Search the Community

Hello everyone, I have decided to see a patient advocate at TrueResults in Phoenix to see if I am qualified for the gastric sleeve. I gave all my insurance information to them before my appointment (I have Highmark BCBS through my employer, Centene Corp). The patient advocate informed me that they verified my coverage and that I meet all the requirements for a bariatric surgery. However, my BMI is under 40 and I do have one of the co-morbidity mentioned in the insurance requirements which is HBP. My dilemma is that the patient advocate said that I am required to be on two blood pressure pills in order to qualify - which I am - but the customer service people at Highmark BCBS keep telling me that I need to be on three HBP pills in order to qualify (they even sent me a hard copy of the requirements). I don't know who is right and I don't want to start this journey and to find out that I am denied. Has anybody else experience something like this ? I would think that the insurance people at TrueResults have accurate information, but I doubt it right now. The customer service rep at Highmark gave me the requirements for Highmark BCBS in general, but I know every employer might override these general requirements. Please help ! Thank you. Isabella

Ok guys. I'm an ER nurse at a large hospital that is also a Bariatric Center of Excellence. I also have a sleeve. I can tell you that in all of our Bariatric education that we have to do as a BCE the sleeve was never mentioned. ER nurses have to know a little bit about everyone at every age, we cannot know everything. I have always asked my patients about their condition if I'm not familiar with it (I don't always have the time right then to look it up) but as soon as I get a chance I educated myself. For those of you the have the unfortunate experience of needing an ER just tell them you had a partial gastrectomy and everyone will know what you are talking about. It's relatively the same thing. Ok. Off my soapbox rant. Sorry. ????

I had a one month follow up visit with my NUT yesterday and she had me bring my Vitamins in. I had bought Caltrate chewable vitamins with Vitamin D and apparently didn't realize they were calcium carbonate instead of calcium citrate! I am having a difficult time finding reasonably priced chewable calcium citrate. My NUT said they must be chewable, and not gummies. I think I might try Bariatric Advantage 500 mg chewies, but they are so darn expensive!

Same with me. My surgeon has only a few sleeves. Most are gastric bypass and they didn't go to the one support group meeting I went to. All the written instructions and nutritional advice (and any other advice) was for bypass patients. It's like we are the red-headed step children of bariatric surgery. (Please no offense to redheads, you are beautiful) My gallbladder is full of stones, but I am asymptomatic. I was afraid of the ducts clogging so I agreed with the surgeon that it should stay. Six months out and no problems so far.

I'm 13 months post-op from sleeve and hiatal hernia repair. I'm seeking tips and hope to hear similar experience from those who are at least 12 months post-op, please. I had a visit to my bariatric office today for a routine follow-up visit. Today was the first time I felt negative about that visit, very stressed and struggling. The entire pre and post-op process has been slow and steady results (that's okay) and I've had a mostly positive experience, until recently. I think I'm in "the honeymoon is over" phase. For months my weight loss basically stopped, but I was only 15 lbs from goal and not upset to take a pause for a few months. During the weight loss "pause" my hair finally stopped falling out, my energy was getting better, and that enabled me to increase some activity. My clothes were still indicating that I was slowly shrinking, even if the scale didn't move much. I was fine! NOW, just in the past 2-3 weeks, I've experienced my first real weight re-gain, and additionally my clothes got a little tighter for the first time since I started this journey - about 5 lbs up. ( Just FYI, this isn't temporary hormonal/period stuff, I'm almost 58 and haven't had any of that for a long time. ;-D) Weight regain terrifies me!!!!! It's also depressing when you realize you have to live in a permanent state of serious dieting to make progress: Tracking everything daily, thinking about every bite, planning your life around dieting, etc. (fighting day in, day out). In most ways it's just like before going through this surgery..... Choose to live in a constant state of dieting and exercise, or else GAIN. *sigh* My sleeve restriction at this point isn't that much. If I let myself, I could eat a ton of food and I can see how easily and fast I could gain it all back. I fear this because I've had a lifetime of emotional eating issues. I could fail if I let myself. Has anyone else experienced this and felt this way at around the 1+ year mark? If you've been here and pushed through, what are your best tips that got you through this successfully? Thank you! xo

