TSB

My surgeon requires patients to have been non-smokers for 3 months prior to surgery. He also randomly tests to see if patients have really quit. He cited all the reasons prior posters have menitoned. It has been a rough part of this process for me, for sure. Giving up caffiene has been hard too, as I used to drink coffee pretty much all day long. Sometimes when I read posts here from people whose surgeons require hardly anything of them before they get the surgery I get a little frustrated and jealous. But, when I think logically about it, I am lucky to have a surgeon who, along with his staff, is so throrough and rigorous with their requirements. In the long run I think it will result in me being healthier physically and more mentally prepared.

CONGRATULATIONS, MARIPOSA!:w00t: The steps I have completed thus far are in my signature line. I go for a sleep study consultation on May 13. My second one-on-one w/ the nutritionist is May 18. Upper endoscopy is May 22. May 26 is my Psych eval. I imagine there may be an additional visit after my sleep study consult to do the actual sleep study. My surgeon will not submit for insurance until after all of the testing is done and he and his staff are satisfied I have met their requirements (i.e. non-smoker, no caffiene, adherence to a high protein low-cal diet -- I am allowed 1200-1400 cal per day.) I will be some disappointed if after all of this the insurance denies me

The older I get the less inclined I am to keep secrets. I really don't care who knows or what they think about it. As far as not telling husbands how much your weight is -- I am over that too. I married my first husband at 19 and would have died before I told him how much I weighed. I married my second and current husband at 38 and he was standing right next to me at the doctors when I got weighed. As I approach forty (in a couple of weeks) my attitude is take me as I am, baby!:thumbup:

My surgeon only offers the lap-band. I think it would be nice to have a choice. His rationale is that the lap band has been around longer than Realize, so he trusts it more.

My surgeon requires 3 months of non smoking prior to surgery will do blood tests for co2 levels. I quit Feb. 18, fell off the wagon Feb. 26 & 27. Quit again Feb. 28. Fell off the wagon again March 4,5,6,7,8 & 9. Quit again on March 10 and have not touched them since :sneaky: It is VERY hard. Frankly, when I get stressed my first instinct is I really want a a cigarette! I am using Chantix, which helps. It does not help with the "habit" per se. But it does something to the way the receptors in your brain react nicotine. Even when I fell off the wagon I kept taking the pill, because quite frankly they tasted really bad and didn't do a thing for me as far as that nicotine buzz you get. Good luck!

I am in the very same place as you, WDW -- anxious to get rolling! The clinic coordintor at my surgeon's office also told me that best case scenario for me would be late summer, early fall. All I do is just keep plugging away at all of the prerequistes. I am a non smoker now (surgeon requires that his patients have not smoked for 3 months prior to surgery.) I smoked for about 15 years (excluding the 9 months I was pregnant with my youngest child who is now 13). I have tried to quit many times, this time I feel like it will be permanent! So, that is one non scale victory I am savoring while I move toward getting banded. I also have given up caffiene. One of my doctor's requirements, which was almost as hard as giving up the cigarettes. But, I have found that the insomnia that has plagued me since I was a teenager has greatly diminished. I don't toss and turn for an hour or more when I go to bed at night! Another NSV to savor! I've also gotten a jump on eating healthy, which has resulted in some weight loss. In short, what I am trying to do is focus on each step of the journey ....from the sounds of many of the posts I have read on this site....this is a life long journey and you have to pace yourself. Best of luck to you!

Yup, I am slated for a ton of tests as well. When I had my blood work done they took 6 or 7 vials! Monday I go for my upper right quadrant ultrasound (liver & gall bladder), chest x-ray, upper GI, ekg, and one-on-one meeting w/ the nutritionist. Patriot's day is a holiday in Maine, so I have that day off of work, which why I scheduled all of those tests for one day! After Monday I still have to do a sleep study, psych eval, and upper endoscopy -- those are all scheduled for May. So maybe by June I will know one way or another whether I can actually have this surgery or not!:wub:

I have not been advised that I would be on a liquid diet yet. I have been told that I need to lose 10% of my body weight prior to surgery. I went to the group nutrition class where we were told that we should have 60 to 80 grams of lean protein a day and should drink 48-64oz of liquid a day. We were also given food journals. And told to track everything we eat including time of day, amounts, calories, protein grams, and ounces of liquid. Maybe I will get a more specific plan when have my one-on-one w/ the nutritionist on Monday. The whole liquid diet for a week or more sounds pretty rough. I hope I don't have to do that.

CONGRATS! :smile:

My surgeon has a whole set of his own requirements that seem to have nothing to do with what my insurance company requires. I won't even be submitted for insurance approval until I have satisfied the surgeon's requirement.

