure things out? Or did your insurance pay for your wound care/full extraction? Did you have to pay to get the 're-implant'/'new implant' done here in the U.S.? I'm still marveling at what an incredible job you did losing weight and what a tough cookie you are! You look tiny but FIERCE! Amazing!!!

LOL...now I'm wondering if I should consider surgeons that are in Canada! I HATE flying but was willing to consider it although you would think in a state the size of Texas I SHOULD be able to find a really good surgeon. I haven't been looking HARD but I'm about ready to start. I've returned here honestly to re-read this forum and try to figure out how to find a really good surgeon-match that I trust and to also figure out 'how much am I looking at' and 'what are my top priorities'. My chest is SO bad I want to say a boob job, but my arms are just horrific and bothersome. So probably arms are first, followed closely by my chest...and if I could fit it in. I'd do something with my neck..OMG..my neck. Just don't get me started..ugh.

This July it will be 5 yrs out since my gastric bypass. Originally I wanted to put goal weight at 150 but even when I was 16 and on the swim team and burning calories like crazy, the lightest I ever was, was roughly 145. As a teen I even did VERY UNHEALTHY things to try and get down to what at the time, according to the notorious insurance standards, was a medical goal weight of 114 -135 lbs for my height at the time. I never managed to get down to 114 despite going on under 600 calories a day (again, with no medical guidance..I was a teen and listened to peer pressure and society tell me what was 'ideal'). So to think that in my 50's that I need to even try for that kind of weight, I figured I'd just disappoint myself plus I'm older and my body has changed. I finally set my goal at 170. Fast forward to THIS year (year 5) - I had consistently been tracking between 169-175 (and been THRILLED) and for some reason I hit a rough patch about 7 mos ago where I was hungry all the time, scary hungry considering I had been more at ease with my life and not feeling like I had to monitor anything. Things felt like there was a natural rhythm to hunger and how I addressed it. I didn't feel desire to overeat and my family said I still 'ate like a bird, but I realized I had let bad habits creep back in and it was more a boredom thing and honestly, extreme stress. What I was doing that let calories creep in was I was eating more frequently. You can overcome any 'restriction' at some point by eating frequently. I gave myself 'guard rail'/target weight zone instead at the end of my first year post surgery. If I'm in my 'zone', then I'm not actively trying to gain or lose, I'm content. If I get up towards the high end of my zone, I re-evaluate what I'm doing. I ended up in 1 month blowing past the high end of my zone to a weight spike that I had not had for 3 solid years. I had been consistent AND happy with where I was at. Thankfully I've course corrected and with some help I'm at my lowest weight ever since I was...er...18? I'm 165 right now and as I am also considering plastics, I'm going to re-review the valuable info on the plastics forum/threads as I know I want weight 'stability' for sure. I knew when I did the surgery that I personally wanted to wait until a few years out because honestly, I was afraid I'd find some way to tank the surgery even though I waited 5 yrs before having the surgery to work on myself mentally/emotionally. I also knew I'd have to pay for it out of pocket so I would need YEARS to save so I figured I could lose the weight and tone what I could so the plastic surgeon, if I was fortunate enough to find one I could trust, would know what they had to work with. I'll let them tell me if they also feel I'm ready. I have SO much loose skin that I honestly don't know with it removed if I'd weigh 5 lbs less than what the scale says. I also learned my watching my 1000 lb life that loose skin doesn't weigh as much as I THINK it should..LOL. That is why I'm only attributing 5 lbs to my loose skin I think you are doing AWESOME! I'm glad you are keeping your goal where it is. Just settle into your 'new fantastic self' which is just another facet of the already awesome person you were! We can both spend time researching the plastics info while you are in this new chapter of your life and I'm hanging out at 5 years hoping I win the lottery or at least a big payoff scratch off so I can put some money 'down' with a plastic surgeon..LOL!

