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Here are the regs for you http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=57&bc=AgAAgAAAAAAA&ncdver=3

Yes and no. Yes bc I got my surgery for free and had an amazing team who I can contact for ANYTHING I need. No bc the criteria was very intense. If you messed up one time you had to start all over. I complied with everything exactly, but I watched some people who didn't and it was sad.

I told them I needed surgery (didn't say what) and took a week and a half off. I wish I would have taken a full 2 weeks or maybe even 3. I was just so tired and would have dizzy spells at work bc I wasn't concentrating on getting my fluids in. But you'll find that everyone will give you a different answer bc everyone recovers differently. Good luck!

I have that nosey co-worker also. She has made it very clear in the past about her views on weight loss surgery. She has already asked twenty questions regarding a day off I took for my x-rays and lab work.... "Is this lab work something extra, or is this part of your yearly check-up exam?" All I said was I have to have some blood drawn. And she proceeded to go on and on about what our BC/BS pays for and what it doesn't. See how nosey she is? Both of her kids have lost 100+ lbs. with diet and exercise and feels that anyone else could do the same. (not that she has much room to talk) I work in an office of 5 people. What am I going to tell them? I can't just take a week off work for no reason. I am thinking of telling my boss that I need to have a cyst removed from my ovary. (is this a "white" lie?) I really don't want the lectures, and the constant questions about what I'm eating, what I'm drinking etc.....because I'll be hearing it day in and day out from my nosey co-worker. And I hate confrontation. So I guess I'm gonna lie regarding my reason for needing a week off work. I do like Carlene's responses...I've written them down to memorize!

My story is similar to yours. My surgeon is very conservative too. I lost 100% ewl before complications after kids. Had my band out and asked my surgeon which would be better for me after band and he said I should do sleeve. Hope he is right bc doing surgery in June! Maybe get another option? I had heard the same things as you about sleeve being less successful but there are plenty of successful revisions on this board. What complications did you have?

After the trauma to the muscle in my belly, I having a hard time bending over bc gravity pulls on it. Is anyone else having trouble? I can't lay down in bed, it's too much for that one muscle.

I only did a day of liquids after a fill if that. It seems much harder with the sleeve and I'm thinking its bc its so long. I did 2 weeks of preop then 1 week of solid liquids. I am now on creamy soups and Friday can add in tuna and eggs. Tuna sounds like a feast to me at this point

My point was, if a bar can refuse to serve drinks to someone who is obviously impaired (they didn't have to drink there; they could have come to the bar drunk already...happens all the time), then why is it such a stretch of the imagination for a restaurant to refuse to serve food to someone who is obviously well fed already? I understand the logic, even though I don't condone it. Even another example is the fact casinos can and do refuse to allow addicted gamblers into their casinos, once they are put on the "do not allow" list.

just know that it's normal and you just keep trudging along. we never lose as fast as we want and there are times the scale doesn't move. the best thing is to not focus on the number. i'm serious! its a huge mindf**k, and most of us fall into it. it serves no purpose. stay positive, and keep doing what you are doing. don't cut your calories any more. watch the carbs and sugar. make sure everything that goes into your mouth is high in Protein and low in carbs/sugar. how is your bowel program? sometimes you need to increase Fiber to keep things moving through. please dont fall into the 'im a failure, im in a stall' bs you see so often happen. this is a year+/ lifetime process. my other recommendation is to keep track of your weight on a graph. i dont know if mfp has graphs. one good one that does is called libra. it is so cool to see the progress in visual data. i love my graph!!

I was up walking within 4 hours of waking up and out shopping less than 24 hours Walked a couple miles that first two days. Flew on a plane, drove 5 hours, plowed my driveway, fed horses, more shopping, errands, laundry, etc all within the first 5 days. Back to work within a week.

