Wheetsin

No, not the case. It should mean that, but it is never a guarantee. It merely states that the insurer intends to cover the service, but on final review of the claim, they may determine the service to have been unnecessary (for example). Kind of very scary, huh? They usually don't deny pre-approved claims/services, but it happens. Get ready for a fight, but I think $65K is worth it. I know it's hard not to feel like the victim. Your surgeon's coordinators should advocate for you. If you have benefit access to a coverage advocate, use it.

This is a really sticky situation. At the end of the day, the patient has responsibility to pay for any services rendered - so first, do not accept insufficient explanations from your insurance company. You need to understand exactly what happened, and why. Often things like this happen because there's an employer-enforced exclusion that is either missed, or wasn't in the system at the time of pre-approval. Either way, you need to spend some serious time on the phone with your insurance company and find out EXACTLY what happened: is it an approved procedure, do you have any type of exclusion (as your HR dept too), when was the exclusion put in force, etc. DO not accept anything less than exactly the info you're looking for. If necessary, have a conference call between you, your surgeon's coordinator, and a manager at your ins. co. I've had to do that a few times for myself, and helped several people through the process. Don't be timid, shy, or back down. You have a right to understand what happened. Even if pre-approved, there is no guarantee of payment. I don't want to be a bubble burster, but I'm already seeing a lot of people saying "it was preapproved so they have to pay" (or thereabouts). That's just not the case. That little disclaimer in bold is on virtually every phone queue waiting message, piece of paper you get, etc. from every medical insurance provider out there. Does that make it right? No. And it's not really intended for situations like this, but it's a pesky little loophole. That's how they get out of paying for mistakes like these. (Insurance companies can also go back and "change their minds" on something paid, and revert it to a blance owed... IIRC they can do this for up to 2 years.) I would also speak to your surgeon. Those billings amounts are what they bill insurance companies retail, which is a GROSSLY inflated amount over what they usually charge self pay patients, and is NEVER the amount the insurance company actually pays. If nothing else, perhaps your surgeon's office can revert the bill to self-pay rates. Example: Insurance company charged $57,000. Insurance company pays $8450 (total of "contract" or negotiated plan rates) Self pay rate: $12,300. Feel free to PM me if you need more help. I have a lot of background in the insurance industry, and have been able to give people some advice that actually helps on occasion.

I'm spending way more than $5 per "meal" on sashimi, which is the only thing (right now) letting me skip the protein drinks, so... it's all a wash in the end. And either way, it's much less than I spent on a meal pre-op!

I'm on Omeprazole 20mg twice a day. If I forget to take it for a few days, or don't get both doses in, I can tell I've missed it. Especially if I have anything citrus (e.g. lemonade drink mix).

But we all know you don't drink soda for the taste, you drink it for that sweeeet carbonation burn! You're so defeating the purpose! I gave up soda when I had my band, for the first several years. Around yr 4 (IIRC) I allowed myself one every week or two (Fresca is the only soda I can stand). DH laughed at me b/c I bought a 12pk at it lasted 8 months. I freely drank soda while waiting for my revision. I don't really miss it. With my band I badly mised soda for several weeks, but just that burn, not the taste.

Search for conbinations of "cheat" and "pre-op". You'll find you are definitely not the only one.

I don't think there's anything wrong with last meals. I just hate seeing people going into this thinking they will never be able to eat X again. Once you're all healed up and through your graduated plan, you can eat anything that's tolerated, and there don't seem to be too many intolerances. So "last meal" becomes something more like "not for a while meal" or "last gross portion size" - and then it's just not as important. I didn't have a last meal with my band (well, I had a last dinner before pre-op diet, and it was BLTs (I hate bacon so for me it was tomato & mayo sandwich, which I LOVE) because I didn't really care and that's what DH wanted.) Before sleeve, the last thing I had before my pre-op diet started was my Sbux standard, because it has a LOT of sugar in it and I knew it would be a LONG time before I'd let myself have one again (and I love them, and had been having 3 - 5 a week in lieu of meals, and just wanted it a LOT). Last "meal" (not beverage)before sleeve was sashimi, which I still eat now, but it's what I wanted that night. *shrug* I guess I'm not a real celebratory person.

Which procedure do you want? It's my firm belief that the procedure, not convenience or coverage, should determine which people go with. I know people who wanted VSG but got RNY because it was all their insurance would cover, and I don't know a single one of them who says, "Boy, I'm glad this is what I got." If the procedure I really wanted meant I had to drive 150 miles, I'd drive it yesterday. I mean, that's only what, a bit over 2 hrs? (Guesstimating) I drive 2 hrs a day r/t to work.. no biggie, just bring good music and have a reliable driver once or twice.

