Tiffykins

SOoooooooooooooooooooooooooo awesome for you ! ! ! Would you mind sharing if you have Tricare Prime or Standard??? I have a friend that is having a full tummy tuck covered by Tricare Standard (her out of pocket is 15% for all allowable charges). She's been approved because she gained 100lbs with 3 pregnancies, 2 c-sections, and can't lose that lower abdominal fat/skin from having 3 big, big babies. Thanks for your informative and inspiring post. I think I'm going to wait about 6 months after the c-section to have my plastics done.

I've taken NSAIDS (Advil, Aleve, 800Mg Motrin, every Advil Sinus/Cold relief) in some form or another since being 6 weeks out, and have never had issues. It is recommended to take it with something in your stomach just like it's recommended when our stomachs are not altered. People with their entire stomachs can get ulcers from overuse, and/or not taking it with some food in their stomachs. The ability to take NSAIDS is the #1 reason that the sleeve is preferred over RNY since we have a normal functioning stomach, just smaller in size. I either eat a bit of yogurt, or 2-3 crackers and then swallow the pill with the smallest amount of liquid that it takes to get the pill down. At over 2 years out, I've never had any issue with NSAIDS, and my surgeon approved using them. There's been 100s of patients win appeals with insurance denials because of their medical need to take NSAIDS. I'm not saying to go against your surgeon's advice. I'm simply sharing my experience, and I'll share that with my clotting disorder I am required to take an aspirin every day. If I had any other surgery(RNY of the Band), this would not be possible, and my high risk ob was ecstatic to find out that I had the sleeve instead of the band or RNY. I'll take this aspirin regimen for the rest of my life. There is no cure, and it's directly related to a genetic condition. Aspirin is the only treatment available for daily use, and I have to have the drug DDAVP given during surgery to help my platelets clot properly.

I've just read a lot of stories on OH from vets that were taking a good quality Vit D orally, but when their surgeons checked their Vit D3, it was considerably low. I've never had any issues with any of my Vitamin levels, and have been able to keep them within normal ranges with Celebrate vitamins as well. From what little I've read, and researched, Vitamin D3 often goes unchecked, but it contributes to low Vitamin D levels that can't be brought up to normal levels. There's also many forms of Vitamin D supplements. The ones that RNY and DS patients rely on to get their numbers up is the dry form of Vit D because of the malabsorption component of their surgery. OregonDaisy on here could probably explain it better because she's suffered with low D, and used the dry D to get her numbers up.

40something is NOTHING chickee ! ! ! You'll do fabulous. . . I had a goal weight of 150lbs, and went below to my maintenance weight of 125-130lbs so anything is possible with the sleeve. I'm hoping once Tatum arrives that I'll be able to drop and maintain back around 130lbs. My husband prefers me with a little more curves, and cushion. After all, he married me at 270, so he definitely likes more fluff that what I was carrying at 120-125lbs.

I ate on a schedule because I seriously had zero physical hunger nor did I have an appetite early out. I had to force myself and actually remember to eat. I went so far as to set an alarm on my cell phone to remind me to eat and drink. I'm over 2 years out, and still never experience physical hunger so I can't rely on any physical signal to tell me to eat. I eat on somewhat of a schedule now, but a lot of my eating still happens because "oh crap, it's 12:30pm and I haven't eaten anything". It's harder in the pregnancy because that means I have to eat more heavy calorie meals and carby meals to hit my goals for each day, and sometimes I'm eating as late at 10pm so I'm not too far under my caloric intake goals.

The sleeve began as a stand alone because it's the first stage of the duodenal switch procedure. Surgeons would perform the sleeve, and then follow up with either RNY or DS for the malabsorptive component. However, results were so fabulous with VSG alone, patients stopped coming back or didn't need the 2nd staged procedure. High BMI is typically over 60. BUT, with that being said, there are several (8-10) high BMI patients on OH that have gotten to a healthy BMI with the sleeve only. It took them 12-18 months, but they didn't need the 2nd stage. My BMI starting with the sleeve was 49 so I was technically considered a heavyweight, and had great success with the sleeve. That information I posted is older than the newer studies that were released late last year. And, they have honed their technique and bougie sizes have become more standardized with a 32-40fr used for longest success. Anything over a 42-48fr was so showing a higher incidence of regain at 2-4 years out, and that's why surgeons went smaller on the bougie to ensure full dissection of the fundus.