Hi there. I'm a newbie to this site/forum. Used ObesityHealth for all my pre/post op journey. I hadn't heard of this site though so giving it a go. You can never have to much support! My story, very briefly is that come Nov 2nd I'll be 4years post op from having a VSG. I just turned 31 on the 22nd of August, was 27 when I had the surgery though wanted it forever. I was always the fat kid even in high school when I suffered thru Ana/Mia/EDNOS. Had crazy co morbitities before surgery. High BP (took meds), type 2 diabetes (took needs and SS insulin), high cholesterol and my triglycerides were SO high my Dr couldn't get a read on the blood work-we tried numerous times. I was 6'4" and at my highest weight 435 lbs. I was 410 by surgery. My goal for myself was between 200&180lbs though I went and still go more by inches and measurements and how I feel more so than the scale. I quickly dropped to my lowest post-surgery weight of 220lbs within about 14months. However, I cross addicted and returned to old patterns of EXCESSIVE excersise to fill the other voids in my life I didn't want to face. It was to the point where if I had to work at 9am I'd be getting up at 2:30/3am to workout before work. And I always worked out at home. I'd start with a 15min Oxycise session (an aerobic breathing program that focuses on isometric/isotonic and stretch positions) then I'd move to weightlifting for an hour then a 30-40min session of Hip Hop Abs followed by 2hrs of Tae Bo and I'd finish it all off with an hour of Power Vinyasa Yoga. I did this daily for months on end and often without rest days. Eventually life happened and I started to realize how crazy I was being and tried to adjust. At this point I was happy with my body-in retrospect I was happy with myself but at the time I still saw the fat guy in the mirror who's Dr wanted me down to 170, I would have made peace with 200 at that point bc I was almost art my personal goal. Still, as fit as I was by scientific standards I was still obese, had a Dr pushing more loss and friends/daily worried I was "too skinny" and through all this I never took a breath to actually ask myself what I thought, where I wanted to be and where I'd be comfortable. Yeah, stupid. Then, started going out with friends, experiencing restaurant foods and things I'd never touched since surgery...including alcohol. Started dating and now living with my partner but in my comfort, indulgences and dealing with a back injury that limits my workouts now-prob for the best-I managed to gain back about 90lbs over the next 2 years or so which brings us to present day. I'm back looking for support from others who may have regained and are in the same boat and hopefully finding a friend(s) to lose the regain with. Also hoping to continue to help other post op newbies from making the same mistakes I made. Its quite easy if you're not careful. Anywho, that's my Story and why I'm here. Hope to chat with some of you and see you around the boards. Anyone else in this room in the regain boat?

I'm one month out and I feel nauseous 80% of the time. Nothing sounds good and I really don't want to eat, ever. I force myself to eat but it's typically a Protein bar, and even then I can barely finish 1/2. I still drink most of my protein, and am getting usually 70 grams a day, however, I only get about 300 ish calories sometimes up to 450. It's not the food that makes me feel sick, it's just all the time. I actually hate having to eat bcs i never feel hungry and always feel sick. . It's quite miserable. Anyone experience this? Does it go away?

thanks for the tips, seems everyday that goes by i get more and more fed up with my drinking. going to try and go this weekend without drinking. as far as your comment about your friend she must have been a bybass because our pyloric valve doesnt allow alcohol to pass any sooner.

So I had my revision on April 29, 4 1/2 hour surgery, my stomach had prolapsed and was adhered to my liver. Passed out in the hospital, couldn't get a BP for about 20 min, and ended up staying 3 nights. No pain since drain was removed ( the drain somehow slipped into my pelvic area causing A LOT of pain). Anyhow, I am just weak weak weak! Walk up the stairs sit for 20 min, have to sit to make jello. I can drink anything at least 4 oz at a time. Getting about 60 gm of protein. Prob 48 oz water/liquids. Still on full liquids. My BP is still low this morning it was 92/56. BS was 124. No fever, very little pain, largest incision does look a little angry. Down 14 lbs including pre-op. Do I sound normal? I'm just soooo weak! Thanks Laurie

Hi...My name is Dee. I'm 42 and live in Texas. I am getting banded on Tuesday the 19th. I'm looking for a buddy I can talk to and learn from. I haven't told anyone outside my family about this. I'm not ready for the world to know yet. I guess I just don't want to hear all the BS...

