brittu

I was told by Dr. Aceves' office that OTC Prilasec is fine to use instead of Nexium. The pill is small and that seemed to be what they cared about. They have the knock-off at Costco fairly cheap. Seems to be working just fine for me. PPIs all have basically the same affect.

I'd recommend calling and talking to someone at UHC. I see nothing in their bariatric policy that requires a BMI > 40 for 5 years. The only reference I see to time is a 6 month supervised diet. They just published an updated policy in June so perhaps an employee was misinformed. You can reference their policy in your discussion and ask them to point out where the 5 year requirement is stated. I don't think you have to go to appeal yet, you might want to dig a little more with t hem first. UCH Policy: https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Bariatric_Surgery.pdf

The only issue for me is that the first day I had them I had the worst gas pains of my life. Had to lay down for an hour.

They had both Muscle Milk's when I was at my Costco the other day. It's hard to imagine they'd stop carrying them but you never know. They broke my husband's heart when they stopped carrying Balance bars.

I had to look and see where you lived because I swear I had the same person cut my hair. I hadn't actually been too concerned about my hairloss until she went on and on and on about it...

You can clip it, I've done that (I've had 6 abdominal surgeries). When they first appear they're still attached at the other end. If you'll try to pull on it you'll see what I mean. The nylon ones take longer to dissolve but will eventually pull out.The ones that are more string like seem to come out sooner.

Soda makes me really unhappy - I burp and don't enjoy the feeling of pressure at all. It's been ok if I let it get flat. But I don't really miss it. I think sushi would be fine when you're ready for solid Proteins. Just go slow. The rice in a roll might bother you but you'll figure that out pretty quckly. Eating and drinking at the same time really hurts. I'd gotten out of the habit in the time after my band was removed before I was sleeved. I can drink right up until I eat but I really have to wait for the food to be gone before I drink - otherwise the pressure is really unpleasant. Honestly, you'll get used to it.

I had my surgery in Mexicali. If you google Mexicali you'll see that it has a crime rate about the same as Witchita. I didn't seem scary to me while I was there (I've been all over the world and visited places that I would really consider scary). You're well taken care of on the drive, at the hotel, and in the hospital. And I drank bottle Water and didn't use tap water to brush my teeth. I ate at the hotel and didn't get sick at all. Wish I could say the same of other places I've been to.

You fight them, Mila. Only a few insurance companies insist on the patient regaining all their weight before a revision. Most have policies that consider a revision a continuation of care and you can overturn the denial with a little work. Best of luck! The sleeve is worth it. Britt

I have been fighting the longest revision appeal in the history of appeals (about 14 months now). I figured all that work ought not go to waste. So I've posted the letters on a blog in case it helps anyone. I had a lap band that failed. I eventually won the fight to get it taken out and am still fighting for coverage for my revision to a VSG. My insurer is Federal BCBS and my appeal is now at the OPM in Washington, DC. My latest letter is a summary of all (and I do mean all) of the arguments for medical necessity and references to a dozen or so studies that prove my points. Here's the link: http://vsgappeal.blogspot.com/2010/07/summary-appeal-letter-studies-and.html If this doesn't work it's on to a lawsuit. Looking just at the details in the latest letter I don't think they have a denial leg to stand on and I'm pretty sure I'll win. Just hate to waste the time and taxpayer dollars to take it that far. But I'm pretty motivated - they have to get this fixed so it doesn't happen to other people. Britt

I just used UHC as an example of bariatric revision policies for my appeal. Here's what they say: Surgical revision or a second bariatric surgery is proven for inadequate weight loss if the original criteria for bariatric surgery (BMI, co-morbidities and patient selection criteria) continue to be met. Surgical revision of bariatric surgery is proven for complications of the original surgery, such as stricture, obstruction, pouch dilatation, erosion, or band slippage when the complication causes abdominal pain, inability to eat or drink or causes vomiting of prescribed meals. You can see it all on their web site at: https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Bariatric_Surgery.pdf

You know, the beauty of dating is that it's like test driving a car. You can see if it fits you and if it doesn't you drive it back to the showroom and try something else out. I've been married for 20 years. Marriage isn't easy under the best of circumstances but it's best when the person "gets' you and, honestly, you'll know when it happens. Of all the relationships I've watched fail over the years I'd say the number 1 reason is marrying the wrong person in the first place. I've had so many friends tell me later they knew it in their gut but went ahead. The guy was better than what they'd had before or they were afraid they'd never find someone. But it's just so much easier to walk away before you're married than after. You wouldn't drive off the lot with a car that wasn't what you really wanted, so it's worth considering whether you ought to be with someone if you're not sure they're right for you either.

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.