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I had been obese since I had my first son at the age of 18. I would lose weight and then gain it. When I was 24 years old I wanted to get RNY but then I got really scared and didn't go through with it. 2001 I lost my mother to Breast CANCER. she was only 40 years old. She left 5 kids behind 2 were under age. I was able to get custody of one of my brothers but the youngest one his father sent him to Dominican Republic. We lost contact with him. I was depressed I was 22 years old with 2 kids of my own and my brother. Living at my in laws house. I just started to eat so much.. My weight just started to go up.. 2005 I decided to try to lose weight. I was eating right and exercising. I lost weight but not what I needed to lose. a year later i got pregnant with my 3 baby. Of course I gain all the weight and more. I was so depress but I couldn't stop myself I just kept on eating the wrong food. On 2011 around September or October I started researching weight loss surgery. I wasn't sure if my insurance would cover it. Somehow I got to the website of the New York bariatric group. I asked some questions. They answered me right away. He asked me questions and said I was a good candidate for weight loss surgery. He asked me if I wanted to go in to speak to a surgeon. I said sure they gave me an appointment for November. I meet my surgeon and they did a couple of test. He told me that I can get surgery. He explained to me the 3 different one that the insurance covers. I decided to get sleeved. By feb. 2012 I had seen all the doctors and got clearance from all. I went to see the surgeon and decided to get surgery March 6, 2012. I had my sleeve it was a little rough the first month but it was the best decision. In a year and 8 months after I was able to renew my vows. Before surgery I wore a size 22-24 the day of my wedding my wedding dress was a size 4. I went from weighing 278-123. I was really thin I asked my surgeon if I can gain 15-20 pounds. He said to becareful but we kept tracking everything to make sure my weight gain wouldn't get out of control. While tracking that I was having a lot acid reflux problems since 3 months after I was sleeved. My surgeon did a hiatal hernia repair 02/2013 to see if I would get some relief but it didn't work. So January 26, 2015 my surgeon decide to revised my sleeve to a RNY. Now I am recovering from my RNY. I feel so much better. I got immediate relief of acid after RNY also lost 12 pounds from the 20 i gained. I feel great

Wowzers. Didn't realize it could be so costly. Luckily in Alberta it was covered entirely by our provincial health plan. I had looked into banding in Great Falls Montana and it was $15000 US. Glad someone informed me of our renewed policy covering bariatric surgery here. Plastics however will not be covered so if I do that I will have to self pay.

Hi. I was scheduled in OCC with dr Ariel Ortiz in July. They’ve been closed throughout the pandemic. Now that they’re re opening in July they came out with a tremendous amount of new requirements that are making it very difficult for me. (For example need to be there 2 days before surgery) I’m strongly considering switching to Tijuana bariatrics with dr Garcia or renew with one of their doctors. what are your thoughts? I’m so confused. 🤦‍♀️ I just want this done already!

On December 11, 2012 I had my first appointment with the bariatric surgeon who would, four months later on March 20, 2013, install a lapband around my stomach. This decision and surgical action was major and dramatic, but I was sad and desperate as well as exhausted, defeated and no longer willing to buy into the fallacy that I could do this without surgical intervention. So I lay down my previous weapon: the cycle of "traditional" dieting which I had been believing in and paying into since I was 14 years old. Traditional dieting was so clearly not working for me; I had lost and regained weight my entire life and I no longer had the energy to do one more round at Weight Watchers, filling up on salads and bulky foods to keep my hunger at bay, gaming the points program so I could work in a dessert each day, hanging on by my fingernails from one meal to the next, and fearing vacations, birthdays, holidays, as I knew these would either see me feeling frustrated and deprived, or overeating because "hey, I've already gone over my points. Might was well start back on Monday." I had done hours of research and had a good idea of what lay ahead. I had a few fears as a pre-op, notably the fear that I would no longer be able to "eat as much as I wanted" when I wanted. I also feared the surgery itself (I try and stay out of hospitals as much as possible) but I was willing to override these anxieties to become one of those people that I see here, on this forum: a success story, transforming myself inside and out. I had made a list of why I was doing this and I brought that to the hospital where, the night prior to the intervention, I read and re-read my hopes for this surgery. I was ready, peaceful and in a mindset of self-care when they wheeled me to the OR the next morning. I am now 8.5 months post-op, almost 50 pounds lighter than I was on the day of surgery. It goes without saying that I am happy to have back a more aesthetically-pleasing exterior, renewed energy and mobility, and a load of self-confidence. My original fears about surgery were unfounded: the lapband gives me a physical restraint to overeating, certainly, but it also has an effect on my brain and how I view food now. ( I call it the nicotine patch for the stomach as it dims the appetite much like the patch works for smokers.) I should not have worried about missing the ability to stuff myself, as that is of no interest to me today. (Just the thought of that makes my band tighten!) I am free from the dieting mindset that I must seek bulky, filling foods or I'll cave and break my "diet" because my lapband clicks in and gives me satiety when I eat my small portions of lapband-compliant foods. I don't have to log points or calories, and restaurant dinners, parties, vacations or holidays are not viewed as opportunities for white-knuckling deprivation or, alternately, opportunities to go off my eating plan and eat all the cake, Cookies and candy that I can, "until Monday." I have experienced so many unexpected benefits as the result of my decision and the most striking is this wonderful sense of fierceness that I now have. I feel so strong, capable and confident! This fierceness has manifested itself in many ways. Physically: alongside my daily dedicated exercise, I now do aquagym and ride my bike each weekend when I'm out in the countryside--26 km logged last weekend through the fields of Normandy! Mentally: I travel out of my comfort zone--last month I went to Morocco, a place I'd always dreamed of going to. Professionally: I seek opportunities to speak publically and am involved in more professional conferences, meeting others in my field which has the effect of re-energizing my own committment to my job. I am so grateful that I did not try and convince myself to give Weight Watchers (or another diet program) "just one more try" last year. I know as surely as my heart is beating that I would weigh more today than I did last year at this time had I not had surgery. Instead, I am looking towards this Christmas season in deep gratitude for my self-care, not fearing the supermarket aisles filled with chocolates, buttercream buche de noel (that was a real binge food for me pre-surgery), and special holiday foods. I know that I will eat peacefully, enjoying my small portions of delicious food, and I won't be waking up on January 1st feeling fat and guilty, and embarking on another futile attempt to diet and "do it for good this time."

