Introversion

Note: I am a case manager for a major insurance company, so my response is colored by my knowledge of the health insurance industry. For those who may not know, Medi-Cal is California's version of Medicaid. The California Medical Assistance Program (a.k.a. Medi-Cal) is California's Medicaid program for lower income persons, disabled people, kids in foster care, indigent pregnant women, and childless adults with incomes less than 138% of the federal poverty level. If you are on Medi-Cal/Medicaid, you've got to take whomever you can get as far as surgeons are concerned. Just pick a PCP who will refer you to a reputable bariatric surgeon to expedite the process. If you insist on being sleeved by Dr. Quebbemann, you might be waiting a very long time. It's an unspoken reality that Medicaid/Medi-Cal patients are the lowest priority for surgeons due to pitifully low reimbursement rates, so pick a PCP and be open to a variety of good bariatric surgeons. You cannot be picky with Medi-Cal. Good luck to you.

There's no need for a fancy blender unless you're in the mood to spend money. I use a $15 Hamilton Beach blender that's not loud.

Generally, sleeved people do not suffer from dumping. Only 3 percent of sleevers experience dumping; therefore, 97 percent of us do not dump. Nonetheless, it may be a good idea to moderate your intake of sweets or abstain from them altogether if sugary treats are one of your triggers. I can eat chocolate without any problems. I regularly eat spicy foods such as jalapeños, Tabasco sauce, cayenne pepper, and so forth. I have not vomited since getting sleeved over two years ago. Here's my view...rigidity regarding food choices is usually disastrous. Many people who tightly restrict their food choices and say "never" often see this tactic backfire. The more you restrict, the more intensely you may crave. I have no forbidden foods because I am not on a diet. Restricting intake is part of the dieter mentality and I refuse to participate. Many of us sucked at long term adherence to diets prior to weight loss surgery, so why put oneself through the same misery? Good luck to everyone.

Thursday's planned meals Breakfast: coffee with half & half and sweetener Pre-workout: grapefruit, leftover chicken divan Lunch: leftover chicken divan Afternoon snack: apple with peanut butter Dinner: flatbread pizza with turkey pepperoni Bedtime snack: peanuts, turkey sausage stick

Stalls are a normal part of the weight loss phase. As a side note, you are losing more rapidly than I ever did. It took me nearly 4 months to lose 38 pounds, but you've accomplished that in less than 2 months. You're doing well. Good luck on your journey.

Planned meals/snacks for Wednesday Breakfast: coffee with half & half and sweetener Pre-workout: ham & cheese sandwich, grapefruit Post-workout: homemade protein shake Lunch: broccoli chicken divan dish Afternoon snack: grapefruit, Quest protein bar Dinner: broccoli chicken divan dish Bedtime snack: peanuts, turkey sausage stick

I was sleeved two years ago and only weigh myself once a month. My weight has remained the most stable it's ever been in my adult life, fluctuating upward or downward by less than a pound. Frequent weigh-ins will not prevent one from overeating or going off the rails. In addition, unless a person is falling off the wagon with eating, there's no valid reason to weigh in frequently. Weekly/daily weights would result in anxiety for me. I prefer to live my life not beholden to the scale. Good luck to everyone during this lifelong journey to improved health.

I wore a baggy sweatsuit that wouldn't rub against my incisions. I also wore slip-on shoes, a.k.a. flip-flops, to avoid needing to bend over when taking them on and off. Your abdomen will be sore, so you should wear stuff that prevents bending over to put them on.

I didn't visit with a dietitian until two weeks after my weight loss surgery was performed. My insurance required one pre-op consult with a dietitian, which was done over the phone. The supervised weight loss program doesn't need to be supervised by a dietitian or nutritionist for insurance purposes. Health care providers (e.g., doctors, nurse practitioners, PAs) have enough nutritional and dietary knowledge to supervise these visits.

Tuesday's planned meals Breakfast: coffee with half & half and sweetener Pre-workout meal: ham & cheese sandwich, apple Lunch: Buffalo chicken dish with melted monterey jack Afternoon snack: Quest protein bar Dinner: Buffalo chicken dish with melted monterey jack Bedtime snack: peanuts, turkey sausage stick, string cheese, pickle

It's somewhat pointless to take a multivitamin on an empty stomach. A multivitamin needs to be taken with food to facilitate proper absorption. Multivitamins contain the fat-soluble vitamins A, D, E and K. If you don't swallow your multivitamin with food, these fat-soluble vitamins will not be absorbed by your body correctly.

Sodas and other carbonated drinks will not stretch our sleeves or pouches. However, soda is not good for bariatric surgery patients due to a plethora of valid reasons: https://provostbariatrics.com/can-you-really-stretch-your-pouch/

My insurance company did not require a 6-month supervised diet, but many health insurance companies do have this requirement. It usually consists of six visits with a physician, nurse practitioner or PA spaced six months apart. Each visit requires a weigh-in and a quick documented 'educational session' on weight control. My insurance company required one consultation with a dietitian pre-op. My consultation was done telephonically (over the phone).

