Djmohr

I had a crazy experience with the billing of my annual nutritional panel. I moved states so I have my PCP running all my labwork for me annually. She was provided with the list of testing required. The good news, all my labs came back great with the exception of my BUN levels. They are slightly off and I have stage 3 kidney disease although it has been in remission. Anyway, nothing to really worry about at this time. So yesterday I get my explanation of benefits in which all the labs were done. To my horror, CIGNA tells me that I am not covered for that bloodwork! And the bill for it is going to be near $3000.00! First my husband nearly came unglued which then stresses me out. I of course said, there must be a mistake it was just routine lab work done at my general doctors. Now keep in mind my surgery was 2 years ago and we moved states and changed insurance as well twice now since then. So I called Cigna and they inform me that the testing is coded as Bariatric Surgery Follow up. I immediately said, I had surgery two years ago, this was not a follow up, it is just a nutritional panel done by my PCP to ensure I have proper nutrition. She informs me anything tied to Bariatric surgery will in fact be denied. Of course my max out of pocket has been met this year because of my shoulder surgery and months of physical therapy. I told her this was processed incorrectly and I would be contacting the doctors office. Of course to let them know they should not use the word Bariatric in their coding at all. Has anyone else experienced this? And if so, were you able to get it resolved? I am worried, I don't have another 3K to give for blood work annualy. And of course not a single person warned me that when I would have my PCP do it, lab work would not be covered. Thoughts?

Hi There! I am so sorry for your loss! Losing a parent is so difficult especially when it is that fast. It is these times when chaos usually sets in for those of us with eating disorders. As you said, you know what you need to do. I might suggest looking back to your original goal and using it to focus yourself. For me that tends to work best but you have to figure out what is going to work best for you. My suggestion is to go back to the basic rules you had to follow post op. It's is a good place to start. Best of luck and just know you have a lot of people here that will support you. YOU CAN DO THIS!

I used spanx shape wear because I feel like it has the most control. I have had 152lb loss and have no choice but to pursue an Abdominalplasty and breast lift. It's like all my fat melted downward. We call it the mudslide.....LOL

@@SuperDave Thanks. So far that is what I have done and plan to do if they don't change the codes. Not that I would ever do this but if this happens to others I can see why some avoid getting their blood work done annualy. Who the heck can afford those costs? Step 1 - doctors billing office is looking at it now and we will push hard to get those codes changes Step2 - of step 1 fails, I will be calling the billing office to ask what they are going to do to write this off or at least down. Someone should have told me that these labs would not be covered at all. It's another of those things you don't know until it happens. Ugh! Did I say how badly I HATE calling both the insurance company and the doctors billing office? I was on the phone nearly all afternoon yesterday.

@@may.demers You are right taking Vitamins that first month or so really isn't fun but it does get easier. And you have to find the right ones to work for you best from a taste standpoint. After about a month or two you will be able to swallow your vitamins and not have to chew them. I think I got the go ahead at week 8 post op. I take a generic (Walgreens brand) multi Vitamin with added Vitamin D, I take a generic D3, A generic B1, a sublingual B12, and then the hardest one for me was to find a calcium citrate that I like. Well I tried many and many were simply gross. This is an important vitamin for us so I would finish the gross ones and try something new. I ended up going with Bariatric Advantage Calcium Citrate Chews, I like strawberry and orange flavors. They taste like starburst and honestly I could sit and eat them like that LOL. That of course would not be a good idea. I buy them on line at Amazon Prime so I can get them quickly. Everything else I buy I get them on sale at Walgreens for buy 1 get 1 free or buy 1 get 1 half off. Both the multivitamin and the D3 have enough for one bottle to last you a year so the cost is reasonable. You can certainly do what you want but I would recommend that you stick to the plan if you had your surgery. If you don't take them you are going to end up with other complications. Hopefully things will get better for you and you will see the value in this surgery. I lost all my weight and even a little more and so far am keeping it off. I am healthier and have more energy than I have my whole adult life. Best of luck to you.

