silverthreads

I wouldn't worry too much. I had the same issue, except that I didn't have many records. Your history shows you close to the line for 5 years so it clearly shows you have struggled with this for a long time--not just recently. I too had BCBS in another state and since I do have comorbidities was trying to document a 35 BMI. I was approved with the first submission. These things are subjective so even if you are disapproved you have a good shot on appeal. Sent from my iPad using the BariatricPal App

I have the same u have and am paying nothing just had to wait three months waiting on my date now my doctor had to write a letter to the insurance company but.its free Sent from my SM-N900V using the BariatricPal App

You'll have 20% copay for outpatient services and the surgeon's fees. The hospital will be a flat fee of $1,266 if I recall correctly (might be a $20 off). Won't be too bad. I probably shouldn't say this but if you're like most of us 5 pounds gain could happen very easily... All I had to do was walk by a donut shop and breath in! (or so it seemed) Alternatively you can have it done in Mexico (self pay) and it won't be a whole lot more. Good luck in whatever direction you decide to go.

If you use your Red White & Blue Medicare card (not a health plan card like Kaiser, AARP, Humana, etc.) then you're on "Original" Medicare -- sometimes called Fee For Service Medicare. That gives you a wider choice of providers, but bigger copayments. This means that the decision on whether a service is covered is bound by a National Coverage Determination (NCD) and potentially a Local Coverage Determination (LCD) based on the contractor that pays claims for your area. I don't have access to the LCD in your area, but the NCD can be found at this link: https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=57&ncdver=5&bc=AAAAgAAAAAAAAA%3d%3d& Basically it says that if your BMI is over 35 and you have at least one comorbidity related to obesity then you're covered for bariatric surgery. As you might imagine there are some restrictions on which procedure -- for example VSG is covered when done as a laparoscopic procedure but not as an open procedure. It's typically done laparoscopically anyway so that makes sense. (If you read through that NCD it's a little hard to follow -- it's sort of a history of what was covered when so don't worry about things like the certified bariatric surgery center requirement -- that was a requirement years ago but it isn't any longer.) Your surgeon's office will know more I'm sure. They deal with this all the time. I hope that helps.

Do you have Original Medicare or a Medicare Advantage plan? Big difference. Sent from my iPad using the BariatricPal App

The volume you describe sounds pretty normal. pudding is a "slider" food so you can eat more, but that isn't always a good thing! At this point it's easy to eat too much so don't over do it! Sent from my iPad using the BariatricPal App

@@anniebanana you're going to feel better each and every day. The first couple of days are the worst but you're past the hard part. Good for you! Sent from my iPad using the BariatricPal App

I'm glad to read that you're doing better. I hope you continue to get better each and every day!

I think @@Mitch1 and I may be bariatric twins... I'm 9 weeks out, have also lost over 40 pounds and feel just as enthusiastic about the whole process. I will say I was circumspect in who I told--only my wife and best friend at first, plus one doctor who had always been the one who held me accountable for my weight. That doctor was the one who had an odd reaction and caused me to stop telling people! He has since become supportive. I told my Mom after the fact--she's supportive too but would have worried too much if she knew before. Some of my coworkers have commented on the weight loss and change in my eating patterns. I've just said I had stomach surgery and am on a restricted diet. They are supporting me too and have stopped bringing me sweets like they used to do. All is good! This site has been a very good source of information and support. Use it well and good luck! Sent from my iPhone using the BariatricPal App

At your age you've definitely got an edge on me. Just know that some lose a lot less right at the beginning and everyone stalls around week 3. But you'll do great I'm sure.

Well, I have no idea your age, height or weight, or activity level now all of which likely play a role. For me, I lost about 25-30 pounds the first month. I was 250#, 5'8" and 58 y/o and pretty sedentary so that was a great result. Lots of varying results on this board... We guys do seem to have a little easier time losing I think. Sent from my iPhone using the BariatricPal App

@@Jasminelums everyone has these doubts. But if you are like me and so many others on this board you've dieted and lost a bunch of weight several times, only to gain it back faster each time. Isn't that why you started down this path? I am surprised to say I don't miss the way I used to eat at all. That's key--I eat less but I'm more satisfied. For most of us it's just that way. The most common regret on this board is that they didn't get the surgery sooner. Don't let your doubts get the best of you.

Amen to that!

I was sleeved just weeks before I turned 58. No problems at all, and frankly even at just 2 months post-op I feel better than I have in many years. So glad I did it. Now, if I didn't have 58 years worth of minor injuries it would be easier to kick up the exercise but I'm doing it fine just the same. I did injure my knee pretty badly about 2 months prior to surgery and I'm really noticing that this hasn't healed as quickly as it once would have. Gotta play the cards you're dealt though!