I'm actually scheduled for an exploratory peek into my pouch on June 6th so it should be interesting. If they don't find anything there, the bariatric surgeon said the traditional upper and lower GI do not go through every part of either our intestines or the bowel, cannot remember, but that he knew of 2 doctors in this area that had an 'extra long scope'. Gah, I don't want that to be the NEXT thing we try considering I just went through the yucky 'prep' for a traditional upper and lower GI last month...lol. I would think my 'new' GI doctor should have come up with some of this stuff and not just punted me to the bariatric surgeon and told that I may need a 'revision' as it sounded to him like 'dumping'. It has never felt like the dumping we experience after a bypass/sleeve. It has felt different from it this whole time. This GI doctor has decent reviews so maybe I will just follow up with him after exhausting the 'could it be related to my bypass' route he has sent me on and see if he has any other ideas of what it could be. At this point, I'm getting kind of tired. My primary who is usually really good to work with told me 'you may just have to deal with ongoing, chronic pain'. He and I will talk about that 'not helpful at all' statement.

Hey Warren, I'm presuming because they would only look at fixing the opening if they did feel it was contributing to the pain and other issues I'm having 'downstream'. This would not be a true revision in the sense of reducing the size of the pouch. My insurance company also only pays for 1 bariatric surgery in your 'lifetime'. They would only pass for the revision of opening if it were medically necessitated, and they would not consider 'failure to lose weight' or a 'weight regain' as medically necessary. My GI wanted me to talk to the bariatric surgeon who specializes in revisions. The surgeon does not think what is happening to me is 'dumping due to widened opening'. He said it doesn't sound like dumping to him and if that happened to everyone whose opening widened, everyone would be having "dumping" issues after a couple of years. He did point out that both the upper and lower GI I had done do not look at the inside of the pouch so if there is a hernia that is causing the on again/off again pain and on rare occasions bleeding (looks like coffee grounds), then the GI doctor would not know as they never 'scope' the pouch for a routine upper/lower GI. He also indicated that depending on the scope size a GI doctor uses, it doesn't go through every single space that we have (due to us having been um "modified"?) so it would take a doctor who uses an extra long scope. That last part I must confess I do not understand at all. He does have me scheduled right now for a laparoscopic investigatory procedure to take a look inside my pouch and see if there is scar tissue or a hernia that needs to be addressed. He also gave me prescription acid reflux meds and said if i got better after 'taking' them, I could cancel the procedure in 2 weeks. What he fails to understand and I've tried telling his office, I can go a month with no pain. Then I go back to back days in extreme pain. Have not been able to tie it to specific food, time of day I'm eating, etc. My right side starts with a stabby/cramping pain (closest I can compare if it feels like the pain I used to get when I ovulated or that 'stitch in your side' type feeling. It often goes downhill from there. I have tried to get it figured out now for 2 years but taking ANY medicine and 'not having an episode in the next 2 weeks' does NOT give me a definitive answer as I do not have this pain all the time, it is just enough to be frustrating and has lasted LONG enough to be concerning. The 'coffee ground' type bleeding that I have observed is one and off for the past 3 months (maybe it started a while ago but now I know what to 'look for'. I don't like going under anesthesia but I'm probably going to keep that procedure scheduled as I have no guarantee that ANY medicine given for the next 2 weeks has 'fixed' any issue. I wonder if anyone else has ever had their opening revised but not their pouch out of curiosity.

I'm not sure...surgeon just said that tightening that opening alone would not cause major weight loss. Unsure if during a full blown revision if they also reduce the size of the 'pouch' and tighten that opening. I would think 'pouch size' is a possible element as well but this doctor did not elaborate, I'm assuming since the goal of my revision if not to lose more weight maybe? If I ever get time with him outside of the investigation in the OR, I will ask.

WarrenInEC, I saw the bariatric revision surgeon. He doesn't think it is dumping and said that the upper and lower GI done would not have taken an image of the inside of my pouch so there could potentially be an internal hernia. He suggested possible laparoscopic investigatory surgery in a couple of weeks. He said a revision to tighten the opening wouldn't necessarily force me to lose more weight, which is perplexing to me but I'm not looking at it as a solution to lose weight, I just thought that would come with the "package". I'm assuming the reason I still feel restriction when I eat is simply because of the 'pouch' then. I thought I understood all of this 5 years ago when I had the surgery, but I obviously did not comprehend everything. Well, we'll see what the next few weeks brings... I assume you had a revision then as that is a big difference in the opening size..lol. If so, what was it like?

