Cia2020

My surgeon's office appealed with the EXACT same language as the first request to go from VSG to an RNY which was denied. Hello month wasted, of course they would deny it again. What's that line about repeating the same behavior expecting a new result? Sheer laziness! 😡 I'm currently waiting on a call back from the appeals department at my insurance for clarification on one of the points of the revision criteria:
Weight loss to 90% or less of ideal body weight
If my understanding is correct, since I only lost 27% of my excess body weight and I'm a good 55 pounds from my ideal body weight (not even my goal, but I'm 35 pounds from that too and only lost 24 pounds total) I could be considered for revision. What I find is ridiculous is I have a few cm sliding hiatal hernia visible on my upper GI literally every time I breathe, hiccups countless times a day associated with that, GERD no responding to PPI use resulting in mild (so far) esophagitis, and documented dysphagia just with liquids on a swallow study done plus I've had vomiting with foods like meats that got "stuck" because my esophageal muscles aren't working properly anymore. All of which would be resolved with revision to bypass.
Add in I have family history with cancer on both sides, including with my grandad and aunt on my dad's side who had stomach cancer (removed whole stomach) and esophageal cancer (multiple bouts) respectively, and this scares the crap out of me. I don't want to be on a PPI for years, which is not safe, or wait until I have 4 months of documented severe esophagitis that could turn cancerous. Not to mention what this could do to my asthma and high blood pressure during this whole Covid era, neither of which were resolved by the initial surgery either. Why does insurance have to be such a 🤬 ?!!

My surgeon's office appealed with the EXACT same language as the first request to go from VSG to an RNY which was denied. Hello month wasted, of course they would deny it again. What's that line about repeating the same behavior expecting a new result? Sheer laziness! 😡 I'm currently waiting on a call back from the appeals department at my insurance for clarification on one of the points of the revision criteria:
Weight loss to 90% or less of ideal body weight
If my understanding is correct, since I only lost 27% of my excess body weight and I'm a good 55 pounds from my ideal body weight (not even my goal, but I'm 35 pounds from that too and only lost 24 pounds total) I could be considered for revision. What I find is ridiculous is I have a few cm sliding hiatal hernia visible on my upper GI literally every time I breathe, hiccups countless times a day associated with that, GERD no responding to PPI use resulting in mild (so far) esophagitis, and documented dysphagia just with liquids on a swallow study done plus I've had vomiting with foods like meats that got "stuck" because my esophageal muscles aren't working properly anymore. All of which would be resolved with revision to bypass.
Add in I have family history with cancer on both sides, including with my grandad and aunt on my dad's side who had stomach cancer (removed whole stomach) and esophageal cancer (multiple bouts) respectively, and this scares the crap out of me. I don't want to be on a PPI for years, which is not safe, or wait until I have 4 months of documented severe esophagitis that could turn cancerous. Not to mention what this could do to my asthma and high blood pressure during this whole Covid era, neither of which were resolved by the initial surgery either. Why does insurance have to be such a 🤬 ?!!

My situation is a little different (GERD and hiatal hernia, but sleeve seems okay) but here is what I would suggest based on what I have learned trying to understand my problems.
It might be worth getting a second opinion from a surgeon in a different practice who is willing to look at your upper GI imaging and tell you if they think the sleeve looks properly shaped or not. I have been reading this doctor's webpage where he talks about how, in some cases, a misshapen gastric sleeve can aggravate GERD: https://houstonsleevesurgeon.com/category/acid-reflux-and-heartburn/

If you are having significant GERD, you should probably get on meds for that and see if that is enough to control it. When I was reading about this, I did see one study that talked about how, for some post-sleeve patients, the GERD gets better after about 3 years or so because your stomach becomes more "compliant' by that point (and then there is not as much pressure in the sleeve to push the acid up), so if the GERD is controllable with meds, you could try waiting it out and see if it gets better. If it doesn't get better, or if it is not responding to the meds. then you have to decide if you want to get an RNY, or if you want to try the Linx, or possibly ask your doctor about this new procedure I recently learned that some doctors are trying for those of us with sleeves who are having GERD: https://www.sciencedirect.com/science/article/abs/pii/S000296102030814X

