NikkiDoc

My work has a cafeteria. M-F I have 1 egg scrambled with spinach and tomato. Probably 3 days out of 5 I get a sausage link. I had been skipping the sausage but my skin and hair was getting dry. I realized I wasn't getting enough fat in my diet. Weekends I will have a Protein shake or left overs from dinner. Yesterday, I had the day off and had a half cup of split pea Soup that had some ham in it.

I prefer Penn Maid. However it may be a local brand as I am in Pennsylvania. It is the only brand that I like the low fat. (I don't do no fat)

Blended Wendy's chili was good. I had 10 days pre-op full liquid. Post op was 1 week clear liquid, 1 week full liquid then 1 week pureed. So I am going to echo everyone else being able to have pureed is pretty good. I did not like the baby food. I didn't mind the pureed chicken salad. I sometimes bought the buffalo chicken or chipotle chicken flavored for variety. I would also put a tiny bit of bbq sauce in with the mayo to puree. Pureed egg salad is good. I added some Guldens mustard for a little flavor. Cottage cheese and yogurt were good. Pureed soups were okay. I did like homemade split pea Soup or bean soup since I make those pretty thick. A couple of bites and I was full. As I got closer to the soft foods stage I would blend it a little bit less so there were very small soft pieces in the puree. I did use Protein shakes for at least one meal a day during the puree stage. I was drinking a Protein shake a day until about 4.5 months in just to make sure I was getting my protein.

I went to one informational session and asked the surgeon how many VSG he personally performed. I got a 5 minute song and dance about how long the sleeve had been being performed and it was a very safe surgery. He never answered me. so how experienced was HE at the surgery and follow-up care? Who knows. It may have been a language barrier thing as I think Chinese was his primary language. I didn't want a language barrier either. This was a progam that was being started a few months after the informational session at my local hospital. He and another surgeon doing baratric surgeries at a hospital about an hour away. But the support staff at the local hospital would be new. Neither surgeon were exclusively bariatric.

I had my surgery with Barix Clinic and the facility was Forest Health Medical Center. I really liked the surgeon and the facility. I know they do plastics there. It is by Oxford Valley Mall in Langhorne. The only drawback for the facility was no Wi-fi..

I would not eat it since it is too low in Proteins and likely too high in sugars for my program. My program does not count carbs they count sugars and there are certain types of sugars I cannot have if they are in the top 5 ingredients and if the sugars are more than 2 grams per my serving size. Without the ingredients I can't 100% tell if I can' have it based on the sugars. But I wouldn't bother due to the low Protein There are a number of yogurts with higher protein and lower carbs/sugars per serving.

My surgeon's plan is no liquid 10 minutes prior and 30 minutes after. I will take a small sip - very small sip- during a meal or right after a meal if the meal is spicy or if my mouth is very dry. I will sip the Water and hold it in my mouth for a moment before swallowing to try to get the most bang for my buck out of that little sip. I try to follow the letter of my surgeon's law but sometimes I need a little liquid to help me actually eat. If I consume a total of 1.5 oz at a meal I would be very surprised and it is not at every meal. By far most of my meals I don't drink anything during my meal. At home I sit down with no drink and only get something if I absolutely need it. I have vomited exactly once when I first moved from soft foods to solid foods. I ate my chicken, ate some broccoli and drank more than a sip of water. Nothing like running to the bathroom at the restaurant. We were out to dinner with friend's for my husband's birthday. That taught me real quickly to not drink with my meal. I was always told that since you cannot each much during any one meal/snack you don't want to fill up with liquid prior to the meal. You need to have the room to get in your Protein and maybe a few green vegetables. If you fill up on liquid then you get hungry sooner which can lead to grazing or needing to add another snack during the day. For the 30 minutes after eating this is so you don't flush the food out of your sleeve to quickly which can lead to you getting hungry too quickly.

