Tuesday, October 18, 2011

Sleeve Gastrectomy - Was it worth it?

Sleeve Gastrectomy - Was it worth it?

Absolutely YES! ...for now.   The issues I hoped the Sleeve Gastrectomy would solve were my constant hunger, fast eating, and over stuffing of my stomach.  And it certainly solved all of them.  I am now enjoying slow munching.  It's amazing how I'm not hungry all the time.   Of course losing 22 lbs in a month helped my psyche.  So far, so good.  However, every now and then I think I need to ask myself,  "Was it worth it?"

Monday, October 17, 2011

Sleeve Gastrectomy - Acid Reflux - GERD

Sleeve Gastrectomy - Acid Reflux - GERD

Before my Bariatric Sleeve Gastrectomy, my doctor asked me if I had a problem with heart burn, acid reflux or GERD.  I told him that I occasionally would take TUMS, or an acid reducer, or an acid controller.  But I didn't think I had a problem.

After my surgery, my doctor mentioned that I had a significant hiatal hernia and that he repaired it.
My suggestion to everyone is to not ignore heart burn or acid reflux.  It can become a very serious problem.  If left untreated, it could cause Barrett's esophagus and a risk of cancer, or an esophageal ulcer.  Make sure you check with your doctor.

Sunday, October 16, 2011

Bariatric Surgery - How much does it cost?

Bariatric Surgery - How much does it cost?

At my last doctors' visit, I asked how much would the Sleeve Gastronomy cost if I paid cash for it.  Here's the approximate costs for the three bariatric surgeries that my doctor performs: 
            Lap-Band:  $11,000
            Sleeve Gastrectomy:  $15,000 - $17,000
            Gastric Bypass:  $23,000
Caveat:    Of course all costs can change at a moment's notice, and each State might have different requirements.  In other words, these costs can give you a good idea of the price range, but don't take them to the bank.  

Saturday, October 15, 2011

Sleeve Gastrectomy - Meeting the "Insurance" company requirements

Unless, you're paying cash, it can be a long time, 3 months to a year or longer or never, to meet the insurance company requirements before they will pay for the Sleeve Gastrectomy surgery.  Apparently, not all insurance companies will pay for this surgery, because some consider it "experimental".

My insurance company did pay for my surgery and here are some of the requirements that had to be met:
1.  BMI (Body Mass Index) of 40 and above or BMI of 35 and above with significant other severe problems like, high blood pressure, diabetes, high cholesterol, sleep apnea, etc.
2.    6 months under a doctors' office weight management program (not programs like Weight Watchers) it has to be at a doctors' office or 3 months at the Bariatric Surgery Office.
3.  Visit a psychiatrist for a psychiatric evaluation.
  4.  Attend a bariatric nutrition class.

Bottom line: If you are considering having bariatric surgery, visit the surgeon's office, as soon as possible and find out what your insurance company requirements are with the surgeon office "insurance" person.  It might be a very long time before you can qualify for the surgery.   It's very frustrating to be emotionally ready to have the surgery, but  having to wait a long time to meet the insurance requirements.

Friday, October 14, 2011

Sleeve Gastrectomy - Calorie Counters & Calorie Burned Gadgets

I'm keeping a careful food diary of what I'm eating.  Throughout the years, I have tried many on-line and paper food diaries.  My latest favorite is  myFitnessPal.com.  this is  an on-line program which links to an app on mobile devices.    First thing, it's FREE and secondly, with my iPad, I can scan a food barcode and it puts all the nutritional information in my food diary.  Pretty nifty.  On-line, it has great printable reports and graphs.  I keep my iPad in the kitchen, so I input the food diary as soon as I can.  I found out that if I wait too long, it's amazing how I forget what I ate.

I wear a "Bodybugg" (bodybugg.com) device on my arm to keep track of how many calories I burn.  Not only does it keep an accurate track of calories being burned, but also it's an excellent pedometer.  I've been wearing this device for many years.  It also has a food diary, but I prefer myFitnessPal for recording the diary.  Years ago, BodyBugg was the only game in town, but now there are many similar devices available.

I transfer the BodyBugg information into myFitnessPal, so I have one place for producing reports.



Thursday, October 13, 2011

Sleeve Gastrectomy - Nordic Walking

Since I want to keep walking as much as possible, my husband and I signed up for a Nordic Walking class to add some interest.  It seems like it's one of the hottest fitness trend in Europe.  However, it looks like we're the first ones in our block to do it. 
I would suggest taking a class for this; there is more to it than you would think.  Good technique is necessary, you wouldn't want to do a faux pas, the exercise police might complain.
Seriously, it's a great exercise, because you use your upper body to propel you instead of swaying your arms when you walk.  I'm amazed how easily I can climb up and down hills, especially in Colorado, when no matter which direction you go, it's uphill.  I also noticed that it reduces stress on my knees, hips and lower back!  It feels like the poles and upper body absorb some impact of each step.  So far, it's fun.

