James Marusek

After surgery, the body is in a major heal mode. Many individuals find it difficult within the first few weeks to meet their Protein and Fluid daily requirements. But keep trying and you should get there. Isopure is concentrated protein. Studies have shown that the body cannot absorb all the protein if taken at once. So make sure that you are spacing out your Isopure throughout the day.

Welcome and let us know if we can be of any help.

I went through mid-life crisis around 30 years ago, so surgery was not a repeat of that experience. But I did discover that it was enjoyable to buy new clothes especially tight fitting designer jeans.

Congratulations.

Disputing health insurance companies is a little bit like talking to a brick wall. Even when the words are in black and white in the policy, they deny claims. But if you have the time and patience and want to give it a go, then by all means try. It sounds like you have 2 disputes. One is with Active Health. They required that you lose 5% of your weight before you qualify. But you failed to do this (with the consent of your surgeon). The reason you gave is that you would fall below the 35 BMI requirement. Many insurance companies require that you try and lose weight and that your qualification to the BMI requirement is determined at the initial weight officailly taken when you first apply for the surgery. So if you had lost the 5% of your weight you might not have been penalized for it. The area that I would explore is why your surgeon did not push you to lose weight during the pre-op period. Was there some medical issues that would make this weight loss a problem. If so can you surgeon's office articulate this in a letter to your insurance. The second dispute might be with BC/BS, that appears to be out of network. The cost incurred generally includes the hospital, the anesthesiologist, the surgeon, and a secondary surgeon. It is difficult to ensure that all of these are within network before surgery. Maybe impossible. I believe BC/BS offers fairly good policies and I suspect that most hospitals are within network. So anyways I would check to see what is in network and out of network for each of these elements. This is probably accessible over the internet. During my second round of pre-op testing, one of my specialist clearly showed up as being in network (that is why I chose him) but when I received the bill I was charged as an out of network. His name was clearly listed on the latest in-network doctors. When I talked to the insurance they claimed he was out of network. I told them that their website clearly showed him as in-network. But they still disputed the charges. I met with the specialist staff, they said the specialist was in-network and that they would handle it. And they did. I never received that bill. Also even though I made sure that my hospital, surgeon, anesthesologist were all in network prior to the operation. I received a large bill for the assistant surgeon. I didn't even know there would be an assistant surgeon. It turns out that this assistant had not yet submitted the paperwork for becoming qualified for in network. I asked the surgeons office to reconsider and they said they would take care of it. Again, this charge disappeared. So I had better luck working the problems out with the surgeons, hospital and other doctors than with the insurance companies.

After surgery my wife suggested that I experiment with essential oils. I followed her advise and found there was some substance and benefit to using essential oils capturing their medicinal properties. So you might say that I became New Age in my Old Age except I didn't let my hair grow long and tie it in a pony tail and I don't walk around wearing hippy beads. I am 33 months post op RNY surgery. Immediately after surgery one of the interesting observations that I experienced was a complete absence of hunger. I found that it was not difficult to lose weight when hunger was not constantly, continually gnawing at your bones. But after about a year or two, hunger does return but not with the same intensity as it was before surgery. One of the oil formulas that I created and experimented with I called Anti-Hunger. I found it to be beneficial. The formula is contained in the following article. http://www.breadandbutterscience.com/Surgery2.pdf

There are several types of signals. Hiccups and sneezing are common. Also nose starting to run. Another signal is when the food changes taste. When you start to eat, food is enjoyable but you hit a point when suddenly the food begins to taste bad. One more bite and you are into full blown dumping. Dumping for the first time is not all that bad. It is a good teacher. You do it once; your body very quickly educates you on the dumping triggers. But if you experiment with dumping, do it at home rather when you out-and-about in public. Otherwise it can be a major embarrassment. Also many people do not experience the full feeling until they reach the solid stage.

After surgery my problem was diarrhea in the beginning. It wasn't until after around 2 months when constipation became a major issue. I talked about this in an article that I wrote under the subsection titled Constipation. http://www.breadandbutterscience.com/Surgery.pdf According to my Bariatric surgery manual that I received, eating whole apples becomes an option at the 10 month post-op mark. But I was eating them around 4 or 5 months. But there is another option. Applesauce is approved at the 5 week post-op mark but you will need to make this yourself. I found that the best approach to do this is cutting up the apple into slices and removing the core but leaving on the skin. Put these into a blender with a little white grape juice and bend to a consistency of apple sauce. The grape juice should have only natural sugar, no added sugar.