IMO you need to way lower your carbs. You said that during the day you stick to the diet but fall off he wagon when you watch TV at home. TV has tons of ads for food. Either start watching movies and Netflix and things without commercials to see if not having ads for food every 15 minutes helps. If watching TV just give you the time to be bored so you graze time to find a new hobby. Knitting, cross stitch, crocheting- these take both hands and you won't want to get food on your project so you can't eat at the same time. Maybe take night classes through the local community college. Our local school district has adult night classes in all kinds of stuff- exercise, computers, cooking healthy meals, knitting, scrap booking, horseback riding, foreign languages. They are inexpensive. Do something so you don't have time to be bored and graze. Go through your cabinets/fridge/pantry and get rid of the carb such as Pasta, bread, crackers, white/brown rice. Only get your carbs from green vegatables. Don't buy corn, lima Beans, etc... I rarely have fruit. I might puree some in my Protein drink for a change in flavor. Don't have carbs and slider foods in your house, car or at your work. Don't put those temptations in easy reach. Plan your meals for the week and prepare them ahead of time. Make it easy to grab the right thing and hard to grab the wrong thing. If you are starving keep things like celery, carrots, grape tomatoes already cut and washed available. Graze on those. If you really hate them plain then dip in hummus not in dressing. For drinking I like Mio liquid Water Enhancer. They come in a bunch of flavors. I will sometime buy a gallon of DIET Chik-fil A lemonade and water it down. I do not drink juice or soda. I do use a straw because for me I could never get in all my liquids without using a straw. For some reason I never drink as much out of a bottle or cup. I would try a little longer and go back to the basics before I would do a DS. Do you know what size bogie your surgeon used? Has he done any post-op testing to see how big your sleeve is currently? Could you surgeon have been a little generous in your sleeve size? Have you considered a second opinion with another surgeon either in your current practice or another bariatric practice? They may have a difference protocol that will help you. If your current NUT/dietician isn't helping you call another bariatric practice and see who they recommend. Thinking outside the box, make an appointment with an endocrinologist. Thyroid issues are frequently under diagnosed. Many PCPs do not do all of the correct thyroid panels. Most PCPs don't seem to recognize stuff like Hashimoto's so they don't know to refer to a specialist. Many obsese woman have PCOS. There are diabetic drugs that can be used off label to help- metformin, Byetta etc.. The endocrinologist may be able to help your figure out if you have any other undiagnosed metabolic issues that are slowing your weight loss. For me to have any weight loss I need to be strict about high protein and low carb. I cannot get my carbs from fruit, potatoes, starchy vegetables, rice or grains. Even whole grains are out. I do not do low fat. I will eat real cheese and butter in moderation. the exception on the cheese is I will eat low fat cottage cheese (not fat free) and 2% Cracker Barrel cheese. But if I grab a cheese stick from the convenience store I don't stress. I do not fry things. I will use EVOO to saute or to oven roast vegetables. Incidently I do not track my calories. It is not how my surgeons program tracks things. My program has me eat a minimum of 62 grams of protein and drink 64 oz of water. I keep the sugars low and the fat below 11 grams per meal. The sugar guidelines are a little explicit than "low" but it would be hard for me to type it out. I always eat my protein first and then green vegetables. I don't have room for anything beyond that. I eat 5-6 meals and do not graze. Good luck and I hope you find a good program that works for you.

Travel cup with straw, immersion blender. I could not get in all of my Fluid without using straws and the straws have never bothered me. I like the immersion blender for shakes and when I was doing pureed stage. I use the immersion blender less now that I am 5 months out and am not drinking a daily Protein shake. I only drink them a couple of days a week now.

I have worked in insurance for 26 years. Generally the approval for a surgery like this is based on medical necessity and therefore it does no matter who performs the surgery. However for WLS some insurance companies require it to be done through a Centers of Excellence. Therefore it still would not be restricted to the particular doctor as long as you have it done by a Centers of Excellence surgeon. Medically necessary is medically necessary. Odd thing on Centers of Excellence are programs/surgeons the insurance company has designated as COE and not necessarily ones that hold that designation by some official organization. In other words the list of COEs can between insurance companies and it isn't as cut and dry as all network providers are COEs. That does not mean that you might not have to jump through a few more hoops. The new surgeon may have additional pre-op testing and will likely want to resubmit everything to your insurance so they have the approval also. My surgeon did not require me to see a pulmonologist or have a sleep apnea study. The other surgeon requires all of his patient's to be either cleared by a pulmonologist or have sleep apnea study. I know they have a few other differences in the pre-op requirements.

OP- Call your insurance company and ask for a list of psych doctors in your area that take you insurance. Insurance will have a list. Most insurance companies have a bariatric program for the approval process. If they have that ask to talk to a bariatric case manager they may be able to let you know if there are psych doctors in your area that specialize in bariatric patients. If there isn't anybody close it may be worth it to take a half day from work, get an afternoon appointment and drive to one that is in network.

I am really very open about it. I have pretty much told everybody. Most people ask questions about what I can and cannot eat, how often I can eat, how much I can eat. Everyone has been supportive. I have only had one person who sorta tried to talk me out of it. However, she had lost her husband unexpectedly due to a massive heart attack at a fairly young age only a few months before. She was genuinely concerned about me having the surgery and the risks that come with anesthesia and major surgery. She was the first one to offer to be my walking partner once she understood I was not changing my mind and that I had done the research.

