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To be honest I would make the trip once a month to the surgeon and nutritionist just help you get back on track and to make sure you're okay or see if you can do it via corresponding with them on your computer. Have them contact your primary physician once you've established yourself with the surgeon and nutritionist to coordinate the proper way to take care of you. Have the surgeon and nutritionist write them a letter or call them of what needs to be done for you on a regular basis and why. Maybe this way you might get the care you need. Another thing you could do is going to the next bigger town to a doctor who is more open about taking care of you and will work with you. Look on your computer and see if anyone works with Bariatric patients some where closer to where you live. Research as much as you can. Well these are my suggestions do what you will with them. Take care.

My visits to BariatricPal are very rare, as I'm a poor navigator. I just posted, however, a notice of the next Greater New York Bariatric Surgery Clothing Exchange (October 22). I'm so glad I did, or I wouldn't have made my way to this notice for the October 17 Face to Face meeting. It's now engraved on my calendar. Since the Face to Face is for our area, I hope I'm not out of bounds with the following link to the clothing exchange info? Laurie http://www.bariatricpal.com/topic/351620-greater-new-york-bariatric-surgery-clothing-exchange-free-10222015/

By: Michael J. Orris, D.O., M.B.A., FASMBS Many weight loss patients in Phoenix, Tempe, Scottsdale and Tucson come to our bariatric surgery practice seeking to improve their health through surgery. Like bariatric surgery patients across the U.S., many are concerned about the cost. Insurance coverage for these procedures varies by state and provider, and many other factors are also considered. Most insurance providers, including Medicare, require patients to have thorough documentation from a doctor that says surgery is medically necessary. This includes your weight history and BMI, your obesity-related health conditions and medications, and a detailed description of how your weight affects your daily life. Companies also often expect a patient to have made dedicated efforts at weight loss before surgery. They may want to see gym membership documentation or require participation in a medically supervised weight loss program for up to 6 months. Another consideration for coverage is where a patient can have the surgery performed. Some providers require patients to have their procedures done at facilities with the highest standards and success rates. Your weight loss doctor can be a resource to help you get your surgery covered. Most practices have finance coordinators who can help you navigate the complicated insurance considerations. If you do not qualify, many practices also offer other financing options such as payment plans to help you get your health back on track. Concerning Weight Loss Surgery Candidacy Patients often want to know what qualifies a person for bariatric surgery. All patients must undergo a thorough screening from a physician to know whether surgery might work for them, but here are some factors that might make you a candidate: · What is your BMI? Obesity is measured by calculating a patient’s body mass index, or BMI. Bariatric surgery patients typically have a BMI above 40, or above 30 if they also have a medical condition related to obesity, such as diabetes. You can determine your BMI by using a BMI calculator. · Have you tried and failed with other weight loss options? Most insurance providers and reputable weight loss surgeons require that you have made a concerted effort to lose weight using more traditional methods before you undergo surgery. You should be eating a good diet and exercising regularly under the guidance of a bariatric specialist. If your doctor determines that such methods are not enough to improve your health, you may be a candidate for surgery. · Is your health at risk? If life-threatening medical conditions related to obesity are a factor, you may qualify for surgery. Diabetes, heart disease, high blood pressure, and sleep apnea often result from obesity and can be relieved by bariatric surgery. If you have one of these medical concerns and think you may be a candidate for surgery, talk to a bariatric specialist.

From reading great advice on this forum I made a list of these items & gathered in preparation........ :-) bariatric Protein powder (I like the fusion chocolate mousse) & some pre-made Protein drinks for quick & easy grabs GasX (sounds like the gas afterwards for a few days is quite painful) Nexium (ditto on the acid) liquid Tylenol (to use after the dr's liquid painkiller has finished it's job) lots of gatorade, s/f Jello, Water bottles chewable bariatric Vitamins (again the Fusion isn't bad...the mixed berry looks a bit intimidating but is relatively easy to chew up and swallow...my dr advised 2 of those a day for always after.) pill crusher (this is a cool little thing I found at WM which crushes any non-chewable pills you have to take) low cal/lactose free yogurt of course my chapstick! that's all I can remember at the moment! Best of luck! I go in tomorrow morning............(feels like the first day of school when you were a kid!)