I honestly think that this is where that support team that is part of many bariatric groups comes in. We need help seeing our selves as who we have become as much as we need that help in transitioning into who we are becoming as we lose the weight some of us have had for most of our lives. I was worried about the sunken in face, and the jowls that might come and the wrinkles that might suddenly appear as the weight came off. Sure I see the sag, and I see the wrinkles and yet I feel amazing! I am not 20 years old anymore, but I feel once again like I have a renewed vigor for life. I have lost a small child, it's no longer on my back and the load is lighter. I am moving around more and getting out more and feeling better then I have in years. I earned the sag and the wrinkles, they came from living. If they bother me enough I'm going to fix them since we live in a world where that is possible, why not? I didn't start this Quest with perfection in mind, just health and happiness!! I hope you all are finding that today as well!

Both sleeve and rny remove that grehlin secretions...however and vets will tell you many, maybe most get it back down the road. It is why developing good habits are important during the honeymoon phase when it is gone. Our bodies are smart and figure out how to renew those connections, my advice to anyone contemplating bariatric surgery is to go on YouTube and watch every video dr. Matthew weiner has produced. Very informative and research based.

I am sorry to hear your frustrations as well. It doesn't sound like your doctor is giving you a lot of information to work with. I would strongly recommend you meeting with a nutritionist or dietician that is familiar with lapband surgery and get some ideas on meal plans. I will tell you that potatoes and Pasta don't work well for many of us. I am able to eat almost anything except those things and scrambled eggs. I feel like if you had specific ideas of what you can eat, etc you may feel less frustrated. There are also books on the band and recipe books. If there is a nutritionist you could see through your surgeons office they would have insight into the band. My bariatric center has them on staff and they have given me a lot of great ideas and even on how to eat overall. I am able to eat steak, ground meat (love chili), chicken, ham, etc. I feel like I can pretty much eat anything except starchy foods (incl. doughy bread) and the scrambled eggs. I really don't feel deprived at all. Truly. I hope the New Year brings renewed success w/ the band. You have done a great job so far.

Today marks 3 months since I was re-born into this brave new world! And since that day, I cannot even begin to enumerate the exponential feelings of wellness and hopefulness that have begun to saturate my life. My goodness, I knew I needed help, but I had no idea how much of an addict to food I really was, and how every aspect of my life was somehow either tied around food, or mitigated by food, most of the time in negative nonsensical self-harming ways! Never in my wildest dreams could I have imagined, or even supposed in my defeated mind, that I could come so far in so little time! But here I stand, 3 months later, half way there, 54lb’s lighter, working out north of 1 hour every day (no excuses and I love it, and actually look forward to it!), no longer prediabetic, experiencing wellness, dancing around with my kiddos with giddy abandonment, full of energy, wanting to take pictures again, with a renewed sense of self-worth, with a focused mind, doing a double take at that lady in the mirror, being more in control and feeling so positive about most of my food choices. Friends, there is a brand new energy that I oscillate with these days, and there is an inner joy about me that I forgot I was even capable of experiencing. I have spent today with a heart full of gratitude to God, I think that is most of what I feel today. Grateful that I have been rescued from what was not only a miserable, but a horribly unhealthy, sunken life. That I came through surgery and could see the faces of my kiddos again! For the amazing friendships I have made along the way on Bariatric Pals, without whom this journey would have been an infinitely lonelier one. You know who you are…thank you!!! All this…and I’m only half way there!!! I’m more motivated and pumped than ever before. So I wanted to share this with you, thank you all for your love, encourage you in your journey (especially if you were like me, so torn about the decision to do or not to do!) and invite you to let me know where you are in your journey, your thoughts and laments around 3 months, or before or after! Just a collective pause to savor the goodness J Sending you Sunshine! Ellie

I've had a minor set back. My knee was causing me pain, so I took a month off. I went to a doctor then was referred to a specialist. Looks like I need surgery. My patella has arthritic growths that are digging into the soft tissue beneath. Good news is that it is not related to my lifting. Bad news is that he said it was "maturity related". I.E. he called me old! I have started lifting again, but with a renewed focus on my form. I must have been getting sloppy before because I don't seem to have the pain after deadlifting nor squatting. But I played volleyball with my daughters and that inflamed it pretty bad. Surgery will need to happen, but I want to push it off as long as I can. Since you are trying to lose weight again, are you following a bariatric diet currently?

