First NUT Visit (long sorry)

 Hey I managed to get into a cancelled NUT appointment and just got back.  She brought up two things and I was looking for some experienced feedback.

1) Tricare (my insurance) doesn't pay for a sleeve,  because I'm going through a MTF (military treatment facility) Tricare is not involved so I am able to have it BUT she said I need to check into if there are any complications from the surgery and I can't see a mlitary doctor, will Tricare pay?  

My questions are twofold for that one.  Who the heck would I call to find out if it would be covered and honestly how long post-op are we talking for complications?  I know I will be within the easy use of a MTF for at least 3 months post-op but after that no guarantees.  

2) My major food issue is sugar.  I crave it, I'm obsessed with it.  I am seeing and will continue to see a psychologist(as long as there is one available you never know what will happen at your next PCS) but, with an RNY you may/usually get dumping with excess carbs/sugar.  I'm wondering if that may be a positive to keep me on the straight and narrow.

Anyway I felt the meeting with her was productive and she's very upbeat but I did leave with more questions as up to that point I was 100% for the sleeve.  

I'd particularly like to hear from Sleevers who had a serious issue with sugar before hand. 

Thanks!

I wish I could help you with the first issue - but I am clueless when it comes to military care.

However - I just wanted to pass along something (anecdotally, of course). 
I had the same sugar issue you did.  Between sugar and 'white foods', I was always a goner.  Ice cream, chocolate, sweet tea, candy....I needed sugar.  I would shank my grandmother for it. 

I am only about a month out from the sleeve -- but I can tell you that I cut it out before surgery (and it sucked royally).  I would have tackled my 18 month old niece and nephew for a gummy bear.

However, after surgery?  I don't want it.  Even my protein drinks are too sweet.  My vitamins are too sweet.  Heck, even the Mio drops (sweet tea) are too sweet.  I do not crave sugar any longer.  I can walk by a piece of chocolate without whimpering.  And, I guarantee that it isn't just willpower working here.  I just flat out don't want it.  The thought of it makes me ill. 

Your experience may vary - but it is a rather disconcerting change for me - - in both a good and a bad way!  I fully expected to still WANT/NEED my sugar fix - - but it seems to have disappeared along with 60% of my stomach!

I'm overweight because I have trouble with portion control and have made bad food choices (like cheeseburgers, pizza, etc). I've never had much of a sweet tooth.

I'm only 2 weeks post op, but like Jerilyn, I don't want anything even remotely sweet. I agree with her that the protein drinks & even the chewable vitamins are too sweet!

I also have no appetite at all and have to set timers to remind myself to eat.

 RNY you may/usually get dumping with excess carbs/sugar

I know nothing about the insurance deal.. sorry, but about the RNY- only about 30 odd percent get dumping, and with some- this passes as they get further out from surgery.

I have 2 friends with the RNY, neither dumps.. the odds are not in your favor.. plus, this is a complication, one you really don't want to wish for..

Look up info on reactive hypoglycemia, and look at the revision boards to see just how much this "helps".. sorry if it sounds snarky (not my intent) but no surgery fixes the carb issues. The pre-op and immediate post-op diet of the sleeve is a good de-tox, and behavioral modification is needed with any surgery to succeed. Some RNYers go on to have "late dumping" a fancy way to say reactive hypoglycemia.. which can be downright dangerous if severe, and even mild cases are responsible for regain.   

 Thank you for the information.  I don't know why I thought the dumping percentage was higher for RNY.  It looks like my insurance worries are for not, I'll verify tomorrow but they cover pre-existing so any issues with the surgery should be covered even if I don't see a military provider.  

I really think this seals the sleeve for me!  Good to have some closure.  Now to get the rest of these visits over with!

I just called tricare yesterday about this surgery and they told me it is covered. If the mtf doesnt offer it you can get approved for the surgery with an out of network provider. I have tricare prime south region. So call tricare directly and ask.

 my referal actually went through tricare for bariatric surgery and they sent me to the mtf then that was the end of them..
if anything goes wrong its usually within the first few weeks so if you have access to a mtf you would be able to go back... by three months out you should be good to go..

for me i no longer have access to a mtf unless i travel a few hours to get to one.. this saturday im moving again and the closest mft to me will be 3 hours away...

