jg7979

Makes things not want to stay down for me. At most, I swish a sip after I am finished just to rinse.

Isopure Low or Zero Carb powders , Unjury Chicken Soup Flavor, and Unflavored powder are my post surgery choices. Premier shakes were okay for me pre-surgery and I could chug them from the carton and not taste too much (a shaker bottle is great to avoid tasting them too much too). I felt like I was quitting smoking again with withdrawls from food/flavor variety by being limited to so few textures and flavors--the struggle is real, but part of the surgery process involves retraining your brain. After surgery I had to start using powders in skim milk or water because the thickness of the premade shakes made me gag. I spent a week on nothing but chicken soup flavor because anything sweet made me nauseous (I had to buy different chewable vitamins too). Expect your tastes to change to bit as the process moves on. Trying mixing in unsweetened cocoa powder, decaf coffee crystals, cinnamon,and peanut powder too. The clear drinks leave a pasty film in your mouth that is worse than the shakes to me.

You probably wouldn't need the sleep study/consult then... like SusieQ said, it is a little different for everybody. I was fortunate that I did not have to see a pulmonologist or have a cardiac stress test. Some of the requirements may also be related to the surgeon's selection criteria and not just insurance approval. http://www.aetna.com/cpb/medical/data/100_199/0157.html This is the clinical policy bulletin that describes Aetna criteria to qualify-- every member must meet either have a Physician-supervised nutrition and exercise program (6 months over two years) OR Multi-disciplinary surgical preparatory regimen (90 days). I did the multi-disciplinary regimen which was a busy 90 days. obesity-surgery-precert-form.pdf

If you have access to Aetna's website, you can access the list of providers. aetna-ioq-bariatric-guide.pdf

Here is my list of charges that are pretty much in order leading up to surgery: Surgeon Consult (Specialist Copay) Nutrition Consult (Cash Payment) Initial Blood/Labs –26 labs + urine (Provider billed $682) Cardiology Consult w/ EKG (Specialist Copay) Abdominal Ultrasound (Coinsurance) Upper GI X-Ray w/ Barium Swallow (Coinsurance) Chest X-rays 2 views (Coinsurance) Upper GI Endoscopy plus facility, anesthesia, and pathology (Coinsurance) Providers Billed $2100. Surgeon Visit for monitoring (Specialist Copay) Nutrition Class (Cash Payment) Sleep Specialist (Specialist Copay) CPAP/Apnea Overnight Study (Billed as specialist copay) + Interpretation (Coinsurance) Psychological Consult/Evaluation (Specialist Copay) Nutrition Class (Cash Payment) Minor Bloodwork for Pre Anesthesia Testing (Billed $6) Pre Anesthesia Testing (Specialist Copay or PCP Visit) Nutrition Consult (Cash Payment) Surgeon Office Visit (specialist copay) The actual surgery is not included. This is just to meets Aetna's requirements and get approved for surgery. I also did not have to see a pulmonologist, nor did I have to get a cardiac stress test (had one a few years ago).

I told them--there were questions when I suddenly started drinking protein shakes and stopped eating ice cream after lunch. Also, I used FMLA for all of the appointments, etc. and applied for short term disability for surgery. I could have just as easily taken my PTO and not said a word. A lot of it depends on what your job offers you to cover time off, but it is one of those things you have to do what is comfortable for you. You are doing it for you, so don't let the negative voices weigh you down...

I go back to work in the morning after three weeks off, and I am surprisingly excited. At work there will still be a focus on getting enough fluids and remembering to eat a meal. The post surg problems/concerns I have now are related to low calorie/low blood sugar moments, so I don't think sitting at home is going to help me learn how to adapt, but I had a very smooth recovery from what I have read. The best advice I have is never trust a fart if you are away from home...

It was 2-3 weeks after my last nutrition class. I didn't even know it happened. When I received the letter, I called the surgeons office to ask if they needed anything, and they said I was all set. Insurance just sends the standard letter, but no news is good news when it comes to approval.

