DLCoggin

I think the answer to this depends a lot on your insurance company but it is a valid concern. I agree with nomore that your doctor's office should be able to give you some good information based on their experience with your insurance company. You don't often hear of someone who was not approved because of excessive weight loss but that does not mean it can't happen. My doctor's office told me when I was on the pre-op weight loss that you don't want to lose too, too much weight which could possibly lead them to deny. They also told me that once you have been approved, it would be illegal for the insurance company to resend the approval because of further weight loss. So once you're approved, you don't have to worry about it.

I love that unsweetened almond milk! I put a little Splenda in it and it's just great. And 50% more calcium than milk. I have an 8 oz glass almost every day after my walk. Great!!

Welcome to the family! You're gonna love the new you!!

I've been drinking two to three cups of decaf since I was about three months out. Coffee is loaded with antioxidants and has a ton of other benefits. I absolutely believe that it helps me feel full between meals. I drink it with splenda and flavored creamers - I'll take my chances with the extra 35 calories. Love my coffee and ain't giving it up till someone prys it out of my cold dead fingers!!!

Starbucks has decaf coffee but sometimes you have to wait for them to brew a new pot. I love coffee and drink two and sometimes three cups a day. I was worried about having to go with decaf but I was very pleasantly surprised with any number of decaf k-cups for Keurig brewers. Very close to being as good as the caffeinated coffees. Highly recommended!!

Every surgery has risks and loved ones often get concerned when they hear that. It might help your daughter if she understands the benefits and risks beyond what a doctor can explain in a short meeting. And it might help you be more comfortable as well. Here are some great online resources to get you started. There are many more. The bottom line for me was that the odds were overwhelmingly in favor of my surgery being successful. I would do it again in a second. You're gonna love the new you!! http://www.hsph.harv...vention-source/ (Harvard School of Public Health) http://www.webmd.com/ http://asmbs.org/ (American Society for Metabolic and Bariatric Surgery) http://iom.edu/Repor...Prevention.aspx (Institute of Medicine of the National Academy of Science) http://www.wlslifestyles.com/ (This is a digital magazine with an ENORMOUS amount of information on weight loss surgery. Cost is $19.95 for a one year subscription and imho that's a real bargain.) http://www.mayoclinic.com/

Big time normal! Sometimes I swear folks must be able to hear my stomach talking from another room!

About ten seconds after I got the OK to eat real food! LOL! Once you're cleared for solid foods, you really can't go wrong with anything that swims. Loaded with protein, low fat, low carb, low calorie. I practically live on tuna, shrimp, tilapia, cod, scallops - all great!!

You might try getting some unflavored Protein powder. First thing in the morning, put a scoop of the powder in a small bowl. Depending on the powder, one scoop is 20g or more of protein. When you eat or drink something, put a pinch of the Protein Powder in. You can add it to almost anything and if it's just a pinch, you shouldn't notice the taste too much. By the end of the day you've eaten an additional 20g of protein, a pinch at a time. I sometimes wonder if doctors and others do a good job of helping folks understand the importance of protein. Unlike fats or starches, your body cannot store protein. Amino acids are the building blocks of protein and the nine "essential amino acids" must be obtained from food - they are essential because your body cannot manufacture them. That means they have to be replenished. Every day. Carbs are king when it comes to energy but when you're on a low carb diet, your body will use protein for energy instead. Every cell in your body contains protein. Remove all of the Water in your body and 75% of what's left is - protein. Protein is critically important in the healing process following surgery. Protein is a key player in helping the body fight off bacterial and viral infections. Protein will help minimize muscle loss during rapid weight loss and will also help reduce hair loss to a minimum. Try anything you can think of until you're getting ALL of your protein in, every day. Perhaps Winston Churchill said it best - "It is of no use saying that 'we are doing the best we can'. Success, means doing what is necessary."

