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I used Dr Valenzuela through Mexico bariatric. My surgery was a month ago :-) went extremely smoothly. No complications. And the care was far better than I received up here in Canada :-) goodluck:-)

I am in the Liver Reduction portion of the plan, so I'm drinking 5 Protein shakes a day. What I do is buy Jello sugar free / Fat Free pudding mix flavors to mix it up some. I have Vanilla Bariatric Advantage shake mix, Water, then add a couple of ice cubes, then a teaspoon of the Jello mix (they have chocolate, lemon, butterscotch, cheesecake, white chocolate, etc). That little teaspoon really changes the flavor of the shake and keeps it from being so boring.....works for me at least!! Just be sure to buy the sugar free/ fat free version!

My team says bariatric vitamins only after surgery. I know a lot of people just take regular multi vitamins and are fine though, I guess it depends on what your body needs. With that being said, there are less expensive options of the bariatric vitamins than here though.

I'm almost 2 years post surgery and never hit my goal weight. I didn't have that much to lose, weight before surgery - 190, 5"4 but I only got down to 140. Covid has hit, I'm a bit blue and I'm up 15 pounds. I'm disgusted with myself. I'm going back to protein shakes in morning, any suggestions? I've continued to take bariatric multivitamins, do I need to continue for the rest of my life? What kind of protein do you eat on a daily basis? I can only eat so much chicken and eggs. I need some variety. I have no energy and probably down due to the pandemic. What are you doing to stay motivated? Thanks!

Klbs: I just started my Kaiser journey toward the lapband. Their process is somewhat lengthy. You PCP usually will have you do all the tests you need prior to getting the referral to the bariatric division. Next you get a card letting you know when your orientation is. I just had mine today in SSF. It is a 3.5 hr class explaining the steps to getting Bypass or banding and what the differences are as well as you new way of eating etc... They stated to expect the whole process to take about a year. In fact they told me not to expect my next apt for another 24 weeks!! Meanwhile I am supposed to lose as much weight as I can. For SSF its not 10% its individually tailored and I wont know what I'm supposed to lose for about 36 weeks.. The speaker said that our start weight will be the one we were referred with and everyone in the room will be expected to lose between 20-50lbs before they will be approved for the surgery. I know there are other threads that go into detail a little more on the Kaiser steps but thats my experience so far.

Okay, in the interest of full disclosure, I should tell you that my "skinny" jeans are 1x with an elastic/drawstring waist. At my heaviest, I would only admit to a size 2x, but honestly, even those were getting snug. When I lost my first 20 pounds, I tried on these 1x jeans and they were still uncomfortably tight in the thighs and caboose area. So, I've been reluctant to try on anything smaller in the past month. Even though I only lost 2 pounds in December, I've added pilates to my walking routine. When I tried on the "skinny" jeans today, not only did they slide easily over my hips, but I actually had to tighten the drawstring to keep them up! I guess my body has become smaller even though the scale hasn't reflected a dramatic loss. I was beginning to lose some of my enthusiasm recently, but this small NSV has given me renewed hope. Happy New Year Everybody!

Samantha, The difference is, this time that 16 lbs is forever. Obviously the other times you regained, or you wouldn't have landed in the waiting room of a bariatric surgeon!! 16 lbs. Wow. I llost 23 lbs before surgery. I reached goal in 5 months....losing the final 55, that averages out to 11 lbs per months. I think that is pretty damn awesome! Now I'm 14.5 lbs below goal and wearing a size 4 jeans! I never thought I was losing slow....maybe I was dense....had the bar set to low but the surgeon and everyone else was thrilled. I never once cheated, I treated this surgery like the most important diet of my life...I could continue to lose, it is a struggle to get in the 1200 calories per day that I need to maintain. I hope it's like this forever. 16 lbs the first month. That's amazing. Granted, when I went to WW, I could drop 20 in a month, way more than I lost with my sleeve....and I could re-gain it pretty fast as well. I did it three times, losing 50 at one point. Counting points works, but who the heck can do that forever??!!!

Hey everyone I just wanted to share that I had the gastric bypass one week ago today and so far so good! I think the preop diet really helped me to prepare for this. The surgery went very well and I didn't need much pain meds in the hospital. I made myself get up and walk and was released the next morning. I had bloating and gas as expected but not too bad. I really want to thank the Methodist Hospital Bariatric Program (Sacramento, CA) and my surgeon Ruby Gatschet for such a smooth process. I referred to my postop eating booklet once I got home and have lost 4lbs so far. I am looking forward to progressing in the booklet and changing my life to better my health.