I have BCBSNC (State Health Plan)...and I have to do to the 6-month medically supervised weight loss visits, too. I called BCBSNC yesterday and they stated that all BCBSNC policies that support bariatric surgery have went to that rule due to Medicare changing their rules (NC changed with them). I'll most likely be going to Duke Raleigh Hospital for mine, and my surgeon said he hopes that when the plans come up for renewal on 12/31 that the policy will change back and the 6 months of visits will no longer be required. *fingers crossed* I've actually thought of having the surgery down in Mexico due to the wait and the cost being about the same. Still considering it, actually.

A beautiful way to give yourself the gift of better health, a thinner body and a renewed Life Future! If. any of you want to talk more, I can give you the perspective of someone 10 months out from a RNY bypass, 125 pounds lighter, many dress sizes smaller, it hasn't been picture PERFECT a recovery but It Is What It Is, it's My Story and the Last Chapters are not yet Written, for I Am Still a WORK IN PROGRESS. And I am still grateful to my surgeon, facility, and most of all , to My God who has brought me yet this far. I'm usually positive, optimistic , been through a lot in my now 73 years of life, I live in almost in the Exact Center of my state -OHIO so just wanted to Welcome You All to Bariatric Pal, I believe you will meet a wonderful bunch of People here!

Insurance contracts are pretty specific about what they will and will not approve. If yours specified that you had to be above a 40 BMI for a specific time frame, then an appeal likely won't help. BUT, do read the contract carefully. It may make allowances if you have comorbidities---and your doctor might be able to make a case on that basis. Failing that, the place to go for help is your HR department. They renew insurance contracts annually, and they're the ones who are really holding the purse strings. If you ask (pressure!) them to make their coverage of bariatric surgery less exclusive, it can really make your life lots easier.

I'm not completely sure. I've just started reading their website. Below I've copied the info from their home page. It's suppose to bring the band back to new tightness.... I've been banded a year and only have lost 20 lbs.. I'm so frustrated so I'm willing to try anything to help. Hope below helps explain.... The 5 Day Pouch Test by Kaye Bailey Does my pouch still work? Have I broken my pouch? Have I ruined my tool? These are questions many weight loss surgery post-ops find themselves asking occasionally during their journey. Perhaps it feels like we can eat more food or we know that we are eating more food. Sometimes these questions are asked when there has been a weight regain. This is the 5-day plan that I have developed and used to determine if my pouch is working and return to that tight newbie feeling. And a bonus to this plan, it helps one get back to the basics of the weight loss surgery diet and it triggers weight loss. Also, it is not difficult to follow and if you are in a stage of carb-cycling it will break this pattern. Sounds pretty good, right? Order the 5 Day Pouch Test Owner's Manual The 5 Day Pouch Test should never leave you feeling hungry. You can eat as much of the prescribed menu as you want during the day to satiate hungry and prevent snacking on slider foods and/or white carbs. You must drink a minimum of 64 ounces of water each day. A reduction of caffeinated beverages is suggested, but do not stop caffeine cold turkey. Weight loss is not the intent of the 5 Day Pouch Test, however, many who have tried this plan report a significant drop in weight. More importantly they celebrate a renewed sense of control over their pouch and eating habits and easily transition back to a healthy post-surgical weight loss way of eating. Understanding Hunger, Appetite and Satiety Below you will find a brief list of the menu for each day. Please click the "Read more" links for further detail and hints and tips that will enable your success with the 5 Day Pouch Test. Days One & Two: Liquid Protein low-carb protein shakes, broth, clear or cream soups, sugar-free gelatin and pudding. Read more. Day 3: Soft Protein canned fish (tuna or salmon) eggs, fresh soft fish (tilapia, sole, orange roughy. Read more. Day 4: Firm Protein ground meat (turkey, beef, chicken, lamb), shellfish, scallops, lobster, fresh salmon or halibut. Read more. Day 5: Solid Protein white meat poultry, beef steak, pork, lamb, wild game Read more. Good luck! I believe you are going to like the results when you give this plan an honest try. Cheers! Kaye Bailey Days 1 & 2 | Day 3 | Day 4 | Day 5 Article: Slider Foods Spell Weight Regain For Weight Loss Surgery Patients Soft processed carbohydrates, slider foods, are the bane of good intentions and ignorance often causing dumping syndrome, weight loss plateaus, and eventually weight gain for gastric bypass, gastric band (lap-band), and gastric sleeve bariatric patients. Learn what slider foods are and why they cause weight regain for weight loss surgery patients. Read Article LivingAfterWLS General Store LivingAfterWLS | LivingAfterWLS Blog | LivingAfterWLS Neighborhood Home The Plan Recipes FAQ's Featured Articles Video Broadcasts The Store Blog Neighborhood Testimonials Tools Follow Us Share on facebook Share on twitter Share on youtube Free Monthly Email! 5DPT Bulletin For Email Marketing you can trust copyright 2007 - 2012 LivingAfterWLS, Ltd. Liability Co. ~~ All Rights Reserved.

