brittu

I've had to read just about every study every written on the sleeve as part of my insurance appeal. From what I've read, 32f seems to do the best when it comes to long term weight maintenance. Drs. Cirangle and Jossart have an ongoing study that's at 7 years now and their data is pretty convincing. But I think in general anything 40f or under is successful for over 80% of patients. Part of why I went with Dr. Aceves is that he does a 36f oversewn down to a 32-34. I had damage from my band and wanted my sleeve oversewn based on the data I read. And I wanted a small stomach. I'm good at losing weight, I'm terrible at maintenance. Plus I have esophageal dilation from the band so I suspect my intake will be higher that most. I think the advice to talk to your surgeon is good. And I'd also recommend checking out the studies on pubmed and springerlink to see what you think.

Well that's an easy question :-). I had a band that helped me lose most of my weight for two years before it slipped and I had esophageal dilation. After the slip it was terrible and I had to fight the insurance company for months before they took it out - I should have just gone to the ER and had it out in emergency surgery, it was that bad. And even when it was still working it wasn't a good life. I was bent over sliming up stuck food often enough that it made my children cry and eating out was like playing Russian Roulette. But the sleeve is everything I thought the band would be and more. I eat anything and am full somewhere between 1/4 and 1/2 a cup. I don't have any hunger. I don't like sweet stuff any more. It's just amazing. I'm down 24 pounds in 7 weeks. My primary care doctor (who is banded) is jealous. My local surgeon things the band will be gone within a few years. I had to pull a bunch of studies together for my insurance company and the failure statistics at 5 year out are abysmal. My guess is that a class action suit is in the works. He's thrilled with the sleeve, of all the surgeries he does he says his sleeve patients are the most satisfied.

Congratulations! I was there in June. It's amazing how little pain there is with a spinal isn't it? Never had a surgery like that with no pain. Although the difficulty peeing was a little weird. Your new life is ahead of you!

I totally get it. Ernesto couldn't get me from the airport to the hospital fast enough. I waited over a year (a big learning for me, I'll never wait for something so important again). The night before I was scared so wrote my standard "just in case" letter to my family. The valium they give you certainly helped me. You'll love Dr. Aceves and his team. It's been about 7 weeks and I'm so happy with my sleeve. Congratulations!!!

1) How long have you been sleeved? - Not quite 8 weeks. 2) Who was your surgeon? - Dr. Aceves 3) What were your experiences with your surgeon? - Fantastic. Dr. Aceves was wonderful and I chose him because of his extensive experience and track record. But everyone I worked with was top notch. It was my best surgical experience (I've had 6 abdominal surgeries). 4) Would you recommend your surgeon? - You bet. And I would also recommend Dr. Cirangle in SF and well as Dr. Billing here in Seattle. I would have gone with one of those two if I had won my insurance appeal. 5) How much weight have you lost since your sleeve date? Since the surgery it's been about 24 pounds. 6) What type of sleeve do you have? 36f oversewn down to 34 or 32. It looks skinnier than I imagined on the x-ray. 7) Would you recommend the type of sleeve you have? I had a lap band and was successful with it until I had complications. There's no comparison between the two. With the sleeve I don't get sick, am satisfied quickly, and am never hungry. 8) Do you find you still have the necessary level of energy to sustain a good workout? Don't know yet, tomorrow's the first day I can exercise. But so far I don't have any issues with energy in general. 9) Do you find it difficult to keep the weight off once you have lost it? Don't know yet. I've had a long stall but I lost so much weight so quickly I'm not that worried about it. 10) Do you have trouble eating, such as getting ?stuck?? Never. And no nausea or vomiting. It's so much better than my band. Sweet foods don't taste very good any more and make me kind of queasy but that's not necessarily a bad thing. 11) What is the one things about getting the surgery that you regret? Only that I fought my insurance company for over a year and regained all the weight I'd lost with the band. I wish I'd just gone self-pay after the denial and fought for reimbursement after the fact. 12) Would you do this surgery again, or would you have made another choice? In a heartbeat, I'd just have done it sooner.

My doctor is really conservative so it's 8 weeks before cardio (I'm dyin' to get back on the elliptical) and 12 weeks before pilates or yoga. It's killing me. I love my pilates.

