Search the Community

What's new for 2009 when it comes to pre-certification is for outpatient bariatric surgery: This applies to both Standard and Basic Option you can find out more by going to the website www.fepblue.org and downloading the 2009 brochure. You must now obtain prior approval for outpatient surgery for morbid obesity, outpatient surgical correction of congenital anomalies, and outpatient surgery needed to correct accidental injuries (see Definitions) to jaws, cheeks, lips, tongue, roof and floor of mouth. Previously, these types of services did not require prior approval. Like it's been mentioned here I would call BCBS Fed at the number on the back of your father's card for further clarification.

I have wondered about the "limit" thing. I have a friend that currently has lapband. She was trying for revision through her new insurance. She found out that they have a "1 per lifetime" limit on bariatric surgery even though THEY didn't have anything to do with the original surgery. It would seem to me that it would be cheaper on the insurance company to go ahead and cover the surgery rather than paying for the multitude of specialists that she would have to see to deal with the affects of obesity on her body. As for recovery, it is VERY similar to getting the band. I am on lifting restrictions for 4 weeks. I work at a pretty physical job so I am actually off work on short term disability for the entire time. I have heard of people going back to work soon after surgery (like less than a week). The hardest part, to me, is getting my fluids in. It is very easy to get dehydrated post op. I struggle to get in 5 cups of Water a day. I working on it, but it can be tough. I'm in contact with a few revisioners. They still VERY happy with their decision to revise. They inspire me daily. I will admit that it was their sucess that made me finally talk to my doctor about revising.

I received a lap band in 2009 (had complications with it and had to have it removed in 2010) and now getting a sleeve on the same date, July 9. I can tell you from experience, the pain is minimal. If you do experience discomfort, you will be given pain meds to minimize it. Gas pain is probably the biggest cause of discomfort from this type of procedure, although not as common as in years past. If you experience this type of discomfort (pain in your chest, shoulders, back, etc), walk as much as possible. This helps to disperse the gas. I can tell you that this surgery is a very safe, not only as a patient, but as a medical professional. I am a Surgical Technologist and can attest that this procedure is extremely common and safe. There a many abdominal procedures that use a laparoscopic approach and patients tolerate it well. Your experience will most likely be a good one. When you return home, you will have a new life to ahead of you. This is my third trip to the operating room (as a bariatric patient) and it's well worth it! I am so grateful to have this second chance. Good luck to you all and God Bless!

Congratulations on your weight loss and also for reaching out for help. It takes a lot of maturity to do so. I agree with what others have posted above. Do you know what your Protein goal is? If so, are you getting in all of your protein and Water every day? Getting enough protein and water will help you feel more satisfied. Keep a water bottle with you at all times so you don't get dehydrated. I think Snacks are fine as long as they are protein-based and that you plan for them. I too have found MyFitnessPal invaluable for tracking my protein, etc. I have worked for years with college students and have taught Freshman seminars. One thing I suggest as a student and as someone who has had WLS, is that you make sure you use a calendar. Use it to plan out your days and weeks. Include everything that requires your time and attention like: Classes Deadlines Study Time Homework Assignments Exams Exam Review Projects Project Milestones Commuting Time Meal times Snack times Exercise times sleep (make sure you schedule enough time to get some sleep!) Social Time Parties Football Games and other School Activities Club Activities/Meetings Church or Spiritual Practice Appointments Errands Laundry/chores (You probably get the picture.) The point I am making is that you need to plan ahead, especially as it relates to your food, water, exercise, and sleep. Learn to practice HALT. Don't let yourself get too Hungry, Angry, Lonely, or Tired. All of these can lead to grazing and bad food choices. You probably won't have time to get Bored -- another thing that leads to grazing and bad food choices. You may also want to see if you can find a local support group and a nutritionist who works with WLS patients. See if there is a Bariatric Center of Excellence near you and ask for a referral. Your school may or may not have a nutritionist on staff which might be an option for you but I would make sure whatever NUT you choose that you find one who has experience with WLS. Also, as someone mentioned above, don't be afraid to talk to your campus food service folks to make sure they have things available that work with your program. Fortunately, most college food services are extremely focused on providing healthy choices. Best of luck with school and with your continued success.

We had Sams and Costco but when it came time to renew, we kept Sams because they offer a military discount on their membership. They are both the same distance for us. I just got a Costco membership because I did the numbers and with the shakes alone, it will pay for itself in three months, with the price difference. I will pay for Costco and my husband will keep Sams. Sams Club has free shipping on orders of 99.00 or more.

Hi everyone!!! I’m new to this sight and need all the help I can get 😩. I’m Pre Surgical for Gastric Bypass, I’ve gone through every test known to man. I see my Bariatric Dr Aug 13th, hopefully I will get a date for my surgery. Feel free to comment, I would love advice!!