Generally during surgery, the patient receives antibiotics to prevent infections from the surgery. This kills not only the bad bacteria but also the good ones. So therefore after surgery it is generally recommended that you restore these colonies in your gut. That is what probiotics do. Many people experience constipation after surgery. Some of this is due to the fact that some patients do not drink enough fluids each day. These are some of the methods individuals have recommended to counter this problem. * Eating apples with the skin * Smooth Move Herbal Tea * Prune juice (warmed) * Prunes (4 in the morning and 4 at night) * Magnesium citrate * Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). * Haribo sugar free Gummy Bears * Aerobic Magnesium 07 * Low Fat Bran Muffin (recipe). 80 calories each 1 cup flour 2 teaspoons baking powder ½ teaspoon baking soda ½ teaspoon cinnamon 2 cups bran Cereal 1 ¼ cups milk 1 egg ½ tablespoon applesauce optional: banana, berries, mini chocolate chips Bake 400° F for 22 minutes But since you are still within the first 30 days after surgery, some of these options will be currently unavailable to you.

Prior to surgery, many unwelcome medical issues were showing their ugly head because of my obesity. That was the major reason why I had the surgery. I am 33 months post-op RNY. Almost immediately after surgery many of these conditions went into remission and stayed there. So I consider the surgery to be one of the best decisions I ever made. There are tradeoffs in life and in this case I had to trade my deep love for food for good health.

I have found that a wondergel cushion available at Bed Bath and Beyond helps a lot. As you lose fat, you are also losing your built-in cushion.

After surgery I became lactose intolerant so I could not use dairy products. But after around 2 months, this condition went away. I am 33 months post-op RNY and dairy no longer presents a problem.

I am 33 months post-op RNY and I eat tomatoes all the time, especially in my chili. But after surgery you may have to wait a few months before you reintroduce them back into your diet.

Congratulations.

Some of the Purity Fruit bars contain sugar and corn syrup. But the ingredients label on the one your asking about does not. So it must be a "no sugar added" variety. This one uses Sucralose (splenda) as a sweetener. So I believe these will work fine for you.

Dr. Yoosoo Chang from the Sungkyunkwan University School of Medicine in Seoul, South Korea, and colleagues, followed the health of over 62,000 healthy young and middle-aged men and women. There were about 900 cases of chronic kidney disease (CKD) that developed in the participants over the course of the study. And participants with higher BMIs were more likely to develop the condition than others. In particular, obese participants had 6.7 cases of CKD per 1,000 persons, while the incidence in overweight people was only 3.5 cases per 1,000. The situation was even worse for obese individuals 40 years and older — 19 cases per 1,000. http://acsh.org/2016/02/10/healthy-obesity-may-be-an-oxymoron-new-study/

Congratulations.

It is common for some patients that undergo gastric bypass to experience a condition called Reactive Hypoglycemia. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778 So I do not know if this is common for gastric sleeve patients. But I would agree with GibbsGirl that this is the area that I would explore.

Good luck on your surgery and check back with us when you are on the other side to let us know how it went.

I would recommend a pill splitter and a pill crusher.

I agree, the policy states "either, or". So I agree with Cervidae. But on the second point she made actually according to this policy if your BMI was greater than 55, none of those requirements apply. You are automatically qualified.

Congratulations and let us know if we can be of any help.

Let's see! At around 3 months out, your meal volume is beginning to increase. This gives you an option to maximize your weight loss. Your daily Protein requirement is met by the amount of protein you obtain from supplements (Protein shakes, protein bars) combined with the amount of protein from meals. As your meal volume increases, you can derives significant amounts of protein from your meals IF you concentrate on consuming high protein meals. As I progressed in increased meal volumes, I went from 3 protein shakes per day over time down to 2 then down to 1 and then finally none. Protein shakes do contain calories. As I started dropping off the shakes my stall ended and I began to lose weight again.

In the first month after surgery you body is in a major heal mode. Don't be too concerned about weight loss in this stage. Just make sure that you meet your daily Protein, Fluid and Vitamin requirements and walk around 30 minutes per day and then let the magic happen.

Congratulations.