Neoteric Verve

I posted this in another forum on VST but I realized it may be more fitting here. I was looking around the web and saw this guide on VSG dietary guidelines. If anyone wishes they can click the attachment and save it, print it or just read it. I made a copy and am thinking of taking a few to my next support group in case anyone wants one. I think it's only 14 pages (well the 1st page is the title page). I am reading through it right now. Enjoy. I credit Liz Goldenberg MPH, RD and Jaimie Sherry MS, RD, CDN of www.cornellwls.com for the booklet. dietary_guidelines_sleeve_gastrectomy.pdf

I have Aetna. I have read Clinical Policy Bulletin #0157. I haven't seen that they require an H.Pylori breath test. However, my surgeon is. His office manager, Tina (his SISTER btw) said that the insurance is only waiting for this test to approve me for the surgery. At this point I do feel the office is only trying to squeeze more money out of me. I feel I have been lied to on at least two occasions and they charge my 4x's the copay for office visits. I really don't feel like starting over with another physician. Since it's only one exam I think I should do it and get it over with. Once I get my surgery done I can relax a bit. I'm really sick of this doctor's office (and his damn sister, Tina).

The whole process gets me more and more anxious the closer I get to being able to submit for approval. I've combed my insurance (Aetna) clinical policy bulletin backwards and forwards. A little history: BMI is over 50 dating back over 7 years it has gone from 43 up to nearly 54 (53.1) My PCP has for the past 3 years advised me on weight loss methods I have had my psych evaluation and clearance Attended a nutritional counseling and a support group Labs and ECG (EKG) are done Now I'm not sure how, but my surgeon's office said I was eligible to submit under Aetna's "Physician-supervised nutrition and exercise program". I have had monthly visits to my PCP regarding my weight and remedies for the last several years. The surgeon's office manager was apparently overwhelmed when my PCP sent over seven years of charting. So, my question is do I allow the office to submit now or wait until after the second week of August after the 3-month program of the surgeon is completed?

Look here, Jawja Peach. You have nothing to be fearful of. There is a littany of information on here alone. You name it someone here most likely can answer it. Pre-Op, Post-Op and long-term maintenance. Insurance, nutrition, fitness and well-being. VST has got it. Best of luck to you on your journey to a new you. Jeff

Well in that scenario that would be about right. But my surgeon's office submitted with a doctor visit, one nutrition counseling, labs, weight history of 4 years, psych Eval, sleep study and PCP letter. In addition, my BMI is over 50 but no comorbidities.

Ok. I went to my nutrition class Thursday. While there the office manager said she sent my file for approval already. Why?! You see in my signature line all that I have completed. I thought I had two each of nutrition counseling and support groups to go. I don't wanna take chances with Aetna. What if I get denied? Why bother submitting now? It works if I get approved and fails miserably if I dont. The only things not in my signature line are my several years of documented weight and exercise discussions with my PCP. What should I do? Sit and wait?

You are 100% correct. I get spooked when I read on here how insurance companies (Aetna and all the BCBS' in particular) are so anti-approval. I'm not quite 10 feet tall so Aetna better shape up, fly right and approve my arse (and my stomach)!!!

I am still nervous, The anxiety is tortuous. I was at 431 and now I am about 415. my goal is to hit 400 or less by surgery time. I thought I'd have a while to go. I hope that even at 415 Aetna doesn't think this is just a cosmetic procedure. Insurance companies can be very fickle.

In a few words: Testosterone to Estrogen ratio. That we as men have more "T" than "E" is what does it for us.

Good luck and Git R Done!!

Had that Flagyl before. Doctors: Zofran didn't help!!! Stop prescribing it, PLEASE!

She's a bit kidded. My surgeon said my surgery will most likely be the first or second week of Sept. Hers won't be until November. She told the doctor that I "only care about myself". But "she isn't worried" because "November is fine" with her. I think she was ok when we both had to do the six month program. So why did I get pushed up? Easy. I go to the PCP at least once a month. For the last several years. Since my gallbladder was removed last August I've been going twice a month. We discuss weight management and exercise options. She takes my vitals and orders labs every 6-8 weeks to make sure I'm ok. My wife felt going every month wasn't necessary. Granted, at the time we weren't big on WLS but I discussed it with both the PCP and the bariatric surgeon. So now that surgery is imminent, I benefited from continual medical conference. This is why I got moved. I have consistent documentation. Is she upset, mad or what? I think she's somewhat upset. Am I wrong? I asked and she said she was fine.