Being from Colorado, I have a plethora of poles in the house.  I have many poles for skiing, snowshoeing, and trekking (backpacking).   You would think one of those would work for Nordic Walking.   Nope, had to buy another set of "special" Nordic Walking poles.  Glad I did: you got to get the "right tool for the right job".  Besides, the poles were from a Colorado company.  Buy local, I say.  The company is www.boomyah.com.  Check their web site for more information.

Wednesday, October 12, 2011

Sleeve Gastrectomy - Exercise

For the first month after my Sleeve Gastrectomy, I walked as much as possible.  Within, 2 weeks, I was reaching my 10,000 steps goal, which is a little over 4 miles a day.  I've now been walking 10K at least 3 times a week.  Two months after my procedure, the doctor said I could restart my "Women's Result” exercise program.  It's a great program that incorporates weight training and aerobics.  My favorite at-home exercise is using the Swiss fitness ball.  I was concerned about rolling on my tummy, but my doctor said my stomach would be healed by then.  I just have to pay attention to my body and stop anything that doesn't feel right.  

Tuesday, October 11, 2011

Sleeve Gastrectomy - Diet and Nutrition

During the first 10 days after surgery I was on a "full liquid bariatric" diet.  As the name implies, it is liquid protein sources, such as whey protein powder with skim or soy milk; the good old standby, "No Added Sugar Carnation Instant Breakfast" and various carb control drinks.  Of course, I had to drink lots of water and chewable multivitamins.  All my prescription medication had to be crushed. 

Next comes the "pureed" diet.  Added to the "liquid" diet, I can have scrambled eggs - finely mashed, low-fat small curd cottage cheese, yogurt, and stage II baby food meat (which I declined).  I was able to go to our favorite Mexican restaurant with friends, and have their wonderful refried beans.  It took me about a half hour to eat 1/2 cup of refried beans.  I noticed our bill was considerable less than normal, since I still can't have alcohol drinks ( alcohol is dehydrating and adds calories but no nutrients) and soda (carbonation fills the stomach too much).  Beans and water, life is good!  I did sneak a few tablespoons of my husband's flan.  Yummy!

I am now on the "Soft" diet, which are foods that can easily be cut with the edge of a fork and should contain some protein, such as egg, tuna or chicken salad made with fat-free mayonnaise.  I can now take my smaller pills without crushing them.  I have to add to my multi-vitamin with Iron pills, Calcium Citrate with Vitamin D, and Vitamin B-12 (sublingual).  I will have to take these last three pills, for the rest of my life.  

Six weeks after my surgery - several days from now, I will be on a "regular" diet for the rest of my life!  I will be able to eat want ever I want, BUT here's the fine print: I should have 60-80 grams of protein each day; portions should be 1/4 to 1/2 cup per meal, gradually increasing; eat three meals each day; no skipping meals; 64 oz. of fluid; eat slowly, introduce new foods slowly, and always,
CHEW!  CHEW! CHEW!

Saturday, September 17, 2011

Sleeve Gastrectomy - Learning the fine art of swallowing

The first thing I had to do after my surgery, was to learn the fine art of swallowing without getting a pain in my stomach.  Since my new stomach is about the size of an egg, there's not much room to gulp vast quantities of liquid at a time.  Sipping as in "sipping cognac" is the preferred method.  The goal is to prevent taking in air bubbles when I drink.  Also, I have to pace myself and wait a few seconds or minute before the next sip.  I have to give my stomach time to digest and drain before the next sip. 

I learned very, very quickly that drinking too fast or too much produces a sharp small pain in the stomach usually for a short time, a few seconds, which is rather uncomfortable.

I stopped using a straw, due to the air that is sucked up with the liquid.  Also, I was not very successful sipping on a glass full of ice cubes.  I guess I was drawing in too much air trying to get to the liquid. 

Friday, September 16, 2011

Sleeve Gastrectomy - First Post-OP Visit

One week after coming home from the hospital, I had my first Post-OP visit.  I passed all the tests with flying colors.  The doctor removed the JP drain.  He showed me the hospital radiology pictures of my stomach, after I had drunk the barium.  I now have a stomach that looks like a banana.  Very cute, I must say...

Thursday, September 15, 2011

Day Two – Surgery – Sleeve Gastrectomy - Going Home

At 6:00 AM, I got the official OK from my doctors to be discharged from the hospital.  However, I had to wait for the paperwork.  It was somewhat more complicated and delayed due to the change-over the previous night to a new computer system. 

To pass the time, I sat inhaling on my incentive spirometer, a nifty plastic device that encourages deep breathing after surgery.  There's a small ball that when I inhaled the ball rises and I try to get it to hit a certain range.  Reminds me of an arcade game, where the prize is healthier lungs. 

