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Bariatric advantage meal replacement shakes mixed with my tears as I watch everyone eat a bunch of grilled meat.

Hi everyone! I was wondering if anyone had any info on bariatric (VSG) requirements with Prestige Insurance (Florida Medicaid)? I was told by member services that it is covered when medically necessary, but they wouldn’t tell me what the requirements were ie., length of time for supervised diet visits, specific BMI info, nutritional and psychic evaluations. I am scheduled for an informational session in Tampa in a week, but I can’t get any info from my insurance or perspective surgery center and it’s so frustrating. Also if you have any other FL Medicaid insurances and know the surgery requirements for them, pls let me know what they are, bc I’m still within the time frame to switch insurance plans. Any help would be much appreciated. Thanks!

It depends on your doc and your insurance company. They may both have specific requirements. Each doc is different. You already know you have sleep apnea so you'll likely have to go to a nutritionist so they can tell you your diet is bad. Then you'll have to go to a psychiatrist/psychologist so they can tell you that you have an eating disorder. Then you'll have to go to a bariatric surgeon so they can tell you that you are fat. Then perhaps a six month medically supervised diet. Some have to try to lose weight, others MUST lose a certain amount of weight such as 5% of your excess weight. As you can see, it is clearly money well spent.

Here are a couple of thing that may help you find a Dr. in your area. First, if you look in the upper right corner of your screen (on the blue bar) use the quick search bar and put in Kentucky Dr.s or Kentucky banders, anything having to do with your area or dr.s in your area. It will search Lapband Talk for you. I did a search for Kentucky Dr.s and here were the first 4 threads, they mention Drs in your area. http://www.lapbandtalk.com/f11/does-anyone-know-anything-about-dr-kaza-kentucky-50474/ http://www.lapbandtalk.com/f38/ohio-some-parts-kentucky-27091/ http://www.lapbandtalk.com/f18/lap-band-kentucky-49740/ http://www.lapbandtalk.com/f11/dr-argotee-paducah-kentucky-20706/ http://www.lapbandtalk.com/f38/just-saying-hi-ky-46661/ Then, write down the Dr.s names and search them on Tricare's online physician finder to see if they are in network. I would also, check the forum for local Kentucky people - they may be able to tell you. Your other option (scary one) is call Tricare and have them give you a list of Bariatric surgeons within 400 miles or so, they aren't much help, but you can try. Hopefully this will help narrow down your search. Like I said, you could fly to Houston, have the surgery with My Dr. for a 12 copay, stay the night in the hospital, then the surgeon will pay for your Hotel (not sure how many days) I am pretty sure this is pretty common practice, so it probably wouldn't matter who you went to as long as it was a Tricare surgeon, they would probably provide you with a Hotel. (I AM NOT PUSHING MY DR.) I can't stand when people do that on here, but you can look up his website and see how many days they pay for and such. Texas Laparoscopy Center

:confused2: Has anyone used the Bariatric Department at Cleveland Clinic? My doctor is recommending it, but I have heard that it takes them a long time to work through insurance? Anyone have somei nfo on that?

I don't understand why your doctor would say no more fills, when your band isn't even full. Every person requires different amounts of fill. Everyone's anatomy is different. Plus I've heard of some people finding the Green Zone and later as they lose weight, they lose their restriction as their anatomy changes their stomachs get smaller and so does the band, and then require an additional fill to get their restriction back. And I also know of a man here at bariatric pal that has the 14 cc band and he has 14 cc's in it. I'm only 4 months out and I had my second fill on November 8th and was at 7cc's in a 10 cc band, and I think I was at Green Zone, but I had to be unfilled 3 weeks later for surgery. Ten days out from surgery, my doctor put 6 cc's back into my band, and I will get another fill in a month. So time will truly tell if the 7cc's will keep me optimally restricted.

In feet usually Vitamin D or minerals: calcium, magnesium, potassium but usually for cramps like Charlie horse. Are you taking bariatric multivitamin? What is the doctor saying so far? What have they prescribed? No fractures? Both feet at the same time?