I'm 5yrs out and I am brutally honest about this surgery. I am the type I'd rather you tell me like it is instead of sugar coating it. I've lied to myself almost my whole life with the "I don't eat that much.." excuse. I am where I am today because I did it to myself. The obesity I did myself and the surgery I did to myself. I accept my actions and trust me its a dark life when ur in a hospital and all u have is urself and ur thoughts. I do not intend to terrify ppl to have the surgery but I can say this I care enough for my fellow bari patients to tell yall the truth and what can happen. Bariatric surgery has became so mainstream now I fear a lot don't take this seriously hence why suicide, sex addictio. Or alcoholism rates are so high for us. The reason you will probably hear about my story in every post is bc I would have truly appreciated someone in my pre-op post-op days coming to me with the truth. Instead I felt dooped. Out of all the reading on forums etc not once were there a person openly honest about how it truly affected them. Do you know how hard it is to be deathly sick and you hear rude comments from nurses such as "bet ya wished u had just got a gym membership huh?!" Or to have your family just get tired of listening or you lose relationships bc of your condition? It really hurts to come to a site and literally pour your heart out only to be berated by somebody you look to for support. We may weave our story in all the time but we do so bc we know or HOPE fellow bari pt will listen and not mind to do so bc unlike everyone else we r all supposed to be on the same road. Accept us all no matter what bc haven't we lived a life of hell prior to surgery due to the constant degeading conments and stares...let this be the one place u can trust to come to and know ur not going to be hurt..we r all entitled to that. =)

I was ok two weeks after surgery. The first week was rough and the second week I was tired, but back to work full time. At the start of the second week I started feeling almost normal again, although not being able to eat real food kinda put a damper on that. If you have the ability to cook for yourself and have a kitchen where you can stay hydrated and well-fed, you'll be fine on vacation. I don't think I was really crazy about the heat for a few weeks after surgery. My procedure was done at the start of Sep and I live in Florida, so also miserably hot at about 2 weeks post-op.

okay dokey, I am just going by your sample menu...so I know it may not be a good reflection of what you eat weekly but here are some thoughts. Why a Protein Shake in the morning? Is it bc you are too tight? If not, maybe replacing it with a solid food (with protein). Also, you listed salad twice. Salad is a slider food, and not very nutritionally beneficial. It won't keep you full or give you much energy. I agree though that maybe you are not eating enough calories. Have you tried tracking with the daily plate or other websites? A lot of people say they need somewhere around 1200 to keep their weight loss steady. Also, what does your exercise look like? If you are exercising regularly, maybe you are losing inches but not pounds? If you aren't exercising, maybe if you started it would help jump start things again? Those are just some thoughts. What weight did you start at?

