WLS Q & A Database

1. Hair Loss (May 17, 2008) (View) (3 answers)
2. About Protien and Hunger (May 17, 2008) (View) (4 answers)
3. RNY the most important things to do after wls? (May 17, 2008) (View) (4 answers)
4. 7 yrs post op and gained 20 lbs in last 18 months, what's wrong? (May 16, 2008) (View) (5 answers)
5. Vitamins (May 16, 2008) (View) (7 answers)
6. Traveling one week after first fill (May 16, 2008) (View) (5 answers)
7. what employer covers wls in miami valley (troy ohio) (May 15, 2008) (View) (2 answers)
8. I have less to lose than many RNY patients (May 15, 2008) (View) (9 answers)
9. Anyone who had VSG wished they had RNY instead?? (May 15, 2008) (View) (4 answers)
10. Can anyone recommend a good insurance company for Idaho patient? (May 15, 2008) (View) (1 answer)
11. Should I choose RNY or VSG? (May 15, 2008) (View) (6 answers)
12. Does losing the weight too fast make your face wrinkle real bad? (May 15, 2008) (View) (15 answers)
13. Back pain? (May 15, 2008) (View) (5 answers)
14. Hi, I m 1 yr out of rny bypass surgery and suddenly since last couple of days i have (May 15, 2008) (View) (10 answers)
15. Having the RNY what to expect? (May 15, 2008) (View) (11 answers)
16. Dr.'s George and Dr. Mark Wilson out of Pittsburgh Pa? (May 15, 2008) (View) (4 answers)
17. medifast oatmeal DISGUSTING :( :( :( HELP! (May 15, 2008) (View) (6 answers)
18. Has anyone had the lap band going thru Aetna I have had a hard time getting info (May 14, 2008) (View) (6 answers)
19. Anyone With Less than 70 lbs to Lose Had Surgery (May 14, 2008) (View) (8 answers)
20. do you always get the sagging skin? (May 14, 2008) (View) (7 answers)
21. does your employer let you put in medical leave papers for surgery? (May 14, 2008) (View) (6 answers)
22. Is it possible to take vitamin B-12 injections? (May 14, 2008) (View) (14 answers)
23. sensitive tongue (May 14, 2008) (View) (8 answers)
24. ANYONE THAT HAS GONE THROUGH THE PROGRAM WITH KAISER, FREMONT, CA FACILITY (May 14, 2008) (View) (4 answers)
25. I blew my diet at lunch. Lap Band 4-16-08 (May 14, 2008) (View) (6 answers)
26. Should you still be tired and week? (May 14, 2008) (View) (11 answers)
27. Anyone who had Dr. Caruana, after approval letter how long did it take to get surgery (May 14, 2008) (View) (4 answers)
28. ANYONE HAD BOTH RNY AND LAP BAND DONE (May 14, 2008) (View) (6 answers)
29. anybody fought & won denial by United Healthcare in Wisconsin? (May 13, 2008) (View) (4 answers)
30. When you have a headache what do you take? (May 13, 2008) (View) (18 answers)
31. what should I do? (May 13, 2008) (View) (12 answers)
32. full liquids (May 13, 2008) (View) (7 answers)
33. RNY or LAPBAND --210lbs??? (May 13, 2008) (View) (16 answers)
34. Does gastic bipass cure diabetes? (May 13, 2008) (View) (18 answers)
35. I am 5'8.5" and I weight 260. I am still not sure what route to take the RNY or LB. (May 13, 2008) (View) (16 answers)
36. I just want to know whats the difference between a 4cc lapband and a 12cc lapband (May 13, 2008) (View) (3 answers)
37. Any one know a Doctor that have knowledge about PCOS in Savanna, GA? (May 13, 2008) (View) (4 answers)
38. Avatar (May 12, 2008) (View) (1 answer)
39. Frequent diarrhea 1 week post of (May 12, 2008) (View) (7 answers)
40. Has anyone in this forum qualified for Ohip who lives in Ontario Canada (May 12, 2008) (View) (6 answers)

Q: 7 yrs post op and gained 20 lbs in last 18 months, what's wrong?

[May 17, 2008]     Evelyn, Congratulations to you for losing the weight, having children and then losing weight again! Kudos to you! I also am scared of gaining my weight back. After losing 80 pounds of the 100 needed to lose, I suddenly gained 10 pounds in one month! I was devestated! Nothing I did helped. I even joined other weight loss groups. I went from eating a quarter-size meal to being ravenous all day. Please check with your nutritionist, doctor and nurse. In my case, it was a new medication I was taking for fibromyalgia. It worked great BUT was making me gain weight and HUNGRY. If none of this points you in the right direction, keep trying! Find the answer. You can do it! Debbie Romano     — Debbie R.     (See other answers/post your answer)

Q: Hair Loss

[May 17, 2008]     Protein, protein, protein. If you are not getting enough protein in your diet this will happen. I have over 3 months post op and I get between 65g to 80g of protein every day and instead of hair loss my hair grows like a weed. That has never happened to me before. Like I said Protein, protein, protein that is the key.     — Christopher P.     (See other answers/post your answer)

Q: Hair Loss

[May 17, 2008]     I have heard that Nioxin from a hairdresser will help. Protein, protein, protein as well. Good luck, Dawn Vickers, RN, BLC, CLC     — Dawn V.     (See other answers/post your answer)

Q: Traveling one week after first fill

[May 17, 2008]     Take plenty of familiar foods with you. Those that you are sure you can tolerate and hold down. Make sure to eat before going to the "eating" events and listen to your tummy not your mind. If you eat before you go, you will be full and the only battle will truly be taming your mind from telling you it wants all you favorites. Arrive late and even choose to walk away when the temptation feels overwhelming. You have the power in you, Good Luck.     — Maria S.     (See other answers/post your answer)

Q: 7 yrs post op and gained 20 lbs in last 18 months, what's wrong?

[May 17, 2008]     I am 4 years out and have not had any kids since surgery. Hats off to you first of all. I am hungry and have gained weight too, but I suppose real life happens, yes even after surgery. The important thing is to be real with yourself and use that self-discipline that we learned right after surgery. It's the only tool that will keep us on track and hopefully prevent us from going overboard in our eating. Diets are temporary, we know this from experience. Self-discipline is a conscious decision to make right decisions for the long run. Good Luck.     — Maria S.     (See other answers/post your answer)

Q: Hair Loss

[May 17, 2008]     Make sure you take your vitamins and exercise. Fruits and veggies and tons of berries for the antioxidants. Your body is still healing itself, remember it has gone through a tremendous change. Although you may be back to your routine, your body is still working on the inside. If your not getting enough antioxidants, your body will take that much longer to heal and possibly have a hard time recooperating.     — Maria S.     (See other answers/post your answer)

Q: About Protien and Hunger

[May 17, 2008]     Everyone said basically what I would say too...You have some bad habits and silly excuses for these habits. You only hurt yourself with this attitude. I'm sorry for being the strong hand here...but if you don't want to cause yourself problems later, if not sooner...you need to follow the pouch rules. Everyone told you why not to drink water with your meal...There is also the possiblity that you did stretch your stoma by placing heavy water on top of food and forcing it to stretch...That would leave you hungry and eventually may cause you to gain weight. Dense, lean, protein will fill you longer than anything else. (As long as you don't drink with it) Eating carbs that are not complex is probably what you are doing since you say you don't eat much protein. Carbs make you crave more carbs and you will begin eating more and more each meal to satisfy that craving. Your instestines LOVE bad carabs...Makes your gut so happy and later GASSY! Tell me I'm wrong! ;) The less carbs you eat, the less hunger and cravings you have. I'm not trying to be mean...I promise, I really care about my WLS siblings! It's a lifetime committment and I hate to see anyone struggle or hurt or live in constant fear of gaining weight. No one can help you if you to refuse to help yourself while asking for help...So forgive me for being totally blunt and honest...You have a little baby and some 18 years to get thru to watch him grow into a man...I want you to be healthy and ready to be a healthy thin, amazing mommy and one day a grandmother that can run and move to play with her grandbabies...But you have to commit to taking better care of yourself now!!! Right this second!!! You can wait 30 little minutes to drink water...If I can...you can and trust me...I have a really hard time too. I even set an alarm when I feel like I might cheat. If I am REALLY thirsty...I eat a little piece of fruit ...like a few grapes or strawberries and that helps a whole lot to get thru the 30 minutes. I sometimes try to stretch it out to 45 minutes just to train myself to be even stronger. Get in some good protein! You are at a point now where things get harder to maintain. You better take control now. Good luck and hugs...     — .Anita R.     (See other answers/post your answer)

Q: 7 yrs post op and gained 20 lbs in last 18 months, what's wrong?

