I am scheduled for surgery on April 6th for the sleeve. However, I am VERY NERVOUS! I am going the hiatal hernia route, but my BMI is only 28.2. I've considered canceling the surgery because I'm scared that my BMI is not high enough. I am going to Dr. Nick Nicholson. Anyone else have a similar situation? What do you recommend I do......should I go through with it or cancel?

THANK YOU "shavelic" and "woo woo" for your understanding in my situation. I don't know if I actually said this or not, but my mother was severely obese and has diabetes so her doctor gave her no choice but to have gastric bypass 7 years ago. My doctor has recently told me that I am at very high risk for becoming a diabetic. My question is: Why would I want to wait until it is too late IF I decided to do this surgery? My mom feels so much better about herself but she is still on all her Diabetic meds. I am heading in the same direction as my mom. AND even though I have tried every diet out there, I am going to give it one more try and see if I can do it. My surgery has officially been cancelled for now. Hopefully this will calm down certain people who seem to not know my situation.

Edited March 27, 201511 yr by addygirl

@@addygirl I applaud your desire and interest in proactively improving your health. However, in my opinion, surgery is not necessary to do this.

I would recommend forgetting about dieting. Yes, I said it! FORGET about dieting! Instead, use all of the information you have available and adopt or continue with a very healthy eating and lifestyle.

Best of luck to you.

What do you recommend I do......should I go through with it or cancel?

The OP specifically REQUESTED opinions. People gave just that, and backed it up with reasons. Opinions are based on personal bias or belief, and may be right or wrong.

Then there is medical best practice. Current medical standards in the United States do not indicate weight loss surgery for people with a BMI of 29. That is why centers of excellence do not do surgery on overweight individuals with BMIs under 35 unless there are comorbidities. Just because you can find a surgeon to operate on you does not mean it's a good idea. In time, perhaps medical best practice will change, but with known current standards, WLS in this individual is likely contraindicated.

Having said all that, it's a personal decision. The OP was seeking opinions to help make a good decision, and it didn't take much persuasion for her to rethink it. Personally, my opinion is that @@addygirl is making a good choice by trying to improve health with traditional diet and exercise. I don't know you, but it is the same thing I would tell my daughter.

Addy girl please message me. Let's talk.

I'm in Dallas and I think you are too. I am a low BMI as well.

You can read some of my other posts, but I can totally relate to you and I think I can share a lot of insight with you.

Always willing to help ....

I genuinely want everyone to find good health and get weight under control. I had a lapband for 10 years - not a good experience and I suffered alot and was still obese. It was a terrible life altering experience. I have been sleeved 3 years, good experience but it still impacts my life.

I lost 100 percent of my excess weight with the sleeve and could not have done it without...so I understand the feeling of wanting something to help get out of this cycle of gaining weight.

What I didn't understand is that diets don't work as they are a temporary alteration in habits and permanent change is needed. Even post sleeve, I have to work at maintenance. I chat with others that are even more years out than I am and the struggle with regain, acid reflux is a real issue across the board.

Statistically, most people have some regain a few years down the road.

What I am trying to express is the serious nature of getting this surgery and to be sure it's really worth it.

I am really pleased the OP is considering options. Around here we have these lifestyle programs that go like two years where you get coaching on how to live a healthy lifestyle. They aren't cheap but you learn the things you'd better learn post sleeve or you will regain anyway....and you leave with your anatomy intact. No risk of leaks, reflux, ulcers etc.

Good wishes for much success!

I have yo-yo'ed back and forth with my weight for the last 10 years. The doctor said I would not qualify for the sleeve through insurance but I would Qualify for hiatal hernia surgery with insurance. He said that they will just do the sleeve while they are there. I am 50 lbs from my goal weight. However, my BMI is still below 30 and that worries me. I'd almost rather have lap band instead.

What concerned me about this was that your surgeon would go in to do a hiatal hernia repair and then "just do the sleeve while he was in there". I don't know if you are self pay or your insurance is paying for your surgery but for your surgeon to suggest that I think is unethical. What happens if you suffer a complication as a result of "just doing the sleeve while he's in there?" Who's going to pay for that? This is a major operation where about 80% of your stomach is removed permanently and requires life long changes in eating as well as other adjustments.

And as far as the band goes - I got mine in 2008 and hate it. It has never done one thing it was promoted as doing. It never provided satiety while at the same time preventing me from eating more because it would cause pressure or pain. Never caused any significant weigh loss either (I did that on my own pre surgery). And your friends who say you can just adjust and readjust the band to accommodate food functions are irresponsible. And then just remove it when you're tired of it? It doesn't work that way. The use of the lap band is on its way out with many bariatric surgeons. Research shows it is the poorest WLS for long term weight loss and 50% eventually get their removed.