I developed another hiatal hernia 3 months post VSG (had one repaired with my VSG. I then developed GERD, esophagitis, and hiccups. It was to the point that I was suffering with my work and sleeping.
The picture is from my Upper GI. The stricture from the hernia was so bad my surgeon faxed over approval paperwork the day he called me with the results. I ended up having to appeal it over the phone while hiccuping the entire call with the insurance company but ended up having revision with hernia repair surgery 3 weeks after my phone call to insurance at 8 months post VSG.
And technically while they remove most of the fundus you still have one even after VSG because it’s upper most part of the stomach connected to the esophagus farthest from the pyloric valve. Outpouching might be the beginnings of a hernia and coupled with the GERD might be what’s making the hiccups so bad.

Isn't that the hardest part? "Don't focus on the scale!" is a mantra for after surgery but prior to it, we are all its slave and live in fear of its judgement and retribution. Evil sadists, the lot of them, stringing you up for every mistake you enjoy. Oh, popcorn, how I long for you!
Okay, I kid, but it is hard to know what your weight will mean for you. You need to ask your insurance and office plainly "If I can't lose this weight but show I am doing this to try (diet, food tracking, exercise) per the program... what is the program policy?". My surgeon emphasized I could "not" gain weight between my pre-surgical consult and surgery, but neither of my insurances have weight or program requirements that way. What they do require is that I follow the clinic program, so my surgeon could choose to postpone if I was not in compliance. I was 100% on board... before my surgery got canceled 1 week into my liquid diet. After that torture, and working from home for 8 weeks, of course I ballooned. Ughs!
I kicked my butt and started back on my program a few weeks ago, then got my reschedule last week. I am back to my weight in January when I saw him, but 10 pounds over where I was the last time I started the liquid diet in March, which is frustrating. I will do it though and not cheat! I make it a competition to get through each day and I love to win. I had to find my motivation again with this whole situation derailing it, but it IS hard when you don't know about surgery. It is so easier to stay motivated with a deadline, at least for me.
So I guess my advice is to 1) get an answer from your program about the weight and 2) find that motivation. You might not lose the pounds but find a way to prove you are on the program (journal food, fitness tracker?) to let them know you are a proactive part of your own success, if they will just work with you.

So for many years I droned on with life like one of those bees, just doing my job. Day in, day out, mom, wife, life just happened. I've been heavy since I was 18, but my weight got really high after I was in a head-on collision with a drunk driver at age 19 in my first year of marriage, and it took me that first year to walk unaided again. My new hubby? Well, his culinary highlights were hamburger helper and spaghetti-os in red solo cups (so he could avoid dishes, of course!). It took 2 months to wheel my chair into the kitchen and take back over, but I was determined! Of course, limitations and a diet that was never stellar to begin with didn't leave us with super healthy meals.
By 2001 I was 240 pounds. Then I had 2 kids by age 25, getting to 270. I was a lazy stay at home mom of course, ha! I kid! No, wait, that was 2 kids! Seriously, they were 2 1/2 years apart, there was no time to be lazy. I dieted, I ran around mom'ing... but I was locked in that oh so familiar spiral of lose some and gain more.
Then both my kids hit middle school, I went back to work at their school, and I got EVEN HEAVIER! I hit my highest weight of 324, and my body started to make daily life difficult. The hardware in my shattered leg is painful. The torn disc acted up. The plantar fasciitis was murder. I was sick endlessly (Okay, that's mostly the school germs, kids are GROSS!). So I started tracking my food and exercise. I saw my doc. I went on phentermine. I lost 70 pounds. I regained 20 but stopped there for 9 months, unable to lose but not regaining it all back. A minor victory, hoorah! I tried phentermine again paired with walking a 5k every day before work. I lost 10, but it stopped working after a week.
My doctor, who I've seen since that fateful car accident, kept suggesting surgery. I kept putting it off. Money. Fear of crappy doctors who don't listen to me when I know my body best, anesthesia, and having to take pain meds I don't want. Money. Well, I doubled up my insurance, decided to woman up--helped by my best friend going through the same program a year and half ago--and I made an initial foray into the surgery world.
Well, it might have taken me 19 years to get to this point (half my life!) but I was shocked at how easy this process has been. I saw the nurse twice, then a psychologist and the nutritionist once between Nov. 20th and Jan. 2nd. I had to wait for January for my new primary insurance to kick in, but they accepted my past appointments and both insurances don't have any mandatory time or weight loss... seriously, jaw dropped. Saw the surgeon on Jan. 29th, and he scheduled me for an endoscopy March. 2nd. That's my last hurdle, beyond changing one of my meds and some labs just prior to surgery. Woo hoo!
I work with special education elementary students so I needed right before Spring Break or summer because our schedule is just too hectic to put my needs first. So I asked, holding my breath after being told this surgeon works on Thursdays, "Is March 26th available, the only day during the school year I'm willing to do and have been hoping for since day one?"
It was! I have to think that, even though I waited for-freaking-ever and tried endless diets that failed over and over, making me feel like a failure, the fact I'm already 2 pounds away from the 5% weight loss the clinic wanted me to lose, and every appointment has been like clockwork, and my date was available... THIS is the "final solution" that is meant to be. It's going to work. I'm an oversharer (can you tell? LOL) so I've told a lot of people in my family, friend circle, and coworker cohort, so I have a ton of people who will help me be accountable because everyone has been supportive.
So, gastric sleeve surgery in Vancouver, WA on March 26th is it. The deadline. The morning I shall wake up for the last time as the old me, and the day I will go into surgery knowing it'll be the new me coming out with the tool that's finally going to work. And, if later I'm not in this same headspace, I can come back and read this post and remember just why I *know* this is going to be the right decision for me.