To clarify, many surgeons will refuse to see a post-op patient if they had their procedure ANYWHERE other than with their practice. That means another state, or another city, or even another practice in your own city. Others only care if it was outside the US. And most, if they will see a patient that they didn't operate on, will charge a 'retainer fee', ranging anywhere from 500-2k. So it's not just a concern for medical tourists, but for anyone who wishes to go elsewhere. It is definitely something to think about. For me personally..... My gastroenterologist will be looking after me for any issues. This will be the simple things, like incision checkups, labwork, etc. Should there be an emergency, I will be going to one of two ERs. Both of those ERs happen to use general surgeons that do bariatric procedures on their oncall rotations. Any general surgeon can fix you up should something happen. You don't need to specialize in bariatrics to go in after a leak is found, etc. (I wouldn't want a 'routine' general surgeon to DO the VSG, obviously, but post-op complications don't require more than that). It is also important to note - if you are a self-pay patient, your insurance will most likely not cover emergency surgery once it's all said and done if the issue is directly related to the surgery. (A long time down the road is a different matter, but I'm referring to leaks, etc). It doesn't matter if it was in the US or in Mexico or somewhere else. You can frequently get 'coverage' through your original surgeon where he and his practice will go back in and fix things if something occurs. BUT, you're still playing the odds that if something happens, it'll be in your town, and you end up at their hospital where he has privileges. TLDR version - These are ALL things that should be considered when you do your research. But be careful about rumor mills and how some local surgeons may phrase things. It's a business, and they want you to go through them. They tend to conveniently avoid some of the facts at times.

I would look around and find out what different surgeons charge. I'm in Houston and the self-pay pricing varies by thousands of dollars depending on which doctor you use for the procedure. In addition to the surgeon, differnet hospitals have varied self pay pricing. I was lucky because my hospital is a Bariatric Center of Excellence and also had an excellent "cash" price. Also, in my case, I have a hiatal hernia so my insurance is subsidizing the procedure, making my out of pocket costs about $4,000 less than they would be with no hernia. My surgeon suggested that I do an EGD and take a look since he suspected it anyway and it would reduct my overall costs. Don't get too discouraged. It may take a little more work than you thought but you will find a solution that works for you.

I check references called patients and decided on dr. Illan bariatric pal team mexico. If Alex B. Founder of this site supports him it was good enough for me. BEST decision ever! BILL YANEZ is coordinator for team mexico. Tell him I sent you, he will take great care of you. Personal service no big business feeling.

I need to find a primary care physician to write a medical necessity letter who has written them before. I moved to the Denver area and do not have one. I have a couple of co-morbidites, and am in the pre-op stage. I am at the 4 month wait period and need to get the letter ready to submit to insurance. How do I narrow the search down to find a primary care physician who does not have a problem with Bariatric surgery who will write the letter?

Hi Tracy - How you feelin? Steve - hope to meet you soon. I was banded by another doc in town but have switched to Malley for my fills. Have you seen his life size signed Kiss Poster? I've only heard about it. Seriously though Malley is great and his staff is top notch. You should come to one of his support group meetings that they have over at the NewHope Bariatric Center. Its a great place to talk with people face to face that have already had the band. We always welcome "visitors". With or without the band. Dolphin - Where are you in KS? if you don't mind me asking. Choosing to be banded is a very personal decision but for me I have NO REGRETS. It was the best choice I ever made. Surprisingly enough I hadn't even really been thinking about WLS surgery but my primary care doc referred me to someone she said was a bariatric specialist. She thought the doc would work with me to come up with the best weight loss strategy for me wether it be diet, exercise, pills, etc. It wasn't until I got to the seminar that I realized he only did WLS surgeries. But I was sold by the end of the presentation and have never looked back. My starting weight was 255 and I've gone from a size 24/26 to a 10/12 in about 2 years. And with no health issues.

