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@@Smdnght28 The sleeve is done quite frequently at my practice - probably just as often as RNY (Gastric Bypass @@mr1121 ). If you really want the sleeve I'd get a second opinion (your surgeon sounds a little old school).

Check out the news stories on Ron Lester. He is an actor. you might know him from 'Varsity Blues' or the series 'Popular' a few years ago. He played the fat(politically incorrect) kid. He was 500+ lbs when doing those parts. He underwent a vertical sleeve operation(a form of gastric bypass) and lost 305 lbs. He looks good now, but says that he has a problem getting parts. When he was 508lbs there weren't very many people trying out for those parts, but now there are bunches of other guys trying to get the same parts. Invisible, not quite, but it definitely takes some getting used to. gk

They do the endoscopy to make sure you don't have a hernia that can cause problems, My endoscopy is tomorrow..I already know I do have a hiatal hernia, so now after the surgeon looks at it he can decide if it needs to be repaired, he can do this on surgery day. The lap band is much safer than gastric bypass though the results take longer with the band. Good luck!!

The person posting about the infection does explain quite clearly that they are on antibiotics and have been for 2.5 months because of having had surgery with Almanza. You can talk this away all you want, it's in black and white. Maybe it wasn't MRSA, but it was an infection from the surgery. Is Almanza doing the sleeves and bypass at Angeles hospital? I do not believe for one minute that corners are not being cut with the prices as they are. Impossible. Unless you guys are donating your time, these costs have to be absorbed for dirt cheap surgery. Considering the overall rep of Betancourt/Emmanual and their very long history on this board and every other I would just hope people really watch what they are doing. Then we have the issue of paid posters. You can't talk your way out of that one either. One of them emailed Elisabeth apologizing for being paid to push your facilities and slam dunk anyone who dared to tell of negative experiences. She couldn't do it anymore and apologized to a mod for this. She's never even BEEN to Emmanual! The paid posters aren't even bright enough to hide what they are doing. They are spamming every WLS board with this nonsense, not just here on LBT. Don't you realize it makes you guys look worse? Seriously, if you guys are going to lower yourself to paid posters at least get some bright ones. Those you have now... well, there are surely brighter crayons in the box, aren't there? If everything is as great as you say it is then why is there a need for paid posters? Other doctors... their patients are posting. Then we have the issue of the email I received from your facility suggesting that if I don't stop posting what I know then they will attack my doctor on the boards. They will come up with fake information and slam dunk him on every WLS board they can find. For God's sakes, where are the professional ethics at Betancourt/Emmanual/Almanza? My doctor has nothing to do with my posting. Why not attack my dentist while you guys are at it? You know, for a short time I really started thinking Andres was trying to clean things up, improve his rep, do things the right way. When one of the paid posters explained that P. L. is no longer associated with you I honestly thought to myself that maybe things are changing. I was clearly wrong. Ethics, they are a GOOD thing.

I am considering VSG surgery. I have actually done all of the pre op tests, and all but the final nutritionist consult. I have been overweight most of my life, and have always been very active. I ran cross country in high school even though I was considerably heavier than anyone elso on the team. I can still run 5k's but not as easily as it was in the past. I have lost 50+ pounds in the past only to regain most of it. In the last 10 years my heaviest was around 280, and my lowest was around 225, and I am 6ft. I now have sleep apnea, arthritis in both knees, and other joints, high cholesterol, a borderline high AIC and I am only 29. I mentioned that I was considering a WLS seminar to my wife and she said she was interested. We both attended a seminar and went to follow up consult appointments. The doctor suggested gastric bypass for her (her BMI is in the upper 40's) and a band or sleeve for my, but strongly suggested the sleeve over the band. Now that my wife has lost some weight by diet and exercise, she is not sure she wants the surgery. I have also lost weight with diet and exercise in the past and I always seem to regain all or most of it. Now with all the issues I am having it is harder and more painful to exercise much. The nutritionist keeps asking if this is the path I want to take, and she thinks I can loose the weight without surgery. She said that I should let my wife have the surgery and with changed eating habits in the house I would loose my weight. She said they had a woman with a BMI of 35 had gastric bypass at their practice and now she has trouble staying above a BMI of 20. I want my wifes decision to be her's and I try not to push her in any direction. I am not sure if I should go ahead and have the surgery even if she does not, or try the diet and exercise route again and see if I can keep it off this time even though I have not really been a healthy weight in 10+ years.