Long story short - had gastric bypass in July of 2019. Highest weight 400. Current weight 167 to 173. I still feel some restriction to this day. Meals are small and I don't eat high fat, high sugar food. 2 yrs ago, I started having right sided pain. It felt like ovarian pain so saw OB & had 2 ultrasounds nothing showed up there. Pain worsened & had gall bladder removed 1.5 yrs ago. Adjusted diet again to deal with gal bladder being gone and things seemed ok. A few months after the right sided pain returned. About 4 mos ago, pain got so bad at times I'd be in a ball on my bed considering going to ER (which I HATE doing). Went back to primary got CT scan. Nothing found. findings. Then he referred me for colonoscopy & upper GI. I thought finally 'this was it, we've ruled out most other things'. I also had seen blood in my stools and it was old blood, like coffee grounds so I thought ok, not hemorrhoids? Just got back home from colonoscopy & upper GI. Good news is no polyps or other concerning things. Bad news is main finding was on bypass "Patient's surgical anastomosis noted to be widely dilated, raising possibility of Dumping Syndrome as a cause". OK, we know what dumping is. Thought it was post surgery when we ate food (i.e. sugar, high fat) that processed too fast, etc. & you had dumping. Is the type of dumping they mention different from post surgery dumping? They recommend I see revision specialist. Has anyone else had revision NOT due to 1st bariatric surgery not being successful but for a "medical reason" like this (other than GERD, heartburn). I'm not even sure insurance will pay, but I have 2 yrs worth of history on this. Even it if does pay, I dread what this means - more hair loss? If I do this, will I need another in 5 yrs?. I also still feel restriction kick in although yes, nothing like 1st 2 years My highest weight right now hovers at 173. I hoped I'd get to 150 but closest I've come is 167-168. Is revision another 'nuclear detonation option'? ANYONE have a revision specialist in the North Texas area they can recommend so I can at least get a consultation (north texas = Fort Worth, Dallas, Arlington, Keller, Bedford, Euless, Hurst and Denton) I've also wondered if there is a chance of some straggler/stone from gallbladder surgery 1.5 yrs ago that should be considered? Any input would be appreciated. This is causing issues on my job as the pain hits out of nowhere (not X amount of time before OR after a meal, that I have been able to discern. Thank you!

I had gastric bypass in July of 2019. Highest weight was 400 before losing a bit on my own. Current weight varies from 167 to 173. I still feel some restriction to this day. My meals are usually small although I know we can all 'eat around' the restriction by eating smaller, but continuous meals and this was a slippery slope I fought back against. About 2 yrs ago, I started experiencing right sided pain. It felt like the pain I used to feel when I ovulated so I assumed it was ovarian (post menopausal). Saw OB & had 2 ultrasounds and they couldn't even see my right ovary (like, where did it go?) and the left was fine. Since they couldn't 'see' the right one, they said that was good since there was no obvious signs of..I don't know tumors, growths? The pain continued to worsen & I finally had gall bladder taken out about 1.5 yrs ago. I adjusted diet again to deal with gal bladder being gone and things seemed to go ok. A ew months after that the right sided pain returned. About 4 mos ago, the pain got so bad at times I'd be in a ball on my bed considering going to the ER (which I HATE doing). Went back to primary and he sent me for CT scan. CT came up with no findings. Then he referred me to GI doctor for colonoscopy and upper GI. I thought finally 'this was it, we've ruled out most other things'. I also had seen blood in my stools and it was old blood, like coffee grounds so I thought ok, not hemorrhoids? Just got back home from colonoscopy & upper GI. I thought doing the prep was bad 10 yrs ago, but it is much harder having had bypass surgery. Good news is they found no polyps or other concerning things. Bad news is I was stunned their main finding was regarding my bypass "Patient's surgical anastomosis was noted to be widely dilated, raising the possibility of Dumping Syndrome as a cause for her complaints". OK, most know what dumping is. I thought it was post surgery when we ate food (i.e. sugar, high fat) that processed too fast or was too much for us to handle. They recommended I see a gastric bypass revision specialist. My question is, has anyone else had a revision NOT due to their 1st bariatric surgery not being successful but for a "medical reason" like this (other than GERD, heartburn). I'm not even sure insurance will pay, but I have 2 yrs worth of history on this pain. Even it if does pay, I dread what this means for me - even more hair loss? If I do this, will I need another revision in 5 yrs again at which point I'll be getting up there in age. I've also wondered with the CT scan, etc. is there any chance of some straggler/stone from my gallbladder surgery 1.5 yrs ago that should be considered? Should I post this in the revision group instead? I read through some and was unsure. Are we allowed to cross-post? Any input would be appreciated. This is causing issues on my job as the pain hits out of nowhere (not X amount of time before OR after a meal, that I have been able to discern. Thank you!