My surgeon has lifting restrictions for 4 weeks minimum. But at 15 days post op, I have no noticeable pain in my abdomen or around the incisions. The biggest challenge I have is nausea and getting the protein and fluids in.

Unjury chicken soup has been a lifesaver! I have added curry powder, franks hot sauce, italian seasoning...anything I can find in the cabinet to change up the flavor. I have to hold my nose just to stomach the chewable vitamins now.

It is like rolling dice here... I can go a couple days normally, but then a day or two of non stop misery. My surgeon said no imodium--your body is adjusting and the process takes time. Imodium will shut the bowel down and only prolong the adjustment period. I have not been able to link it to a particular protein powder or shake either, but I am starting to suspect it is the multivitamin or Tricor I take. Probiotics don't seem to have an impact either. def afraid to go back to work before this is under control....

Most, if not all, of the negative reactions I experienced were from normal BMI/thin people. People who don't struggle with weight need to check their privilege and be more supportive.

You don't have to justify your medical choices to anyone. Don't deny yourself access to a tool that can improve your quality of life because of somebody's opinion.

I have been very candid with coworkers and have addressed their concerns and misconceptions directly. Doing the research has helped me understand the process more thoroughly too. Most of my coworkers are supportive. They have been patient with me through the caffeine withdrawal and blood sugar dips. Sadly, my family has been more critical of my decision than any coworkers. Still, it's my body and my choice. I feel no guilt or shame when I choose not to share or intentionally evade questions.

I have been very candid with coworkers and have addressed their concerns and misconceptions directly. Doing the research has helped me understand the process more thoroughly too. Most of my coworkers are supportive. They have been patient with me through the caffeine withdrawal and blood sugar dips. Still, it's my body and my choice... I feel no guilt or shame when I choose not to share (or intentionally evade questions).

I use decaf instant crystals to flavor protein shakes. I was told that it is caffeine that should be avoided--though the acidity of coffee can cause stomach upset.

Same experience here... The few hours post surgery were painful, and I had the occasional gas pains but nothing crazy. The nurses commented on how fast I walked after surgery, and my ability to get up without assistance. The Heparin shots barely left a mark (though the IV area was a little tender). There we a few nights at home in a recliner because the incisions were painful when lying down, but I have not had any issues with drinking enough fluids or taking pills. I am definitely less hungry and shedding weight, but it is not nearly the horrorshow I feel like people think it is. I feel beyond ready to start soft foods, but I am sticking to the liquids and focusing on retraining my brain to avoid boredom/emotional hunger... Perhaps we are extra fortunate, or our presurgical regimens were extra effective....

Try a diet similar to the liver shrinking pre-op diet you will be on for the VSG. I was on 4.5oz lean protein and 1-2 cups of vegetables OR a premier protein shake 4x a day. No more than 3 servings of fruit or yogurt per day. <50gr carbs daily. After 3 days, I no longer felt hungry all the time and I started losing weight fairly quickly.

The best estimate is your out-of-pocket maximum. Between the scopes, scans, and pokes to get cleared for surgery and the actual surgical costs, you are going to reach the max. My advice is to start the process soon to keep all of the costs in the same year, or wait until next year and max out your HSA/FSA contributions to pay for it. Before I signed up, I did not realize all of the pretesting that was needed--ultrasounds, x-rays, lab tests, ekg/cardiac, stress test, endoscopy, sleep study, psych clearance, nutrition classes. There were several thousand dollars in bills before I was ever approved for surgery. I have Aetna PPO and they require you to use a facility they designate as a center for excellence, so the requirements may be higher than the non-insurance/cash programs. I have been billed about $20k for the actual surgery (hospital, surgeon, anesthesia), but insurance has reduced contracted rates. I will likely receive a couple more bills, but my out of pocket for surgery is about $2500 because I already spent $2000 on the other expenses (not including nutrition classes). The hidden costs: All of these appointments and tests require substantial time away from work. Lean protein and fresh vegetables cost more. Protein shakes, protein powders, supplements, etc. add up quickly (and you will want variety). I will save on prescription costs though since I will not need several medications anymore.