A lot of people have different diets, some even allow lean Protein and food each day. It's more about your health, eating low carb/fat to shrink your liver and make it more pliable to move around during surgery, and getting into good habits. I think restricting food for a full month for me (2 weeks before and 2 after) actually caused me to want to eat more when I finally started pureed foods. Also, eating when you're on liquids can cause you to restart that cycle to get your body out of the "I'm starving!" phase. Days 3-5 were the worst, but after that, I really wasn't more than mildly annoying during meal and snacky times.
You can do it! Try and remind yourself of "your why" you are having this surgery in the first place. Hold onto that. And, for the love of all that is holy, don't watch commercials!

A lot of people have different diets, some even allow lean Protein and food each day. It's more about your health, eating low carb/fat to shrink your liver and make it more pliable to move around during surgery, and getting into good habits. I think restricting food for a full month for me (2 weeks before and 2 after) actually caused me to want to eat more when I finally started pureed foods. Also, eating when you're on liquids can cause you to restart that cycle to get your body out of the "I'm starving!" phase. Days 3-5 were the worst, but after that, I really wasn't more than mildly annoying during meal and snacky times.
You can do it! Try and remind yourself of "your why" you are having this surgery in the first place. Hold onto that. And, for the love of all that is holy, don't watch commercials!

A lot of people have different diets, some even allow lean Protein and food each day. It's more about your health, eating low carb/fat to shrink your liver and make it more pliable to move around during surgery, and getting into good habits. I think restricting food for a full month for me (2 weeks before and 2 after) actually caused me to want to eat more when I finally started pureed foods. Also, eating when you're on liquids can cause you to restart that cycle to get your body out of the "I'm starving!" phase. Days 3-5 were the worst, but after that, I really wasn't more than mildly annoying during meal and snacky times.
You can do it! Try and remind yourself of "your why" you are having this surgery in the first place. Hold onto that. And, for the love of all that is holy, don't watch commercials!

A lot of people have different diets, some even allow lean Protein and food each day. It's more about your health, eating low carb/fat to shrink your liver and make it more pliable to move around during surgery, and getting into good habits. I think restricting food for a full month for me (2 weeks before and 2 after) actually caused me to want to eat more when I finally started pureed foods. Also, eating when you're on liquids can cause you to restart that cycle to get your body out of the "I'm starving!" phase. Days 3-5 were the worst, but after that, I really wasn't more than mildly annoying during meal and snacky times.
You can do it! Try and remind yourself of "your why" you are having this surgery in the first place. Hold onto that. And, for the love of all that is holy, don't watch commercials!

