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IN & OUT OF THE WLS CLOSET I was happy about my decision to have WLS and thrilled when my insurance company finally approved it. I shared this happy news with many friends, acquaintances, family members, and coworkers. I don’t know but I assume that they discussed it amongst themselves to some extent, expressed opinions or concerns, and perhaps worried about my decision, but none of them gave me frankly negative feedback. They might have been thinking it, but they didn’t say it. I very much doubt I would have reversed my decision if someone had said, “That’s too risky/it’s a bad idea/I don’t want you to/you’re crazy/or whatever.” I’m going to assume that you, the reader of this article, are an adult over the age of 18, with the right to vote, the obligation to serve in the military, and (at some point, depending on your location) the right to purchase and use tobacco and liquor. Unless a judge has declared you mentally incompetent (and that’s harder to accomplish than you’d think), you are the one who’s responsible for your body – for its care and nourishment and any medical treatments or procedures that affect it. So if you’re in the early stages of considering WLS, whose input are you going to trust to inform your final decision? A bariatric surgeon, or your dad? Your primary care physician, or your sister? Your therapist, or your hairdresser? And hey, I’m not slamming hairdressers. Mine could do very well indeed as a therapist, but she has a cosmetology license, not a mental health practitioner license. Last summer I was startled to hear a 50-something bandster state that she had gotten her husband’s permission to have plastic surgery. His permission? Huh? Does that mean he’s the only adult in that relationship, or what? I’m not against asking permission, mind you. I ask my boss’s permission to undertake certain tasks or projects at work; I ask the State of Tennessee for permission (i.e., a driving license) to drive a car; if I still lived in a suburban development, I might ask the zoning board for permission to add a room to my house; I ask the government of China for permission (i.e., a visa) to travel in that country. I’m an extremely independent person in many ways, so I have to stop and think carefully about what I might ask my husband permission to do. We have our own separate checking accounts as well as a joint account, so I might ask him for “permission” to spend a chunk of that joint account on a big purchase like a computer or a car. Everything else gets negotiated. I have a lot of experience in negotiation because of my business career. I negotiated things with everyone from my coworkers to my suppliers. But people who do that kind of thing for a living aren’t the only ones who negotiate, and negotiators aren’t necessarily politicians or manipulators trying to advance some evil cause. My own career as a negotiator probably started when I was a child who realized that good behavior often yielded a treat. My negotiations with my mother went something like this: It’s 7:00 o’clock on Thursday morning. Mom is brushing the tangled cobweb of my hair in preparation for braiding it. I am sniveling because the untangling hurts. The negotiation begins. Mom says: “Jeannie, if you stop whining right this minute, you can have Cocoa Puffs for breakfast.” Jeannie sees an opportunity and negotiates this agreement by asking, “Can I have chocolate milk on my Cocoa Puffs?” Mom sighs and yanks at a hank of hair. Jeannie snivels a little bit more. Finally Mom says, “Yes, you can have chocolate milk on your Cocoa Puffs.” Jeannie instantly shuts up. Negotiation over. It’s a win-win situation. Everybody’s happy… for maybe 15 minutes. In 15 minutes, Jeannie’s hair is finally tamed into two narrow braids and it’s time to choose an outfit for school. This time Jeannie begins the negotiation. “Can I wear my pink dress to school?” Mom says: “That dress is brand new. We’re going to save it for church.” Jeannie says: “I promise not to get it dirty.” And so on and so forth. Well, that’s enough time spent traipsing along Memory Lane. My point (and, like Ellen Degeneres, I do have one) is that the “yes or no” WLS decision is yours. Everything else (how to make it work best; what your family can do to help you; how much to tell your nosy coworker) needs to be negotiated with (or modulated by) the people who will be involved in your WLS journey on a daily basis and possibly renegotiated as time goes on and your needs change. The negotiation may be simple (“Will you take the kids to McDonald’s for lunch if I pick up your dry cleaning?”) or complex (“Let’s talk about how we’ll handle Thanksgiving Dinner this year”) or downright messy (“I feel like you’re trying to sabotage my weight loss.”). That’s life, isn’t it? BE CAREFUL WHAT YOU ASK FOR Getting feedback from others is usually a mixed bag experience. It’s wonderful to get the positive stuff and uncomfortable to get the negative stuff. It’s also very frustrating when your announcement elicits no response at all. What if you tell your sister, “I’ve decided to have weight loss surgery,” and all she says is “Oh.” What’s that all about? She’s shared her thoughts about your hairstyle, your boss, your kid’s struggles with math, your parents’ new car, your high blood pressure and now she has nothing to say about something as momentous as weight loss surgery? If you’re like me, your mind gets busy filling in all the empty spaces with scenarios and speculation. My own little mind is always full of running commentary (most of it – well, some of it – never uttered aloud). When I’m exercising, I’m planning what to wear to work that day. When I’m driving to work, I’m considering the best way to write the first or fifth or fifteenth sentence of my next article. When I’m driving home at the end of that day, I’m replaying a conversation I had with a coworker and fiddling with what I could have said better. So when I encounter my complete opposite (someone who has nothing to say on a matter that’s important to me), I cast my fishing net into my teeming mental pond, scoop up a dozen squirming fish, and off I go into Wonderland. “Wonderland” as in the land where I wonder, and wander, on an endless circular track. Around and around Jean goes, and where she stops, nobody knows, least of all Jean. The official term for that is “projection”. You project your own internal drama onto someone else’s blank white movie screen without having the first clue about what’s really going on behind that blank screen. You’ve known your sister all her life, ever since she supplanted you as the baby of the family. That’s what, 35 long years? After 35 years together, you might think you could predict her reaction to almost anything, but it’s also quite possible that you cannot correctly read her mind. Your suspicions about her reaction to your weight loss surgery announcement may be accurate, but you’ll never know that unless you specifically ask her. That’s more or less what happened to me when I first began discussing weight loss surgery with my husband. We had been married for 20 years, so he had two long decades of experience with his wife launching herself into risky situations (be it a new job, an overseas trip, adopting a pet, redecorating a house, taking fen-phen). He had been amazingly patient through all of that, not just because he loves and supports me but also because he knows that hell hath no fury like Jean with an obstacle in her path. So when I said, “Today I made an appointment to go to a bariatric surgery seminar,” and he said nothing in response, a dozen things ran through my mind. He thinks I should be able to lose weight by dieting. He doesn’t want me to lose weight because he likes fat girls. He thinks this is another of Jean’s wild goose chases and if he leaves it alone, she’ll get over it and move on to some other project…and so on and so forth. What was actually going on in his head was probably more like, “I wonder if there’s more rice in that saucepan, but if Jean forgot to buy soy sauce again, I won’t have another helping because I can’t eat rice without soy sauce. If Jean has weight loss surgery, will we ever get to eat rice with soy sauce again? Will we be living on warm water and melba toast? Did I remember to fill the cat’s water dish before I came in the house? We really need to get the cat