I'm 2+ years out (26 months since surgery), so take my words and utilize them as you wish. My weight loss phase was painfully slow. It took me 18 months to lose 100 pounds. Nonetheless, I maintain my weight loss without tracking, dieting, counting, measuring, or restricting. I weigh 118 pounds and maintain on 2000+ calories daily, although I don't really track it. I'm also hypothyroid and insulin-resistant, but daily exercise has kept my metabolic rate boosted. Here's the real deal...most of us weren't able to adhere to diets for the long haul prior to surgery, so why live like that after bariatric surgery? Dieting, counting calories, measuring food, tracking, and restricting intake are all aspects of the dieters' mentality that I refuse to partake in. I am not on a diet. I eat freely, but stick mainly to lean protein because it is difficult to overeat protein regardless of your lack of restriction. We can eat 25 slices of toast (2500 calories) and never feel any restriction, or eat 2 chicken breasts (275 calories) and feel stuffed. It's all about wise choices at this point in the game. My restriction has also lessened with the passage of time. I can eat 2 fast food double cheeseburgers in one sitting even though I choose not to. I can eat 2 extra large slices of pizza in one sitting even though I choose not to. The type of food we place in our mouths matters far more than the size of our sleeves or pouches. Sliders, a.k.a. slurry foods (crackers, pretzels, popcorn, chips, bread, cookies) are the root of most peoples' regain problems. These foods turn into a liquid slurry in our digestive systems and you'll never feel full, so you can eat unlimited quantities of them. If you eat sliders, tread carefully and don't fall off the cliff. You'll notice nobody ever says, "I am regaining after eating 100 grams of protein each day. I eat chicken thighs, steak, ground turkey, and hard-boiled eggs, but the weight gain won't stop." Protein has a high thermic effect; our bodies burn considerable calories digesting animal-based proteins. Many of those who regain started incorporating slider foods into their diets. Unfortunately, sliders promote rapid weight gain since they 'slide' past the stomach into the intestines where the calories are stored as fat. Good luck to you. Let me know if you have any specific questions.

My surgeon provided bariatric advantage as part of my program fee. I don't need them pre... only post for 2 weeks

Lets see if I got this correct: you do not have a fill at this time and you were unfilled due to swelling? From what I understand being totally unfilled is much the same as not being banded. If I were in your shoes it would be very easy for me to regain all that lost weight. Don't be down on yourself for that! I am a binge eater. I can always be good during day time, but then the monster is unleashed towards afternoon evening. I can't get full. I eat all the wrong foods because I get discouraged, knowing there is no control. An addiction that I felt powerless over. I know the eating is emotional, but there is a physical componant to it. That hunger, that obession with food, when will I eat again? What will I eat? Then the loathing myself when I overate. The fear that I was going to eventually die from this......I felt lost. So I had the surgery and after the initial restriction, I realized I was back to my old habits again. I had my surgery June 24th. I had 4 fills and honestly other then not being able to take big bites I felt little difference then I did pre-surgery. I got stuck once with chicken and so I was very careful to chew my food. I'm sure this helped me eat less, but NOT a lot less. I didn't have the totally unabashed cravings as in the past but fairly close and certainly was eating too much to loose weight. And I was trying, really trying. I wore my bodybugg, I decided to diet. Again good during the day and then night came and I would blow it. I will admit there was more control but still I was obsessed with food. I maintained my loss, but just. I would loose 5 lbs, binge eat (with the band and 4 fills) and gain the 5 lbs back. Then last Monday a miracle occured. I got my 5th fill. And walla, like magic, or rather for me a miracle I no longer have cravings. Its weird......I tell you weird. I am very emotional about this because I didn't think this was possible for me. I also had begun wondering if the band would do anything for me. Having fought food my entire life. For the absolute first time I do not think about food 24/7, I am not hungry. I eat for nutrition. I NEVER could understand people who could do this. My mind just did not work this way and I didn't think it was possible. I am eating 3 SMALL meals a day w/o snacks and feeling happy and satisfied. I have no desire to binge. I do not feel hungry. Strange for me, exhilerating and for the first time in 10 years I have hope of being healthy and "normal". HOPE is a big thing when you have lost it. Please don't give up. Call your bariatric team. They will know what to say to you. Do you have a support group? If you do go to the meetings. Find a mentor. I hope this helped. 2 weeks ago I felt much like you described. I knew I was on my way to regaining all of my weight. Today I'm buzzing with excitment for my future......there is a joy that is hard to describe. I have control over this hideous monstor. You will get there! :thumbup:

you go to the main site, aetna.com, then in the "search" field you type in "bariatric surgery" - otherwise it wont come up or you have to search through pages of crap.

Hi 3boyzmom, I have read a couple of places that BCBS is one of the easier places to get approved but each state and plan is different. I started my process last June by asking my pcp if I was a candidate for a LapBand. She said yes and gave me a referral. I had to attend a seminar first and in the mean time I check my insurance qualifications. It required a 6 month physician supervised diet and exercise. Needless to say, I didn't get my appointment with the bariatric surgeon until February. By that time I was just under 40 BMI and the doctor said I might not qualify. I was so upset. A few weeks later I was called to tell me I was approved. Due to a work conflict, I was unable to schedule my surgery until 5/6. The past four weeks have been the hardest. Good luck to you and I hope everything goes smoothly!

