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Do we have to follow up with our Doctors FOREVER? :(
VSGAnn2014 replied to AchieveGoals's topic in POST-Operation Weight Loss Surgery Q&A
I'm coming up on two years post-op next month (August 2016). At that time I'll see my surgeon and his bariatric P.A. Before I see them I'll have another comprehensive blood panel done, and we'll look at the blood work at that time. Even though the sleeve doesn't have the big nutrition malabsorption issues of the gastric bypass or some other procedures and even though I take my vitamin/mineral/other supplements regularly, I am taking a conservative approach about my health after WLS. I know that right now I'm doing great (have lost 100 pounds and maintaining well at 135). But I still want to check in. I feel that seeing my surgeon annually is an accountability check for me. Like others said, if you don't see your bariatric team going forward, you should definitely have your bariatric blood panels done annually and review the results with your PCP or another doctor who knows what they're looking at. Congrats on your success thus far! -
As @ShoppGirl said, if it happens, it's temporary. Even if you do lose some, you'll get past it. As to what, if anything you can do about it, there are some things that may help? Research on this is kind of sparse, but collagen, as well as biotin (a.k.a. vitamin B7), supplementation may help. Collagen is the main protein found in bone broth, so you could get extra protein from the bone broth, and potentially help ease the impact of post surgical hair loss. If you don't like or want to use bone broth, you can also buy collagen powder that you can add to other foods. Some collagen supplements have B7 in them as well. There are a few minerals such as iron & zinc that are also helpful. In addition, vitamins C, B2, B9 & B12 are important to hair growth. In short, make sure you're taking your bariatric multivitamin and it should keep the shedding to a minimum.
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Do we have to follow up with our Doctors FOREVER? :(
LisaMergs replied to AchieveGoals's topic in POST-Operation Weight Loss Surgery Q&A
Hi- couple of things: Once a bariatric patient, always a bariatric patient. Same if you had a heart attack- you always always follow up with your cardiologist. After a year, most surgeons, including mine, see you yearly. They do so for many reasons, the biggest being to make sure you are healthy, no issues with your new stomach, and also- if you start slipping, they want to hear from you to get you back on track. I can't quite understand why it would be an issue for any of us to see the person who helped us transform once a year? Small "price" to pay for health. There are plenty of people who end up with some kind of deficiencies because they aren't following their plans. Plenty who "slip" and are lost. I'd imagine if I moved I would ask my surgeon for a referral to someone he knew so I could continue my follow ups. Many GP docs aren't tuned in to bariatric needs. Just my two cents worth. FYI- post op- saw my doc 1 week, 3 weeks, 6 weeks, 3 months and then I will see him at 6 months and 1 year post op. Yearly thereafter. Those are his requirements. Sent from my iPhone using the BariatricPal App -
Benefits of losing weight slower than expected
mrsbailey921 replied to butterfly23's topic in Gastric Sleeve Surgery Forums
Some of these responses claiming slow weight loss are nowhere near slow weight loss. My surgeon said more than 10pds a month loss is excellent for the surgery, considering 10 PDS a month is average. I am 10 months out and about 54 pounds down... Now that is slow! Benefits of a slower weight loss is... I'm not shocking my body... The loss is more gradual and thus looks very good on me. Plus no one knows I had surgery unless I tell them. I don't have what I call "Bariatric face". ???? -
Happy New Year from BariatricPal! - December 2015
Alex Brecher posted a topic in General Weight Loss Surgery Discussions
style="margin:0;padding:0;background-color:#d8dde8;color:#5a5a5a;font:normal 13px helvetica, arial, sans-serif;position:relative;"> Hey BariatricPal Members! Happy New Year! BariatricPal wishes each of our members a happy and healthy year. We hope 2016 is a year you meet all your goals, whether they include getting weight loss surgery, hitting goal weight, or maintaining your loss. Here’s what we have in this newsletter to get you motivated and ready to go. A New Year’s Message from BariatricPal Time to Buckle Down: Here’s How Make Those Resolutions Last All Year! So take a look through the newsletter, then spend a few minutes to set your resolutions. It may help to come to the forums to talk about your goals and whatever else is on your mind! Then you may want to head out the door for a quick walk for a great start to the New Year. Happy New Year! Sincerely, Alex Brecher Founder, BariatricPal A New Year’s Message from BariatricPal We want to wish all our members a happy and healthy New Year! We hope 2016 will be a year that sees you come closer to achieving your dreams. We hope BariatricPal will be an important part of your weight loss surgery support system as you work towards your goals, whether they are to look into weight loss surgery, lose weight, or maintain goal weight. A Quick Look Back at 2015 2015 was a busy year for BariatricPal! The forums