how did you get the wls process started?

what do you think is  the best way to start the process  and the fast way to get things done - I am just begining all of this and i am ready to start everything - but where do i start- so i can get the ball rolling? how did you get the wls started?

Loving heart, welcome!
I would say the best way is a slow and thoughtful process. One that gives you the opportunity to do LOTS of research and make an educated an informed decision (which surgeon, which surgety etc). I will share a few articles, links and some thoughts I send to people preop! This is for the rest of our lives a decision not to take speedily (despit our wish to be healthy last week, year, decade! LOL).

www.asbs.org great resoucrse look at the links for pts!

Preparing for Weight Loss Surgery

http://my.webmd.com/content/Article/101/106101.htm?printing=true
By Heather HatfieldWebMD Feature Reviewed By Michael Smith, MD
###WARNING THIS WILL BE LONG!### Take all the time u need to digest it and look at the links! This will ensure your decision is educated and informed and best 4 u!
There are multiple weight loss surgery options. This is a good thing because one size tool does not fit all. Hopefully you can research a few to make the best-educated and informed decision possible for what is RIGHT/BEST for you. People sometimes feel very passionately about their choice, this can come out in a 'my surgery is better than yours' type of discussion. In reality they all have +/-. Each is superior in some ways and has drawbacks in others. The 3 most common surgeries TODAY are: *ranked only in most common to least.....
1) Roux-en-Y Gastric bypass, either done as an open procedure or laparoscopically; usually transected pouch now and proximal bypass (there is a version of this w/ distal bypass meaning more malabsorbtion, more risk complications/defic. but an option esp for the Super Morbid Obese)
2) Adjustable Lap-Band
3) Biliopancreatic diversion w/ Duodenal switch (either as a one stage procedure or two stage w/ a partial sleeve gastrectomy first then the Duodenal switch (malabsorption part) last 6-12 mo later or so. DUODENAL SWITCH:
http://www.duodenalswitch.com/


There are other procedures, the BPD w/o the Duodenal switch, the Vertical Banded Gastroplasty, JI bypass, most have been abandoned due to risks/complications and or not holding up long-term....Then there is also the Mini-gastric bypass, only done by a few surgeons. *Controversy exists on all WLS but this one esp.
MINI GASTRIC BYPASS:
http://clos.net/get_mgb_paper.htm
http://www.minigastricbypass.net/contents.htm
The Sapala-Wood micro pouch gastric bypass (pouch is 1-2cc vs 15-30cc, MICROPOUCH:
http://www.coricenters.com/moremicropouch.html
the Fobi pouch which is a RNY w/ a silastic fixed band around the stoma.... FOBI's site:
http://www.cstobesity.com/

A good place to look at the different surgeries w/ +/- is here:
ASBS site (history of surgery, bariatric centers of excellence etc):
http://www.asbs.org
click on for pts and the story of wls

OH has also put together a nice site here:
http://www.obesityhelp.com/content/wlsurgery.html
BSCI: (they have a free newsletter)
http://www.bariatricsupportcenter.com
WEB MD ARTICLE ON WLS:
http://my.webmd.com/content/article/46/2731_1656?z=2731_01647_6513_00_36
US BARIATRICS NEWSLETTER:
http://www.usbariatric.com/SupportGroupEvents.htm#The_Silhouette_has_Changed
Dr. Terry Simpson: (has a free newsletter & HAS BOOKS FOR Sale)
http://www.drsimpson.com/
www.nawls.org great site some stuff is free others is subscription, newsletter
web: http://www.livingafterwls.com free newsletter!
Here is the link for the Oct. 15th issue of Barbara Thompson's WLS Center Newsletter.
http://www.wlscenter.com/NLArchive/oct_15_2006.htm
OH MAGAZINE:
http://www.oh-magazine.com

OH STORE:
http://obesityhelpstore.com/index.html

WLS LIFESTYLES MAGAZINE:
http://www.wlslifestyles.com


SABARIATRIC (good info for rny or lapband and nutrition info!)
http://www.sabariatric.com
Pouch Rules:
http://www.waynesmith.net/lapband/faq/pouch_management.htm
http://www.digitalhorsewoman.com/pouchrules.htm