Every program out there has different rules. Sounds like yours is exactly like mine. I move to mushies at 4 weeks. Until then nothing but full liquid. So far it's not horrible but I'm getting a little tired of the same things over and over. I don't like sweets or chocolate so all of the drinks turn my stomach. After 1 week home and repeating the same stuff over and over, ....yawn....... I really think this is the most cautious route. We were told that 90% of the healing happens in the first 25 days (or something to that effect) so that's the logic of keeping it Fluid. I don't mind the stricter plan but I think it would be fantastic if some company came out with pre-made bariatric canned soups boosted with Protein and pre-strained. Not that I'm lazy..........

Hi everyone, I'm Tanya. I live in Northern California with my husband and my two daughters. I'm 35 years old and I have been overweight all of my life. I weighed 320lbs on 5/13 when I had my weight check with my local Kaiser doctor and this morning it was 304lbs. I have been wanting weight loss surgery for years but I didn't realized it was a covered benefit of my insurance until April of this year. I have lost weight in the past, a couple times I lost 80lbs but it always comes back. If I lose 80lbs, I still weigh 240lbs and still have 100lbs to lose! It's so overwhelming and I seem to hit a wall at 240 and can't get under it, so I give up. I attended orientation at Kaiser Richmond's Bariatric Surgery Program on 6/14 and have been on the pre-op plan since 6/15. So far the hardest for me has been no gum, no drinking with meals and no snacking! I have been really good and haven't cheated yet and the weight is falling off. I'm also walking 60 minutes a day and today I'm also going to try a bike ride, I hope I don't pop the tires! Our local program does either the sleeve or gastric bypass, they say the lap band is becoming obsolete and don't even do it anymore. I chose the sleeve because I liked the idea of the order of digestion staying the same and liked that it is a restrictive surgery and not a malabsorbsion surgery. So far I have gotten tons of encouragement just by reading all of the posts on the forums. I'm looking forward to getting to know more of you better and sharing my journey with you every step of the way! I have an appointment with my surgeon, Albert Im, on July 14. I hope to be down to the weight he recommends at my appointment so I can get a surgery date!

Hello Sunset21May, It took about 6 weeks after my PCP refered me to the surgeon, after I did get to talk to the MD, he refered me to the Nutritionist and the Psychololgist for an eval and counceling. After that, it actually went pretty quick. I was already for my primary care at Kings Daughters, Temple and they also just started with the Lap-band. You also have a choice of going to Scott and White for bariatric surgery. I am very comfortable with Dr S. and his staff. For me it was the best thing ever! If you have any questions just ask ! Greetings Lulu66

There is a type of low blood sugar problem that can occur after gastric bypass surgery. It is called reactive hypoglycemia. Here is a link to the condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass Generally this problem begins to occur several months after surgery. Since you are only a week after surgery, I suspect this is not the cause. These are the symptoms of hypoglycemia: An irregular heart rhythm * Fatigue * Pale skin * Shakiness * Anxiety * Sweating * Hunger * Irritability * Tingling sensation around the mouth * Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: * Confusion, abnormal behavior or both, such as the inability to complete routine tasks * Visual disturbances, such as blurred vision * Seizures * Loss of consciousness If you were diabetic and taking medication for the condition, the medication might be driving your body into hypoglycemia. If so this is a sign that you need to cut back on the diabetic medicine. But if you were diabetic then you probably have a glucose meter and could test to see if your hypothesis (low blood sugar) is a correct one.

Thanks, Pearldrop! I'll start preparing my bariatric-friendly appetizers!

Wow, that's high! Is your clinic requiring you to take it as a sleeve patient? I've been fine taking a regular sublingual B-12 supplement. Most of the bariatric multivitamins have a lot of extra B vitamins. I use a multi plus the additional sublingual B-12.

Thank you Dave. You are very knowledgable with actual scientific fact and not "goggled" so called "facts". You are also post op (as am I almost 9 years) which makes your posts of more value for actual life after Bariatric surgery.

Maybe you should consider finding another nutritionist. I have prepared to bariatric surgery three times, including this time -- I am definitely doing it this time, just have a couple insurance hoops and I jump thru the last hoop on Nov 7 and then I'll get a surgery date. But I have been to lots of nutrition classes -- required by the different surgery centers -- and met many nutritionists -- and this is the first time I heard a nutritionist tell a newly post op not to use Protein shakes. I suspesct that it a bias of your nutritionist and not a science-based piece of advice. Like DLCoggin said: you need protein and this post op period doesn't last forever. There is a wide range in quality of Protein powder and shakes. My goodness, I don't think I could get enough protein in my egg-size stomach post-op if I had to eat only eggs, meat, fish. Some proteinpowders are loaded with bad chemicals, poor sugars or sugar substitutes and many are against all protein powder. I use 100% organic usda certified whole whey protein and you can add to the natural flavor to anything and get in a lot of protein with every swallow. 100% whole whey protein organic is good for everyone. And the post op phase doesn't last. In Seattle and now in East Bay of San Francisco Bay area, every bariatric medical person I have talked to says only liquids for first couple weeks -- how the heck can you get any protein in if you are on all liquid? I expect I will want to stay on Liquid Protein longer than they advise because I will be anxious about how my stomach will handle real food. Your nutritionist has good intentions but it seems to me she has a bias about protein supplements. At least ask her for her philosophy or ask your doc. And if you are suicidal, as others have said, get some help. And hang in. It gets better. I know it because everything always does.