[May 17, 2008]     If the other suggestions do not work, there is a new PROCEDURE (not surgery) called Stomaphyx. Under conscious sedation just like an upper endoscopy- they go down to the stomach through the esophagus and tighten the stoma. You go home shortly after you wake up. Nancy Nurse     — Nancy C.     (See other answers/post your answer)

Q: 7 yrs post op and gained 20 lbs in last 18 months, what's wrong?

[May 17, 2008]     Evelyn...have you been over to the grads forum? Maybe you will feel comfort in knowing you are not alone in this and there are many longer term grads struggling with a little or some with a lot of weight gain occassionally. I just learned something yesterday that I didn't know. It seems that our intestines go from about 1 inch in diameter to 3 inches and learns to multi-task to compensate for our malabsorption of calories. (Therefore a 10% gain is absolutely normal.) Along with it's regular function of separating water and liquids for waste, it now has learned to aborb calories...So as we go out further in years, in order to maintain our weight we actually have to either exercise more or drop a few hundred calories rather than add more. This makes it very very difficult for many people. On top of this, our metabolisms are so screwed up after all we put our bodies thru with gains and losses and age...So some people will actually have to add MORE calories so the body doesn't think it is starving...It's just difficult because no one knows what your specific body is doing to compensate. Trial and error is how you figure it out. I breezed thru the last 4 years and suddenly I had to cut my calories. SIGNFICANTLY! That was soooo hard. But I did it and I'm maintaining. I had to cut out ALL sugar...ALL non-complex carbs and eat lean and protein. (I feel MUCH better too...non-grumpy pouch monster) I don't deprive myself of what I want, but I don't spoil myself either. Once a week...or twice...I eat some rice or pasta or potatoes. Or I might have a sandwich on bread. But if I am counting calories, which I have to do when I see the scale going up...those are the first things out of my diet completely. It really shouldn't be anything new....as this is how we were taught to eat for life, but after 4-10 years...we've already learned to eat those things again...The secret? DON'T eat them anymore (moderation only) I found that when I am idle (not eating) I am drinking water..LOTS of clear, colorless, water. The less you add to your liquid the better your body reacts. Sometimes when I think I am hungry, I'm just thirsty...I drink 32 ounce glasses of water between every meal (It keeps your kidneys cleaned out from all the work it does with the vitamins we take too) It shocks me sometimes how water can satisfy me for hours. You are not alone...and you did awesome all these years with pregnacies and all! Don't be so hard on yourself. Come on over to the Grad's board and see for yourself the struggles and the stories. There are a bit of all...Success, struggles, long term problems, mental issues, skin issues, neat ideas, recipes, hugs, hand holding, support, comfort...UNDERSTANDING, if nothing else. Good luck     — .Anita R.     (See other answers/post your answer)

Q: About Protien and Hunger

[May 17, 2008]     Hey Stephanie....Since you're over 2 years out and I presume have lost a significant amount of weight, then I assume you're doing something right. First of all, as I understand it, water doesn't stay with you (in the pouch) for any length of time, regardless of whether you have food in your pouch or not. Liquid (any kind) will just flow right through u. The point about not drinking while you're eating if for 2 reasons: it washes the food through your pouch faster, thereby making you feel less full AND it also washes it through to your colon faster thereby gettingn less absorption of nutrients....I guess it compounds the malabsorption that is already in place. Being thirsty all the time is certainly a problem...as well as being hungry. Based on your letter and that fact that you "never did the protein thing" I'd have to say that could be the reason you're hungry all the time. A piece of chicken or any kind of meat fills me up WAY quicker and stays with my a lot longer than when I eat spaghetti, or mashed potatoes or any kind of carb/sugar food. I doubt that everybody needs the same amount of protein....and maybe you're getting more than you think. But long time lack of proteing can lead to serious malnourishment. But for the hunger pangs alone, I'd recommend eating some meat before you eat other food and see if that satisfies you more. Good luck.     — Cj J.     (See other answers/post your answer)

Q: RNY the most important things to do after wls?

[May 17, 2008]     Nevalle... I thought that I didn't need my vitamins and supplements after about two years. I became lax in taking them daily...and only took them when I remembered or if I thought about it...I figured that if I can gain weight, I must be getting in nutrients...I eat at least 5 fruits and veggies every day! I rarely eat sugar or bread or pasta and rice. So I thought I didn't need vitamins and that I was doing fine. I felt fine...looked good...then 4 years out I went to the doctor after not taking my iron at all...and my vits, maybe 3 times a week. I was so low on most of my bodies vitamin stores. I was so anemic that I was put on bed rest for two months. My doc was afraid I would have a heart attack or brain failure from lack of oxygen in my blood. The crazy thing, was, I was trying to lose 3 lbs that I gained...I felt fine except for muscle cramps and a little dizziness and maybe feeling a little "lazy"...But AFTER taking high doses of iron...I realised how sick I really was and was just ignoring all the symptoms. DON"T MESS WITH YOUR VITAMINS!!!! Take them...I am healing and no longer anemic, but still deficient...I have to see my doc every two months for now to see how my levels are. I was lucky...really lucky. If I had gone much longer in my deficient state, I could have irreversible brain and heart damage as well as other organ damage from the anemia. I would have had to have iron infusion therapy or complete blood transfusions to get my blood making healthy cells again. I fixed it myself...How? Taking my vitamins and supplements and taking better care of my health as well as my weight loss management. Everyone gave you great advice on what to take...so I won't go there. But I will say that your vit levels must be checked yearly to make sure you are taking the RIGHT doeses for YOU! Our bodies all heal and compensate for malnutrition in different ways...but we all malabsorb (RNY and DSers anyway) I don't know anything about the other surgeries...     — .Anita R.     (See other answers/post your answer)

Q: About Protien and Hunger

[May 17, 2008]     Without "doing the protein thing" and getting pregnant, there was a strong possiblity you could have had issues with your pregnancy. Protein supplementation, or making SURE you have a diet very high in protein is imparitive to a long healthy life. Protein is so important, and although you don't state so, I'll assume you had RNY surgery. Drinking before and after meals is important so you gain maximum nutrients from your smaller meal portions after surgery. That's the reason NOT TO DRINK some 30 minutes prior to and after meals. While eating, I may take a sip of water to clear a taste from my mouth once or twice, but this is only an ounce of water. I think a strong reason you seem to be hungry all of the time is that you're washing most of the food from your pouch by drinking so much with meals. This is probably what's going on in your situation. DAVE     — Dave C.     (See other answers/post your answer)

Q: RNY the most important things to do after wls?