These are what I take: B12-Natures Bounty sublingual Calcium Citrate- Bariatric Advantage chewy bites I have the lemon, chocolate and caramel. I also have the Calcet bites lemon and chocolate and Citracal + D. I like variety!! Multi-Centrum I buy the Walmart brand-same ingredients and ALOT cheaper. Until I was able to swallow BIG pills at 4 weeks, I did the Bariatric Advantage Orange chewable multi. Iron- Bariatric Advantage Chocolate Raspberry Truffel chews and Ferrous Gluconate supplements from my dr. (I am anemic and have to take more!!) Hope this helps! Kelly

Hello everyone! My name is Kaila and I am brand new to this forum (actually any forum) and I am definitely looking for some help with this journey. I will start a little about myself. I grew up the majority of my life in New Hampshire, am currently a proud army wife and mom of an almost 3 year old boy. I work as an office assistant and also as a home sales consultant with Seacret. I've spent the majority of my life taking care of others that it wasn't hard to forget about myself, leading to my unhealthy diet and with stress and anxiety, an addiction to food. After moving to Colorado I gained a lot more weight in a short period of time because trying to breathe in this elevation was so difficult it took away my physical activity that I had in our other home. Within 3 months I became prediabetic, hypertensive, and had high cholesterol. I had my surgery and all my preop appointments at Evans Community Hospital at Fort Carson. My doctor was Dr. Mayfield. He was amazing. Very personable and straight forward. He didn't sugar coat anything, but definitely made you comfortable to talk to. I had a month of pre op appointments including mutliple nutrition appointments, wellness (metabolism testing), bariatric surgery group counseling and psychological evaluations. Going through the appointmetns were really important and informative. My doctor was very lenient on the pre op diet. I ate reasonably and cut my calories down by half, but I still enjoyed my cravings occasionally. The day before surgery I ate up to 1:30 pm (only 2 very small meals concidering my Vitamins definitely helped minimize my diet, so I definitely reccomend takin them before surgery for at least 2 weeks) and they provided me a magnesium drink that cleans out your system. At that point I could not have anymore solid food. Day of surgery was a bit tough phsycailly. I just remember waking up and all I could say was pain and shake my head. I spent 2 nights and 3 days admitted. They try to make you walk right away, but I didn't walk until the 2nd day. I was very much under the anestisia for a lot longer than I wanted to be. In order for me to go home I needed to drink 4 - 5 oz of clear Fluid within 1 hour. The first time I tried to drink it I became really sick. Eventually I was able to drink 8 oz. within 3 hours, so they let me go home. My problem right now is that I am on the full liquid diet, but I cannot injest more than 35 oz a day, and only clear fluids. Its painful to drink still ( 5 days post op) and I can't really drink any full fluids yet The first day I tried I ended up in the hospital again dehydrated. Has anyone else had such a hard time drinking after surgery? All I keep hearing is that the 1st week is the worst, but people I've read their information or seen youtube are drinking full liquids like champs the first week, so it makes me feel a little broken. Im also having a really hard time with commercials. If I see Little Caesars pizza one more time I may snap. I have also had such a heightened sense of smell. I could smell my grandmothers plain toast while she was upstairs. It seems like it's making it more difficult. Also, walking is increditbly difficult. There's always a sharp or dull (it changes) spot under my left breast where my stomach would be, but when I walk it becomes more painful. Should you push through it or take it easier? Any advice would be wonderful. I am definitely open to anything that would make my life a lot more comfortable right now!

Hi Adamsmom and welcome. I am from Northern California and I am close to getting banded. I meet with the surgeon on October 8. I am taking three weeks off, utilizing vacation time as I don't want any of my co-workers to know that I am having surgery. I am hoping for a December surgery date during Xmas break. What type of insurance do you have and did you contact them to make sure bariatric surgery is a benefit? That is where I would start the journey. Best of luck to you and keep in touch!

no problem. Not I think most ppl on here are from the U.S and many have gone to Mexico for bariatric surgery. Best of luck.