I'm so sorry your dr. Made u feel this way!!!! Gaining 10lbs from April to June isn't horrible!!!don't beat up yourself about it... You are Human and things happen... Besides this time next week you'll be embarking on the new you so try to focus on that... Try your very best not to let anything or anyone bring you down!!! I'm sending positive vibes your way!!!! Good luck!!! Your bariatric family has your back!!!!

Sleeve surgery..... my bmi is over 40 and I have hypertension. I've met all requirements and done everything they've asked. Now they want documentation that my obesity is not endocrine related and want my mild reflux treated..... which is weird cuz it's not bad enough to need treatment.... I'm waiting for my bariatric office to call me back with the next steps. I'm about to file a complaint with the state commissioner because this is a covered service and they are denying me for irrelevant reasons. Insurance is the most frustrating thing. Why I pay thousands of dollars a year for them to deny coverage over and over again.

@@10stackzz You are right about the mind being so important. I believe that having bariatric surgery is 10% about the surgery and 90% about the head games regardless of which surgery you choose. I don't think it is a quick fix though.... at least not for me.

Yes, I also went to Mexico. I had my primary do my EKG, labs, dvt testing, and I work for gastroenterologist and had an endoscopy as well. My dr is now my post op Bariatric dr. He is wonderful. I have had the worst reflux and indigestion and am now on two meds. I hear it's suppose to resolve after 6 months! If your surgeon is in mexico I still highly recommend you obtain a gastroenterologist locally where you live. There is alot they can help with.

Stalls happens to nearly everyone. Personally I suspect that the people who do not hit stalls also find valuable antiques at garage sales, win free cruises and never get traffic tickets. I stalled from week 3-7 (but did not know because I did not weigh myself except at the doctor), then I suspect I stalled multiple times after that too. I still made it to where I needed to be. Bariatric teams usually stress the importance of hydration over food at this point post surgery. There is usually more concern from the complications of dehydration vs low calorie intake - we are trying to use the excess stored fat after all. Ask your team if it is okay to only eat the amount you are comfortable with and at the frequency that works for you. The extended eating time frame is usually for when we start solids. Most of the time If we hold up our end of the bargain (mentally), our bodies will do the same. It will all come together eventually and life after WLS will not always feel like a chore. Good Luck!

Well, I'm not sure where to start. I have been lurking for quite some time and now I am coming out of the shadows. I have known for over a year that I wanted WLS but never thought I would be able to do it. I thought I would be miserable for the rest of my life. I am at my highest lifetime weight and it is seriously impacting my quality of life. I can't walk for more than 5 minutes without my back screaming at me. My knees are constantly aching as is my left hip. I have a 2-year old daughter that I want to play with and take on walks, and I feel like I am only partly in the game. A dear friend of mine lost her mother earlier this year. After the funeral she sat me down and said that she had all these regrets for what could have been in her life and that I don't need to waste one more minute being unhappy. So I got off my keester and started making things happen. I am the HR Manager at my company, so I know quite well what is covered and not covered. We use BCBS of GA and our policy does not provide for WLS. I also have Tricare but that will be going away here shortly. I just finalized my divorce. Knowing all this helps a lot, because I decided I will have to do self-pay. There is a bariatric program (Center of Excellence) in my city, but I am not comfortable with it. I have been admitted to the hospital for several different things in the past so I know the level of care to expect. It stinks like hot garbage. So after a lot of research, I want to go with Dr. Aceves. For a lot of the reasons that have been listed before in the forums and the research I have done online, I feel like this is the place for me. I pressed the "contact me" button on his website and now I'm waiting to start my journey. I am a bundle of questions and most of them it seems everyone else has already had. I am a single mother but a dear friend has volunteered to stay with my daughter while I am "out of town". She is the only person that I am willing to tell about all this. She supports me regardless. My parents do not. Other people put a lot of fear in me by asking "what about your daughter? you are being reckless because something could happen to you." My thought behind that is that something could happen to me right now. I am already functioning well below capacity so I need to make things better. I have no intention of telling my job what I am doing. I will tell them that I need time off for "a personal surgery". I am hoping I will be able to go back to work when I return from Mexicali. This has gotten quite long so I will close it out and hope that everything goes well.