@@Jenn-naySeveNiner I am guessing you have more pain and nausea which is likely due to dehydration. Do you know how much liquid you are getting into your system at this point? It is the number 1 reason for nausea, dizziness, weakness, and even pain after Bariatric surgery. It is also dangerous if it goes on too long. The best thing you can do right now is focus on Water intake. Once you do, you will feel much better. I promise!

Unfortunately there is no magic skin poofing button. LOL I wish! I have lost 152lbs and have a lot of the same issues with chaffing. Even so without long history of having that skin problem documented most insurances will not cover removing it, because they say it's cosmetic. I say BS. I had a terrible time with my bat wings....they were very large and even though I had gotten to my optimal weight I still had residual fat and tons of leftover skin and no matter what I did, nothing helped. I did not even realize how badly it pulled on my neck. So I pain 5950.00 to have them removed 5 weeks ago. I have to do the same with my stomach and breasts because everything is hanging low pulling on my spine. I have osteoarthritis of the spine and have had 6 back surgeries so far. Hoping to hold off another one. Anyway, you think insurance would cover these things given Morbid obesity is a metabolic disease. Yikes! It will cost me another 18K to have both my Abdominalplasty and breast lift with augmentation. That is the bad news.....the good news is there are excellent surgeons out there who can do this kind of work if you can raise the funds to do it. It is the only way I know of taking that skin off your body. It simply will not go away without it.

I had capsules and had to open them and put them in a spoon of yogurt. It still tasted like crap but it was better than trying to use a sip of Water. Thank goodness they stopped having me take them one month post op.

My surgeon also insisted it be removed at the time of surgery for all WLS patients. He did not have to worry about me because 17 years ago I went on a low fast diet, lost 75lbs in 3 months and my gallbladder went crazy. By the time they figured out what the hell was so wrong with me (I could only eat boiled potatoes and dry Cheerios, everything else made me sick) My gall bladder was so full of stones and infected that they had to do an open gall bladder surgery. Back then it was 3 nights in the hospital and 12 weeks off of work for me. I of course had them bring my work home which was great. I still remember my general surgeon telling me to be careful after having it removed that likely I would begin to gain weight again. He wasn't wrong.....within a 2 years I gained back all that weight and added another 25lbs to it before I decided to go on the Atkins diet. LOL I lost all that weight and then gained it all back and then some.....can you say yo yo diets.....don't work. I finally stopped trying to lose weight because it was literally going to kill me. That is how I ended up at 310lbs.

@@kathykb If you lost hair before on a diet it might be likely that you lose it again. The good news is it does come back. I had a very thick head of hair prior to surgery (I am Italian). I got my Protein, Water and Vitamins pretty quickly and have remained there since so it was not from a lack of protein, I took Biotin nearly from the beginning, that has nothing to do with your hair falling out but it will help with regrowth....maybe. There is a lot of debate about that. Mine started falling out a lot right around 10 weeks post op and the more weight I lost, the more and faster it came out. I will be honest I was scared but I wanted to get healthy more than I care about my hair. It kept falling out until the rapid weight loss stopped around month 13. I continued to lose weight until I reached goal at 18 months post op. The whole time, my hair was coming back in like crazy and now I have a very very thick head of curly (very curly) hair. In fact, I have to get it thinned out just to make lay properly. LOL Whatever you lose it will come back and should not leave bald spots however mine got thin enough to see my scalp. I lost it from all over and I swear I have hair growing even lower at my temples and scalp than I had before. I stopped taking biotin right around 15 months post op simply because my hair was coming in like crazy and I am not convinced it did anything that would not have happened before.