[May 17, 2008]     One of the reasons for RNY is to improve your health. But due to the way the surgery works, you have to take vitamins and calcium citrate AT SPECIFIC LEVELS for the rest of your life. These levels of vitmains are at least 2x the adult RDA and near 2000mg of calcium citrate on a DAILY BASIS. Failure to do so will lead to possible permanent other health issues, that may not be reversable. Vitamins and calcium citrate are a part of daily life after RNY surgery, or any wt loss surgery.     — Dave C.     (See other answers/post your answer)

Q: Traveling one week after first fill

[May 17, 2008]     ok...my answer was going to be the same but different. Maybe the others know better! The first few fills I didnt feel the effects.... They say wait a week but personally I learned differently. I had surgery 12-20-7 and just went to disney in april. It didnt totally ruin my vacation but sort of. The only thing I suggest and or learned and didnt thinik of was...I was eating heavier meals than before (meat, etc) and eating later. My symptoms were coughing or rather choking at night...I did not relate the two. Anyway, I didnt connect it till 2 days before I left. I wish I had waited. You get anxious to lose weight, but it is not worth being miserable and being away. probably you will be fine, but why chance it? If you do go, lighter meals in the evening or rather be conscious of eating more and dont eat too late     — Linda R.     (See other answers/post your answer)

Q: what employer covers wls in miami valley (troy ohio)

[May 17, 2008]     Hi, Home Depot (full time), federal government, Starbucks, Kinkos, Kelly Temp(corporate), Wild Oats, Target, AmEx, Visa, Mastercard, Intel, UPS, about anywhere union. There are others, those are the ones I know off the top of my head. Good luck!! Annette     — Annette P.     (See other answers/post your answer)

Q: About Protien and Hunger

[May 17, 2008]     I have always been a big water drinker too and especially with meals. I remember drinking my glass of water at a meal and then drinking my mom's too. Then on to diet life, they always said to drink lots of water, fill up on water, eat your allotment and fill up on water. Now my surgeon tells me not to drink 30 minutes before a meal and for at least 1 hour after because water liquefies the food eaten and makes it pass out of the stomach too fast. He says that for the brain to really get the message that you've eaten enough, the food needs to stay in the stomach for about 45 minutes. This allows the message to be repeatedly sent to the brain so we finally "get it". Wow, this is going to be tough. Anyway, I figured that would be a really hard habit to break the habit of drinking with meals so I started practicing a couple of weeks ago. (I have RNY 5/28) I just don't have a glass at the table at all. Not having the water has done a couple of things. Sometimes it makes me chew longer. Sometimes I realize I need to cut my food smaller so that it can be chewed more thoroughly. What I have really noticed is that I don't get hungry as quickly and that almost exactly 1 hour after a meal I get really thirsty, so I don't forget my water. What I thought would be really difficult has not been so bad after all. The surgeon told me to eat the protein first as it is thicker and provides a bit of a plug that keeps the rest of the "meal" draining more slowly from the pouch. You have food in your pouch longer, your brain gets the message repeatedly, and you won't get hungry for 4-5 hours. I encourage you to "do the protein thing" and not drink 30 minutes before and for 1 hour after your meals. Try it for a week. What could it hurt? I wish you success. Being hungry is not fun whether it's true hunger or head hunger.     — Laura H.     (See other answers/post your answer)

Q: RNY the most important things to do after wls?

[May 17, 2008]     Correction: I didn't mean to say our bodies can not absorb Vitamins and Minerals, I meant to say they can not absorb them as well as they could before surgery. I want to also comment that 1% milk is a good drink, but in limited quantity because of calories. Juice is in limited quantity too, and should be watered-down with half water and half juice. Hot or cold caffeine-free Tea is fine, you can add Splenda or Equal if you want. As for protein, I but canned tuna and chicken. I find the canned chicken is softer and easier to digest than chicken I have cooked. I also eat some no sugar added applesauce, and I personally find it easy to get in vegetables by eating baby food vegetables. They are 100% natural and taste natural and good. I buy baby food squash, carrots, peas, and so on... What you eat depends on the "food stage" your at right now - how long ago you had your surgery. You will progress in steps through various food stages as per your Surgeons recommendations...     — Gina A.     (See other answers/post your answer)

Q: RNY the most important things to do after wls?

[May 17, 2008]     You must continue taking vitamins and minerals and make sure you get enough protein and water for your whole life.... It's not hard really, just take two adult chewable multi-vitamin supplements per day, (not together, take one in the morning and one in the evening). Centrum has chewable adult. Or, 3 children's chewables a day. You will also need extra Vitamin B Complex. GNC sells a liquid B-Complex. You'll also need a Calcium + Vitamin D chewable twice or 3 times a day. GNC sells a chewable. Our bodies now can not absorb vitamins and minerals and calcium, etc. so we must supplement for life. I just keep my 3 bottles handy (multi-vitamin, B-Complex, and Calcium+D) and take them 2-3 times a day, it's easy. Also, get plenty of fluids (anything with no sugar, no carbonation, and little or no caffeine). I personally buy bottled water by the case, each bottle is 16-20 ounces, and I buy the sugar free drink mix powder that they sell to put in the water. Crystal Light makes it, as well as store-brands, and Hawaiin Punch. They come in a box of 10 packets, and you just pour a packet in to the water bottle and shake it. (I pour a little water out first to make room for the powdered mix). You need about 64 ounces of water a day, which is about 4 bottles of water. I also buy sugar-free General Foods International Coffee. You just mix 4 teaspoons in 8 ounces of hot water for a nice latte-type coffee. They have flavors like French Vanilla and Suisse Mocha. You need 70 - 80 grams of protein a day. My Surgeon said protein should be your first food choice for life. We all need to get our Vitamins, Minerals, Calcium, Protein, and Water to avoid health problems now, and later in life...     — Gina A.     (See other answers/post your answer)

Q: Anyone who had VSG wished they had RNY instead??

[May 17, 2008]     Remember that the vertical sleeve gastrectomy or "sleeve" has only been around for a few years as a stand-alone operation. So it hasn't much of a "track record" yet, unlike the Roux-en-y. You won't find many people who are as much as five years out from the VSG, especially when you ask here. It's in the nature of this question-and-answer board that most of the people answering, like most of the people asking, are either pre-ops or fairly recent post-ops. So if you're looking for regrets, or second thoughts, regarding any operation, a "graduate" or revision board is a better place to look. It's good to have a look at such long-term boards anyway before choosing a surgery. All but a few people who are in the first year or two after any weight-loss operation are giddily enthusiastic about their surgeries because of the rapid weight loss and the fall in sizes. It's several years down the road, after side effects of the operation have had a chance to show themselves, and after the pounds lost have had a chance to creep back on, that people have, and can offer you, a fuller picture.     — Virginia N.     (See other answers/post your answer)

Q: 7 yrs post op and gained 20 lbs in last 18 months, what's wrong?

[May 17, 2008]     You may want to do a "start over" diet, track your calories, bump up the excercise. That should kick start things. Good luck.     — Kristi H.     (See other answers/post your answer)

Q: Traveling one week after first fill

[May 17, 2008]     I agree w/ the first two post. I personaly would postpone the fill. I would be terrible if you were too full and had problems w/ it. You may want to talk to your dr about. I'm almost 7 wks out and won't get my first fill until the 30th, And am doing ok. Just eat carefully and don't overindulge. Good luck.     — Kristi H.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 17, 2008]     This is a good question. I'm in the same situation. My opinion is go for the surgery that will best help you reach your goal of weight loss and help with the fiight against diabetes. The insurance would not approve you, if you didn't need the surgery. It is one thing to lose the weight, and another thing to keep it off. Don't miss this chance to get medical help. Joining this website as given me alot of important information about the different procedures available to me. The doctor told me that the lapband would not work for me because of the sweet/crabs and medical issues.     — Nevalle W.     (See other answers/post your answer)

Q: Vitamins

[May 17, 2008]     I am 2 months post op with a lap band. I take Centrum Chewables for adults. They actually do not taste so bad. I also take Calcium (with vitamin D and K) simply because of the need for these important vitamins, (also recommended by my Doc). Jeri     — Jeri B.     (See other answers/post your answer)

Q: Having the RNY what to expect?