The only thing is get a copy of the blood work they want you to have done so that you can get your pcm to get them run for you...

as for the rny you can never guarantee youll be one of the 30 percent that dump so id not rely on that..

good luck..

ABout sugar/carbs too - how it is 1 month, 2 months, 3 months, 6 months out of surgery is not the same as 1 year, 2 years, 3 years, the rest of your life. 

The sweets in shakes are NOT the same as sugar, it does not react the same in your body, its not the same chemical reaction.  For *many* of us the things that were food traps before surgery are the same food traps after surgery (depending on how far out you are, how much you let those things come back into your every day life, how hard life is squeezing you at the moment). 

MANY folks here who are not terribly far out and who are further out will tell you that they were fine until... (dot dot dot) And the dotdotdot tends to include carby things, sweets, et cetera.  Their prior food traps.

You may or may not have a similar dumping syndrome with the sleeve some folks do, but not everyone with Roux-en-Y dumps either. 

For many of us, the only thing that changes is the size of our stomach, and the size of our britches - we typically are still sensitive to the same things, react to the same things, reach for the same things to numb us out - whether it works or not. 

So - all of that to say, do not count on surgery doing ANYTHING but giving you a smaller stomach at first, therefore a running start at losing the weight. After your swelling goes down, after life squeezes you, and people start treating you like you were not ever heavy and doing the food pushing, like they will, because its how yall danced before - (the royal YOU, not specifically you) for most of us maintenance is ALL US.

I had someone argue with me that I was successful in maintenance because of the size of the bougie used and I have to tell you that is one HUGE steamy pile of ****  I can eat ANYTHING and anything that *is not* dense protein, I can eat large amounts of.

So.  if you count on what is ABSOLUTELY true - that at first you have a detox period (liquids and food progression pre and post surgery) and for a few months you HAVE to consume way smaller amounts and take that for what it is, but know yourself and set yourself up for success - you will be successful!

Some folks really can eat just a little of whatever and be fine.  Most of us - not so much, so if you go in just counting on the very basics, whatever comes out on top is gravy baby! 

MMMM!  Creamy pepper gravy!  :}

Hi there, Army Wife!  Good luck with the insurance thing.

I completely relate to the sugar addiction.  I am a hardcore sugar addict, and I had to have a 12-step program to give it up.  And, that's how I had to manage it - give it up.  This may not be your experience, but I cannot eat two Oreo cookies.  I would eat the entire package.  If I left any, I heard them calling to me from another room until I came back and ate them until they were gone.  For me, the addiction says "you can have one, you deserve it!"  Then, well, let's just say it isn't pretty.

When somebody suggested I just not eat those foods, I was stunned and scared silly.  But after detoxing, there is something wonderfully freeing about not having to make that decision over and over again ("if I eat a donut now, I can skip lunch and still be okay...").  It wasn't easy, but it is 1000 times easier for me than trying to learn how to just eat 10 M&Ms.  It may not be true for you, but I would do a lot of things to get my fix (eat food out of the garbage, steal food, hide food, lie about what I was doing so I could go out and buy food).   Giving up the sugar didn't solve all my problems with food, but it did solve all my problems with sugar.  Which was a blessing.

 Oh goodness I could write that post!  That's me to a "T".  Matter of fact my NUT recommended going to OA.  I had tried OA previously but just couldn't get in with the group where I was.  It was a lot of god talk and I'm an atheist so it really turned me off.  But she said that not all groups are like that and she was a firm believer in "working the steps".  So, I think I may just have to give it a try again.  You listed two of my top three "go to" foods, cookies, donuts and Nutella.  I swear I spend more time thinking of those 3 than anything else.  

Thank you very much for the input I appreciate hearing from your experience and seeing where I may be heading.  I must say the thought of never having an oreo again is daunting BUT I think being healthy is better.