Going on 3, maybe 4 yrs post-op. Wow, never thought there'd come a day when I didn't remember. For past 2 yrs I've endured right sided pain. At first I thought it was ovarian but got that checked (was fine) and was a bit high for ovarian. During scans of ovaries/abdomen, it was consistently noted my gallbladder was 'distended'. Sometimes I'd have attacks of pain that would last for hours. I was always stunned when scans would say no 'sludge, no stones, nada' so I thought great, another medical mystery. Finally when I ended up in ER over Christmas 'sludge' and stones were finally noted so they decided to remove it. I was in so much pain that even getting to ER is a blur (husband drove). I do know surgeon said that while gallbladder removal surgery was technically not a big surgery, the fact that I had gastric bypass did mean surgery may take a bit longer as they had less room to maneuver since abdominal area was 'segmented'. That I remember. I came to, according to my husband, hours later and I wondered wow, why did it take so long? Has anyone had gallbladder removal post weight loss surgery and experience same thing (procedure took longer, etc.) MAIN reason I'm back here after few yrs of absence is there are no other people I can go to that can give me at least comparative experiences (i.e. they've not had weight loss surgery so we are anatomically "different"). Honestly, my gastric bypass was a CAKEWALK compared to getting gallbladder out. Is this normal or have I become a weenie in 3 yrs? It literally still HURTS. I am now roughly 21 days post op and I still have right sided pain almost like my gallbladder was never removed. I mean, I know it has been but WHY does it feel like something is still just 'not right'? I figured I was just having a slow recovery and going to hospital/ER is never fun, especially during holidays. Maybe I should have gone back by now as no urgent care place will see me on this. Primary dr not available until tomorrow but what is he going to do besides refer me? Kind of kicking myself for not going back to ER but am always dreading that 'we don't see anything wrong' type conversations...although about 70% of the times I've gone to an ER, there has literally been a legit issue. My right side hurts...and honestly one area feels like it is burning/on fire. I have no fever. No yellowing of the eyes or skin...so I'm just sitting here in wait mode trying to decide what makes the most sense. Symptoms I am having besides ongoing pain and the burning sensation, is hot flashes/heat waves like NO TOMORROW! (is that from the anesthesia??)...clammy all the time...cold sweats throughout the day, nausea...sometimes brief chills..when I walk I'm having to do the same compression/pain compensation that I had after bypass surgery (although honestly I don't recall constantly feeling like I had to hold my abdomen after bypass surgery. I've done cold packs, heating pads, etc. trying to find some home remedies. I've used up the entire prescription of the muscle relaxer which was the one thing, more than the Tramadol which seemed to give some very very brief relief. Sometimes I feel like my insides are tying themselves in a knot. Only thing I can think of is I'm having abdominal spasming and that..it will abate at some point? I can't keep having this interfere with work which is another whole issue. When you tell your workplace you are having issues after gallbladder surgery...well, you know how you get that feeling especially from others who have had something like gallbladder removed where it truly was no big deal and they are wondering...why are you struggling? Some know I had gastric bypass surgery but I really don't want to have to spell it out for others..ya know? Curious to know if anyone else had similar struggles, did it go away...what did you do? Am I an idiot for not already going back to ER to get checked out instead of just continuing to be in pain or does it indeed just take us longer to recover. Interesting side note, if you ever get online access to your medical records from a hospital/doctor, sign up as I was able to read my freaking surgical notes!! Oooh, another sore point - they noted in my surgical notes my gallbladder or some part of it had grown into/adhered to something else it shouldn't have so they had to 'cut it away'...and they also noted a bile leakage they wanted to fix but could not do the preferred 'solution' as they could not maneuver so they went with a Plan 'B' (my wording). I mean...how about you tell me this stuff after the surgery so I don't have to read about it? My husband said I was gone for literal hours - longer than my bypass surgery by far. Any input even if you sailed through your gallbladder removal is welcome.

