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I work as a nurse and my typical patient is usually elderly, a new post op patient, a recent moderate to severe stroke victim, a bariatric patient who had a bad outcome, an accident victim, and/or a person who has been debilitated for a long period of time. The typical patient is a one person hard tranfer or a two person mild transfer. They weight anywhere from 100lbs to 500lbs, with the average being around 200lbs. They need to be tranferred into and out of the bed/wheelchair/bathroom and lifted and repositioned often while in bed, I work three-12 hour night shifts in a row so lots of this. I am hoping to have my sleeve done during a two week planned vacation, and return back to work about 10 days post op. I will be able to avoid a lot of the lifting by saying that I have had stomach surgery, but there is always times when it is hard to do. For anyone out there that is in a job like mine with this type of lifting, what is the amount of time you took off. I want to let my body heal properly, but at the same time I hate to make my co-workers work a lot of extra days to cover my days if I am off, so I would like to be back as soon as possible. Worse case I can tell my boss that I had the surgery and will only work if there are always two other people there with me, sometime there is only me and another worker. I hate to take this road because there are to many things that can go wrong and it is a major hassle to always make sure everyone hasn't forgotten that I need these needs met. Plus I hate feeling like I am whining or not pulling my weigh, I went through a year and a half of many complications with my lap band so everyone knows I have had these type needs in the past, so I really hate to go down that road once again. Any advice would be welcomed.

I was sleeved 06/13. I had my 1 week post op yesterday... For the stats fans: 5'3" SW: 234 CW: 222 GW: 135 This last week has been utter hell! I have been in a severe amount of pain. I'm so jealous of the people who feel nothing afterward! My left incision is TIGHT and I have a huge bulge because it's so tight. It's swollen and hurts like a SOB. Especially when I go from sitting to standing. YOWZA! But the worst part is the pain with swallowing. Ever since my first baby sip of water on surgery day, I've had pain when I swallow. It is so much pressure and feels like a weight is sitting on my chest. Because of that, I'm not meeting my fluid or protein goals. The most fluid I have had in a day was 46 oz and protein was 32... And that was on my best day. My surgeon said she wasn't surprised I'm having issues because she thought the opening between my stomach & esophagus looked tighter/smaller than it should have been while she was in there. So that pain is because things are getting stuck. The plan is to go back in and have my esophagus dilated, but she wants to wait 4 weeks to give me time to heal. 4 weeks of this pain and exhaustion! Meanwhile, I have a standing order for IV fluids at my local hospital for any day I don't reach my fluid goals and anytime I'm feeling exhausted or just not feeling great. Which is all the time since I'm dehydrated and not getting enough protein! They also said I should wait to go back to work until at least a month or until after this issue has been fixed! I don't know what to tell my boss because I am not telling anyone about my surgery. Even worse... It's a brand new job! My first one after 6 years as a SAHM! I told them during my interview that I was having surgery (not what kind) and that I would need at least 2 or 3 weeks off. They said for the right person, they would make anything work and offered me the job on the spot. They said it was their first time ever hiring someone immediately, but they knew I was perfect for the job and team. That made me feel amazing! But fast forward a month into the job when it was surgery time, they only gave me 12 days off and put me back on the schedule. I told them I wasn't sure if I could come back that early, but that I would keep them posted. They sort of agreed to that... But a month? Now I don't know what to say! My doc provided me a note, but it says 'bariatric surgery' in the company letterhead. I can't use it... I only told 2 people about this surgery... My husband and my mom. And I am not comfortable telling anyone else. I'm sad it didn't go as planned... frustrated that my doc didn't fix it during surgery when she clearly saw it wasn't right, exhausted, and real tired of being in pain! Is anyone else going through this? I feel so alone! Please do NOT comment just to say "I never had any pain or issues!" Or "I'm going back to work 5 days post-op!" Yeah... Congrats. 😏😜😂 I can't tell you how disheartening it is to read all the stories like that. I'm glad for you, truly, but super jealous it didn't go like that for me! So, please don't be salty! Lol!