Here is a longer one...kinda makes my head hurt. IS STARVATION MODE A MYTH? NO! STARVATION MODE IS VERY REAL AND HERE’S THE SCIENTIFIC PROOF QUESTION: Tom, I was wondering if you had seen the 6 part e-mail series sent out by [name deleted] from [website deleted]. if you look at the last part, he basically states that “starvation mode” is a bunch of crap made up in order to sell diet programs. He didn’t mention you, but it almost sounds like he’s talking about you specifically. How do you feel about this? ANSWER: Yes, I saw that article/email and the author is mistaken about starvation mode. In his article, he accused those of us who use the term “starvation mode” as being unscientific and he even says “dont buy diet books if they mention the starvation mode.” I’ll make it clear in a moment, that in this case, he is the one who doesn’t appear very well read in the scientific literature on the effects of starvation and low calorie diets. I do have to point out first that the effects of starvation mode are indeed sometimes overblown. There are also myths about the starvation mode, like it will completely “shut down” your metabolism (doesn’t happen), or that if you miss one meal your metabolism will crash (doesn’t happen that fast, although your blood sugar and energy levels may dip and hunger may rise). Another myth about starvation mode is that adaptive reduction in metabolic rate (where metabolism slows down in response to decrease calorie intake) is enough to cause a plateau. That is also not true. it will cause a SLOW DOWN in progress but not a total cessation of fat loss. As a result of these myths, I have even clarified and refined my own messages about starvation mode in the past few years because I don’t want to see people panic merely because they miss a meal or they’re using an aggressive caloric deficit at times. I find that people tend to worry about this far too much. However, starvation response is real, it is extremely well documented and is not just a metabolic adaptation - it is also a series of changes in the brain, mediated by the hypothalamus as well as hormonal changes which induce food seeking behaviors. Here is just a handful of the research and the explanations that I have handy: Ancel Key’s Minnesota starvation study is the classic work in this area, which dates back to 1950 and is still referenced to this day. In this study, there was a 40% decrease in metabolism due to 6 months of “semi-starvation” at 50% deficit. Much or most of the decrease was due to loss of body mass, (which was much more pronounced because the subjects were not weight training), but not all of the metabolic decline could be explained simply by the loss of body weight, thus “metabolic adaptation” to starvation was proposed as the explanation for the difference. Abdul Dulloo of the University of Geneva did a series of studies that revisited the 1300 pages of data that keys collected from this landmark study, which will not ever be repeated due to ethical considerations. (it’s not easy to do longitudinal studies that starve people, as you can imagine) Here’s one of those follow up studies: “Adaptive reduction in basal metabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores. Dulloo, Jaquet 1998. American journal of clinical nutrition. Quote: “It is well established from longitudinal studies of human starvation and semistarvation that weight loss is accompanied by a decrease in basal metabolicrate (BMR) greater than can be accounted for by the change in body weight or body composition” “the survival value of such an energy-regulatory process that limits tissue depletion during food scarcity is obvious.” Also, starvation mode is a series of intense food seeking behaviors and other psychological symptoms and if you do any research on the minnesota study and other more recent studies, you will find out that starvation mode as a spontaneous increase in food seeking behavior is very, very real. Do you think sex is the most primal urge? Think again! Hunger is the most primal of all human urges and when starved, interest in everything else including reproduction, falls by the wayside until you have been re-fed. There are even changes in the reproductive system linked to starvation mode: It makes total sense too because if you cannot feed yourself, how can you have offspring and feed them - when you starve and or when body fat drops to extremely low levels, testosterone decreases in men, and menstrual cycle stops in women. Starvation mode is not just adaptive reduction metabolic rate - it is much more. There IS a controversy over how much of the decrease in metabolism with weight loss is caused by starvation mode, but the case is extremely strong: For example, this study DIRECTLY addresses the controversy over HOW MUCH of a decrease in metabolism really occurs with starvation due to adaptive thermogenesis and how much is very simply due to a loss in total body mass. Doucet, et al 2001. British journal of nutrition. “Evidence for the existence of adaptive thermogenesis during weight loss.” quote: “It should be expected that the decrease in resting energy expenditure that occurs during weightloss would be proportional to the decrease in body substance. However, in the case of underfeeding studies, acute energy restriction can also lead to reductions in resting energy expenditure which are not entirely explained by changes in body composition.” Starvation response is even a scientific term that is used in obesity science textbooks - word for word - CONTRARY to the claim made by the expert mentioned earlier who thinks the phrase, starvation mode is “unscientific.” Handbook of Obesity Treatment, by wadden and stunkard (two of the top obesity scientists and researchers in the world ) quote: “The starvation response - which is an increase in food seeking behavior - is most likely mediated by the decrease in leptin associated with caloric deprivation.” Textbooks on nutritional biochemistry also acknowledge the decrease in metabolism and distinguish it as an adaptive mechanism, distinct from the decrease in energy expenditure that would be expected with weight loss. In this case, the author also mentions another downside of very low calorie diets: spontaneous reduction in physical activity. Biochemical And Physiological Aspects of Human Nutrition by SM. Stipanauk, professor of nutritional sciences, Cornell University (WB Saunders company, 2000) Quote: “During food restriction, thermic effect of food and energy expenditure decrease, as would be expected from reduced food intake and a reduction in total body mass. Resting metabolic rate, however declines more rapidly than would be expected from the loss of body mass and from the decline in spontaneous physical activity due to general fatigue. This adaptive reduction in resting metabolic rate may be a defense against further loss of body energy stores.” Granted, it is more often referred to as “metabolic adaptation” or “adaptive reduction in metabolic rate.” However, starvation mode and starvation response are both terms found in the scientific literature, and they are more easily understood by the layperson, which is why I choose to use them. Another effect of starvation mode is what happens after the diet: A sustained increase in appetite and a sustained reduction of metabolic rate that persists after the diet is over. Although controversial, this too is documented in the literature: American Journal clinical nutrition 1997. Dulloo “post starvation hyperphagia and body fat overshooting in humans.” American Journal Clin Nutrition 1989, Elliot et al. “Sustained depression of the resting metabolic rate after massive weight loss” quote: “Resting metabolic rate of our obese subjects remained depressed after massive weight loss despite increased caloric consumption to a level that allowed body weight stabilization.” and Dulloo 1998: “The reduction in thermogenesis during semistarvation persists after 12 weeks of restricted refeeding, with its size being inversely proportional to the degree of fat recovery but unrelated to the degree of fat free mass recovery.” By the way, this explains what some people refer to as “metabolic damage” and although this is not a scientific phrase, you can see that it too is a reality. It is the lag time between when a diet ends and when your metabolism and appetite regulating mechanisms get back to normal. Last, but certainly not least, and perhaps the best indicator of starvation mode is the hormone LEPTIN. you could spend weeks studying leptin and still not cover all the data that has been amassed on this subject. Leptin IS the anti starvation hormone. Some people say leptin IS the starvation mode itself because it regulates many of the negative effects that occur during starvation. leptin is secreted mostly from fat cells and it signals your brain about your fat stores. If your fat stores diminish (danger of starvation), your leptin decreases. If your calorie intake decreases, your leptin level decreases. When leptin decreases, it essentially sounds the starvation alarm. In response, your brain (hypothalamus) sends out signals for other hormones to be released which decrease metabolic rate and increase appetite. In summary and conclusion: There is no debate whatsoever about the existence of starvation mode - IT EXISTS and is well documented. There is also no debate whatsoever that metabolic rate decreases with weight loss. It happens and is well documented, and it is a reason for plateuas. There’s really only ONE debate about starvation mode that is — HOW MUCH of the starvation mode is comprised of adaptive reduction in metabolic rate and how much is due to loss of total body mass and increased feeding behaviors? Researchers are still debating these questions, in fact just earlier this year another study was releasd by Major and Doucet in the international journal of obesity called, “clinical significance of adaptive thermogenesis.” Here’s a quote from this latest (2007) study: “Adaptive thermogenesis is described as the decrease in energy expenditure beyond what could be predicted from the changes in fat mass or fat free mass under conditions of standardized physical activity in response to a decreased energy intake, and could represent in some individuals another factor that impedes weight loss and compromises the maintenance of a reduced body weight.” I respect the work that other fitness professionals are trying to do to debunk diet and fitness myths, but this fellow didn’t seem to do his homework and totally missed the boat on this article about starvation mode. What’s really odd is that he didn’t quote a single study in his article, despite his repeated reference to “scientific research.” If he wanted to argue against adaptive reduction in metabolic rate and chalk starvation mode up purely to increase in food seeking behaviors… and if he wanted to attribute the decreased metabolism with weight loss purely to lost body mass, he easily could have done that. But he didn’t cite ANY studies. He just expects us to take his word for it that “starvation mode is a myth,” and people like me who use the phrase starvation mode are “unscientific” Either way you argue it - and whatever you choose to call it - “starvation response” is a scientific fact and that’s why prolonged low calorie diets are risky business and mostly just quick fixes. The rapid weight loss in the beginning is an illusion: Starvation diets catch up with you eventually… just like other habits such as smoking appear to do no harm at first, but sooner or later the damage is done. For years I’ve considered it so important to understand the consequences of starvation diets that my entire burn the fat program is built around helping you recover from metabolic damage from past diet mistakes, to avoid the starvation mode, or to at least keep the effects of the starvation mode to a minimum so you can lose the fat and keep the muscle. Sincerely, Your friend and “Burn The fat coach” Tom Venuto, CSCS, NSCA-CPT www.BurnTheFat.com PS. For more information on getting lean without starving yourself or harming your metabolism, visit my website at www.BurnTheFat.com.

