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I'm thrilled that you had such a wonderful experience. There are MANY competent and caring doctors, top notch coordinators, and clean facilities in Mexico but we don't hear a lot about Dr. Illan or Baja Bariatrics so thanks for the review.

I just wanted to share the wonderful experience I had going through bajabariatrics.com for my vertical sleeve 2 weeks ago - Dr. Jalil Illan is top notch and the care and treatment I received, both before and after surgery, was more than I expected. I truly feel a greater connection to Dr. Illan and his team then I do with my PCP here in the States - and I love my doctor here - but the care and time was incomparable - the hospital was clean and private (with a great view), the doctor was thorough, knowledgable and friendly (much more approachable than many doctors I have seen in the US), and his coordinator, Omar, is someone I now truly consider a friend - he was with me every step of the way and was much needed support and source of comfort! I work in a hospital in the US and STRONGLY recommend that if you are traveling south for your procedure---choose no one but Dr. Illan and Baja Bariatrics - there is no one better and you will not be disappointed.... Please feel free to message me or ask anything I may have left out that you are interested in by the way, I am 15 pounds closer to a healthier me and couldn't feel better!

This is the place I've found that sells the large bags of Bariatric Advantage for the least amount of money: http://store.carbessentials.net/ The catch is that they only sell vanilla and chocolate, but those are the ones I usually buy since they're good base flavors. If you order at least $75, shipping is free. They also sell the Calcium citrate chews and Vitamins as well, but the BA vitamins are vile.

I'm new here and have been looking for help with some of the problems I'm having with my band. Here’s part of my story. I got banded 6-12-06. I was 400 lbs and in a really bad place. I got down to 314 lbs in about 5 months. Unfortunately, I haven't been doing very well and now I'm back up to 360 lbs. I had a fill in March 2007. This was my 4th fill, now up to 6cc out of a possible 10cc. Prior to this fill it seemed the band was having no effect on me. I was able to eat like I had no band. After this fill I had mixed experiences. Eating Breakfast and lunch was often very difficult. After one or two bites of food it seemed to get stuck. I would take small bites and chew it well, at least most of the time (sometimes I’d forget and put too much food in my mouth or I’d eat too quickly). I would experience pain in my chest and then throw up. Sometimes I forced myself to throw up to try and relieve the pain I was experiencing. Usually this helped but I would be unable to eat anything for the remainder of the morning and afternoon. By the time I would get home from work I’d be really hungry. Now for some reason that I can’t explain, I had no difficulties eating (or some minor discomfort). There was no pain and I would be able to eat just about as much as I wanted as if there were no band in place. Obviously this was the worst time to stuff myself, it being that close to bedtime. This pattern continued for a while and I started putting the weight back on. I went to see my bariatric doctor and he said I was just eating too much at night and the food was just sitting in my pouch all night into the afternoon of the next day so that when I tried to eat there was already too much food in the pouch and I’d throw up. I agreed I was eating too much food at night but I never really bought into the idea that the food was just sitting in the pouch all night into the afternoon of the next day. I tried working with a nutritionist but the problem continued. The doctor sent me for a barium-swallowing test and the results showed I had severe refluxing going on. They prescribed Nexium and after a few months there was still no relief. I still can’t understand why I would experience such problems during the day but by night it was as if I had no bad. Has anyone else ever experienced this? The day problems aside it was my understanding that the band was supposed to prevent you from overeating. Yet in the evenings I could just go on eating until I felt full, which was always after consuming a huge quantity of food (for example 6 slices of a large pizza or almost a pound of pasta). I never could get an explanation as to why I could eat so much with the band. I feared getting another fill because I was already having too much trouble eating during the day. I stopped eating breakfast and tried to have a sensible lunch. Sometimes this worked but too often it didn’t. I couldn’t point to a particular food item either as the cause for pain and throwing up. meat, vegetables (raw or cooked), fruit, grains or other starches have all at one time or another caused this problem. I’ve tried drinking some hot tea or coffee before eating lunch. This seems to have helped in some cases but doesn’t always work. Finally my doctor performed an endoscopy to see if the band had shifted. Everything looked fine is what he told me. On Friday, October 12 I went for another fill, now at 7cc. Friday went ok. I had lunch and a small dinner (at least small compared to what I was usually eating at dinnertime). Late Friday when I was taking my evening medications I experienced a fair amount of pain again. I didn’t throw up but was in discomfort for a while. On Saturday I tried eating about 1/3 cup of celery salad (just shredded celery root in Water, vinegar and sugar liquid) for lunch. Well even after counting 30 chews before swallowing I felt pain in my chest as if something was stuck. After a short period I threw up several times, not food just a clear mucus type of liquid. After an hour or so I felt better but I couldn’t eat anything else the rest of the day. I tried several sips of Crystal Light but this was very uncomfortable. I didn’t dare try taking my medications. Now it’s Sunday. I was able to take my AM meds without problems. For lunch I tried ½ can of tuna (in water) with some Miracle Whip Light on a small potato bread roll. Spent about ½ hour eating it and now I’m experiencing some discomfort and refluxing. Has anyone out there experienced this or know of anyone else who has? I’m just at a loss as to what to do. Any help would be appreciated. Sorry for being long winded and thanks for listening.