I liked the idea of dumping too, but it really doesn't happen for me. I can overeat (slightly, I still have a pouch after all!) sugar and carbs, and while I don't feel great, I wouldn't call it dumping. But I'm not that disappointed, although I do need to be more responsible for my eating now that I'm two weeks away from being two years out. It can be a struggle, but when I get back to basics, it's much easier! I have to be honest and say I have been far from perfect and even had weight gain. I'm learning a lot more about why I eat, things I'd never considered before. I admit this is something I've been working on for 30+ years but hey, I'm a slow learner!! And yes, I know I should have done that pre surgery, but I thought I had. Then I had to go back to work after a year of not working (nine months after surgery, and at my goal weight) and it took me a year of being back at work to realize how the compulsive urge to binge is directly related to work stress. Stick with the basics for as long as you can, and if you ever stray or have regain, just get back to basics again. Most importantly, no liquids with meals or 30 minutes before or after (or at least 15 minutes), meet your protein and liquid goals (whatever yours may be) and eat your protein first. That's the rest of your life. I might not be the right person to answer this because I'm still taking two steps forward, one step back getting back on track, but I do know the rules, even if I don't always follow them!! Bottom line? You absolutely have to change the way you eat for the rest of your life. I wouldn't recommend following my path but if you do, don't beat yourself up. Just pick yourself up, and get back to basics asap. And stay plugged in to groups. Socialize with other bariatric patients, in all stages of the journey. You can do this!!

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You can find the BCBS-Illinois medical policy regarding bariatric surgery here: http://medicalpolicy.hcsc.net/medicalpolicy/home?ctype=POLICY&cat=Surgery&path=/templatedata/medpolicies/POLICY/data/SURGERY/SUR716.003_2010-07-01#hlink Their requirements are: BMI greater than 40 OR BMI greater than 35 with two of the listed co-morbid conditions that have not responded to conservative medical treatment Documented Three month supervised, comprehensive weight loss program which includes counseling in dietary, physical activity and behavioral changes. Phsychological Evaluation and Clearance Be sure to confirm with BCBS to make sure that your plan follows this medical policy. There are some plans managed by BCBS-Illinois that are self-funded and are able to set their own criteria for medical necessity.

I am on day 3 of 14 of the pre-op diet. The last two days must be clear liquids only. I am using Bariatric Advantage vanilla w/ skim and some fruit in it in my morning shake, then I have a Syntrax Nectar w/ water around lunch with a salad or steamed vegetables. Then in the evening I have been having Unjury chocolate splendor w/skim and steamed veggies or a salad and a chicken breast only if necessary. I also can have 2 control bars if needed which I think you can only get at the doctor's office. I am hovering around 1000 calories a day with that combination. Today is the first day I didn't have the 2 control bars, I had a half of one this morning and half in the afternoon.

Hi, I am trying to find anyone who has been banded at the hospital in Princeton, NJ. They have a center of excellence designation but I can't find anyone who has been banded there. I would be interested in finding out about the process over there. I am scheduled for surgery and I am having some cold feet about using that hospital. Do they have a section designated for bariatric patients? Did you recover in a room or in a 'step down' area waiting to be discharged? How was the treatment by the nursing staff? I would really feel better if I could hear a surgery day story from that hospital because every place seems to do things differently. Thanks in advance

I am finishing up day one of my preop diet and I have to say it is MUCH better than I thought it was going to be. As part of my fee, I get a one month's supply of shakes and Vitamins. I am drinking Bariatric Advantage chocolate and it is pretty good. I get to add fruit, today I chose strawberries, and so that makes it even better. I have a shake for Breakfast and lunch and then I get a cup of Soup for dinner and one yogurt that I can gave any time of day. I just decided to make my own soup so I made green chili (I love New Mexico) soup with chicken and Beans. It came out great. I bought a bunch of one cup size containers on a whim last year and they are paying off helping me portion all my dinners. I am happy that with a few bumps in the road behind me on my journey, this diet is helping me to stay positive for the weeks to come.

In the B Vitamins, aside from what you get in the multi- it is best to just do a B12- that Vitamin is not absorbed from food in the sleeve. My list is Muti vitamin- look at what is in a bariatric one from Bariatric Advantage or Celebrate and find the equivalent to two of them if you dont want theirs. Calcium - carbonate requires more stomach acids than we have after surgery, so that is why the recommend citrate- you need 1500 mgs a day B12- sublingual is advised- they have this at Trader Joes. Those are the main ones- and you dont want to become low in anything as it really hard to rectify. The thing is, though this is not a malabsorption surgery your intake of food will be dramatically less, thus the need for vitamins. I have heard that skipping this can really lead to low energy, exhaustion, etc. I have also heard it is pointless to pic your Protein shake etc. before surgery as your taste buds change. I have a bunch of samples I will be trying in the next two weeks as I start my liquid diet tomorrow prior to my 5/9 surgery. I have set of a box also- i have my vitamins, my magic bullet for pureeing food, my shakes, my shaker/blender, my crystal light if I want to spruce of the flavor of my Water, etc. This place is a great resource and you will find threads everywhere to add more info. Good luck!