Good for you for trying to work through this early. I do agree with the others that you don't need to go to the liquid diet to see if you can do it, you just have to do it when the time comes. Take 1 day, 1 hour, 1 minute at a time if you have to and keep your eye on the prize. Don't think about how long it will be, it will be over before you know it and then you will be on the post op diet. For now, start focusing on small changes that you can maintain. I read somewhere that it takes 13 days in a row to build a habit, and one to undo it. Try working on simple things like: 1. Eating good quality dense Proteins. chicken, turkey, beef, pork, seafood. Some of the best food I found after surgery is fish and shrimp. Low in calories, filling and stays with you. Also lobster and crab....I am alergic to those but used to eat them years ago and if I could I would eat them often. 2. The biggest habit of all is ensuring you are drinking a minimum of 48 to 64 oz of Water every day. It really is one of the hardest habits to build but will make you very very successful early on. If you cannot drink water, add SF crystal light to it but drink every day all day long. 3. Use a smaller plate to eat off of. I use a very small Cereal bowl, even now 23 months post op. My 1 cup of food looks like a lot and many times I cannot finish it. 4. Chew chew chew your food. You need to pay close attention while you eat and go very slowly. This really does give your brain time to get the signal for your stomach when it is full. This rule is very important because one spoon or forkful after surgery can mean the difference between pain in your chest and vomiting. I don't vomit, but if I eat more than I should my stomach hurts very bad. It is a sharp pain as if something is stuck but it's not, I just ate too fast or too much and it can ruin a meal post surgery and make you miserable until it passes. 5. Just get a little more active everyday. If you don't walk now, start. Go a little further every day. It will help you during recovery. 6. Get rid of all the junk (yes, Cookies too) in your house. Remove Pasta, rice, bread, sugary sweets from your pantry. Donate all of the processed packaged goods like that blue box of Kraft Mac and cheese that was in my kitchen. No More soda or caffeine at this time either 7. Stay away from fast food! If you need to eat out, go to Panera and get a Soup and salad or to noodles and company and get a buff bowl. Very healthy options here. 8. Start buying lots of vegetables, fresh and frozen are best. Learn to cook them to your liking so you eat them with your dense Protein. 9. If you don't cook, take a cooking class or two, you will need them. The best foods for you are the homemade ones that you know what is going in them. Pinterest has really great healthy recipes and even some that are not so healthy but you can change if you are a cook or learn enough to get bold. There are also a ton of Bariatric recipes that could help you. Now I am not saying do this all at once. I started with 1 or 2 as I had a nine month process. I would work 1 or 2 each month and before I knew it I was no longer drinking anything but water and I was very well hydrated. I also stopped watching tv while eating just so I could pay more attention. There are other rules for after surgery but this should be a good list for you to focus your efforts on. Don't try to do everything at once. Lastly if you are a smoker you need to quit now! Give your self time to get back that addiction. It is not an easy one to break and most surgeons will not operate if you are a smoker. It is because your body heals poorly and for WLS patients when the nutrition is much harder the first couple of months you don't need to be healing poorly from both smoking and lack of nutrition. Sorry for the long post but my nutritionist gave me a simliar list after my first meeting and I was so thankful that I was able to use my waiting time. It helped me lose 152lbs. I now weight 158 and have been at goal since March. This has been the best decision I ever made for myself. I have an exciting new life because of weight loss surgery.

@@kathykb It sounds like you are doing great! Congratulations!

Guys, I don't mean to be a jerk here but very bad things can happen if you smoke with healing post any surgery. Especially ones where they are cutting your stomach out or rerouting your intestines or both. Thank goodness I quit 30 years ago but my program did several tests that they told you about just to make sure. If it was in our systems surgery was cancelled. Not postponed cancelled. After everything you have gone through, you have to decide what is more important. It was clearly layed out that our Bariatric program would dump us as patients if that happened. They simply don't want the risk of complications given we are morbidly obese and have enough problems. It is all about the healing with smoking. I just had my first plastics 5 weeks ago and my surgeon told me she won't even take on a smoker at all. You may get lucky and have no complications but it seems to me, you have enough to worry about with all the changes you will be going through. Have you figured out what drove you to smoke and smoke so much? Those same issues could impact your eating behaviors too. Maybe it is just me, but not a chance in the world I would have done anything that would cause me to have a surgery cancelled. Do you know if that is what your surgeon will do? Or what are the ramifications if he discovers you have been smoking. Maybe a short relapse won't matter..... Not sure here but my advice would be to speak with a therapist about why and nip it in the bud.