Congratulations on your decision to take control of your life and health! As a fellow Oregonian, I can tell you that there are several good surgeons/hospitals in the Portland area. Salem Hospital's Bariatric Surgery Center also has a great program and the staff are awesome. This is who I chose. Salem Hospital and their bariatric surgery center are also recognized as national centers of excellence. If you know others who have had WLS, talk to them to get their recommendations. Do your research and attend a few informational seminars (this is pretty much how you have to start the process with any bariatric surgery program). You'll get a feel for which surgeon/program will be the best fit for you. The seminar will also give you a more clear picture of each type of surgery. Depending on your insurance, it can be a lengthy process with many, many hoops to jump through or it can be a very simple and quick process. Expect to go through several pre-op procedures, labs and clinic appointments (surgeon, dietician, psychologist, etc.) either way, though. You came to the right place for support and advice. The members here are wonderful and very helpful. Good luck and keep us posted on your progress!

1) My insurance had a 'no wt gain' stipulation and it was from my starting weight and I had 6 months required supervision. 2) My insurance approval was sent in after my last NUT appt. , I already had my physical clearances but had not had my surgery labs and EDG - those are scheduled after approval. 3) N/A - had Humana 4) If your insurance requires PCP approval, then yes a PCP can be biased and could stall your chances. BUT you can change primary physicians, or fight through the PCP's supervisors - everyone answers to someone. This has happened to people on bariatricpal, and they changed to another PCP. Mine wanted to send me to a Humana bariatric physician 2 hours away and I said NO. I will petition my insurance to go out of network - at in-network cost because that is a burden to go that far and it was approved. Good luck.

Can't buy Bariatric Advantage in UK, anybody happen to know a good alternative in this country, thanks.

I'm with BCBS of Mississippi state and we have to participate in a six month weight management program also before receiving our surgery date. The way it works for me is for 3 months I'm assigned a life coach who with discuss healthier eating habits to get you on the right track. It's done over the phone and lasts about 30 mins. The next 3 months you will be assigned a Bariatric nurse who will walk you through preop and post op stuff. Also during the last 3 months you are getting everything u need done for surgery. Not hard at all. My husband is getting sleeved with me and we are hoping for the first of October.

Hi. I am in RI and hope to have surgery in June. I hear that Tufts and MGH are great. Check them out on line under bariatric surgery and make an appt. for a consult. Good luck to you!

