Search the Community

Do they have a special unit dedicated to bariatric surgery?

I have Medica which is adminsitrated by United Healthcare, In fact the bariatric policy is United Healthcare's policy and Gastric sleeve is covered by UHC. No longer considered investigational. Ask to see a copy of their current policy, Do not take their word for it! I was originally told that the Sleeve was investigational and not covered. I pointed out the policy has been revised and offered to send them a copy of the one I found on their website. They were looking at an out of date policy!

I know I've posted a million times about Kaiser...but the person I'm technically a 'dependent' under wants to shop around more.... I know Aetna excludes Bariatric Surgery on their Individual plans, does BCBS, United, Cigna or Humana?

Well our company is nationwide and a co worker of mine just found out today that Anthem BCBS no longer covers it. I had originally called to inquire about PS. Then the lady said we dont cover that ( the bariatric surgery ) so they wouldnt cover the PS. I told her well I had it a year ago , apparently they changed their rules in January. They no longer cover it. I feel so bad for her, its the only thing she has had to look forward too. So I guess it doesnt matter what the company size. I was lucky I got in before it changed, but for those who are having issues. Many insurance companies have been sucessfully sued for weight discrimination. You might want to research just to have your own ammo. I do know zerox was one that got nailed for it.

Surgery is June 3rd! My dietitian said gummies do not have Iron. I used to take them. She said after surgery Flintstones chewables are fine 1 week after surgery. I also will be taking b12 sublingual (they dissolve) and citrical chewables. I tried the bariatric Vitamins and they made me nauseated.

My office set me up with Nascobal (B12 nasal doses) and their bariactiv vitamins. It's submitted through your insurance and you pay $25 or less a month. It was designed specifically for Bariatric patients. I have been taking them pre surgery and I really like them (all chewable/dissolvable). They were also really quick and helpful setting it up through my insurance. A lot cheaper than buying new each month.

Bariatric advantage on line it has everything you need in one chewable tab .

My Dr and RD have always suggested that most proteins come from food, and most of mine do with the exception of breakfast as I cannot eat eggs which is a great source of protein. Prior to my surgery I was a frappachino-holoic and found that I LOVED the believe cappuccino (bariatric eating site). They are a bit pricey as well as the s&h, but they helped me get over my frapp addiction and it was a taste I got use to. Best of luck to you.

Since I don't know and am not sure, I'd ask that you speak to your dr., nutritionist, bariatric consultant or someone in the medical field to be certain on those guidelines and when you can go beyond 4 oz.s. There are guidelines to follow to help you make a lifestyle change. And you can stretch your sleeve out. I'm not sure how leaks happen, what all causes each of them, but I had one and believe me ---- I'd rather make an extra call to pester my dr. or his office or a medical professional than wish a leak or it's effects on anyone else.

Can you say yum??? Ordered Bari wise hot chocolate from bariatric choice and it is delish, about 80cal no fat less than 5gm carbs and 15grams protein!! I miss my coffee and hot chocolate this time of year and this really hits the spot!! I purchased a few of the variety packs (about $11) for 7 and love the mint and raspberry chocolate trying the amaretto and its yummy too!

Yes, the scale can be your worst enemy. The only weight I hold myself accountable to is my PCP's and my bariatric surgeon. I get weighed once a month on my surgeon's scale and that's the number that counts. I will occasionally weigh myself at home but weight don't count. It becomes a frustrating obsession if you keep weighing yourself constantly.

You have only had one fill and sometimes it can take a lot more before you get the sign to stop eating. I know someone personally who had his band completely unfilled because he was going on a cruise and he wanted to binge eat on everything. After the cruise he decided not to get re-filled because he liked his food too much. What was his point in getting the band if food was more important than a weight loss? What's my point in saying this? You probably will need a couple more fills before you feel like there is a stop point. With binge eating there is no stop point. You had this surgery for a reason, it is not a lose weight fast scheme. It takes time for the body to adjust. My friend who had his band unfilled has gained all his weight back plus more! Do you really want that? If you stick with it and choose healthy eating the binge eating will take a back burner to healthy eating habits. There are times when I feel like I could eat the whole world. I choose not to. I didn't have major surgery just to see it all come back. If you feel you must talk to a psychologist and by all means let your bariatric surgeon know. By the way, you can still go on a cruise and lose weight. I've done it and lost 10 lbs on a cruise. I did not deprive myself of anything. I just ate smaller portions. I know you can do this. It just takes time, perseverance and a lot of determination. Good luck and I know you can do this!