have been blossoming. We have a weekly VIP Member Challenge going on. As a community, we hit a total weight loss of 3 million pounds! We also opened The BariatricPal Store! This had been in the works for a while, and it is a thrill to be able to support the weight loss surgery community through supplying healthy foods and supplements. Check the store often to see what’s on sale, and see our blog for the latest store news, recipes, and discounts. More to Come in 2016! We always have more projects up our sleeve. We expect 2016 to be filled with growth and exciting new developments for BariatricPal, so stay tuned! We know none of this is possible without your support, so a huge Thank You to all our members! Insure Nutrition We are always thrilled to welcome a new newsletter sponsor into the BariatricPal family, and this month, Insure Nutrition is giving us the pleasure of doing just that. Our latest sponsor, Insure Nutrition, is an online company that specializes in getting health insurance coverage for nutritional supplements. Its Post-Bariatric Surgery Nutrition products includes Premier Protein shakes in chocolate, vanilla, and strawberry flavors and OptiSource High Protein drinks in caramel and strawberry flavors. Checking if you are eligible is easy. Insure Nutrition encourages you to use its online form to find out if you qualify. Our sponsors help make BariatricPal newsletters and other services possible. We encourage you show your thanks by considering them first for your bariatric needs. Unjury and Opurity BariatricPal is proud and excited to announce two new sponsors for our newsletters. The new sponsors are Unjury, a supplier of wonderful tasting, highest quality protein supplements, and Opurity (from the makers of UNJURY), highest purity vitamin supplements for bariatric surgery patients. Their support lets us keep BariatricPal newsletters coming to you each month. Unjury was founded by a master’s degree dietitian who has been helping patients since 1974. It is committed your health. You know the importance of getting enough protein after weight loss surgery, but you also know that meeting your protein goals can be challenging. Unjury makes your task not just easier but actually enjoyable. Product flavors include Chocolate Splendor, Chocolate Classic, Vanilla, Strawberry Sorbet, Chicken Soup Flavor, and Unflavored. These ready-to-use protein powders come in single-serve and multi-serve containers, and contain high-quality whey protein to keep you full and nourished. Launched in 2007, Opurity is dedicated to using the purest ingredients in its supplements. Opurity Bariatric Multivitamins have two unique big advantages: First, each multivitamin requires only one tablet per day*. Second, Opurity is so dedicated to quality that it is unique in using no ingredients from China. Choose from chewable orange-berry multivitamins for gastric bypass and gastric sleeve patients or for lap-band patients.Opurity also sells chewable calcium, vitamin D and folic acid/vitamin B-12 chewables. All supplements come with a 100% satisfaction guaranteed. They return policy is: “Yes you can return it.” Support from Unjury and Opurity helps us continue to bring you the services you enjoy on BariatricPal, so please support these two brands! When looking for your bariatric surgery supplements, first visit Unjury.com and Opurity.com. Purchasing from these companies helps support BariatricPal. Thanks to Unjury and Opurity for your generous sponsorship, and thanks to BariatricPal members who support our partnership! *You still need calcium and sublingual B-12. Time to Buckle Down: Here’s How It’s the New Year! That means the parties stop, the holiday treats disappear, and the stores advertise healthy foods for weight loss. Breathe a sigh of relief as the holiday food goes away! Easier to Focus There’s a good chance you slipped up a little during the holidays and need to get back on track. Even if you were perfectly disciplined, you may appreciate going back to your regular life. It’s easier stick to your everyday routine when there aren’t as many distractions. Go with a Sensible Plan For most WLS patients, a detox or fad diet isn’t the way to go. The most effective is to go back to the basics, cliché as that sounds. Focus on lean proteins and fill up on vegetables. Drink a lot of water. Eat slowly. Plan ahead. Measure your portions and log every bite. Make a Few Resolutions Remember to make them controllable, feasible, and clear. Here are some examples of better and less good resolutions. Controllable: “I will log every bite of food and stick to my 1,200 calories a day.” Not controllable: “I will lose 2 pounds every week.” You can’t control what the scale says, but you can control what and how much you eat. Feasible: “I will work out 5 days a week, leaving myself 2 days to recharge.” Not feasible: “I will work out every day.” What happens if you get sick, need a little extra sleep, or need to take a friend to the doctor? Did you fail at your resolution? Clear: “I will have fish three times a week.” Not clear: “I will eat more fish.” How do you know if you’re following your resolution if your goal is to eat “more” fish? How much is “more?” Set the Stage for Success Regardless of your specific resolutions, you’ll make more progress in your weight loss surgery journey if you set up your environment to help you succeed. Clear out your kitchen – pumpkin pie, egg nog, and Christmas cookies should be nowhere to be found. Restock it with nutritious foods you need. It should be packed with lean proteins, such as chicken, fat-free dairy products, tuna, eggs, and beans. There should be fresh vegetables and fruit, plus frozen and canned ones to do in a pinch. Round it out with some whole grains such as oatmeal, and healthy fats such as nuts and olive oil. Get your kitchen scale and measuring cups out of storage and put them in a prominent place. Check the gym schedule, get out your workout clothes, and lace up your walking shoes so you’re ready to get out the door for some exercise. There are some extra steps you can take to make progress easier this year. For example, if you’re still gathering information on weight loss surgery and trying to choose a surgeon, make a list of surgeons’ phone numbers and questions so you’re ready at a moment’s notice to make the necessary calls. Make Those Resolutions Last All Year! This year, make it easier to keep your New Year’s Resolutions with a subscription to your weight loss products from The BariatricPal Store. Choose your favorite protein bars, shakes, and smoothies, bariatric vitamins, instant meals, and great-tasting snacks. You’ll be reminded to focus on your goals every time you receive a delicious delivery from The BariatricPal Store! Just select “Subscribe and Save” on eligible products. Receive your products every 1, 2, or 3 months (your choice). Choose the quantity you want to receive. Get an automatic 10% discount on your subscription items. When your healthy meals are delivered year-round, there’s no need to go off your meal plan. You save time and can be confident of being nourished while you lose weight. That’s what we have for this newsletter. We wish you the best in your weight loss surgery journey in 2016, and hope you’ll keep sharing your goals and progress with us on the forums. Again, Happy New Year! -
Has anyone had insurance deny your consultation appt with a surgeon?? My bmi is about 48 I'm 270 and only 5'1. Comorbidities had high cholesterol and I'm in last stages of finishing my sleep study with a diagnosis of sleep apnea. My insurance will cover any bariatric surgery... I'm calling the insurance rep tomorrow but very bummed ....
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How to get in enough protein? (1 week post op)
pammieanne replied to sarahb309's topic in Gastric Bypass Surgery Forums
I love Premier Protein, however, my doctor/NUT doesn't want me drinking it the first 6 months... they want me drinking protein with whey Protein isolate instead of a mixture like Premier has in it. (I believe it has Milk protein first) Now that being said, lots of doctor's approve Premier. I'm just telling it as my NUT tells me... that we can't absorb as easily. I drink Bariatric Advantage, New Direction, and Chike. There are other's out there, and I'm going to be on the search once these are gone because I'm getting tired of them LOL -
Metabolism- Eating 3x A Day Or 6x A Day?
UXgrrl replied to sirensiren's topic in Post-op Diets and Questions
I asked the dietician that in the hospital because I thought it sounded odd too. In fact, the nutritional booklet that they gave all the bariatric patients had meal plans for both 3 and 6 meals a day. Here was her logic, and after she explained it to me it made sense: since you have to stop drinking 30 minutes before and after each meal and since it should take about 30 minutes to eat a meal, that means you have 90 minutes x number of meals every day that you can't be drinking fluids. For 3 meals a day that's 4 hours off, for 6 meals that's 9. Considering a lot of us have trouble staying hydrated in the beginning I think it's a reasonable concern. One of the things they pushed hard on during our healthy eating class was breaking the "snack mentality", and there is concern about eating small amounts multiple times a day leading to all-day grazing and never really feeling full. That being said, the dietician did mention that some of her patients come back after a month or so and complain that they feel hungry all the time, in which case she suggests they add in an additional fourth meal, but just keep track of everything. I don't know much about the research relating to metabolism -- I know mine is low due to a lifetime of no exercise -- but I've heard that muscle building can help raise it as well, since it takes more calories to maintain a pound of muscle than a pound of adipose tissue. Until I get my asthma under control enough to do cardio I plan to do some light weightlifting to help with muscle toning. -
Life After Bariatric Surgery Q&A
4MRB4PHOTO replied to 4MRB4PHOTO's topic in POST-Operation Weight Loss Surgery Q&A
You might be correct, but I would hope that an organization of almost 4000 members of the bariatric profession would publish the up to date medical information. Unless the source of the food is extremely dense with protein, a post WLS person won't be able to eat much more than 30g at a time. -
Life After Bariatric Surgery Q&A
4MRB4PHOTO posted a topic in POST-Operation Weight Loss Surgery Q&A
This is a link to the ASMBS's page on FAQs post WLS. https://asmbs.org/patients/life-after-bariatric-surgery Many of the same questions are asked over and over, here's a one-stop source to some of them. -
Please post GS weight loss for first 3,6 12 months?