At last year’s annual physical, I asked my primary care physician (PCP) if I would benefit from weight loss surgery. She said, “Yes, weight loss surgery would benefit you. But, not something as drastic as the by-pass due to absorption issues.” Great – that is all I needed to hear. Last summer, I completed the program at my local bariatric center – even though I met insurance criteria, I was immediately denied – both insurance appeals were denied – I got determined – started researching all options - then chose my surgeon in Mexico. (My BMI was 36 and I had a co-morbidity and met the insurance requirement for surgery, but was denied because my hypertension was controlled with two medications.) It never occurred to me to ask my doctor for her “permission” to go to Mexico for surgery nor did I check to see if she would treat me after surgery. She said I would benefit from weight loss surgery, so I was doing it! After surgery in Mexico, I faxed her the surgery notes and she helped me get off all my blood pressure medication. Fast forward to today and this year’s annual exam. This was my first visit to the doctor since surgery in February. Of course my weight is down, my resting heart rate was great, and my blood pressure NORMAL with a normal sized cuff. YES! The appointment started out like normal, she was asking how I was feeling, etc. Told her I felt great, was eating well, exercising, and losing weight after bariatric surgery in February. She said, “Oh yes! I got the surgical notes you sent me…did you REALLY go to Tijuana and have surgery?! I thought you might have been kidding!” It was sort of comical. As I started with the story – here eyes were huge! But, once she understood my surgeon’s credentials, facility certification, what procedure I had, post-surgery follow up, she had a big smile. My PCP said, “You did good! Our medical system is such a mess and everyone watches the doctors & hospitals, but who is watching the insurance companies? Oh, and I would be really interested in talking to your surgeon about how to practice out of the country. We love the Caribbean and I would love to take care of the ex-patriots living there.” She looks at my incisions and said they looked great. For anyone considering Mexico and concerned about what your doctor might think, don’t be. If your doc is on board with weight loss surgery for you, they might be really interested in learning more about medical care outside the US too.

I asked the dietician that in the hospital because I thought it sounded odd too. In fact, the nutritional booklet that they gave all the bariatric patients had meal plans for both 3 and 6 meals a day. Here was her logic, and after she explained it to me it made sense: since you have to stop drinking 30 minutes before and after each meal and since it should take about 30 minutes to eat a meal, that means you have 90 minutes x number of meals every day that you can't be drinking fluids. For 3 meals a day that's 4 hours off, for 6 meals that's 9. Considering a lot of us have trouble staying hydrated in the beginning I think it's a reasonable concern. One of the things they pushed hard on during our healthy eating class was breaking the "snack mentality", and there is concern about eating small amounts multiple times a day leading to all-day grazing and never really feeling full. That being said, the dietician did mention that some of her patients come back after a month or so and complain that they feel hungry all the time, in which case she suggests they add in an additional fourth meal, but just keep track of everything. I don't know much about the research relating to metabolism -- I know mine is low due to a lifetime of no exercise -- but I've heard that muscle building can help raise it as well, since it takes more calories to maintain a pound of muscle than a pound of adipose tissue. Until I get my asthma under control enough to do cardio I plan to do some light weightlifting to help with muscle toning.

I don't have any magic, I wish I did for you but these are my ideas. 1. Get with your bariatric support group if your doctor/hospital offers one. Get with their nutritionist and keep in regular face to face contact for accountability and support. They want you to SUCCEED! and I'm sure will support you. 2. If you saw a psychologist or did a psych eval with someone before getting approved to be banded, consider going back to that person who has a relationship established and get the counseling going to see if they can help you get to the bottom of what has you off track. Again, they can give you impartial advice and will be a great cheerleader to help you. 3. If you aren't doing daily food logging for self accountability, please do use this right away. Sometimes just seeing what we are eating in writing is powerful. I use www.myfooddiary.com, I hear alot of people like www.sparkpeople.com and others have mentioned www.dailyplate.com but whatever works for you, consider this right away. 4. See if you can get a mentor or lapband buddy connection. See the lapbandtalk mentor/buddy thread where people are offering to do this. If you can find someone locally, find someone you can call up on the phone.

I had zucchini sliced in a glass dish with a buttery mixture of spices over it then I laid the fish on top n finished covering the fish with the mixture. Yummy. N cauliflower with cheese. from bariatric foodies.