I have one and I use it alot. The only thing I don't like is that it has a little rubber ring seal that's hard to get in and out. If I had to buy another one I'd probably check to see how it seals first. I don't have any more of those rings so I just close it tight and watch for the vibration of the blender to make it come loose. It's great for shakes with ice, kids' smoothies and I also used it a lot to blend up soups and other foods for mushies.

Good for you! I know what that feels like. I remember the day I decided I wasn't going to waste another 6 months fighting my insurance company over the revision. It was freeing and I knew that making t he decision was the first step. My sleeve is really working well. Visited my doctor today and am down 28 pounds. She was amazed. And jealous, she's got the lap band and wished she had a sleeve. She actually sent her parents for sleeves about a year ago. A new life lies ahead for you!

You're doing great! I'm just behind you by a couple of weeks. I've been stalled for awhile - that darn scale just won't budge off of 208.2 but I know once it starts moving again I'll feel like there's no stopping me. Congratulations on doing so well!

I understand your concerns. I had the band and even before it slipped I was miserable but I just ignored the awful food stuck incidents and the sliming because it was working. I hated how eating felt, like there was food at the top of my stomach where it wasnt supposed to be. I never actually felt full unless I ate enough to fill up my stomach under the band. My throat hurt and sometimes the heartburn was so bad I'd have to pull the car over and cry. At that point I was glad it was reversable. Fast forward 7 months to when the insurance finally agreed to remove the band. I start gaining back my weight until I'm right back where I started almost 4 years ago. And I'm thinking I sure hope the sleeve works and is permanent. I've been sleeved for a little over 6 weeks. It's just night and day. This is how I thought the band would be but way better. I don't get hungry, I just get empty enough that I know I need to eat. I eat small portions and stop eating when I'm full or when it doesn't taste good any more. I'm still learning not to eat too much. I had esophageal dilation so I worry about food filling up above my sleeve. A couple weeks ago I ate a little too much, it didn't hurt I just felt like I used to after Thanksgiving - uncomfortable. And it occurred to me that this is permanent. Small portions and making sure I don't feel uncomfortable is how it'll be for the rest of my life and that's really just fine with me. I'm learning how to find things to enjoy besides food - eating as entertainment just isn't possible now. And that's a good thing. I hated waiting for the year+ that it took to finally get a revision but it gave me time to read and research. I'm very happy with the sleeve. It's what I thought it would be with even fewer complications - no nausea, no pain, no hunger and a nice sense of satiety with very little food. I'm glad it's permanent.

Thanks for sharing. I had surgery on June 8th and lost 22 pounds in less than 4 weeks and then nothing. If I can just get past this first stall I'll get it in my head that this works and be fine. When I had the band I don't remember stalls bugging me so I don't know why I'm frustrated this time around. I want that dumb scale to stop saying 208.2 every dang morning :-).

I think you'll be fine. I had surgery on a Wednesday in Mexicali and was back at work here at home on Monday. I was a little weak and tired the first week but back to normal after that. And it's nice to be busy when you're on liquids.

The adjustment that eventually happened for me (with my band when it was working, I've only had my sleeve for 5 weeks) is how HUGE regular portions looked. After a year just looking at how much other people had on their plates made me queasy. I think you eventually get so used to small amounts and small bites and enjoying them that excess looks really unappealing.

There's just no difference between the band and the sleeve. With the sleeve you get reduced or no hunger and a normal eating experience where small portions feel just like a big meal used to. Most people can eat most foods - most importantly can eat lean meats and vegetables. With the band you get expensive fills as you chase after the elusive perfect level of restriction. Over 50% of the people who get the band have complications and many of the complications cause permanent damate (I now have a dilated esophogas). You still have your full stomach which means the food that makes it through the band has a nice big stomach to land in. You get hungry but you don't really get full, you just get a bunch of food at the top of your stomach that comes up your throat if you don't stop. And then there's stuck food - hardly anything in life is that uncomfortable. My surgeon believes the sleeve will overtake gastric bypass within the next 10 years. And we both thing the lap band will eventually be recalled once some past patients with permanent damage like me get together with a lawyer and create a class action law suit. Sleeve, the easy choice. I can't believe how well it works.