Welcome to the bariatric world! I think everyone has a sagging skin issue. I didn't have a lot with my arms, neck and face thankfully but I do have an apron now and my boobs sag more then they did before surgery (tmi?), and while I am tickled my thighs no longer touch when I walk, if I walk fast they slap. I plan on having a mommy makeover surgery to fix the things I don't like. They next time I see my doctor I'll be talking to his plastic surgeon about fixing the issues. I had surgery 6/7/22 and I've lost 122lbs. Even with the sagging skin I'm down from a 26/28 to a size 14 that is starting to get loose. I have such a better quality of life. I would not change one day post op. Even if I never got a mommy makeover. I think the majority of my brothers and sisters in the bariatric world would agree that they are happier post op sagging skin and all. You'll do great! We are here to support you!

Anyone on here go through NW bariatrics in Post Falls Idaho? Dr Pennings? Thanks

I have BCBS of IL and I got my lapband 9/15/11. Congrats to those of you who are looking to get the approval. I had to do 6 months of supervised diet, but have to admit that it went quicker than I expected it would. Some companies exclude bariatric procedures, but when BCBS IL approves your surgery, they deem it as medically necessary, and they do cover all maintence required as well - and that includes fills. I too thought that they would not cover fills - but I've had a fill every month since being banded, and they've covered every fill.

Also, another comment from Dr. Spival to my daughter when she had her surgery....that the two most important things with the band are the placement of the port and the placement of the stitches to hold the band in place (the flap they make), that that's where the experience and knowledge of teh surgeon comes into play. (Clearly my first surgeon didn't have a clue)...I'm sure the other doctors the other poster has mentioned are probably okay too...but to me if you can get the best for around the same price, why not. But I will say Houston has some of the best surgeons around, hands-down, not just bariatric. So whoever you decide to go with, as long as they're experienced, you'll be good. (I should have listened to my own advice two years ago.) :)

Weigh in day: 187lbs. The scale has not moved. So I am back into the swing of things for 3 more days until I hit the road to go camping again this weekend. This weekend will be purely a social event without ANY work included or even thought about! The weekend in Jasper was Amazing! We met 50 New Canadians from all over the world and provided them with thier first camping experience. I truly have had a renewal of love for my job. I forget sometimes when I am stuck behind my desk under mountains of paperwork. The real ones are much much more amazing! In bandland, things are at a steady pace. I have been lacking in my exercise routine with work being so busy. My food choices were terrible this weekend travelling in a van with 3 young adults for 800km. I was easily influenced and all to quickly made the foolish excuses in my mind that all of the junk that we packed was really for them. Pffft, I'm not kidding anyone! I got home later Sunday evening and had a grilled chicken breast with salad for dinner. Monday, grilled shrimp and pineapple skewers with some brown rice. Tonight, stuffed peppers and Turkey sausage. I also got back on the workout wagon lastnight too so I can't complain. I am course correcting! I learnt that at my fancy staff summit earlier this year. Last week, Sparms bestie and I were talking about the dating world for people our age and people our weight. The matter of assumption about fat people being lazy came up in conversation and it pissed me off, so I thought I would share. Really, a person like me who has been active and healthy (besides being 250+ lbs)for most of their life is automatically pegged for being lazy. I am and have always been anything but LAZY. I personally, can't stand a lazy person. It is one of my pet peeves and maybe that's why this whole topic makes me angry. I am just curious about how many of you out there have been pigeon-holed into the bon bon eating, soap watching, couch surfing fat girl? And what do I plan to do about it? Nothing! Continue to workout my frustrations! Cheers all!

I met my doctor on Wednesday and I've lost 18kg/40 pounds!! I was so happy. And he was very happy with me. He didn't want to give me a fill since I'm doing really well. He also said I'm putting too much pressure on myself. That he was happy and I should be as well. I should read too much about how much other people are loosing because our bodies do not work the same. But I'm incredibly happy. Also this is kind of a milestone. This is the second time I've lost 40 pounds in one run .... and well then I gained weight again. But this time, I'm going to get further, I'm going to loose more so ever pound after this will be a new milestone yay. This Friday I was sooooo hungry at lunch that I was dreaming of all kinds of food I was gonna eat that day. I had an omelette at work. I ate a bit too much. I ate until I was full and I never do that. But hunger does that to you. I was full all day! I couldn't imagine eating dinner even. I did but just a little. Before the lap band, if I got full, I could begin to eat again in 2 hours but not now. And guess what, I love it. This rarely happens that I eat so much. maybe happened 3-4 times in 6 months. I told my doctor that I was still learning and he understood that. I will do mistakes and learn from them. Ok 3-4 times eating to much haha, ok I might be a slow learner hehe But I'm so happy now. I tried on a dress I wore last Christmas and it's too big now And my panties. Seriously, I need to renew them! They are a size too big. My bra is still the same size ugh! hate that. But I was telling a coworker how much I'd lost and she told me that she noticed my hips ass getting smaller and yay again! soooo happy! I've always hated my hips and ass. I would do the Kardashians proud. They were even large when I was in a normal weight. But so far so good! loving my new life