I am truly sorry guys but anything that has 15g of protein per ounce - should raise a flag and this one is no exception. The ingredient list on Pro-Stat64 reads: "Hydrolyzed Kosher Collagen Protein, Purified Water, Citric Acid, Natural Cherry Flavor, Glycerin, L-Tryptophan, Sodium Benzoate, Phosphoric Acid, Potassium Sorbate, Sodium Phosphate, Sucralose. May Contain Neotame or Acesulfame-K." I copied this directly from the description at: http://www.cvs.com/shop/product-detail/Pro-Stat-64?skuId=367346 Hydrolyzed Proteins are usually produced by heating with acid or sometimes by treating the protein with proteolytic enzymes which is then followed with additional purification and filtration. Any protein can likely be hydrolyzed but whey and collagen seem to be the most common. There is some evidence that this processing results in a loss of nutrients and probably reduces the quality of the protein. They also are prone to have a bitter taste. Hydrolyzed whey protein is not recommended for bypass patients. Collagen protein is not recommended for anyone that I'm aware of.

Welcome to the family Roxy! Lift your head up high and know that you are on your way to whole new life. The journey is nothing short of astounding and we'll be there with you every step of the way. You're gonna love the new you!!!

It is my understanding that requiring the PCP to write a "letter of medical necessity" is pretty much a standard requirement by most insurance companies. Presumably the assumption is that it is the PCP, not the surgeon, who would be most familiar with your medical and weight loss/gain history. Other clearances such as, in my case, my cardiologist may also be necessary depending on your history.

Big, big congratulations Dave! I absolutely love your excitement and enthusiasm! For the pre-op guys out there that are struggling a little with their nerves, perhaps you'd be interested in sharing your pre-op thoughts and concerns and comparing that to your actual experience up to today? Any surprises? Better than expected? Worse than expected? Great job and congratulations again!!

Here's a quote from my post that I did yesterday: One word of caution - stay away from the Protein "bullets" and "shots" that you will see in stores and read about online. If you look closely at their ingredient list, you will see that they are made with collagen protein. These products are attractive to bypass patients because they contain very large amounts of protein in very small volumes - usually 3 to 4 ounces. The problem is that collagen protein is an incomplete protein (meaning that it is missing one or more of the nine essential amino acids that your body requires and cannot manufacture) and more importantly, collagen has a PDCAAS digestibility score of 0.08. All the protein in the world is useless if your body cannot digest it. If you see "collagen" (or any derivative of it like "collagenic") in the ingredient list, it is not quality protein.

Perhaps I'm confused but if today's weight is 188 and your pre-op weight was 229, that's a loss of 41 lbs. July 30th was six weeks post-op so you lost 6.83 lbs per week. It don't get much better than that. Congratulations! Well done! Celebrate your success and keep doing exactly what you're doing. You may be having a bit of a stall. Natural part of the weight loss process and it will pass. Patience and realistic expectations are absolutely crucial. Stay focused on following the protocol, stay active, and stay away from the scales for at least a week, two would be even better. Absolutely no reason to be discouraged.

I definitely had a plan B as well. I had my gall bladder out many years ago. The plan was to do it laparoscopically but when the surgeon got in there, he found there was too much scar tissue from an appendectomy when I was a kid. He had to do the open procedure to remove the gall bladder. I advised my RNY surgeon of that and she said the same thing your doctor did, she felt that she would probably be able to do it laparoscopically but in the event that was impossible, she would do the sleeve. I made it clear that I wanted the RNY if at all possible but if not, go ahead and do the sleeve. Fortunately, she was able to do the RNY without any problems. My surgeon told me that in the hundreds of surgeries that she's done, she had only one case where she could not do it laparoscopically so I'm betting it won't be a problem for you!!