food and Feelings: The Importance of Making the Connection By: Louisa Latela, MSW,LCSW I had been asked to speak to a Post-Op WLS support group a couple of years ago... around the time that gastric bypass/ weight loss surgery was just starting to become “popular.” As a psychotherapist who has been working with persons struggling with weight issues for more than 17 years, I was astounded when I spoke to this support group and realized that many bariatric patients have never made the connection between food and feelings. The first woman to speak said she had become obsessed with having to be a size 0. She was in a size two and would not buy any type of clothing that was larger than that and was actively trying to get to that 0. She was exercising compulsively. Another woman reported that she was drinking more and acting out sexually. One participant said she “had it all”: great husband, great kids, a job she loved and all the money she could want, yet she had never been so unhappy. She was starting to eat chocolate again. Yet another member said she was so nervous, she did not know what to do with herself. When she got home at night she would be watching TV and get up and walk to the kitchen, open up the refrigerator door, then dose it and go hack to the TV She would do this several times every night. Other people expressed great fear of what life would be like as a thinner person. I started to explain to them that I believe we are all born these perfect little psychic bundles of love. We are who we are in each moment, expressing our truth with freedom and innocence. If we’re happy we laugh, sad we cry, hungry we eat, full we stop. It doesn’t occur to us to not be real about who and what we are and how we feel Then as we age we start to get sometimes very subtle and sometimes very overt messages that who we are is not ok - that it is not safe to express our truth. This can come from getting messages like “big boys don’t cry,” “oh, that doesn’t hurt,” “that was a stupid thing to say,” or maybe you heard your parents arguing and asked your mother what was wrong and she said “nothing is wrong everything is just fine,” and you start to think, “It didn’t feel fine to me. It felt like there was some anger, like something between my parents was really off;” but your mother who to this point you’ve believed tobe the expert about life said everything was ok. Then you start to think, “Something must be wrong with the way I think or perceive things.” You learn to not trust your instincts. Then one day someone comes along and asks, “What color is the sky?” and you think, “Well, I think it is blue, but I don’t know if what I think is right. The last time I cut my finger, it hurt and I cried. I was told that it didn’t hurt that bad, and I shouldn’t cry. I don’t know. Maybe the sky is purple or green.” And when we are unable to express our truth, it creates a great deal of anxiety. Often, families teach children to manage feelings like anxiety with food. When we are focused on food, we learn that we do not have to be present to the current situation, nor do we feel the pain of not being able to trust and/or express ourselves. Food eventually becomes a reliable coping mechanism, a comfort zone that allows us to ignore and disconnect from what is real. Weight loss surgery patients who take the time to understand how and why they became morbidly obese and make the connection between food and feelings may make sturdier lifestyle changes that support long term weight loss. In the past two months I have had four people call my office who were 2-3 years post op. They were all starting to gain their weight back (anywhere from 25-65 pounds) and were desperate to understand why and learn what they could do to change it. None of these people had sought out any psychological counseling either before or after their surgery. They all thought, “It will just work because I won’t be hungry and my stomach can’t handle enough food to make me get fat again.” Unfortunately this was not the case. They had very little insight as to how they were using food to manage the intensity of their emotions. One way to start to understand the role compulsive eating has played in your life, is to be aware of when your thoughts turn to food when you are not physically hungry, and ask yourself; “What would I be doing right now if I wasn’t thinking about food?” It is in these moments that it is very helpful to journal. It doesn’t have to be in a fancy book, it can just be on a piece of scrap paper. The purpose here is to start to make you conscious of when you may be eating for reasons other than physical hunger. Before you can change a behavior you must first become aware of it. Write down anything that comes to mind. Try not to filter what you are writing. If you don’t know what you would be doing or what you are feeling write about what “not knowing” feels like, and ask yourself “what kind of nurturing do I need right now?” I believe that compulsive eating is always an attempt to self nurture and that self love and compassion is the foundation upon which a successful recovery program must be built. People who are in the process of losing weight and attempting to change their lifestyle may be hard on themselves. Any small deviation from their meal plan may be looked at as a failure, triggering feelings of anger, depression and shame. They may be trying hard to cope, but the shame that follows this kind of self talk can intensify the feelings of hopelessness and lead one to give up on oneself entirely. It is