I work in a hospital on a bariatric floor and we require all abdominal surgery patients to wear them. not just bariatrics.

@@toasty I hate that there is a discrepancy among doctors when detailing post-op diet. Just like with pre-op dieting. Trying to filter through the information can be confusing, difficult and frustrating. I have known several people who didn't have a pureed food phase. They were given the okay to have deli meats (lean), flaky fish and even shredded chicken breast at two weeks post-op. In fact a couple of the girls I follow on Youtube talk about their diets the first 2-4 weeks and they talked about having grilled chicken and sliced deli meat with soft cheese spread. Ugh, I am so confused! On my sheet is specifically details that at days 8&9 I can have thinned cottage cheese, strained cream Soups, yogurt. Then starting on day ten I begin my Bariatric SOFT Protein diet. Then that is all my diet can consist of for almost three weeks before starting the Bariatric Regular Diet. Which would add fruits, vegetables to the already soft protein diet. Does any of this even make sense? Or am I just hungry?

Well I get the saliva and feeling I have to vomit. Same feeling I get when I have the stomach flu. When I over eat or don't chew, I have real pain. But eating too soon after vomiting always brings this feeling. As for the post above, I just want to add, you owe no one an explanation. If you are under the weather or feel like you are going to vomit in public all you have to say is "I think I have a bit of the flu coming on". It won't be the first time someone has been ill in public that does not have the band. As for me now, I haven't eaten for 4 days although I am able to get some bariatric drink down. I have known I am going to have dental surgery and I guess the stress has closed my band opening. Let us know Angie when you get a surgical date.

So, my surgery was approved, and I was scheduled to have my procedure on the 9th of April 2012. Well, yesterday I received a phone call stating that I'll have to bring $4500 in order to receive services. I was completely devastated. I literally cried myself to sleep. Throughout this entire process, the fact that I'd have to come out of pocket for anything but my remaining deductible ($1500) was never mentioned. I have United Healthcare, Choice Plus, and they've implemented a Bariatric Resource Service program that covers expenses associated with the surgery, yet I still have to come out of my pocket $3000 and it doesn't make sense why. I've tried calling for additional information, but my case manager and the representative at the surgeon's office didn't provide me with much insight. Is anyone else familiar with this plan, and how it operates? I felt so defeated yesterday, I was going to give up, but I can't, too much is riding on this surgery. Thanks for reading, Sandi

I've been stalled for about 6 months myself and I still get stuck. But, I know why I'm not losing weight. I eat the same amount of calories I burn off. So, no weight loss. Funny how that works eh? So, if you want it to work, consume fewer calories than you burn. Count your calories. If you don't have restriction or near the green zone, find out why? Talk to your bariatric WLS nutritionist too. They have great insight into how you can make this work. Like Missy said, it's not going to make you lose the lbs if you don't use it properly. tmf

