PolkSDA

Hmmm.... then I wonder why I was in there for so long. There was no indication from either the surgeon or other staff that there had been any difficulties with my surgery, and there were no major issues following the procedure. Then again, my surgeon appears to be somewhat OCD and overly meticulous. Maybe he was triple-tying sutures or making bows. 😁

Congrats! We started at approximately the same weight, but I don't believe I'll ever lose that much just due to my height and frame size/type. Losing more than half your weight is amazing!

This concerns me if true. My sleeve was done robotically and I was in the OR for a bit over 4 hours. I question what they could have performed in 20-30 minutes. Different procedure?

Otherwise known as "Skinny People's Disease" or SPD. Never been overweight a minute in their life and have zero frame of reference. Because it's easy for them to stay fit, it therefore is easy for everyone to stay fit, so the obvious answer (to them) is that you're just not trying hard enough. An alternative GP would be my recommendation; their not being "in your corner" moving forward could prove troublesome for the original poster down the line.

100% this. It's a life changer (and quite possibly a life saver).

I tried going as long as I could post-surgery without buying clothes, as I still have a ways to go, but finally reached a point that 3XL clothes were looking like tents, so I've been buying on the cheap at Wal-Mart (I've never had a fashion sense, nor cared about it, so cheap is the overarching factor). Lemme tell ya, it's nice being able to buy off the rack and at clearance sales, neither of which I'd previously been able to do.

Depending on the day, either a protein shake as breakfast or some dark coffee with Gingerbread Cookie Equal (the stuff is like crack cocaine if you're a fan of ginger).

Being able to buy clothes "off the rack" rather than having to go to a DXL store. It's amazing the difference in cost. When I started the journey I had a 56-inch waist, which non-Big&Tall stores just don't stock. I've been reluctant to invest a whole lot of money in clothes as I've been losing weight, as ideally I will continue to lose sizes for a bit longer, so why pay for clothes I'll (hopefully) only wear for a couple months. It's like the reverse of being a kid/teenager, when Mom would get frustrated that I outgrew clothes yet again. However, at some point the old clothes start looking awful, like you're wearing a tent... not to mention heavy and uncomfortable AF. Being in a transition state with sizes and not wanting to spend money, I went to Wal-Mart and bought some $10.97 jeans... first time wearing jeans in over 30 years. Hard to wrap my brain around it... the jeans weren't unbearably uncomfortable. I was able to buy 44-inch waist and now several weeks later, they're already feeling a bit loose. My next shopping trip, it might be 42. They had a bunch of dress shirts on clearance that rang up at $2. The XL (down from 3XL) fit easily. At that price, who cares if they fall apart in a few washes. A whole new world: Being able to shop clothing sales and clearance. That hasn't been part of my life in many many decades.

I experience this consistently as well, even now at 9 months out from surgery. Luckily only when standing up from having been bent down/over for any period of time. I don't experience it when just standing up from being seated or lying down. The first time I experienced it I was out shopping. I had bent down to read Blu-Ray titles on a floor-level shelf, and when I stood up, the room spun. I had to hang onto the shelf for dear life for about 30 seconds to get my legs under me. Scared the sh*t out of me. The severity of the effect has diminished slightly over time, but I still need to be very aware of this when I bend over for something and try to make sure that there's something to hold on to or lean on once I stand up.

The multivitamins are Equate (Wal-Mart generic) equivalent to Flinstones chewables. The Vitamin D and potassium supplements are just the cheap Spring Valley (again Wal-Mart). The calcium chews I use are Viactiv from Amazon. Tasty!

I've always run low on Vitamin D, so that's not new. Also I'm not gunna lie: the immunity system benefits of Vitamin D has been a concern over the last year. I don't go crazy with it: one 5,000 IU capsule a day in addition to what is in the multivitamins. The low potassium is something that cropped up in a post-surgery blood panel.

I was told to avoid caffeine for the first 30 days due to the potential diuretic effect, and they wanted to make sure I got enough fluids. Now almost 9 months out, I am back to my normal caffeine habit, 2-4 large cups per day.

My medical team recommended Flinstones chewables, and 9 months out I've stuck with them. I buy the Equate (Wal-Mart store brand) equivalent. I take 2 per day, one in the morning and one in the evening. I also take 2 calcium chews per day, an extra potassium supplement and a Vitamin D supplement.

People all calculate differently. My surgeon and nutritionist both use the weight from my first consultation visit when assessing progress, so it includes the weight gained or lost while in the program leading up to date of surgery. In my case, the starting weight of 383.4 is from June of 2019. I was 337 on my surgery date in mid-July of 2020. However, my all-time highest weight is probably from 2016 when I weighed approximately 410. 410... 383.4... 337... it ends up being semantics IMO. The only thing that really matters is that the weight now is well below all three.