PollyEster replied to Tim C's topic in Gastric Sleeve Surgery Forums
The amount, and speed, of weight loss in the first six months after bariatric surgery is mainly determined by genes, so one person's results are in no way predictive of anyone else's. There are gender-specific differences in weight loss that you'll also likely benefit from. Genetic expression, however, is dependent upon environment, so we can all help our DNA along after surgery -- and for the rest of our lives -- by following key evidence-based bariatric rules such as no liquids 30 mins before or after meals, staying hydrated, practicing portion control, mindful eating, protein first veggies second, chewing food extremely well before swallowing, not slipping back into old eating behaviours and food habits, reading labels if you eat packaged foodstuffs, getting in at least 150 minutes of moderate intensity aerobic physical activity per week, getting enough sleep, and taking all of the required vitamin and mineral supplements. Wishing you well with your surgery! -
Happy 3Rd Month Anniversary To Me
134andhappy replied to 134andhappy's topic in Gastric Plication Surgery Forum
Thanks Sue. Yes heading back in 3 mos for my check up...I don't trust bariatric dr's that have less experience with this surgery...restriction feels where I would expect it to be. I eat half a ham and cheese wrap from whole foods and I feel extremely full. Still can't get more than 3 -4 max sushi rolls in. -
Looking to go from sleeve to either bypass or DS
RickM replied to Megxelizabeth91's topic in Revision Weight Loss Surgery Forums (NEW!)
For treating a regain problem, I prefer the DS as it is stronger metabolically than either the VSG or RNY - the RNY is too close to the VSG in strength to reliably offer a significant improvement in weight loss, from what I have seen over the years. Figure maybe 20lb loss on average - about what one would expect from going through all the intense dieting associated with going through surgery again. (There are some who do significantly better, bit it seems to be more a function of their determination to "make this work" or "not screw it up again" than the actual surgery itself. Call it something like a surgical placebo, lol.) By your surgeons not finding the codes for the DS implies that they are talking about the newer SIPS/SADI/"loop DS" which is a single anastomosis adaptation of the traditional BPD/DS (biliopancreatic diversion) which has been routinely covered by US insurance and Medicare for the past 14-15 years, but is a more complex procedure that relatively few bariatric surgeons perform. Some practices that do the SIPS/SADI use the BPD/DS billing codes which is technically insurance fraud, but if they're comfortable doing it, that's their concern. Revising the VSG to a DS, of either flavor, is straightforward as each use the VSG as its basis (some don't even consider it a revision, more a "completion" of the ultimate configuration.) The strong point of the BPD/DS is its regain resistance - regain is possible as it is with any of these procedures, but it is harder. I know many with the DS who are 10-20 years out (my wife included) who are still maintaining a healthy weight; some are up a bit more and working on losing their "Covid 19" - just like "normal" people but major regains are relatively uncommon. The SIPS/SADI type of DS seems to fall somewhere in between the VSG/RNY and the BPD/DS - I have seen a few in the various forums who have had it and seem to be doing well with it, but it doesn't have as long a history. Any of these procedures - the RNY, DS or SIPS - will be somewhat fussier and less care-free than your VSG when it comes to supplements and follow up; the RNY is maybe a bit less so, but one can get into some serious trouble with any of them if one slacks off. If keeping up with supplements and annual labs is not an issue with you, then any of them should be fine. -
Are 300 calories a day typical postop?