LAP BAND:
http://www.thebandsters.com/
http://health.groups.yahoo.com/group/Bandsters/
http://www.lapbandinformation.com/RECOMMENDED_FOOD_PLAN.pdf
http://www.obesity-online.com/Pat_and_docs_info/index.html
http://www.inamed.com/products/obesity/us/clinician/lapband/prodinfo.html
http://www.drchampion.com/lapband.htm
http://www.sabariatric.com/assets/forms/AGB_Diet_000.pdf
http://www.lap-band.com/
http://www.waynesmith.net/lapband/
http://www.obesityhelp.com/forums/LapBand/
http://www.obesity-online.com/Pat_and_docs_info/index.html
http://www.obesitylapbandsurgery.com/adjmain.html
http://www.asbs.org/html/story/chapter5.html

2 BOOKS ABOUT LAPBAND:

Laparoscopic Adjustable Gastric Banding : Achieving Permanent Weight Loss with Minimally Invasive Surgery (Paperback)
by Jessie H. Ahroni Ph.D. A. R. N. P. $12.48 on amazon.com
http://tinyurl.com/zfno9 ISBN: 0595311148
Paperback: 130 pages Publisher: iUniverse, Inc. (May 31, 2004)

Lap-Band for Life (Paperback)
by Ariel Ortiz Lagardere MD FACS
Price: $13.57 on amazon.com Paperback: 331 pages Publisher: LM Publishers (December 5, 2005) ISBN: 187913666X http://tinyurl.com/kkrou

BOOKS:
Weight Loss surgery: Finding the thin person hiding inside of you 3rd ed. By: Barbra Thompsons
http://www.wlscenter.com/

The doctor's guide to weight loss surgery How to make the decision that could save your life By: Dr. Louis Flancbaum
http://www.wlsguide.com/Foreword.html

The Success Habits of Weight Loss Surgery Patients By Colleen Cook http://www.bariatricsupportcenter.com

Exodus from Obesity; The Guide to Long-Term Success After Weight Loss Surgery By Paula Peck RN http://www.paulapeck.com/

all RNY good reads!
GB ONLINE GROUP I recommend:
http://health.groups.yahoo.com/group/GastricBypass-InfoCentral/