The nurse showed me how to empty the JP (Jackson Pratt) drain, which was attached to my abdomen, and was used to remove unwanted fluids that build up in my body.  The JP drain is made up of a thin rubber tube (inserted near my belly button) and a soft round squeeze bulb.  About three times a day I drained the JP and recorded the amount.  It was removed during my first post-op visit a week after discharge from the hospital.  There was no pain and for the most part, I didn't notice the JP drain during that week.

Mementos from the hospital:          
  •  Special support stockings to prevent blood clots and pulmonary embolism, that I wore while in the hospital.
  • Pill Crusher - this is a simple device, consisting of two nesting small plastic cups that when you twist and turn, crushes the pills.  A really good pill crusher that actually works very well. 

Sunday, September 11, 2011

Day Two – Surgery –Sleeve Gastrectomy

Waking up early, it was extremely quiet. I had no pain;I was not nauseous.  I could feel the gentle massage on my legs by the massage boots.  Life is good!  Then came the parade of aides, nurses and doctors.  This was a very busy day.

Breakfast came with a tray of broth, tea and Jell-O.  I’m on a liquid diet for the next 10 days.  Jell-O is now my BFF, “best, favorite food”.   All my pills also have to be crushed.  Crushed pills are not very pleasant, either: they are bitter or chalky. 

The big event of the day was going to radiology for the “Drinking of the Barium”.  Since my stomach was stapled, the test would show any leaks.
Thankfully I passed the test.  I’m leak free!

Lunch came with a tray of broth, tea and Jell-O.

Now for a stroll around floor, this was not an easy chore since I’m hooked up to oxygen, IVs for fluid, a catheter, the Jackson Pratt drain, and monitoring devices.  Thank goodness for my entourage, consisting of my husband, and several aides.  Wearing a super large hospital gown, I felt like a bride walking down the aisle with maids in tow.  But instead of flowers, I had an oxygen tank.   I now know why the hospital is so quiet, the hallway floors are carpeted!

Back in the room, more tests, but no more pain button nor a catheter.   Just more crushed pills.  At every shift change, the new nurse and aides wrote their names on a white board; a nice touch to know who’s who.

Dinner came with a tray of broth, tea and Jell-O.

It was time for another paseo around the hallways.  A huge Colorado electrical storm was brewing.  Since, my room was on the 9th floor. I had an outstanding view of the storm and its lightning.
At night, we opened the shades for a panoramic view to watch for several hours one of the most fantastic electrical storms, with continuous bolts of lightning.  It was nice to be provided with such exciting entertainment.

Going home tomorrow.


Wednesday, September 7, 2011

Day One – Surgery – Laparoscopic Sleeve Gastrectomy

My surgery for Laparoscopic Sleeve Gastrectomy was at the University Of Colorado Anschutz Medical Campus.
This is a new hospital complex on the old Fitzsimmons Army base in Aurora Colorado, which is north-east of Denver.  The Army base was torn down several years ago and the Univ of Colo hospital complex is immense.  They are still building, so construction is everywhere.  It is a teaching hospital for the Univ of Colo.

Arriving at the Inpatient building was very pleasant and calming.  It has a huge atrium, sofas and plants like any high-end hotel.  The unpleasant part was being there at 5:30 in the morning.  It least we beat the Denver Rush Hour traffic and found a close-in parking space.  Check-In was quick; I also could have used the computer kiosk for check-In.  The waiting area is again, not like what I’m used to at older hospitals.  It had tables, sofas, and comfortable chairs, more of a lounge area.  There were also LED computer monitors for patient information.

I was then escorted into the surgery prep area. This was like a typical hospital.  I met all the doctors, nurses, aides, etc. that were involved in my surgery.  Since this is a teaching hospital, they came in pairs and triplets.  One reason I chose a “teaching” hospital was that there are so many additional eyes that there would be less chance of someone falling asleep on the job.

They took my vitals, inserted two IVs, and with a Sharpie, marked my tummy, just so they don’t forget which tummy to cut into.  

Last thing I remembered was being wheeled down a corridor and that was it for several hours. The surgery took about two and half hours and several hours in recovery.

Next thing I heard was my husband and a nurse yelling at me to “BREATHE!   BREATHE!”  This was also the first time I realize that this is a major operation, not to be taken lightly.  I think when people hear the word “Laparoscopic” it implies a quick operation, a “piece of cake” type of thing.  What it really means is smaller incisions and perhaps a quicker recovery.  Not a quick romp around the park.  I had general anesthesia, which was part of my recovery problem. 