Hey Stac and CCBC, after waiting an hour for him to come to bed last night, I went out to get some water (I already had a full glass.. LOL). When I passed him I said, you not coming to bed? He said oh yeah, just gaming. He quickly shut it off and came right to bed. He was all lovey dovey. IDK maybe he is bi-polar. I was happy he seemed ok. He was really fussing earlier over nothing. Today he is back to himself but I still have to wonder... what the heck is going on with him. I have taken both comments to heart and I will try to be more understanding as well as show more attention. I will see if that works. I just hope that people know losing weight isn't going to make your spouse love you more. If the love is gone, nothing is going to help unless both parties make an effort. I just read The Emotional First Aid Kit for bariatric patients which touches on the whole post op weight loss jealousy. A spouse may be very worried (like CCBC said) about your getting all sexy and leaving them. I have been married 5 yrs and have 2 kids. There is nothing more important to me than family, but emotional abuse is NOT acceptable - no matter what is going on around you. If he does this again, we will need to have a heart to heart.

Hi, I'm new here. I'm sticking a toe in the Water of lap band surgery for all the reasons that have been said on these boards a billion times before. Anyway, Bryn Mawr Hospital is reasonably close to me, and they've had a bariatric surgery unit since 2009. Has anyone gone there? What was your experience like? Any feedback, both positive and negative, is welcome. Thanks.

I'm in the presurgery phase (as a disclaimer), Bryn Mawr is also close to me. I looked into them as an option but was concerned about the number of bariatric surgeries their surgeon has performed. It was far less compared to what other surgeons in this are state on websites. That seemed odd to me. Ultimately, I chose Phoenixville and I am very happy with my surgeon and his team. I also considered UPenn, but I did not want to travel into the city for all my visits. I've heard they have a fantastic program. Good luck to you!

I got th Unury samples , and the Bariatric Advantage samples as well as some nectar samples. Then I also found that the site Vitalady dot com will send you a sample of all these different kinds for a nominal amount (fibro brain tonight so I am not sure how much.) So I now have about 12 kinds to sample! I actually posted in the nutrition section wish I could find some people around my area to get together with to do a taste test. Wouldn't that be fun? I will probably start my You Tube series with the taste tests instead, though of course everyone likes different things so my experience might not be yours. I expect the most pertinent issue will be how s trongly the Protein taste comes through.

I'm wondering if anyone else is having to complete the following checklist from their PCM with Tricare Prime? I'm actually Tricare overseas Prime Remote. I just spent the entire AM on the phone trying to explain that this is not the requirements per the Tricare Manual Chapter 4 Section 13.2. After I couldn't get a clear explanation on how they came up with this checklist through International SOS (3rd party used by Tricare Prime overseas for referrals) I spoke with the regional Tricare office in Germany. I was informed they came up with this checklist so "not just anyone" could get the surgery. I was then informed I could just go to the PCM and have them submit a letter addressing my Hx of attempts, comorbid Dx and etc. But was informed approval was on a case by case basis and if denied could appeal. (Duh Rolling eyes) So aggravated that the requirements are not the same across the board for Tricare Prime. I'm 5'1 and approx 198lbs with sleep apnea. I'm aware that b/c I'm not 100lbs overweight according to Metlife charts I will be denied although my BMI is and has been above 35 with the comorbidity for >5 years. I have tried every diet known to man as I'm sure you all did too. I loose the weight but it never stays off. We have been overseas now for 6 years but I don't have the documentation they are requesting in my medical record b/c we are remote (not at a MTF) and these diets are not covered by Tricare therefore paid for out of pocket. I also recently read in the Fed Recorder that the requirements will change from the Metlife Chart to BMI on 3-16-2011. Anyone else aware of this and have spoken with Tricare in regards to the change. Right now I'm afraid that I've stirred the pot too much and will be denied just for demanding where they came up with this checklist. If anyone has a better contact through Tricare I'd love the name and number. Any advice is appreciated. Wish me luck. I plan on seeing a PCM on the 16th of March and keeping my fingers crossed. Step 1: Patient Review (All items must be checked by the PCM and applicable to the patient) Documented morbid obesity for 5 years. Meets definition; body weight is 100 pounds over ideal weight for height and bone structure, according to the most current Metropolitan Life Table, and such weight is in association with severe medical conditions known to have higher mortality rates in association with morbid obesity; or, the body weight is 200% or more of ideal weight for height and bone structure. List any co-morbid conditions: ________________________________________________________________________________ DEROS date at least 12 months from the anticipated surgical date. Date of DEROS: _____________ Participation in a documented nutrition/exercise program for a cumulative total of 6 months with documented ability to lose 10- 15 lbs within the last two years. (Patient‘s inability to comply with a diet and exercise regimen prior to surgery indicates poor compliance and an increased risk of adverse outcomes) Comprehensive evaluation and review of significant medical or psychiatric history by their Primary Care Manager (PCM), surgeon or mental health professional/counselor indicating good candidacy, readiness for bariatric surgery, and confirmation of positive family support system. Education regarding the need for lifelong follow up. The patient has been advised that TRICARE policy does not cover breast lifts, thigh and arm reduction, and that a panniculectomy must be deemed medically necessary to be covered by TRICARE. Step 2: Post-operative Management Primary Care Manager must acknowledge capability to provide appropriate post operative medical management to include: (all items must be checked in order to be considered for approval): Dietary Counseling Mental Health assessment or referral Laboratory assessment plan for possible nutritional deficiency _________________________________ __________________________