If you're near Ft. Hood, you should find out if they'll take you for the sleeve, or at Lackland at Wilford Hall. I know of three retiree wives that have all had VSG performed at Ft. Hood (2) and 1 at Wilford Hall.

Correct. You'll always need to take it sublingualy. The portion of the stomach that is removed is where the intrinsic factor is and that's what breaks down B12 to be absorbed properly. Your dosage will vary based on your labs. At this point, I pop a 2500mcg 3-4 days a week instead of every day based on my labs. I took one every day for the first 18 months post-VSG, and at my 18 month follow-up, my b12 was super high so my surgeon knocked my dosage down to a few times a week. My labs went back to normal ranges in 3 months with my first prenatal labs that were pulled. It's a Water soluble vitamin so it didn't take long for my body to get back in normal ranges.

No different than the chick that was eating JELLY BELLY Beans and Red Hot Candies as she walked through the San Diego airport after surgery in Mexico on her way back to Canada, and then she had a layover and the airport had a Chili's restaurant and she decided to indulge in their chili and chips and salsa, 2 days post-op. I'm just hoping people like this do not breed ! ! !

I should add that regaining weight, NO matter what anyone says, for the pregnancy is definitely difficult for me mentally. I've shared that on here a couple of times, and yes, I realize it's baby weight, and that I will lose it. BUT, that doesn't change the fact that I've gained weight after working my a&& off to lose it. So, while I'm overjoyed with pregnancy, beyond elated that she is growing, healthy, thriving, all the good stuff, I can tell you that gaining weight after being in maintenance for 1 year, and being 20 months post-op when I got pregnant, is really a mindtwist. It messes with me mentally. I always said "Oh I won't care about gaining weight" THAT is a complete lie!!! And, I'd rather admit the way I feel about it, and be realistic than deny those feelings and not be able to work on them.

Honestly, VSG does NOT make you high risk as long as you stay on top of your labs, follow the post-op, and then allow your body to settle into maintenance. I am able to easily eat the recommended 1700-1800 calories with 100gr of Protein and a minimum of 100gr of carbs per day, on top of pushing about 80-100oz of clear fluids. I would recommend that you wait until your body has settled at a good maintenance weight just like what was recommended for me. I begged my surgeon to release me early for TTC only because we were looking at a possible deployment, my weight was stabilized, and my labs had always been stellar. I was released because of my results, my labs, and we needed to see if we could even get pregnant without medical assistance. In the 13-14 months that we tried, I had 2 chemical pregnancies. VSG did NOT contribute to the losses, it was just my body. I had one in January 2011, and got pregnant February 2011, and today I am 6 months pregnant with zero issues related to my VSG. You will absorb all the folic acid you ingest, and I take my Celebrate multi with Iron per my high risk ob. I am high risk for other issues. The stomach doesn't break down folic acid like it does the B12. You'll need to use a sublingual or get injections for B12. The folic acid is absorbed in our intestines. Let me just tell you about band life with pregnancy. There's a few on OH, and they gained lots of weight, puked, and caused slips, and had emergency band removal due to complications even with wide open bands. Morning sickness puking does NOT bode well for the band. I puked on Water some days with my band so I can't imagine being pregnant with it. You should use protection, preferably 2 forms of bc during your losing stage. Your hormones are so out of whack early out, not to mention most post-op diets are low carb, and capacity is half of what it is once you hit about 9-12 months out. Low carb causes ketosis which will cause fetal brain damage and increase risks. Here is a picture that shows where nutrients are absorbed in our intestines, it's used to illustrate malabsorption for RNY, but with the sleeve, this is NOT an issue since there is no re-routing. I just wanted you to see where the folate is actually absorbed. I already researched so much about pregnancy after weight loss surgery, I was prepared. I'm very happy that I can stay on my Celebrate multi with iron, and that my labs have remained stellar throughout this entire pregnancy. I've had labs pulled every 4-6 weeks since I was 5.5 weeks pregnant. Believe me, the band is not safer, nor does it have less complications. There are plenty of us here, and on obesityhelp.com that have HAD to revise. It wasn't just a matter of wanting to, we did it out of necessity. I won't recommend the band to my worse enemy. Best wishes in your research. If you have any other questions, want some research articles, information, statistical data, or other information about the VSG and the band, please feel free to let me know.