fixed but I don’t want another argument about whose turn it is to take a critter to the vet. Oh no, Georgie’s puking in the living room again. If I ignore it, can I get Jean to clean it up? I’m going to write SOY SAUCE on the grocery list in big letters so Jean won’t forget to buy it. Maybe if I ignore the weight loss surgery thing, it’ll disappear, like Georgie’s puke”…and so on and so forth. I’m not trying to make my husband’s thought processes sound asinine (for a taste of truly asinine thinking, you really need to listen to a few minutes of my own stream of consciousness). I’m just making the point that our minds are full of stuff that may be worthwhile or interesting to us but doesn’t necessarily have to be shared in detail with everyone around us, and that nobody but the Amazing Kreskin can hear someone else’s thoughts. When my husband finished his dinner (without a second helping of rice) that night without making any response to my bariatric ambitions, I asked him, “So what do you think of the idea of me having weight loss surgery?” And he said, “I’m not crazy about it, but if you really believe it will help you, I’ll do my best to support you.” And what did I say to that? All I said was, “Thank you.” I could have said a lot of other things. I could have said, “Why aren’t you crazy about the idea?” I could have quizzed his knowledge about weight loss and weight loss surgery. I could have asked him if he would still love me and desire me when I was thin. I could have gone on and on for hours, while adding to my own anxiety and creating a host of brand new anxieties in his poor head. But instead I said, “Thank you,” because his promise of support was all I needed to hear at that time, and we had a lifetime of conversations ahead of us. And I said “Thank you” because when I’m in the planning stages of something big that will require a group effort, I try not to invite discussion that will derail the whole project even before its engine starts. You may have a different style, and you may think I was postponing a discussion that should be tackled immediately, but my approach is: one step at a time. I don’t try to build Rome in one day. I pick up one brick, walk it over to where I want the wall, put it down, and go back for another brick. Eventually the wall (or Rome) gets built. IN & OUT OF THE BAND CLOSET My feelings about sharing my WLS journey with other people have changed as time has gone on. For three months before and about 18 months after my band surgery, bariatrics was the #1 subject in my mind at least 75% of the time. I had to exert effort to not talk about it constantly. If I hadn’t discovered online WLS forums, where I could talk about it constantly with other people who talked about it constantly, I think my head may have exploded. I didn’t talk about WLS with every single person in my everyday circle of friends and acquaintances (for example, I decided not to tell my church friends about it, mostly out of laziness), but most of the people who knew me as obese also knew about my surgery. When I had lost my excess weight, the focus of my life began to shift to other things. Yes, bariatric surgery was still important to me, and so fascinating that I wrote a 500+ page book about it, but as my interests and activities grew and changed, I acquired a whole new set of friends, acquaintances, and coworkers who had never known Fat Jean. It didn’t occur to me to tell them I’d had WLS any more that it occurred to me to tell them I’d had a hysterectomy or hemorrhoids. If the subject of weight loss or dieting or exercise came up, I was willing to talk about those topics, but not necessarily in the context of weight loss surgery. I guess you could say I was in the band closet then, though I won’t admit to hiding in there. I still wanted to talk about bariatric topics, but not with the general public. I made two new friends during that time who know about my band surgery. One of them had heard about it from her mother (a former coworker of mine) and the other heard about it from me. Otherwise I was kind of enjoying being perceived as a “normal” woman by people who couldn’t even imagine me as a fat woman. But one day my feelings changed. I opened the door of my band closet and peered out. It was time to get out of there. Here’s what happened. During an exercise class at my fitness studio, another (naturally slender) student began making fun of fat people, and a few more people there chimed in. They just couldn’t imagine how someone could “let themselves go” like that. It sounded to me like these well-meaning people were saying that obesity is a choice – that the fat people had made a conscious decision to overeat, under-exercise, and gain an unhealthy amount of weight. It sounded to me like these well-meaning people were saying that fat people don’t have the willpower or intelligence to maintain a healthy weight. And suddenly I heard myself say out loud, “Those people aren’t proud of their fat. Don’t be making fun of them.” After a minute or two of mumbled objections, those well-meaning people fell silent, and soon the conversation took a new direction. Months later, when I was about to publish Bandwagon Cookery, my friend, instructor and personal trainer, Caroline, suggested holding a book-signing event at the fitness studio. At first I was wary of the idea. It would require me to step out of the band closet and expose my bariatric secret to a community of people who had never known Fat Jean. It would require me to step out of my comfort zone and into the limelight. I’m not afraid of public speaking – I actually enjoy it in most circumstances – and I’ve told my WLS journey story plenty of times, but mostly to bariatric patients and professionals. At Caroline’s loving insistence, we hosted the book signing, which was well-attended by women for whom weight management was an interest but for whom obesity was not an issue. One of them had a sister who was banded, but the rest of the guests were blank slates when it came to bariatrics. I want to share with you what I told this audience after announcing that I had weight loss surgery, something that I felt they needed to hear before I could tell my nitty-gritty obesity story: “I need to talk about the elephants in the room. The elephants are the beliefs that many people have, that obesity is a moral failing and that weight loss surgery is taking the easy way out. Obesity is not a choice, nor is it evidence of inadequate willpower. It’s a chronic and incurable disease caused by a combination of genetics, environment, and behavior. Weight loss surgery is the only effective long term treatment for obesity available in the United States today. And weight loss surgery is by no means the easy way out. Weight loss is hard work with or without the help of surgery. Has my weight loss been easier because I had bariatric surgery? Of course it has. That’s one of the reasons I chose surgery – because without it, my previous weight loss attempts had been so difficult and so ineffective. “I’m glad to have my Lap-Band, but it’s just a little piece of plastic, a tool that reduces my appetite. When I stick my hand in a bag of potato chips, my band doesn’t yank it out again. When my alarm goes off in the morning and I want to roll over and go back to sleep, my band isn’t what gets me out of bed, into workout clothes, and into this fitness studio. When I’m thinking that I need a 2nd helping of mashed potatoes, my band doesn’t shout, “Don’t do it, Jean!” When I’m sad and thinking that buying and eating a gallon of ice cream would make me feel so much better, my band doesn’t hide my car keys on me. “I am the one who makes decisions about what I eat and how I exercise. I am the one who’s responsible for making good food choices and changing my eating and exercise behavior. So I get the credit for my weight loss, and I’m the one who has committed to maintaining that weight loss for the rest of my life.” Looking back, I’m not sure how much of an impact that speech had on any of my listeners, but it had an impact on me. Hearing myself say those words affirmed my important and life-changing decision to have bariatric surgery. Whatever you do as you go forward on your weight loss journey, be proud of what you’re doing. It’s a courageous thing. If no one else congratulates you for the undertaking, you should still pat yourself on the back for it.