http://www.aboutmso.com/pp/prospectivepatients.cfm
~~~~~~~~~~~~
This ? has been asked before so I saved a post on it...I am biased on RNY that is what I chose for ME, it doesn't mean it is better or the best, it is what I was comfortable with for me, so I am not here to bash anyone's surgery etc just give you my view (we all have one!)

Deciding to have WLS is a major, life-changing event and shouldn't be made on impulse (I am not saying this is you I am saying this for anyone thinking about it!). I recommend anyone be 110% sure this is what you want to do because it is PERMANENT!
Things to think about:
· How long have you been researching WLS?**Hopefully at least a good 6 months or so****for many it is years!
· Do you understand the procedure, I mean really understand the nitty gritty of what they are going to do to your intestinal system! Not just it will help me lose weight but *for instance w/ the Roux-En-Y gastric bypass* that they are going to cut your stomach in 2,make a small pouch, the old stomach hopefully is transected from pouch by staples and surgically cut in 2! Then the intestines are cut a few feet or so down and rerouted so you lose weight because the tummy is restrictive and bypassing the intestines decreases absorption....Know the risks involved with this!!!***(Nutritional/metabolic/physical/psychosocial): ex B12 and vitamin deficiencies/protein deficiency/hernia/adhesions, risk of depression post op related to grief over loss of food and hormonal surge of estrogen/trauma of surgery, marital/relational difficulties/high divorce rate)...
· Surgical risks: (not all inclusive..
~Bleeding, ~Complications due to anesthesia and medications, ~Deep vein thrombosis/clots, ~Wound Dehiscence, ~Infections, ~Pulmonary problems, ~Spleen/Liver injury, ~Stenosis of new connections (stricture), ~Hernia, ~Death.
· Depression possibly related to grieving the loss of food, decreased metabolism, and hormonal surges from estrogen being released into the body from rapid wt loss/fat breakdown....
· Gallstones....need for 2nd surgery to remove this.
· Long-term osteoporosis (metabolic bone disease), severe vitamin./mineral deficiencies
· Hair loss (temporary due to anesthesia, trauma of surgery but will continue if you are protien/vit and mineral deficient!)
· Food intolerances (possibly meats, esp. red meat, lactose intolerance, sugar, fats, fried food)
· Dumping syndrome (Nausea/vomiting/diarrhea/chestpain/palatations/sweating/tiredness for minutes/hours/days) *when eating highly concentrated fats or sugars (a desired behavioral response that ~ 50% of post-ops get)
· EXCESS SKIN....OK my philosophy is you fit in your skin or you don't...Do say you don't want to feel bad after, ask yourself do you feel bad now? If yes are you healthy now as a MO person? Yeah many insurance companies pay for some plastic surgeries if medically necessary it may be a fight, but you can get some of it removed possibly....If though this will deter you I say the chances are great you will have some amount of excess skin, no one knows how much...Age, gender, prior diet/weight changes, pregnancies all affect this and the best chance on has to control this is (although limited) exercise, water and protein....So if this is a huge issue don't have surgery.......Excess skin may be by far the most distressing side-effect for people as we already come with altered self-esteem/body image!!!
· What type of research have you done? (Internet, in-person support group meetings, talking with others who have had surgery, surgeon consult, surgeon seminar, articles, books?????)***Knowledge is power and is the best tool we have for success and happiness afterwards****
· What are your present support systems? Friends, Family, co-workers.....**Although not 100% necessary if others are on board it sure as heck makes the ride all that much easier!!!***
· What are your current stressors? ***WLS is a time when you need to be as stable as possible, going through a divorce, bankruptcy, death of a close relative, job loss...well WLS may be a good option but pick the optimal time as it is stressful enough if everything is good, when you are going through something extra stressful you are hampering your success possibly and not having the old standby of food to rely on can be HELL!***This is not to say there ever is a right time and things can happen post-op but be kind to yourself and do what's best for you, waiting 3 months may make all the difference in the world! After all this is about forever!!!
· What is your nutritional/obesity/diet history?***WLS is not for everyone, it is for the Morbidly obese (BMI above 40 or 35 with major comorbdities such as sleep apnea, Coronary disease, Diabetes....)This should be no ones first attempt at dieting (*I know this is not yours again just general guidelines)...Anyone who says this is the easy way out, KNOWS NOTHING about the surgery or the struggles you will endure and lifestyle changes necessary post-op for success! They are usually ignorant, jealous or both! Again your education and knowledge here goes a long way...Everyone seems to know someone who 'died' or had a 'terrible experience' with WLS...BUT no one seems to have a name or number to call that person!!! It is again based on hearsay a lot of the time and their own fears and insecurities...You are doing this for you remember that, it is nice to have support, so educate friends and family, bring them to a support group!!! It can only help! Many programs require wt loss preop...I know many people disagree with this or don't understand why..IMHO I think it is a generally good idea to start instilling dietary, exercise and overall lifestyle changes preop, there is nothing magical about the surgery that makes u wake up and think like a thin person (*I WISH!!!!) So making small changes are helpful pre-op...EXERCISE is one of the biggest keys to success (IMHO again) and anything you can do preop will help you keep up with this and be healthier for surgery!! (and a better surgical risk!)