I've been researching, and after speaking with my dad, i am now at a crossroads. I am seriously considering RNY but i'm still considering lap band. On a happier note: i went to my appointment and now have my overview class scheduled for May 8! My PCP is very positive and right behind me every step of the way. She said, "we'll get you through this process as quickly and painlessly as possible" I'm very happy she's with me. I also this I'm her first refferal to bariatrics as shes just as interested in the process as i am.

HI Everyone, :laugh: I am really really struggling...I am seriously having the fight the insurance co & my PCP blues. Pasted below is draft copy of a letter that I am working on to send to the insurance co. and maybe even the insurance consumer division. Although a really tight squeeze for now, I am working on Plan B. Dr. Alvarez in Mexico, 9750 for sleeve. Here struggling...having gained 18 pounds since September 15--all of my clothes are fitting way way way toooooo tightly! Bumming Here's my letter! I just dont know what to do.... Any insight is greatly appreciated! I am not sure if I should be outright saying I want to request an appeal or just asking for an update. Please review and give me your insight. Thanks! Group/ID Number: XOH842901948/H06800 Primary Care Physician: Dr. Derek Kelly Diagnosis: 278.01 Morbid Obesity Procedure: 99241 Office Consultation Referred For: Office Consultation Requested: 12/9/08 Denied: 12/9/08 Services Requested: Consult with Dr. Vitello for a Sleeve Gastrectomy Referral Authorization No. 23,562'Denied (Referral Denied'This is a request for an out of network non-contracted provider with Managed Health Care Associates Managed Health Care Associates 2740 W. Foster Avenue, Suite 411 Chicago, Il 60625 FAX: 773-271-0264 Illinois Department of Insurance Consumer Division 100 W. Randolph Street Suite 15-100 Chicago, IL 60601 Greetings I a writing to formally request an updated status of the referral decision rendered in December 2008. First of all, the services requested are inaccurate. Since October 2007, Dr. Derek Kelly has provided referral authorizations for me to see Dr. Vitello regarding lapband adjustment. From October 2007 until September 2008, I visited Dr. Vitello for lapband adjustments and presented with complications of my adjustments on a monthly basis. Resultingly, September 2008, I had to have emergency surgery to remove my lapband due to slippage. I followed up with post-operative care with Dr. Vitello, who then consulted with me regarding revisional bariatric surgery. In the interim, I informed Maria, of Dr. Kelly's office and contacted the BCBS of IL to be advised of my benefits coverage and protocol for seeking revisional surgery. At that time, I was advised of the criteria for coverage, which I meet now and did so at the time of request, and advised Maria of the same. She advised me to have Dr. Vitello submit the referral authorization and that she would handle the request, as she had handed the processing of all of my prior referral authorizations to Dr. Vitello. Upon mutual interest, Dr. Vitello petitioned for referral authorization for revisional bariatric surgery, vertical sleeve gastrectomy. My last follow up appointment with Dr. Vitello was October 31 and the referral authorization was submitted twice by Dr. Vitello's staff (University of Illinois at Chicago) before warranting a response by the Managed Care Group. This petition submitted in full disclosure, my operative and post-operative reports and medical necessity substantiating the need for the procedure. According to my insurance terms, bariatric surgery is a covered benefit as long as it is deemed medically necessary; this is furthered for revisional bariatric surgery with indication that as long as the first bariatric surgery was medically necessary, there is no waiting period for clearance for the authorization of a revisional surgery. Additionally, according to my policy's terms and conditions, I have been advised of the following: Repeat of a covered bariatric surgery may be eligible for coverage only when ALL of the following criteria are met: For the original procedure, patient met all of the screening criteria, including BMI requirements The patient has been compliant with a prescribed nutritional and exercise program following the original surgery Significant complications or technical failure (i.e., slippage, etc.) of the bariatric surgery has occurred that required take down or revision of the original procedure that could only be addressed surgically Patient is requesting reinstitution of an acceptable bariatric surgical modality. Dr. Vitello submitted his referral authorization to Dr. Derek Kelly indicating my request to reinstitute an acceptable bariatric surgical modality, vertical sleeve gastrectomy. On December 9, I received paperwork advising of a decision of denial for a consultation. It indicated the denial was based on the fact that the services are available in-network and the request was from a non-contracted provider. The basis of this claim request for out-of-network coverage is due to this surgical procedure being revisional bariatric surgery, which is an acceptable bariatric surgical modality. Secondly, the letter advised of an alternative for the non-approved service, to contact Dr. Kelly for a referral to an in-network specialist. On December 15, 2008, I met with