Dave_NW

Hi Sarah. Welcome to the Forum. Madigan has the best military surgical center in the Northwest. They'll treat you respectfully, and will give you the answers you're after. They do a lot of band surgeries, plus sleeve and bypass, so they have a lot of experience. You're in good hands there. The thing with Tricare Prime is all about the referral from your PCM to have surgery, and the request for surgery approval from your surgeon back to Tricare. If you meet the requirements, approval is nearly a slam dunk. Tricare Prime is one of the easiest insurance carriers to get approvals from. But you need to follow their very specific rules. Once you do, surgery happens at whatever rate you want it. If you find yourself on a long waiting list to have surgery, (which could happen with a military hospital), you may want to do what I did: Go to a Tricare-approved civilian hospital for your surgery. Lap banding is common enough here, you may find using a different surgeon may work better for you. I went to Swedish Hospital in Seattle for my surgery, and I have no complaints. They were great. The process can be pretty fast, if you jump through the hoops in the right order. My intial consult with Swedish was September 29th, and I was approved for surgery on October 21st. Mutual and holiday scheduling conflicts delayed me actually having my surgery till December 6th, but I could have had it done in late October, if things had worked out better. So it's pretty fast. Madigan may be a bit slower because their staff has a lot of people they're dealing with. You should ask them for a time frame. Excess skin removal: Tricare doesn't approve cosmetic surgery. But if you dvelop a medical necessity to have the skin removed, such as rashes or infections from the skin being there, I'm told they will pay for the surgery. So it all depends on how carefully you and your surgeon/PCM determine the level of your "medical necessity." Good luck! Dave

Kayla, when I came to the decision to have my lap band surgery, it was because I finally decided "for me" that it was my best option. I did it for myself, first and foremost, and for my family and friends after the fact. But "I" was first in line. And I have never been so glad I did something so good for me. My family and friends are thrilled with the changes so far, but nobody is more pleased than I am. My only regret was that I didn't have this done years ago. At 57 years of age, I've lost my 30s and 40s and most of my 50s decades to being overweight. It was progressively getting worse, it negatively affected everything I did every day, and I finally decided I'd had enough. Ask yourself where you'll be in 20 or 30 years if you don't have the surgery you know you want to have. Changes come from all sides, and it's way more than just weight loss. Since my surgeon and I started monitoring my weight five and a half months ago, I've lost 65 pounds. I've lost almost 50 pounds since my surgery in December. I still have a lot more to lose, but I'm well on my way. I've had three fills, and am still learning how to balance what I eat against what it means to live with a band. But I'm getting things sorted out, and I'm absolutely delighted. Every day is filled with little victories: I can bend over and tie my shoes. I can cross my legs without it hurting my hip joints. I can stand up for more than a few minutes without my outer thighs going to sleep from pinched nerves. I've gone down several pants and shirt sizes, and I'm like a kid in a candy store when I walk through a normal-sized clothing store, and know I can find something on the regular racks that fits me properly. No more mail-ordering fat guy clothes, or shopping at stores that make tents for Omar. I fit in a restaurant seat without crushing my stomach against the table top. I can drive my friend's sports car and actually fit in the seat! I'm excited about being able to do my job these days without the side effects of obesity. My doctor is happy, my family and friends are happy, and I'm beyond happy that I did this. If you do decide to have surgery, ask your good friend to be there for you, and not work against you. Tell her you value her friendship, but that this is a decision you need to make for yourself. She no doubt wants to help you, and thinks her "weight loss method of the day" is the right thing to do. Tell her this is something you want to try doing for yourself, and let's see how it goes. If she is truly a friend, she'll close her mouth and support you. And who knows - once the surgery proves successful for you, maybe she'll find a new way to lose weight, too. Best of luck with whatever you decide! Dave

Welcome aboard! Sounds like you're doing as you should. If everything else is on track, take a close look at your nutrition and your exercise levels. If you eat too little, not enough Protein, or too many carbs, your weight loss can slow down, and even stop completely. If your calories are too low, your body goes into starvation mode, and holds onto everything - resulting in little to no weight loss. You need to balance what you're eating with the amount of calories you're burning, so you can convince your body into losing the weight it doesn't need to keep. Also, muscle weighs more than fat, and with all the exercise you're doing, you may be building muscle, which can offset the fat pounds you're burning off. You may be getting more fit, but not losing numbers on the scale. There isn't a magic answer, and everyone has a different journey. The trick will be learning what your body needs, and then providing it. In my case, I was stalled for quite awhile, with very slow weight loss - maybe one pound every two weeks. After I figured out how many calories I need to maintain my current weight, I could adjust my intake to leave a deficit every day. After enough days, I naturally lost weight. As I juggled things to suit what was happening with my overall picture, the weight began going away faster. I'm now losing at a pretty good rate. Hang in there - you're on the right track. Good luck! Dave