...Start eating smaller portions, it is hard if you go from eating super sized fast food today to clear liquids for 2 weeks (*this is my equivalent of psychological hell/torture!!!) Start slowing down when you eat, put that fork down in-between bites, cut up your food to small pieces, stop drinking and eating at the same time (cant do it or shouldn't postop so start now!) Start taking in 64 ounces of fluid a day if u aren't already, will need to postop! Cut out carbonation, caffeine, sugar, alcohol and chocolate (these are 5 recommended things to avoid postop for many esp. in the first year) again make postop life easier on yourself not harder start ahead!!!!Try on new coping skills for size, they wont miraculously appear postop! Stock the house with clear liquids, crystal lite, diet kool-aid, broth, diet jello etc so u are ready when u get home!!!!Try and avoid the 'last supper syndrome' you will eat most everything again eventually, perhaps in smaller quantities, so don't have a feast each night of things u think u will never have again!
· Ask yourself: What is my ability to make lifestyle changes? Be compliant with post-op recommendations???
This is only a tool....(*sorry can't say that enough!)....
a. Need to exercise nearly daily for health/wt loss and help with excess skin
b. Need to supplement with B12, multivitamin, folate, Iron, Zinc, Calcium citrate, protein shakes possibly give or take things.
c. Need for LIFELONG FOLLOW UP!!!! If you're not taking care of self now you MUST postop or you may trade far worse illnesses for the Morbid obesity you have now malnutrition and vit/mineral def can be permanent and irreversible!
· Know that extended release medications may not be as effective or absorbed well (**esp. birth control pills in woman of childbearing age use alternative form of BC)
I could probably ramble on all day about this..I hope some of this helps you! Any specific ? email us or me offline! Take care and good luck it is an awesome journey!! *not perfect and a positive attitude helps!
DO this for you and only you!!!!Start journaling now www.obesityhelp.com is a great site, start your own profile there! Also if you haven't seen this document (pouch rules) print and read! A good basic guide to things that will help you use the tool and be successful as possible (*for most of us!!!)
http://www.digitalhorsewoman.com/pouchrules.htm



The Bypass as well as the lapband have all of the risks that come with having an operation, the lapband may involve shorter OR time and no rerouting of intestines. Both can lead to gallstones & excess skin r/t wt loss, Neither is "SAFE" BOTH need to be considered carefully and not taken lightly...it must be an informed decision and used only as a last resort for people who are 100lbs overweight or have a BMI of 40 or greater, unless their BMI is 35 and they have comorbidities (DM, HTN, sleep apnea...)
The surgeon really should be going over all the risk/benefits with the patient, whichever procedure they the PERSON chooses. I would though encourage anyone who is contemplating this to educate him or her to make the best-informed decision possible. Weight loss surgery is not for everyone. I am glad there are different options, because not everyone can have a bypass...and the band is an option for those that cannot/do not (want to) have their GI system altered.
I promote weightloss surgery (band or gastric bypass) to those that are informed and understand the risks/benefits and have weighed them heavily!.
The bypass is what I know most about and have had. WHY? There is more research on this surgery (IN THE US), it has been around longer, perfected, esp. in regards to weight loss (depending what research you look at the band may only give the person a 38% wt. loss vs. 78% wt loss is a standard for GBP), The band has only been used in this country since June/July 2001 (In Europe 10-15 years). and long-term complications still are not all known, Can the band stay in forever? Who knows, many do opt to get a bypass after ineffective wt. loss with the band, (So why go thru 2 operations if the bypass will be your final destination? IF your insurance will pay for a SECOND operation?!), many see the band the same in terms of wt. loss as the VGB (vertical gastric band, which has almost been abandoned or revised to bypasses in this country r/t ineffective wt loss (no malabsorption). With the band, there are risks such as: stomach perforation, pouch enlargement r/t band placement/slippage, band slippage, erosion of the band, erosion of band into the stomach, body rejects foreign object (the band), access port problems (flipping etc), saline evaporating from port requiring more f/up fills, more follow-up is needed for the fills.....Also the lapband is not done everywhere yet in this country, insurance companies are still reluctant to pay for it, insurance companies are paying for the bypass, without much issue. These are the reasons I chose what I chose...