Well, there are 2 kinds of laxatives: osmotic and stimulants. Epsom salt is essentially magnesium sulfate, an osmotic laxative that replaces magnesium in the body and essentially causes your GI system to pull more fluids into the poop so you can pass it easier. Think stool softeners: colace and Miralax. I assume she cringed or made a face because use of Epsom salt isn't something we hear too much of in this day/age of products like Miralax. Also, using Epsom salt as a laxative can cause magnesium imbalance (needed for muscle contractions), increases your need for water, and can lead to dehydration if you're not careful. Just from reading all the frequent posts on BP about constipation and how to fight it, everyone has their own method that works for them. Until then, I think we all have a certain amount of anxiety with BMs. Me, I make sure I take a fiber supplement every day and I drink lots of water. If I miss more than a day, I will take a low dose dulcolax just to keep things moving. I do not wait. Waiting only increases discomfort and makes things more difficult to resolve. *In my first month or 2 after being sleeved, I used milk of magnesia for the same purpose as the dulcolax. I DID NOT want to have to strain with those first few! both Dulcolax and MOM are stimulant laxatives=stimulates the muscle of the intestines to push things along. I've heard lots of bariatric patients promote Smooth Move Tea. I haven't tried it, but I've had other teas like it. They are also stimulant laxatives and rather powerful ones if you steep the tea long enough. Hope this was helpful!

