rat427

While reading this I snorted a mouthfull of diet green tea so violently that I am fearful the sky is falling. Should I call the surgeon?

Surgery early on a Tuesday morning, back to work for 2 hours Wednesday afternoon, back to work full time Thursday. Actually, I felt great 4 hours after surgery, no pain medication. I guess malingering is not in my vocabulary.

I use Atkins low carb Protein shakes. They are 11 ounces with 15 grams of protein and 2 grams of net carbs. Then I step on it twice with 2 scoops of Jay Robb Protein Powder with 25 grams protein each scoop. Also very low carbs, I think 1 or 2 grams per scoop. So, I get 65 grams of protein right there for Breakfast. The only problem is getting it cold enough but I do blend it in the bullet.

Sounds like a lot of malingering to me. My operation was at 730 AM March 31. I felt great that afternoon with just some tightness around the incisions. Day after, the only pain was a little around the big incision when turning in certain positions. Never used any painkiller. Out of the hospital day after surgery. Went to work for a couple of hours that afternoon. Two days after surgery, I went back to work full time and have not regretted it for one second. BTW, I started driving two days after surgery. All tenderness at the big incision area was gone in 6 days and it never was a problem anyway. The surgeon said I did so well that he suggested pureed foods after 10 days and regular foods 7 days after that, carefully with experimentation. If you would get out and do something instead of laying around, you probably would feel better.

Op March 31, 2009 I have been taking potassium M-20 tablets almost two years along with a diuretic, torsemide 20 mg. I continued to take both during the pre-op 10 day liquid diet. My hospital admittance blood work showed a high potassium level, so I have not taken the potassium since resuming the diuretic. Obviously, my potassium needs to be carefully tuned.

OP Mar 31, 2009. My doc said ok to try pureed on April 10 and then regular on Apr 17 because I was feeling so good and had had little to no pain. Went back to work on the 3rd day. However he did say that the hospital recommendation is conservative so that some will not get in a bind. He said to experiment with the solid food and see how it goes. The reason for taking it easy up the food chain is so that you can learn to recognize the language that your device is speaking to you. If you throw too much food bulk at it too soon, you may not learn to recognize what the band is saying to you. The language it speaks is not the same as a full stomach sensation from previously. I am learning with regular foods slowly. By this I mean that it says different things with different foods.

I use one 11 oz Atkins high protein low carb shake with 2 shots of 25 gram protein powder. This is 65 grams of protein and very low carb and 380 calories.

Mine was Mar 31 and the little twinges have been gone since about two weeks out. It apparently took that long for the stiches in the muscle under the long incision to stop pulling.

Just start experimenting with softer solid foods at first to find out how you react. Wait before trying dry foods or just take it slow. My operation was pretty easy, back at work two days after, a little pulling at the long incision if twisting just right, no problem working or sleeping or driving. I have been driving after the second day. Operation on March 31, started pureed food April 10 and solid food April 17. The doc suggested shortening the liquid and pureed periods, since I have been feeling so good, maybe not good but great. It was solid food before I could recognize the band talking to me and I am still learning to understand its language. It is not the same as a full stomach previously. I lost 15# on the 10 day preop and have lost 17# in the 26 days since, so I guess that is adequate. It is 3 weeks to my next appointment and he says that he will adjust the band if I am not losing weight. Maybe the novelty has not work off yet but a serious adjustment will be required after the novelty does wear off.

Have any of you guys been able to eliminate or reduce your beta blocker medicine after losing significant weight? Is this something I can look forward to?

I am on day 2 at 5:30 PM of a 10 day pre-op that consists of about 800 calories from 2 Atkins shakes, 8 ounces of light yogurt, 16 ounces of "no sugar added" juice (tomato or apple), 16 ounces of chicken or beef broth, and unlimited sugar free jello and diet drinks ( Arizona diet green tea and diet rite cola). Yesterday I had 506 calories and so far today I have had 259 calories. I have had no interest in cheating and have not felt starved, yet. I was at 433 and lost 46 in the last 2 years since taking a diuretic along with lisinipril for high blood pressure. So, I have a long way to go. Damn, I wish this device was available when I was a younger man. I did not get to where I am now by proving that I am a successful dieter.

high volume diet soda drinker - diet pepsi favorite second day of 10 day pre-op now - op is 3/31/09 Arizona diet green tea seems good - zero everything except 10 grams sodium per 8 oz. Available in cans, bottles, and gallon jugs. I love Crystal Light peach tea but my wife thinks aspartame is responsible for all illnesses, physical and mental, known to man. Will probably use Arizona post-op.

What is it with all these women invading the mens room? They take over the entire rest of the forum with their over-analyzing, over-planning, over-organizing, over-reporting, and silly frilly ticker tapes and then they still are not satisfied and try to take this section over also.

Sounds like she picked up the shoe and it fit her foot perfectly. She admits that men do not post in the powder room, why does she insist on posting in the mens room? My original question was for other men to comment, not invaders.

Anyone have experience with Weinstein, Hannon, Lane, or Ringold in Mobile?

Two meds for BP. Cozaar gets me to 140/90 and the addition of a diuretic gets me to 110/60. Adjusted to half the Cozaar but the whole diuretic gets me to 120/80. The cardiologist added the diuretic.

What is going on with Medicare? There seem to be new requirements in Virginia. Is this nationwide or just the Medicare contractor that handles Virginia. This contractor seems to be acting like a HMO.