I am not implying Bypass is not without risks, It has many risks...more serious? Depends which side-effect/complication you get, depends who you talk to....I had a complication, but came through it fine, I had adhesions and scarring that caused a stricture on my small bowel, this could of happened if I had the lap band, our bodies make adhesions, it is a risk of abdominal surgery...mine were in the wrong place and caused a problem! Malabsorption...which in essence means lifelong follow-up with a clinical nutritionist, for labs... and supplements of: calcium, iron (maybe), B12, folate (maybe) and a multivitamin for life. Protein also needs to be a focus of the bypass persons diet, and sometimes supplementation is needed. Hair thinning at 3 months, r/t protein deficiency, but it grows back in full after a few months (not baldness mind you thinning) Dumping syndrome...now some say this is a benefit, sort of the ultimate behavior modification..if you eat sugar/fat you feel awful, tired, nausea, diarrhea..so you don't eat that food again!

What is agreed on is careful screening medically, surgically, nutritionally as well as emotionally/psychologically. Eating disorders need to be looked at, esp. compulsive eating. A good aftercare plan is key, having a multidisciplinary team to follow you (Good PCP, Surgeon, Nutritionist, therapist, support group) are all factors shown in research to lead a person to the best outcome/wt. loss possible.

THERE REALLY IS NO WAY TO OUTLINE EVERYTHING THAT IS GOOD/BAD/UGLY WITH EITHER PROCEDURE. FOR ME BYPASS WAS THE ANSWER, FOR SOMEONE ELSE IT MAY BE THE BAND.
GOOD LUCK!
How To Choose A Bariatric Surgeon
http://www.beyondchange-obesity.com/medicalMatters/howToChooseASurgeon.html

When you're looking for a Bariatric surgeon/points to ponder:
http://www.amylhwilliams.com/questionsforsurgeon.html good link also

1) Check out info on this site: http://www.nydoctorprofile.com/ (*search under his name & look for any malpractice suits, payouts etc. You can ask about that).

2) Is he board-certified by the American Board of Surgery?
www.absurgery.org
American College of Surgeons?
http://web3.facs.org/acsdir/public/Detail.cfm?CHKDGTS=00299031800

3) Is he a member of the American Society of Bariatric Surgeons? http://www.asbs.org/html/about/membersearch2.html

4) What is the mortality rate (is the number of deaths) of the surgeon, the success rate (those losing > 50% of their excess wt at 5 yrs out)? Complication rates (wound infections, hernias, strictures, leaks, reoperation etc)? Average length of time in hospital.

5) The surgeon you find should be well experienced in the area of weight loss surgery (BARIATRICS). It's clear that the more experienced the surgeon, the lower the risk of mortality. Ideally, you would prefer to find a surgeon who has performed at least 100 of these procedures. (I say over 500!). I also recommend a surgeon who dedictes his practice to WLS, not one who does a case a week....

6) What you are looking for doesn't stop with numbers and statistics -- you will also need a multidisciplinary team one that includes: Surgeon, nutritionist, exercise physiologists, psychological support & support groups, that can be utilized pre- and post-operatively.

7) Look for a center or hospital that offers educational seminars to those who are just beginning the process so you can learn more about the actual procedure, the benefits, and the risks.

8) Is the hospital a Bariatric Center of Excellence? http://www.asbs.org/html/about/coe.html or http://www.surgicalreview.org/locate.aspx
http://www.facs.org/viewing/cqi/bscn/fullapproval.html

9) The preparation, both physical and mental, comes next, and is as crucial to the entire process as the actual procedure. Look to a surgeon that requires clearance from (what is indicated w/ your particular medical status) various doctors (psych/endocrine/hemotology/pulmonary/cardiology/nutrition etc). No this is not @ hoops this is making sure your health status is optimized before surgery. Preop smoking cessation, preop wt loss..etc.

10) What procedures does he do? Open or Lap? What is his follow up plan? Recovery time?

Education is a tremendously important part of the preoperative process & there is no question that there are major risks associated with the operation. However, those risks can be minimized by having a thorough preoperative workup so there aren't surprises during the procedure, and by making sure the surgeon is experienced and qualified. This is a courageous step for people to take, and it's not just about weight changing -- it's about life changing. SO take your time, find the right surgeon/surgical program for you for your life and your health and success long-term! WLS is a decision many of us make, but should not be made impulsively (*the average time one thinks about and has WLS is 2 yrs!) as we as MO people can feel quite desperate and see this as a last resort and can sometimes go with whoever is telling us they will perform, that may not be in our best interest!
EDUCATION IS KEY, AS IS A COMMITMENT & dedication to a healthy diet and exercise regimen, continual follow-up with doctors to monitor progress, and commitment to a new life.

Ask him all these questions or any others think of or you think of, if HE isn't right, find someone who is! After all you're putting your life in his hands and needing someone to care for you for life!!! Be an educated consumer of your own health! HUGS!