Dr. Kelly in follow-up to the denial. Dr. Kelly advised that he needed to submit supplemental supportive documentation along with the referral for processing to secure an affirmative decision. Dr. Kelly then proceeded to review my operative report records from the surgery and reviewed my other health records in my medical file and interviewed me regarding my health status. Dr. Kelly indicated this procedure should take approximately 30 days maximum and to anticipate an affirmative response to proceed with revisional bariatric surgery and that I had his medical support in substantiating the medical need. I have been waiting since December 15, 2008 and to date am more frustrated now than ever. For the past 2.5 months, I have meticulously called Dr. Kelly's office regarding a status update. Maria, the administrative assistant, has provided several updates. The updates have included the fact that the previous medical director retired and was replaced and the new director was then on vacation, to the medical director making request for additional paperwork (which was submitted), to the medical director needing to meet with Dr. Kelly regarding the details of the approval process for this type of referral authorization, to the medical director and Dr. Kelly being unable to meet to further discuss the nature of my referral, to Brenda communicating that there was never a properly submitted referral from Dr. Kelley to the Managed Care group which resulted in the initial denial decision. In my first direct contact with Brenda Blazek, the Referral Coordinator who signed the referral denial letter, she claimed to know nothing regarding my case and further indicated that there was no documentation in my file. When I followed up with Maria with Dr. Kelley's office, she advised that Brenda did not find any information in my file because all of the information was being held by the medical director. Whatever the real case is, this is neither professional nor acceptable in accordance to my patient's rights under section 502(a) of ERISA. Just yesterday, I called and spoke with Maria five times to get an updated status, to exhaustedly be declined, yet promised an update by the end of the work day. I have not spoken with Maria, nor have I missed an update call from Maria. This has been my experience for the last 2.5 months. Below is an excerpt of the fax sent to Dr. Kelly, which was confirmed as received by Maria on February 5, 2009. Maria, I would like to reiterate that on 12/9 the referral authorization stated that the procedure, Vertical Sleeve Gastrectomy, is a covered benefit in-network; however my request was to have the procedure done by an out of network provider. Additionally, this was confirmed by Tammy on yesterday at 12:50 with Blue Cross Blue Shield that this is a covered medical benefit as long as it is deemed medically necessary. My appointment with Dr. Kelly in December was to have provided me with a specialist referral to have the procedure done or we could have executed an appeal. I think Dr. Kelly submitted an appeal for coverage of the procedure; however, I am requesting to have this surgical procedure done by Dr. Vitello or be advised of the in-network provider who can perform this surgical procedure. Even in accordance to the appeals process, the timeline has been elongated to address issue of medically necessity when that is not the matter'the issue is approval for out-of network coverage or referral to an in-network specialist. I hope this clarifies the situation more. I will call you tomorrow to see if you have an updated response. Additionally, I was contacted by the non-contracted provider's office as a follow-up to the request in January and February. Last week, I advised them of the insurance referral hassle that I have been experiencing and they formally resubmitted their request, directly to Dr. Kelly (attention Maria), to the medical director of the Managed Care Group and to Brenda Blazek. To date, no response has been received; however, they have confirmed receipt of such documentation. Resultingly, I am assuming that since the only official documentation I have received to date is the referral denial, then I am evoking my patient right to request an appeal, specifically an expedited appeal process. However, I am highly dismayed because Dr. Kelly advised that there would be no need to execute an appeal. I would like to seek clarity first on the status and if this is in order, I would like to request an activation of the appeals process and under separate cover I will or will have my attorney to handle the appeals process. Before escalating to that level, I am very much interest in seeking resolve immediately. If and when I need to activate an appeal, I am requesting an expedited appeal process because my health at this point is continually declining and it is therefore imminent and serves my best interest to not further jeopardize my quality of life by waiting for a decision. Since December, the following symptoms I have presented: my breathing has become labored and therefore results in extreme shortness of breath my severe obstructive sleep apnea condition has worsened (hypopnea with severe oxygen desaturation) my acid reflux has returned my amenorrhea has returned and I have again began experiencing tumultuous joint, knee and lower back pains __________________ Originally posted at www.lapbandtalk.com