in these moments that we all need to tell ourselves the same thing we would tell a child or loved one. Would we tell them they are a failure because they did not follow their meal plan? If we wouldn’t say it to them, then why would we say it to ourselves? It is in these moments that we must be extra kind and compassionate with ourselves. It is a time when we really need to give ourselves an emotional hug, and think about the idea that we are doing the thing that we least want to do (that is eat in a way that does not support good health). That we have done this is an indication that this behavior feels safer than sitting with some uncomfortable feelings. Sometimes we all struggle to love ourselves enough to believe that we are worth the effort of hanging in there with ourselves as we attempt to make behavioral changes that will support us living a healthier life. Know that food is not good or bad, it just manipulates the energy in our bodies. Notice when and what you are eating and ask yourself; “Will this food support good health for me? How will I feel physically about 20 minutes after I am done eating this? How will I feel emotionally?” It has often been said that our lives are a manifestation of our intentions. Think about what that might mean in your life as you observe the way you eat. Is the way that you are eating and self caretaking an indication that your core intention for your life is something like: “It is my intention to have a healthy, joyful, abundant life” or is it something else? Just notice and think about what you would like the intention for your life to be. That to which we put our attention, expands. As I mentioned earlier, it is not uncommon for people to express great fear and concern regarding what will life be like as a thin person. How will I handle attention from the opposite sex? What will I do with all the extra time and energy I will have when I am eating for good health and energy? What will I do without the protection of my excess weight? As people travel down the road to recovery from morbid obesity, they are sometimes surprised to find out that they are not so much afraid of failure, but of success. Uncovering feelings of unworthiness, asking, “Who am I to be successful and — have a big life?” When actually they need to learn to ask the question, “Who am I not to be? What gives me the right to not have a fabulous life?” It isnot uncommon for people touse excess weight as a way of putting distance between themselves and others. When this is the case, one must learn to be assertive and set appropriate boundaries, and at the same time, risk being vulnerable and experience emotional intimacy. It is important to acknowledge and process any of these feelings that might surface, because if ignored, they could trigger intense feelings of depression, a common co-morbidity for bariatric patients, and fear which can sabotage your success. I believe that depression is an energy that is “depressed,” that it is a sign that there is something in one’s psyche or soul that wants to be expressed but has not had such an opportunity. (This is in no way meant to say that people who suffer from clinical depression need not consult with a physician and take meds as directed). When this oft times creative urge or passion tries to surface and it gets stuffed back down, a person often experiences this phenomenon as depression. As a bariatric patient one must start to explore what it is that excites them, what is it that sparks their interest, what triggers feelings of passion and excitement? Allow yourself to follow your passions. Allow yourself to play. Playing is a vitally important “nutrient” for the well being of our mind, body and spirit. It truly nurtures one’s soul. It is important to understand that feelings are just energy in your body. They, like food, are not good or bad or right or wrong. You do not have to react to your feelings. You can breathe into them and just notice them. Eventually you will begin to understand how to change your feelings as you become aware of your core beliefs and self talk. We are taught in this society that we always have to “feel good” and if we begin to feel angry, sad, anxious, etc., we must do something to stop the feeling; but, what is truly healing is to embrace the feeling, and just sit with it. It will eventually soften, and then you can move through it. When you start to truly “listen to yourself;” you will know what actions you must take in order to live a life that supports your highest good. I am writing this article because I feel so passionately about the need to get this information out to the weight loss surgery population to help them understand that surgery is only the first step. Please, if you have had, or are considering having this surgery, be sure to set yourself up with a good aftercare plan that includes individual psychological and nutritional counseling/support, realistic exercise instruction, follow up with a primary care physician familiar with weight loss surgery and group support. Surgery is not a magic cure. There is both emotional and physical work to be done in order to live a life free from compulsive eating. But IT CAN BE DONE!! Copyright 2004 DDB Media LLC www.wlslifestyles.com All rights reserved. Used with permission. If you have any questions or comments about this article or are making the connections between food and feelings I would love to hear from you. You can visit my website at www.louisalatela.com, email me at louisa@louisalatela.com, or call me at 856.429.9799.