Planned menu for Monday... Breakfast: coffee with half & half and sweetener Pre-workout meal: chicken enchilada casserole & half a grapefruit Post-workout meal: homemade protein shake Lunch: leftover chicken enchilada casserole Late afternoon snack: nuts, Enlightened ice cream bar Dinner: leftover chicken enchilada casserole Bedtime snack: turkey sausage stick, pickle, string cheese

Sometimes the truth stings... Also, some individuals are more comfortable with cheerleaders, yes-people, Pollyanna types, and others who offer false reassurances and/or tell them exactly what they want to hear. Human nature is bizarre at times. When confronted with a choice between the real deal and a faker/shaker, many people select the phony, especially if the phony person is nice or 'supportive.'

Some people can stop compulsively craving and binge-eating sugary treats only via abstinence. For these people, sugar is their drug and they'll never be able to eat it in moderation. Therefore, they must abstain from it altogether. Again, I commend you for exploring this issue before you commit to surgery. It takes a lot of guts and healthy self-introspection to admit to having a problem and doing something about it.

No...you can still eat sugary foods compulsively with a gastric bypass or sleeve. Only a small percentage of bypass patients experience the dumping syndrome after eating sugar; however, the majority tolerate sweets without any issues. You can still binge-eat with a reduced-sized stomach, one donut or cupcake at a time. These are sliders, a.k.a. slurry foods. They turn into a liquid slurry once you swallow, sliding through your stomach and into your intestines rapidly without ever challenging your sleeve or bypass pouch. You can eat 50 cupcakes and never feel full. In essence, the bariatric surgeon operates on your stomach, not your mind. 90 percent of success with bariatric surgery involves changing your psychological outlook on eating. Good luck to you.

Things will return to 'normal'...just not during your weight loss phase. I am more than two years post-surgery. I eat out at restaurants. I enjoy the occasional mixed drink such as a pina colada or rum with coke in social settings. However, I waited until I approached my goal weight before reintroducing these things into my eating patterns. Good luck to you.

You're 5'2, correct? If so, you have nothing to worry about unless you drop below 192 (with a comorbid health condition) or below 219 lbs without any comorbidities. At 5'2, 192 lbs would represent a BMI of 35, while 219 would place you at a 40 BMI. As a reference, I am 5'1. I qualified for the sleeve through my insurance at 199.7 pounds (37 BMI) and a comorbid condition of elevated cholesterol. On the day I had surgery, I weighed 218 pounds with a BMI of 41. Yes, I had gained weight due to my inability to control my compulsive eating patterns. Good luck to you!

I used to be an 'all in, all out' eater, too. Either I was eating ultra-healthy stuff, or if not, I compulsively ate the most unhealthful meals and treats imaginable. I have since dropped that 'all or nothing' mentality toward my way of eating. If I want something unhealthy, I eat it, but I'm not eating five or six servings of it. Even with bariatric surgery, you can overeat the crappiest junk food. A person with a sleeve or bypass can eat 10 donuts and never feel fullness or satiety because crap such as donuts, chips and crackers are 'slider' foods: they turn into a slurry and slide through your stomach without ever making you full. You can eat unlimited amounts of the aforementioned foods in addition to popcorn, pretzels, cookies, etc. Many bariatric surgeons do not warn potential patients about slider foods, yet they are the root of most weight regain in the weight loss surgery community. Personally, I attended a few therapy sessions with a counselor once I approached my goal weight. You are taking the first step by admitting to your problem. Good luck to you.

Your surgeon is, in all likelihood, performing the operation whether you adhere to your pre-op diet or not. Most surgeons wouldn't walk away from a $10,000 payday due to patient noncompliance. Here's the kicker...if your liver is enlarged and in the way, the surgeon might not be able to perform your surgery laporascopically. He/she might have to perform an open surgery, which entails a large incision from your breastbone to the navel. A laporascopic surgery with 5 tiny incisions involves faster healing and recovery than an open surgery with a huge incision.

It depends on how physical or sedentary your job is, as well as how you recover. I had a partially active, partially sedentary job as a nurse supervisor at a hospital when I was sleeved. I took two weeks off, but could've gotten away with returning after a week since my recovery was uncomplicated.

I had Blue Cross/Blue Shield of Texas and wasn't required to undergo a supervised weight loss program during the pre-approval process. My friend had a different BC/BS health plan and underwent the 6-month supervised weight loss visits. She was not required to lose weight; however, she had to have 6 documented visits with a physician, nurse practitioner or PA that recorded her weight. She actually gained weight during the process. She pre-qualified for the sleeve at 218 pounds and ended up at 231 pounds a week before surgery. She lost 7 pounds on the pre-op diet and weighed 224 on surgery day.

I, too, did not have a urinary catheter inserted. My gastric sleeve surgery was only 30 minutes long, so there really was no need for a catheter. By the time I needed to go urinate, I'd already awakened from the anesthesia and gotten up out of bed to walk to the bathroom with assistance from hospital staff.

In the realm of bariatric surgery, Cream of Wheat is considered a slider, a.k.a. slurry food. Slurry foods 'slide' into our sleeves before rapidly entering our intestines. They do not stay in our stomachs long enough to challenge the sleeve or provide a sense of fullness or satiety. Hence, you will never feel full eating Cream of Wheat. You will not feel full until you start eating solids such as meats, eggs, Greek yogurt, cottage cheese, non-starchy veggies, and other foods that will challenge your sleeve. Good luck to you.