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I'm only 10 months out so relatively new and you've gotten some very good information - I'll just add two things in case they are of value.

I went to an info workshop which was about 45 minutes and was really more about the insurance aspects. My first consultation was 8 hours and 6 different appts plus blood draws, so many blood draws -- after that, the hospital decided I was a good fit to start the program and I decided their program was a good fit for me. I think my appointments were 1) surgeon, 2) bariatric doctor, 3) RD, 4) psychiatrist, 5) psychologist, 6) bariatric nurse - of them, I ended up seeing the psychologist, the bariatric nurse and the RD the most over the next 6 months (and it has held through my first 10 months as well (along with the so many blood draws)).

Also, it seems that a lot of programs have a pre-op diet but mine did not, I was on liquids the day before as the surgical/anesthesia requirement and the surgeon said "try to lose 10 lbs" from day 1 (august) to surgery (feb) so I didn't have any of the pre-surgery items that a lot of people seem to have.

I had iron and D issues before surgery (on and off for years) and right now my labs for both are tracking an increase from pre surgery -- I think this is because I am much much more disciplined about vitamins and supplements than I ever was before; before it was an annoyance -- now it could lead to life or death issues so I'm committed!

Good luck with your decisioning and with the VA. You deserve better, everyone that served deserves better than the VA.

I had both of my RNY's open and I would never do it again. Not only do you have a huge ugly scar but there are more complications i've had 7 surgeries through that scar. 3 hernia surgeries. I'm happy that I have lost over 200 pounds and I'm not done yet. Its been 12 years since my revion

I guess I am not alone with issues. After a second surgery for a leak I was put on life support in the ICU, because I couldn't breathe on my own. After being there about 6 weeks I was put in rehab for physical therapy for another 6 weeks I was so weak I couldn't do anything. I was trached and couldn't speak, I couldn't feed myself, and trying to walk was a joke. I was finally let go from the hospital on christmas eve because I insisted. 2 weeks later I was in another hospital having surgery on bedsores attained while I was in the coma. I must have had 25-50 surgeries and debridment that year(2004) but this all ended in 2005. I've not had any problems from that. Infections, wound vacs, and things like that don't bother me any more and I have to sympathise with anyone who has to go through this torture. My healed wounds never have caused any problems except with an occasional pain. Most of the scars are on my butt, but the worst one is the incisional one. It started leaking fluid about 2 weeks after I came out of ICU. It was one thing after another I have not recovered completely from the first surgery yet. I was P. O.ed at the procedure that I went to the Obesity Help Conference to tell them all what to expect to happen if they weren't careful. That when I met Dr. Sonanstine. He checked me out to see if the revision could be done. in 2006 I had a revisional RNY. He knew I was scared so he took all the necessary precautions to make sure things went right. (He has relocated to Columbus OHIO). The original surgeries were done by a general surgeon trained in bariatric surgery not a bariatric surgeon. I weighed in are 395 Lbs preop, and I currently stay between 190 and 205. I'dd like to lose about 30 more pounds but I am content where I am. I was 5'9" but have shrunk to 5'6", from spinal fractures from falls. I can't stand up straight anymore. I don't have osteoporosis yet.

You didn't mention the procedure you are seeking. The most common are RNY (gastric bypass), VSG (gastric sleeve) and DS (duodenal switch). Each of these yield a different answer to your question, and yes, your mileage may vary based on your metabolism. If you get a sleeve (or lap band, but hopefully that isn't even offered - just don't) and have a slow metabolism, you may fight every calorie tooth and nail unlike someone who has had the DS and their metabolism physically altered to a great degree.

For instance, I had the DS 13 years ago and probably eat 2000-3000 calories of high protein, high fat foods daily, with a sprinkling of "other" foods, and maintain a size 8 or 10.

Also adding (almost forgot) that my DS was done open. My surgeon just preferred her eyes and hands on the job with a procedure as complicated as the DS. She glued my incision all the way down so there were no sutures to worry about. I wore an abdominal binder for a few weeks because it felt like my guts would fall out, but other than that, it really wasn't a big deal. It was all healed in two weeks. What did catch me by surprise was how listless I was for a good six weeks even though my incisions were healed. I was told I was a cheap date to anesthesia and I just needed more time to get it all out of my system.

One thing I realized years later when I took up yoga is that there are some core muscles that don't want to cooperate at all. Other than that, I have a big scar as my only reminder of an open surgery.

Plusses about open surgery:

• No pre-op diet to shrink the liver is necessary because no tools need to maneuver around the liver. Doc can pu**** aside themselves if they need to.
• Procedure is actually shorter open than it is with machines, so less time in anesthesia.