On the days where I have made my band angry with me I know I need to go on liquids for awhile. Well the soups at the Bariatric center cost me an arm and a leg and my doctor has told me I can just get other soups at the store and add my Pure protein to it. He never has been specific as to what brand of soup I can use.....sooooooo what brands of soups have you all used? Snacking. Yeah yeah yeah I know, biggest rule they tell you is no snacking. BUT on the days that I am not in my home state and need a fill, I know three meals aren't going to satisfy me throughout the day. Normally, I'll eat a handful of sugar snap peas if I feel a little hunger pain before the time I need to eat or maybe some frozen berries. But that gets kind of monotonous and makes me feel sick to my stomach. So suggestions on that as well? Thanks everyone![:

Anyone else get one of these? We each got this weird stuffed bear with instructions on how to hold him against our bellies to brace for coughing. He's made to kind of fit against you and provide support. He's kinda fun....wears a little teeshirt that has illustrations of your procedure on it so you can show people with a visual. Weird, but kinda sweet. He has no butt. LOL And he's kinda ugly.

What's your favorite brand of Bariatric vitamins and supplements and why ?

He's speaking of the hiatal hernia. It's a condition in which part of the stomach pushes up through the diaphragm muscle. I've watched a ton of the actual surgeries on YouTube and the fix usually consists of a couple stitches. I think all bariatric surgeons are taught to look for this as part of the bariatric surgical procedure.

My doctor recommended the Optisource Bariatric chewable. You take like 4 a day but they have everything that a WLS patient needs.

I would stay on your Dr. advise, or Bariatric Advantage multi chewables, since 4 weeks is still so short of a time. I think I'd go heavy on Vitamins for the rest of your life, right? Perhaps there are some more you can graduate too, after blood-work to see where you may be lacking. I'd request a blood work up. =) That's just me.

is there anyway you can keep the insurance you have by applying for insurance on your own with a bcbs plan that does offer the bariatric surgery? So frustrating, I hope this works out for you.

That's something you need to clear with your bariatric and primary. It will depends on your levels.

First thing in the morning: sublingual Vitamin B-12 - 1x per day (1 total) calcium citrate plus Magnesium - 2x per day (4 total) > I take the second dose before bed. Vitamin D3, 5,000 IU - 1x per day (1 total) Potassium, 3% RDA - 1x per day (1 total) With Breakfast: Multi Vitamin plus Minerals - 1x per day (1 total) Ferrous Sulfate (Iron) - 1x per day (1-2 total) One hour before dinner: Calcium Citrate Lozenge from Bariatric Advantage (I forget half the time!) Omega 3-6-9 (4x per week or when I remember) Before Bed: Last dose of Calcium Citrate, 2 Pills Biotin, 2,500 mcg That is a lot, but it has kept me healthy with all of the rapid weight loss and my hefty workouts. There are a lot of vitamins/minerals in all Protein shakes too! In time I plan to reduce the amount I'm taking, especially one dose of calcium and the biotin as well since my hair loss has stopped, finally.

Hi everyone. I just joined the forum because I'm going out of my mind thinking about my upcoming surgery. I have been looking into weight loss surgery for the better part of eight years, with every issue life can throw at me popping up along the way. Then, all of a sudden, in the space of two or so months, every roadblock seems to fall away, and the team at the University of Chicago has offered me a date in less than two weeks for the DS procedure. I am such a combination of excited and scared, motivated and freaking out! It's hard to describe, but I know many of you have experienced the same thing. I am having weight loss surgery because I would like to avoid the many problems lurking around in my gene pool (diabetes, MS, blindness, etc.) and I would like to live a long and happy life. But I feel like I had convinced myself that it would never happen, and now that it is happening so fast, it's so thrilling and scary at the same time! I'd love it if any of you could share any stories you might have relating to your pre-surgery experience. I'd also appreciate any advice. I've got all my vitamins ordered (from Bariatric Advantage) and I've got all of my pre-op requirements done as well.

Thank you! I see that we have about the same numbers. I can't believe you already had plastic surgery. How did that go? If I might say (and you already know this) but be patient, you will break the stall. I finally did. I went to my bariatric surgeon today and I'm down again. He said even if I don't loose in the next year, my body will still change, muscle tone, skin, etc. He doesn't want to see me again for another year. woohoo So I think I will wait a few more months before I see a plastic surgeon. Keep up the good work, the worse is over, IMO. We are AWESOME!!!!