Uncanny how we mirror each other. I am 6'3" 430lb. My wife is 5'4" and 310lb. We however, don't have children. Unless a pretentious Shih Tzu counts. I don't know what to say and saying nothing can be just as bad.

Y'all are welcome!

You're just the best!!! Thanks for giving valuable insight into her thought process. All have been a great help and I just don't wanna make her feel bad. Just because I get approved for Sept doesn't mean I have to do it in Sept, right? Maybe I can wait until she gets approved. We're both in need of this. Myself, I'm 6'3" and 400+lb. She is 5'4" and 310lb. Yes I'm called a cute, cuddly bear and people rarely guess my correct size. Most think I'm "only" 325lb or so. Big but athletic. But she looks hotter! We were both big at marriage. She's stacked too! So maybe I'm not seeing her the way she sees herself. In any event I can't thank y'all enough for the advice and everything. It's very much appreciated.

Very sound advice. Thank you. I haven't said anything to her yet. After years of marriage, I know when to zip it! Certain things are catalysts for arguments. I thought she was possibly upset because she either wanted us to do this simultaneously or she wanted to go first. She has said that she'd feel bad if ever I weighed less than she did. Now if I get sleeved by mid Sept that gives me two months of losing before she is sleeved. Now I hope for good results but I don't plan on dropping 120lb in two months. Plus, her birthday is in late Sept. I don't think she wanted to be taking care of me during that time...

Thanks ladies. Khy, that's my issue. I have only been to one NUT counseling and a support group. I read the bulletin (0157) and it appears that I qualify under section I-C-1: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Physician-supervised nutrition and exercise program: Member has participated in physician-supervised nutrition and exercise program (including dietician consultation, low calorie diet, increased physical activity, and behavioral modification), documented in the medical record at each visit. This physician-supervised nutrition and exercise program must meet all of the following criteria: Member's participation in a physician-supervised nutrition and exercise program must be documented in the medical record by an attending physician who supervised the member's participation (GOT THIS DONE). The nutrition and exercise program may be administered as part of the surgical preparative regimen, and participation in the nutrition and exercise program may be supervised by the surgeon who will perform the surgery or by some other physician. Note: A physician's summary letter is not sufficient documentation. Documentation should include medical records of physician's contemporaneous assessment of patient's progress throughout the course of the nutrition and exercise program. For members who participate in a physician-administered nutrition and exercise program (e.g., MediFast, OptiFast), program records documenting the member's participation and progress may substitute for physician medical records; and Nutrition and exercise program must be supervised and monitored by a physician working in cooperation with dietitians and/or nutritionists, with a substantial face-to-face component (GOT THIS DONE); and Nutrition and exercise program(s) must be for a cumulative total of 6 months (180 days) or longer in duration and occur within 2 years prior to surgery (GOT THIS DONE), with participation in one program of at least three consecutive months. (Precertification may be made prior to completion of nutrition and exercise program as long as a cumulative of six months participation in nutrition and exercise program(s) will be completed prior to the date of surgery.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Hanging knee raises, and pretty much anything Shaun T has on DVD. He and Tony Horton (both BeachBody employees) have great programs. It seems that what Tony does in 90 days, Shaun does in 60.

I am REALLY obsessing over this. I want this now! I know that most everyone says it's a process, It will go faster than you think. This I believe to be true, However, the day-to-day of it all is quite riddled with anxiety for me. Everyday I comb the net, researching pre and post surgery protocols. I have made composite lists of things I may need after surgery, To say that I left NO stone unturned is a gross understatement. And I just started the process in June. Going back and forth trying to determine whether or not Aetna wants a 3 or 6 month process is a source of frustration in and of itself. I can only speculate that some (not all) of my anxiety will be alleviated when I get a definitive surgery date.

I'm just as excited for you as I would be for myself!! Congrats on Day 1 of New You. Be happy and careful with your new sleeve. I pray for you a speedy recovery.

Dude!!!!!!!!!!!!! Nicely Done. 'Nuff Said.

Walking helps me tremendously. The key to exercise effectiveness for fat loss is to stay in your target heart rate zone for 45-60 min. For you that is approx 101-118 beats per minute. to start out however, 84-101 BPM is adequate. Several types of medications can lower your maximum heart rate and, therefore, lower your target heart rate zone. Beta blockers, most anti-arrhythmic medications, some Calcium blockers and digoxin are among the most common. In some people, H-2 blockers prescribed for acid reflux also reduce maximum heart rate. If you're taking any of these medications, ask your doctor if you need to use a lower target heart rate.

I have. PM me and I will talk with ya.