I can tell you my experience: My highest weight was 235. I lost almost 20 pounds pre-op (on my own diet and my surgeon's pre-op diet). Surgery day I weighed 216. Month 1 I got up (finally) to almost 800 calories (was hitting closer to 500 most of that month). Months 2-4 I ate 800 cals/day on average. Months 5-6 (thanks to my bariatric PA's advice - who knows TONS of stuff about bariatric nutrition, more than my NUT, frankly) I gradually bumped up my cals to 1,000 cals/day. Months 7-8 I gradually raised my daily cals to 1,200. I hit my weight goal (150 pounds) 8.3 months post-op. In the last 2.7 months I've been trying to hit 1,750 calories/day -- the calorie budget that my PA, my NUT, my exercise consultant and I all independently determined would be a good maintenance diet for me. That's pretty hard to do, and as a result I've lost another 6 pounds. However, I think that finally at 144 pounds the 1,750 cals/day thing is working for me. I am sooo glad I didn't eat 800 calories for 8 months. There's no way to know for sure, but my feeling is that if I had eaten less during that time that my maintenance calorie budget would be lower than it is. I don't want to lose anymore. I am older (69 years old now) and look just fine. I also want to be able to bounce if I fall down. And I don't want to eat like a bird to maintain some fantasy 125 pound weight that's too light for me at my age. This has worked out really well for me. Everyone's mileage may differ considerably from mine, but that's my story.

What about checking with local hospitals to see if they have any bariatric surgery care? They may be able to do your fills or guide you to a source.

There are some great surgeons in Mexico, however you must be very careful when choosing one. For instance, stay away from the ones that still use the outdated 4cc bands. The 4cc bands are no longer used in the US due to their very high rate of complications, but many Mexican surgeons still use them because they can get them at a cheaper cost. Also, you need a bariatric surgeon locally to do your fills and manage your health. It's very important you find one before having surgery in Mexico because many American doctors won't touch a patient banded in Mexico so it's crucial you have one established ahead of time. Otherwise, you run the risk of coming home with a band no one to fill it or help you. Just my personal opinion, but I wouldn't go to Mexico for any form of Medical Tourism, including weight loss surgery. I just don't feel like your health is something to "shop around" for the best deal on. Best wishes.

Thank you all for your suggestions! I actually found out my employers insurance (which I don’t currently have now) covers Bariatric surgery! So my plan is to enroll in Nov & start my journey in January! Anything I can do prior to get me ready? For the weight loss program is that something you wait for and your dietician gives you or can you pick one and do that ahead of time? Appreciate it!

Since we are on the subject, what are some good bariatric vitamins to get online?. I am pre surgery and I take a good amount of vitamins every day and I am sure they won't be good for my new tummy post op. I appreciate any feedback on this subject. Annie

I use Upcal D (a powder you can mix into food), Calcet chews, and Bariatric Advantage chews. I also occasionally drop a couple of calcium citrate tablets into a fruity Protein shake (they don't dissolve as well in the milky shakes)

Hi Everyone, Happy Saturday  I'm in the process of ordering online. I'm really feeling Procare bariatric chewable one a days vitamins . Instead of advantages bariatric vit... Is there anyone with frist hand knowledge of this brand? How long should I wait before wearing compression waistband?

Does anyone know of surgeon in Alberta that does the sleeve surgery funded privately as opposed through healthcare. I am asking for a friend who doesn't want to go out of country (like I did) and doesn't qualify for it to be covered by healthcare here (BMI is not 40). Thanks for any help

I said I wouldn't weigh myself until the doctor's office and then yesterday, I was following a thread that said you are supposed to lose 20 lbs the first two weeks post op. Unlike some people, my doctor and Bariatric Center allowed me "full" liquids the first week (meaning milk-based products) and cottage cheese (which can be chewed). So, I was never on clear liquids post-surgery. My walking has consisted of using a tread mill a few times (at my neighbor's house) and real-world walking (shopping trips, etc). I haven't pushed myself harder because I DO FEEL IT when I am done on the tread mill or shopping. Overdid it grocery shopping. Didn't lift anything heavier than 10 1bs, but the stretching, bending, etc...It added up after an hour.

