So, I'm new to this website and am really just looking for advice and support on this start of my potential bariatric journey. A couple months back, I never would have thought about having WLS, even after a nutritionist and doctor both brought it up. Now, I have multiple comorbidities that just recently piled on and am thinking WLS may be a good way for me to jump start my weight loss journey.

I have Tricare (TriWest) and I'm very curious as to how that whole process goes. I have an appointment with my PCP today to start this discussion and am kind of nervous about what she might have to say. I wouldn't be able to have the surgery until the summer since I am a full time student so I have time to do any sort of nutrition counseling that they may want me to do. I'm just very nervous and looking for some guidance.

I'm also not sure about which surgery is right for me. I know with Tricare, they only cover a certain number of surgeries and I am very interested in RNY or Lap Band. Right now, I'm leaning toward RNY but I'm worried because of how invasive it is as well as the fact that we had a family friend have terrible complications with it. What opinions do you guys have?

Thanks so much!

Hi Paigeh93 and welcome to the group. I have Tricare (south) so we basically have the same insurance. I chose three months from my first appointment with my surgeon to my surgery date to complete the insurance requirements to have RNY. That's because of the three months of doctor supervised weight loss requirement we have. It took three months and two weeks and I was under the knife. If you haven't already gone to your Humana Tricare site and looked up the requirements for weight loss surgery you need to do so. For me the process was very easy. All the paperwork was collected and then submitted to Tricare by my surgeon's staff.

Look up a Bariatric Surgeon in your area who uses Tricare to pick your doctor. If you can choice from several pick the best. I had to go outside the hundred mile radius to get mine.

As for the type of procedure you should get, do your research throughly because it's a personal choice and opinions vary. I'm very happy with the RNY but I did have complications after surgery that put me back in the hospital. I factored the odds of that in before the surgery by being as healthy as I could get. I was a big smoker and drinker leading a stagnate life so stopped it all at the end of 2013. At the time I wasn't thinking about the surgery but only my health. It just naturally led up to WLS.

I wish you the best of luck on your decision and I'm looking forward to hearing about your progress.

Does Tricare not cover the Gastric sleeve? If you are not looking to have this done till next summer, then maybe it might be a good idea to check out and see if they will cover the sleeve by that time so you can have more options. Many insurance companies are starting to cover it. In my opinion, the LapBand is not the best idea due to the potential for band slippage requiring more surgery, and the weight loss is not that great. RNY is a more involved procedure than the sleeve or the lap band and has a higher risk of complications. However, if you are diabetic, the RNY seems to cure or improve it dramatically. Another consideration-- I am assuming you are younger as you are a full time student-- perhaps a medically supervised diet and exercise program might be the best option and effective.

Best of luck to you as you consider the options!

I'd look into the sleeve if I were you, too. It's a great option.

i have tricare prime north

at the time of my surgery, tricare did not cover the sleeve

i was too scared to have the bypass (being super morbid obese and still vain)

and went with the lapband and plication...no issues for me

but my dr told me something i tell whomever asks which surgery

no WLS will work unless the patient aids this tool of assistance and that

is changing what we eat/and begin to exercise..any WLS has good and bad and any WLS can have issues or some not at all (like i have experienced)

i wish you all the luck

go with what YOUR doctor recommends for YOUR lifestyle

and then use it as they advise for best results and with all things in life,

results will vary.

Talk to the doctor. In there are any bariatric seminars in your area attend and ask questions, get info, etc... Weigh the pros and cons. I too heard that lap bands are on their way out and most people get either the sleeve or bypass, yet there are plenty of people on this forum who are banded and perfectly happy.

I've been pretty successful with banding. A few bumps and humps to get over.

Always had an iron-stomach. With banding, it's a lot more sensitive. Takes getting used to.

carolinagirl:

I have Realize band. Surgeon stitched some of my tummy up over the bottom of the band to prevent slippage.

DOn't know if I had "with plication".

What's plication?

Hi.. I suggest checking out the boards on here.. Band to sleeve .. sleeve to rny.. I was a successful bandster for 6 years until it eroded. I chose to be revised from band to RNY because after seeing the sleeve to RNY revision I felt I wanted to go with the one that has the best success rate and the last surgery. I have tricare but I was a self pay. Long story there. Anyways I am 6 months from my RNY and I friggin love it! I wish I had done this first! It's been a breeze compared to the band! I have had no complications, I am 13 pounds from goal and I feel amazing! I can tell you from experience every wls patient has their own preferred wls surgery. I was a huge advocate for lapband but I wouldn't recommend to anyone now. Do your own research. The revision boards on here are what made me choose RNY and I'm thrilled I did. Good luck and I am sure you will be thrilled with whatever choice you make.

I think this is definitely a personal choice that should be made with the aid of your surgical team. Comorbidities should play big role in your decision making. If you suffer from diabetes and Gerd, RNY is an excellent option to assist in making those illnesses go away. Gerd is a huge factor in deciding between RNY and the sleeve. RNY is the best option if you have that problem, the sleeve makes that worse. I am not sure about the lap band as many surgeons are offering it but it seems like it is falling to the bottom of their list. I was told if you are very young (and in good health, able to exercise alot) the band was a a option. You have to work much harder at the band. You still have to eat right and excercise with the other options as well, We were just told that the band is much more successful on younger, healthier people. Not sure if this is true.