Here is a list I've developed - some are questions I asked and many have been added to my list. This is a VERY long list, but hopefully some of the questions will be new to you I have a friend who is going to his initial consultation next week too and he asked for a list too. * What is your re-admittance rate? * What is/are the typical reason/s for re-admittance? * How many of your patients have had leaks? How long after surgery were the leaks typically discovered? What was the resolution (% healed on their own vs. % needing surgical intervention)? * Other than leaks, what is/are the most common complication/s? What is your experience with these complications – how many and how resolved? * What would cause you to change to an open procedure? * How many rows of staples do you place? * Are the insides of the staples checked, too? * Do you sew over the staple line? * Exactly how do you test for leaks immediately after surgery (before the barium swallow test the next day)? * Is the part of the stomach that is removed also tested for leaks? * What size bougie do you use to measure the “sleeve?” How do you determine the size of the sleeve? * Can the sleeve actually be stretched by eating/drinking too much? On occassion vs regularly? Why? How to prevent? * What is the biggest factor in failure after this surgery? * What is the biggest factor in succeeding with this surgery? * What is your mortality rate? Of this, what % is attributable to the surgery itself and what % was from pre-existing conditions? * What type of post-surgery support do you offer? Is there any additional cost for the support? * Where were you trained? Are you board certified? How long have you done bariatric surgeries and what other types of surgeries have you done/do you do? * Why did you chose bariatric surgery? * How many sleeves have you performed? Over what period of time? * At what hospital will my surgery be performed? * Who will be my anesthesiologist? What is his/her experience, training, etc.? * Why do you believe you are the best surgeon to perform my surgery? What differentiates you/your practice from others in the D/FW area? * When can I return to work post-surgery? What will my limitations be and for how long? * Based on your experience, in this practice, what % of excess weight does your average patient lose with the sleeve? How long is the loss maintained? What can I do to increase my success? * Why do you feel that your pre/post surgery nutrition guidelines are the best? Have you tailored your plans for sleeve patients or do you use the same plan for sleeve, bypass & lapband? If the same, why? * Do your patients have a support group on FB or via other social media? Other than the formal support group/monthly classes, do your patients have informal support groups? How do I join these groups? * How much interaction should I expect with you vs. with your staff post-surgery? If mostly your staff, what is their training and experience with bariatric WLS patients? Will I typically see the same staff members on my post-op check-ups or will it vary? * Are your staff members, such as nutritionist, available for one-on-one consultations? If so, what are the charges, if any? * What are the requirements to become a "Center of Excellence?" (does this designation really mean anything?) * If I decide to go the self-pay route, is there coverage available for potential complications? If so, where do I get it? How much is it? Will the surgery center/hospital/other docs accept it 100% or could I potentially have additional out-of-pocket expenses? * I've read that most obese patients over 50 have hiatal hernias. According to your website, those are repaired during the sleeve surgery. If I'm self-pay, how is that handled? What if the costs associated with the hernia repair aren't fully covered by my insurance or what if I haven't meet my deductible? * Are there questions I should have asked but didn't? * What would you like to share with me? Sorry for the long list - I'm one of those Type A's

OK, I don't know if this is true or not but I found this on a website: "the bypassed stomach remnant or body remains present because it still has important jobs to do – namely the production of digestive enzymes and juices and hormones which still play an important role in digestion and metabolism. Removing the stomach would increase the invasiveness and risks, magnitude and recovery time of surgery markedly and bring very minimal advantage." http://www.sasseguide.com/blog/what-happens-to-the-%e2%80%9cold-stomach%e2%80%9d-in-gastric-bypass/

I know this is an older thread, but it seems to perfectly address my concern. I live alone, and am very independent. I stayed with my parents after a hip surgery and was so stressed out by the constant noise and activity that it really wore me down. I'd really like to just get home after my bypass, and be there alone. I have a nice, quiet apartment. My parents and brother (an EMT) are a mile away. I have emergency pulls in my apartment that will bring nurses to my door from the nursing home my building is connected to. So, help is not far away. The trouble will be in convincing everyone (especially my mother) that it will be okay, so I'd love to know how you all managed if you did it alone. Also, I have a rambunctious 70-pound dog. I'm worried about handling her after bypass surgery. Any opinions on how long it would take before I'm healed enough to not worry about being yanked around a bit? Thanks to anyone who sees this and has ideas for me I'm worrying far ahead of time, but that's how it goes with me.

I had my gastric bypass in 2013. I did really well at maintaining until I suffered a serious knee and back injury. As a result of being unable to exercise or be active I gained weight. 9 days ago I started the reset diet. So far its working miraculously. It is teaching me to eat properly again, reducing my intake and lots of more energy. I also started using patchaid vitamin patches as well.

My original surgery was MGB, but welcome to the team! We're few, but we're good! How long did they make your bypass, do you know?