I don't know where you live, but where I am, CBD is a big thing. It's supposed to be wonderful for anxiety and more natural than xanax, etc. (though I take the xanax myself). I'm considering looking into CBD for my anxiety. I'm awaiting my surgery (I don't even have a date yet), so I can't relate to the head hunger just yet. I have been going to bariatric support groups, and they suggest keeping your hands busy, walking and all of that. Or a rewards system that doesn't include food (i.e., you didn't snack, give your self a marble and once the jar is full, you can buy the shoes you've been eyeing).

The reason one person can have UHC, Aetna, BCBs, etc and have it covered and another person can have the same company and not have it covered is the insurance companies cover what your employer contracts with them to cover. I work for UHC and UHC has a bariatric exclusion written in our contract. I have a friend that works for a title company and they have coverage through UHC and it is covered. It's based on what your employer contracts with the insurance company to have covered.

Today I spent hours going through the binder of information given to me by the bariatric team. I am one of those super organized, Type A personalities, so it was necessary for my peace of mind to have dividers and tabs and plastic sheaths for the important papers. Kinda crazy, I suppose, but that's me! Next I went through all my diabetic magazines and clipped the yummiest sounding recipes. :-) So far on this journey toward surgery-- 1. I established the insurance requirements (a complicated story I may share at another time) and got the preliminary clearance. That was a relief! 2. I discussed my desire with my personal physician, a fabulous doctor and man I respect greatly who has been my GP since moving to KY 3 years ago. His approval and support was not a deal breaker, necessarily, as I was 80-90% sure surgery was my best course, but it was important to me for him to be on board. It was a relief when he not only didn't disagree but also confirmed the positive reports I had read about the local surgeon and bariatric program. 3. I (and my husband) attended the informational seminar offered by the Bariatric Weight Loss Program here in my home town. The surgeon was at the meeting, as well as others on the team, and the info was very thorough. So far nothing to give me pause! I filled out the request form, then waited.... 4. The wait wasn't too long. Gayle, the program coordinator, called me about a week later to set up my first appointment with the surgeon Dr. Farrell. 5. August 4 was my appointment with Dr. Farrell. Before meeting him I also had brief meetings with the dietician and again with Gayle. A binder containing detailed information about the pre-approval process and appointments, the surgery itself and surgery prep, diet pre- and post-op, possible complications, exercise, recipes, and much more. VERY thorough! I even got a few samples of protein powder and shakes. 6. August 11 was my appointment with a cardiologist for "surgical clearance." I had seen this doctor just over a year ago, before my diagnosis of sleep apnea, to rule out any cardiac issues. Nothing had shown up at that time, and as a prior patient I was able to get in to see him quickly. Unfortunately, I have been very sick with bronchiolitis and possible pneumonia, on strong cough medicine and steroids. The latter (I'm convinced) is why my heart rate was high, and of course my chest wasn't as clear as it should have been. For this reason the doctor recommended a follow up ECHO and treadmill test to be sure all was well before surgery. As an RN, I could not argue the logic even if it adds more to the process. Better safe than sorry! 7. Gayle called the next day to give me dates for all the various appointments: Psych Eval, Support Group meetings, endoscopy, Nutritional Eval, Exercise Eval, and a Healthy Lifestyle Class. These, along with the cardio followup, are scheduled over the next month, beginning tomorrow. No set surgery date as yet. The initial estimate was early November, but it seems to me mid to late October makes more sense. My birthday is on October 26, and while it doesn't sound like too much fun to spend one's birthday in the hospital, in pain, and unable to eat at least a small piece of cake, I am willing to make the sacrifice if it means getting the rest of my better-health-and-skinnier-life started! I'm ready!