I would go by what your physician/nutritionist tell you. As with many other aspects, presumably guidance will vary. In my case, I was told no alcohol for 1 year following surgery. Also, if you have lost a lot of weight, and due to the changes in your system, inebriation may hit you much faster and more severely than prior to surgery. Carbonation is a lifetime no-no. I think I've had 2 partial cups of soda in 8 months. I wouldn't have believed it prior to surgery, but I don't miss soda. I now drink unsweet/diet tea and zero-sugar vitamin waters instead. One thing that I have found incredibly difficult is locating low-calorie noncarbonated energy drinks. They just don't exist. EVERYTHING in the energy drink space is carbonated. Rockstar Recovery Lemonade was a Godsend and I was ordering 3 cases every 2 months... until 2 months ago when Pepsi changed the formula and made it carbonated. Bastards.

It's interesting that the responses are so varied. I know that I'm exceeding the caloric intake of my nutritionist; she said I should be eating 850-1000 calories per day right now. I'm at 1200-1500... but the weight is still coming off, albeit at an increasingly slower pace. When I started this journey in June of 2019 I said I would be content if I could get down to 250 pounds. As the weight has come off, I set the goal lower at 225. I've just passed my original goal at roughly 8 months from surgery, and with any luck I'll hit 225 sometime this summer. I figure that as long as I'm still losing, all is well.

I was told from day 1 that protein shakes are included in the liquid goal. As far as the prefab 11-oz-in-a-cardboard-carton protein shakes, it's extremely YMMV. It's actually more texture than taste for me. Worst brands for me: Muscle Milk (lumpy and thick) Pure Protein (maybe I got a bad batch, but they were clotted even after shaking, made me retch) Quest Best brands for me: Equate (Wal-Mart; cheapest and surprisingly good) Atkins (only 15g of protein per 160 cals unlike the others which are all 25-30g protein, but by far the best tasting, especially the mocha latte flavor)

Keeping informed/copied is one thing, but IMO I would not "get involved" with direct communications with the insurance company unless needed. You may inadvertently agree to something without realizing its ramifications. Let the medical team handle the direct correspondence. They know this industry; you don't. The last thing you want is for the insurance company to come back after the fact and say "on date xx-xx-xxxx you agreed..." when you had no idea you were agreeing to anything. The language/nomenclature of both medicine and insurance are jargonistic and complex. Getting involved unnecessarily could either delay the process or at worst upset the apple cart. The internal billing, fees, and writeoffs for the procedure and all the lead-up and after-care will contain a zillion transactional amounts, some likely not resolved until months after the procedure. Getting involved and asking "what is this line item?", "what does this term mean?", "why is that there?" is likely to not be productive. At the end of the day, what matters are your personal out-of-pocket costs and obligations, and it is fair to ask the medical team to keep you apprised of any decisions that change those personal costs, but to get involved in the transactional details is going to be an exercise in futility... for all parties concerned.