~~~~~~~~~~~~~~~


The single BEST piece of advice I can offer being 5 yrs out is this to anyone:
***Disclaimer some may consider this a no-brainer, others a downer, some a new view, psychobabble, whatever thought it is just my opinion, so take it for what it is worth, and it is meant to be helpful/insightful and thought provoking at a time so many of us are caught up with the right vitamin to take, amount of water to drink, etc.. it is meant to challenge beyond those tasks to see the small stuff matters but that there is a larger and more global view as well to consider!!!***

Establish your mindset to accept that weight loss surgery is not a cure/quick fix for morbid obesity, it's a very effective/powerful/wonderful tool that can be used lifelong to combat the chronic/lifelong disease of morbid obesity that has NO *current* CURE (*So at 1 yr out when many say 100# gone forever I sometimes shudder, it is never gone forever it is gone for now but the work has just started at 1 yr out IMHO). The tool is flawed and can be defeated as well (emotional eating, grazing, drinking calories, eating/drinking together, alcohol use, high calorie dense foods, too many simple carbs, overfilling pouch, carbonation, no consistent exercise routine). Considered WLS as part of a life-long process & commitment to challenge your personal awareness/responsibility/consistency/accountability and that a life-long requirement to follow up with physicians, a regular exercise program, and healthy eating. Accept it will come w/ potential challenges & imperfections (risks, side-effects, complications, challenges such as plateaus, not meeting goal, regain, possible depression, grief over the loss/safety of food/obesity may of offered/invisibility it offered although may of been unwanted at the time/the new attention you get, possible anger or anxiety w/o comfort of food as it used to be/limits it may impose, effort it requires to be healthy etc.) that these frustrations are part of the process to make you healthier see them as challenges not difficulties, positive self talk helps!. Your mindset will be the most important tool for success, as all the challenges of traditional diets/exercise plans for health will be present after WLS as well *Yup so many say I will never diet again, well let me say diets don't work *because people go off them* correct but you will have to be mindful of food and pay attention to intake and exercise for life, so in a sense your dieting for life! Even after WLS.... The surgery won't make a person change, but the beauty is YOU HAVE COMPLETE control over those changes/choices needed after surgery for success, the choices are there and the best use of the mind/psychology will harness those. Surgery is such a drastic choice that so many are successful due to a recommitment to healthy living and choices that is one reason it works and we say it is a 'rebirth'.

Changing habits pre -wls is the mindset that will keep you going, the surgery is a piece, the easiest/smallest IMHO. *It is however the milestone/landmark we set to focuses on. But truly the afterlife is the most challenging, the ever evolving challenges from things like getting in enough liquids to food introduction to vitamin taking, new ways of eating/drinking, introduction of exercise consistently to battling with the scale obsessions & disappointments as well as all the wonderful WOW moments. Have the support system needed to create the healthiest environment as well, willpower fades, the tools robust effects fades as well as the honeymoon closes...Harness your enthusiasm and mind for 6 months doing all you can to influence (not only wt loss) but the healthy lifestyle you want to adopt for maintenance, that elusive animal no one has mastered pre-wls. Exercise can become more routine after 6 months as well. Again the mind is just as/more useful than the pouch...it is the operator of the tool! Stress inevitable, so see each issue/stressful time as an opportunity to use your new tool/mindset! (Like I say use things as excuses or opportunities because holidays come and go each year as do parties, office food/celebrations, hurt feelings, sadness, losses, etc)


I know this isn't one message it is a million crammed into one right! Anyone who knows me knows I am never brief, this is my PASSION (giving back), WLS saved me from myself. It isn't easy or fair, but accepting life is imperfect just as the world we live in, embracing that imperfection and controlling what I can has helped me get thru many issues. There is no perfection, I work on that daily. So what to do about all of this babble?

Get a good journal, start writing today all the reasons you are COMMITTED to this change, what your expectations are (hopefully realistic for wt loss 50-80% of excess not an ideal body wt) and that the goals are not wt related alone, the functional ones how you can integrate into life easier, (clothes fitting, less medical co morbidities or risk of, less meds, less pain (physical/emotional) the benchmarks you are setting, take measurements and photos each month along w/ weights to document the journey. the mind is powerful but may be challenging to change so the photos/measurements help when the HUNKAMETAL doesn't register a loss. We are much more than a number on a scale, free from the numbers and see how much you are more than that as a person, your abilities etc....The journey is full of hills and valleys, some bumps and many more pleasures to see, it can be an awesome ADVENTURE!

