2goldengirl

I tried to change something in my profile this morning. I got an error message that I had an invalid surgery date. I don't have a surgery date, there was something else I was trying to change. I can't get the change to stick. Help, please. Also, my surgeon is "not listed". How do I get Diane Kwan MD added?

My process would have taken much less time, but my insurance changed their requirements and didn't do a good job of communicating that, so there were some delays as I had to educate everyone along the way. So in order: 1. Initial appt. w/ PCP to get referral. 2. RD consult 3. Psychologist eval 4. Initial consult w/ surgeon 5. Visit with gastroenterologist to schedule EGD and upper GI 6. Visit with pulmonologist to schedule sleep study 7. Labwork 8. Upper GI X-ray 9. EGD (duodenoscopy) 10. Sleep study (to rule in/out sleep apnea) 11. Second appt. with surgeon to review results of labwork and diagnostic tests. My insurance doesn't require these, my surgeon does. Before I had my initial PCP visit, I attended an orientation session, and I'm attending a monthly support group of pre and post op bariatric patients. It took nearly a month to get an appt. with the gastroenterologist and with the psychologist, because the holidays got in the way. The truth is, it's hard to be overprepared if surgery is your choice. Long-term success is all about the choices you make postop. The preop process can be nerve-wracking, time consuming, and all of that, but all along the way, you're forced to face that this is a serious, life-changing decision.

These comments are most assuredly in very, very poor taste. I love Lipstick Lady's approach! Sometimes I think people are so surprised at change in others they simply neglect to engage the internal edit button. Keep on keepin' on. You are absolutely beautiful and deserve your success!

Excellent! In my hospital days, I asked one of our plastic surgeons how long following a weight loss someone ought to wait before considering plastics. He said that after about a year, someone would have benefited as much as they could from their skin's own elasticity. He also said that sometimes someone with a significant weight loss has some up and down as they settle into maintenance. So I'm thinking that's what I'll do, wait til a year after goal. I know for sure I want a boob lift, heck, I need one NOW.

Fantastic progress! Hope you feel even better than you look!

Most immaediately, I'm looking forward to the end of the pre-op required testing phase of this journey. Second appointment with my surgeon is on Tuesday. Postop, I'm looking forward to wearing a white shirt or tee without feeling like a headlamp!

Congratulations! Your loved ones must be so happy to have you healthy!

The one thing from Popeyes I never touch are the biscuits! Their mashed potatoes and gravy, though? Heaven. And their chicken is kryptonite to me.

They asked me to be there 90 minutes ahead of time, and I was, and they moved my case up. I was in the procedure room by about 2:20. First thing I asked for was a glass of Water, and the lovely nurse even asked whether I preferred it cold, or room temperature. I'd have had to wait longer to have it done to get an early-morning case, and this way I didn't have to take a day off work for it.

My EGD is this afternoon at 3, so I haven't had anything to drink since 6:30 this morning. Yes, I would like something to eat, but more importantly, I am dying for a glass of Water here! OK, Whinge over. Carry on.

It shouldn't matter what your BMI was, only what it is. The policy doesn't say you must have had a BMI > 40 for any timeframe. As far as the documentation, remember this: your surgeon submits the request. They do this all the time. They want to get paid, so they want you to be approved. They will ask you for anything you need. and yes, you did spell "comorbidities" correctly!

Well she's certainly a lap dog!

This is one of the protections with an H M O plan - we can't be balance-billed like this. I think a payment plan is the only way to solve this. I'm sorry!

No, that isn't it. Employers may exclude the benefit, but they aren't allowed to dictate medical policy. And in five-plus years, I've yet to handle a Blue Shield of CA case that excluded the benefit. We did have one health plan (self-funded by a county for county employees) and they excluded bariatric surgery as a "cosmetic procedure". Oh, and this was a county with one of the highest obesity rates in the state. go figure. Ask to speak to the office manager for your surgeon's office. Ask her or him to find the policy on Blue Shield's website, no password is required to view medical policies. Ask that they do this while you are on the phone (or standing there!). Understand that patients do sometimes lie to get what they want - this is why most MD offices are reluctant to accept the notion of change if it hasn't come down to them from proper channels.

I think the first thing you need to find out is: is there a BMI cutoff to pass the physical. There very well may be, and a BMI >50 may put you out of the running at this time. I did some checking online and evidently the fitness test for firefighters is standardized. This link may be helpful: http://home2.nyc.gov/html/fdny/html/units/recruitment/cand_prep/5_fitness_standards.shtml I do notice they mention "very low body fat". Honestly, I'd focus on getting healthy this year, and take the test next year.

The three month period is suggested, not required. Big difference. the three month period is to allow for preparation and education - things like preop testing, sessions with an RD, that kind of thing. Do you have H M O or P P O? Just be aware, many surgical offices CALL Blue Shield to verify that you have the bariatric benefit and to verify requirements. Unfortunately, many of their Provider Services reps don't both to look up the policy and will say you need to do six months because that's what they're used to. Demand (politely) that the office refer to the policy online directly for policy requirements.

I've authorized dozens of bariatric procedures and an assistant surgeon has never been requested. Whether or not an assistant is covered is based on standarized criteria, meaning that it's either necessary for everyone or nobody, depending on the surgical code requested. I'd definitely do more checking, call around different practices and ask whether their surgeon's require an assistant or no.

In terms of grams of Protein, 1 large egg is the same 7 gm of protein as 1 oz of lean meat. Hope this helps!

A lot depends on what they expect in the physical. is this a physical to gauge your overall health, or is it a fitness test"?

I buy beef bones at the supermarket, usually packed about 2 lbs a package. They make especially good broth if you brown them in the oven first. Get yourself a package of chicken wings to make chicken broth. It's just Huz and me at home, but we typically buy bone-in chicken because we like the flavor of bone-in better.

At this stage, I wouldn't worry overmuch about the carbs. Remember how little you are getting in in a day. Far, far less than you used to.

Go for it. So long as you don't end up getting a cold or an injury, the worst that happens is you walk more than you planned.

Honestly, I don't think you need to worry. I've had two Goldens and they're so attuned to their humans that they really know when something isn;'t right with you physically. Our first Golden was a moose of a dog, 27-1/2" high at the shoulder. He and DSD adored one another and she regularly greeted him with enough enthusiasm that roughhousing resulted. She had surgery on her wrist & her mom was concerned that the dog might bump into it. DSD came in the door from the surgery. He walked over, sniffed very delicately at the wrappings on her arm, and sat at her feet, wagging his tail. This same dog was an absolute angel when I broke my right arm and had pins in it for six weeks. He never left my side, unless I said "move". Our current Golden was wonderful with DSD when she had her wisdom teeth out recently. He didn't tackle her. He was very polite, and made sure he stayed close by her for the weekend she stayed with us. I think they smell changes in our body chemistry when we're stressed or hurt and they respond extra gently - at least, the Goldens I've known have done.

@@Kristin7676, you are definitely not getting enough calories for both healing from surgery and weight loss. See if you can't gradually up your intake. One really easy way is with avocado. It has the texture you're on at this stage and is a healthy fat. Half an avocado can up your intake by 160 calories, and it's full of potassium and B Vitamins as well.

I agree, you may not be eating enough. Do you track your food in something like Sparkpeople or MyFitnesspal? How many calories are you getting? An hour a day pool workout (depending on whether you're swimming laps or doing Water aerobics) can burn a LOT of calories. Your body has also had to heal from surgery. I disagree with the adding muscle argument - you aren't eating enough to gain muscle, the best you can hope for is to keep your lean mass while you lose. You actually need a calorie surplus to gain muscle.