Hi MsRhonda, Your port can be sensitive for a little while. Have you overdone it? Other than walking most docs tell you not to start exercising until the 6th week. I know I did around the 3rd week and wasn't a good idea as I did feel it in the port area and my bariatrics center told me to stop as I was in the healing phase. If you are concerned then call your surgeon's office and def. call if it gets worse.

Hi everyone! Had my PCP appointment today. I asked for a referral for bariatric surgery and he put in a referral for it, and he referred me for the health classes (I'm assuming and HOPING the Options program?) he says its a process, which I know. Anyhow, just wondering how long it took for them to call you to get everything going? He said they would be in touch with me. I'm getting my bloodwork done tomorrow as he said it would be good to have that done and over with. *edit: spelling

My sleeve surgeon just did a gallbladder removal for me a couple weeks ago. I saw him today for follow-up and he chatted a bit about a bariatric surgeon conference he just attended in Sydney, AU. Just as background, my surgeon does mostly sleeves and the occasional bypass. He used to do a ton of bands but now only does the band if the patient insists. He still maintains a lot of bands. He said that the band is way down in Australia and whole areas of the country have no band surgeons anymore. He also said that the re-operation rate (for all types of re-operation) is as high as 40% with the band. He said that the band has a lot of potential points of failure, including that the port can flip, the needle can puncture the band during a fill and cause a leak, or lots of other ways that are not really direct failures of the band. He seems pretty down on the band now but wants to give his existing band patients the highest standard of care. He also confirmed that Allergan has sold the lap band to another company, Apollo Endosurgery. I googled that and found a story in the Wall Street Journal. http://m.asia.wsj.com/articles/SB10001424052702303471004579165961441181356?mobile=y He said that the sleeve is gaining massive popularity because of the low complication rate, high success rate, and that they are starting to feel really confident about the long term prospects of the sleeve, starting to see some patients with more than 10 years sleeved. He said that the sleeve may stretch 3-5% over time but then it stops. He said it is like taking a t-shirt and cutting off a sleeve. You can stretch the sleeve but it will never be nearly as big as the shirt. The bypass is going to be around a long time and is still very well regarded. It is the #1 choice for people with reflux or bowel diseases and it is the best salvage surgery for people who have reflux problems after the sleeve. The DS is very uncommon these days because the sleeve works so well on its own. This is my surgeon's summary to me about the state of bariatric surgery in Australia today from the point of view of the surgeons.