The Back Story In February of 2012 I was diagnosed with “complex endometrial hyperplasia with atypia”. Basically, pre-cancerous cells of the uterus. My gyno said at 40 it was a slim chance of my getting pregnant and I should have a hysterectomy. I asked him if my chances of getting prego after WLS would increase and he said that my egg condition would probably decrease even more and it would be a miracle if I got prego. At this time I had decided already to get the sleeve and was not sure what to do about the hyster. He said if I was not going to schedule the hyster very soon I should come back in 6 months and have another d&c to test my endo cells. In june I decided to meet with another bariatric surgeon, Dr. Cribbins in Dallas, for 2 reasons. His pre-op diet was NOT liquid only, and he did surgery with the davinci robot (less pain, faster recovery). I had the thought that maybe I could get both the WLS and the hyster at the same time, with one recovery and one bout with hair loss. He said that would not be a problem and referred me to a gynecological oncologist who he worked with before that sends his patients over for the sleeve. Today, July 11, I went and met with the gyno onco, Dr. Heffernan of Dallas, FULLY expecting to hear you need a hyster and we can do it at the same time as WLS. Well, he unexpectedly threw me a curve ball….. This is basically what Dr. H said: “Women who are obese produce an ongoing, UNOPPOSED stream of estrogen. This stream of estrogen over a long period of time changes our endometrial lining when it is not opposed by progesterone. “ So basically, some endo cancers are caused by obesity. He has had people with my same diagnosis, get RID of their abnormal endo cells and have no cancer or pre-cancerous cells! He has had women with endometrial CANCER, get cured of the cancer!!!!!!!!! What is the combination? Progesterone treatment (megace orally or mirena iud) and weight loss (recommends the sleeve)! Why weight loss? Because we lose that overabundance of estrogen created from being fat or from PCOS. He said that getting the sleeve is the best medical intervention life saving/changing thing I could do. I heard everything he said but did not process it until during my 1.5 hour drive home. I could possibly not need a hysterectomy and may not have to slam the door shut on having a child???? And, not develop cancer???? I thought my choices were, get hysterectomy, or get cancer. He gave me a 3 month scrip for megace and said it was possible by the time I had my hysterectomy my stuff could be all cleared up. Say what??? This morning when I woke up I was convinced I was going to be getting hysterectomy and sleeve in the same shot late august early sept. Now it looks like I will be getting a endo biopsy/d&c in a month, and if it is not WORSE then what I had in January, just getting the sleeve and maybe an IUD. And who knows, a year from now maybe I will be pregnant. In my 20 years of being Fatty McFatterson, I NEVER had heard that obesity was/or could be directly related to endometrial/cervical cancers. Now I am obligated to let many people know!! I REALLY hope this long (poorly written cuz it is late and my mind is racing and tired) post can help someone in their decision to change their health!!!!!! With renewed HOPE, Crystal

Today marks 3 months since I was re-born into this brave new world! And since that day, I cannot even begin to enumerate the exponential feelings of wellness and hopefulness that have begun to saturate my life. My goodness, I knew I needed help, but I had no idea how much of an addict to food I really was, and how every aspect of my life was somehow either tied around food, or mitigated by food, most of the time in negative nonsensical self-harming ways! Never in my wildest dreams could I have imagined, or even supposed in my defeated mind, that I could come so far in so little time! But here I stand, 3 months later, half way there, 54lb’s lighter, working out north of 1 hour every day (no excuses and I love it, and actually look forward to it!), no longer prediabetic, experiencing wellness, dancing around with my kiddos with giddy abandonment, full of energy, wanting to take pictures again, with a renewed sense of self-worth, with a focused mind, doing a double take at that lady in the mirror, being more in control and feeling so positive about most of my food choices. Friends, there is a brand new energy that I oscillate with these days, and there is an inner joy about me that I forgot I was even capable of experiencing. I have spent today with a heart full of gratitude to God, I think that is most of what I feel today. Grateful that I have been rescued from what was not only a miserable, but a horribly unhealthy, sunken life. That I came through surgery and could see the faces of my kiddos again! For the amazing friendships I have made along the way on Bariatric Pals, without whom this journey would have been an infinitely lonelier one. You know who you are…thank you!!! All this…and I’m only half way there!!! I’m more motivated and pumped than ever before. So I wanted to share this with you, thank you all for your love, encourage you in your journey (especially if you were like me, so torn about the decision to do or not to do!) and invite you to let me know where you are in your journey, your thoughts and laments around 3 months, or before or after! Just a collective pause to savor the goodness J Sending you Sunshine! Ellie