At 9 days out, I had to travel a little over 400 miles by car to attend nursing training. It was 10 hour training days, and I was on my feet for 6-8 hours per day for 3 days straight. I had paid the 4,000 non-refundable fee for the training long before I finished insurance requirements. Because of the surgeon's office screwing me around with a date, I had no choice. I won't lie, I felt lousy, but I drank a lot of carbs and full calorie Gatorade, and I was able to get through it. When I got back to the hotel every evening, I was knocked out until it was time to get up the next day. If it's new job orientation, and all you'll do is sit and listen, I think you'll be fine. Just make sure you're sipping the entire time, and go home and take naps everyday. Also, know in advance, the nearest hospital with a bariatric program, just in case you have complications. Good Luck!

They didnt take any blood or run labs. My bariatric doctor hasnt ran any blood work since pre-op. They gave me labs they want done and sent to them for my year check up. Luckily I have a great primary care dr and we have monitored things and other than my Vit D being a little low all labs have been great. I think my surgeon is a great surgeon and has a very very low complication rate and I am thankful for that but the follow up stinks!

Confusion can be caused by a variety of problems. This website lists 80 causes. https://www.healthline.com/symptom/confusion The ones I would focus on are numbers: 1, 7, 27, 28 and 62. #1 Hypoglycemia (low blood sugar). Many people develop a type of hypoglycemia after bariatric surgery called reactive hypoglycemia. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass This can also occur if you were diabetic prior to surgery and did not reduce your prescription medicine after surgery. #7 Low blood pressure. If you had high blood pressure prior to surgery and were taking prescription medicine for that condition. This may be an indicator that you may need to come off some of that medicine. # 27 Hypokalemia (low potassium levels). Make sure you are taking vitamin/mineral supplements for potassium. # 28 Hyponatremia (low blood sodium). Make sure you are getting enough electrolytes. # 62 Beriberi (B1 deficiency). I would also lump B12 deficiency into this one. After Gastric Sleeve surgery, my surgeon recommended 100 mg. Thiamine (vitamin B1) weekly and 500 to 1000 micrograms sublingual B12 weekly. While you were in the hospital, you were probably given a shot of B12 which is good for one month. Since you are 4 weeks post-op that is probably wearing off and you need to begin taking B12 weekly. I am not a doctor, so take everything I say with a grain of salt. But those are the areas I would explore.

Depends on your insurance requirements, as well as the bariatric program you choose. I just had my initial consult this Friday and found out my insurance does not require PCP clearance, but lots of plans do. Some bariatric programs may still require it even if it's not required by insurance. I also second suggestions to find a new PCP.

had a gastric sleeve a year ago tomorrow. Lost a bunch, put some back on. Starting to make the transition to plant based for my health mostly (reflux, diabetes, etc). I have read lots of good information and have seen Forks Over Knives, it was informative. My questions is on Supplements. Of course our bariatric doctors say Multi-Vitamin and Calcium supplement forever specifically for bariatric patient. Plant Based information says don't take any supplements. What do you all do? Trying to find a good middle ground. I'm on day 3 of my transition of trying to go plant based, what is your advice?

My surgery is approved and I am scheduled for November 22nd! I couldn't be happier! I thought I would share the news and my steps that it took to get here. While I only signed up on Bariatric Pal recently, I have read along to many of your stories since May. It's nice to hear the steps to the process and I know it helped me so here goes my process so far . My journey started on May 25th, my file was submitted to insurance on October 31st, I was approved by Cigna on November 4th, and my surgery is now scheduled for November 22nd. May 25th=Attended seminar, heard from the surgeon, and learned about the different types of bariatric surgery. June=Had my first appointment with the surgeon where we discussed my background, family history, and what type of surgery I was interested in. August 3rd=Psychologist visit where we discussed what type of support I have for the surgery, my background, and my feelings towards the surgery. August 3rd, September 2nd, & October 7th=Monthly dietitian visits. We would go over my food log for the month, any questions that I might have had, and discuss my progress. July, August, September, October=Monthly appointments with my primary doctor where we discussed what I am doing to lose weight. November 11th=Pre-surgery testing including an upper GI test, chest x-rays, EKG, and blood work. November 11th=Pre-surgery dietitian visit where we discussed what I will be eating post-surgery.