My WLS journey has been at a Bariatric Center of Excellence in a major Medical Center. The Weight Loss Center here has done thousands of surgeries in the last ten years. The program is discouraging patients from pursuing the lap band procedure because of the risk of complications. In my classes, I met two lap band revision patients that have had multiple issues. After talking with them, I am very comfortable with my decision to do the sleeve.

The 30-day mortality rate for VSG is 0.08% according to this information: http://asmbs.org/resources/studies-weigh-in-on-safety-and-effectiveness-of-newer-bariatric-and-metabolic-surgery-procedure That's less than 1 in 1000 and remember, that 1 in 1000 likely had other health factors and risks, like heart disease, respiratory problems, etc. If you are an otherwise healthy person (aside from being obese) and are not super morbidly obese, your odds of dying are VERY VERY slim.

You can definitely do keto, but it might not be especially high fat for a while--most bariatric nutritionists seem to favor a low-fat, low-carb diet for new patients. And very few people get through the first few weeks without something artificial. (I relied on sugar-free jello, sugar-free popsicles, and SO MANY PROTEIN SHAKES.) If you're really dedicated, though, you could probably minimize most of that. For instance, Eggface suggests "double milk" (1 cup Milk mixed with 1/3 cup Nonfat Dry Milk Powder = 16 grams of protein per 8 oz. serving) as one option. Most plans won't force you to eat beans or fruit or high-carb veggies, though; the focus is very much on protein sources, mostly animal-based ones. If you're worried about dumping from high-fat keto, you might consider discussing the option of the sleeve instead of the bypass with your surgical team. (There are people with sleeves who experience dumping, but it's pretty rare.) But like Matt said, not everyone who goes bypass has a dumping problem from fat, either.

There are proabably lots of reasons for the wide variety in weight actually lost. Many folks are not ready to actually do the hard work to shed the big numbers....everyone CAN be successful by following the plan the bariatric team will lay out. One thing to keep in mind is that everyone will lose in different ways and at different speeds because each body's physiology is different. Work the plan and the plan will work!

In the spring of this year, I changed jobs, moved and finally obtained health insurance that doesn't exclude WLS. After speaking with several co-workers regarding recommendations for a PCP, they almost all suggested that I go to an internationally known teaching hospital. I established myself as a patient of one of the internal medicine specialists and, until today, have been very happy with the coordinated care that I have received. The clinic related to this hospital provides complete care, including labs, diagnostic testing, and specialist care in-house. All of my medical records are available for all of my doctors to review. If my gyn orders bloodwork, the reports are available for my PCP, my bariatric surgeon and my endocrinologist to review. They also have a secure online site that I can access my test results myself. However, today I am wondering if this practice is too bureaucratic and regimented. I have been taking the antidepressant Effexor XR for over 10 years. This drug runs through your system very quickly and causes horrible, awful withdrawal symptoms if a dose is missed. I had my prescription set up with "autofill" with my pharmacy. I don't call in monthly refills; the pharmacy automatically processes refills and notifies me when I need to pick up my medication. Thus, I was not aware that the refills had run out and new script needed to be obtained. Last week, I called the pharmacy to check on the meds and I was told that my doctor needed to authorize a refill and they had contacted their office. They stated that there was nothing I needed to do. On Monday, when I had one dose left, I called the pharmacy and was told the same thing. I panicked a bit because of the short supply of my medication. I was told that my PCP denied the request for a renewal of the script. I determined that the pharmacy called my doctor near my former residence who denied the renewal because I was not currently a patient of his. I told the pharmacy that they needed to contact my current PCP and they informed that they had faxed her also. I also called the PCP department as well. I was told that the refill would be called in within 24 hours. Today, I followed up with the pharmacy, who has not heard from anyone regarding my script. My PCP doc is working the hospital until Friday. She is not responding to her admin assistant's urgent message on my behalf. The pharmist flatly refused to give me a dose or two hold me over. I am dizzy, nauseated, irritable and unable to control my emotions. I am scheduled for an upper endoscopy tomorrow with my WLs surgeon ( the last test before I get a surgery date, insurance is approved. As a last resort, I called the bariatric department to see if my surgeon would call in a small script to hold me over and to enable to me undergo the endoscopy with him tomorrow. If I am shaking, hurting and vomiting, I doubt he will be able to do the endoscope. My request that the surgeon call the script was flatly refused. I was also accused of lying by the patient coordinator on the phone because she didn't see any indication that I had called my PCP more than one time yesterday morning. Apparently my PCP's secretary didn't note the calls in the system. My surgeon's patient coordinator believed their computer over me. At this point I am emotional mess and a physical mess. I don't know what to do. Tomorrow, I don't know if I should try to have the endoscope done or if I should try get an appointment with my former PCP and drive 3 hours to see him. I am worried about what kind of aftercare or emergency care I may receive if I have surgery with this surgeon's practice. I am sure that I am going to change pharmacies and change PCPs. I have never experienced a situation where there wasn't another internist or P.A. available to cover for another. Am I overreacting? Does anyone have any thoughts or suggestions?