Appeal. Now. Blue Shield of CA H M O doesn't require six months any longer, and they haven't since July 31, 2015. You should never have been denied in the first place. So long as your surgeon and/or PCP documents your previous attempts to losewweight, that's good enough. Here is the link to Blue Shield's medical policies: https://www.blueshieldca.com/provider/authorizations/clinical-policies/medical-procedures/policy.sp You'll find the policy for bariatric surgery under "B". Your medical group or IPA may be unaware of the change, but they should have looked it up online before denying you. Blue Shield didn't do a good job of letting their groups know of the change. It delayed my process as well. It's your group that did the denial (Blue Shield contracts with them to process authorizations), but appeals are handled by Blue Shield directly. Good luck!

2B, I am in the same boat! I am looking at my 5 year anniversary and I am so disappointed in myself. I have gained back almost all I have lost. I too just lost motivation and all those bad habits came back. What finally lit a fire under me was a recent back x-ray I had taken because I hurt my back. The x-ray techs were all staring at the screen and I was getting a little nervous and wondering what they were seeing. The nurse came back, asked me if I had on any jewelry and I said no. She described what she was seeing and I knew immediately that my band showed up on the x-ray! They let me see it. It was amazing. I had never seen it before but there it is, plain as can be. Evidently not too many medical people in my area see a banded person. They didn't know what it was. Wish I had a copy of that x-ray; that would be real motivation. But it got me thinking again and I made an appt to go see my bariatric nurse to check out my band and fill level. I am ready to start again. I have had no support of others, I live alone and no one sees how much I eat. I am going to make frequent visits to this web site to find support here. I also advertised on Craigslist for anyone interested in a support group in my area but so far no takers. It's hard to do this alone. Hope you find support here and are able to get back on track. You deserve this!

If you don't get any more clear instructions on the pre-op liquids, here is the break-down of what is required from Loyola University Medical Center: 1) 4 1/2 cans of "High Protein" Slim Fast daily OR 2) 5 1/2 packets of "No Sugar Added " Carnation Instant Breakfast Drink with fat free or 1% milk daily. OR 3) 5 individual cartons of Atkins Advantage daily OR 4) 4 1/2 bottles of "Glucose Controlled" Boost daily. Notes: a) Each selection is approximately 800 calories and 60 grams of Protein. These instructions also allow Crystal Light, Water, decaf tea, sugar free gelatin and sugar free popsicles. c) Paragraph about diabetes: **If you have diabetes and are taking oral medications and/or insulin, you will want to discuss this with the doctor who manages your diabetes. You may also choose to use products that are NOT "low carbohydrate" versions. Make sure to monitor your blood sugars more closely as this is a very drastic change in your diet. Call your doctor if you experiencing high or low blood sugars. Caveat: My bariatric team is not your bariatric team, but you asked, so I put this out there as an example. It worked well for me, but your mileage may vary. Good luck with your surgery.

Set up appts with a PCP who so familiar with patients who have had bariatric surgery. I am sure there are good surgeons out there who do quality follow up, as many here on this site will attest too, but honestly, there are many surgeons who simply don't give a crap about you once the surgery is done. I saw my surgeon for about 5 minutes before my surgery. He stopped in my hospital room for about 5 minutes after surgery, and I have not seen or heard from him since! He did schedule a followup appt, but when I went it was a Nurse Practitioner who saw me. I guess that was ok, but I was very weak and struggling. She did blood work, but never followed up with me with the results. In two days after that visit I was in ER due to severe dehydration. She has never once followed up since. I basically have written off the surgeon and work with my PCP. If you have a PCP start going to him and forget the surgeon!

The psychologist that I went and saw wrote a summary to my surgeon about my visit. I had to take this MMP1 (something like that) 500 question true false exam. I marked true on a lot of questions such as I have low self esteem. This is due to my weight but you can't explain that. Now the letter is summarized with "I recommend bariatric surgery with reservation" and that he recommend that I see a psychologist. Do you think this will make me exempt from UHC's requirements?

