BetsyB

My doctor recommends purees (protein only) starting Day 3, and for 2 weeks. After that, things advance from soft to solid (still only protein) pretty quickly. In Week 4, if memory serves, nonstarchy veggies are added, and soon after, a fruit or legume serving/day is added. Other complex carbs (grains, starchy veggies) are not added back in until at least 75% of excess weight is lost--if then.

The best way I've heard appropriate sip size described, I think, is this: you know the tiny area beneath your tongue between the base of your tongue and the back of your bottom teeth? Liquid can pool there. A sip that fills that little space is just about exactly the amount we should aim for.

I need to lay in some cross-stitch supplies--busy hands really are a great deterrent to eating!

Oh, my goodness, Elfie--what an enormous weight of stress you've been carrying! I think it's really positive that you've identified your difficulties with sweets (and carbs in general)--being able to see that they became a bit of a crutch during a very trying time is really impressive--because, well, stress often makes it harder for us to look clearly at what we're doing and identify things we need to change. You have the tool. You know how to use it. And I know you will. I'm so sorry for the loss of your father-in-law. That alone would be enough for anyone to bear. Adding the accidents? Too much! Thank goodness they produced mostly logistical headaches...but even when injury is escaped, there is a HUGE fight-or-flight response. And a big part of that (hormonal) response is a biologically-mediated craving for carbohydrate. When your cortisol jumps, so does hunger/carb hunger. It sounds to me as though you've managed that better than you might be giving yourself credit for.

AWESOME post, Elfie!

Are you sure he didn't mean that you need to lose on the preop diet--rather than since he last saw you? I mean, the timing of appointments is not always aligned with the things we are doing. I'm on the last legs of my preop diet, too. I've lost 8-9 pounds, and am having surgery on the 12th. No mention was made of weight loss being the goal. Emphasis was placed on the need for compliance in order to reduce liver size. I think your surgeon is likely to be okay with your loss. If you've been compliant, that's what matters.

It's less tart than regular (thinner) yogurt, but the tang may still be too much for you. I like it with a tiny bit of Splenda and some good-quality vanilla (like Nielsen-Massey). I use little enough fruit that sweetening it a bit helps. But I also really love it, unsweetened, or in savory uses (with herbs, for example). The texture is heavenly.

In the produce department, I've found minced ginger in plastic tubes---usually placed in the fresh herb section. To mince it by hand, I usually julienne it thinly, then line up the strips and cut them crosswise into a fine mince.

I'm not "on" it, as in "imposed by a doctor," but have a miserably slow metabolism that does function best around that caloric level. Which explains my need for the band!

Yes, the surgeon will submit all of the reports from the various consults to your insurance company. I was told the typical wait was 4-6 weeks, and I was approved right smack at 5 weeks after submission of the paperwork. The day my surgeon got the approval, I got my date. It was just about a month later (this coming week), but much of the delay was due to the holidays and the doctors' vacation schedules. (There are two doctors in the group, and they always operate in tandem; if one is on vacation, the other does not operate.) During that time, though, there were things to keep me busy. There have been appointments for bloodwork, to sign the consents, and another seminar focusing on the preop and postop diets.

My evaluation was far more extensive, and far more nerve-wracking. I have no history of mental illness, but the psych I saw drew things out for three sessions (only one required), and submitted a 14-page report of largely irrelevant information to my surgeon, who sweetly asked, "So...what did you THINK of that psychologist?" When I told him that I kind of thought the guy was a tool, he said, "Yeah, he seemed kind of 'special'" We could laugh, because I was approved. But I left my final meeting with the psychologist very, very worried I would not be, based on his report. It was a pretty nerve-wracking experience for me.

I'm not yet banded, but will have an overnight stay. My surgeon prefers it, and it's considered the standard of care by my insurance. I'm grateful for it. I am sure I'll be ready to go by the time the discharge papers are signed and my ride shows up. But a night without worrying whether dinner for my family is planned or the dog needs to go out or homework is done is a good thing. If I were home, I'd try to do all of the above.

I'm nearing the end of my preop diet. It's involved two Protein shakes and one protein/veg meal each day. The shakes must have 15 or more grams of protein and fewer than 10 grams of carb; what I use is my own choice. In addition, I'm allowed to have 2 servings each of broth, sugar-free popsicles, or sugar-free Jello. Post op, I'll have one day (surgery day) of Clear Liquids, one day of full liquids, and then be permitted 3 Tbs. of pureed protein 3x/d as tolerated.