Cashley, That line "Just because you can, doesnt mean you should" was quoted by Jessie Ahroni who is a bandster and published author, diabetes specialist, Phd nurse practitioner who is located in Washington and works for a well known bariatric practice. It was used out of context here, but holds very true for many bandsters who say they can eat a whole pizza pie and then complain they aren;t losing weight. Now in this case, it really didn't apply because the person was asking a legitimate question about having first bite syndrome followed by a bottomless pit scenario where they were still able to eat a portion which they felt was too large for a person with proper restriction. I guess what I am saying is you have a point, but you were rude in making it Gayle made some good points and you were extremely disrespectful. Babs in TX 334/180 ish -154 ish

Right! I have made a joke of it but it is a serious issue that is concerning me somewhat. I think I know the answer to my problems but would welcome some input on this. Since my op in July, I, unlike most other sleevesters, do not get any clear signals of when to stop eating. I don't feel full until it really is too late. I quite often keep going wondering to myself if I am feeling full or should be feeling full. I mean this has been my problem all my life because before I had bariatric surgery I could easily keep eating way past when I was feeling full or should have been. Do you know what I mean? Anyway, just recently, after eating I am feeling really rough. I feel shaky all over and it feels like my heart is racing. I don't get it after drinking and I don't get it if I just have a biscuit, for example, so I am certain that it is a quantity issue and just need someone to clarify that for me or confirm that that is the case. It may be that I am being too adventurous in what I am eating as well, although most of what I eat is still accompanied with a sauce of some sort in order to help it go down. Yesterday we took our daughter back up to uni and stopped for lunch and I didn't order a meal as it was a waste, but, I did have a few bites from my family's meals and that included a couple of fries, onion rings and breaded mushrooms. I felt fine at the time I was eating and even had a bit of apple crumble with some cream (only a very small amount), but, after we came out and got in the car I felt terrible and it lasted for about an hour afterwards. My heart seemed to be really racing and I felt so shaky and awful that I couldn't sit or stand or anything. In the end we had to find a supermarket so I could go in the toilets to be sick. I was sick there and then later on I was sick again into a bag in the car (family were not impressed at that!). Now,I am convinced that I overdid it and ate the wrong things , you know, they just didn't agree with me and maybe it was too early to try them, but, I had no warning of feeling full at all. I felt fine until I said to myself that maybe I should stop eating at this point! I didn't physically feel full at all. I just don't seem to get the signals that other people here talk about having. I have an appetite most of the time and crave stuff and can physically stuff myself. 'I' have to tell myself not to eat, not my body. It's weird. I have just had my lunch now and I have had to make myself stop eating just in case I feel awful after. I have only had a very small amount of cottage pie with gravy and whilst I generally feel ok I didn't feel too brilliant after I had finsished and was worried that I was going to end up feeling really ill again. Is it the food I am eating, dairy, processed, carbs....? I am not thick but am a bit confused at this point and it may be obvious to you so please help if you can. Thank you all Helenxxx

Pianoguy, I would really recommend St Lukes..I am a week away from surgery and the support system and entire program have been a great asset. I attended a preop class which let me know what to expect- ive attended support groups-ive met with a very helpful nutritionist who as part of my surgery cost I get to see 3 more times after surgery. The insurance specialist for the bariatric surgeons really goes above and beyond to help you through that process. Its also considered a center of excellence which some insurance companies require. Good luck!

