Ashley A.

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I hope everyone is doing well and had a great weekend...tomorrow will officially put me at 3 full weeks post op band to sleeve revision.

I would have to say this has been a completely different experience than I expected. The grass isn't always greener on the other side..at least not yet.

I'll report my numbers first-day of revision: 301..7/6-292..7/13-286 so that is total loss of 15 lbs since the revision and a total of 168 loss total with the weight I loss with the band. I'm officially 27 lbs away from my first mini goal. I know the loss will slow down once I can actually eat solid foods.

Last week was the worse week in all of my bariatric post op life, I was struggling so bad with getting enough calories, protein and fluids in. I was beyond frustrated and very emotional. I think it was a mixture of everything going on, last Thursday was my first day back to work also..

Last week I attempted to have 1/4 cup re-fried beans with sour cream and guacamole, some days it would go down, other days it wasn't happening. This resulted into a couple of stuck episodes and bping..I know they say when you get the sleeve the stuck incidents are not near as bad as they were with the band..well this felt just like a stuck episode with the band, maybe even a bit worse.
What is happening when I eat is the substance is sitting in my small pouch the band originally created and then eventually passes through the sleeved stomach, so my stomach is still acting like I have a band and is giving me restriction there. The surgeon is hoping that with time it will get better. I just have to be patient and take things slow..The recovery process with the sleeve has been completely different and a lot harder than when I had the band done.

The 3rd week is the week I should have been moving onto more soft foods/pureed foods like scrambled eggs, canned meats like tuna, chicken, etc I have decided to continue with full liquids so I'm sticking to yogurt, cottage cheese, sf pudding and soup. I don't want to take the risk of getting stuck and damaging anything. I will probably attempt some tuna or chicken salad with lots of mayo this weekend to see how it goes.
I have been having to avoid protein shakes this week due to extreme stomach pains when trying to drink them, I really hope I haven't developed a lactose intolerance but I'm going to do some research to see how common this actually is.
My goals for this week were to focus on protein, water, and get some exercise in.

I've been struggling this week so far with everything.
If my caloric intake is good then my water is bad, I haven't been reaching near my protein limits at all, I would say I've been getting in probably 400 cals a day and maybe 30 grams of protein since I haven't been able to have the shakes. I've been trying to find some greek yogurt smoothie recipes to substitute the protein powder..haven't had much luck yet. Water has been horrible, I've been only able to get around 40 oz in a day. I'm still going to attempt to exercise some this week. I got my first kettle-bell last week so I'm excited to start using that. I downloaded Bob Harpers Kettle-bell Cardio Shred so I will do that once I can do more cardio and core exercises.

I know things will get better as the days go on! Hope everyone is having a great week! I will post again soon.

Hey Everyone,

I had my band to sleeve revision last Wednesday 6/27 weighing in at 301 which is a 51 pound gain from the lowest weight I ever was with the band. I was released from the hospital late evening Friday 6/29. I had a few rough nights once I got home, Sunday was the worst day out of them all. I hadn't had a BM since the morning before surgery and then Sunday, I felt like I was going to die all day. Everything was making me go to the bathroom, it was just pouring out of me..and then my period came also..it was a mess..sorry I know TMI.
I had my follow up appt with my surgeon yesterday 7/6 and weighed in at 292!! So that is a 9 lb loss for the first week. I officially have 33 lbs to go to get back down to the lowest weight I saw with the band. My goal is to hit that goal by October 11th which I when I see my surgeon again.
I think this is doable.
As far as food goes, I've been having a protein shake for breakfast, sf pudding, carbmaster yogurt, and creamed soups throughout the day. I have been getting around 67.6 oz of water in everyday. I'm currently taking a chewable multivitamin, dissolvable B-12 and 2 calcium citrate pills, one in the am one in the evening. My surgeon also wants me taking some type of acid reducer so I have been taking a 40 mg nexium in the mornings. Apparently an acid reducer is supposed to help with hunger since acid in our stomachs makes us think we are hungry? I'm not sure if that is accurate but it seems to be helping so far!

Ive decided to post all my measurements I have record of below. I have gained a few inches since I last took them, I plan on taking them every 6 weeks once I start exercising!
Thanks for reading.

Measurments	4.27.09	8.10.10	9.14.10	1.17.11	1.8.12	7.7.12
Bust	57	56	52	48	43	44
Waist	59	57	55	49	48	51
Abs	69	64	64.5	51	46.5	47
Hips	68	63	63	57	54	57.5
Thigh	37	35	33.5	29	30	30.5
Up Arm	20	19	18.5	18.5	18.5	17.5

Hey Everyone,

I hope all is well,

I have had a crazy couple of weeks..first let me say that I have been sticking to the pre-op full liquid diet since Wednesday 6/20, I weighed 310 that morning, yesterday morning when I weighed I was at 303 so luckily I was able to lose the 7 lbs I gained since seeing my surgeon last on 6/7.