Its all done! Preop diet, labs, covid test, clear liquid day, family meal prep, a little meal prep for me... and, BOOM, surgery is tomorrow. Yikes! My hubby is working, and my 16 year old daughter is dropping me off at 10 AM. Might as well with no family visitors allowed.
🤞 for a smooth process!

Biopsy came back just mild gastritis, yay! Day 4 of liquid diet starts today. Meh, it's been fine... BUT I've been busy working the first 3 days. Thought I just had to get through 2 days off home with a well-stocked house while also making dinner each night, but now school is canceled due to the coronavirus concern and I stocked up even more since I have 2 teenagers here. And I'm here. With them. All day. And the food. Until April 27th. 😧 I'm fiercely competitive, so I am making it a game with strategies not to cheat, and damn it, I WILL WIN!

So for many years I droned on with life like one of those bees, just doing my job. Day in, day out, mom, wife, life just happened. I've been heavy since I was 18, but my weight got really high after I was in a head-on collision with a drunk driver at age 19 in my first year of marriage, and it took me that first year to walk unaided again. My new hubby? Well, his culinary highlights were hamburger helper and spaghetti-os in red solo cups (so he could avoid dishes, of course!). It took 2 months to wheel my chair into the kitchen and take back over, but I was determined! Of course, limitations and a diet that was never stellar to begin with didn't leave us with super healthy meals.
By 2001 I was 240 pounds. Then I had 2 kids by age 25, getting to 270. I was a lazy stay at home mom of course, ha! I kid! No, wait, that was 2 kids! Seriously, they were 2 1/2 years apart, there was no time to be lazy. I dieted, I ran around mom'ing... but I was locked in that oh so familiar spiral of lose some and gain more.
Then both my kids hit middle school, I went back to work at their school, and I got EVEN HEAVIER! I hit my highest weight of 324, and my body started to make daily life difficult. The hardware in my shattered leg is painful. The torn disc acted up. The plantar fasciitis was murder. I was sick endlessly (Okay, that's mostly the school germs, kids are GROSS!). So I started tracking my food and exercise. I saw my doc. I went on phentermine. I lost 70 pounds. I regained 20 but stopped there for 9 months, unable to lose but not regaining it all back. A minor victory, hoorah! I tried phentermine again paired with walking a 5k every day before work. I lost 10, but it stopped working after a week.
My doctor, who I've seen since that fateful car accident, kept suggesting surgery. I kept putting it off. Money. Fear of crappy doctors who don't listen to me when I know my body best, anesthesia, and having to take pain meds I don't want. Money. Well, I doubled up my insurance, decided to woman up--helped by my best friend going through the same program a year and half ago--and I made an initial foray into the surgery world.
Well, it might have taken me 19 years to get to this point (half my life!) but I was shocked at how easy this process has been. I saw the nurse twice, then a psychologist and the nutritionist once between Nov. 20th and Jan. 2nd. I had to wait for January for my new primary insurance to kick in, but they accepted my past appointments and both insurances don't have any mandatory time or weight loss... seriously, jaw dropped. Saw the surgeon on Jan. 29th, and he scheduled me for an endoscopy March. 2nd. That's my last hurdle, beyond changing one of my meds and some labs just prior to surgery. Woo hoo!
I work with special education elementary students so I needed right before Spring Break or summer because our schedule is just too hectic to put my needs first. So I asked, holding my breath after being told this surgeon works on Thursdays, "Is March 26th available, the only day during the school year I'm willing to do and have been hoping for since day one?"
It was! I have to think that, even though I waited for-freaking-ever and tried endless diets that failed over and over, making me feel like a failure, the fact I'm already 2 pounds away from the 5% weight loss the clinic wanted me to lose, and every appointment has been like clockwork, and my date was available... THIS is the "final solution" that is meant to be. It's going to work. I'm an oversharer (can you tell? LOL) so I've told a lot of people in my family, friend circle, and coworker cohort, so I have a ton of people who will help me be accountable because everyone has been supportive.
So, gastric sleeve surgery in Vancouver, WA on March 26th is it. The deadline. The morning I shall wake up for the last time as the old me, and the day I will go into surgery knowing it'll be the new me coming out with the tool that's finally going to work. And, if later I'm not in this same headspace, I can come back and read this post and remember just why I *know* this is going to be the right decision for me.