When people ask how much weight I lost I count from the highest I was just before my 6 month supervised diet. If they ask how much since surgery I will count the 10 day pre-op diet as I consider that as part of the surgery and prep for surgery.

My aunt needs to get in more Protein and she has a lot of food restrictions. She cannot have sugar and is lactose intolerant. I figured WLS shakes won't have sugar and I know there are people on the board who are lactose intolerant. So what Protein Shakes do you drink that taste decent? For those of you that are really sensitive to lactose is the whey protein based shakes an issue or do you need to drink something else? My aunt is working with a NUT. Aunt is looking into Ensure but I think she is overwhelmed so I figured I would ask here. Due to a storm that rolled through our area she is without power. Having some protein shakes on hand would have been nice for her as what she normally eats needs to be microwaved to thaw and then cooked. With the power outage it was hard. So any thoughts on good tasting protein shakes for lactose intolerant people?

You are supposed to sip, sip, sip and sip some more on that Water. I drink a minimum of 64 oz a day but generally more like 80-90 oz a day, sipping all the way. Sipping liquids will be your new normal. No guzzling. My surgeon had me swallowing pills day 3 after the surgery. His guideline was smaller than an M&M. If they are bigger than that I need to break them to smaller pieces. He prescribed Actigall which comes as a capsule and we wants me to take it with dairy like cottage cheese or yogurt and to swallow with warm water. The dairy keeps it in the stomach longer so it can dissolve and the warm water softens the capsule so it will dissolve quicker. Since the surgeon prescribed it I doubt it will stretch it. Disclaimer: Before breaking, dissolving or crushing any pills please check with your pharmacist. Some pills that are enteric coated or extended release should only be taken whole. Since you are newly sleeved you probably still have a lot of stomach swelling and that is why you can feel the pills. It is my understanding the portion of the stomach left after VSG is very hard to stretch. You should be fine with both the pills and sipping liquids. Keep on sipping.

Even if it is the criteria for the WLS that is "secret" instead of the sleep study my answer is the same. Escalate to HR, insurance company supervisor or manager, department of insurance. Out of curiosity what insurance company is this?

My friend had the band 6 years ago. She got divorced 9 months ago. He cheated on her most of their marriage. He behaved like an overgrown child, refused to do therapy or couples therapy. They had been married 25 years and had 2 adult children. The weight loss increased her self esteem enough to finally kick his butt to the curb. I think she was always afraid that nobody would want her when she was fat and she would rather be unhappy than alone. I think that weight loss can change the dynamics of a marriage. In her case he should have been dumped a long time ago. The weight loss gave her the self confidence to do it.

I had sleeve and hernia repair. I took some narcotics the couple of days I was in the hospital. It also helped me sleep. Once I got home I never even needed a Tylenol. I napped only a little bit through Day 5. My pain level was initially like having done WAY, WAY too many sit-ups. That tight muscle feeling when you get out of bed or a chair that then loosens up as you move around. It quickly faded to a I did too many sit-ups to no big deal. I walked a lot, I made meals for hubby since I was home. Due to weather DH would take me to the mall or Lowe's a couple of times a day to walk starting Day 4. In between I would walk in circles in my house- kitchen, DR, LR, hallway, family room back to kitchen etc... 6 days after surgery I went out to Breakfast with friends- I brough broth and SF Jello. But I was comfortable moving around and sitting in regular chairs. I was wearing PJ bottoms. Funny thing was they were running a 15% discount if you were wearing pajamas so hubby got my discount. I had the world's easiest recovery though.

I am not doing any with my PCP. However, I saw my surgeon and NUT at 2 weeks, 6 weeks, 3 months, 5 months. I probably should have seen my PCP right after surgery when my BP numbers started to improve. Instead I just stopped my BP meds. 1 week post-op and then 6 months seems far apart. Although I guess those that have surgery in Mexico have no real follow-up.

I had off 2 weeks. However, I probably could have gone back that quickly. However, I sometimes think I had the easiest recovery from sleeve/hernia surgery in history. I had no gas pains, I had lots of energy and was getting bored, I napped only the first couple of days, my sleeve has never had an issue with anything. My pain level was initially that of having done WAY, WAY too many sit-ups and quickly faded to did too many sit-ups. Things would stiffen up and initially getting out of bed or chair was tight but the more I moved/walked the quicker the tightness went away. The big reason I did not go back sooner was I have an hour drive to work. So 2 hour round trip, 1 hour lunch, 8 hour day equals 11 hours. That is a really long day and a long way from home if I do crash. Plus I have 100% pay for disability for like 26 weeks. I pay for it so I figured I would use it.