... but not for the reasons you might think. I questioned whether I should make this post in the preop section or here, but since it's my first post on the forum, it might as well serve as an introduction as well. My apologies in advance for the verbosity, as I have a tendency to ramble. At age 54, I've been morbidly obese since I was a teen. I have no personal frame of reference as to what it means to be fit or eat healthily. Sure, there's the cognitive recognition of what those concepts are and what they should mean, but nothing in my own life experiences that are relatable. I'm 6'1" and at my heaviest weighed 410. Five years ago I was diagnosed with high blood pressure, which medication has fortunately kept under control. In June of 2019, when I weighed 385, I was diagnosed with Type 2 diabetes. It was at this point, that I realized I actually needed to do something about losing weight beyond paying lip service. I've been feeling it more in my knees and ankles the last few years, and the notion that should I ever need a knee replacement or other major joint surgery, that I would likely be denied due to my weight wasn't an enticing prospect. I've made token efforts at points in my life to dieting and exercise, but nothing consistent; nothing that "stuck". So I spoke with my primary physician about bariatric surgery options and started down this road. After consultations and doing my own research, I decided on the sleeve gastrectomy. Over the several month "trial period" (not sure what the technical term is), meeting with dieticians, the surgeon, the psychologist, etc., my surgery was approved and scheduled for mid April of this year... well, you can guess what happened. Thanks to COVID-19 everything was put on hold. I freaked out a bit at that point. My work schedule is such that certain times of the year are no-go as far as being away for extended periods. What if my recovery takes longer than expected? What if due to the quarantine and stress eating (believe me, it's a thing), I gain weight again and they kick me out of the program? Having all this uncertainty on top of all the uncertainty going on in the world... being in a high-risk group for COVID, the business I work for having to completely retool how it does business, the financial market crash (at the time), the civil unrest in an election year, etc.,put my head in a not very happy place. I'm also stressed by the fact that I have no immediate support structure in the event things go wrong (either medically or if I slip with respect to eating habits). I have no family, no significant other, and I live alone. Under normal circumstances, I'm perfectly fine and dandy with all three of those things, but for the first time in my life, I'm faced with the prospect of not having support when I might need it. I've never head surgery in my life, outside of two colonoscopies, which all things considered, I've been blessed in that regard, but again I have no frame of reference of what to expect and what to do in the event things don't proceed as planned. I've avoided reading many of the threads here simply because I don't want to read about worst-case scenarios, as I know that my mind will tend to drift there, and I don't want the negatives of what *might* happen to dominate my thoughts right now. So back to the present... at the beginning of June things started to open back up in the state, at least as far as allowing elective surgeries to be back on the docket. I'm scheduled for surgery on July 13. The 14-day preop diet (which I started on June 29) that my hospital prescribes is more restrictive than many others. No meat in addition to no carbs or fats. It's a 1000-1150 calorie per day diet. As someone who normally would eat 3000-5000 calories per day, that's effectively a snack. So I'm in the middle of day 6... and everything is fine. And I have no idea why. I *SHOULD* be frothing at the mouth, hangry, threatening to eat the neighbor's cats, etc., but for some reason I'm not hungry at all, and this cognitively makes no sense to me based upon my "normal" eating habits. I've been actually eating less than 800 calories per day, not even up to the recommended 1000-1150 calories. Breakfast: protein shake (30g protein, 140-160 calories depending on brand) Morning snack: Yoplait light yogurt (90 calories) Lunch: 12-oz pouch of steamed vegetables with garlic and pepper (80-140 calories depending on what mix I use) Afternoon snack: apple slices (50-80 calories) Dinner: Another protein shake (140-160 calories) Evening snack: another yogurt (90 calories) I'll mix in sugar-free jello (5 calories) throughout the day or some celery sticks as needed, and if feeling peckish will do an extra pouch of steamed vegetables. What's freaking me out is why I'm not freaking out... if that makes any sense. It shouldn't be this easy, and I worrying that I ma be lulling myself into a false sense of security/complacency. Or is my brain somehow making this easier on me, as somewhere deep down in the depths of my subconscious I fundamentally realize that I *have* to make this work? I don't know; it's hard to convey. I was at 351 on Sunday prior to starting the diet (and yes, I pigged out on Saturday and Sunday knowing what was ahead) and am now down to 339 as of this morning, which is a good thing. Just trying to get a handle on why my brain is operating the way it is... At any rate, good to be aboard.

I'm actually going to NOT recommend this. Insurance benefits and coverage are a potential minefield of complexities. To venture into this arena as a lay person is not for the faint of heart. If your PCP and (proposed) surgical facility are part of the same system, I would rely upon them and their insurance experts and resources to handle all if the minutiae. After all, that's part of the service you're paying for. Only if you start getting pushback, denials, or nonresponse from the medical team, would I recommend getting involved with the process. At the same time, be aware of you medical insurance coverage, its deductibles, copays, in-network vs. out-of-network coverage. Once you are approved, ask what your out-of-pocket costs will be and make sure they align with your understanding of your medical coverage obligations. In my case I was NEVER involved in the insurance approval or documentation process even once. I never had any direct contact with my insurance company. The bariatric medical team/department handled all of the paperwork, the application and approval process, everything. My only involvement was after the fact when I got the bill for my copayment ($375 surgical copay was the only cost I ever incurred outside of $30 physician visit copays). In my case it was when I was diagnosed with (early stage) type II diabetes in June of 2019, following having been on high blood pressure medication for several years. I figured that at age 53 I was living on borrowed time if I didn't make some rather drastic changes... I'd kinda like to live to see retirement. I had looked into weight loss surgery in 2000 or so, but it was still relatively new, the options were limited, and the complication rate was MUCH higher. So I told my PCP that I was potentially interested in weight loss surgery and would like to re-explore options. He referred me to the bariatric department. I had an initial exploratory meeting with an LPRN, and once we tentatively determined that sleeve gastrectomy was the best option, they set me up an introductory meeting with the surgeon. Only after that consultation and pre-surgery weight loss goals had been determined did they initiate insurance approval. As was explained to me, the biggest factors in the approval process are BMI and comorbidities (exacerbating medical conditions). In other words, if your BMI is above X you have the best chance of approval, or if your BMI is X-10 but you also have an additional medical condition(s) (diabetes, high blood pressure, , etc.). So it can be somewhat of a sliding scale and will likely vary by insurance company. What followed was a 6-month+ process of meetings with dieticians, the surgeon, a full psychological evaluation, and proven attempt to lose weight even before surgery is scheduled. My surgery was originally scheduled for April of 2020, but COVID intervened and it was canceled, ultimately occurring in July of 2020. Lemme tell ya, trying to maintain a weight-loss/healthy(ier) way of eating while the world and society is collapsing around you and being prone to "stress eating" ain't fun. Remember, in March/April of 2020 we didn't yet know what direction the pandemic would take... this was the time of panic buying, overreaction, and just general freaking out. Our department started working remotely on March 17, 2020 and we were still adapting to the world of Zoom meetings. Looking back on things, I'm surprised things worked out... now I'm a heck of a lot lighter... and STILL working from home.