[May 16, 2008]     I didnot have any pain we whatsoever. Although at the hospital they gave me IV pain meds. I walked 3 hours after surgery and felt pretty good. I never did use te pain med prescribed to me when I left the hospital. Good Luck!     — Michele M.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 16, 2008]     I weighed 204 at surgery (5'3") and just barely met the Medicare requirements of a BMI of 35. (I am 66.) I had RNY and it was a piece of cake. Had it done on Monday, released from the hospital the next evening and never had hardly any discomfort. My main reason was also to get rid of my diabetes. I was released from the hospital off of all diabetic medications. My sugars for the first month were bouncing right around 100. After that they were elevated some and my internist says he may have to put me of a very low dose of something. I won't mind that at all. The main thing is I feel so good! I have energy that I haven't had in years! I have lost 29 pounds in 7 weeks!     — Shirley F.     (See other answers/post your answer)

Q: sensitive tongue

[May 16, 2008]     Thanks for everyone's replies. I appreciate it. I have been to a dentist and he was perplexed, really couldn't identify it. There is no coating on the front half of my tongue whatsoever. It started when I had Bell's Palsy and my doctor put me on high doses of prednisone. My dentist and doctor don't think the palsy or prednisone caused the problem, but that is all I remember that was different (about 3 years ago). I am very prone to canker sores when I use tartar control toothpaste, and I have had thrush before, but this is so strange. Today I wasn't bothered by it at all. It is hell getting older. Thanks again! Deb     — Debbi S.     (See other answers/post your answer)

Q: what employer covers wls in miami valley (troy ohio)

[May 16, 2008]     I have Anthem BCBS. I work for the Archdiocese of Cincinnati, but I know that my doctor's office (Dr. Anderson) mentioned that Anthem was usually pretty good about covering. There was an exclusion, but it was worded so that it wouldn't cover the surgery EXCEPT for in the case of morbid obesity (that's me!). I was approved in 4 days. I have heard that United Healthcare (what I had before BCBS) is tough to get approved, but I will bet there are people who have it and were approved. Even BCBS can attach exclusions to policies so that it won't cover wls. You can check with HR people, I don't know how you can pose that question, though, without them thinking you would be on sick leave once your ins. kicks in. Good luck     — Debbi S.     (See other answers/post your answer)

Q: ANYONE THAT HAS GONE THROUGH THE PROGRAM WITH KAISER, FREMONT, CA FACILITY

[May 16, 2008]     Hi, I am currently in the program at the Kaiser in Fremont. I went to the orientation, then about 3-4 months later met with the surgeon. If you are accepted then you have a psych evaluation and complete any tests the doctor prescribes. I had the orientation meeting in Sept of 2007 and will be having surgery in July or Aug 2008. There are alot of people in the program so it takes awhile but that gives you time to lose the 10% and start making your new habits a part of your life. Be patient and work hard it will happen. Best of Luck     — Debbie G.     (See other answers/post your answer)

Q: Having the RNY what to expect?

[May 16, 2008]     Yes there is discomfort after the surgery. But I was up and walking late afternoon that day. In the end any discomfort I had was well worth it.     — Tracy V.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 16, 2008]     Well, I am 39, had 100 pounds to loose and am 1 year out and at goal. I had the RNY. It was laproscopic and for *me* it was an extrememly easy surgery. Easier than my c-section and easier than an open abdominal surg I had for a prior colon cancer. It IS an easier surgery on a smaller person. That is why I wish the insurance companies would be reigned in: if the obesity could be restrained BEFORE people got to 500 pounds they would have a better / safer outcome. I am VERY happy with my decision. My blood pressure is down. My kidney labs are better now. I just could NOT get off the sugar on my own, even after the cancer, so I chose the RNY. I am very pleased. Who knows how big I would have got as I got older? Anyway, I researched it; started out thinking I would go with LapBand since I "only" had 100 pounds to loose. Then after going to the seminars chose the RNY instead due to my sugar addiction (and good luck getting insurance to pay for ANOTHER surg if the 1st one doesn't work & is not the surgeon's fault.) I think THAT is they key; figure out what will work for YOU and go into that decision with confidence. That is part of the reason there are people who are so militant that their decision is the only right decision; because it WAS the right decision - for THEM. That is where you need to be. Do enough research to be SURE. :-D We wish you the best!!!     — Melanie G.     (See other answers/post your answer)

Q: Should I choose RNY or VSG?

[May 16, 2008]     Well, I am 39, had 100 pounds to loose and am 1 year out and at goal. I had the RNY. It was laproscopic and for *me* it was an extrememly easy surgery. Easier than my c-section and easier than an open abdominal surg I had for a prior colon cancer. I am VERY happy with my decision. My blood pressure is down. My kidney labs are better now. I just could NOT get off the sugar on my own, even after the cancer, so I chose the RNY. I am very pleased. I think THAT is they key; figure out what will work for YOU and go into that decision with confidence. That is part of the reason there are people who are so militant that their decision is the only right decision; because it WAS the right decision - for THEM. That is where you need to be. Do enough research to be SURE. :-D We wish you the best!!!     — Melanie G.     (See other answers/post your answer)

Q: Does gastic bipass cure diabetes?

[May 16, 2008]     I am 17 days post op I went in taking a daily med for my diabetes and since surgery I have not taken any meds and my levels are always normal when I check. Of course you can not eat sugar or carbs so that controls quite a bit for some of us the diabetes is from our weight. So now that I have lost more weight I haven't had problems.     — Melanie C.     (See other answers/post your answer)

Q: Vitamins

[May 16, 2008]     You NEVER take children's chewables they will not work for Bariatric patients. My doctor has me taking Bariatric Chewable Multi Formula Vitamins. The best I have found are called Bariatric Advantage Chewable Multi Formula which are high in vitamins B-Complex, A, D, E, K and essential minerals. You also will need to take a Calcium Citrate. Both are made by the same company. They come in several different flavors, my favors are the, Cherry, Orange and the Tropical. Just do a google search for Bariatric Advantage and research what they have online. You will not go wrong with them. I swear by them.     — Christopher P.     (See other answers/post your answer)

Q: Vitamins

[May 16, 2008]     After the surgery, you will not be able to swallow the regular vitimuns, and if you have a RNY you will need something that works in seconds, as you will just pass them to the colen without much assistance. Childrens vitimuns don't work. Look at www.BBvitamins.com for a line of products that ar for baratric patients.     — William (Bill) W.     (See other answers/post your answer)

Q: Hi, I m 1 yr out of rny bypass surgery and suddenly since last couple of days i have

[May 16, 2008]     I can't take any oral decongestants, so i have been taking afrin nasal spray for several yrs or dristan. Get the moisturizing type. Works great. And of course Musenex for the chest.     — Kristi H.     (See other answers/post your answer)