over65 replied to over65's topic in POST-Operation Weight Loss Surgery Q&A
I have been faithfully taking one Bariatric Fusion Multivitamin, B12, Calcium/D3 and Biotin since day one as instructed by doctor in postop orders. Been a little confused about multivitamin. I take fusion chewable once a day according to discharge orders. But bariatric center in preop education said I needed to take 4 each day. Will double check on Monday on postop visit. One thing I don't like about fusion is they do not include Vitamin K. Will ask if I need to get separate Vit K. If I take Fusion 4x a day, I get 1200mg Calcium in addition to the 1200 mg I get from Calcium+D3. I think that is too much Calcium (2400 mg). Until Monday, I am taking just one Fusion a day which gives me 1500 mg Calcium. I already have early osteopenia in hips by bone density scan so Calcium/D3/Vit K are all necessary to rebuild lost bone. Recommded D3 for me is 4000 IU per day so I take additional two D3 2000 IU per day. I really don't like that I get no Vit K in FUSION. The company that makes FUSION told me the don't include Vit K because interacts with a few people on blood thinners and that deficiency of Vit K is "rare". Then why do ALL OTHER Multivitamins on the market (bariatric, OTC and kids) all include Vitamin K? I am not believing I don't need Vit K supplement. But will wait to see doctor before I add Vit K supplement. -
Trying to get ideas for meals and wondering if purchasing a cookbook specifically to Bariatric Surgery or Post Sleeve is worth it? Also If anyone has bought a cookbook and really loved it “please let me know the title!
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Sleeved 2 years ago, thinking of D/S. Any here go to Mexico?
Threetimesacharm replied to Hopefully A Butterfly's topic in Duodenal Switch Surgery Forum
Yes I agree you should have had a gastric bypass at your weight. If Dr Ungson is no longer in practise I am sure that whomever he trained is well qualified. I had bariatric surgeries in Mexico by two different doctors and both surgeries were great. Best of luck!! Oh and I hear that yes DS is under 10,000 I had a quote and I beleive it was 9 and change. -
Sleeved 2 years ago, thinking of D/S. Any here go to Mexico?
catwoman7 replied to Hopefully A Butterfly's topic in Duodenal Switch Surgery Forum
be sure to do your research. This has been discussed on another bariatric forum I'm on (not in awhile, though). There was one surgeon named Dr. Ungson who was supposedly really great, but he's no longer in practice. There are another couple of good ones as well - but also some really not-so-good ones. They may have been discussed here as well - check the search feature and see. -
Sleeved 2 years ago, thinking of D/S. Any here go to Mexico?
gina171 replied to Hopefully A Butterfly's topic in Duodenal Switch Surgery Forum
Have you gone back to your surgeon and bariatric team to see if they can work with you to see if your sleeve can still work for you? Sent from my iPhone using the BariatricPal App -
What to do about complications?
shedo82773 replied to 50yearoldme's topic in Mexico & Self-Pay Weight Loss Surgery
I had my RNY out of town. It was 2 1/2 hours from where I live. I fired my surgeon and started going to another Dr. But my PCP always adds what needs to be done on my regular bloodwork order and then faxed to my Bariatric Dr. Now my hubby did go to Mexico for his Sleeve, unfortunately, he didn't use Bariatricpal. We used another service and am not happy with the service at all. But now the same Dr that I use is taking care of him. I also forgot I had Strictures and needed 5 EEndoscopes with 4 Dilation. My Surgeon that did my RNY did 4 of them. But the Bariatric Dr in Portland did my last one in 2015. We both have not had any problems with getting care that we need. Now hubby did go to the ER when he thought his Sleeve opening was infected but if there was any real problem we would take the trip to our Bariatric Dr. -
Thanks for answering! I am following the program but I was constipated too and went to the ER and gain some weight without eating anything!,, I think it was something that they put on my IV that has a lot of proteins and vitamins ( they call it the bariatric fluid) . I will be more patient!!! Thanks
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I've looked at some bariatric cookbooks and I do not think they are worthwhile. There are tons of free recipes available on the internet. After the first couple of months, you don't really need bariatric-specific recipes (but don't sleep on the ricotta bake -- it is delicious and I made it regularly during my pureed and soft food stages). I have found a lot of wonderful recipes on Pinterest. I've had the best luck searching for "skinny" and "WW" (Weight Watchers). "Healthy," "low-carb," and "keto" also have some good results; you just have to make sure they meet your requirements ("keto" recipes in particular can be a mixed bag, because some of them are very high in fat, which can cause dumping for bariatric patients).