VSG is covered at military hospitals. To help you better, I can ask some questions, and you can send me a message with the answers if you don't want to answer publicly. Which type of Tricare do you have Tricare Prime, Tricare Prime Remote, Tricare for Life (for retirees/dependents of retirees), Tricare Standard? Where are you located, and what military bases, posts, forts, whatever military installations are around you? I fought to have VSG for my revision from the band. I had to jump hoops, and fight for it, but it's totally worth it.

Is there a military hospital that you can go to and get the sleeve if that is the surgery you really want. I refused RNY/bypass when I had to revise from the band and I listed the reasons below. I've also included the basic information about both surgeries. There are many reasons why I chose VSG instead of RNY, and my VSG was covered at a military hospital 100%. I would recommend checking out the obesityhelp.com website, look under surgical forums, check out the Revision forum so you can see how many people are looking to revise from RNY because of weight regain or complications, and then check out the failed weight loss surgery forum just so you can get an idea of people that are further out. Here are my reasons for getting VSG instead of RNY: The Vertical Sleeve Gastrectomy procedure (also called Sleeve Gastrectomy, Vertical Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction, Logitudinal Gastrectomy and even Vertical Gastroplasty) is performed by approximately 20 surgeons worldwide. This forum is titled “VSG forum” to include the two most common terms for the procedure (vertical and sleeve). The earliest forms of this procedure were conceived of by Dr. Jamieson in Australia (Long Vertical Gastroplasty, Obesity Surgery 1993)- and by Dr. Johnston in England in 1996 (Magenstrasse and Mill operation- Obesity Surgery 2003). Dr Gagner in New York, refined the operation to include gastrectomy(removal of stomach) and offered it to high risk patients in 2001. Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach. It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption. It is a purely restrictive operation. It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals. Anatomy This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction. The lack of an intestinal bypass avoids potentially costly, long term complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions. Comparison to prior Gastroplasties (stomach stapling of the 70-80s) The Vertical Gastrectomy is a significant improvement over prior gastroplasty procedures for a number of reasons: 1) Rather than creating a pouch with silastic rings or polypropylene mesh, the VG actually resects or removes the majority of the stomach. The portion of the stomach which is removed is responsible for secreting Ghrelin, which is a hormone that is responsible for appetite and hunger. By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing loss of or a reduction in appetite (Obesity Surgery, 15, 1024-1029, 2005). Currently, it is not known if Ghrelin levels increase again after one to two years. Patients do report that some hunger and cravings do slowly return. An excellent study by Dr. Himpens in Belgium(Obesity Surgery 2006) demonstrated that the cravings in a VSG patient 3 years after surgery are much less than in LapBand patients and this probably accounts for the superior weight loss. 2) The removed section of the stomach is actually the portion that “stretches” the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. Remember, resistance is greatest the smaller the diameter and the longer the channel. Not only is appetite reduced, but very small amounts of food generate early and lasting satiety(fullness). 3) Finally, by not having silastic rings or mesh wrapped around the stomach, the problems which are associated with these items are eliminated (infection, obstruction, erosion, and the need for synthetic materials). An additional discussion based on choice of procedures is below. Alternative to a Roux-en-Y Gastric Bypass The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons Because there is no intestinal bypass, the risk of malabsorptive complications such as vitamin deficiency and Protein deficiency is minimal. There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients. The pylorus is preserved so dumping syndrome does not occur or is minimal. There is no intestinal obstruction since there is no intestinal bypass. It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur. The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007). First stage of a Duodenal Switch In 2001, Dr. Gagner performed the VSG laparoscopically in a group of very high BMI patients to try to reduce the overall risk of weight loss surgery. This was considered the ‘first stage’ of the Duodenal Switch procedure. Once a patient’s BMI goes above 60kg/m2, it is increasingly difficult to safely perform a Roux-en-Y gastric bypass or a Duodenal Switch using the laparoscopic approach. Morbidly obese patients who undergo the laparoscopic approach do better overall in their recovery, while minimizing pain and wound complications, when compared to patients who undergo large, open incisions for surgery (Annals of Surgery, 234 (3): pp 279-291, 2001). In addition, the Roux-en-Y gastric bypass tends to yield inadequate weight loss for patients with a BMI greater than 55kg/m2 (Annals of Surgery, 231(4): pp 524-528. The Duodenal Switch is very effective for high BMI patients but unfortunately it can also be quite risky and may be safer if done open in these patients. The solution was to ‘stage’ the procedure for the high BMI patients. The VSG is a reasonable