Hi Everyone, I live in North Ga. I went to Dr Daly at Northside. I was banded on July 2nd. The Hospital stay was great and they also have a support group there. I just love Dr Daly. He did my Mom's bypass surgery 8 years ago so I did not want to go to anyone else.:cool:

Any doctor who performs gastric bypass on someone who is within a normal weight range should have his license revoked.

Perhaps when someone asks why you chose band over bypass you can just say, "I just felt it was the better choice for me personally" and leave it at that. Honestly, your reasons are your own and they have no right to demand that from you. Good luck!

my understanding is that it is different for people with a sleeve and RNY due to the valve at the bottom of the stomach that regulates how quickly food leaves the stomach. however the sleeve can't stretch very much as they have removed most of the stretchy part of the stomach. you can and will have it sort of reflux back into your esophagus if you eat too much or drink a bunch with eating. not a pleasant feeling. happened a couple of times with drinks early on when my stomach was swollen and I was still getting the hang of things. With the RNY my understanding is it can very well empty the stomach quicker with the bypass bit of it.

I'm anxious to hear what is said about Gene pro too, as it's on my list of approved protein supplements, and I'm doing well with it twice a day. I love that it's unflavored & I add it to crystal light, dissolves great. I'm 2 weeks out Lapband revision with Gastric bypass. Sent from my SAMSUNG-SM-G870A using BariatricPal mobile app

For those who had bypass, how much time did you spend in the hospital?

Thank you so much. I just tell you life like this is very hard and it infuriates me when people tell me "Oh you went the easy route" no way shape OR form is gastric bypass easy. It messes with you emotionally, physically, spirtually..basically completely! I'm going the 10th to see what is supposed to be a very good bariatric surgeon. My lower half seems fine now, but its the upper I guess where the stint is. My spasims are so severe they feel like a heaart attack. It's horrible. I can truly honestly understand why suicide rates are so high due to this surgery. It's horrible. I'm probably scaring all these poor people to death, but i'm just trying to be honest and show you all that not everyone wakes up off that table "healed." Obesity is a disease something we all have to figure out ourselves. How why when did we get this way and then comes the hard part accepting you did it yourself...no matter how hard you try to deny it. Trust me I did it. Advice to those having surgery. Listen to your bodies you hear full, you stop walk away. Learn to eat things you thought you never would. Tofu is my favorite and your going to laugh but dehydrated vegies are also my favorite. I can't drink any milk because I became lactose intolerant afterwards. Be careful and listen to your body please. i have a friend who is the same amount of time out of surgery as I and she's already gained back. I teeter between 124-133 and have since 2011. 5 years post op and saying that I feel is a big thing. I'd like to see the ones having surgery come back wih the same success stories. I wish you luck and if you need me just hollar. Thanks yall

I was quite concerned about acid reflux as well. At my consultation, my doctor told me to go with bypass if I had regular acid reflux. Otherwise, he'd recommend the gastric sleeve. I had a very large hiatal hernia. He said he was 99% certain that was what my occasional reflux was from and that after the repair I should be fine. I'm on PPIs for 6 months during healing. But, it is widely known that it is possible to have bad reflux about 2 years after. However, most of those cases are from unhealthy eating habits. I'm 2 weeks post op with no reflux issues right now, but I'm on meds as well.

I was banded October 2011 and had complications from day 1. I had a very large hiatal hernia that needed to be repaired, and it wasn't. It took me 5 years and 3 months and 4 doctors later to find one that would remove it December 2016. It then took me another two doctors to make the hernia repair and do the gastric bypass for me on June 18.

That sounds horrible, I had reflux for about 6-7 months non stop with the lap band I could barely take it anymore. I did not have reflux prior to the lapband. I am concerned about the reflux I have now and converting to the sleeve. Have you ever heard of the linx system? I talked to a surgeon about it already. It may prevent you from having to convert to bypass due to reflux. Awesome on reaching your goal. I have done all the tests you have done. I had a scope, gastric emptying, manometry, and today I did an upper GI. They do see I am refluxing on the upper GI. All other tests came back normal. I hope it just may be a hiatal hernia that is to small to see because there is currently no real explanation for it. Best of luck!

My Apologies, Didn't see the date on the side there, just that you were listed as a lap band, and you didn't state you were going in for revision. Good luck on everything! I hit 50 lbs lost today since my pre-surgical check in on March 2nd!

Welcome, Kimber! You'll find quite a few people who have had or are planning sleeve-to-RNY revision surgeries. Hopefully you'll click with some folks following your same path!