Just use caution when progressing your diet. Just because you feel healed doesn't mean you are. Everyone is different and you may not lose your desire for food, but a lot of sleeve patients go through that stage. I still have it some days so even at 9 months out there are little struggles that no one really talks about. As for the vitamins, if you want a capsule to swallow, I would check out the Twinlab multi capsules. They are a more complete Multivitamin for adults, and are recommended by several of the Vitamin gurus that I follow pretty religiously on OH. Click on the spreadsheet icon within this link. This is a comparison chart made by Jill on OH that lists all of the popular vitamins used by bariatric patients. I'm switching to the Twinlab multi and I order all my vitamins/supplements from vitacost.com You don't have to log in, or sign up to view it and save it. Just click on the spreadsheet chart, it'll pop up an excel document. Link for vitamin comparison: http://cid-afaf4604e9981bb6.skydrive.live.com/self.aspx/.Public/VitsComparison.xlsx I place a big order, and they charge a flat rate of $4.99 for shipping. Here's the link from vitacost.com for the Twinlab multi that is listed in the comparison chart. Twinlab Daily One Caps with Iron -- 60 Capsules - Vitacost $8.63 for a 30 day supply (I will take 2 of these capsules just like I take 2 of current chewable multi) On the agave, from what I've read it's on the "low glycemic index", but it's got 5grams of carbs per ounce so it's definitely better than other sweeteners if you can tolerate it, it is high heat processed just like the other sweeteners so it's not a raw or whole food. It's processed much the same as maple syrup from what I've read on it. In regaining your health, changing your eating habits, and switching gears mentally really helps. Once you're a few months out, making healthy choices gets more difficult because you are cleared for regular foods, temptation becomes stronger, and if you give in this early out, how are you going to manage those temptations once you are a few months out, and can eat that 1/2 container of ice cream? That was my biggest concern to be honest. It wasn't about just the physical weight loss. It was about completely changing my relationship with food, and my lifestyle had to be remolded. My mentality with food had to change, head hunger became a thing of the past, and I am in control. The sleeve makes it easier to avoid temptation, but if I wanted to, I can easily eat an entire can of Pringles, but I choose not to because honestly, why would I want to screw up all the hard work it took me to get where I'm at today. Seeing a nutritionist is a wonderful plan as long as they are familiar with Bariatric Eating, and your nutritional needs. I'm not sure which food stage you are on, but if it's mushes/purees, the enchilada isn't terrible, but there are plenty of mushies/purees and even soft solids out there that are better options.

Constipation can be a difficult problem after surgery. After several months after surgery I developed this complication. After trying several stool softeners that gave me no relief, I finally resorted to inserting a glycerin suppository up my rear end every three days. Obviously I did not want to make this fix a permanent thing. I stumbled onto a simple fix. I found that if I ate an apple before I retired for the night, I would have a good BM the next morning. The trick is that you must also eat the skin of the apple. This approach has worked for me for over a year. Constipation can be brought on by a lack of fluids, so make sure that you are meeting the requirements in this department. Other suggestions on past threads for this problem are: Smooth Move Herbal Tea Prune juice (warmed) Prunes (4 in the morning and 4 at night) Magnesium citrate Insoluble fibers (Garden of Life Raw Fiber or Renew Life Triple Fiber). Haribo sugar free Gummy Bears Aerobic Magnesium 07 Low Fat Bran Muffin (recipe). 80 calories each 1 cup flour 2 teaspoons baking powder ½ teaspoon baking soda ½ teaspoon cinnamon 2 cups bran Cereal 1 ¼ cups milk 1 egg ½ tablespoon applesauce optional: banana, berries, mini chocolate chips Bake 400° F for 22 minutes

@@bigtula That's how I felt with muscle milk, chalky! I am going to stick to making my own from the recipes I got from my bariatric team.