Isn't that the hardest part? "Don't focus on the scale!" is a mantra for after surgery but prior to it, we are all its slave and live in fear of its judgement and retribution. Evil sadists, the lot of them, stringing you up for every mistake you enjoy. Oh, popcorn, how I long for you!
Okay, I kid, but it is hard to know what your weight will mean for you. You need to ask your insurance and office plainly "If I can't lose this weight but show I am doing this to try (diet, food tracking, exercise) per the program... what is the program policy?". My surgeon emphasized I could "not" gain weight between my pre-surgical consult and surgery, but neither of my insurances have weight or program requirements that way. What they do require is that I follow the clinic program, so my surgeon could choose to postpone if I was not in compliance. I was 100% on board... before my surgery got canceled 1 week into my liquid diet. After that torture, and working from home for 8 weeks, of course I ballooned. Ughs!
I kicked my butt and started back on my program a few weeks ago, then got my reschedule last week. I am back to my weight in January when I saw him, but 10 pounds over where I was the last time I started the liquid diet in March, which is frustrating. I will do it though and not cheat! I make it a competition to get through each day and I love to win. I had to find my motivation again with this whole situation derailing it, but it IS hard when you don't know about surgery. It is so easier to stay motivated with a deadline, at least for me.
So I guess my advice is to 1) get an answer from your program about the weight and 2) find that motivation. You might not lose the pounds but find a way to prove you are on the program (journal food, fitness tracker?) to let them know you are a proactive part of your own success, if they will just work with you.

Best to both of you, Cia2020 and Ann777! I hope my post yesterday didn’t leave you feeling down—-I was in a pretty “real” mood and told it like it is from my experience, thus far. Plus Cia2020 saying she was pissed off put me in touch with my own pissed off that hell yea, it’s work!!!😤😅!!

Though our WLS is a tool, and at least makes losing possible (which is something I haven’t been successful at prior) it is still hard work in being diligent and living daily life and exercising on 600-800 calories a day. That in itself is heroic! BUT, the WLS has been a HUGE GIFT, and FANTASTIC and COURAGEOUS DECISION!

One thing I’m noticing is that this journey has been kind of like giving birth, sometimes painful and difficult but once you’re through it, your memory of the pain fades and you only remember the JOY and AMAZEMENT. For example, right now if someone asked me how pre-op diet was, or the early weeks of post op diet, I would say “Oh, it wasn’t bad at all”, and mean it. Yet when I was in the moment, it was not easy every day. By any means! Some days were extra challenging—but so was the bloat, disgust, hopeless futility of waking up in a carb-coma-like-feeling after having stuffed myself back in the day.😝 Or standing in my closet searching for something that fit and didn’t reflect the truth of the “body form I had attained”.

This is worth it! and thankfully we have one another to vent to, to help pull us through so we actually DO get to the end of the rainbow.🌈
Hang in! It will be more fun when we reach maintenance level!

I'm 11 days post op today so we are very close in dates. The liquid stopped working for me after week one but then I could bring in Protein Shakes and cream Soups. For the past 2 days a ricotta bake and tuna salad (along with shake for breakfast and snack) have kept me satisfied. I hope things get better for you soon.

I am on day 7 of the liquid diet and I am down 7lbs. I am so ready for the next 7 days to fly by!

I’m about 3 months out and rather agree with you and get that feeling, too. You’ve described it perfectly. It’s a challenge and not sure ‘what’ we can do except try to determine foods and liquids that agree with and sustain us, then “budget” them out through the day in order to keep us satisfied. Popsicles no longer do it for me, either.
I’m eating scrambled eggs (almost every night for dinner) 1/2 cup watermelon, or 1/2 cup fresh strawberries, or 2-3oz Kirkland sliced turkey breast, 2-3oz tofu, 1/2 cup home made 3 bean salad, microwave frozen vegetables, once in awhile tsp. of Peanut Butter, V-8, a Premier Protein Cafe Latte shake each morning as Breakfast, grilled fish, tuna salad, ...pretty much these are the foods I can tolerate. 🤷‍♀️
I plan my Protein and fluids, then fill in my hunger with the lower calorie things I can have. We chew and chew and chew, and then the food passes through rather quickly. It’s WORK some days, especially if I’m not busy—coming out the other side will be worth it, but IT IS WORK.
I’m sorry I can’t tell you the coming weeks will be a breeze, but this has been my experience. Maybe others can share a few of their strategies?💝