Looking preferably for someone in the DFW area, but will travel farther if I need to (i.e. Austin or Houston). Looking for surgery on upper arms, a breast lift Unsure if I want anything inserted into my breasts like implants but also not sure if a lift will look good without putting something back into the deflated balloons that are my chest now. My upper arms and chest (and all the loose skin that flows out from under my bra, from the sides of any bra I've tried, etc.) are the things that bother me the most. I've always thought I probably couldn't handle (pain-wise) getting my abdominal area done but obviously there is PLENTY of loose skin there and I wouldn't mind having my mons...looking better. I just need some names/referrals so I can start shopping and I don't know if my priorities might change based on costs and whichever doctor I end up selecting. I've tried just general Google searches but honestly I don't trust them and asking on local Facebook groups is not the same as talking with people who may have used doctors somewhere I can get to...and you have all been on the journey of losing a large amount of weight and the issues that came with that so I would prefer to have a surgeon who has a lot of experience with operating on people who have lost a great deal of weight which is the main reason behind their quest for surgery. Ugh..just got diagnosed with COVID so apologies in advance if I didn't string together coherent questions....

YES

Ugh, I did some of my usual minimizing stuff. Dr running some blood tests as my liver enzymes were out of whack when they were checked the day of my surgery. I'm also very very constipated which I had taken meds to resolve. That will hopefully resolve tonight but I know..I just know that the pain I'm having has nothing to do with that. He did talk about getting me referred to a gastroenterologist quickly and getting some scans done but I was so out of it while I was there I didn't pin him down on are we doing this as an ASAP thing or ??? I hate when I don't stick to a plan. He did agree that I should not be feeling worse as the days go on....