Great ideas and great recommendations, thank you all! Eating slower is something I've become painfully aware of this past week, especially. I always drink with my meals because it helps me get down food faster -- a full lunch with a Protein + 3 veggies will take me about ten minutes to finish because I eat so fast! I've started moving my Water away from me when I eat and counting the chews (at least 20) to slow me down. That's something that will take me awhile to get used to. I haven't specifically been told to cut out my caffeine by my doctor and NUT. I have one 8 oz coffee every morning, but I have been alternating it with tea. Is cutting out caffeine something that is advised by most surgeons? I know it can increase cravings, but it's never had that effect on me and I drink it in moderation, so I've never worried about it before. I've always continued it through other diet plans. Water.. is a continuous battle as well. I never get enough water, but, I've been working on always keeping some in front of me to get used to slow, continuous intake. Sips, as is recommended after surgery. MyFitnessPal is always a must.. ninjarutabega if you want to follow Prayer.. also a continuous battle. A will and living will is a great idea. I haven't pursued these things before. I've started looking at broths and mixes that look good to me, including instant miso, swanson's, and dissoluble Fiber. Going back to Netflix to watch anything having to do with weight and dieting.. including re-watching Fat, Sick and Nearly Dead as well as the All of Me bariatric special. Exercise... working out a plan. Bought a fitbit yesterday to track and increase my steps, and act as a silent witness as I climb stairs at work. Visiting planet fitness sometime this week to renew my membership and begin a cardio routine. Trying not to obsess but both enjoying and hating the anticipation @@Dub Those numbers are killer, congratulations! I'm settling in somewhere between 160 and 175 as a goal weight for myself. it's still kind of a dream to realize this time next year, I could be close to that.

Best thing I ever did, its worked really well for me. I have had to work with it, but I wanted to change my lifetyle and it helped me to do that. One thing I will point out - a lot of general practioners have sketchy knowledge of the lapband at best, so do your own research, make up your own mind and dont be discouraged by her views on it. The only person to really advise you is the surgeon. My GP was supportive and thought it was a good idea, had to look up bariatric surgeons to find one to refer me to. When I went back a year later for a renewed referral (necessary after 12 months in Australia) he asked me if it was time to have it removed! I was a little floored, to say the least, how could he have been so supportive if he knew so little?

Hi all, I am new to this group but looking forward to participating. Here's my story in a nutshell: I had a Realize band placed in February of 2009. My starting weight was 268. The band was fantastic and I lost weight steadily, with the exception of a few months when I realized how easy cookies were to eat. In December of 2010, I hit the 100 pounds lost mark, I also found out I was pregnant that same week. At about 4 weeks pregnant I had a really nasty 3 day stomach flu. A few days after recovering from that, I started throwing up again. I could keep food down for a few hours, but it was all coming back up. I lost another 15 pounds in 2 weeks. I thought it was just severe morning sickness, even though in 5 previous pregnancies I'd never had morning sickness. I saw my Ob who told me to immediately get my band unfilled and if I was still throwing up the next day he'd have to admit me into the hospital. I got a complete unfill and immediately felt better, but with no restriction and absolutely no mental/physical/spiritual preparedness for no restriction, my love affair with all things bread and pastry renewed like we were never apart. I gained 40 pounds in the first 4 months of my pregnancy. I managed to gain back a little control, but ended up gaining about 60 pounds before I had my daughter in August of 2011. The weight gain took a great emotional toll on me, but I just knew that 6 weeks postpartum I'd get a fill and be right back on track... You know where this is going, right? In October of 2011 I got my band refilled. Pre-pregnancy, my fill level was at 7.2cc in an 11 cc band. We filled it to 3.5 cc and 3 weeks later filled it to 5 cc. I had very little restriction and it just didn't seem right. I'd also started getting heartburn. I went back a few weeks later and we filled it to 5.5. That lasted 24 hours, I had to go back in for an unfill and we went down to 5.2 so I could get water down. I still didn't have much restriction, but I did have terrible heartburn and vomiting in the middle of the night. I lived with this for a few months until I couldn't stand it and went back in and had .5 cc removed. This made the heartburn manageable with daily meds and tums always at hand, but there was no restriction. I could eat all the bread, pasta, rice that I wanted. I knew I had a slip, but didn't have insurance to cover bariatrics, so I lived with it. I tried eating less, exercise, weight watchers, even a juice fast but I've gained 20 more pounds on top of the baby weight. Fast forward to now and I finally have insurance to cover bariatrics. I went in a few weeks ago and had my upper GI. It showed a slip above the band, virtually my entire stomach is above the band, which is why there is no restriction felt, but the band was so tight that flow into the rest of my digestive tract was severely restricted. Food just sat there for a really long time, and the results of that we're just kind of gross. We unfilled the band completely to see if the slip would fix itself, although, we all knew what that result would be. The pregnancy hadn't caused the slip, the stomach flu had and 9 months of an empty band hadn't helped it unslip. I got that confirmation this week. My band is still slipped and the restriction is still severe even empty. I'm frustrated, but quite relieved that there has been a real issue this whole time and it wasn't just me. We're now going through the process of getting insurance approval to revise to a sleeve and I couldn't be happier.