The bariatric surgeon I just met with reviewed the three types of weight loss surgery with me to decide which would be best, even though I knew I already wanted the sleeve. He said these things regarding how much you need to lose, and the rate at which you'd like to lose it.

Gastric Bypass - for people needing to lose 80% of their weight in a 1-1.5 year timeframe

Gastric Sleeve - for people needing to lose 60-70% of their weight in a 2-year timeframe (slower loss)

LAP-band - for people needing to lose 50% of their weight over an extended period of time (slowest loss)

He also said that despite those percentages and timing, it's really about what you feel most comfortable doing. He said the people he's performed lap band on generally prefer a slower loss where they are in control (with the fills and such) and it's not permanent, in that it can be removed at any time. Whereas, sleeve and bypass are more permanent.

I was diabetic before my sleeve. But my diabetes is completely gone. I also had high blood pressure. Gone. Snoring? Gone. You have to make the decision that is best for you. I knew the lapband was not a consideration at all for the amount of weight I need to lose. And the complication rate post op was just not something I was comfortable with (also, the surgeons at my hospital really do not like doing them anymore because of that) So for me the only two surgeries I was considering were sleeve and bypass. In the end I did not want the plumbing reroute that the RNY entailed. If you look at weight loss sleeve and RNY have similar end rates, but RNYers tend to lose faster initially. I've lost 96 lbs since my surgery in May.

I'm 21 years old and I understand that people may think that I am too young for WLS but with the health issues I have recently started to have, I believe it's just going to get worse and worse. I am a 21 year old living in a 60 year olds body. I gained my weight very quickly. From January to March of 2012, I gained 50 pounds. I had always been very slender and was extremely active, especially since I was in the Army at the time. I gained another 20 pounds before the summer.

I love running but now I have so much pain in my knees, it's agony to go on a run. I also now have bilateral pulmonary embolisms (blood clots in my lungs). These really hinder my oxygen intake as well as extreme chest pain. They're also causing pulmonary hypertension. I now also have sleep apnea and asthma as well as high blood pressure.

I haven't taken this decision lightly and never would have thought about WLS until all of these health problems arose. I saw my PCP on post today and he is giving me a referral though we'll have to see what Tricare says. He's also concerned because I gained weight so quickly that it may be an adrenal problem so I'll be going through some testing for that. He believes I am a good candidate and understands why I am so concerned. I just want a boost so I can exercise like I want to.

Btw, Tricare only covers RNY and Lap Band. I am interested in the sleeve but unless my MTF has a bariatric surgeon (which I don't believe it does), insurance will not pay for the sleeve and I can't afford out of pocket.

You can really learn a great deal from this website regarding the different types of surgeries. As far as what is right for you, I don't think anyone on this forum will be able to tell you 100% what is right for you. Your doctor should be able to give you his or her recommendation, although mine did not, he said the choice was mine. My reasoning to go with RNY had to do with the cravings that hopefully would be curbed from the actually bypassing that part of the stomach/intestines where cravings are created. I was a big sweets person before surgery and loved my bread, now I don't really miss either. That's why I chose this surgery. I can honestly say I had little or no pain after surgery and the post-op was really routine.

Just as the post above, I see my weight loss surgery as one step in a life style change I started 4 months ago. The next being brand new healthy eating habits, and finally regular exercise. WLS will not be a "magic cure" on its own. but you can be really successful if you add the other steps.

Best of luck in whatever one you decide!

Just wanted to give an update, I went to my doctor to discuss WLS. He was very open to it, especially with all of my health problems. He ordered a group of tests to check on my endocrine/adrenal function because he was concerned about how much weight I had gained in a small amount of time. He has discovered that I have Cushing's Syndrome and currently have a tumor on one of my adrenal glands. Cushing's Syndrome causes rapid weight gain and will not allow you to lose it. It also causes many other symptoms that I have had over the past year and a half. At this point, WLS will not happen especially since Cushing's Syndrome has a decently high reoccurrence rate and then I would have gone through surgery for nothing.

Just wanted to say thanks for all the great advice!

Just wanted to give an update, I went to my doctor to discuss WLS. He was very open to it, especially with all of my health problems. He ordered a group of tests to check on my endocrine/adrenal function because he was concerned about how much weight I had gained in a small amount of time. He has discovered that I have Cushing's Syndrome and currently have a tumor on one of my adrenal glands. Cushing's Syndrome causes rapid weight gain and will not allow you to lose it. It also causes many other symptoms that I have had over the past year and a half. At this point, WLS will not happen especially since Cushing's Syndrome has a decently high reoccurrence rate and then I would have gone through surgery for nothing.

Just wanted to say thanks for all the great advice!

So what's next? Will they remove the tumor and treat with meds?

Edited November 26, 201411 yr by BLERDgirl

So what's next? Will they remove the tumor and treat with meds?

The tumor is on only one adrenal gland so I will have surgery to remove that gland and will be on meds for a couple of months but my other adrenal gland should take over eventually and I will be able to get off of the meds once that happens.