I have a follow up with my primary today but am fully ready to be sent to ER or go to ER if not directed to. Luckily I've been with this primary for more than a decade...heck...maybe almost 20 years and he knows 1) I am no pain weenie 2) I'm not a hypochondriac 3) I don't seek out pain meds and honestly most don't seem to be worth much HOWEVER when I'm in excruciating pain these days, I'm ready to try anything almost to get even a moment's relief The pain, as many stated, is almost like before removal. I can be in general discomfort, great discomfort or 'curl into a fetal position and try to breath thru it discomfort'. They don't warn you/inform you that having your gallbladder out is not a magic fix and also I wish I had known more about the downsides of not having a gallbladder, not that this would have changed me getting it removed or not but I sure would have been more mentally prepared. I have some of the 'follow up if you get these symptoms' type things going on but NOT the heavy hitter ones like jaundice (yellow eyes/skin) nor high fever. I've had blips of a few low grade temps, whatever they call it these days - 99.4, 99.2, 99.8. My daughters and I are odd as our normal body temps almost never show 98.6, we are all 3 about 95% of the time shown as 97.X. I don't know why and if that is even significant or just normal for many ppl. The discomfort/pain is 'alive' for sure over here (oof, and the bouts of nausea and 'flushing'/redness/clammy-soaked skin). Now I also have a continued burning sensation where..I guess my gallbladder used to be? My stomach gets very bloated/distended. I did a video the other night because I kid you not, I looked like I was 4 or 5 months pregnant. I was a bit taken a back as I'm used to seeing my saggy/deflated stomach and alarmed as I thought...OMG...how much weight have I gained over the holidays...!! (Answer - 8 pounds)...I do know in the past 2 days I've become very constipated so I just know that this is going to end up being a big focus if any scans are done. Yeah, I know...there is a lot of 'stuff' in there. The constipation is due to some unwise food choices and the fact that I'm not eating as much fiber as normal and I tend to have 'cycles' of constipation even when my diet is steady, predictable, relatively low in fat and high in fiber. I've taken stool softeners for past few days and just took a laxative. Anyone know if 2 to 4 years post surgery, can you have SO much constipation that you look VERY pregnant? For the ongoing pain/discomfort/burning I've tried: Not eating for most/90% of the day, drinking broth, doing a day of protein shakes, eating very little, eating a lot (not planned but it happened)..and none of this has impacted/alleviated the discomfort so I'm honestly..puzzled. Dang, I remember the bypass post op months when sometimes things didn't feel right - in hindsight I had some struggles with abdominal spasms and I'd get scanned and they'd be like 'nope, everything is ok'. I guess I should remember it is OK to go in and be seen and get verified that 'everything is ok' I guess that is why i honestly cringe at the thought of going to ER's, etc. Obviously I mentally know at this point that 'not going' is not a solution either. My appt with primary is in roughly 2 hours, I'll be mentally prepared to go wherever he feels is best if he does want me to go be 'seen/scanned', etc. TY to all who have taken time to comment. Hopefully for those who have not had their gallbladder removed you now know to do a bit more research/ask questions. Not saying this should change a recommendation to get a gallbladder removed but there are things you may need to do to make adjustments to your 'diet' post removal that did not get mentioned, nor was I fully aware of the gallbladder's role in our bodies and the fact that nothing else that I'm aware of 'leaps' in to take over that role. I SHOULD have done my homework. I've had 2 years of warning that my gallbladder was NOT Happy. I could have been better prepared. Blah.. Will let y'all know what I find out today and spread what my experience shows me/informs me/clarifies for me in the hope it may help someone else out down the road.

Haven't been doing well the past 5 weeks..no weight loss. Letting calories sneak in during the day. COVID is driving me nuts especially with a spouse home 24/7 eating carbs and many trigger foods that they used to not eat in front of me. Getting back to business as I still have so much to lose. Down 175 lbs from highest weight ever but lost 60 lbs of that in 3 years doing keto off and on before surgery. My 1 year 'anniversary' was yesterday (7/25) so from the date of surgery I lost 115 lbs. If I had stayed on track, that # could easily have been 10 lbs more but that is not something I can stay hung up on.

Only thing that I can say for myself with a VERY very resistant/challenged metabolism is that outside of weight loss absolutely slowing down as I approach a year ( was warned this would happen) is that my dr still has me on 800 calories a day. We do not move to 1000 calories until after a year has pass (am 1.2 months away from a 'year'). I also do not exercise enough so I am leery of increasing my calories until I 'fix' this. So many ppl outside of those of us 'living it'...think WLS is the easy answer. It definitely helps, but until I started hanging out here years ago, I did not realize the amount of work and constant diligence that is still required.

While I was much bigger at 390...I'm still rather LARGE+++ at 250 lbs (ok, scale said 253.2 today..sigh). It seems that most of the people I've followed when I've had time were already at their goal weight before finding dr's and talking procedures/options. I can see that this probably is required as it would be hard for a doctor to correctly advise/tell what I'm going to have leftover at 170 vs. 253.2. 170 is my first goal - obviously the 'charts' want me at 140-150..sigh. I guess the ONE thing that I can do is start saving money...a whole LOTTA money! I wish I could tell 'now' what procedures I'd want done and in what order. I KNOW I want my arms done - they have always been bad even when I was a 135 teenager and on the swim team for years. Getting up to 390 and I have arm flab the size of small cities. The 'girls' are deflated balloons that breastfeeding 2 kids..or attempting to...did nothing to help. Just had mammogram and it was 'clear' but it hurt like a you know what. My last one was done when I was 390 7 years ago. They are now so totally deflated it felt like the tech was trying to roll out pizza or bread dough with the machine. They don't class me as high risk yet as my Mom diagnosed with breast cancer in 60's. My maternal cousin, however, was diagnosed at 49..and hard partial breast removal. Honestly, I figure mine are going to turn on me some day and I'd like to beat them to it. Just wondering what I should simply leave alone until I'm down to 140-170....