Hi Everyone, I just wanted to introduce myself as "Pixie Dust." I just attended my first seminar in making a decision which WLS is best for me. I have decided on the Sleeve. I had a one-on-one with a Bariatric Nurse yesterday & have an appt with my family doc on Friday (to renew my meds), so will bring the blood work order I received from the nurse, to see if my doc would like to add anything else to it, since he sends me every 6 months for lab work. Then hopefully have my blood work done on Saturday morn. Monday I go for my psych eval...it was just moved up from from a month from now, since I've made it clear that I need my surgery sometime in the summer time due to my children's school schedule. If I can't have surgery this summer, either I will go to another hospital in search of a summer appt or wait till the following summer. Please wish me luck.! Next month I have an appt with a physical therapist to show me which exercises I can do safely due to my knee being bone on bone & needs to be replaced (but holding off as long as I can!) I've been overweight most of my life, but not morbidly obese like I am now. In my early 30's I lost about 100 lbs on WW, which made me feel great & look great. Unfortunately, over the years, I've added almost the entire amount back. I have tried to diet but it's so much harder to lose weight the older you get & I'm done with the struggle. I suppose after surgery, I'll have a different type of struggle, like trying to figure out what I can eat safely & trying to stick with healthy foods. My child with autism keeps begging me to lose weight so I won't die. How about that for a reality check? So I have no choice but to do this. I won't lie, I'm very scared regarding the surgery. I'm scared if I will feel a lot of pain, if I end up with a blood clot, if I can't cope with my lifestyle change. What will I do as I'm an emotional eater? How will it feel cooking for my family when I can't eat (I'm thinking liquid diet here, let alone post surgery!) ? Are these normal fears? Am I even too old to do this?? I'm in my early 50's. I've also wondered "why didn't I do this sooner" as I see pics of people on this site who have had the surgery done. Will I have regrets for any reason? Guess that about sums me up! If anyone has any advice, please share it with me! ~ Peace