solution to this problem. It can usually be done laparoscopically even in patients weighing over 500 pounds. The stomach restriction that occurs allows these patients to lose more than 100 pounds. This dramatic weight loss allows significant improvement in health and resolution of associated medical problems such as diabetes and sleep apnea, and therefore effectively “downstages” a patient to a lower risk group. Once the patients BMI is lower (35-40) they can return to the operating room for the “second stage” of the procedure, which can either be the Duodenal Switch, Roux–en-Y gastric bypass or even a Lap-Band®. Current, but limited, data for this ‘two stage’ approach indicate adequate weight loss and fewer complications. Vertical Gastrectomy as an only stage procedure for Low BMI patients(alternative to Lap-Band®and Gastric Bypass) The Vertical Gastrectomy has proven to be quite safe and quite effective for individuals with a BMI in lower ranges. The following points are based on review of existing reports: Dr. Johnston in England, 10% of his patients did fail to achieve a BMI below 35 at 5 years and these tended to be the heavier individuals. The same ones we would expect to go through a second stage as noted above. The lower BMI patients had good weight loss (Obesity Surgery 2003). In San Francisco, Dr Lee, Jossart and Cirangle initiated this procedure for high risk and high BMI patients in 2002. The results have been very impressive. In more than 700 patients, there were no deaths, no conversions to open and a leak rate of less than 1%. The two year weight loss results are similar to the Roux en Y Gastric Bypass and the Duodenal Switch (81-86% Excess Weight Loss). Results comparing the first 216 patients are published in Surgical Endoscopy.. Earlier results were also presented at the American College of Surgeons National Meeting at a Plenary Session in October 2004 and can be found here: www.facs.org/education/gs2004/gs33lee.pdf. Dr Himpens and colleagues in Brussels have published 3 year results comparing 40 Lap-Band® patients to 40 Laparoscopic VSG patients. The VSG patients had a superior excess weight loss of 57% compared to 41% for the Lap-Band® group (Obesity Surgery, 16, 1450-1456, 2006). Low BMI individuals who should consider this procedure include: Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency. Those who are considering a Lap-Band® but are concerned about a foreign body or worried about frequent adjustments or finding a band adjustment physician. Those who have other medical problems that prevent them from having weight loss surgery such as anemia, Crohn’s disease, extensive prior surgery, severe asthma requiring frequent steroid use, and other complex medical conditions. People who need to take anti-inflammatory medications may also want to consider the Vertical Gastrectomy. Unlike the gastric bypass where these medications are associated with a very high incidence of ulcer, the VSG does not seem to have the same issues. Also, Lap-Band ® patients are at higher risks for complications from NSAID use. All surgical weight loss procedures have certain risks, complications and benefits. The ultimate result from weight loss surgery is dependent on the patients risk, how much education they receive from their surgeon, commitment to diet, establishing an exercise routine and the surgeons experience. As Dr. Jamieson summarized in 1993, “Given good motivation, a good operation technique and good education, patients can achieve weight loss comparable to that from more invasive procedures.” Next: Advantages and Disadvantages of Vertical Sleeve Gastrectomy >> This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco. Advantages and Disadvantages of Vertical Sleeve Gastrectomy Vertical Sleeve Gastrectomy Advantages Reduces stomach capacity but tends to allow the stomach to function normally so most food items can be consumed, albeit in small amounts. Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin). Dumping syndrome is avoided or minimized because the pylorus is preserved. Minimizes the chance of an ulcer occurring. By avoiding the intestinal bypass, almost eliminates the chance of intestinal obstruction (blockage), marginal ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency. Very effective as a first stage procedure for high BMI patients (BMI > 55 kg/m2). Limited results appear promising as a single stage procedure for low BMI patients (BMI 30-50 kg/m2). Appealing option for people who are concerned about the complications of intestinal bypass procedures or who have existing anemia, Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures. Appealing option for people who are concerned about the foreign body aspect of Banding procedures. Can be done laparoscopically in patients weighing over 500 pounds, thereby providing all the advantages of minimally invasive surgery: fewer wound and lung problems, less pain, and faster recovery. Vertical Sleeve Gastrectomy Disadvantages Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass. Higher BMI patients will most likely need to have a second stage procedure later to help lose the rest of the weight. Remember, two stages may ultimately be safer and more effective than one operation for high BMI patients. This is an active point of discussion for bariatric surgeons. Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss. This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur. Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure. Considered investigational by some surgeons and insurance companies. Next: >> Frequently Asked Questions About Vertical Sleeve Gastrectomy This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco. Bypass information