LAP-BAND,laparoscopic banding,bariatric surgery,obesity Tracy's FAQ LAP-BAND: Surgery Technique Weight-Loss Surgeries Compared You could also join his egroup and talk to lots of other patients. It's really a great group. Dr. Aceves is the VP of the Mexican Bariatric Assoc., and the Secretary of the International Bariatric Assoc. Both those positions are voted on by members so he is even respected by US docs. Things that you want to look for are issues such as... does your doc do surgery in a clinic or hospital? Mexico is not the same as the US, if you were to have a complication in a clinic and needed to be transported to a hospital it is not as easy as calling 911 and they are there in minutes. It's a whole different ballgame. I preferred to be in a fully equipped hospital with an ER, ICU, CCU, PICU, OR, etc. What kinds of procedures does the doc do? Does he ONLY do banding? Banding is the easiest of all procedures. I chose Aceves because he can do the tricky stuff, the bypass to band revisions, sleeve, etc. Many docs won't touch the hard stuff. How close do you want to be to the border? Some have a preference, some do not. I wanted to be close to the border. Just my personal opinion but I think the best two docs in Mexico from my research are Rumbaut and Aceves. They are who others refer to for the more complicated procedures. They both work out of a hospital, they don't do assembly line surgery, they both open the patient, place the band, and close the patient unlike other docs who have the asst. surgeon do most of the work. They are both well respected in the Mexican medical community, they both train US docs in banding, they are both safe surgeons. When people talk about how many bands someone has done, keep in mind that many times the docs strive to do 10 procedures a day. They have the Asst. Surgeon do most of the work, they spend about 15 minutes in OR with the patient, the asst. does everything else. Personally, I wouldn't want to be the 10th OR patient in the day. Rumbaut and Aceves limit their surgeries to 4-5 daily because they are doing the entire procedure. Lots of things to think about and consider when going to Mexico. It can be a very safe experience, but research is essential.

Dave, Tricare won't cover VSG outside a MTF. Honestly, I was faced with the same dilemma, and as luck would have it, the MTF near us had 2 surgeons that had performed enough VSGs for my standards, and one of them had removed bands, and converted to RNY so I jumped through the hoops to have my revision at the MTF even though I see a civilian for everything else, and my band surgeon was a civilian with Tricare Prime. Tricare will not cover the sleeve outside a MTF until Medicare starts fully covering the sleeve. They did the same thing with bands. They will not overturn a denial, they will not do anything to cover the sleeve outside a MTF. I've been through it myself, and I've walked 4 friends through the process from Florida, DC, and Cali. I was hellbent on getting the sleeve, and I would have self-paid with Dr. Aceves in Mexicali or Dr. Nicholson in Dallas if Tricare would have not approved my revision. If I would not have been able to have VSG and self pay was an absolute no go, I would have had my band removed and stayed fat. I wouldn't get RNY if you paid me, and I refused to have another band placed even though both of those options were immediately approved without hesitation by Tricare. I'm sorry to be the bearer of more bad news. BUT, it's been "hinted" that Medicare "might" start covering VSG around 1/1/2011, we "heard" the same thing in 2009, but I have hope that Medicare will get on the ball, and Tricare will follow suit. If there is an MTF near you, check them out. I'll help you in any possible way I can with the Tricare situation. I'm an insurance agent as well, and umm pretty much know how to work the system. Keep all your paperwork from your current appointments, keep getting your PCP to weigh you, keep doing everything you have been doing. Do not settle for a surgery you are not 100% about.

I have to admit, this is a situation I would have enjoyed. I would have taken great pleasure in giving her a bit of attitude (okay, a LOT of attitude) and a bit of education. I would have gotten right back in her face and explained how it all works and I would have explained that I did not want the path she clearly has chosen. I would never dream of being insulted by her behavior, I would have enjoyed the pleasure of watching her back down. ;o) But, that's me. Again, I wouldn't have thought twice about telling her the price. Plant the seed, you know? All of us have issues to work through, including nurses. The only people that have ever been that way to me are obese people who have had WLS and are not overly successful with it. THOSE people are brutal. When I was so sick with a band and needed a revision before I was so ill I would no longer be a good surgical risk I had a few that insisted that if I didn't have the band removed, gain all my weight back and THEN have a revision then that meant I was anorexic. It was weird, 100% of the time the only people who were on my tail about getting a revision without waiting to regain everything back were WLS failures, people who were not able to do it with surgery. Those that were doing well or at goal they were 100% supportive. I have a hunch that nurse was going through her own stuff. I'm not sure I'd write a letter to the hospital, but I would contact her and let her know how she made you feel and take it from there. See what her response is. THEN go to the hospital if you are still not happy. We all have our demons, that's why we needed surgery.