My Vitamins must be chewables, no gummies what so ever. They're sugary and don't have the vitamins we need. And my Calcium must be calcium citrate with Vitamin d, chews, which is very hard to find. Luckily my doctor sells Bariatric Advantage Sent from my SM-G900P using BariatricPal

Is there anyone else out there dealing with what I am going through? I had my lap band done on Jan. 28th 2010 and it couldn't have gone smoother. I lost an astoning 71 pounds and felt like I became the person I should have been a long time ago. My nightmare started the day after my port revision. It had flipped in June of this year and of course was told is was a simple procedure...woke up twice on the table but I guess that can be common with a twighlight...ever since he did the revision it has been pure hell for me. He relocted the port, I have nothing but pain and none of my fills are working. I have had 3 fills since the surgery and nothing is working. I have expressed this to him and he did a CT Scan to see if there was anything going on around the port. Of coursenothing came up so why look into it anymore....he did a fill that day and I woke up at 4am in so much pain my husband had to help me out of bed. I laid on the couch for 24 hours with an ice pack and Tylenol. And cried a lot. I called the nurse and told her everything again and she has been very kind but kind doesn't help. She told me to make another money making appointment and have a heart to heart chat with him and write all my questions down. Not sure what else I can tell him!! When a patient has that much pain wouldn't you think your doc would look into this further or give you options. He told me it could soft tissue/scar tissue from the surgery or my body is rejecting it. Now I can't get in to see him for almost a month. Dec.21st!! Just in time to renew my deductable. I shouldn't worry so much about the money because my insurance does cover a lot of it, but I still have to pay some. So when I see him I am going to give him these options..either do a test to make sure the whole band is working, no leaks, port flips, or band slips. I have been poked so many times I feel like pin cushion. I don't even think he is getting the fluid in the port.. When I drink the water it does get stopped and then he does his thing with the fill. But then the next day I feel like there was nothing done. I think I have a surgeon who is not listening (not the first time), doesn't care or does't believe me. I am actually getting scared. Would've something is really wrong and he is missing it! So again, options are test, see a different surgeon or get the band removed which breaks my heart. It worked so well for me when it was just right. I am so sad about this right now. I thought I finally had found the answer to my obesity and its all messed up due to a flipped port. Gosh darn it! I also travel one hour to there. I go to Froedert in Milwaukee which is an awsome hospital. One of the best. People come all around from the world to go there. How did I end up in this mess. This time my husband is going with me....can someone please hlep me or support me in anyway. Give me any advice..I need something to keep going....I hear all these success stories and I want to be one of them. I was on my way too. Please, maybe just a pat on the back for me right now.Dec. 21st seems so far away. He is going to be gone I guess. There are two other docs in the practice whom i wish i picked now. I have met both of them and they are awsome. oh well...thanks for listening everyone...HELP!!!

Hi there, Kaiser (SoCal) has a mandatory 24-week Healthy Options program pre-surgery where they teach you about the lifestyle from A-Z, and in that time frame, expect you to lose some weight. My Bariatric team specifically said that the 10% rule is out the window; and that Kaiser no longer requires that a medically supervised diet is followed. I am doing the full-food program since I already use a full-nutrition supplement 1-2 per day, and am adjusted to a partial liquid lifestyle. Currently losing about 1.5 pounds per week on my own, which puts me almost exactly at 10% total weight loss before my operation in late-December/mid-January. As I receive info, I'll post in the forums! Knowledge is power. Sent from my iPhone using the BariatricPal App

I'm at the Kaiser SoCal group... all of San Diego. What have the psych appointments been like? I have diagnosed Bipolar II and BED, but the surgeon didn't seem to be concerned since I'm well into maintenance mode and on a very low dose of the meds. One of my anxieties has been getting through the program only to be rejected by the psychologist, but I've read in medical papers that upwards of 3/4 Bariatric patients have been diagnosed with BED and there is a! 82% depression/anxiety underling psychological case issue. I think I was approved to move forward because I got all of this under control? Any insider information would be greatly appreciated. ❤️ Sent from my iPhone using the BariatricPal App Thank you for the add! Haven't even thought of Tumblr—it would be good to diversify the feed. IG has been incredibly informative from a visual standpoint over what to expect skin-wise et al. Sent from my iPhone using the BariatricPal App Hey! Which Kaiser are you going through? I am going through Richmond Ca Kaiser, they have been great so far. I am on my 2nd psych appt, so any questions, maybe we can talk! Sent from my SAMSUNG-SM-G900A using the BariatricPal App Hey there—sorry for the double response, still learning the app there is a loose comment in the thread for you! Sent from my iPhone using the BariatricPal App

All bariatric surgeries have their success stories. And all can be defeated. Some surgeries are recommended by surgeons over others based on your medical history and comorbidities. If that is not a factor in your case, you surgeon may leave the decision up to you. But if asked directly, most surgeons will make a recommendation for one surgery over another. And as others have suggested, nothing will build your confidence like your own research and you're in the perfect place to benefit from the experiences of so many great folks. Welcome to the forum! You're gonna love the new you!!