The long-term complications of the Lap Band have been one of my top concerns. I cannot get satisfactory answers from my bariatric program. What they have said to me is, "Do the research." So I did, in peer-reviewed medical journals. And what I'm finding is downright scary, so scary that I'm at the point now where I'm probably not going to have this surgery.

Each person has their own "negatives". I personally had an extensive, exhausting and mentally/physically draining recovery because I was a revision patient with major complications. The negatives for me were: 1) Trying to sip enough early out seemed impossible 2) Taste buds changing 3) Developing a whey protein intolerance and mild lactose intolerance post-op 4) Lack of energy early out, but it was temporary Of course, the positives far outweigh the negatives especially since everything I experienced was over within a few weeks to couple of months, and I have a very normal, active, fun social life. There are plenty of us out here that "get WLS" there's others that don't. Unfortunately, the sleeve only does so much. I still have to be mindful of what I put in my mouth. I can still suck down a 3000 calorie milkshake if I wanted to so the point is making a permanent, and lifelong commitment to better food choices, and to honestly change your relationship with food. The sleeve makes this process much easier. Every WLS has failures even the heavily touted Platinum standard Duodenal Switch. I've read several stories of regain, or DS'ers not getting to goal, and their surgery is far more drastic than even RNY. I take 4 vitamins a day. That's it, nothing major, 2 multis, 2 calcium citrate. Make it a habit, it's really not that big of a deal. To address some of your concerns: 1. Death - huge I know. Ask your surgeon their mortality stats. If it's more than 1% get a new surgeon, and find out the details. 2. A Leak - also very risky. Same as above 3. My head hunger issues will be brought out huge. Start working on it now, get a new coping mechanism in place before surgery, therapy is a great tool especially if you can find someone that works with bariatric patients, along with support group meetings and using online support groups, find a buddy that has surgery around the same time to share ups and downs, get a mentor that you trust, and can talk you off the ledge when you're wanting to take a dive in the pool of caramely goodness of Girl Scout Samoa cookies. 4. My "food to cope" tool will be gone! Same as above 5. possible acid reflux... what's worse being fat or popping a Prilosec or Nexium to prevent reflux? 6. Gaining the weight back Establishing better habits, measuring portions, staying within your caloric intake guidelines is the best options to avoid gain. It's easy to gain weight, I won't lie, but for me, it's still super easy to lose it by following the rules. 7. not really losing anything that's pretty rare, I've read plenty of slow losers, but you have control of how you lose weight. Some do it differently than I did and that's okay, some do not want to give up carbs, I did because I knew I'd lose fast and hard. That's the path I chose, and I couldn't be happier with how I did it. Some have metabolic issues that slow weight loss down, and that has to be taken into consideration as well as activity level, and each individuals needs. One thing you have to remember is that the VSG is not some miracle that is going to cure it all. They operate on our stomachs, not our brains. So, getting ahead of the curve by establishing some good habits NOW will go a long way post-op. Eating slower, chewing your food more, sit your utensil down in between bites, do not drink with your meal, eat protein first, stretch your meal out to at least 20 minutes. Don't sit in front of the TV to eat, focus on what you are putting in your mouth/body and see how your body responds. Best wishes! ! !

I'm new to this site. I've been at lapbandtalk for several months. I've been to the seminar, which covered all the different WLS available. I had my consult and beginning a journey. Due to health problems, I'm having to go through a series of different testing and I have to go on a 6 month pre op diet per my insurance company. My problem is that I have no idea which journey to take. I was so set on lapband but after suggestion from others, including several at the bariatric center, I'm looking into the sleeve. I was just becoming very familiar with all the details of the band and now I have to start over here to learn about the sleeve. I just need to know I'm making the right choices for me. So any advice, tips, info that can be offered..I'd really appreciate it. I know I will be visiting and reading here alot but anything that I need a heads up on would be helpful. Thanks!