Q: Vitamins

[May 16, 2008]     Chewable or liquid is really the best for absorption...Swallowing a hard pill is not easily absorbed and not recommended at all by most surgeons for those reasons. I chew two adult Centrum every single day. I've used GNC liquid vits too. And other adult chewables. Many vitamins need stomach acid that RNYers no longer have enough of...Other vitamins are absorbed in the small instestines which are bypassed...Then yet, some vitamins are in oil form and we malabsorb fats and oils! FOR THESE REASONS, you need a water soluable multi-vitamin that is absorbed in the mouth with saliva enzymes and then in the pouch where it is already liquid and easier to absorb without the small intestines. Vitamins in pill form are barely broke down enough to absorb them and washed out of your pouch before they do any good for you. I personally use a vitamin that includes Vit K and preferably does not have iron as I prefer to take that separate from all my vitamins especially calcium. The two vits cancel each other out because they are absorbed at the same receptor and calcium defeats iron every time by binding to it. That is why there are a lot of iron and calcium/vit d deficiencies. Calcium should always be supplemented separate too since most multi vits in any form use calcium carbonate with we do not absorb...Calcium Citrate with a Dry form of Vitamin D3 and magnesium (so the calcium does not bind you) You cannot absorb calcium without D3. I learned this 4 years later after all my deficiences put my health in danger... Be careful of those "natural vitamin companies" they often are dosages not designed for WLS people with malabsorption. You need a good range of vits and minerals in your supplements. This is only my opinion from my own research and my experience with malabsorption problems that are all fixed!     — .Anita R.     (See other answers/post your answer)

Q: Should I choose RNY or VSG?

[May 16, 2008]     You need to research, read, and study about any procedure yoiu may consider. That being said, RNY sounds pretty drastic to me for a relatively small amount of weight to lose. After all, you have to live with your decision for the rest of your life, except for the lapband. I chose VSG, and am certain I will never regret my decision. Consider your choice very wisely.     — Mary C.     (See other answers/post your answer)

Q: Anyone who had VSG wished they had RNY instead??

[May 16, 2008]     Absolutely NOT and I never will wish I had RNY instead. I will never have to worry with malabsorption , dumping, or any of the other many issues they may deal with. AND my weight is falling off with very little effort and no side effects. VSG is a great surgery. But no matter the choice, you have to be determined to make your tool work.     — Mary C.     (See other answers/post your answer)

Q: Does losing the weight too fast make your face wrinkle real bad?

[May 16, 2008]     I'm 5 months out and get compliments that I look good or healthy. But upon close self examination, I see the wrinkles that are more noticeable now that there isn't so much fat pumping them up =} I've lost about 75 pounds, and I'm starting to notice the drooping - more in my stomach and arms than anywhere else. I believe that once my body adjusts, I'll loose the tired look I have (some) days and get that healthy, youthful glow. (I may be kidding myself.) Genetics, environmental factors, skin care, and skin damage all play a part.     — Kris W.     (See other answers/post your answer)

Q: Back pain?

[May 16, 2008]     If you are outside doing bending, stretching or lifting, that's probably the cause. If the pain is bad enough or continues, see your doctor. You may even want to call them just to get their opinion on the best course of action.     — Kris W.     (See other answers/post your answer)

Q: Having the RNY what to expect?

[May 16, 2008]     Right after surgery, I had more discomfort than what I would consider pain. I didn't use the morphine (except when the nurse pushed it before tube removals), and I didn't use any pain medication once home. BUT, everyone is different - different experience, different pain tolerance. My body didn't feel strange... just sore and tired. I really felt good for the most part, but I was easily exhausted!     — Kris W.     (See other answers/post your answer)

Q: Vitamins

[May 16, 2008]     You can take really any vitamin you can swallow. Most surgeons suggest children's chewables or adult chewables early on so you don't have any problems with them getting stuck. After a few months, most people can swallow a normal sized capsule or tablet. Once I could, I take multi's from Costco, calcium citrate from Costco, and others I order off of Iherb.com. All in pill form. I am 5 years out and the only thing I'm low in is vitamin D. Going to start upping that now. Keep an eye on your labs and you'll be fine.     — Lori J.     (See other answers/post your answer)

Q: Vitamins

[May 16, 2008]     Hello, I am still waiting to have a RNY and from everything I have read and researched "Children's Chewable Vitamins" are NOT reccomended for WLS patients... they are not potent enough. Get you some ADULT chewable multi vitamins, you need these! Sincerely, Gerry Smith     — Gerry S.     (See other answers/post your answer)

Q: Vitamins

[May 16, 2008]     I don't know what you mean by natural vitamins, but doing research on vitamins, it appears that liquid vitamins are absorbed better than pills. So I chose liquids. The first brand I used cost $60 a month, and I used them for a few months, but found them to be pricey. I looked around some more, found another brand at $20 a month, and guess what? The lesser expesive ones are the ones I've used for the past 7 months, yet they have higher vitamin levels than the more expensive brand. They're mentioned on my profile page,and my lab results are in the end of my long story there. Lab results are from this past Tuesday, my 2 year labs, after 7 months of this liquid. Vitamin D is low normal, but that has been an issue that you'll note from reading my long story. These are as natural as you can get, no sugars, no calories, no carbs, safe for diabetics, and end up costing about $1 a day after UPS delivery fees. Price per bottle is reduced if friends go together and purchase mutliple bottles in one shipment--reducing the total cost per bottle some $5-7, depending on the number of bottles on the order. 4 bottles is about $101, costing under $26 for a month's worth per bottle.DAVE     — Dave C.     (See other answers/post your answer)

Q: How long do we take yukky chewable multi-vitamins?

[May 16, 2008]     I was advised by my surgeon that I would need to take the childrens chewables for life, however I have found other vitamins that seem to have more in them but they are not chewable, so my question is, will they work with the RNY bypass as I do not want to have more issues with improper vitamin taking.I believe they are all natural.     — Rebecca A.     (See other answers/post your answer)

Q: Does losing the weight too fast make your face wrinkle real bad?

[May 16, 2008]     There is nothing wrong with wanting to look good as well as feel good! I lost 100 pounds in 8 months after bypass surgery and was also concerned about wrinkles and how my face would respond to extreme weight loss. I am proud to say that at 3 years post-op (and at 43 years old!) there are no wrinkles or loose skin. I believe a lot has to do with how you care for your face pre-op. One word...moisturize! Use moisturizer with an SPF every day! If you are out in the sun, use sunblock. Not only on your face, but neck as well. good luck! Debbie     — Debbie K.     (See other answers/post your answer)

Q: Traveling one week after first fill

[May 16, 2008]     I will probably get flamed for this but: I would suggest you delay getting your fill until you return. You will be in an environment where you will not be in full control of what food is available in an early stage. Wait until you are home and can make the transition in a comfortable setting.     — S.F.V. L.     (See other answers/post your answer)

Q: Is it possible to take vitamin B-12 injections?

[May 16, 2008]     Old lab ranges show normal at 200-900, with the note that brain damage can occur at 400! According to more recent studies, a level of 800 is considered the "bottom" of ok. Since I started at over 2000 before WLS (1994), I do shots weekly to hold levels barely around 800. My dh (also WLS 1995), does shots weekly and holds around 1500. Our surgeons think we're "high", whereas our PCP finds us ok. so, it's dependent on your lab levels. Some ppl start LOW pre-op, such as my DIL who was 31, normal diet, and dangerously low. If she had not had WLS, no one would've known! It was caught in her pre-op labs. And ppl over 50 automatically need to begin sublingual or injections (you choose), and monitor levels. BTW, it costs me about $2.50 for 12 shots on my insurance + syringes (not). But when I did private pay, about $7 bought me a large vial, 30, I think. It's CHEAP to shoot yourself.     — Michelle C.     (See other answers/post your answer)

Q: Traveling one week after first fill

[May 16, 2008]     I was fine after my first fill, but maybe you should postpone it a week, so you can enjoy your reunion and trip and not worry? My second fill caused me a bit of discomfort for a while. Just an idea....     — Lois D.     (See other answers/post your answer)

Q: Should you still be tired and week?