My nutritionist said no Slimfast, Atkins, Boost, Ensure or Carnation Breakfast. One of the presurgery requirements for my surgeon's patients is to try at least two different Protein shakes before surgery to find out what you like. I have tried the EAS 100% whey Protein (chocolate flavor), shaken w/ ff milk. Tastes just like chocolate milk to me. I have tried the ON 100% Whey Protein (vanilla ice cream flavor). I have mixed it with ff ice cream and milk in a blender -- tastes just like a vanilla milkshake. And I have also tried the Designer Whey 100% Whey, strawberry Flavor. I mixed that in a blender w/ mixed berry ff, sf yogurt, some frozen berries and a little ff milk. It was very yummy and kept me full for several hours. The nutrtionist in my surgeons practice gave us this rule for selecting protein drinks: There should be no more than 10 calories for every gram of protein.

Best of luck to you, Hopeful!:glare:

Well I have not had surgery yet. As far as dimentions go; I am currently @ 217 at a height of 5' 3" and can wear some 16w, but mostly 18w.

I like water, myself, but it can get boring after a while. As for the coffee, I have weaned myself off of the caffienated stuff and now do decaf. I keep a box of the individual bags in my desk drawer. I also found Gatorade's G2, which is really low in calories. I tried the special K protein water mix -- my nutritionist said the mix is okay, but the premade bottles are not. I guess there is a difference in sugar content or calories or something:confused3: I bought the pink lemonade & mixed it w/ about 16 oz of water, it was a little too tangy for me. I think if it is more diluted it would not be so bad. Plus you get those extra few grams of protein.

Have just recently begun this Journey, myself. Met w/ the surgeon for the 1st time on 03/13/09 Attended group nutrition class 03/20/09 New patient orientation scheduled 04/01/09 Will have blood work done on 04/10/09 Upper GI, Upper right quad ultrasound, chest x-ray, EKG & individual nutrtionist appt. 04/20/09 (have that day off so scheduled as much as possible) Upper Endoscopy scheduled for 04/24/09 sleep Study Consult 05/13/09 Psych Eval. 05/26/09 I also have to shoot for a 10% weight loss and have been a non-smoker for 3 months. Will hit the 3 month mark in May. The folks at the surgeon's office said that if I don't quite make 10 % that would not neccessarily mean no surgery. I have not weighed myself since the 1st appt. I have been religiously keeping my food diary since 03/21 and on average am eating between 1200-1500 per day of a high Protein diet. At any rate, the clinic coordinator told me that realistically I should not plan on surgery until late summer, early fall --IF the insurance approves it. But I am pretty motivated on the weight loss and seem to be moving right along w/ all the pre-op appointments. I think I will meet all of the surgeon's requirements w/ no sweat, but the insurance company maybe an issue. As of now, my only health issue is high cholesterol, which the insurance company does not perceive to be life threatening. Since my BMI is below 40 (barely), I have to have a life threatening issue. So, this sounds weird to wish for, but I hope the sleep eval. determines that I have sleep apnea! It would make insurance approval a breeze.

Not sure what the labor laws are in your state, but that sounds pretty bad to me. Here in Maine, if you work 5 hrs you are required to take a 30 min break. I'd look into it if I were you. Your state department of labor should have that info availiable online. Good luck.

Geez, my surgeon must be a real hard ass compared to some of the requirements I am hearing from others. Before my surgeon will even consider doing the surgery I have to have been smoke free for 3 months, given up caffeine, given up soda, given up fruit juice, and have lost 10 % of my body weight. This is in addition to the usual, psych eval, ekg, etc.... I have been doing a high protein diet for the last 3 days and I guess, from what I understand, I should be on a high protein diet for the rest of my life. The folks that I talked to at the Bariatric center have explained that patients have to show that they are capable of making the behavioral changes required before getting the bariatric teams approval for surgery. Once they approve, then and only then will they submit to your insurance company. It is a challenge, but I think the expectations are perfectly reasonable and are designed with the patients best interest at heart.

Except for in this instance, anyone who listens to the news knows this is a real concern. I wondered about those bandsters that go to Mexico for surgery when I heard this reported yet again this morning on NPR. If I were exploring the possibility of surgery in another country, these are facts that would definitley weigh on my decisions.

This is a perfectly normal anxiety to have before surgery. I have had 3 c-sections and an abdominal hysterectomy ..... each time I went through a "what if I die?" phase.