Just wondering... Is the doctor telling you the BMI requirement is 50 or did you actually read that in the benefits statement? What insurance do you have? Maybe I can take a look for you. It sounds to me like the BMI requirement for a DS (in which the first half is a VSG). I've never ever heard of a VSG requirement higher than 40. I think there might be a mistake here on the part of the doctor's office. Maybe they even submitted the wrong procedure code? There's a new one for VSG.

Just thought I'd mention that I didn't have any problem renting movies in iTunes while I was there. I used my computer and downloaded two TV shows to my iPhone that I watched on the flight home. Also, Skype was great. I paid $10 and then just used my iphone to make all my calls. I had my hospital neighor use my phone too because there per minute rate was so low I found it impossible to use more than about $4 of my credit.

I went with Dr. Aceves and was happy to find out that everything I'd been told about him was true. The care I received was fantastic. It was my 6th abdominal surgery and the only one where I didn't have any pain. What I really liked is that they just seem to do more than everyone else: more time in the hospital, more leak tests, a drain (which I think made a huge difference - I didn't retain IV fluids, and the most wonderful thing of all the spinal block. It was really as good or better than I could have hoped for. I'm really happy with my choice and only regret that I didn't have the band out and the sleeve in in a single surgery a year before when I got my first insurance denial.

I've ordered several times from DietDirect and BariatricEating. There's also a store near here called Super Supplements that has lots of things. If you google low carb there are several good low carb stores online too.

When I was checking it ran anywhere from $12,000 to $21,000 with around $15,000 being the most common. Although I could have done it here with a local doctor with good experience I chose Dr. Aceves and was super happy with my experience. It would have been nice to be so close but I also appreciated the extended hospital stay. I think there's at least one very reputable sleeve surgeon not too far from you.

Thanks Dr. Jossart! Dr. Himpens has a new study he published last month. I emailed him and he's going to send me a copy. Take that Office of Personnel Management! I'm not giving up until they make sure they have a clear policy in place so nobody has to go through a year of misery and insurance appeals like I did.

Dr. Jossart, Is there any data or written opinions or policies or anything available on the following: VSG as band revision procedure band complication statistices, particularly after band slips or pouch dilation I?ve been fighting my insurance company for coverage for over a year. They finally took the band out but refused to cover a revision. They?ve thrown everything at me from the investigational claim (which I used your studies to refute) to too low a BMI. Now they?re saying that there?s no proof that a VSG is an appropriate revision surgery and have asked me for more documentation to show that VSG is used and is appropriate for band revisions. The only people in the world I can think of who might have information are you and Dr. Cirangle. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p> Can you help? Is there any article or statistics you could point me to? Some sort of letter or medical standards or even your medical opinion I could send them for the next round of review? I'm about to be unemployed and getting reimbursed for my surgery would make a big difference for my family. Thanks! Britt

The calorie difference is so minimal between skim and 1% that I just drink what I like. I don't think the minor bit of fat hurts - your body uses sugars to store fat, not fat anyway. I either go for 1% with acidophilus or a deluxe skim I can sometimes find that has extra added Protein. I love that, it's like 2% in taste and texture.

Huh? I'm not sure where you're getting your information from. Mexicali is one of the safest cities in Mexico. Their homicide rate, for example, is identical to that of Witchita, Kansas. Kidnappings and bank robberies and other violent crimes are very rare. Because it's a border city there are drug seizures at the border just like any other border city - not much different than Blaine Washington a few hours north of me. It's a city of 700,000 that looks pretty similar to any other southwestern town. There were strip malls everywhere. Neither the hotel nor Dr. Aceves office had a problem suggesting we walk to a Chinese restaurant a couple of blocks away. I saw no evidence of police drug or gang activity and plenty of families and average people out and about. Mexicali has lots of agriculture but it's also home to a large number of assembly plants and food processing factories. It's actually considered one of the most prosperous cities in Mexico. Law enforcement and government families from other cities nearby actually raise their families there. The hospital wasn't surrounded by guards or otherwise showing any concern about the threat of violence or crime. Mexicali isn't Juarez or Tijuana. I think it's always a good idea to check the facts before scaring people with these kinds of comments.