I hope your appeal goes through. I understand your frustration. The requirements through Tricare changed on 2/14/11 to the following: Check out the Federal Registrar to see if this may help your case. I spoke with the Tricare director in WA and was told the change was effective 2/14 but Tricare reps might not know about the change for a few months. http://federalregister.gov/a/2011-3207 Show citation box (A) Payment for bariatric surgical procedures is determined by the requirements specified in paragraph (g)(15) of this section, and as defined in § 199.2( of this part.Show citation box ( Covered bariatric surgical procedures are payable only when the patient has completed growth (18 years of age or documentation of completion of bone growth) and has met one of the following selection criteria:Show citation box (1) The patient has a BMI that is equal to or exceeds 40 kg/m 2 and has previously been unsuccessful with medical treatment for obesity.Show citation box (2) The patient has a BMI of 35 to 39.9 kg/m [2] , has at least one high-risk co-morbid condition associated with morbid obesity, and has previously been unsuccessful with medical treatment for obesity.

Bariatric advantage, premier protien shakes from costco and Maxx... all have under 2 carbs and about 30 grams of protien.

One thing that gave me comfort about going through Kaiser is they have never had any deaths since they started their bariatric program. But, they attribute this to carefully screening their patients to make sure they're healthy. So, if you're in good health overall, and have co morbidities under control, you should really have little to worry about.

I have Kaiser, mine was 43 and I had 2 cormorbidities. However, I lost 55lbs pre-op and my BMI went down to 37, but they still did my surgery and here are their requirements: To be referred for bariatric surgery, candidates must be at least 18 years old and must have a: BODY MASS INDEX (BMI) >35 WITH SPECIAL CIRCUMSTANCES As recommended by the appropriate specialist to the Regional Bariatric Medical Director or designee and approved by the Director or designee BODY MASS INDEX (BMI) 40 - 49.9 With one comorbid condition from Category 1 - OR - Any two comorbid conditions from Category 2 - BODY MASS INDEX (BMI) 50 OR GREATER No comorbid conditions required. Hope this helps you!! Kelly

I'm here in San Diego and was sleeved on 1/31/14. My surgeon was Dr Zorn with Pacific Bariatric. He's awesome and really encouraging. My highest weight was 251 and I'm now stuck at 185 for some reason. It's a little discouraging so I came here t see who else was having the same hiccup with weight loss.

I had a feeling you would say that (that it is difficult living without the band). Its been pretty easy so far with my food but I think its only been a few weeks since my band was taken out and my stomach is still swollen. I can tell that I can eat more than I used to (little restriction) but I also have little appetite and no cravings (thank goodness). I will investigate this new band you talk about and see if my bariatric surgeons use it or not. I think you are in Australia? I am in California in the US so the band has not been around as long as it has been where you are located so maybe they are more advanced than here. I also heard from someone from this site about doctors suturing not only the port area to the stomach but also suturing the band to the stomach. Have you ever heard of that? Maybe this would help slippage. Maybe the new band solves the problem of erosion and slippage. I was wondering how your port healed after it was taken out? The area were my port was located has been accumulating Fluid and has scar tissue. Its like the size of a small egg. Its very hard. I can't sleep on my stomach like I used to because of the pressure of laying on this area. My doctors have told me that this is common and have been to the doctor twice for them to take the fluid out. It feels like a fill or unfill when they withdraw the fluid. They told me if it continues to fill up with fluid, they could be a drain in it. Its slowly getting smaller so maybe my body will accumulate it eventually. Thanks for sharing your experience. Good luck to you! Please keep us posted on what you decide to do. You will be helping not only me but others that are trying to figure out what do without their band.

Is he from a Center of Excellence in Bariatric Surgery ? You might want to check the Ins. Like I said, because, they could require a COE only ! You need to find out.

When I went to my Bariatric classes, I was told that this is not a problem with gastric surgeries ( Roux n y, gastric sleeve and lap band) because in part of all the fluid we have to drink ( 64 oz) and the body's need for extra protein to heal and maintain now that be eat less. I don't think the grams of protein will be a problem, but, you should ask you doctor. You will be monitored though with blood lab work and one of the labs measures the amount of protein. Kidney function is also monitored. If either is too high, your doctor would and should know and adjust your diet accordingly.