kbVA

I have Tricare Standard - so I can self-refer. I've gone to two different initial consults with doctors AND have talked with Tricare myself of course, but I'm getting two different stories about how it all works from these offices. Office 1: psych eval NOT covered - self pay nutrition appointments covered - must take 3 consecutive months (surgery can't be any sooner than 90 days) Office 2: psych eval covered nutrition NOT covered - self pay & nutritionist appointments required but that they can be done quicker than the 3 months if you want to progress a little faster Calling Tricare myself today confirms what the Office 2 said but then again, other times I've called Tricare I've heard slightly different especially about the 3 month waiting period and what that really means. Just wondering if anyone has real life experience working with Tricare. I am on a bit of time crunch in terms of the flexibility of scheduling. I'd like to get this done around July so my mom can come out and help with the kids before she returns to work. I'm just not sure how possible this all will be without some outside help so my husband can be with me - my mom is very supportive of the surgery so I know she'll be great to have around post-op as well.

So - hormonal eating. A BIG problem for me and for someone like me who is considering the sleeve surgery, I worry that this will be a big hindrance for me. Obviously, with surgery I can't do *too* much damage, but I'm still concerned. Some months aren't too bad, but some months I do a LOT of damage with hormonal eating. I realize it's hormonal because I will literally wake up one morning (after period has started or just ended) and not feel like a raving food beast anymore. But when it strikes, it's BAD. I just can't be satisfied, I want only foods that are terrible for me - the badder the better. Some months I can get a handle on it, especially if I recognize it coming on, but some months I don't realize it until I'm knee deep in my 10th pint of ice cream....kind of exaggerating....kind of.... I'm just so frustrated by this! For so long I've thought that I just have to learn to deal with it, but maybe I'm missing out on some great help out there or idea that can help me tame this beast. I'm on birth control (lower dose hormones), we have 3 kids and aren't positive we are entirely done yet or one of us would be getting some kind of permanent BC done. I always struggle some with portion control and my love for baked goods (hence the surgery) but this is another factor that has significantly impacted my ability to ever be a normal weight.

@stacyrg2 I loved what you said: " I look at post surgery as a change of mindset. I don't think anyone who sees me eat out now would ever guess I've had surgery. I eat as a normal weight, health conscious person would eat. I make good choices, eat my allotted amount and I'm done. Your post describes post op life for me to a tee (although my calories/carbs are not at your level, I find for me, my plan of 1200-1300 cals a day, 100+grams of Protein and the remainder healthy carbs and fats works well." That sounds fabulous to me - I can do the 1300 calorie, monitoring what I eat now, but it takes ALL my brain and willpower. It's possible, but exhausting which is why I think I always lose 20-ish pounds, then put it back on (that and some hormonal/PMS eating I discussed in the ladies thread). It sounds wonderful to get some assistance to eat like that all the time (or most of the time:). In fact, reading through some of your stories here, I realize that in the beginning, this is the *opposite* of conventional calorie counting and diets I've done. Usually you start out with your set calories, lose weight, and as you keep losing, you have to keep decreasing your calories/exercise to help compensate (more or less) - - - with surgery, it sounds like you start out super low calorie (because you need to go easy on your stomach post op, obviously it's tinier), but then you actually seem to work UP to that 1200 or 1400 or whatever it is that you can maintain at. That is totally different initially than the conventional method. I think I'm totally on board for the weird and new changes in eating, especially for those first months and year, but what I'm still hung up on is the fact that I have to get *surgery* to make that happen. I'm just not loving the idea right now of having to undergo all that - I'm nervous, worried about both the actual procedure and having those scars on my stomach, etc. I keep saying - I love what the surgery DOES, but wish I didn't need actual SURGERY to get it! Isn't there some hypnosis or magic wand we can put my brain under to think it has a tiny stomach? I'm going to have resolve this fear sooner or later obviously.

That whole pizza, bag of chips, and pint of ice cream you mentioned....did you sneak into my house and film me doing that to get that idea??? That sounds pretty spot-on when it's the super bad PMS times! Thanks everyone - I figured the sleeve would help restrict the damage I could do but it's nice to hear that it's all leveled off for the most part for you all and that without the hunger hormone surging for a long while as well (sounds like both the PMS and hunger hormone surges together have been disastrous) that there's hope. If the worst I ever do on a PMS rant is a PopTart....that will be amazing:)