I had both a hiatal hernia and a ventral hernia repaired during my band surgery. Nobody said anything about hernia size, but the surgeon downplayed the hiatal hernia, saying, "Oh, we'll just take care of that when you're on the table." Sounded like he wasn't at all concerned. You should probably call and ask your surgeon, but I gather these kinds of hernias are routine enough that you should be just fine. Good luck! Dave

When my hospital billed Tricare for my surgery, which included repairing a ventral hernia and a hiatal hernia during the surgery, the total was more than $74,000. I about fell out of my chair when I saw that. But I monitored the Tricare website, and eventually saw that Tricare only paid them about $12,000. There's a reason to make very sure the hospital takes Tricare insurance before having this surgery - Nobody wants to pay the unpaid difference! In my case, my total out of pocket costs, including the hospital stay and office visit copays, has been only about $100. That's a far cry from the $74K originally billed. Have I mentioned I like having Tricare Prime as my insurance? Dave

Bren, I'm glad you're feeling better. For as awful as those first few days can be, the recovery happens pretty quickly. It's like a house of cards, and once something changes, there is a lot of effect on all sides. Just keep your head in the game, and use your common sense. You'll be back to (new) normal in a very short time. I'm really glad the Gas-X helped. I'm surprised more surgeons don't recommend it. Even if it doesn't help too much physically, the placebo effect can make you feel better. One thing I got that helped me sleep better at home was one of those bed-wedge pillows. I could lay it flat, and sleep slightly inclined. Then when I wanted to sit up, I could flip it around so it leaned back against the headboard. It made a world of difference in my sleep quality. Wishing you continued smooth recovery. Dave

I'm the last person to recommend a surgery to anyone, but you asked which was better for diabetes. As I understand it, the RNY bypass is an instant cure for diabetes because they remove the duodenum. You may want to discuss options with your doctor. Dave

Sorry you're having trouble. The first few days after surgery are the worst. A lot of what you're feeling is perfectly normal. Different people feel post-surgery pain more than others, but I don't think anyone does any "track star" stuff, although it may seem like it. As your swelling goes down, a lot of your pain will ease. If your surgeon had such a time with band placement due to your liver size, you're naturally going to be more sore than someone with a smaller liver. And think about it - you did a three week liquid diet, so how much larger was your liver initially? It may have been really big. So you're better off for having done that diet. I recall that the liver only shrinks by about 10% from the diet. The five holes is normal. I had two hernias repaired when my band was placed, and I ended up with 13 incision sites. That was kind of a shock. I had interns who assisted in the surgery coming in to count my incisions. I felt at times like they wanted to autograph them or something. Having trouble peeing is also normal, as a side effect of the anesthetic they use during surgery. Within a few days you'll be able to go like before. I can't imagine the nurses saying not to sip Water. That was beaten into me from my first conscious thoughts after I woke up. Walking will help dissipate the gas, and relieve the pain. I did hourly laps around the hospital floor, and laps around my house after I got home. It was uncomfortable, but within a few days the gas was gone, and with it went most of the pain. Gas-X strips helped me out. If you're feeling the urge to cough, try to do so. You may have Fluid in your lungs from the anesthetic, and the sooner you get rid of it, the sooner you'll be able to breathe easier. Sincerely wishing you a speedy recovery. Stay strong. Dave

Glad you got your answers today, and you're more at ease. The first weeks after surgery can be pretty stressful, because you're going through so many changes. Hang in there - it does get easier. After you figure out what does and doesn't work for you, I'll bet you're going to rock this band. Good luck! Dave

Just my 2 cents, (okay, maybe 4 cents), but I think you should explore using a different surgeon. It sounds like these folks are jacked up and not communicating with each other very well. You're being given conflicting information from people who are supposed to know what's up. Your insurance should have written requirements that are clear and concise, not up to speculation. You need facts, not opinions. The sleeve may "work better" than the band, but mainly for people who are willing to deal with the other side effects of sleeve surgery. Sleeve patients do tend to lose faster, and may lose more weight initially, but after several years, the weight loss numbers tend to equal out. Since weight loss is not a race, after a few years when things are equalled out, does it really matter which surgery you had? Do the math: Removing 85% of your stomach for the rest of your life, vs. a reversible, adjustable, removable device that helps control your appetite. If you develop problems with a sleeve later on, what recourse do you have? Bypass surgery is your only option. Not so with the band. If you're willing to participate in your weight loss, work the plan, and put forth the required effort to make it happen, a band can be a dynamic tool to help in your weight loss. Good luck! Dave