So I guess this works as double duty - an introduction and a (kinda) question. I am a Registered Nurse...a very fat nurse! And I've been that was (fat, not a nurse ) for almost 13 years. I've done diet after diet. Acupuncture, moxibustion, hypnosis. HCG to the point I got gallstones. And each year, my weight just keeps climbing. I'm ashamed to say that the only significant weight loss I had was after I had met the love of my life, and then lost him...(but later found him...and my lost weight, grrrr!). I have stereotypical PCOS and Metabolic Syndrome (hello, black hairs on chin - I grow an impressive beard!), so that has exacerbated my weight issues. I started seriously looking into bariatric surgery 6 years ago, but didn't like the available choices of RNY, DS and then LapBand. Over the intervening years, I decided to try to get a LapBand anyways. I had one of those insurance companies that required a 6 month supervised diet, consults, etc...I jumped through all the hoops, found a surgeon I liked...and then he quit! Left private practice to accept a teaching fellowship. I was very bummed. So I figured this was my clue to try dieting again. So I went back to more failed, frustrating dieting. About this time, I was diagnosed with diabetes, which complicated matters even more. After nearly a year, I decided to go the LapBand route (again!). All my previous tests had expired, so I had to do the 6 months supervised diet and consults again...then got turned down by insurance due to an exclusion...the appealed and won!...set a surgery date and then got very, very ill. The chest xray that was done the week before my surgery showed a shadow in my lungs, so I had to see pulmonary, etc. Turned out to be nothing, but by then my precious "vacation" days from work were wasted and I had to go back. I felt ashamed and defeated, and just gave up on trying to lose weight altogether. Here it is, 2012, and I can now add hypertension, high cholesterol and tryglycerides and hypothyroid to my medical litany. And finally in January, I said....enough is enough. I'm going to make this happen! I'm 5'8, 310lbs....what would I advise a patient to do in my situation? So I called my insurance and found out that they do not cover bariatric surgery for any reason. ANY. I'm trying to not make any rough comments here, but it's terrible that I am an RN, I devote my life to the health of others, and my company has specifically excluded dietician visits for weight loss, weight loss plans and bariatrics....wtf?? But I digress. After realizing that I would get no help from insurance, deciding to self-pay was the least difficult choice. My darling husband (the aforementioned lost love who was later found ) had a RNY over 2 years ago with wonderful results, and has been very supportive. I've spent the last month researching my options, and have decided that Dr Aceves is worth my time and money. His track record and reviews have convinced me that Dr Aceves is the best choice for my new sleeve and new life. And here is where I come to the crossroads. My family is totally unsupportive of bariatrics in general, and Mexico as a whole, so I will not be telling them. The can comment ad-nauseum. I'm still pondering what to tell work - I work in a very tight-knit facility with only a handful of nurses, and my role is such that my absence for even 10 days will be sorely missed (when I fractured my foot in December and I was gone for 2 days, it was mass chaos!). I really, really don't want to tell my boss WHY I need a week and a half off, so I'm trying to figure out how to be creative. The problem I was NOT anticipating, was needing to find a new primary care physician. When I told my MD what my plans were, she began to tell me how I just needed some willpower, and that she could not support me going to some "back alley hack" in Mexico. She then implied that she would refuse to assist with my follow through care, and that if I did indeed go to Dr Aceves for a sleeve, I would need to find a new PCP. So I'm stuck on these two things - work and finding a PCP who will be ok with my having weight loss surgery out of country. Argh. I have not set a date for surgery yet...I keep thinking I need to try to get time off first and then try to make a date, but what if one's not open....? I can't afford to lose my job, too many bills! But I need to regain my health. Getting through every day at work is like running the gauntlet, in more ways than one. Anyways, sorry to ramble. I just want to add what an inspiration it has been to follow along with everyone's progress with their sleeves - I've been reading this forum for quite a while! Thank you so much for your help on my own journey -Asche, The Crazy Cat Lady

Totally forgot to mention that just because we aren't telling the world doesn't mean it's truly a secret. I'm very open and transparent amongst the bariatric community, so much so that i volunteer and mentor patients at my local bariatric surgery center. And i'm in 4 support groups online, trying to help others going through the process. I'm willing to help them in any way possible. I just get easily annoyed with random strangers asking me to many questions lol, when they have nothing positive to gain from it. So people know but it's who i chose to inform.

Are you taking an Iron supplement? I was sleeved 5 (maybe 6) weeks ago. A month after surgery I had no energy. Lack of energy (needing a nap) is one of the signs of iron deficiency. I was taking a Multivitamin that didn't have iron because the one with iron I couldn't keep down after surgery. I went and bought an iron supplement at GNC & it has made all the difference in the world. I haven't needed a nap since. Before, I HAD to take a nap! Also I make sure to take the Bariatric Advantage D & sublingual B12. All three are supposed to help with maintaining energy. Good Luck Teresa

An interesting read on why hair loss happens: https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/

WHOOP WHOOP!!! 4 years post op, I am finally getting the scale to move again and my regain is officially gone. I was doing some Keto type eating, but now I'm trying to cut back the fat so it's more like a 'bariatric' type eating, just a low carb, high protein thing. I had been losing nicely for a long time then the scale completely stopped. What I THINK was happening is that my body had adjusted to ketosis and I was probably taking in a little too much dietary fat so I wasn't burning my own fat. Now that I've tweaked it my regain has dropped off and I'm back 'on the move'!!!! Hoping for a good 7-10 lb loss over the next month before I have some medical testing