@@theantichick what you said: "I want to get to a place exactly like you describe... a normal healthy diet where I don't have to obsess about food and exercise, but eat mostly right and go and do the things I want to do." is also exactly what I'm looking for (and trying to push past these fears to achieve). I know and anticipate that I'll always have to be attentive towards my diet if I ever want to maintain any goals and not get back to this (250) again, but I'm hoping and assuming that with this surgery I can get the help to get a thinner body to do all that effort and work in. @@theantichick what you said: "I want to get to a place exactly like you describe... a normal healthy diet where I don't have to obsess about food and exercise, but eat mostly right and go and do the things I want to do." is also exactly what I'm looking for (and trying to push past these fears to achieve). I know and anticipate that I'll always have to be attentive towards my diet if I ever want to maintain any goals and not get back to this (250) again, but I'm hoping and assuming that with this surgery I can get the help to get a thinner body to do all that effort and work in. @@theantichick what you said: "I want to get to a place exactly like you describe... a normal healthy diet where I don't have to obsess about food and exercise, but eat mostly right and go and do the things I want to do." is also exactly what I'm looking for (and trying to push past these fears to achieve). I know and anticipate that I'll always have to be attentive towards my diet if I ever want to maintain any goals and not get back to this (250) again, but I'm hoping and assuming that with this surgery I can get the help to get a thinner body to do all that effort and work in.

Fears - I've got some! (I've just had my initial consult too so I've got a few months of obsessing over these fears - yeah! Mainly: the SURGERY. I've never had surgery before, other than wisdom teeth. I'm freaked out that they are going to make these incisions in my stomach, that I'll have scars (and have no idea how well they'll heal), that some other complication will arise, that I'll feel weird that after 33 year of no knives being stuck into this body, it's going to get all cut up and I'm getting rid of a perfectly good stomach just because I can't cool it on the eating. It's like I like the idea of what the surgery *does* but not that I have to have *surgery* to have that. Make sense? I'm a ball of up and down emotions about it. I totally talk myself out of it one morning, then by the afternoon I think it sounds good. I try to tell myself that FINALLY being under 200 lbs for the first time in 10 years will be all worth it. That buying clothes and working out will be more fruitful ( I love Body Pump but I feel like all this muscle is just hidden under years of fat). My mom is very supportive (almost TOO supportive - she doesn't understand why I wouldn't be willing to crawl through broken glass just for the chance to be thinner again) and my husband is supportive, though he doesn't understand my surgery phobia. So there - my fears!

This has been a very helpful thread! My mind is obsessed right now with all the unknowns and questions. I've just had my first initial consultation but I've been contemplating this for a long time. I think I've moved past my hang-ups of what eating will "look like" in the future - fear of being on this tiny, restrictive diet for eternity. I'm learning that the initial phases will be stricter and that in the losing stage I'll likely be strict with myself, but once I get to a weight I think I can maintain, life will feel more normal. Not normal as in "eat whatever the heck I want" again, but able to better control portions and control myself around certain foods. THAT is what I long for - a normal, healthy relationship with food. I'm hoping this will reset me back to a weight I was long, long ago so I can reset formally much better habits that I used to have and a body that will hopefully help me to do that instead of fighting against me all the dang time. Now, for my next hang up - SURGERY. Why does the above that I mentioned^^^ involve cutting an organ up and having to operated on??? I've never had any operations (other than wisdom teeth:) and I'm freaking the freak out over what feels like a drastic step. I've looked into this fairly brand new procedure - endoscopic sleeve gastroplasty - where they mimic the sleeve and the effects last roughly a year, but it's non-permeant. I'm heavily swayed to the at idea, however it's entirely self pay and it's a LOT. Like around $15,000. It's still in the early stages of this method and if it was a whole lot less I'd probably be doing it to avoid my fear of the surgeon's knife and its permanence. I KNOW it's all laparoscopic and that I should think it's no big deal, but I can't get over that I do think it's a big deal. Despite my high weight, I have no comorbidities, I'm quite healthy (admittedly, that may not always last). If I had some health problems related to my weight, I'd be saying "get me under that knife - now!" but my latest hang ups revolve around getting 80% of a perfectly good organ removed just because I like all food (the good and the bad) way too much. Sigh. I'm a mess!

I've been to consultations with both Dr. Moazzez and Dr. Fitzer (in Reston, different practice) - I like both surgeons but the Reston Hospital is quite a bit more convenient for me to access. I really really liked Dr. Moazzez, but now I'm confused with the insurance requirements (maybe I can find a Tricare thread on here somewhere so I can get some real world experience! Dr. M's office says: 3 consecutive months nutrition, no mention of my payment - I pay for psychologist eval, and bariatric drinks Dr. F's office: need to do the 3 nutrition appointments, but does not have to be over 3 months (can shorten) and I DO pay - psych eval is covered I'm just confused and frustrated that even though my insurance is the common denominator here, both offices are totally different in what they say is covered and how it all works. I've called Tricare a few times and what they say is more in line with Dr. Fitzer's office. So if I do want to go to Dr. Moazzezz do I tell Pam she's wrong about my insurance . I'd like to do this in July (no later than August, I really need my mom to come out to help and she goes back to work then). I'd like to go to Dr. Moazzez but it's already confusing. This is more of a rant than actual question, but if anyone has suggestions, I'm all ears:)