Hi Julie. Congratulations on your surgery! You'll soon feel better, and your new life will begin. The discomfort you're feeling is normal. I'll wager it's mainly gas left over from the surgery. The key to dispelling that gas is to move. Walk till you feel like you're going to collapse. Try walking around your house, up and downstaairs, wherever you can, as often as you can. The more you move, the sooner the gas goes away. Gas-X strips can also help. Sip Water constantly. You can't ever sip too much. This will aid in the healing of your band, will keep your stomach calm, and will also help dispel gas pockets. If you feel the need to cough, don't fight it. You may have Fluid in your lungs leftover from the anesthetic. Once you cough that up, even more of your pain will go away. Each day will get better than the day before, but the first week after surgery is always the trickiest. Hang in there! It gets better. Dave

Sorry, but you need to slow down and take a breath. You're way ahead of yourself. During the first four to six WEEKS after surgery your primary goal should be about healing, not weight loss. Weight loss comes later. If you abuse your system by moving too fast, eating too much or eating solid foods before advised by your surgeon, you run the risk of damaging the band placement (a slip) or of stretching the pouch created by the band placement. So try and relax and follow your surgeon's orders. It will pay you back in the long run. After you're healed up, the fills will start. It may take several fills before you begin to feel restriction, but remember that the band will not prevent you from overeating, if you want to. Eating healthy, stopping yourself from eating too much or too often, and exercising are the keys to the weight loss you're after. It's cliche to say it, but the band really is a TOOL. It is not a magic bullet. You have to work it to your best advantage. Weight loss takes work, and is not automatic. But I can promise that if you do as your surgeon instructs, if you get out of your chair and start moving, and if you follow the program, you'll soon be rewarded with weight loss. Over time, it will add up to meaningful numbers. Wishing you the best of luck! Dave

Now THAT'S funny. Isn't it amazing how animals monitor our lives, even when we don't? I have a cat who is a bit of a skittish thing, hides under the couch a lot, and only shows up when she thinks there's something in it for her. If I rip open a cheese stick package, and (even better!) peel open a yogurt cup, she's RIGHT THERE in my face, forceably begging for a taste. I give her a tiny bite of cheese or let her lick the yogurt spoon when I'm done, She doesn't beg for other food, and doesn't get any, but she is so insistent when it's these two. The funny thing is it doesn't matter how quiet I am with it. She hears it, and is instantly in my face. Dave

Nice work! Congrats! I know how great it can be to feel you're accomplishing the work you need to do. Keep it up! How can we see the pics? Dave

I haven't had that problem, but the PA who does fills at my surgeon's office told me she always draws out some saline when doing a fill to check the color. She said discolored saline may indicate a leakage of some sort, especially if the volume in the band is lower than expected. Since you had less in your band than you expected, as well as the discoloration, you may want to explore the possibility of a leak with your doctor. Good luck! Dave

I have Tricare Prime, and to my knowledge there is no time requirement for how long you've been obese. You may want to print out the Tricare requirements to show them, and ask them how or why they are saying there is a time requirement. When I was initially interviewed by my surgeon's team, I was asked what my weight was at various ages. They saw the trend that I had been progressively overweight for years, but not morbidly obese until a few years ago. So maybe that was enough for them. I was approved within a few days of the submitted request. Tricare approves people based largely on the doctor's recommendation for surgery. So make sure you convince them of your sincerity, and how you want to avoid the chronic issues your family has. Being proactive in your weight loss may be enough. Good luck! Dave

There may be dfferent kinds of "stuck," but if you're feeling the pressure right at the place where your band is located, it sounds like the same kind of stuck I described. If the pressure you're feeling is in your lower stomach, then it may be gas. Try Gas-X and see if it helps. In my case, the sensation of beng stuck is immediate after swallowing something that doesn't go all the way through. I get that knot right at the bottom of my sternum, but above my diaphragm. It's a very distinct sensation, and is quite uncomfortable. As the item moves through the band, I can feel it going. Dave

I'm at 7.2cc in a 14cc band, and I get stuck occasionally, most often after eating broccoli, no matter how it's cooked. Go figure... Dave

Wow! That is amazing! You deserve to feel so proud of your hard work! Congratulations! Dave

Wow, I thought I was the only one. I get hiccups when I'm done eating, too. Dave

Erin, I'm sorry you're having trouble. If you've been at this more than a year, you definitely need to schedule a visit to your doctor, and discuss things. Maybe you need more in your band? If you had success in the beginning, what's different? Maybe you need to evaluate how it was vs. how it is now, and go back to basics? Start with the "pouch test" (search the forums for posts about that), to make sure your band is working right. Then decide how best to proceed. Check your nutrition, because if you're not eating right, it's easy to find yourself snacking. Eat more nutritious meals on schedule, so you won't be hungry in between times. Up your activity level, so you burn more calories. It sounds cliche to say "Weight loss is mathematics - calories in have to be less than calories out" but it's pretty much true. Other things come into play, certainly, but if you go back to the things you did in the beginning, it's a good place to start. Your doctor will have some great advice, I'm sure. The other thing I highly recommend is to try and find a local support group. Seeing people face to face can be an enormous boost, since you'll see you're not in this alone. Others have been where you are, and their experiences will help get things back on track. If you're alone, it's easy to fall into a rut. The trick is getting yourself out of it. Wishing you only the best success, Dave