That's all the same information I've been given. It is NOT covered because Medicare is NOT covering it, and Tricare is a gov't ran insurance that follows suit on Medicare covering things. They did the same exact thing with lapbands several years ago, and then they went back and retroactively paid for people that self-paid for the band.

That's awesome. Is there an electronic form of your policy that lists sleeve gastrectomy as a covered procedure so I can save it to my archives of Tricare documents? I would love to have this for others that are having issues getting it covered, and I can pass it along to them since so many people are having issues. I can send you my email, or if you could direct me to where is says it on the Tricare website that would be great. I just checked the website for the Tricare regions, for Prime, Standard and Prime Remote and didn't see it listed as a covered procedure under the bariatric procedures. But, I could be missing it. Hopefully, your Tricare will pick up as secondary and you can get the other portion covered that Aetna might not cover paid for by Tricare. There is a lady on OH that has Tricare as secondary, and she's in the appeal process right now with getting them to cover the other portion that Aetna didn't cover.

VSG is only covered at military hospitals. Tricare Standard, nor Prime will cover the procedure with a civilian until Medicare picks up VSG fully. They did the same thing with the band years ago. There are a lot of MTFs performing VSG, you'll just have to call the bariatric department and find out if they offer it. There is one lady that got Tricare to cover it with Standard, but her story is a bit different and she had to switch to Standard and will remain on Standard through John Hopkins health plan. Her husband is retired so they do not have the normal Tricare Prime, as it's switched to Tricare for Life, and then it's managed through the Medicare system. I've been round and round with Tricare for over 2.5 years at this point, and had many friends across the U.S. in every Tricare region attempt to get VSG on Standard. One friend even took it to a Congressional complaint level, and she was still denied. My advice is to first call your MTF, find out if they offer VSG. If they do, get a referral from your PCM, and follow the program set in place by your specific MTF. Every MTF is different, and has different requirements. If you have questions, please feel free to contact me.

I just want to share to be very careful that they do not pull the skin too tight in your nether regions. I recall very well 2 stories on OH plastics boards a couple of years ago that 2 different patients had panni's done, and some "countouring" with lipo to their girly bits. One was okay with the results, but she was not happy with the end result because she still had loose skin on her love handle area, and kind of weird end results due to muscles in her lower abdomen that would have been resolved fully with a full tuck. The other lady was extremely upset, they had over-contoured her lady bits area, and stretched the skin too tight, and she ended up with 2-3 additional surgeries to add fat from her butt and to do a skin graph back into that area to give her some relief from the first surgery. With the panni, they essentially pull all the skin up and in from what I've read without messing with the muscles underneath which kind of jacks with the contouring of your natural body shape. Pretty much, most people are able to get insurance companies to cover the bulk of the fees, and then the patient pays the difference between a panni and a full tuck.