"Gastric Bypass [or sleeve] now, or Quadruple Bypass later" Well said indeed @@Seagull We all have second thoughts before the surgery. I know I did--but I haven't had a single regret that I went through with it. Sent from my iPhone using the BariatricPal App Sent from my iPad using the BariatricPal App

OK...so I'm not the only one who found the instructions didn't add up! My surgeon's program was pretty different, but the math was similarly flawed. Do the best you can and you'll be fine! At one point my surgeon was lecturing me on the evils of Protein shakes--that I should be getting all my protein from natural foods, nothing processed. "Protein shakes are slider foods that don't keep you satisfied and you shouldn't have liquid calories". It was early on so I did the math for him--2 oz. of lean protein (all I could eat with the restriction then) 3x/day wasn't going to get me anywhere near my 80 gram goal. He looked stunned for a moment and then relented--"well maybe for now until you can meet your goals without them". I really don't think anyone had pointed that out to him! Sent from my iPad using the BariatricPal App

Good for you -- and as you rightly say for all of us who have started down this path! Sent from my iPad using the BariatricPal App

I had the luxury of taking six weeks off. I was told not to lift more than 10 pounds the first two weeks, and not more than 20 for another four. (They don't want you to get a hernia while the abdominal wall is still weak.) I felt quite good after two weeks, but still got tired in the afternoons. A daily nap was a luxurious tonic. I went back to traveling my first week back to work--no problems at all. Two travel food recommendations: Wendy's chili and Chick-fil-a grilled chicken nuggets. Quest bars travel well too and are good in a pinch! Sent from my iPad using the BariatricPal App

They inserted the lines that they'd use for IVs in the preop /recovery room and might have given me some medication then but I don't think so. I walked into the OR, and they started their prep. In just a minute I remember them putting my arms out to my sides and hooking up an IV. That's all I remember! No scary mask and breathing in the gas like the movies... Waking up in post-op was uncomfortable for a few minutes. I remember thinking it was hard to breathe--just hard to draw air in my lungs. I said something and was reassured--and within a minute or two it was fine. Piece of cake. Sent from my iPad using the BariatricPal App

@Christianmo7 I too am so sorry for your loss. I lost my Dad last spring after a long illness. While it was expected it still left a hole in my heart. I can't imagine the shock of losing someone you love so suddenly. Your feelings of not wanting to do anything are perfectly normal and only human. Don't fret over natural feelings. As others have said so well take it one day at a time. Find strength by knowing your father loved you and was proud of you. He'd want you to be strong and stay the path. We all find ways to deal with our loss. I threw myself into my work--perhaps not the healthiest response but on reflection its exactly what Dad would have done. I've also spent a lot of time visiting Mom and trying to help her in any way I can. Notice too all the love around you--your many friends on this board is only the tip of the iceberg I'm sure. We all feel powerless to help in times like these. Just know that we're all here in your corner, ready to help you in any way we can. Many hugs... Sent from my iPad using the BariatricPal App

I was a heavy coffee drinker prior to surgery. I weaned myself down to decaf before surgery so I wouldn't be in withdrawal when I might otherwise be miserable... The hospital actually served me English Breakfast tea with my first meal (lots of caffeine I think?). No matter, I only took a couple of sips. I found after surgery that one cup of decaf was all I wanted (I wanted 4+ cups of strong Peets French Roast before). After six weeks I started doing one cup of half regular/half decaf. Seems to work for me and no ill effects. Sent from my iPad using the BariatricPal App

@@LipstickLady you are an inspiration! Thanks for what you are doing to help those in need and congratulations on your newfound freedom. I salute you. Sent from my iPad using the BariatricPal App

I'll second bellasmommy99. We all have slightly different recovery experiences but there's a definite theme -- the first week is the worst. You've had major surgery, can't get many calories in, getting in/out of bed is a challenge -- oh and coughing is hell. This passes. Try to make sure you get your fluids in -- that helps a lot as does walking several times a day. It doesn't have to be a lot. I walked down the hall of my apartment building -- and noticed that every day it was easier and I'd walk farther. Get lots of rest and give yourself the break you've earned by starting this journey. You'll recover like the rest of us did. I'll bet by the end of the weekend you're feeling worlds better. Hugs.

I'll add my two cents here. Inner Surfer Girl is right -- we all hit this. I've read this a lot before I had my VSG and then I lived it... I'm about 2 months out now -- I too did really well in the first few weeks -- lost about 25-30 pounds in the first month, then stalled for almost a month. Now I'm back to losing consistently again. Everyone's journey is a little different, and they call it the "three week stall" because on average that's about when it hits. From what you wrote you've done extremely well losing 40 pounds in 2.5 weeks. Your body fights this though and needs some time to adjust -- it's going to hold on for a while. Nothing's wrong, you might stall for a week or a month. In my experience I completely stalled for about 10 days, then I'd lose a pound -- and stall for a week, then maybe another pound, stall for a week. It's frustrating after losing weight so fast at first but you'll be back to losing in due course. Oddly, I found (since I weigh every morning consistently) that I'd usually spike up unexpectedly the day before I'd lose. I swear one morning I was up 3.5 pounds and I hadn't done anything differently! That 3.5 pounds (and more) was gone the next day. There isn't much you can do but follow your surgeon's recommended program. So don't fret, it's part of the journey. I like to think of it as a long hike down the side of a mountain -- much of the path leads down, but some parts are level (or even uphill) and you still have to walk them to get to the lowlands below. Good luck on your journey.

Simply awesome. You look great -- all your hard work is really paying off!