Glad to be of help. I found it on sale ($30 off) at Best Buy a few weeks ago for a friend. costco.com also sells them, with a free year's subscription, so it's the best overall price I found. Amazon sells them, too. Check around, and see what you can find. The prices seemed to be pretty consistent. Good luck! Dave

I've had two fills since being banded in December. I'm currently at 7.2cc in a 14cc band. I feel some restriction, some of the time. I can still eat anything, and can easily over eat. I only get stuck if I take large bites, eat too fast, and/or if I don't chew thoroughly. I get hungry after three or four hours, but if I eat something small that often, I don't ever get truly hungry. My weight loss is erratic, where I'll go a week or more without losing anything, then I'll drop a pound or two in one day. I had my last fill February 14th, and I've lost only about five pounds since then, but I haven't lost anything in over a week. I have my "100 Days Since Banding" appointment in three days. I'm scheduled for my third fill that day, if I need it. It's a two hour drive to my surgeon's office from my home, and I need to take the day off work to go there, so I want to make it worthwhile. The question I have is, "Do I need that fill?" I'm thinking maybe a small one, like .5cc or so? Most people I've read about say they find they're at good restriction at around 8cc or so in a 14cc band. I know everyone is different, but I'd appreciate some experienced bandster advice. What do you think? Thanks, Dave

Jess, I have one, and think it's excellent. I have the Bodymedia armband, which is the same as the Bodybugg, made by the same company, Bodymedia.com. Main difference is it also measures your sleep quality and duration, which the Bodybugg doesn't, I believe. They come in several models, with or without external monitors to see at a glance what you're doing throughout the day, There is even a bluetooth version that lets you track on your iPhone or Droid with a free app. All models sync to your computer via a USB cable. It requires a subscription to the Bodymedia website ($6.95 a month.) I use that to sync my armband both from home and from my work computer. Since it goes to the website, the collected data goes to the same place. So when I log in, I can see what's up, no matter where the last sync came from. It's easy. You wear it on the back of your tricep on the arm you don't write with. It's easy to wear, it's easily hidden by your shirt sleeve, and you get used to it quickly. I wear mine basically all the time (except in the shower - it's not waterproof), because it tracks all sorts of movement, calories burned when you're active or resting, and as I mentioned, when you're asleep. (As you may know, good sleep helps with weight loss.) The nutrition part of it is very good. You enter your food intake by meal, either by selecting from their built-in list of food, or by creating your own items. It saves the entries to show you what you ate today, tracks calories, and shows you in graphic form where your calories are coming from (fat, Protein, carbs, and such.) Where the armband really shines is the personal profile. You set up where you are now, in terms of weight, age, and activity level, then set your goals. It will then tell you how many calories you need to burn daily, how much caloric deficit you need, and how many to consume to make your goals. For example, if it says you need to burn 3500 calories in a day to maintain your current weight, and you eat and burn a total of 2500 calories, you have a 1000 calorie deficit that day. It takes 3500 calories burned to lose one pound, so if you keep having 1000 calories a day deficit, then in seven days you'd have a 7000 calorie deficit, which translates to two pounds of weight lost. (I hope that makes sense. I understand it better than I can explain it, I think.) I find having the armband there helps me throughout the day. I can see how much activity I've had, and how much more I need to get in. Steps taken (it has a three- or four-way pedometer built in), activity levels when working out, and caloric intake and expended all are shown in an easy to read format, so you can see at a glance where you are for the day. If you're short on steps taken, take a walk. If you need higher activity, work out for a bit. It tracks it all. It simplifies the process, and about all you have to do is eat right. It'll show you what more you need to do that day to reach your goals. I think the thing I like best about it is that I don't have to worry about things. I check the armband website, and take appropriate action based on what it's telling me. No more guesswork of whether I've worked out enough, or if I've eaten enough (or too many) calories for the day. When I then enter my weight changes, I can see over time what I need to do to achieve weight loss. Easy, breezy. I can't recommend it highly enough. Hope this helps. Dave

Heading home from the gym I wasn't feeling like cooking, so I swung through the drive-through at Wendy's for a cup of their awesome chili. It's approved by my Nutritionist, and tastes really good. Dave