I was sleeved on 08/31/16, and have had a relatively smooth recovery. A few bouts of constipation and fear that there wasn't enough of my stomach removed since I have not felt any restriction, but nonetheless, an uneventful time. I had my follow up appointment with my surgeon on Friday and he said a couple of things (which I now have in writing), that really bothered me. First, when I told him that I did not feel any restriction, he told me that "the staple line affects about 2/3 of the stomach and the remaining "untouched" part of the stomach, is about the size of a fist. 5-6 cm wide. In every single patient. Every time." Really? I never learned this in my Options class, in my Bariatric Support meetings, or just in general doing the research I did before having the surgery. I originally wanted the RNY, but because I have a huge hernia, my surgeon said the risks outweighed the benefits and he would only do the sleeve. I really have no complaints about the sleeve - I've already lost 36 pounds which is pretty significant, but I'm scared that I don't feel a restriction. I'm weighing and measuring all my food to ensure I don't over eat, but it's still a concern I have. I didn't get severely morbidly obese overnight, and I didn't take this surgery lightly. I'm so scared that when my hunger finally comes back, the lack of restriction is going to make it easy to overeat. I never want to overeat again. Second, I asked him what his goal weight is for me since it's something that was never discussed. He told me that he will be satisfied if I lose 50-70% of my excess body weight. He said that anything more than that is a "bonus." I told him that I wanted to lose 100% of my excess body weight and get to a normal BMI (50-70% doesn't even get me close to it). His excact words are, "Losing 100% of your excess body weight is unrealistic and not a healthy goal, mentally." I feel rather discouraged right now. I am very greatul that I had the surgery and for the ease of my healing, but I'm concerned now that I went into this with unrealistic expectations. I feel no restriction, apparently 1/3 of my stomach remains untouched, and apparently, a goal of losing 100% of my excess weight is unrealistic...Booo!!!!!!

I have United, they are a pain. Keep working on the insurance approval and follow exactly what they want. I started at 370, did my 6 months in which I was definitely expected to lose (modified South Beach Diet for 4 months then I ate like it was my last meal! I stayed at about 310 for last couple months.) My surgery was Dec. 10 lost about 37 since then, My goal is to be under my college weight of 227. I am at 269 this morning when I stepped on my home scale before getting dressed. United wants you to prove to them that you are serious about losing weight and that you will keep at it. They require you to go to Diet Dr. or equivalent every month. It was a great way to get used to bariatric foods. I found I could eat plain nonfat greek yogurt with Peanut Butter powder, fresh fruit, or even diet maple syrup mixed in. I learned how to eat 60 grams Protein a day and to follow a tight diet while walking a bunch. I was worried about losing too much, but that is unlikely. My Dr. told me that if I started losing too much she'd put me on a Golden Corral diet for awhile. I also think United wants people to re-consider if they are doing really well on their own diets and NOT get WLS.

Since my insurance specifically did not cover Bariatric surgery, I was a private pay and did not have to jump through the hoops like the supervised diet, the cardiac stress test, psych eval... that has been required by other people with insurance. Good luck @@SpeakerSpeaking

I crushed my pills for the first 6 weeks, then I was cleared to swallow pills. I even found a bariatric vitamin that I can swallow instead of chew.

Day 10 of pre-op diet and I am fully back on track. Over 11 lbs lost so far and I can definitely tell a difference in my body already. Specifically, my back fat seems to be melting away, lol! Weird, but I will take it. Made a trip to the grocery to stock up things I will need for after surgery, ie. soups, liquid Tylenol, sugar free jello and pudding. My surgeon does liquids only for 1 month post-op, so I'm going to have to get creative. Found a couple of good bariatric food blogs to get ideas from. Also, I made some creamy vegetable soup to freeze and have on hand starting next week. Can't believe the day is almost here!

Sounds to me you probably possibly can be dehydrated. Did you take enough protein/vitamins/food intakes that you are supposed to follow your instructions per Bariatric surgeon's orders? Sent from my iPhone using the BariatricPal App

@Danny Paul, I have Keystone Health Plan East right now, part of Independence Blue Cross of Philadelphia. We are self employed, so we have an individual plan through a broker. Our policy excludes all weight loss programs and bariatric procedures (except a $150/yr max gym reimbursement w/proof of attendance). We recently moved closer to Reading, PA, so we are in Berks County now, and apparently out of IBC's coverage area. So we had to switch plans during open enrollment anyway, but we were already considering it to try to find a plan to cover me for this. We found out that no matter if we get our plan through a broker, like we have been, or through the healthcare marketplace, that No individual or small business plans from any insurance provider in PA offers bariatric coverage anymore. So, we can't even pay extra to get the coverage. You can only get it if you work for a Co with 51+ employees - which I cannot work except for helping my husband with office stuff from home a few hours per week - and he is a 2nd generation painting/carpentry contractor doing this for 30 yrs, so him just getting another job is not an option. PLUS, it's not guaranteed the Co you work for has the ins plan that covers it either. The employer has to choose that coverage allowance when they choose the plan for their employees. PA is one of several states that doesn't require it. Also, you can get it covered usually via Medicare (not old enough yet unless I get SSI/SSD - have begun applying for SSD, but will likely take a few years if I do get approved and I'm not waiting that long to have the surgery...) And, it is covered by Medicaid, but we are above the income limits for that. We discussed so many scenarios for ways to get coverage (all surrounding states do cover it, so should I move to MD/DE/NJ for a year, rent a room, get ins there, and get it paid for? But in the end all of that what such a hassle and took me away from, well my family of course, but also my doctors and everything else. Just too much work. In the end, my husband said he was willing to take out a loan for it. I didn't even ask because I felt it was too much - but even though this is only one step in trying to help with all my many issues, he could see how it could be a catalyst for helping make everything else a little better. So he thinks it's worth it, which kind of blows me away. Obviously I think it's worth it, but always worry about my "issues" being such a burden on my family. Right now I am feeling really blessed by their support. So, let's just hope lots of people need their houses painted this winter so we don't have any slow spells and we can make our loan payments!! Sorry, I this is probably way more than you were asking...