I never had any heartburn/acid reflux issues prior to surgery. I could eat whatever, whenever. Post-surgery, I've been miserable. As I posted in another thread, I let my omeprazole prescription lapse about a month after, as I didn't want to be on it long term due to concerns of kidney damage and other side effects of long-term use. I've been taking Pepsid AC instead, but it's not nearly as effective. Sometimes it does the trick, but at other times not. I have to be really careful about greasy/spicy foods, and especially anything eaten in early evening or later. On numerous occasions I've woken up in the middle of the night in agony. This was not the case when on PPIs. I've since had a consult with my surgeon who has said I shouldn't be scared of long-term effects of PPIs, and if they're more effective I should take them. Not sure what to believe with respect to long-term PPI use...

Never heard of such a high daily requirement. Preop and post-op, I was encouraged to get at least 90 minutes of exercise per week, ideally in sessions of 30 minutes or more.

I tried (and continue to drink) all different types of protein shakes. I don't do the powder. I do the prepacked shakes. I try to stick with the ones that have 30g of protein. All things considered, the Equate (Walmart store brand) are both the best (IMO) and the cheapest at $14.97 per case of 12. I'm not a fan of vanilla flavor (of any of the brands) but the caramel and chocolate are quite good, both taste and texture. Worst brand: Muscle Milk. The consistency/texture is hot garbage and makes me want to retch. I have 2 12-shake cases sitting here that I'm not sure I'm ever going to use. Another good choice: Premier Sea Salt Caramel. My favorite overall, and too bad it's only 15g of protein are the Atkins Mocha Latte. REALLY tasty! Suggestion if you're interested in trying out different brands/flavors: Go to slickdeals.net and set up a deal alert for "protein shake". Then whenever anyone posts deals, you'll get notified. Some of the Amazon subscribe-and-save deals are really good, but they can go out of stock in a heartbeat, so getting notified quickly is key. Do the S&S for the first delivery and then cancel after the first shipment if it ends up being not to your liking. Also keep an eye on prices for subsequent shipments if you opt to keep the brand/flavor, as the price is subject to change at any time. Doing an Amazon subscription for an item does NOT lock in the price. Good luck!

Everyone is different, but for me the first 3-4 days were the worst, especially the first night in the hospital following surgery. I doubt I slept more than an hour. By 2 weeks out it felt like I had never had surgery. It gets better dramatically. Hang in there.

I never had any heartburn/stomach acid issues... until I had my sleeve done in July. Once I allowed my omeprazole prescription to lapse (I didn't want to stay on it long term due to potentially serious long-term complications from the drug), oh boy... I was miserable. Heartburn, that awful taste of bile if I 'threw up in my mouth', I was having serious second thoughts. It was especially exacerbated by late-night eating or fried, fatty, or dairy foods. Rather than go back on a PPI immediately, I first asked my doctor about alternatives to PPIs, and they suggested I try out Pepsid AC 1-2 times a day (once daily plus one additional proactively/reactively depending on a meal in question). It's actually made a huge difference. If I feel heartburn coming on or I'm about to have a spicy/fatty meal, I pop one (not exceeding 2x per day), and within 15 minutes or so all is well. It's been 2.5 months off PPIs and I'm surviving. Being one that historically has indulged heavily in both very spicy and fried foods, it's definitely a struggle to rein in those impulses... Keep in mind that h2 blockers like Pepcid don't decrease stomach acid production as much as PPIs do, so depending on your individual situation, Pepcid might not be effective. As always, consult with your physician, but there are options for controlling stomach acid, not to mention dietary changes.