If your insurance is through your employer then you need to go to HR and complain Them telling you, the customer, to have your doctor call to verify benefits is not acceptable. Call them again and ask for a supervisor or manager if they refuse to answer. I would be livid if they refused to answer if a sleep study was covered and at what benefit level. If push comes to shove you can always threaten to contact the Department of Insurance to file a complaint. (If it isn't an ERISA employer based plan). The DOI complaint won't get you the answer faster but the sometimes the threat will get them to respond.

Thanks for letting me know the differences on the whey isolate versus concentrate. I use Matrix myself and have tried some of the Nectars. I like the Syntrax brand.

You can buy sample packs of Matrix and Nectars. I tend to use Matrix Vanilla. I can mix in frozen no sugar added mangos, peaches, berries or fresh now that they are in season. Add banana. Add SF Hershey's syrup, SF DaVinchi syrups. They come in fruit flavors or I went for caramel, brown sugar/cinnamon, gingerbread. Caramel with the vanilla is my favorite. Hubby likes the brown sugar/cinnamon one in the vanilla. You can add Peanut Butter or PB2 to either the vanilla or chocolate shake. I make mine with milk for the extra Protein. Hubby also likes the Matrix Peanut Butter Cookie. While I love fruit I generally do not like fruit flavored things. I liked all of the ones from Nectars and Matrix that I tried. Orange Cream, strawberry Mousse, Strawberry Kiwi. The Cookies and cream was good too. I liked the Premier shakes well enough until I tried Matrix. There was no going back for me.

While we are all impatient about the 6 month pre-op diet use it as a tool. Make sure you use a NUT that deals with a lot of bariatric patients and knows what you will be eating after surgery. Use this time to start changing your bad habits. If your doctor is going to want you to eat 5-6 small meals or 3 meals and 2 Snacks start doing that. You won't be able to drink during meals and for normally at least 30 minutes after. I can't drink 10 minutes before eating, some surgeons it is 30 minutes before eating. Start doing that. Wean off of caffeine and carbonated sodas a few weeks before your surgery date. Start carrying that Water bottle. Get in the habit of drinking at least 64 oz a day or more if that is what your surgeon will require. Figure out if you are okay with plain water or do you like to add Crystal Lite or MIO? Order some samples of Protein shakes. Buy some pre-made ones. Don't buy huge amounts of them since you tastes may change after surgery. You will probably need at least some during pre-op diet period. Use the time to research what to expect during pre-op diet period, immediate post op, the couple of weeks post op, your new low carb eating after surgery. Go to the support meetings to talk to people. Increase your knowledge base. Read the Bariatric Pal book on the sleeve. Ask your doctor what size bougie he is going to use and why. Ask about catheters, drains, will you be on something to prevent gallstones after surgery. How about something for gastric reflux? This is your time to do the research, ask questions and prepare yourself mentally. You will likely need to get other clearances for both your insurance and surgeon. Psych visit, lab work, upper GI/endoscopy, sleep study, PCP clearance, pulmonary or cardiac clearance, lab work etc.. Each insurance and surgeon has different requirements. Use this time to start getting those done. Having a couple of counseling sessions to deal with some of the issues many of us have that contributed to our overeating can be helpful. If you physically can, start walking now. You will be doing a lot of it after surgery. Start that habit now. There was somebody on this board that just could not deal with the "hoops" he had to jump through for his surgeon and insurance. It made him feel like a lab rat. They were fairly standard pre-op requirements. He gave up on WLS. IMO if he could not deal with the pre-op requirements he probably was not ready for the surgery. I lost 17 pounds on my 6 month diet. Then due to personal circumstances had to wait an additional 4 months before surgery. I gained 4 pounds back over Thanksgiving and Christmas. But I was still 13 pounds ahead. If you view this time as a waste of time, it will be a waste of time. If you use this time to start building good habits it will make your transition after your sleeve that much easier.

On most policies your deductible for the year is a set amount. That amount shouldn't change just because he is going to remove your gall bladder at the same time he does your gastric sleeve. He should just bill the insurance company. It will push up the overall price of the surgery so that may effect how much you pay in co-insurance. It should not effect the deductible or any co-pays. I never pay deductibles or co-insurance up front. You deductible may be satisfied on the anesthesia bill rather than the surgeon. I don't want to mess around with having to get my money back from the surgeon to pay the anesthesiologist or lab or pre-op EKG place or radiologist ect... With your pre-op testing you may satisfy some or all of your deductible. I will pay my co-pay at time of service.