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I tried Celebrate sample packs. The chewable vitamins tasted horrible. I did get 2 packets of 4 in 1 but the vitamins tasted so bad, I threw the packets out. I suspect the 4 in 1 just has their vitamins in powder added to protein shake pack. Find a brand of Bariatric chewable vitamin you like and switch. BARIATRIC FUSION chewable are the cheapest and complete, including calcium. Different fruit flavors but avoid the ORANGE as it is really overwhelmingly strong flavor. For protein shakes, I have been drinking pre-made FAIRLIFE Nutrition Chocolate. I really like it and only 150 cal with 30g protein, 2 carbs in 11 oz serving. Stats: 5'1", age 67, female. Highest weight: 245. BMI 41. Surgery Date: May 28, 2020. Weight at surgery: 211. VSG.
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As you wrote your note, you're actually asking two questions: Does the band work? and Does the band work and remain viable for the long haul. You're going to hear the good, the bad and the neutral in response to both questions. In answer to the first, the band works if the owner works it, as "they" say in the street. It will not work for losing weight f not considered and used as an aid, a partner, so to speak. It usually takes a few adjustments to get it set as an optimal aid. Because it's fickle, adjustments to loosen or tighten may be needed from time to time; there's no way to predict. Then there are the band owners whose bands are just right for them out of the gate. Second question: The band isn't perfect and many have revised to other surgeries. They include those who had legitimate cause and I have no doubt that others just didn't work their bands or abused them. With a band, as with any of the bariatric procedures, regain is always a possibility. Maintenance for the long term is the individual's responsibility and demands vigilance. One downside with the band is that it requires pretty much life-long attention, e.g., annual esophagrams (a.k.a. barium swallows) to be sure it's in place and that liquids and food continue to move from mouth to stomach as they should. Slips are always a possibility; some can be avoided (by not gorging and/or eating too quickly and the like) and some not (perhaps a wrenching movement, which doesn't mean, by the way, giving up ice-climbing or whatever dare-devilry is your passion, which reminds me: No need to give up sex, either). One band star is @@Alex Brecher who founded BP. He had surgery about 14 years ago and has maintained his boyish figure since reaching his goal as far as I know. He's not your deciding factor, of course, but, if he stops in, may be able to give you perspective that I can't. I'm one of those who was doing wonderfully, with goal in sight, but was thrown by a life event and regained most the the weight I'd lost. I'm back on track now. For a while I thought my band might have breathed it's last, but my July esophagram was good and the band is doing its thing. I must take care to pay attention to the signals it sends -- again, that personal responsibility thing. To make a long spiel longer, I'll end by suggesting that you read your replies and compose a list of specific questions to pose to people at the surgery practice you're considering. Also attend its support group to ask and listing to people face to face. This last is not to advise you to abandon BP. All the best.
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Here is my letter: "To Whom It May Concern: I am requesting a “fast” appeal or an “expedited review of my appeal”. In September of 2007, Dr. Morton and my PCP submitted a request for approval for Bariatric surgery. I have been denied and since that time my borderline diabetes has turned into full blown diabetes. I have currently been perscribed Metformin 1000 mg twice per day. My doctor and I feel this procedure is medically necessary. Enclosed is another letter from my PCP and the diet I have been following since September of 2007. My father died from diabetes with many complications including having both legs cut off and his fingers decaying. I do not want to live that life. Quoted from the American Diabetes Association: “Weight-loss surgery helps reduce the seriousness of all four of the diseases studied. Diabetes completely disappeared in 76.8% of the patients and was resolved or improved in 86%.” Enlight of the fact I have just become diabetic, this surgery would help me get off of medication and reduce, if not eliminate, the possibility of dying from diabetes. I do not know why an insurance company would deny a patient a chance to live a full and healthy life. Please reconsider this decision." My doctor's letter was also included. In the process of this I also found the step-by-step procedures for BCBS. I saved it in a word document. Is there a way for me to send you an attachment? I'll try to PM it to you. Denise
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Wow. I use Bariatric Advantage. strawberry and banana are awesome Sent from my SM-G928V using the BariatricPal App