The scar tissue can be removed and/or cut back. I had over a pound of scar tissue removed during my procedure, and it took my surgeon about 2hrs compared to his normal 30 - 40 mins, but it's entirely doable. 3500+ WLS really doesn't mean squat if he is not an experienced revision surgeon. How may revisions has he done? How many band -> sleeve revisions has he done? Doing the procedure on a virgin stomach vs. a revision stomach is not the exactly the same procedure. I would find out how many band -> sleeve revisions he has done. That's really the important number if you want comfort in experience. I'm not trying to "knock" your surgeon, but I've never heard of the revision being impossible due to scar tissue. As my surgeon said, "I had to carve your sleeve out of scar tissue" (haha) "But you got a really pretty one." For a lot of surgeons it may come down to a balancing act between scar tissue and adhesions, and the size bougie or sleeve he's wanting. Do you know if he addressed your adhesions when your band was removed? As for leak risk, it is pretty high (IIRC about 30% for overall "complication") when the removal & revision is done all at once. The more waiting time between the two, the more that risk goes down. My surgeon required 2 months between procedures, but do to an insurance fiasco it ended up being 6 months. I hate that, and love it, at the same time. The scar tissue can be mitigated. As for my surgery, it went fine. I've had no complications (well, an allergic reaction to a medicine, but nothing specific to the sleeve), no nausea, no vomiting. HTH

I've tried the IsoPure powders (easily the most digusting powder). I bought the huge $80 can when I had my band in 2006 and could only make it through 2 drinks. I threw the tub away. I was going to try and make it to GNC tomorrow to try one of the drinks, I've heard from others they're pretty good if they're really cold. I'm glad you shared another positive review for them!

I broke out radically during week 2. It got better after a week. Then TOM was a week early. The next week (my normal TOM week) I broke out -- not nearly as bad -- but different. The first breakout was almost exclusively on my chin (telltale sign of a hormonal cause). The second breakout was the large zit type in weird places. Seriously, in my nose, ear, one in my eyebrow, one on my forehead, etc. The can't you don't really ever see, but hurt like a B if you touch them. Lots of hormonal changes going on. And lots & lots & lots of stress to our bodies. Look up "weightloss acne" or "dieter's acne" for more info.

The only people who are asking are my parents, and I etiher tell them "about" the total amount, or I tell them I haven't weighed lately. They know I do not subscribe to the scale mentality and only get weighed when needed for soemthing else. Often, "abouts" are all I can give. But since I lost it, I report the full amount when I can.

Rose, that's kind of creepy. Especially since you've now duplicated that message in multiple threads. People probably aren't going to want to email you to get your picture, and if they do, that's just weird & I wouldn't think those are the people you want to pull your support from. Is there something to do with VSG that we can help you with?

The "good" news is that this seems to be a rtuth across bariatrics (so we aren't weird!) I could not tolerate scrambled eggs at all with my band, even 5+ years out. I could easily do hardboiled, or any other (except over hard, which is yuck anyway, I like jiggly eggs). I don't know anyone with RNY who has much tolerance for scrambled eggs, either. Nor DS.

Honestly, 60% is more like a lapband average. The 2yr averages for the sleeve should be very comparable to the same time averages for RNY, but we have MUCH better regain stats. I'm not a published researcher in the field and I don't run my own studies, but I would really, really doubt if 60% is an accurate %. Unless that number was taken really early on, before people lost as much as they were going to. A lot of people come into this thinking there's some kind of automatic "window" or "cap" of weight they will lose. You don't have to look through many threads before you see something like, "I need to lose everything before my 6 mos is up". WTF is 6 mos? It's probably a marker at which your BMR is low enough, your metabolism set enough, and your intake expanded enough that unless you begin to really work at it, your weightloss might stabilize. That's it. It's not an expiration date. It's not a date at which your body magically stops being able to lose weight. It's just a timeframe based on when the fastest weigtloss is seen. Here's a really simple equation: If you're metabolizing, you can lose weight. If you're alive, you're metabolizing. Therefore, if you're alive, you can lose weight. That is fact. Every one of is here should consider it our personal goal to beat the statistics, whatever they may be.

