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Today was my consultation for gastric bypass. I have to do 12 month bariatric pre-surgery education. Anyone from Virginia and have Anthem Cova Care Virginia insurance and going through this?

Today was my consultation for gastric bypass. I have to do 12 month bariatric pre-surgery education. Anyone from Virginia and have Anthem Cova Care Virginia insurance and going through this?

I had my first apt. on May 1st I was also overwhelmed by the huge list of to do's before I was approved for my surgery but I think it's pretty normal for bariatric doctors to have coordinators. The coord. In my doctors office did all the scheduling for me so and requested the medical necessity letter from my primary so all I had to do is show up to all the apts. and classes. Last week was my last apt. I already got approval from Ins. Company so now I'm just waiting on my date, she said it will be sometime in August. It's all really fast but I can't wait, I'm super excited! I hope this helps you, good luck.

I have an appointment 8/1/19 with the bariatric surgeon. Has anyone had any other abdominal surgeries? I am worried that he will not do my surgery because in 2012 I had several tumors removed from my stomach. I am so excited to finally be able to do this for myself. I am 61 years old my health is not that great mostly due to obesity.

Pretty sure O.S.U. uses Da Vinci as assitance with bariatric surgeries. But folks, you all know me , CP30 can scrub in as long as my Dr Needleman is there too!😷👍😝

Yes! Can you believe it’s almost been a year?!!!! Wow! I’ll weigh in at the bariatric office on the 7th, which is my anniversary! I don’t have a scale at home so I have no idea where I am but at last weigh in I’m down 80. I’m still 27 lbs from goal but now that I’m older and had a couple of kids (twins), I’m wearing the same size I wore at a lighter weight so I think it’s all just different? I’m going to make myself post before and after Picts one year apart. You guys have been such amazing support!!! Here’s to us, August 2017 sisters and brothers!! ❤️❤️❤️❤️

Hello, Has anyone tried for the sleeve surgery with a BMI of 35 with comorbidities. I had the lapband placed in 2010 and did great , in 2017 started having problems with it and had to have it removed. I tried for a year to keep the weight off , but it has creeped back up . Know I am 35 bmi and tring to get approved thru my insurance. I have High BP and was test recently for sleep apnea. If I have one I would be able to proceed on with this journey , If not I will have to do this journey with out any kind of tool. IT may sound crazy but if I had a mild sleep apnea I would be ok with that , because I figure once I lost weight it would go away . I really need to qualify for this surgery. When I had the lapband I went from 226 start weight , surgery day 216 and final weight was lowest 140 but maintained at 155-158. So now I am 190 and trying for the sleeve , tried when the band was removed but was told my bmi was to low and that only because I had the band as a tool, with out it , it has been a struggle So now I had a sleep study done yesterday, and they say it take 2 - 3 weeks for the results, if it comes back in my favor , I can start the process with the surgeons office once my Dr. sends in the paperwork. But when I look on the web site for my insurance it says you only have to have 1 comorbidity, when I call the insurance they can't give me an answer , so I mad an appointment by phone with one of the Bariatric Dr. with my insurance to find out, they are up in Denver so if he says one then I will get my doc to submit to them and I would go to Denver , But the surgeon in the Springs says 2 comorbidity I think they try to play it safe by saying 2 comorbidity but we will see. So is there anyone else out there in this situation??

I eat very much the same at this point except for rice and bread. I can't eat gluten (horrible rash called dermatitis herpetiformis) but I do bake some almond and coconut breads that are pretty good. I can take them or leave them...haven't made them since surgery. My RD @ the bariatric clinic told me it was not necessary to eat fruit or non vegetable carbs (starch and sugar) if I did not want to. She said it is actually good to avoid potatoes and rice as much as possible. I am fine with that. I do not worry about fats too much but because of the overall restriction they are about 35-40G per day. I aim for net carbs <30 and protein is about 60-70G per day. About 750-850 calories per day. Health wise, all my labs preop were perfect, my cardiac workup was perfect and the surgeon said my liver looked "perfect" at surgery. My blood pressure and heart rate were normal. My PCM even told me he had never seen a 60 year old with a BMi >45 that was in such good shape (on paper anyway) and I think that is from avoiding carbage while overdoing it on nut, cream cheese, regular cheese and those dang low carb protein (candy) bars. This is why I need the restriction.