I have been eating a lot of oatmeal, cream of wheat, blended cream soups such as cream of potato, bean with bacon, and homemade vegetable soup, sf jello and sf pudding with sf whip cream and protein shakes.
For some reason the protein shakes have been giving me horrible stomach aches so I didn't have any yesterday, and today I'm on all clear liquids, so I've been having mainly jello and broth and lots of water. I've been getting in at least 101.4 oz of water a day!!

I have been feeling really good the past couple of days, my emotions have been like a roller coaster-one minute I'm excited, the next I start feeling anxious and nervous. Today its just been weird with how many emotions are..I feel like I just want to scream but it's not a upset scream, its definitely my anxiety kicking in.

My surgery is scheduled at 12:30 pm so I have to be at the hospital at 10:30 am! I'm so excited for this new journey to be starting :) I will keep everyone updated!

Hey Everyone,

I hope everyone is doing well!

I decided to begin vlogging my new journery-I will keep blogging every few weeks but I plan to post videos more often than anything
http://www.youtube.com/amariewls

I went for my pre-admission testing on 6/7 so everything is done with that finally. I went to see my surgeon later that day and weighed in at 303, that was a lower number than I honestly expected to see so that was good. My surgey has been rescheduled to June 25th instead of the 20th.
I was aggravated when they told me this at the office but it had to be rescheduled due to them wanting both surgeons there at the time of the revision so I thought about it and feel it would be best to have 2 surgeons there since they have only done a few band to sleeve revisions so far.

When I went to see the surgeon I was able to ask him the additional questions I had for him as far as the actual procedure goes. These are just random questions I asked.
What are the chances of not being able to do the sleeve at the same time as the removal?
He doesn't think they will have an issue with this, they really won't know what to expect until they get in there and can see. Since they weren't able to detect a slip or erosion, the only thing it could be is scar tissue, if he feels that it is too much of a risk then they will just remove the band and we will have to wait a few months for the revision.
What size bougie is used? This is the tube they stick down the throat into the stomach to create the sleeve.
They use a 34 french bougie.
How many band revisions have been performed?
They have done a few so far, they are in the realm of removing a lot of bands, the patients they have done revisions on haven't had any complications so far
Will I be able to take regular sized pills after getting the sleeve? I was mainly worried about this due to some meds I'm on don't have a liquid/chewable form and the taste is unbearable when crushed
He doesn't think I will have an issue since I was able to take them fine with the band, the sleeve should do what the band was doing for me when I had optimal restriction with the band.

I decided to start my pre-op liquid diet early and started yesterday, that will give me 14 full days of full liquids, my surgeon only requires 10 days. I have been doing well so far, I have just been having really bad headaches from not having any carbs/sugar in my system. I weighed in at 307 yesterday morning, so I'm hoping I can bust out at least 15 lbs during the full liquid diet.  I will update more in a few days with what I'm eating on the liquid diet and how much I've lost so far!
Thanks for reading :)

Hey Everyone,

I hope everyone is doing well.
I wanted to give a quick update. My surgeons office finally received the official approval letter last week so the revision surgery is scheduled for 6/20/12. I'm really excited to be starting this new journey. I decided to create a youtube channel and will be documenting my journey through videos. I posted my first video tonight, I didn't realize how monotone my voice sounds when its recorded..lol I need to work on that.. I'm not sure how to post it here but the link is below if anyone is interested in watching. I will post more of an update next time. Have a great week everyone!

http://www.youtube.com/watch?v=JoE-V3eyCNk
 

Hey everyone,

I hope everyone is doing well..

I just wanted to give an update, on Friday I called my surgeons office to find out if they received the approval letter yet with both codes showing approved, they advised they didn't.
I called the insurance company and spoke with a representative to ask if they could fax over the approval letter. He then checked in the system and stated the 2nd procedure code is still under review and my physicians office needs to call them! WTF!? I had been told by 3 people previously that both procedures had been approved and I told him this and he just said he didn't know why they said that. I called the surgeons office and asked for them to call.
The person I spoke with at the insurance called me later on and advised that he spoke with his supervisor and that in fact both procedures were approved. At that point I was frustrated and just gave up for the day.
Luckily, my surgeons office ended up calling and was told it was approved and was told that the approval letter would be faxed, the surgeons office said a tentative surgery date would be May 18th..but I told them that was too soon so I would like to wait until June. Hopefully they received the approval letter and will be calling me on Tuesday to schedule a definite date. I did end up receiving the denial letter for the sleeve on Friday 5/4 in the mail, this was the decision that was made on 5/1. They supposedly approved the sleeve officially on 5/2 but I have yet to see the letter. I thought I would have received in the mail by now. I will keep everyone posted on what happens.
I hope everyone had a great weekend and has a great week ahead!! Thanks for reading.

Hi Everyone,

I hope everyone is having a great week!