@@AvaFern I have to say that can be true as I have seen it with a few over the years myself. However that being said, I feel like I have been very lucky in this respect. Maybe it is because I have had a lot of health issues and nothing is ever textbook with me so they have to work extra hard at helping me with my health issues. I will also say that I have learned to dump very quickly the doctors that I feel don't care enough to even listen. I have been known to ask the question, "are you going to listen to and pay attention to my lengthy history or will I find someone who can" Seriously, I have done it more than once until I find a doctor and then I stick with them. I searched high and low for an excellent dermotologist when I was in MN. I had very severe psoriasis with arthritis. Was finally diagnosed with psoriatic arthritis. It took many years and several doctors.....All of them want to go by the text book. Well, my psoriasis is on the palms of my hands and the bottoms of my feet. It got so bad that all of my skin would slough off and I would have open hands and feet. Can you imagine how embarrassing that was to even shake someone's hand. (I didn't of course) Well after years of suffering with this to the point I literally could not walk, I got an infection that was moving up my leg and up my right arm. I called my new idiot doctor that refused to listen to all the things we tried and didn't work. She told me to go to the ER immediately and gave me a number for the ER doc to call her. Well, guess what? She never answered the calls. I was in there 5 days and my loser dermotologist doesn't do hospital visits....so they sent in a new dermotologist and it thought here we go again. Well, it turned out that this guy was exactly who I needed to see. He is older, now in his early 60s but this was nearly 10 years ago now. Anyway, he immediately was alarmed with what had been happening and said, "with you my dear, we need to throw the textbook out the window, you have a life threatening infection that should never have happened" Light therapy, creams and the biologics I was on we're not working. He made a suggestion that he would call my dermotologist and talk her through his opinion. I said don't bother, as soon as they let me out of here I will be seeing you in your office. A year later he told me my case of psoriasis was the worst he had ever seen. We developed an excellent relationship to the point where I now travel 6 hours from wi to MN to see him every 10 weeks for my Stelara injections. He used me as a testimonial on his website, I have done radio for him and I will continue to see him and pay out of pocket probably until he retires. I have a lot of arthritis issues that impact my spine and my shoulder joints. I have been searching for the last year in my new home state to replace my docs in MN and every relationship I have built, has been based on how things have worked with my dermotologist. I make it a point for them to get to know me very well and to treat me with respect. My health care is too important to leave it to a doctor that doesn't care. I now have a PCP, a Orthopedic spine specialist, dermotologist and recently even a plastic surgeon who likely won't forget me or give me mediocre care. They know I am outspoken and demand the best care possible. I tell you all this because it is very possible to have an excellent relationship with your doctors at least the ones you see regularly which should include your PCP. Don't stand for anything less unless you don't care either. As for nurses, it's much harder because they change them out so frequently, but there are a few special ones I have been dealing with for years. One of them is Dorothy my Bariatric nurse who herself had bypass 12 years ago. By far she is my favorite and has a pretty outstanding bedside manner. Don't settle for less than the best care you can get. We pay a lot of money for health care in this country.

This is the part of the food plan that I truly struggled with. I started with yogurt, applesauce, pureed turkey and chicken, cottage cheese, ricotta cheese, eggs, tuna...... I found very quickly that eggs were an absolute NO and still are for me. I also found that my pouch could not originally tolerate chicken or turkey even in a pureed stage and I am alergic to legumes and Beans with the exception of green beans. So, for those 2 weeks, I lived on Protein shakes, Greek yogurt, cottage cheese, pureed veggies with Protein Powder added, and ricotta cheese. I also leveraged creamed soups, broth and everything else in the full liquid diet. The good news is, it gave my tummy a full solid 4 weeks with the liquid phases for my tummy to heal before I started on soft foods. Once I started on soft foods, very moist chicken breast, fish or any kind were the Proteins that worked best for me. I could not deal with ground meats until 8 weeks post op and then I was able to tolerate beef tenderloin. YUM!!! Of course only an ounce or two at most. Even now if I get 3 ounces of dense protein I am lucky. I have a big restriction so therefore I still have one shake in the am, 23 months post op. As you said, this experience is different for everyone, as you get started if you begin to have a lot of trouble don't be afraid to go back to the previous stage for another week to allow your tummy to heal better. Many of us have to do that. Best of luck and keep us posted on your progress.