The letter you may write/journal entry today may save you from backsliding at your first plateau or at 1 yr out, a recommitment to those thoughts, and how you have grown over time. These are the things I recommend. I think everyone else has you covered w/ the 'physical items you need'. These are the ever-elusive psychological things you need LOL!
OK if you have read this far thanks for hearing me out! I wish you well.

Welcome, My journey started when I started researching WLS 2 years prior to making the appointment to meet with a surgeon who I thought was best qualified.  If you 've done your research, I would contact your insurance company to make sure WLS is covered and then contact a few surgeons and set up your consultations.  There will most likely be a "to do" list for you - of tests and requirements for you to complete. This journey is a LIFE CHANGING one!  best wishes to you, Britt

I was visiting family in Florida when the subject came up. My SIL is a NUT & she used to work with a bariatric surgeon down there so she was extremely familair with  the process. She brought it up & I thought about it, researched it, & mulled it over, asked questions of a coworker who had it for 3 months. I had an annual physical scheduled with my PCP in March '07 & sprung the news on her that day!! (She had mentioned it 3 yrs prior but I was having nothing to do with it then!!) Anyway after that it went by all so fast... my pcp gave me my letter of necessity, I called Ellis Hospital & got in for the seminar in May & then in July I was on Medifast for 12 weeks & then boom... October 22nd was my life-changing day!!!  I know some people take yrs to get through the process but as you can see for me it took about 6 months. I never once second guessed my decision or questioned what I was doing... I never had second thoughts nor was ever I scared or nervous!!! I had an eerie calm about me & that's how I knew it was the right choice!!! Do as much research as you possibly can. Ask as many questions as you need to. Make sure you choose the surgery type that is best for you & your health & life-style!! Don't let anyone bully you into making a decision you're not comfortable with!!! This is a big deal - a major decision so be as informed as you possibly can!! I found this website to be one of the best sources of info... good, bad or otherwise!! You get honest info & from people who are living it!! Don't be afraid to ask questions - the only stupid question is the one you were afraid to ask!!! Good luck - you're going to be just fine!!!

For me personally.... I thought about it for about 5 years. I had begun the process through a different WLS program in my area which I didn't particularly care for. It wasn't a good fit for me personally... Then last summer I found my current program. And like Cece got the LOMN from my pcp, made the appointment for the seminar (which in my case was 9/29), then had my first appointment with Dr. Clarke on 12/5, started Medifast the same day and my surgery was 1/25. So now I'm 2 weeks out and feeling good (other than a new allergic reaction.. but we'll get through this).. Good luck to you. If I could offer you only 1 bit of advice it would be to interview a couple different surgeons and find the one that you feel the most comfortable with and is the best fit for you. It'll be the best thing you ever do for yourself.

HI and thank you- I actually started my research back in 2005- and then decide not to do as i was started losing weight (because i was ill and was having treatmentss) It took 1 year to lose 56 pounds on the treatments and I then gained in back within a few mon plus i gained more wweight-

I have in narrowed down to 1 dr and the gastric or the lap-  I also called insurance company- they did not give me much info- =other than it must be medically nescc. etc. I called the 2 dr- for info- I have not recieved anything from the one and the other everything was througn the internet - now i have to fill paper work-

How did you mention it to your primary? Should I get an appt with him and get a letter from him at that time? Thanks

You should speak to your PCP as soon as you can & get your letter of necessity before the seminar... it speeds the process up. Have all of your paperwork in hand at the seminar!! My PCP was very recptive to the idea - she actually mentioned it to me 3 yrs earlier & I went to a seminar & decided it wasn't right for me at that time in my life but when I decided it was time I ran with it!! She was thrilled for me & is as into follow-up appts as my surgeon is!!! I saw her a few weeks ago & she told me to make an appt for 4-6 months but to stop in to say hi so they would still recognize me!!! Good luck!!