Some of you may know that in the 11th hour, finally listening to my gut about my original surgeon and his anesthesia team, that I made a switch in doctors. After having gone so far down this road to where I was scheduled for surgery this coming Monday (7/1) with a doctor that had good reviews and a recommendation from someone I respect, I no longer trust myself as much as I did. Dr. Chad Carlton has great reviews as well and they go back for a much longer period of time which is 1 thing I like. However, I am so....well, to be honest I feel quite shaken up about the whole thing even though I feel I did the right thing. Does that even make sense?? While I found that I was relieved initially and my whole family is glad that I changed....my emotions are all over the board since last night. Maybe it's the change of 'I was going to have surgery on 7/1 and now the date is back up in the air..but I'm into week 2 of the liver shrink diet and I was to start bridging to Lovenox (blood thinner) today'...and I know Dr. Carlton was a bit taken aback at the amount I was prescribed. Oh, and switching from sleeve to bypass. Original Dr felt I was too high a risk to do bypass due to clotting history & said we'd do a bypass instead 1-2 yrs down the road (however with Cigna, you only get 1 type of operation for entire LIFE)...original dr said to 'save my pennies'. Dr. Carlton said while yes, my clotting history is a risk (I have a permanent filter) but I come with no other co-morbidities like high blood pressure, high cholesterol, diabetes, etc. that also introduce 'risk'. He said he has done over 6,000 procedures and does mostly revisions to bypass or straight up bypass (he also is 1 of the few in area that has a lot of experience with gastric bypass with duodenal switch?). I have 150-175 lbs to lose and he said that he did have some sleeve patients that were super diligent and were able to lose that kind of weight with just a sleeve...but I know that for many with this much to lose, a bypass is..what...still the "gold std"?? If anyone has any experience with this doctor, could you please let me know. While his reviews are really good, so were the reviews on my other doctor. I don't want to leave ANYTHING to chance. I'm at that point where it's "trust, but verify".

Yep, took it before and still continue to. Both my dr and my surgeon discussed. Haven't noticed any negative changes.

@Brent701 - you just nailed something I've been trying to identify as 'off' with me the past 2 weeks...I know one huge area if physical activity and previously I was actually getting kind of a 'healthy high' as I'd like on beginner trails. Don't know if it is the tons of extra hours I"m working...but I feeling the dread stirrings of complacency..and I'm too far away to have this settle in. I'm been so happy running around with new clothes that I think i'm starting to lose my focus on the prize...I simply cannot give into to patterns of behavior which will, for me, deter me from my goal in the end.

Way to go!!!!!!!!!!!!!!!!!!!!

Just to clarify, my experience is with FSA, not sure what the differences are if you have an HSA (health savings account).

Yep, they should be able to process that payment like lightning. Just like regular debit. Only thing I've encountered is occasionally having the company that is the 'owner' of my flex card, they must get audited like crazy because like twice a year despite the charge being OBVIOUSLY from a doctor like 'cardiologist', they will send me a letter, I simply grab a copy of my EOB for whatever 'charge' they are asking about and send it to them. Ironically they did not audit my large hospital/surgery charge...lol...the audited a $100 or less visit to my cardiologist..lol..I'm beginning to think it is some sort of random audit. Again, I have NEVER had any issue even when the card issuer has sent me a request for information on having my 'charges' denied because I stick to known medical costs that qualify for using the FSA card and surgery/hospitals, etc are definitely legit expenses that are covered under FSA (examples of ones that are not - buy sudafed or cough medicine at the drug store...those are NOT 'FSA' eligible but my true prescriptions ARE legitimately covered under FSA).

Beautiful in both pics, but BOTH are pics of a stunning woman! You have a gorgeously shaped face which will continue to look stunning even if your face gets a bit smaller. I'd legit consider hurting someone to get your cheekbones! LOL