I had my conversion surgery from band to sleeve on june first, i had it done in the Dominican republic because my company excluded bariatric from my policy. i was so scare and even felt regrets the day after surgery. Six week later those regrets are way off my mind, I have never felt better. I've lost 30lbs and I'm static My Self-esteem over the top, as supposed to six weeks earlier I wouldn't look my self in the mirror and today I'm jumping for joy. I've had my my ups and down, when my weight loss stalled I thought I failed, coming to this site has been a blessing. Can't wait so reach my goal weight, only 47lbs to go and I made a promise to myself to not drive my self crazy and enjoy the journey. Any other June first sleever. Share your story

I think the thing that makes me look at vitamins differently is my two pregnancies. I had bad levels my first one and was so constipated (tmi) from iron supplements I started having contractions.. my second pregnancy I took one that was food based and noticed a dramatic difference. The main difference is vitamins and minerals that are manufactured vs made in nature. And the prenatals are cheaper than the bariatric vitamins my Dr recommend. But any vitamin is better than no vitamin. My mom had bypass 5 years ago and hasn't taken anything in a year and is now dealing with iron infusions and b 12 shots :/

I know somebody that had by-pass. He lost almost 200 pounds in a little over a year. 3 Years after that he had gained it all back thanks to Budweiser. The surgery may work for you but need to look at cutting back a little more on the alcohol. It's empty calories. All carbs and sugar. I binge every few weeks or so but not on a regular basis. Another thing to keep in mind is that alcohol causes the loss of inhibitions and if you get a good buzz on you may decide to hit the buffet. I'd definitely discuss it with a bariatric surgeon and nutritionist.

I tend to defer to my NUT, she was with me in the 4 months prior to the surgery and is now my contact after. I also will continue to take classes and go to support groups post-op to continue to be motivated. I am big on doing my own research too, so that is why I come here and other bariatric message boards for more knowledge and experiences. I don't see my surgeon (or his office) again for a year. I am with Kaiser who is big on health education.

The Latest on Nutrition and hair Loss in the Bariatric Patient by Jacqueline Jacques, ND Nutrition and Hair Loss A common fear and complaint of bariatric surgery patients is postoperative hair loss. While for most of us as people, our hair is important as part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like the brain and heart and away from hair. Hair loss has many causes. The most common type of hair loss after weight loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states: anagen, a growth phase, and telogen, a dormant or resting stage. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase,which lasts for approximately 100 to 120 days. Following this, the hair will fall out. Typically, about 90 percent of hairs are anagen and 10 percent are telogen at any give time—meaning that we are usually losing a lot less hair than we are growing, so the hair loss is not noticeable. But sometimes this can change. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include the following: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end-stage liver disease), hormonal disruption (such as pregnancy, childbirth, or discontinuation of estrogen therapy), acute weight loss, crash dieting, anorexia, low Protein intake, Iron or zinc deficiency, heavy metal toxicity, and some medications (such as beta-blockers, anticoagulants, retinoids, and immunizations). Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss will rarely last for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One should be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if any of the following occurred: 1. Hair loss continued more than one year after surgery 2. Hair loss started more than six months after surgery 3. Patient has had difficulty eating and/or has not complied with supplementation 4. Patient has demonstrated low values of ferritin, zinc, or protein 5. Patient has had more rapid than expected weight loss 6. Other symptoms of deficiency are present. Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40mg/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemic, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after biliopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high-dose zinc supplementation as a therapeutic agent for related hair loss2 in patients who had undergone vertical banded gastroplasty. The study administered 200mg of zinc sulfate (45mg elemental zinc) three times daily to postoperative patients with hair loss. This was in addition to the Multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus, we cannot definitively say that zinc would prevent hair loss after weight loss surgery, and further study would definitely be needed to make this connection. A further note: The tolerable upper intake level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60mg/day. Information related to this study has made its way to many a support group and chat room—even to doctor’s offices—with the message that “high-dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high-dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen, or prealbumen.3 Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk.4 With surgical reduction of the stomach, hydrochloric acid,5 pepsinogen, and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion rather than malabsorption is responsible for many cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2g of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Biotin Many individuals believe that supplementing with, or topically applying, the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include Vitamin A, inositol, folate, B6, and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS), and is influenced by genetics. Conclusions Hair loss can be distressing to bariatric surgery patients, and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. References 1. Rushton DH. Clin Exp Dermatol. 2002;27(5):396–404. 2. Neve H, Bhatti W, Soulsby C, et al. Reversal of hair loss following vertical gastroplasty when treated with zinc sulphate. Obes Surg. 199;6(1):63–65. 3. Updegraff TA, Neufeld NJ. Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc. 1981;78(2):135–140. 4. Segal A, Kinoshita Kussunoki D, Larino MA. Postsurgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg. 2004;14(3):353–360. 5. Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity.Dig Dis Sci. 1994;39(2):315–20. 6. Moize V, Geliebter A, Gluck ME, et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):23–28. 7. Mock DM. Biotin. In: Shils M, Olson JA, Shike M, Ross AC, eds. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:459–466.