I came out of surgery able to take in an ounce of Protein Drink and an ounce of Water (at the same time) every 15 minutes. I did need to mix up my Protein intake from room temp clear protein, to cold shakes, to warmed Tomato Soup with added Protein Powder per my nausea tolerance the first 5 days due to nausea with the pain meds but once off those I'm good with any. I drink 50-70 ounces of water a day, (preop I was 80 to 120 minimum) with electrolyte drop ins. That puts me at 80 to 90 ounces "intake" a day. I meet and exceed the Fluid and protein goals.
My 2nd week post-surgery I began to get a painful empty feeling several times a day. Its pissing me off. Its not acid, I'm on omeprazole and do 2 antacid meltaway chewable a day. I can eat an entire Greek yogurt serving tub in 30 minutes, with small bites and putting down my appetizer spoon between them. I don't like it, though, lactose pisses off my digestive system, but I was desperate for a "solid" and popsicles don't cut it either. I can easily get in 500-600 calories with the meal Protein Drinks and 2 Snacks to stop my stomach hurting because of its "empty" feeling. I'm 12 days out. This is ridiculous!
Anyone else come out of surgery this way and struggle with liquids? Please tell me moving to food is going to curb this, lower my overall calories when I can focus on solid Proteins, and let me feel full.

I have been able to swallow all my meds and nonchewable vitamins/supplements from day after surgery with no problems. I bought a pill crusher before surgery but never needed it. Everyone is different but not everyone have problems swallowing pills postop.

Sent from my SM-T580 using BariatricPal mobile app

I'm on a super restrictive milk diet so yeah... feel you. No food, no Jello, no posicles, no Protein nuthings... grrrr! Milk/soy/Fairlife substitute, broth, and flavored water. Yum!
I drink 120 ounces of Water day, with propel drops in for some for electrolytes. I think that has saved me since I am still cooking for the family and working out. If it wasn't for the pounds coming off.... *crazy face* So much of this is mental over physical, because it is very physically hard but it is also possible if we can dig in and remember our reasons.
I also preloaded this whole 2 weeks "meals" into MyFitnessPal and if I don't break my diet I have set myself a reward of 3 new Audible codes for day of surgery. Day 11 is done, 2 more to go, 1 of clear fluids only and I WIN! (Have I mentioned I am also highly competitive and have made this a me vs the milk diet for strongest will?) "I'm gonna win, it's gonna lose" also plays in my head a lot when the going gets tough.

Its all done! Preop diet, labs, covid test, clear liquid day, family meal prep, a little meal prep for me... and, BOOM, surgery is tomorrow. Yikes! My hubby is working, and my 16 year old daughter is dropping me off at 10 AM. Might as well with no family visitors allowed.
🤞 for a smooth process!

I'm on a super restrictive milk diet so yeah... feel you. No food, no Jello, no posicles, no Protein nuthings... grrrr! Milk/soy/Fairlife substitute, broth, and flavored water. Yum!
I drink 120 ounces of Water day, with propel drops in for some for electrolytes. I think that has saved me since I am still cooking for the family and working out. If it wasn't for the pounds coming off.... *crazy face* So much of this is mental over physical, because it is very physically hard but it is also possible if we can dig in and remember our reasons.
I also preloaded this whole 2 weeks "meals" into MyFitnessPal and if I don't break my diet I have set myself a reward of 3 new Audible codes for day of surgery. Day 11 is done, 2 more to go, 1 of clear fluids only and I WIN! (Have I mentioned I am also highly competitive and have made this a me vs the milk diet for strongest will?) "I'm gonna win, it's gonna lose" also plays in my head a lot when the going gets tough.

Wow! We 're running back to back with our current weight stats and my surgery is tomorrow -revising band to sleeve! Best!

Oh, and just use the quote button to quote other peoples posts, or use the @ symbol and follow with their username to do a mention, @pmh22