What I remember of the post-op is not much.  I vaguely remember seeing my husband and not much after that.  I have no idea what the area looked like, how many beds, or who else was there, etc.  This was quite a contrast to out-patient surgeries I had, where I wake up in a nice leather recliner, with a heated blanket, snuggies on my feet and being offered Orange Juice with or without ice. 

Next thing I remembered are several people moving my bed from the Post-op to the 9th floor room.  Within seconds, I realize that general anesthesia have side-effects, like nausea.  I don’t believe I’ve ever been that nauseated in my life.  I’m sure that it didn’t take but a few minutes to get to my room, but it seemed like several hours. 

The doctors and nurses were all fantastic.  I couldn’t ask for more service and attentiveness.  They did get the nausea under control and gave me a button to push when in pain, which I was utilizing at a rapid pace.  I found out that even though you push that button, there is a maximum of pain medicine you may take within certain time limit.  Bummer!  Yes, it was painful, but not for long.

Being still very groggy, I think everything did settle down late that evening. 

The room I had was great, huge by my old hospital standards. There was a sofa bed for my husband to stay overnight which he did and which I am thankful for, although I originally wanted him not to stay the night.  But it was nice to have him there looking after me.  It was also a single room; I didn’t have to share the room with another patient, which added much needed privacy.  That was a big plus in a speedy recovery!


Monday, September 5, 2011

Why I chose Sleeve Gastrectomy over Lap-Band

It all started while watching with the Dr. Oz show several months ago.  Recently, the government and insurance companies have approved the bariatric procedures for people who have a BMI (Body Mass Index) under 40 with other health issues, such as high blood pressure, high cholesterol, sleep apnea, etc. 
On the Dr. Oz show, he explained the bariatric surgery and interviewed people who have gone through the procedure.  It sounded like something I might want to do.  

Lap-Band is a silicon adjustable device that wraps around the upper portion of the stomach.  The band connects a reservoir to a port that lies on the abdominal wall muscles.  The port and reservoir allow for adjustments by filling the port with an injection of saline through the port.
The bottom line is the Lap-Band creates a small stomach pouch which limits food intake.  
Some of the advantages of the Lap-Band that I like are: less risky than other bariatric procedures, (no cutting or stapling of the stomach or intestines); it decreases hunger and makes you feel full longer and it can be removed.  It’s also adjustable via saline injections. 
Disadvantages that I was concerned with:  It’s a foreign object in your body, and you have to keep going to the doctor for saline injection adjustments.

When I first went to my bariatric center, I wanted to have the Lap-Band.  I never seriously considered the sleeve gastrectomy because it was still considered “experimental”.  The center explained the three procedures that I can have: Lap-Band, Sleeve Gastrectomy and Gastric By-pass.   I knew I didn’t want the Gastric By-pass.  Then I realized that the Sleeve Gastrectomy has been approved by my insurance company. 

Bottom line: I chose the Sleeve Gastrectomy because it addressed the two main reasons I believe cause my weight problem:  One, I overeat and I can consume vast quantities of food in a very short time.  The smaller stomach will solve that problem. Two:  I am always hungry.  I’m hoping that with the removal of the Grehlin hormone – my appetite control, will keep me from devouring food like a vacuum cleaner.  I hope it works out!

Sunday, August 21, 2011

What is Sleeve Gastrectomy?


What is Laparoscopic Sleeve Gastrectomy?  Simply put, approximately 70% of the stomach is removed, stapled closed, forming a “sleeve”.  The stomach will be about the size of an egg.  Piece of cake!  Oh, I know, no surgery is simple, there could be complications. 
Another by-product of this procedure is the elimination of “grehlin”, a hormone that says you’re hungry. 
What more can a fat person ask for: less stomach, less food in it and no appetite!  

Kidding aside, this new bariatric procedure has some advantages that you can still be able to eat normally, just in smaller portions; elimination of the “always hungry” feeling.  The disadvantages:  This surgery is non reversible.  I thought I could ask the surgeon to put my left-over stomach is a plastic baggie and I could freeze it, next to the pork chops for future use.  But no such luck, no re-attachment.  Therefore, I had to do some soul searching.  What am I missing with a smaller stomach?  Um, I guess I’ll loose at the hotdog contest at Coney Island and going to “all you can eat” buffets is a waste of money. 

I still can gain lots of weight, if I chow down on hot fudge sundaes and chocolate ice cream sodas.  You can always cheat the system!

Obviously, there is more to it.  Here’s a few websites that I found useful, with more technical data on this procedure and other bariatric surgeries.




My next blog will be “Why I chose Sleeve Gastrectomy over Lap-Band”.

Friday, August 19, 2011

Getting ready for my Sleeve Gastrectomy surgery.

I created this blog to document events of my upcoming bariatric surgery, "Sleeve Gastrectomy".  I'm having the surgery in September, 2011.  I'm hoping that my blog will be useful to someone who is considering a surgical weight loss.