Hello. This is my first time here. I attended a seminar about banding it sounds interesting. Aetna, our insurance carrier, would rather I get Roux-En-Y, but will pay for banding if I have liver or respiritory problems, or abdominal adhesions. I have adhesions, but can't prove it. Here is Aetna's reasons for wanting GB, over LB. Please share your thoughts. Laparoscopic Adjustable Silicone Gastric Banding (LASGB or LAP-BAND): Recent advances in laparoscopy have renewed the interest in gastric banding techniques for the control of severe obesity. Laparoscopic adjustable silicone gastric banding (LASGB) using the adjustable LAP- BAND, has become an attractive method because it is minimally invasive and allows modulation of weight loss. The claimed advantage of LASGB is the adjustability of the band, which can be inflated or deflated percutaneously according to weight loss without altering the anatomy of the stomach. This method entails encircling the upper part of the stomach using bands made of synthetic materials, creating a small upper pouch that empties into the lower stomach through a narrow, non-stretchable stoma. The reduced capacity of the pouch and the restriction caused by the band diminish caloric intake, depending on important technical details, thus producing weight loss comparable to vertical gastroplasties, without the possibility of staple-line disruption and lesser incidence of infectious complications. However, distension of the pouch, slippage of the band and entrapment of the foreign material by the stomach have been described and are worrisome. The published results of LASGB have been highly variable, perhaps reflecting surgeons' relative lack of experience with this new bariatric surgical procedure. Several studies have reported high rates of complications associated with gastric banding include those associated with the operative procedure, such as splenic injury, esophageal injury and wound infection, and those occurring later, such as band slippage, reservoir deflation/leak, persistent vomiting, failure to lose weight and acid reflux (see e.g., Gustaavson, et al. 2002; Victorzon and Tolonen, 2001; Holeczy, et al., 2001). In studies reported to the FDA, 89% of patients experienced at least one side effect. These included nausea and vomiting (51%), heartburn (34%), abdominal pain (27%), and band slippage or pouch enlargement (24%). Nine percent of patients needed to have another operation to correct a problem with the device. Twenty-five percent had their entire Lap-Band Systems removed, mostly because of adverse side effects. In about one-third of those patients, insufficient weight loss was also reported as a contributing factor to the decision to have the Lap-Band removed. One of the claimed advantages of the LASGB procedure is its reversibility. Kellum (2003) noted, however, that “[t]he fact that two deaths in the FDA study occurred immediately following bend removal (one each from 'mixed drug intoxication' and multiple pulmonary embolism) suggest that secondary operations always carry significant risks.” In addition, the long-term safety of LASGB is undetermined. Kellum (2003) notes that one of the reasons that surgeons may want to proceed cautiously before adopting LASGB is the concern about the long-term problems related to apposition of a foreign body with the gastrointestinal tract. “Older surgeons will recall the many reports of migration and erosion associated with the Angelchick prosthesis for the treatment of esophageal reflux.” Several recent reports have detailed problems with LASGB slippage and erosion (Holeczy, et al., 2001; Silecchia, et al., 2001). Gustavsson & Westling. (2002) provided one of the few reports on the long-term outcomes with LASGB, and concluded that this procedure “will not stand the test of time.” The investigators reported that, after a median follow-up of 7 years, 58% of the patients who had undergone LASGB had been reoperated on, almost always with excision of the banding system and conversion to Roux-en-Y gastric bypass (RYGBP). The reasons for reoperation were esophagitis, band erosion, pouch dilatation, leakage from the balloon, and esophageal dilatation. A lower incidence of band erosion has been reported with the so-called Swedish adjustable gastric band due to the relatively lower pressure exerted on the stomach (Ceelen, et al., 2003). The Swedish adjustable gastric band has not been approved by the U.S. food and Drug Administration, and is currently under investigation. Although the Swedish adjustable gastric band offers the possibility of significant technical improvements over LASGB, it still represents a purely restrictive operation like the vertical banded gastroplasty, which most U.S. surgeons have abandoned in recent years. Because of the lack of direct comparative studies, the comparative efficacy of LASGB with established methods of obesity surgery is undetermined. In studies of laparoscopic adjustable silicone gastric banding reported to the FDA, the mean excess weight loss was 36.2% at 3 years. This figure contrasts with a 40-60% excess weight loss reported in other series of VBG and 50% for RYGB. (Maclean, et al., 1990; Willbanks, 1987; Melissas, et al., 1998) and 50% for gastric bypass (Griffen, et al., 1987; Pories, et al., 1995). Kellum (2003) notes that multiple reports have demonstrated the superiority of RYGB over VBG. Since LASGB, like VBG, is a purely restrictive operation, “one would expect that laparoscopic Roux-en-Y gastric bypass would yield superior long-term weight loss results when compared to laparoscopic Lap-Band placement.” Kellum (2003) cited the report of Belachew and Monami (1996) that concluded that LASGB had an identical weight loss curve to the open VBG performed by the same surgeons. Kellum (2003) concluded that “t is obvious that only a prospective, randomized series would definitively establish which operation is best in terms of safety and efficacy.” Investigators from the Medical College of Virginia, one of the eight original U.S. centers performing LASGB, published their results. (Demaria, et al., 2001). The investigators “did not find LASGB to be an effective procedure for the surgical treatment of morbid obesity.” At the time of the report, LASGB devices had been removed in 41% patients, either because of inadequate weight loss or intolerable side effects. In 71% of patients with bands in place who underwent long-term evaluation, a significantly increased esophageal diameter developed; of these, 72% had prominent dysphagia, vomiting, or reflux symptoms. Of the patients who still had bands in place, more than one-third were reported to currently desire removal and conversion to RYGB for inadequate weight loss. About a third of the remaining patients have persistent severe obesity at least 2 years after surgery but refuse to undergo further surgery or claim to be satisfied with the results. Overall, only about 10% patients who underwent LASGB achieved a body-mass index of less than 35 and/or at least a 50% reduction in excess weight. The authors predicted that the overall need for band removal and conversion to RYGB in their series will ultimately exceed 50%. The researchers concluded that more study is required to determine the long-term efficacy of LASGB. Reporting on the results of a systematic review of the published medical literature on obesity surgery, Gentileschi, et al. (2002) concluded that “the efficacy of [LASGB] cannot be determined because of poor evidence.” An assessment of the literature on obesity surgery conducted for the National Institute for Clinical Excellence concluded that LASGB is both more costly and less effective than RYGB for severe obesity (Clegg, et al., 2001). An assessment of LASGB by the Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S) concluded that the “[l]ong-term efficacy of laparoscopic gastric banding remains unproven and further evaluation by randomised controlled trials is recommended to define its merits relative to the comparator procedures” (Chapman, et al., 2002). The French National Agency for Accreditation and Evaluation in Health (ANAES, 2001) concluded that “n view of the inadequate long-term evaluation of either efficacy or inherent risk of gastroplasty rings (notably risks relating to how the prosthetic material is tolerated, and risk of migration of the ring into the stomach), the working group was concerned about the extensive and unevaluated diffusion of this technique which is currently taking place.” An assessment conducted by the BlueCross BlueShield Association Technology Evaluation Center (2003) stated that there is insufficient evidence to conclude that LASGB either improves net health outcomes or whether it is as beneficial as current established surgery, RYGB. “For laparoscopic gastric banding, the available evidence suggests that weight loss at one year is less than that achieved with gastric bypass. More limited evidence on three-year weight loss suggests that this difference in weight loss may lessen over time. Early adverse event rates are low following laparoscopic gastric banding, and are probably lower than gastric bypass. There is a higher rate of long-term adverse events, and there are a number of potentially serious long-term adverse events such as band slippage or erosion. The incidence of slippage of the device from its intended location, or erosion through the gastric wall increases over time, and can result in visceral organ damage, abdominal pain, and intestinal obstruction. The available data are not sufficient to determine the rates of these longer-term adverse events with confidence.” An assessment conducted by the Australian Medical Services Advisory Committee (2003) concluded that LASGB is as effective as VBG but less effective than RYGB in terms of weight loss. The Canadian Coordinating Office of Health Technology Assessment (CCOHTA, 2003) concluded that “[l]ong-term outcomes data on the effectiveness and safety of the laparoscopic adjustable gastric banding procedure is needed.” In a systematic review of the literature on LASGB, Chapman, et al. (2004) concluded “the long term efficacy of LB remains unproved, and evaluation by randomized controlled trials is recommended to define its merits relative to the comparator procedures.” An assessment of LASGB prepared for the California Technology Assessment Forum (Tice, 2004) concluded that this technology did not meet CTAF criteria. Regarding comparisons of LASGB with other established bariatric surgical procedures, the assessment found: Thus, the mean excess weight loss following open or laparoscopic ASGB appears to be roughly equivalent to vertical banded gastroplasty, but significantly less than Roux-en-Y gastric bypass. None of the comparative trials reported on reductions in co-morbidities. Additionally, in spite of lower peri-operative complications, there seem to be more, and more serious, late complications following ASGB. The lack of well controlled, randomized studies precludes any meaningful assessment of the strengths and weaknesses of LapBand compared with Roux-en-Y gastric bypass. Therefore, it cannot be concluded that LB improves net health outcomes as much as or more than established alternatives of roux-en-Y gastric bypass or vertically banded gastroplasty. An evidence review completed by the Ontario Ministry of Health and Long-Term Care (2005) concluded that, “[r]egarding specific procedures, there is evidence that malabsorptive techniques are better than other banding techniques for weight loss and resolution of comorbid illnesses.”