One of my surgeon's requirements is that his patients give up caffiene entirely prior to surgery and forever after. The rationale is that it makes one more prone to ulcers. I've switched to 1/2 caf this week and am limiting myself to 3 cups a day. I used to dring high-test all day long, so am slowly weaning myself off.:frown:

Interesting thread. Not banded yet, just beginning the process. However, I have been jumping around the forum reading lots of posts. My impression is that is more of an issue of personality type/maturity level vs. self-pay or ins. pay when it comes to posters are going against doctor's/nutritionist's orders and then are astounded that they are not losing weight. Just my opinion. :tt2:

I went for my first visit on Friday. It was the longest appointment of my life -- took 3 hours! At any rate, I can see it is the first step in LONG journey. However, I do like that the clinical coordinator laid out exactly what the steps are. I have to have been a non-smoker for 3 months -- If I can stay on the wagon, that will happen in May. I need to try to loose 10 % of my body weight, which is 21 lbs. Have to go to a nutrition class (March 20) and an orientation (April 1). Need a psychological eval, ekg, right upper quadrant ultrasound, sleep study, upper endoscopy, & uuper GI series. The nice thing is the Bariatric Center takes care of setting up all of my appointments. Looks like I am going to busy for awhile! My BMI is only 38, w/ no issues that my health insurance policy considers "life-theartening." I do have GERD and am currently on a cholesterol lowering medication. I have a very strong family history of heart disease and diabetes. But given that I have been told I snore very loudly, they are ordering the sleep study. Apparently sleep apnea is one of the issues my health insurance considers "life threatening." On another note, has anyone else had the experience of their surgeon seeming more pro-by pass than pro-ban? I really have not given much thought to the by-pass, but the surgeon seemed to suggest that the results of the by pass are better. Even so, I can't get past the idea of having my physiology permanently altered.

UGH... really struggling here w/ the quitting smoking. Was successful for 8 days. Then I smoked again for 2 days. Stayed smoke free for 4 days. Smoked again for 2 days (had the last one in the pack this morning). This is so hard . . . . .especially when something happens to stress me out! Going to keep at it, though!

I have Anthem BC/BS. Our plan is called a POS (point of service) Don't know how that differs from PPO or HMO. I am in the early stages of this process. My doctor did a referral in Jan. and I will see the surgeon for the 1st time on March 13. Because I have read about such a variety of experiences w/ BC/BS I did a little investigating in regards to the policy I have through my employer. What I found is copied below. The caveat is that this is specific to the policy my employer subscribes to. If you go to the Anthem site (http://www.anthem.com/ ) and look up your state, you may be able to find out what the policy is re: WLS based upon the plan you subscribe to. Medical Policy Subject:Surgery for Clinically Severe ObesityPolicy #: SURG.00024Current Effective Date: 04/16/2008Status:RevisedLast Review Date: 02/21/2008 Description/Scope Clinically severe obesity is a result of persistent and uncontrollable weight gain that constitutes a present or potential threat to life. There are a variety of surgical procedures intended for the treatment of clinically severe obesity. This document addresses those procedures. Policy Statement Medically Necessary: Gastric bypass and gastric restrictive procedures with a Roux-en-Y procedure up to 150 cm, laparoscopic adjustable gastric banding (for example the Lap-Band® System or the REALIZE™ Adjustable Gastric Band), vertical banded gastroplasty, or biliopancreatic bypass with duodenal switch as a single surgery, is considered medically necessary for the treatment of clinically severe obesity for selected adults (18 years and older) who meet ALL the following criteria: BMI of 40 or greater, or BMI of 35 or greater with co-morbid conditions including, but not limited to, life threatening cardio-pulmonary problems (severe sleep apnea, Pickwickian syndrome and obesity related cardiomyopathy), diabetes mellitus, cardiovascular disease or hypertension; AND The patient must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery; AND The physician requesting authorization for the surgery must confirm the following: The patient's psychiatric profile is such that the patient is able to understand, tolerate and comply with all phases of care and is committed to long-term follow-up requirements; and The patient's post-operative expectations have been addressed; and The patient has undergone a preoperative medical consultation and is felt to be an acceptable surgical candidate; and The patient has undergone a preoperative mental health assessment and is felt to be an acceptable candidate; and The patient has received a thorough explanation of the risks, benefits, and uncertainties of the procedure; and The patient's treatment plan includes pre- and post-operative dietary evaluations and nutritional counseling; and The patient's treatment plan includes counseling regarding exercise, psychological issues and the availability of supportive resources when needed. Surgical repair following gastric bypass and gastric restrictive procedures is considered medically necessary when there is documentation of a surgical complication related to the original surgery, such as a fistula, obstruction, erosion, disruption/leakage of a suture/staple line, band hermiation, or pouch enlargement due to vomiting. Not Medically Necessary: Stretching of a stomach pouch formed by a previous gastric bypass/restrictive surgery, due to the patient overeating, does not constitute a surgical complication and the revision of this condition is considered not medically necessary.