My surgeon's introductory seminar was the first week of July, I saw my surgeon for the first time on July 21 (which started the 3-month insurance clock ticking), got my date in early December, and I'll get my band next week.

Michelle, psychotropic drugs won't rule you out. You are working part-time as an RN--you are well-regulated on meds. If you can comply with hospital policy and procedure at work, you certainly can comply with the kind of regimen required postop. If out of pocket is a realistic possibility for you, that's great. But I would explore whether Medicare does make BMI allowances for comorbidities. Or load my pockets with rolls of quarters. Losing jobs and insurance is terrifying. Facing losing your health is even more so. Medicare was created precisely for people like you--who need a leg up. And helping you achieve and maintain good health is something I, as a taxpayer (since we're all tossing that around), think is a pretty damn good investment.

(Psssst. A roll of quarters in your pocket will add half a pound...)

Does your health plan make allowances for lower BMI if you have comorbidities? Infertility is often considered weight-related. Do you have any other health issues as a result of your weight? I'd try to appeal on that basis--I know my insurance does cover people below their cutoff BMI if there are concurrent health concerns.

Yep, you do lose some bone and muscle mass ---purely because your body no longer requires that sort of sub-structure to haul your body around when it weighs less! Lots of things change, proportionally, as you become smaller. I'm so looking forward to this! And no--my goal weight is not in the overweight range. I would not have the surgery if my surgeon were not encouraging and expectant of greater success for me. I've been a thin adult--I know it can be achieved. I am CERTAIN that, with a band, it can be maintained, as well.

Jen, I'm having my surgery on the 12th, and a couple of things on my list I don't see on yours are bariatric Vitamins (if you don't already have them) Rx for pain meds (the doctor will give it to you ahead of time so you don't have to worry about filling it after you get home) FiberSure (or other soluble fiber) Gas-X a few good-tasting Proteins (in addition to the flavorless) Lots of broth sugar-free popsicles My surgeon advances diet pretty rapidly, so I'll be allowed purees (Protein only for about 8 weeks) on Day 3. So I also have soft proteins on my list--things like ricotta cheese, chicken breast, fat-free refried Beans, etc.

We were actually told that salt is NOT an issue during the preop diet. Our intake is so low, and often MUCH higher in Fluid than normal---so it is flushed from our body. Increasing it a bit during this phase, by using regular instead of low-sodium broths, etc, is a good idea, actually. Hyponatremia can be a problem when you bump up fluid intake so much; you don't want to create electrolyte disturbances. My surgeon okayed herbs and spices and things like soy sauce, hot pepper sauce, etc. I'd probably save the tomatoes for my protein/veg meal of the day.

I think I have the opposite problem--though I've been obese for many, many years, I don't really see myself realistically. As a young adult, my weight was in the 115-pound range, and though I know I'm not there any more, I seem to "think" I'm somewhere between that weight and where I really am. I remember so well how great it felt to be thin. I can't wait to get back to that feeling of freedom. On the other hand, I also know that there is something that caused me to don this cloak of insulation/invisibility that comes with fat--and shedding it really is, in a way, quite scary. (I know what caused it---and I do think I'm ready to do it....but I have a therapist on standby just in case!)

Some of the shakes have sugar alcohols--which can be really hard on the gut. I really love Bariatric Eating's Inspire line of Protein. The flavors are awesome, and the PURE unflavored protein isolate is quite possibly my favorite (it can be added to anything). You can order at BariatricEating.com - BE, Inc. The number one bariatric website for protein, Vitamins, and success..

It boggles my mind how many variations of both the preop and postop diets there are! I fully expected to be on clear liquids, followed by full liquids, for a period of time--and learned that my surgeon prefers we advance to purees on Day 3, as tolerated. This is music to my ears more than halfway through my preop diet---I know I may not be able to get them in right away, but somehow knowing I can makes all the difference in the world. (Solid protein is supposed to satisfy for far longer than liquid. Still, I have a great array of really excellent protein supplements...)

While the approval process was nerve-wracking, my surgeon's office had as many requirements as my insurance company (Empire BCBS). All in all, it simply was a matter of meeting their not-terribly-outrageous requirements. Approval followed almost immediately after the last of the paperwork was sent to them. It was pretty wrinkle-free for me.

I don't know about everyone, but I'm in the 40-range for BMI, and know I will need to have MANY things tucked! I am already working on picking out a plastic surgeon--and I'm not even banded yet. (A week from tomorrow--yay!)