[May 16, 2008]     I have had 7 surgeries in the last 4 years. I have lots of artritis in my joints and had back surgery, knee and hip replacement, and foot surgery among others. But I have to tell you that RNY took more out of me than all the others combined. I teach aerobics and swim so its not like I went into this surgery. I was so weak, it was a struggle just to walk up and down the halls of the hospital. When I got home I couldn't even walk a 1/2 a block. I called the Dr. and they told me it was perfectly normal and it could last up to 3 months. I am almost 11 weeks out and I am now just starting to feel normal. Some days are better than others. When I went in for my 2 week check up, I complained big time about how weak I was. He put me on sub-lingual liquid vitamin B12 every day. It helped a lot. Make sure you get your multi vitamin every day, your 40+ mg. of protein and 64 oz. of liguid. Liquid is not just water, it can include your juice, protein drink and the liquid you add to your food. If you stick with this your energy will start to come back. Good Luck, Paula B.     — Paula B.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 16, 2008]     Hi Lyn, easier how? I am not sure what you are asking. Some people lose weight prior to surgery and it slows down their weight loss after surgery, some don't. Some people lose their diabetes after surgery and some done. I am sure you are not nearly as casual as you sound in your question, but this is not a casual surgery, and you are doing really well on your own. Any chance of continuing to lose weight on your own and skipping the surgery? Losing the weight will change your diabetes as well, even without surgery. Surgery is big and recovery is big for anyone, no matter how much you need to lose. Be careful, and best to you. Take care. Patricia P.     — Patricia P.     (See other answers/post your answer)

Q: Does losing the weight too fast make your face wrinkle real bad?

[May 16, 2008]     Kim, every body reacts differently and age plays a part as well as exercise and diet. You are right that we all want to look good, but the consequences of what we have already done to our bodies comes into play. How obese we are when we get started, how we behave once we have surgery, this all counts. You just have to do your best and be thankful for the weight you lose. It isn't about how others see you, it is about how you see you. That is what counts. Patricia P.     — Patricia P.     (See other answers/post your answer)

Q: Hi, I m 1 yr out of rny bypass surgery and suddenly since last couple of days i have

[May 16, 2008]     Jack, you can use sudafed, I like to use mucinex, it works great, but especially being one year out, you will be fine. Patricia P.     — Patricia P.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 16, 2008]     Wow, what turned on Hugh! Yes, any surgery is easier on less overweight people then the very fat ones. However, talk with the doctor you are going to use and listen to what he has to tell you. RNY will cure your Dibities Type II. Best of success to you.     — William (Bill) W.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 16, 2008]     Wow, we have an aspiring novel writer here. Sounds like you are already heading the right direction since you've dropped 15 lbs. What are you doing that's giving this amazing success? If it's weight loss you're after, it looks like you've found a way!     — Ruth S.     (See other answers/post your answer)

Q: medifast oatmeal DISGUSTING :( :( :( HELP!

[May 16, 2008]     Hi.....I like to fix oatmeal like the package says and then add just a half teasp. brown sugar splenda and a PINCH of pumkin spice....try that....*smile* tastes pretty good!     — Linda A.     (See other answers/post your answer)

Q: I blew my diet at lunch. Lap Band 4-16-08

[May 16, 2008]     Dont worry you havent done any damage. I did the same thing by eating a whole smart ones meal at one time. I got my first fill this past Tues. and now I`m not hungry at all, but I still make myself eat something each meal and snack time like the dr told me. I can only eat about a Tbs. of chicken salad with 4 social crackers for a meal, so then for my snack I ate 2 Tbs. of peanut butter, trying to get as much protein in me so I dont have to take them darn protein shakes. My Dr. gave me 4cc in my 10cc band so my next fill will be in another 4wks. I know about 2 wks after my surgery I felt I could eat anything but I really had to work hard by not giving in time to time. So once when you have your first fill you will see a big difference. Good Luck and dont be to hard on yourself.     — Cathy K.     (See other answers/post your answer)

Q: Does losing the weight too fast make your face wrinkle real bad?

[May 16, 2008]     I know that a lot of RNY patients look drawn and almost mal nurished when they drop the initial weight fast. usually after about a year or so their face fills out a little and they look healthy again. but I do think it varies by each individual.     — Lisa F.     (See other answers/post your answer)

Q: medifast oatmeal DISGUSTING :( :( :( HELP!

[May 16, 2008]     I had RYN 2 months ago and I found Strurn's Whole Grain Oatmeal at WalMart. It is very good and has 1 gr of sugar even with fruit added. I have tried the blueberry and cranberry they are both very good.     — Beverly L.     (See other answers/post your answer)

Q: Having the RNY what to expect?

[May 16, 2008]     Tomorrow I am 5 month post-OP. The first few days in hospital were not that good, but it was worth it. I would do it again in a minute! There is no logic about RNY. As others already discribed it might happen that what you had the other day won´t work the next day to eat. But I had success with changing my eating habits and lost so far 88 lbs. Good luck to you, greetings rina_mo from Austria     — Birgitt T.     (See other answers/post your answer)

Q: ANYONE HAD BOTH RNY AND LAP BAND DONE

[May 16, 2008]     HI THANKS I HAD THE RNY IN SEPT OF 2001. I LOST 135 PDS. NOW I AM ABOUT 1/2 BACK WITH AN AVG. OF 10 PDS A YEAR UP. MY INSURANCE WILL PAY FOR THE LAP BAND AND MY DOCTOR SAYS THAT THE POUCH IS STILL SMALL BUT THE OPENING IS BIG AGAIN. I WAS JUST LOOKING TO FIND SOME INFORMATION ON THIS LAYERING. JAN     — Jan S.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 15, 2008]     I doubt it is easier, but no one can really predict it anway...but the weight loss might be slower since you don't need to lose a whole of of weight...The body is an amazing machine and it fights hard to survive, especially when it thinks you are starving it. There is a lightweight forum...You might find more answers there....I'm a heavyweight, myself! :) BUT...your diabetes will be gone! AND lemme tell ya...that was a relief to me! You will probably be a cute itty bitty person when all is said and done.     — .Anita R.     (See other answers/post your answer)

Q: Does losing the weight too fast make your face wrinkle real bad?

[May 15, 2008]     SIMPLE ANSWER FROM SOMEONE WHO LOST OVER 250 POUNDS THE FIRST 11 MONTHS: NO.     — Steve C.     (See other answers/post your answer)

Q: Should I choose RNY or VSG?

[May 15, 2008]     The short answer is that you need to evaluate what contributed to your battle with obesity--- do you simply need a restrictive procedure because your weight gain was due to portion control, do you need some strong disincentives to limit sugars and dense, refined carbs or do you need a method with the least risk of weight gain. Once you figure that out, you then need to evaluate what level of follow-up care (and particular side effects) ou can live with. Then, you'll have your decision.     — Steve C.     (See other answers/post your answer)

Q: Anyone who had Dr. Caruana, after approval letter how long did it take to get surgery

[May 15, 2008]     Originally I had seen Dr. Carauna and had planned on having Open RNY surgery. I decided to see Dr. Viglianco (who is in the same office) to talk about laparoscopic RNY...my surgery date was 4/21/08 w/ Dr. Vig. Once the insurance approved the surgery I was scheduled for my date 3 weeks later. Call the office and talk to Deanne...I know she only calls with scheduled surgery dates on Fridays so you should be hearing from her soon!! Good luck to you ;o) ps: The staff at Sisters Hospital was fantastic, I hope you will be as pleased as I was.     — Patti M.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 15, 2008]     Who can out do Hugh? Wah! At any rate, it is easier for the surgeons to do a surgery on someone who is not as overweight, it is easier for you to move if you are not as overweight, but, your reaction to the surgery, anesthesia, pain etc. is all individual to you and probably will not be effected by losing 15 pounds. The healthier you are the better. That said, any weight off is weight you don't need to lose later. Seems there are very good results in the reversals of diabetes. This is very exciting! I hope you do well! :))     — Laura H.     (See other answers/post your answer)

Q: Back pain?

