2goldengirl

The reason for different requirements in different areas is because Tricare contracts with different health plans in each area. Each contract is different. Typically Tricare adopts whatever clinical criteria used by that health plan for that area.

I can't speak for others, but I review requests for bariatric surgery as part of my job. Typically the documentation is included in two places: your psych eval, and your surgeon's note. Some surgeons even use a checklist with the more common diet programs out there. As part of the evaluation process, both the psychologist and the surgeon review previous attempts at weight loss. I actually wrote it all down for my doc in table format, along with how much I'd lost and how long it lasted. I did that as a useful exercise for myself, mainly, but it makes it easier for the surgeon to get a grasp of the big picture. The only time you would need to provide proof is if your health plan requires documentation in a supervised weight-loss program for a specific period of time before you can be approved. I hope this helps!

I don't think it's calories that you need to count right now, so much as macro nutrients: protein, carb, and fat. Your lack of energy is perhaps not just that you aren't getting enough protein, but enough calories overall. Let us know how you're doing!

I'm still preop, but I'm in my 60's. Depending on her overall health at time of surgery and yours, about the only big difference postop between you is that recovery is likely to take a bit longer for her - cells don't regenerate as quickly the older we get. I have to constantly remind myself of this, particularly when it comes to exercise. I have a bad habit of forgetting I'm not in my 30's and doing too much too soon. When I'm working to get back into shape, I really need one or two off days a week for muscles and joints to rest and recover. Good luck to your mom, she's fortunate to have a supportive family!

Props to your husband for listening and understanding where you're coming from!

@@Bluesky1, this is appalling. Believe me when I tell you you DO have choices, you do NOT have to suffer abuse. Just because he uses words instead of his fists doesn't make his behavior any less appalling or abusive. No preacher who knows his Bible could treat a wife like this. Contact your local abuse hotline. Now. Please.

That's just rude! They can jolly well go out for their foodyoucan'teat. Grr!

It's perfectly normal to feel nervous. Do something nice for yourself the night before - mani/pedi, (no polish this time, they check your circulation by looking at your nail beds), massage, flowers on the table, clear liquids by candlelight, whatever makes you feel special and pampered and cared for.

If she doesn't feel she can lie, she doesn't feel she can lie. She may have ulterior motives for that position, but she evidently feels that keeping a secret is the same as lying. I'd talk to her in person (this just isn't a text-friendly thing). I'd tell her how badly her threatening not to keep her promise hurt you. And I'd really explore with her why seems to feel that you don't deserve proper credit for your hard work and success. Show her your food and exercise logs. Tell her how hard you've worked for those 50 lbs. Tell her whether she agrees with your decision or not, you deserve her respect for the effort you're putting in. If people DO ask her how you're losing the weight, she can always say "why don't you ask her?". That isn't a lie, that's acknowledging that it isn't her story to tell - and it isn't.

If your insurance doesn't offer a case manager or resource nurse, they don't. period. Ask to speak to the Navigator's manager if you continue to have trouble. Your Navigator may or may not be able to meet with you in person, it depends on whether the Clinic allows that in her/his job description. As far as the insurance information goes, call your insurance company. Ask about your benefits for bariatric surgery. They will be able to tell you what your copay/deductible is, and how far you've gotten toward meeting any out-of-pocket maximum for the year. You will probably be look up your insurance company requirements online: Google "nameofhealthplan state medical policy bariatric surgery". I lot of plans do have their policies online. The Clinic will have an insurance coordinator who works on getting your health to approve your surgery. Probably you won't talk with whoever that is, that's why you have your Navigator. You can ask what the options are for payment of your out-of-pocket portion and any financing options they offer. How it works: once the Clinic verifies your benefit and gets an estimate on your out-of-pocket expenses, they will let you know. That's why you want to check on this on your own, so whatever numbers you get from them make sense to you. As you get your other appointments taken care of, you will either pay copays for them up-front or get bills for them after your insurance has paid their portion, depending on the type of insurance you have. The actual surgery involves charges from the , any assistant surgeon, anesthesiologist, pathologist if there is any testing done on tissue they remove, and the hospital itself. All of them will bill your insurance first. Most of the time, they bill you at the same time they bill your insurance. Don't pay anything until you get a bill that actually shows what the insurance has paid. sometimes it takes a billing cycle or two before the insurance payments are reflected. You're getting information thrown at you all at once, and it can be really overwhelming. Just keep answering questions, taking notes, and asking more questions. It will all be OK!

One other thing - if you aren't drinking enough, that will actually increase your nausea. How are you doing with your fluids?

You've lost 50#. Depending on your intake, you may actually not be eating enough for your needs, which can slow down your losses. I agree, let us know what your protein/fat/carb intake is. Are you logging your food? Measuring?

Thanks, everybody. I've coached more than 60 people through the process, and I've been taking care of postop folks for more than 30 years. It's different when it's YOU that's doing it. I've never lost more than 30# at a go before. It's going to be an adventure.

No advice except to stay off BP! You just had surgery. Rest. Take your pain meds, Take your anti-nausea meds (ask for them if the nurse doesn't offer them). Wait til the nausea meds kick in and then try to walk. It will get better, promise!

No. The reason you are told to take small sips is that big gulps are often downright painful with a new sleeve. I guarantee you have not stretched a brand-new sleeve by drinking water.

Next time add some water or broth. The soup would have thickened as it cooled even without the protein powder.

In answer to your question "how would I know if I have a leak?" - You wouldn't. That isn't something you can self-diagnose. That's why the number one answer in ALL cases where you are worried, the answer is always "call your doctor". Day or night. Weekday or weekend. No foolin'. Any advice you find on the internet, no matter how well meaning or well informed is no substitute for a conversation with your doctor. Sorry to hear about the gall bladder!

Scumbags are scumbags no matter what size you are. Unfortunately, society has encouraged men to treat all women as hit-on-able, which is stupid and sad. Just come up with some snappy take-downs and have done with it.

That's fantastic! I feel the same way you did (and I get these approved for a living, I think I know what will be approved and what won't, y'know?). Good luck!

I'm following along with you. I'm at the age and stage in life where the shelf that walks into the room ahead of me is gonna deflate big time. I won't have anything left but pancakes. I have a friend who has lost 150# and she talks about "folding 'em up and sticking them in my bra like socks". I do know from what I've researched online that adding implants isn't uncommon - evidently once you remove the excess skin, there isn't tissue left to make them perky. As someone who is currently an H cup, the idea of needing implants is mind-boggling.

I agree, make sure you have a local PCP and fill them in on your surgery and progress to date. Get your records from your surgeon. It isn't uncommon for people to relocate and need to find a new specialist. If there is a bariatric support group in your area, attend a session and let folks know that you're new to the area and need a new surgeon for f/u.

In many cases, you can identify your health plan's medical policy concerning requirements for bariatric surgery by Googling "nameofhealthplan State medical policy bariatric surgery". Then you have in writing what the requirements are for your health plan. Make note of the date of the policy. In my particular case, my health plan made the requirements easier after I'd gotten started on the process. This led to lots of confusion, as the member services and provider services people answering the 800 numbers weren't always aware of the change.

Have you asked your mom why she objects to you going to Mexico? Perhaps you could allay her fears and overcome her objections. I'm presuming that it would be your own $ you'd be spending, not hers.

No, it's good information for the anesthesiologist to have, and if insurance is paying, sleep apnea is a qualifying comorbidity for most insurance plans.