The highest incision I had was just below my sternum. It's the one they put the trochar in to move the liver out of the way. I purchased a light support, front closure sports bra and I put it on and wore it as soon as I could. I could not stand walking the cold hallways bebopping around braless. Plus, the abdominal swelling, was more uncomfortable with my boobs sitting on my belly. I wore that bra for weeks on end, and even slept in it. For me, it was extremely comfortable, and gave me some support.

I took mine daily for the first 18 months post-op, and my labs stayed in the normal range until then. My b12 spiked super high normal at my 18 month follow up, and my surgeon had me drop down to 3-4 times per week. It's a Water soluble Vitamin so you're going to expel it in our urine, and since we can't absorb it properly unless it's sublingual or injectable, it's easier to get deficient than it is to over do it. My levels dropped back down to normal range within 3 months when I had my first pregnancy panel pulled in March of this year (3 months after my 18 month surgical follow up). I've continued to take them 3-4 times a week, and my labs have remained normal for B12 through the pregnancy. I use the one from WalMart, and they dissolve in about 2 minutes. I have noticed that if my mouth is dry, it takes longer to dissolve. I also don't ever swish it around my mouth, I just let it dissolve. The Celebrate ones that I had dissolved in about 1 minute, I just switched over because I was low and at WalMart one day.

You can actually change the texture/consistency with how you prepare it. I baked mine wrapped in foil and I would say that I like more mushy consistency noodles so probably too much for your preference, but you can play with them and figure out what works best for your texture preferences. I've seen people talk about microwaving them with holes punched throughout it, and that kind of steams it more than baking it. They come in all different sizes and are super affordable. I can say that they reheat well, and it really does absorb whatever you put with it. I'm a major texture person, and those shirataki noodles had me puking, and that was a combo of texture and smell. No matter how much I washed/rinsed those boogers, I wanted to hurl. These are the two recipes I have used with success in my home: I recommend reading the reviews so you can tweak these to your preferences on texture/consistency. Size of spaghetti squash will change cooking/baking time, and you can cook half at a time to test the waters. This first one, I baked some chicken breast that I had butterflied and stuffed with sun-dried tomatoes, cream cheese, feta, and roasted red peppers mixture, brushed with garlic butter TOTALLY TO DIE FOR RECIPE! http://allrecipes.com/recipe/spaghetti-squash-i/detail.aspx http://allrecipes.com/recipe/baked-spaghetti-squash-with-beef-and-veggies/detail.aspx In this one, I used some skirt steak( fajita seasoned) I had instead of ground beef, and I added a can of Mild rotel instead of diced tomatoes, and it ended up being a more Mexican style casserole vs. Italian (I add a little chili powder and cumin instead of basil and oregano). We are just not big spaghetti family so making it more Mexican flare suited our tastes better.

I also use the dreamfields pasta, and during my losing stage I used spaghetti squash for a pasta substitute. My husband and kiddo didn't even realize that I had used half spaghetti squash and half regular dreamfield noodles. They just thought I was being creative. Of course, I disposed of the evidence of the squash before they were home, and could figure it out, but neither of them complained and ate it right up.

I was prescribed Ambien around 8 weeks out after my 2nd round of complications, and I stayed on it for about 2 months without issue. I took it religiously, and it worked wonders. There are no medication restrictions with the sleeve as long as you are following the prescribed directions of the drug.

Yogurt and probiotics. Tons of clear liquids.

I was taking big ole honkin' antibiotics orally(3 different tablets to be exact) at around 6-7weeks out without issue, along with a Prilosec capsule (which is time-released). I was cleared for all pills, capsules, meds at 6 weeks out.

Shaving without having to contort my fat body into awkward positions was by far the best NSV EVER ! ! ! Seeing the lady bits is a fabulous NSV! ! ! Congrats and keep rockin' your sleeve!