Crap, I wonder if Jill knows that the file is messed up. I'll shoot her a message on OH since she isn't a member here, and find out if she can repost or fix it. Centrum Complete with Iron Twinlab Daily with Iron Bariatric Advantage with Iron GNC Solotron Chewable with bioavailable iron (I take this one, and it was right up with the Centrum, and was pretty close to some of the others listed on the chart that were higher) I considered switching to the Twinlab multi with Iron but a few others said they were huge pills. Not my thing, so I've stuck with my Solotron with bio iron, and have never come up deficient in any of my labs. I did request to have my copper, zinc, and selenium ran this last time since Jill pointed out that my GNC vit doesn't have those, but my levels were normal as were all my Vit A, B, C, E and D, and D3. My vit b and b12 were perfect. So, I'm not going to fix something that's not broken. These are the top ones off the top of my head. I'll try to track Jill down on OH, and get the info back to y'all.

What part of Jersey North or South? I would find a doctor who take Medicaid instead. In Jersey there should be several. Check the major hospitals for their bariatric programs..

@@goodnuff my husband had a hernia repaired a few years before we had bariatric surgery. I did not like the way that Dr. put the mesh in and always thought that it was never "right" now as he has lost weight and been doing more sure enough the hernia has popped back through around the area of the mesh and he needs to have it done again! This time our bariatric Dr. will do the hernia repair, but they are right about restrictions for a few months after the repair work is done. It takes anywhere from 3-6 months for that area to heal. Doing heavy lifting and/or core work could cause the sutures to rupture and push the organs out again and re-create the hernia. When you have a hernia (you probably know this being a nurse) your organs (intestine) are being pushed out through and past a whole or weakness in the muscle. This can end up in necrosis of the organ, and it can lose oxygen and blood flow causing that area to die and cause a whole new host of serious issues. When the organs push through or around the mesh it is even worse as the mesh could actually puncture the organs. Have them take an x-ray, CT scan or sonogram to really check and make sure you are OK. My hubs is a fire fighter and was out of work for nearly 4 months from that umbilical hernia repair due to lifting restrictions. I wish you all the best!! Take care of you!!

I have UHC, but my employer has chosen a plan that excludes bariatric surgery. It all depends on what your employer has chosen.

well, I just looked at my benefits online and it doesn't look like it will cover it. *&&*^%$:regular_smile: My main benefits page says it is excluded, even for medical reasons. HOWEVER, there was another resource for United Heatlh Resources that provides some sort of assistance (not sure to what extent) with bariatric treatments. Anyone had any experience with this? Going to call my GP tomorrow and see what she says I should do.

Just joined the board and thought I would send a quick message on my experience with Tricare. I started the process on Feb. 21st with a referral to a bariatric surgical center from my PCM. Had my consultation appt. at the center on March 4th and was approved by Triwest 6 days later. Tricare really does get those approvals out quickly. I just had my surgery 4/18/08 and lost 17.4 pounds in the first week. I feel really fortunate that I was able to get approved and have surgery so quickly. Feel free to contact me if you have any questions about my experience and good luck.

One more week until our new lives! I hope everyone is doing well. This weekend I was a little nervous that I WASN'T nervous. I have this incredible peace and calmness about me. I am well prepared. I have an awesome surgeon and a great medical team. They have done a super job in educating, informing, motivating, and preparing me to change my life. After reading some many people's comments and threads on Bariatric Pal, I am so glad I chose Hanneman Hospital in Philadelphia! They will not let you get the surgery unless you truly understand all of the stages, the risks, what to expect, etc. Perhaps that is why I have this peacefulness surrounding me. I am SURE I won't feel the same this upcoming weekend! Stay focused everyone! We have worked hard so far. Let's do this right!

The Bariatric pal store has some crunchy protein snacks that are pretty good. There's one that's like sour cream and onion O's. Tastes really good and we're kind funyon like....I used to love those back in the day. Scratched that itch nicely.