@@jane13, there are 6 hospitals in my area and only one surgeon that is in bariatrics. The one that doesn't allow outsiders. I'm good though. Thank you again for the help.

My first after my sleeve surgery was identical to your. I threw up everyday, nausea 24/7, in and out of the ER and hosp, i had to finally ask for a second opinion because my surgeon told me i was just fine. In the beginning i didnt eat anything for 5 weeks. I had been on the strongest antinausea meds and they didnt do anything.. My new dr did an endoscopy and diagnosed me with bile reflux. After starting the medicine it took about 3-4 months before i was feeling normal. My bariatric surg moved away so im now followed by a GI surgeon. I have been doing pretty good. Please let us know how you are doing. I would get a 2nd opinion asap. For myself having the other surg was not guarantee it would fix the bile reflux. In reality it would open me up to a host of other issues. We are about a year apart in age. Prior to surg I was 330 lbs now I weigh 165-170. I feel pretty good after losing 160 pounds. Many of the medical issues I had prior to surg are gone. So there have been positive changes. But I literally thought I was dying too. I had to go to physical therapy to get strength back to start walking again. I hope you get better soon. Laurie

@@Blerdtech91 Welcome to BP! I'm new around here, too. Joined only a few days ago. I'm 29, 5'5" or so, and my CW is roughly 303 (but my scale at home lies and it's been almost a month since I've been weighed in -- going on Wednesday). I started at 340-something. I'm still pre-op, due to get my sleeve in mid to late October, and I have had the joy of waiting six months for my insurance, as well. The six months has mostly gone by quickly, but I noticed the excitement and the feeling that this was really going to happen for me dissipated at about month two. For me it was very easy to feel like this was so far away and I couldn't maintain my initial level of "omg, I'm so happy I'm doing this!!" Once I get close to my final appointment at the end of September, I'm sure the excitement will come back. I'm also anticipating a little anxiety, but nothing I can't handle. The endoscopy I was required to get during this six months was the first time I've been put under anesthesia. No other procedures or surgeries, so There's bound to be some nerves. Has anyone recommended to you a book called The Emotional First Aid Kit? It's written specifically for bariatric surgery patients and is really a great tool to help with the emotional aspects of recovery and life after surgery. It's written by Cynthia Alexander and available for the kindle at $9.99. I also found used copies for $6 plus $4 shipping on amazon. I definitely recommend it! Best of luck on your waiting period and surgery! Keep us updated! Sent From BariatricPal App

I was self pay and went out of my area for surgery - I selected a local bariatric surgeon who took me on as a patient even though she didn't perform the surgery. I pay $120 for my visits with her. For me, it was important to have aftercare and follow up visits with her. I wanted to have a local resource where I can go to make sure what I'm feeling is normal and she can look at my bloodwork and determine if anything is wrong. I get the blookwork requirements from the surgeons office, then have my primary care doctor order the bloodwork so my insurance will pay (they have to code it as anything other than weight loss for the insurance to cover). I then take my results to the surgeon. That has saved me about $1400 this year. In the end, as with everything else with this journey, you need to do what's best for you. I feel like I get a value from my surgeon's visits and I really like what she offers.

If it feels like someone is stabbing you under the shoulder blades with a bowie knife and twisting it around mercilessly, it might be your gallbladder. This is one of those things you should ask your surgeon about. Gas is bad enough, but should not interrupt your day like that. A lot of people have gallbladder issues after bariatric surgery.

Go to a free seminar of the bariatric surgeon of your choice then let your PCP know. My PCP was more than supportive. If not, then it's time to get a new PCP. If you went to a seminar today, you may get scheduled for surgery within 8 weeks so that is about the lead time to expect.

My bariatrics surgeons scale is 5 pounds higher. When I said I hate your scales the nurse told me yeah everybody says they are 5 pounds to high. I laughed and said you would think your scales being int he business they are in should be dead on. No one wants to go to their surgeon and weigh 5 pounds more than you should. Lol. What a downer. Now I weigh at home and I tell my doctors what I weigh. I am not weighing on 4 or 5 different scales.