Hi... I am in N.E. Florida just outside of Amelia Island. I am using Dr. Cywes in Jacksonville for my surgery. I have just started the process and have my appt. with my PCP in Fernandina on the 18th to get all of the final testing done and to get his letter to Aetna. I have already had the Psych Eval and the Nutritionist meetings. Hoping for a quick turn around on this as Aetna will no longer cover bariatric surgery once my group policy renews on Nov. 1 !! Seems like a lot of you on here have gone to Mexico, I have researched that also just in case Aetna doesn't come through ! It is so nice to be able to talk with others that are going through the same thing ! Looking forward to being on here a lot more !

http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/weight-loss-surgery-nutrition-and-hair-loss Weight-loss Surgery, Nutrition and hair Loss by Jacqueline Jacques, ND To view a PDF version of this article, click here. Typically, about 90 percent of hairs are anagen (in a growth phase) and 10 percent are telogen (in a dormant or resting phase) at any given time, meaning you are usually losing a lot less hair than you are growing so you don’t have noticeable hair loss. But sometimes this can change. A common fear and complaint of bariatric surgery patients is post-operative hair loss. While for most of us as people, our hair is an important part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like your brain and heart and away from your hair. Hair loss has many causes. The most common type of hair loss after weight-loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Growing and Losing Hair Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states; anagen, a growth phase, and telogen, a dormant or resting phase. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase which lasts for about 100 to 120 days. Following this, the hair will fall out. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include: Weight-loss Surgery and Hair Loss Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight-loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into the telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss rarely lasts for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight-loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One would be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if: Nutrition Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40ug/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemia, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after bileopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high dose zinc supplementation as a therapeutic agent for related hair loss2 in patients with vertical banded gastroplasty. The study administered 200 mg of zinc sulfate (45mg elemental zinc) three times daily to post-operative patients with hair loss. This was in addition to the Multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies, and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus we cannot say that zinc would prevent hair loss after weight-loss surgery, and further study would definitely be needed to make this connection. A further note: The Tolerable Upper Intake Level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60 mg/day. Information related to this study has made its way to many a support group and chat room – even to doctor’s offices – with the message of “high dose zinc will prevent hair loss after weight-loss surgery.” Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen or prealbumen. Limited studies suggest that patients with the most rapid or greatest amounts of weight-loss are at greatest risk.3 With surgical reduction of the stomach, hydrochloric acid,4 pepsinogen5 and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion, rather than malabsorption, is responsible for most cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2 grams of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Many individuals believe that supplementing with or topically applying the nutrient Biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include Vitamin A, inositol, folate, B-6 and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS) and is influenced by genetics. Conclusion Hair loss can be distressing to bariatric surgery patients and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is mostly likely caused by surgery and rapid weight-loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. About the Author: Jacqueline Jacques, ND, is a Naturopathic Doctor with more than a decade of expertise in medical nutrition. She is the Chief Science Officer for Catalina Lifesciences LLC, a company dedicated to providing the best of nutritional care to weight-loss surgery patients. Her greatest love is empowering patients to better their own health. Dr. Jacques is a member of the OAC National Board of Directors.

Hello all...Dr Metz did my surgery on July 16th 2009 and I have lost right at 70lbs...He was awesome, repaired a hiatel hernia too...Dr. Metz will not be back to COlorado Bariatric...he is traveling all over and did not renew his contract. I was there last week and was told that my "new Dr" is Dr. Brown...wasn't thrilled since I have never even met him, however Allison and Dawn the 2 PA's totally rock...They have always done my fills and answered any questions I have had...I think it sucks that Mets never even notified his patients...

Its open enrollment with my company which has been bought out by another company...I was excited to renew my benefits but to my surprise this new company excludes bariatric surgery in ALL of their plans. I'm 75% complete with preop visits. I currently have to do a 6 month supervised diet with MD, which will not be complete until March. Any suggestions on what to do? This has been devastating to me.

If you prefer January you should be able to ask to schedule it for January rather than December. A few reminders- if you have all your pre-op in 2015 you will have met your deductible and part of any out of pocket limit for 2015. Come January that deductible will reset and you will need to meet it again in 2016. Depending on how big of an out of pocket limit you have if you get everything done in 2015 you likely will meet it with the hospital stay and part of the bills will be at 100%. If you split it between 2 policy years then you may not meet it in either year and have to pay more out of pocket. You also risk that upon plan renewal in January your plan could change to eliminate bariatric coverage. (Unlikely) Your deductible and coinsurance could be increased for 2016. So while it is tough to be doing a liquid diet over the holidays you may want to look closely at the financial aspects of spanning 2 policy years for pre-op and surgery. Plus you can say New Year New You and actually be able to meet that New Year's resolution to lose weight.