To Hawaiian Chick... My email didn't go through, so will just post to you here. My surgeon is in Mitchell, which is about 60 miles form Sioux Falls. His name is Dr. Andrew Reynolds and his collegue is Dr. Michael Haley. They are in a Bariatric Clinic together. In Sioux Falls, I know there is a Dr. Thaemert and a Dr. Strand, but I really know nothing about them as surgeons.

Every insurance company has different requirements. The best advice I can give you is to call your insurance company, find out what exactly they require and what the total amount is covered. If they absolutely do not cover bariatric surgery, then your only options are to pay for it out of pocket or switch health insurances to one who does cover it.

Did you also see your PCP once per month or just the dietician? My bariatric center gave me a form that my PCP had to fill out every month. Plus, I had my PCP scan my food log into my medical record every month. I was approved after six months, but I had 3 comorbidities (HBP, cholesterol & sleep apnea) & a so maybe it had nothing to do with the medical record? And I didn't have BCBS but I dunno...I thought I'd throw it out there... just trying to help? So sorry! /P2P

JUSTIFY ME ---to---> MOLLIFY ME---to---> ADVISE ME GENTLY---to---> GIVE ME **REAL** FEEDBACK---to---> KICK MY ASS IF NEED BE This would be a cool tool. But as co-laborers in helping one another succeed, you need a deep tool kit and have the discernment to know which tools to use and where to use them (almost always privately): For some, listening ears and a gentle word in the moment of weakness (Proverbs 25:11; 25:20). Others, a sharing in weakness, doubt and failure; and the hope of renewal (Proverbs 15:2; 19:11). Certain others, the hard face and stern challenge (Proverbs 27:17). Occasionally, reprimand or reproach (Proverbs 9:8,17:10). For each of these, your goal is restoration of the person and, as quickly as possible, a continuation of the work. However, when necessary, you must separate and terminate (Proverbs 14:7). These are tools of leadership and healing; like a doctor’s tools, they should be used for the good of the others always, the patient if possible and never for yourself. Never. I have reaped the bitter fruit of my own failure to heed this last point many times.

Fortunately, I haven't met any of those kinds of doctors. I had surgery in Mexico, and have had excellent "regular priced" followup care from my PCP and gastroenterologist. And really, the only surgery related followup I've needed in the last year is bloodwork...don't need a bariatric specialist for that. The gastro got involved over a non-surgical issue, and he could care less if I had surgery in Mexico. In fact, he supported my choice of getting WLS despite it not being covered by my insurance. He said it was obvious my surgeon knew what he was doing and was impressed with the results.

Wow... This is a problem unique to banding: mainstream medical professionals haven't a clue when it comes to our situation. Our bariatric caregivers are generally not available for emergencies, sinçe many of us live far away from them and their office hours/days can be limited. What people don't understand is that when an organ is cut off from its blood supply, there is very little time to figure out what the problem is before the organ dies. Did you have a hiatal hernia? This sounds like you did....but I'm only guessing.

Agree 100%. I called my insurance to ask if I was covered, and they provided the full coverage policy for gastric sleeve. This helped a ton! When my bariatric place did the initial check on the insurance they said that I was not covered and would have to be self pay. I told them that I had already checked with my insurance and that they should try again. Come to find out I was covered and the person she spoke to thought she was checking on plastic surgery vs. bariatric surgery.

I agree with the others - I've never heard of that, and I've been hanging out on bariatric boards for a few years now. It's probably just a coincidence.