[May 15, 2008]     I think part of this is probably due to the fact that you are not bringing in as many calories as you used to before the surgery. I have noticed that when I have back pain, the pain often is less severe or dissipates entirely after I have eaten. Many people with back pain rely upon the back muscles and sometimes the muscles in their abdomen to keep the spine straight. When you do not have enough energy, those muscles become fatigued. When they are fatigued, they are weak and cannot do the job of holding the spine straight. At least that is MY theory. I am not an expert on this. This is just something I have noticed with my OWN body. Often just resting and fueling up helps to restore the muscles' ability to hold things in place. Sometimes the nerves in the spine become too irritated and no amount of rest and refueling will do the job. Often the only recourse is to have an injection of steroids to reduce the inflammation. Other times the bones shift and a visit to the chiropractor is needed to realign them. The best thing I have found though, is to keep the back and abdominal muscles STRONG so that it is EASY for them to do the JOB of keeping the spine aligned. Ask your Chiropractor or back specialist for a list of exercises that you can do to help strengthen the muscles commonly used to help hold the spine in place. There are several different exercises recommended. They should have a list available or know where you can find one. I hope this helps, Hugh     — Hugh B.     (See other answers/post your answer)

Q: Does losing the weight too fast make your face wrinkle real bad?

[May 15, 2008]     I haven't had surgery but I have the same concerns as you. I have already started taking supplements to help my hair, nails, and skin so that they are at the healthiest level they can be at before I even have my surgery. I have decided that I will not lose hair and I will do everything in my power to save my skin and not need plastic surgery! I suggest doing the same, check out GNC, they can help you!     — Carrie B.     (See other answers/post your answer)

Q: Has anyone had the lap band going thru Aetna I have had a hard time getting info

[May 15, 2008]     Tracy, call Aetna to see if you have the weight loss surgery benefit, if you do, look on Aetna.com and search for Clinical Policy Bulletin 0157 and it will explain all that must be done to be approved. Hope all goes well!     — Robin B.     (See other answers/post your answer)