OK, the contractor there also has apparently set out Local Coverage Determinations with all the requirements. What happens if the contractor does not agree and denies the payment like apparently happened to my provider, now going very cautious, and my surgery date is way off now, if at all, because of that and the new requirements. It is also possible that my provider has been playing fast and loose with the codes and got caught. I appreciate you checking on that for me.

Trailblazers is the Medicare contractor that handles payment requests from providers in Virginia. In an effort to streamline the procedure, they have instituted LCD or Local Coverage Determinations and are not doing pre-authorizations. My doctor and staff are beside themselves since they had some denials after the work was done. I am aware of the hospital requirement and St. Marys in Richmond is correctly certified. The issue on weight loss is that you have to prove that you cannot lose 10% of your body weight with a supervised program of doctor, dietician, and excercise. Purportedly, the old requirements and maybe still for the rest of the country were 1) BMI > 35; 2) two comorbidities; 3) psyc evaluation. Now, in Virginia, it appears the requirements are 1) BMI > 35; 2) one comorbidity; 3) psych evaluation; 4) doctor weight loss program for cumulative 6 months over a 2 year period proving that you cannot lose 10% of your body weight. The BP comorbidity is not accepted unless three BP medicines together will not reduce BP to 140/90. I had completed all the steps under the old program and was expecting a surgery date to be set. I am angry because the new guidelines were available to providers as early as April 10 and were effective May 17. My provider did not avail themselves of the new requirements and allowed me to sail blissfully along on the basis that I met the requirements and Medicare would pay. This time could have been utilized with my cardiologist and PCP working to meet the new requirements in Virginia. Now that I know Medicare does pre-approvals outside VA, DC, MD, DE, TX, CO, and NM, I may go to another state if that will work with the Medicare contractor there.

Response from Medicare? That seems to be part of the problem. They say that Medicare does not give pre-approvals and the documents on the Trailblazers (Virginia Medicare contractor) website seem to support that. The contractor issues Local Coverage Determinations (LCD) with detailed requirements for all procedures and the provider is required to comply. Would you ask your provider if the Medicare contractor in your state does provide pre-approvals? If so, then I may look for a doctor in another state not contracted to Trailblazers. Trailblazers apparently has VA, DC, MD, DE, TX, CO, NM, and Indian reservations. Thanks for your help.

Sorry, I forgot to state that I have done all the meetings, office visits, nutritionist, nurse, and psycologist and was with days of getting a date when the doctors group involved, was hit with some denials of payment and the new requirements, which have actually been in effect since May 17 and available to the providers since early April in newsletter form.

Also, the office manager for the doctors is thinking about the requirement of an additional waiver in case medicare does not pay. They have apparently had some recent denials and they say that medicare will not pre-approve. Well, based upon all these recent developments, there is no way that I would sign an additional waiver because that would relieve the provider of exercising "best efforts" and employing their "higher professional knowledge and expertise" in dealing with medicare. Actually, I plan to have my lawyer look at the documents already signed prior to surgery to insure that I cannot be left holding the bag.

At 65, 5' 11, and 430#, my BP is controlled at 110/60 from 170/110. The new requirements specify not controllable to 140/90 with 3 meds. So that now lets me out on BP. I do not have diabetes and my cholesterol is below 200 without meds. Have not had a sleep apnea test and I do snore heavily but my wife says she does not detect symptoms of apnea. Might have to depend on the joint pain which only seemed to come up with the recent addition of a diuretic for the BP along with Cozaar. The other issue is the requirement of a doctor and dietician supervised diet along with exercise for a cumulative 6 months over a period of no more than 2 years proving that I cannot lose 10% of my weight. Duh, I have lost that same 10% so many times that it has its own phone number. Either there are many surgeons playing fast and loose with the medicare codes or the contractor here is acting like an HMO.

I put this in the insurance section but that may not get many visitors. What is up with Medicare and the new requirements? Is it nationwide or just the Virginia contractor? I had completed everything and was expecting a date but have been put on hold.

OK, I might as well weigh in on this thread as I am waiting for a date. Everything is done except for the nutrition meeting next Monday. They will not set a date until after the nutrition meeting, so I am hoping the date will be at least by early July. Starting at 430 for my welcome to medicare physical April 24. I had lost from about that point to 398 on Atkins in spring of 2006 before spending 9 months working in New Orleans living in a hotel and gained it all back, again. Over the years, I have lost several clones of me on Atkins but no long term net loss. My LB doctor requires a 2 week liver shrinking liquid diet before surgery and they will not give me any information until the nutrition meeting. For you that have done the pre surgery liquid diet, is something like Atkins canned shakes acceptable for that period or even productive? Is beef and chicken broth with Protein powder better? Or should I go with egg drop Soup from the local chinese restaurant with Protein Powder added? Or all of the above? I would like to hear from some of you guys in addition and in advance of a clinical nutritionist. An additional topic or two. My Doctor and his group recommend Crystal Light for a drink with this LB long term regimen. I love CL peach tea but have become a little alarmed about the aspartame. I have read that aspartame works on the brain to increase head hunger. Anyone have any information about this? So many foods available at restaurants and in grocery stores have MSG in them now and I read that the glutemate in MSG causes a brain reaction that also causes weight gain. Nyone have any information on that as well? Jim