I received an automated call from my insurance today and it said I had an inpatient treatment scheduled and wanted to give me additional information. This was left on my voicemail which I thought was strange so I immediately called the insurance to find out what it was about. The customer service representative checked the the Pre-Certification manager and she advised that both procedures had been approved. The lap band removal and the vertical sleeve gastrectomy were both approved as of today 5/2 so my timing was perfect!
 I then called my surgeons office and they told me yesterday they received a fax saying the lap band removal was approved but the sleeve was denied. At that point I was freaking out because I was so excited when they told me I was approved. The reason for the denial on the Sleeve was due to my BMI only being 39.5 at the appointment the surgeon and I discussed the revision but at the time of insurance submission it was 41.5 so they were waiting to hear back from the insurance company. So I decided to called the insurance Pre-Certification line directly rather than the customer service just to make sure and they stated both procedures were approved and there isn't any denial in their system. As of right now, my surgeon's office won't schedule until they receive the official approval letter, which is supposed to be sent out today. I'm praying the insurance didn't provide wrong information but I spoke with 2 different people so I'm feeling pretty confident they are correct. I will keep everyone posted on what happens! Take Care guys!

Hi Everyone,

I had my medical history/physical appointment with the surgeon yesterday, this had to be done before they could submit for insurance approval. I called my insurance company this afternoon and all of the information was received today and is being reviewed. So I will patiently be waiting to hear back from them. I'm really hoping it doesn't end up being denied, but I'm ready to appeal if that happens.
The appointment went well, I was able to ask a lot of questions and things that I was concerned about. The sleeve is fairly new to their office so he advised that they have only done around 40-50 which I think is a decent number to feel safe with him performing this. I did forget to ask if he has done any other band to sleeve revisions so I plan to ask that at my next appointment. He did advise there is a higher chance of having to get the surgery open. They will start out laproscropically but go to doing it open if they are unable to see with the scope. He asked if I would be okay with that but I never really put any thought into this before. I'm only able to get 2-3 weeks off work so I know if they have to do it open that won't be enough time to come back to work. I think I may have to hold off on this until I have better job security. I have been at my present job almost a year but I wasn't an official employee until the end of September so as of right now, I'm not able to get any type of Short Term leave/FMLA until this September. All of this is just making my emotions go crazy. I will keep everyone posted on how the approval process is going and when I hear something back. Thanks for reading!

Hi Everyone,

I just wanted to give a quick update. I'm currently in the process of submitting for revision surgery. My family doctor sent my medical history over last week, it only took her 1 month this time around which was very surprising. I received a call from my surgeons office on Friday 4/20 and was told I had to see the surgeon again for a full medical history/physical with them before they could submit. I have that scheduled for this Thursday. The surgeon I'm going with this time just joined the practice around 6 months ago so I have wrote down a list of questions to ask him as far as his statistics, etc to ask him on Thursday. I really want to find out what the chances are of him not being able to do the sleeve revision during the band removal surgery. There have been quite a few band to sleeve revisions happening recently and I haven't came across anyone that wasn't able to do it in one procedure yet. I would be devastated if I went under and woke up without a band and no revision.
I contacted my insurance company yesterday to find out the policy, they have 15 calendar days to give me a predetermination whether it has been approved/denied. The surgeon should send in for approval by this Friday 4/27 so I should expect to hear something back by 5/11. I'm hoping for a smooth approval and hoping to schedule for surgery by June. Based on my insurance policy requirements to qualify for revision I have a good chance of being approved, especially since my BMI is over 40 still even after losing so much weight with the band. I will keep everyone posted! Thanks for reading.

Hey Everyone,

So the past month or so has been pretty rough. A lot is happening..
My band decided to get really tight about a month ago so I had to get a complete unfill. I only had 1 cc in there to begin with but I had decent restriction with that little amount. I have been able to eat more than I would like, but I'm trying to stick with the eating plan I was following when my band was working for me and I had restriction. I just find myself being hungry all the time now for some reason.
The surgeon decided it would be best to have the band removed since it has been randomly tightening up for no reason on and off for the past 6 months. He recommend revising to the sleeve the same time he goes in and removes the band. I now have to start the whole process over again, pysch eval, dietician visit, 2 year medical history from pcp, etc. It's like I'm a brand new patient seeking to have WLS.  I just have to wait on my family doctor to send my 2 year medical history before they can even submit for insurance approval. I had to wait 3 months for her to send them the first time around, I'm hoping since she knows I'm having complications she will speed the process up a bit  this time. I looked up my insuance requirements for revision and I think I have good a chance of being approved, espcecially since my BMI is right around 40. It is probably a bit higher now, I haven't stepped on a scale in a bit so I'm sure I have gained some. I really hope the approval process goes smoothly, my surgeon was originally worried since most insurances have a 1 surgery per life rule, I'm with the same insurance company I was before but not working for the same employer, so I'm guessing it would a different policy so that rule wouldn't apply. I will just have to wait and see. Well there is more to come..thanks for reading.