@ I would not be afraid to change as long as you have your pre op physical done. Otherwise it could delay you. If you have not, then I would suggest very quickly after surgery getting a new PCP, in fact, I would share your story with your Bariatric team and ask for a recommendation on a PCP that supports WLS. Even though you don't know for sure what he was going to say, you know he should have talked to you long before now. I had the same situation with my old PCP. In fact she let me go 3 years before saying anything about my rapidly deteriorating kidneys. When she finally did, the damage was done and I had no idea it was even a problem. She recommended I see a nephrologist and he is the one who showed me all the results and how long it was going on for. He is also the one who suggested WLS to stop the disease in its tracks. I never trusted her again and actually called her out on it as well as asking why my nephrologist was the one who had to recommend WLS. She admitted she was not good at having those conversations because she herself is obese. Of course I thought "what the heck, then don't be a PCP" - I immediately went on the hunt for a new PCP. Now I have a great one. Change as soon as you can.

It is near impossible in the first 3 to 4 weeks to get it all in. At least it was for me. I worked hard at it, set alarms, etc.......my tummy was clearly too swollen to tolerate it all. So, I learned to hold the cup, whatever I was drinking at the time in my hand and every few moments I would sip. It was the only way it worked for me. At about 4 weeks I was able to get more than at 2 weeks by 6 weeks I was able to get all Protein and Water in, I remember being panicked about it because they give you this diet and quite literally you had to be drinking or eating something all day long to make it work. When I told them I was not even coming close, they told me to do the best I can and as the swelling goes down, it will allow you to drink and eat what you need to. It takes a while be patient and keep working at it. The most critical thing right after surgery is getting your water so you don't become dehydrated. If you do, then there is a host of things that will keep you from drinking or eating anything. Signs of dehydration are nausea, dizziness, lightheaded and a feeling of being hungry even though you cannot actually feel real hunger at this point. You will do great, just keep working at it.

You have a very positive attitude and let me tell you, the first few months of figuring things out you will need it. I promise, it does gets better as time goes buy. Foods that don't work today, may work tomorrow or next week or next month or year even. The only food that I cannot tolerate is eggs......I keep trying though. I am 23 months post op.... Best of luck to you and stay positive! Congratulations!

@@Gordita81 Unfortunately this process is long and can have delays along the way. You are almost there! It is so worth it in the end, at least from my perspective.

This was very interesting. At my 6 month labs I was determined to be slightly Vitamin B1 deficient. I have been on a B1 vitamin ever since. My levels have been normal since I began taking them. Thanks for sharing this!

@@candiecane I was off my diabetes meds before I left the hospital and my A1C currently sits at 4.8. I will say my diabetes was well controlled with Metformin and diet before surgery so that may be why it happened so quickly for me. Also, I never thought in a million years I would actually get to a normal weight. Once I got going, I simply refused to stop until I got to an optimal weight and I did not know I would feel that way. The more I lost, the more energy I got and the better I felt.

I am sorry this happened. Hopefully you will be able to get in and get your Cpap pretty quickly. It really does not take a lot to fit you for a mask. Have you made an appointment yet?

I know mine is definately my brain thinking about food and not so emotional. I usually will drink a lot of Water when this is happening to me. For example....right now I have a brisket cooking in my instant pot. It smells so good in here and I know I am not truly hungry but I want something. I also know if I go into the kitchen and get a snack like a yogurt or an apple, I won't be hungry when my brisket is done so I won't eat enough of it. Then come 10pm tonight I will actually be hungry. So I know the best thing I could do for myself right now is try water, if it gets to be too much I might have a half cup of milk but only if I cannot get past it. I found myself on here instead. I have to go clean carrots so I know that will keep me busy. It's like a game and most of the time, I am stubborn enough to win. LOL. It only took one naysayer who had bypass previously and gained all their weight back to tell me I was not going to be successful to prove them wrong. It's just the way I am wired.

I am so sorry to hear how bad things are going for you. It might help to know where you are located. There are people all over the world on this site that might make a recommendation on a proper Bariatric surgeon that can help.

Prayers for you today! All will go well and you will be on the mend in no time.