whey was once considered a waste product from the process used for making cheese. It is a highly digestible, complete Protein made from cow's milk. Whey concentrate is about 80% protein with relatively low levels of fat, carbohydrates, and cholesterol (but still higher than whey isolate). So whey concentrate not only has a high percentage of protein but also provides healthy fats that boost the immune system. But if you're lactose intolerant, whey isolate may be easier to digest. Whey isolate goes through an additional micro filtering process that is not used in producing whey concentrate. As a result, whey isolate is about 90% protein. Micro filtering removes the lactose and fat but also destroys many of the immune system boosting properties of whey. Whey isolate can also be significantly more expensive than concentrate because of the additional processing required. The digestibility of various Proteins is published in the Protein Digestibility Corrected Amino Acid Score (PDCAAS). The PDCAAS has been adopted by the Institute of Medicine at the National Academy of Sciences, the U.S. food and Drug Administration, and the World Health Organization. Proteins are ranked on a scale of 0 (least digestible) to 1 (most digestible). Whey, Soy, Milk, and Casein proteins all have a PDCAAS score of 1.0. The bottom line is that with whey isolate you get more protein per gram (but not necessarily any better) and it may be better handled by those who are lactose intolerant. With whey concentrate you get slightly less protein per gram but added benefits from the higher fat content. As several folks have noted, the first test that any protein you're going to drink or eat has to pass is - taste. If you are not lactose intolerant and you find a protein that you like, the difference in protein content for whey isolate vs. whey concentrate vs. milk concentrate should likely be a minor consideration. One word of caution - stay away from the protein "bullets" and "shots" that you will see in stores and read about online. If you look closely at their ingredient list, you will see that they are made with collagen protein. These products are attractive to bypass patients because they contain very large amounts of protein in very small volumes - usually 3 to 4 ounces. The problem is that collagen protein is an incomplete protein (meaning that it is missing one or more of the nine essential amino acids that your body requires and cannot manufacture) and more importantly, collagen has a PDCAAS digestibility score of 0.08. All the protein in the world is useless if your body cannot digest it.

Well, I am cooking challenged so I can offer you any ideas on recipes. But you might consider encouraging the kids to make the cake they want and will enjoy the most. Just let them know that you'll only be able to eat a bite or two. As strange as it sounds, and I can't offer any explanation, but taking a single bite of old favorites or a treat is often completely satisfying. Life style changes are about control, not denial. Celebrating special occasions with friends and family is one of the joys of living. There is no reason to give those precious moments up and every reason to enjoy them. If there will be other food at the celebration as well, just make sure that you have alternatives that you can eat based on how far out you are. Happy Birthday!!

I'm an ex smoker so I know how tough quitting can be. Many doctors test for nicotine pre-op and some will not perform the surgery if your test comes back positive. Smoking stimulates the production of gastric juices that can irritate the lining of the pouch and result in ulcers in the pouch and the small intestine. So smoking post-op is even riskier than it is pre-op. You'll probably never have a better reason or opportunity for quitting!!

You might find the following to be a good place to start: http://www.hsph.harv...vention-source/ (Harvard School of Public Health) http://www.webmd.com/ http://asmbs.org/ (American Society for Metabolic and Bariatric Surgery) http://iom.edu/Repor...Prevention.aspx (Institute of Medicine of the National Academy of Science) http://www.wlslifestyles.com/ (This is a digital magazine with an ENORMOUS amount of information on weight loss surgery. Cost is $19.95 for a one year subscription and imho that's a real bargain.) http://www.mayoclinic.com/

The strengths and weaknesses of BMI continue to be examined but this article also discusses when "normal" BMI should be adjusted based on ethnic differences as well as age and body type. Interesting. http://www.webmd.com/diet/features/bmi-drawbacks-and-other-measurements

Just emailed!

Now that's what I'm talking about! Good for you!!

The opening from your pouch to the intestine (stoma) is usually about 12mm or roughly the size of an M&M. That's why it is so important to chew very well. So depending on what you eat and how well you chew, it may take longer for some foods to pass into the intestine. Of course if you're eating a half cup of soup and still full after several hours, you may want to ask your doctor about other possibilities.

You might find some useful information in my post "Dumping The Confusion About Dumping". http://www.rnytalk.com/topic/2665-dumping-the-confusion-about-dumping/page__fromsearch__1