What an interesting post. I can understand the emotional pull to sleeve at risk adolescents and also adults. I lived those tumultuous obese years like everyone here. But I disagree with preventative sleeving. I am in medical school, and perhaps that education has swayed me. I look at it as cost benefit. Someone mentioned getting the ovaries removed as an analogy. It was a great analogy I think. If a woman has a family history of ovarian cancer she can get her ovaries removed prophylactically and can reduce her cancer risk. But she also will go into early menopause with consequences such as osteoporosis, infertility, etc. But this woman also saves her life. Presumably before having her ovaries removed the woman would have spoken at length with her doctor, researched, made preparations for how to best manage her health after the surgery for years to come. Similarly, a 30lbs overweight woman may get the sleeve. Just like ovarian cancer there is still a risk of gaining weight with the sleeve. Also, the sleeve comes with risks...surgical risks, Vitamin deficiency, energy level. What worries me about making this option readily accessible is that unlike removing your ovaries (no vanity benefits here!), the sleeve and its associated weight loss will cause ppl to flock in for a quick fix without doing the necessary research to ensure they remain healthy. It's akin to getting your ovaries out to avoid having kids when you could have just take birth control or even had a hysterectomy! Having said all that, if a patient feels the desire for a preventative sleeve and can pay for it and goes through a regimented and intensive education (I wish there were even stricter requirements than we see now) and therapy, then there should be an avenue for that. And through that education I would hope many preventative sleevers would change their mind bc they get individualized attention from their physician on how to lose weight and maintain a healthy lifestyle. Kind of like going to driving school to learn the rules is preferable to getting in an accident and then having to take a class on safe driving... Sorry if that was wordy. I had to get it out there.