Hey everyone! So I have started my diet which consists of 2-3 protein shakes a day. What brands of powder do you all suggest? My surgeons office recommends the brand that they sell at the office (bariatric fusion), but if I could buy it at the grocery store it would be much cheaper. Thanks!

https://www.endobariatric.com/weblog/2018/05/09/resleeving-revising-other-bariatric-surgeries/

Asking your provider (insurance provider?) or asking the hospital what their cash price is? These are 2 different things. My surgery billed at 38K but the insurance agreed rate was under 12K (what BCBSIL actually paid). A lot of hospitals in the US offer cash prices in the 11-12K range. http://kcbariatric.com/compare/ http://www.hoab.org/procedures/gastric-sleeve-st-louis-mo/ I believe someone who posted on here said blossom was 10K and that was in 2013. http://www.fox5vegas.com/story/27844392/blossom-bariatrics-at-the-forefront-of-low-cost-weight-loss-surgery Everyone has to make a choice that is comfortable for them. You don't really have to have long term care from your surgeon, you can do your follow up care with your primary. If cost is an issue, there are lots of avenues to explore. Depending on where you live in Illinois a BCBS single plan is going to cost you around $300-500 or more a month for one person (it varies by age and county). I think the lowest out of pocket max on a plan is $4500. So premiums and out of pocket are going to be 7500-9500 alone. Might as well cash pay, because you are basically cash paying at that point anyway. Unless you have your heart set on using Northwestern or University of Chicago, I don't see any other center in Illinois being worth the cost and hassle of insurance.

@@LMSWNYC Sounds like you have a insecure husband and due to his low self esteem and low confidence, he does not like the new you. Whatever happens, do not stop living a healthy lifestyle. As someone above mentioned, divorce isn't uncommon after bariatric surgery. Once you begin to lose weight, you start to gain confidence and realize your self worth. I had the gastric sleeve performed in December 2015. 3 weeks after my surgery, my husband and I separated and he blamed he surgery when in fact, he was the issue. I had not lost that much weight, as I was only 3 weeks out from surgery. A month later, I filed for a divorce. We were married for 7 years too long. When I married my ex husband 7 years ago, I was already overweight. I had no self esteem, no confidence. He on the other hand was not overweight, educated and said he wanted to marry me. I grabbed him by the coat tails because I didn't think anyone else would want me since I was overweight. Every year that we were married, I continued to gain weight because I was extremely unhappy and depressed in our marriage. His actions kept me on edge and I was thrown in competitions with women and his porn addiction. After I had my surgery, I sat down with him and asked him to change his ways or lose me forever. He refused to stop watching porn and also rejected me in the process, yet he insisted he loved me. I left home thinking he would change but he got worse. He ended up finding a mistress and slept with her the day after our wedding anniversary, which was this past January. Our divorce was just finalized in July 2016. I am pretty sure he hates the new me and I am ok with that lol. I suggest that you and your husband consider marriage counseling and I hope he is receptive. If he doesn't wish to go through with counseling and believe that you love him and only him, your situation will just go from bad to worse. I really wish you the best and I apologize for my long post lol. Feel free to reach out to me anytime and please keep us all posted. Congrats on your weight loss and keep up the good work no matter what!

Looks yummy, like a nice bariatric buffet! My scars from my band aren't too bad anymore, but that was over 11 years ago. The only one that is still really visible is the one where they put the port in, it's about 2 to 2.5 inches long and still somewhat purple. You won't have to deal with that though! Other than that, there's one other scar still noticeable, but it's flesh-colored, it just looks like a different texture than the rest of my skin. I didn't use any scar fading cream, but a lot of people have great success with them if that's something you are worried about 😃 Thanks for sharing!

Yeah, that's pretty much what I've understood about the NSAIDS too. Obviously, NSAIDS are generally hard on the stomach for anyone, not just bariatric surgery patients. But some people feel their situation is such that they must have some. I understand that some people have even chosen the sleeve over the RNY because for bypass patients NSAIDS are totally forbidden.

I agree on the bariatric advantage. In addition to lemon, they have raspberry that's pretty good. I take 4 a day. It really helps me with my snacking, because I take 2 about mid morning and 2 mid afternoon, when the munchies hit! They usually fill me up so I don't have room for snack food.