Have you done any research of the qualifications of your surgeon? How experienced is he/she? Please look into that, too. My lap band surgeon was inexperienced and it was a huge mistake on my part to go with him. His inexperience in the area of obesity, weight loss, etc.. became very apparent after it was too late.

@@Cleo's Mom I don't think you are understanding what she is saying about the hernia repair.

What she is saying is that the option was to self-pay for the sleeve, while also undergoing hernia repair that she needs. The portion of the surgery that is for hernia repair is covered by her insurance, and she would pay out of pocket for the sleeve. The difference between the two is only a few thousand dollars.

This is offered by all of the top surgeons in Dallas and other places as a more affordable option to self pay for some people (those with insurance that are in need of hernia repair).

Also, as I mentioned above, the doctor she was planning to use is one of the top surgeons in Dallas, is very highly regarded, and has done literally thousands of sleeves. He knows what he is doing.

Edited March 28, 201511 yr by woo woo

@@Cleo's Mom I don't think you are understanding what she is saying about the hernia repair.

What she is saying is that the option was to self-pay for the sleeve, while also undergoing hernia repair that she needs. The portion of the surgery that is for hernia repair is covered by her insurance, and she would pay out of pocket for the sleeve. The difference between the two is only a few thousand dollars.

This is offered by all of the top surgeons in Dallas and other places as a more affordable option to self pay for some people (those with insurance that are in need of hernia repair).

Also, as I mentioned above, the doctor she was planning to use is one of the top surgeons in Dallas, is very highly regarded, and has done literally thousands of sleeves. He knows what he is doing.

So these doctors do the hiatal hernia, charge the insurance companies for it, then do the sleeve and have the patient self-pay. Who pays for the all the pre-surgical tests required for the sleeve? Are they all the same for both surgeries? Like sleep apnea, psychological tests, nutritional consult, etc? If not, would those also not be self-pay? How much would those be? Who would pay for any complications that arise from the sleeve procedure? Again, would that be self pay?

It seems like all these issues need to be addressed before she makes her decision regardless of how many these procedures these surgeons do like this.

I still don't think you are understanding.

Either way if you took the time to read the thread you would realize that she is not doing the surgery at this time.

I still don't think you are understanding.

Either way if you took the time to read the thread you would realize that she is not doing the surgery at this time.

I did read all the posts and while she said she will try diets for now, she indicated that she is still considering the sleeve so my points still stand.

She asked for people's opinions and I gave mine.

@attygirl: think I will try and see what I can do once again on my own for the next several months and if I can't do it, then I will opt back to the sleeve.

Edited March 28, 201511 yr by Cleo's Mom

The short answer is that the self pay price covers all of the tests that go with the sleeve as well as nutritional counseling and follow up visits and care.

Insurance covers the other stuff.

Edited March 28, 201511 yr by woo woo

Yes "woo woo" you are correct. I have elected NOT to do the surgery, but if I did, then "Cleo's mom" I would only be responsible for $50 for the dietician. If any complications should arise from the sleeve, it would be completely covered through insurance. I have already done that check. However, now that I'm out $3000 for just having the EGD, I thought I'd ask if I could go ahead and do the hernia repair along with possibly another elective surgery like lipo. That way, I wouldn't feel like I totally wasted my money.

Yes "woo woo" you are correct. I have elected NOT to do the surgery, but if I did, then "Cleo's mom" I would only be responsible for $50 for the dietician. If any complications should arise from the sleeve, it would be completely covered through insurance. I have already done that check. However, now that I'm out $3000 for just having the EGD, I thought I'd ask if I could go ahead and do the hernia repair along with possibly another elective surgery like lipo. That way, I wouldn't feel like I totally wasted my money.

Well, best of luck to you with your decision(s). Does the $50 dietician fee mean than all the other pre op tests usually required for the sleeve are also required for hiatal hernia repair (except for dietician)? If you don't mind answering, since you already indicated how much you paid for the EGD - how much was the sleeve going to cost you? You don't have to answer if you don't want to. I was just curious.

But again, I hope things work out for you.

My total out of pocket would have been $6500 and that includes all visits for up to 2 years as well as reconstruction surgery. My insurance would have covered the rest.

Edited March 28, 201511 yr by addygirl

My total out of pocket would have been $6500 and that includes all visits for up to 2 years as well as reconstruction surgery. My insurance would have covered the rest.

I think you will do well in whatever you decide. Good luck.