The first 24hrs is rough. You won't hurt bad but you will be tired and a little sore. By day 3 you will be comfortable moving around. They will remove your drain tube that night and THAT is the best. From then on you will be fine. You can drive whenever you want. Just keep your luggage light bc you can't lift more than 15lbs.

Hi skinniminiwannabe! I love your user name. I'm in Fredericksburg. My surgeon will be Brennan Parmody MD, Bon Secours. I'm in month 2 of my PCP supervised diet (BCBS Fed) I can't wait for surgery!

So it's been awhile since I last posted, but I'm still loving my lap-band! I had my second fill last monday, where she gave me .5ccs (my first fill was 4.4ccs). I was pretty disappointed when I heard how low she was going, but I agreed anyway, bc she didn't really want to give me one in the first place. I'm 3 months out and lost 50 lbs between pre-op and now, so she was really happy with my progress. Well.. I'm thinking i might be at green, or close to it. I can still eat and enjoy foods, but I'm noticing i get stuck if I'm not mindful of my eating. I've had 3 pb episodes, so I really need to focus on small bites, chewing well, and listening for my signals (usually a small hiccup). I'm still eating low carb, because it works best for me. Currently sipping warm green tea because i just had a pb episode with Quest Protein chips.

Hi Melissa, I have a surgeon in mind. My husband was laid off and is starting a new job. Once I know what our new insurance plan is I'll go from there. I'd prefer to use Park Nicollet because it's closer and the wait isn't as long. But if insurance doesn't pan out I'll go to Mexico. It's good to hear BC/BS covers things now. They weren't covering it last year. Now I'm hopeful that whatever plan we're one covers it now too.

I ended buying a can of unflavored isolate whey protein (vegan type) I would put a teasp in my coffee, in my hot teas, in my small soups, in sf pudding cup..it took me a few wks to get my required in. I couldnt sip on water much bc of the esophagus spasms I had for 2 wks...there are also protein shots you can get. cvs carries them...you'll get there. by my 6 wks I was gagging on shakes as well..I did also drink the pure protein shakes I did well with those but I did try the adkins an it was gross! it made my tummy cramp so I thru them out! I am 5 months out an I still eat on the pure protein bars an a few other brands when Its just me an dont feel like cooking.