Q: I have less to lose than many RNY patients

[May 15, 2008]     Take this for what it's worth. I am telling you up front that I am NOT an "Expert" on Weight Loss Surgery. I encourage EVERYONE to RESEARCH EACH surgical option FOR THEMSELVES! THIS is the information that I have found in MY research. I have posted it here for people in an effort to help GUIDE folks and help them START their OWN journey into their OWN research. There are a LOT of differences in the different types of surgical procedures. There are a LOT of differences in different SURGEONS. Some surgeons require more of their patients than others. Some PROCEDURES require more of the patient than others. You need to do some research and find the BEST fit for YOU. I just had a Vertical Sleeve Gastrectomy on March 1, 2008. My surgeon did NOT require me to lose weight. I had a BMI of 43.6. Now that isn't NEARLY as bad as many people. Had I been HEAVIER, he may HAVE required it. I don't know. What I CAN tell you is that I was having problems with arthritis in my knees and my shoulder. That was almost three months ago. Now it is GONE. There is just a TWINGE every now and again but NOTHING NEAR the constant agony that I was in before! I was also a Diabetic 3 months ago. I have had to DROP all of my diabetes medications on Easter Day because the ONE glucovance pill that I was taking caused me to have my blood sugar to DROP to 53 POINTS! My sugars are still a LITTLE high, but under 150 (usually between 114 to 140 after a meal) and WITHOUT medication! In a FEW weeks with some MORE weight loss, I figure that my diabetes will be in COMPLETE remission! I have lost 59 pounds in a little over 2 MONTHS with my surgery (the VSG) and it was done WITHOUT feeling HUNGRY! From what I have learned, your MAIN options are the Lap Band, the Vertical Banded Gastroplasty, the Gastric Bypass, The Duodenal Switch and the Vertical Sleeve Gastrectomy. There are other options, I am sure, but these are the most common that I have found. There are also combinations of these options ALSO available such as the Banded Duodenal Switch, the Banded Gastric Bypass, and the Banded Sleeve Gastrectomy. The Banded options are basically the same as the Regular surgeries but they have a Lap Band added as additional insurance in case of future need. The Lap Band: (http://www.obesityhelp.com/content/wlsurgery.html#LapBand) is well known. It basically squeezes the stomach to make it smaller and creates a pouch with a restriction at the top of the stomach which fills quickly and empties slowly. The advantages of this surgery are that it is reversible if needed and it is adjustable if needed. It is a HIGHLY flexible procedure. This surgery is well known and excepted by many insurance companies. It may be best for people who have a history of cancer either themselves or in their family and may need to take chemo-therapy and for women in childbearing years who may become pregnant. There are also other reasons for wanting this type of surgery, but I don't want to spend ALL day writing this. There is an effective Excess body weight loss over 3 to 5 years of 50% to 60% noted in some studies. The PROBLEM with this option is that there are sometimes complications with this device. Some people have a reaction to the foreign object in their body. People with immune issues should NOT have this device. Lupus and MS patients for example, can have a reaction to the foreign body and it may trigger an immune system response. Other issues with the Lap Band are that it is common for the band to "Slip" on the stomach and cause the pouch to enlarge thus causing the person with the device to eat more and negating the purpose of the surgery. Some surgeons have started stitching the band to the stomach to prevent this from happening. It would be wise to ask your surgeon if you are considering this option if he does this. Other times people have learned to "Eat around the Band" and force the food PAST the band to fill up the rest of the stomach and thus defeat the purpose of the band. Actually, this is an issue with ALL weight loss surgeries. All can be defeated by a patient who is either ignorant or intent on doing so. It seems to be MORE common with the Banded options, however. Another issue with Banded options is that occasionally the bands will erode the outside lining of the stomach causing damage to the stomach that often needs repairs and calls for a removal of the band and or a revision to some other type of weight loss option. This happens in about less than 1% of the Lap Band Surgeries but it IS something that needs to be taken into consideration. In the Vertical Banded Gastroplasty: (http://www.obesityhelp.com/content/wlsurgery.html#VBG) (commonly known as stomach stapling) the surgeon makes a cut into the stomach to create a pouch. He sews the pouch and places a band at the bottom of the pouch. This banded option has less chance of the band slipping since the cut in the stomach holds it into place. It also has the advantage of being somewhat reversible but is not as easily reversible as the Lap Band. It is NOT as well known as it's more famous banded cousin, the Lap Band. There my be difficulties in getting this option with some insurance companies. It has many of the advantages and disadvantages of the Lap Band surgery with the exception that the Band does not tend to slip and let the pouch expand. The Gastric Bypass: ( http://www.obesityhelp.com/content/wlsurgery.html#RNY) is made when the surgeon cuts the TOP of the stomach off and creates a pouch. An OLDER version of this surgery left the stomach intact but had a line of staples that was used to create the pouch. This method is no longer in use much if at all. The surgeon then takes a length of intestine and BYPASSES it. He takes the LOOSE end that is still attached to the intestines and sews it to the SIDE of the pouch that was created from the TOP of the stomach. The BYPASSED intestine is then attached to the side of the intestine that was connected to the pouch so that BILE from the bile duct can empty bile from the liver into the intestine. This option is often the DARLING of insurance companies. Many companies that won't pay for any OTHER Weight Loss Surgeries will pay for THIS one. THAT makes THIS surgery quite popular for many surgeons! This surgery has the advantage of being a HIGHLY effective tool in the arsenal of weapons against the foe obesity! It has an effective rate of weight loss and maintenance of 60 to 80% in some studies at 1 to 2 years. The DOWNSIDE of this weight loss option is that there issues of malabsorption of minerals and vitamins due to the bypassed intestine. This often leaves the patient reliant on his doctor for the special supplements required to maintain his or her health. Other issues are dumping, nausea, and vomiting. Dumping is basically when you have diarrhea that is caused by the intestine's inability to absorb the food that was eaten. Along with the diarrhea can come intestinal cramping, sweating, palpitations and other unpleasant side effects. Some people experience dumping with sweets. Others experience it with fats. Each person seems to have their own issues but whatever they are, they cause them to excrete the food that they ate before it was fully digested. Nausea and vomiting, while experienced by many in ALL weight loss surgeries is NOT experienced by ALL. It does seem to be MORE PREVALENT in the GASTRIC BYPASS and DUODENAL SWITCH patients according to the research that I have seen. The gas and foul smelling stool are also a result of the shortened digestive process due to the bypassed intestine in both the Gastric Bypass and the Duodenal Switch. The Duodenal Switch: (http://www.obesityhelp.com/content/wlsurgery.html#DS ) is the STRONGEST tool in this arsenal of weapons! Many surgeons think it shouldn't be used lightly and often only recommend the procedure for people with a body mass index OVER 50! In the Duodenal Switch, the surgeon REMOVES approximately 85% of the stomach including MOST of the region of the stomach that produces the hormone grehlin. Grehlin is one of the hormones that create HUNGER. Removing the section of the stomach that creates hunger is a HUGE feature of this procedure. The surgeons then sew the rest of the stomach back together and create a tube shaped stomach that resists stretching. The stomach varies in size depending on the surgeon and the patient but can be anywhere from 2 ounces to 6 ounces. Perhaps more. The next step of this procedure involves bypassing the intestine just like in the Gastric Bypass. Instead of attaching the intestine to the SIDE of the stomach, it is attached to the BOTTOM of the stomach where the intestine used to exit. The bypassed intestine is then sewn at one end near the liver and the far end of the intestine is sewn to the intestine that was attached to the stomach to pass bile to the intestines as it does in the gastric bypass. This procedure is MORE efficient than the Gastric Bypass in losing weight. This option has an effective rate of weight loss and maintenance of 70 to 90% in those same studies. The downside when compared to the Gastric Bypass is that Insurance companies often do not know of this option and are often reluctant to pay for it. This option has many of the same issues as the Gastric Bypass. There are some severe malabsorption issues. There are often issues with dumping, nausea, vomiting, GERD (acid reflux), gas and foul smelling stools. The Many surgeons have been reluctant to perform this surgery due to the severity of the complications that can arise. This is why it is often reserved for those who are considered severely morbidly obese. Many surgeons had looked for an alternative to this surgery which lead to what was initially considered a "Half Duodenal Switch" or as it later became known, the "Vertical Sleeve Gastrectomy." The Vertical Sleeve Gastrectomy: (http://www.obesityhelp.com/content/wlsurgery.html#VSG) (if you get the same picture as the Vertical Banded Gastroplasty, just scroll UP) is a GREAT tool to use in the fight against obesity. While not QUITE as effective as the Duodenal Switch, it is often JUST as effective as the Gastric Bypass without the severity of the side effects of EITHER of those two options. The Vertical Sleeve Gastrectomy initially started as an attempt to create a safer Duodenal Switch alternative. While early attempts were not as successful in weight loss reduction, this was mainly due to the fact that the surgeons were relying on the larger size stomach often used for the Duodenal Switch patients who often rely on the "Switch" part of the surgery for some of the weight loss. Once the surgeons started reducing the size of the STOMACH, the Vertical Sleeve Gastrectomy became a much more effective tool at helping the patient loose weight. In the Vertical Sleeve Gastrectomy, the stomach is cut and approximately 85% of it is removed. Just like the Duodenal Switch, most of the cells that produce the hormone grehlin are removed. This eliminates most of the hunger that the patient used to have, if not all of it. The stomach that is made from what is left is turned into a tube that is resistant to stretching. This tube is often designed to hold from 2 to 4 ounces of food or liquid. At this point the surgery is complete. The surgeons just need to close up and the patient needs to recover. The upside to this surgery is that it is simple and has one of the LOWEST rates of complications of all the weight loss surgeries. It also has one of the HIGHEST rates of excess weight loss with one study in California coming in starting at 58% to 77.9% loss in a ONE to TWO year study and one doctor in England reporting that 100% of his patients had a weight loss and maintenance OVER 70% at 6 YEARS of living with the Sleeve. He also reported that patients with hypertension, diabetes, impaired glucose tolerance, obstructive sleep apnea, asthma, or arthritis were all cured or improved after surgery. It has also been said that this is the ONLY recommended option for people with immune system problems. People with diseases like Lupus or MS can have this procedure because there is NO foreign object placed in their body. This also is one of the few recommended options for people with organ transplants. People with transplants need their intestines to metabolize their anti rejection medications. There are possible issues with GERD in this surgery as there are with the Duodenal Switch There are NO malabsorption issues with this surgery. There are NO additional foul odors. There is NO additional intestinal gas. While nausea and vomiting is common in ALL weight loss surgeries, it is NO MORE PREVALENT in the Vertical Sleeve Gastrectomy than in most of the other options. If needed, the Vertical Sleeve Gastrectomy can be easily converted to a Duodenal Switch should additional Weight Loss measures need to be taken at a later date. This act is called a "Revision." Having your Vertical Sleeve Gastrectomy converted to a Duodenal Switch would be said to be having a, "Revision of your Vertical Sleeve Gastrectomy to a Duodenal Switch." The Biggest DOWNSIDE to the Vertical Sleeve Gastrectomy is that it is considered "Experimental" by many insurance companies. While it has not been practiced HERE in the US as a weight loss option for very long (about 5 years or so) it has been done for QUITE a while in Central and South America and in Europe for quite some time. The surgery has been used HERE in the US for OTHER reasons for QUITE a while. It has been used QUITE effectively to treat stomach cancers and ulcers with good effect. These treatments have been done in the US for quite some time. There is a NEW option that is being explored for people that have had the RNY that may be expanded to include OTHER weight loss surgical options and possibly be used to REPLACE them in the future if it becomes approved for that use. This new option is called stomaphyX. The stomaphyX surgery basically takes a post down the INSIDE of the stomach and then FOLDS the stomach in upon ITSELF and makes the available volume INSIDE the stomach SMALLER. There is NO CUTTING on the abdomen or anywhere ELSE. All of the surgery is done through the esophagus. None of the stomach is removed or cut. At the moment, from what I have been able to find according to MY research, the device is only approved for use with Gastric Bypass patients to help make their existing pouches smaller. Permission is being sought to expand the device's use to other types of weight loss surgeries and for use on patients that have NOT had weight loss surgery but to be used in PLACE of traditional weight loss surgery. From what I have been able to find, this device has not been approved for this use yet. To find out MORE about this option go to this link: http://www.themorbidme.com/2007/09/stomaphyx-incis.html . Options for getting surgeries that are not paid for by insurance can be found if you are persistent. You can sometimes petition the company and get them to reconsider with a doctor's explanation. You can also self pay or take out a loan. Many times, the surgeries are cheaper in Mexico or other central or South Ame