grannyk - it's perfectly OK to have more than 1 scoop at a time, but you're aiming for about 30gm per meal/serving/whatever. The Syntrax nectar I use is 6gm per 1/4 scoop. I use 1 1/4 scoops to put me right at 30gm (I mix this one with water). You can really use however many scoops you'd like, as long as the nutritional value for all combined doesn't exceed whatever protein/carb/calorie ratio your plan calls for in Protein supplementation. This morning I had a Premiere RTD (30gm) on my drive in. There was a huge accident, so I was actually able to finish it before I got to work. I've just been doing protein drinks for so long (off and on for 6 years) that I'm kind of over them, right when I really need to be the most dependent on them. And I used to be able to drink them quickly, so they stayed somewhat enjoyable. Now with the sleeve sucking on the same thing for 2 hours isn't quite as charming. Especially since I can't stand them warm, and have to re-refrigerate them every 30 mins or so. I can get all my protein in if I eat sashimi. I love sashimi, but for every single meal, for several days, it's a bit old. At this point (I'm just 5 wks out) it's still that, or a supplement. Ick!

The issue with getting an entire day's worth of Protein in one drink (unless you prefer for that one drink to last you all day) is portioning. Or rather, metabolism. Extremely fit bodies can only metabolize about 30gm of protein at a time. That's why we need to space our protein out. If you're ingesting all of your protein in one go, so to speak, the excess is just that - excess, and will be stored as excess (which is exactly what we're trying to avoid). I just noticed you were sleeved at the same clinic I was (KC Bariatric - yay), but by different surgeons. Maybe Dr. Kowalski uses different guidelines. I've been a patient there since 2006 when I had my first WLS, but have never met him nor talked with him so I have no idea if he uses the same booklet; but all your protein at once really isn't the most healthy way to get it all in. The "dream come true" isn't really just a way to get all your protein in, it's a way to get it all in, in - say - a single mouthful. Someone needs to invent a high quality hydrosalate or whey isolate protein pill!

OMG I can't believe I forgot to post this earlier. So many people have found this helps (for the surgical gas pain). Lay down on your left side with your right knee & thigh drawn up to your chest. That's it. But it helps an awful lot of people. (I think it's a recommendation out of the Mayo Clinic, IIRC)

I was born there, but that doesn't count. A few of my old friends in the Balboa/Coronado/Tierrasanta/Murphy Canyon/etc. area are considering the procedure, but they're not on here, and I know one lady who is working on whatever the program requirements are. I'll see if she wants to join and share info (she's not very computer savvy)

I'm usually objective to a fault, so is there any other perspective from his side that might lend a different way to see things? Maybe he's been busy and trash isn't his prioroty, or maybe he forgot, or maybe he sees this as an opportuity for some down time for himself and hasn't yet realized how "backed up" things are getting, or... Not trying to defend, nor justify anyone or anything. Just throwing it out there that you have a lot of stuff going on physically & emotionally, and maybe this is a mole hill that suddenly seems like a mountain. My DH pretty much insists on a list. "Clean the kitchen" means nothing, but if I can itemize the steps in "clean the kitchen" he does fairly well.

The best for both is walking, and heat usually helps quite a bit. For the stomach/intestinal gas you can try something like Gas-X. THey don't do anything for a lot of people, but others swear by them. They contain simethicone, which sort of foams up and breaks the surface tension of gas bubbles. Kind of like sticking your finger into the foam in a glass of Coke. You can also try natural digestive aids like carrot juice, peppermint tea (great for many stomach ailments), and papaya enzyme (chewable). For the shoulder "gas" - that's largely a waiting game. Your surgeon will probably tell you to walk, maybe use a heating pad, maybe take your painkiller. The latter two don't work nearly well as the first. Heat & deep massage always helped me, a little.

Missing a bit of Protein won't kill you. Not being hydrated will. But the good news is that Protein drinks usually count as Fluid, so you can kill two birds with one stone. FWIW, your weightloss is not slow, IMO. Even after your pre-op loss, you're still maintaing over 5 lbs per week, which is well above the statistical average.

Is it gas in your stomach (i.e. feels like you need to burp), or "gas pains" in your torso/shoulder area?

Not gulping is hard. And go figure, it was the only behavioral change that really concerned me (most others I'd already changed through my band). Sometimes I forget and drink a few mouthfuls and then it's like - crap - I need to either spit this out, or portion it out into 10 swallows because if it goes down now I'm gonna be in trouble... I actually don't have that happen with straws. Proof that they're good for us.

I added more info above. Scary stuff. The best protein-per-volume I've seen is Premiere RTA (30gm/11oz). Syntrax nectars could probably beat that if they had an RTD product. (Hello, Syntrax, you out there?) I'd kill for a way to get 30gm down in just a few ozs.