I was one of the unlucky few that developed a leak. They are life threatening! I want to tell my story to be a resource for anyone who has this type of complication. My surgery date was 5/1/18. Non- smoker, good health, surgery went smooth. 3-4 weeks post surgery, something was definitely off. I had rigor, trouble regulating my body temp, foul smelling burps. I called my surgeon's office daily that Memorial week. I took myself to the ER thinking I was dehydrated. They ran a CBC and my WBC count was 30,000. They sent me home to follow up with my surgeon. Next day, took results in and according to the nurse, my surgeon wasn't concerned. Next day 6/2, had trouble urinating and pain under my diaphragm. So at 9pm, my husband took me back to the ER. They thought it was kidney stones, but the CT scan revealed a leak. They transferred me via ambulance to a larger hospital. My surgeon was out of town (I refused to be seen by him again- so it didn't matter), and I got blessed with the on-call surgeon. I was in the hospital 9 days. He did exploratory surgery 6/7due to the location of the leak. Mine high up like 85-90% are. Thank goodness, I did not have an abscess like the CT showed, but I did have inflammation that he cleared out. All of the samples they took were negative. He also installed a drain that remained in line 7/10.They did an upper GI on 6/8 that showed the leak was still there. Up until this point, I was NPO and on round the clock antibiotics, Saline bag, and potassium bag via IV. On 6/8 picc line was installed and began TPN. They sent me home on 6/12 with TPN, antibiotics and Home health. On 6/20 back into the hospital with surgery to place a stent. Discharged next day. I could have clear liquids, but had to remain on TPN for 1 more week until X-ray showed it had not migrated. 6/27 X-ray showed it hadn't so off TPN and allowed food. Living with the stent was tolerable. Your esophagus is open, so acid reflux is a big issue. I never took a pain pill and found heating pad helped with the upper back pain. I could drive, do small outings with my kids, etc... I even went on a girls trip to see Smashing Pumpkins. This made it easier on my kids mental health, because mom didn't look sick and could do little things with them. I took everything really easy. On 7/19- stent came out and leak healed!!! I'm now on liquids for 1 week and then can advance my diet slowly as tolerated. My new surgeon was with me every step of the way and family and friends were very supportive. They even took my kids out of town on fun adventures. My faith in God strengthened. Luckily my Insurance covers bariatric surgery and complications. I would easily be out $120,000 or more for the hospital stays, home health, 3 additional surgeries, TPN - $1000 a bag, etc...Thank goodness I'm a teacher- so I didn't miss any work. I'm down 50 pounds and regaining my energy daily. If you are diagnosed with a leak, please reach out to me and remain positive. This is a very isolating time, but they do heal. Be assertive, listen to your body, and switch surgeons if necessary. I messaged a recent leak survivor on here and she was a great resource. Everyone's story and experience is different, but knowledge is power. I would love to be a support for you.

HI SueGrace, The only advice I can really give is to take what you read with a grain of salt as your own nutritionist will give you the diet plan she or he wants you to be on, which (in my experience) is individualized according to your unique situation. For example, some people have said they can have alcohol later down the line, others say they were told not to drink ever after surgery. When I went to my pre-op instructional this week, each of us in the room had different pre-op plans. Mine wanted 4 meal replacement shakes + a bariatric meal (dinner entree) for 2 weeks pre-op. Others in the room had 3 shakes a day and no meals, or 3 shakes a day + 1 meal, etc. It varied based on the person. As far as the plan of action for foods POST op, I was told for me that when I'm discharged I am on full liquids, then everything changes in 2 week intervals. So, 2 weeks post op I can move to puree, then 2 weeks after that soft foods (assuming I can tolerate it, etc). My nutritionist said if I feel I can do it sooner, that's fine, but it's a base 2 week plan. but again, that's individualized for me. If your nutritionist or doctor said to go a certain route I'd ask questions if you're unsure, but ultimately go with the treatment plan they advise. Good luck in your journey!

I don't know anything about the extra week you might be facing, but that extra week would be worth it since, according to this article, bariatric surgery is an effective treatment for the most common cause of a fatty liver. Nonalcoholic fatty liver disease is becoming one of the most common causes of liver disease in the western world. The most significant risk factors are obesity and the metabolic syndrome for which bariatric surgery has been shown to be an effective treatment. The Effect of Bariatric Surgery on the Spectrum of Fatty Liver Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061986/ Several drugs also cause fatty liver, including: corticosteroids, tamoxifen (Nolvadex), and methotrexate (Rheumatrex, Trexall). Fatty liver is usually found or suspected when: Abnormal liver tests are found on routine blood testing Fat is seen ultrasonographically when ultrasonography of the abdomen is performed for other reasons, for example, the diagnosis of gallstones Infrequently when the liver is enlarged on physical examination of a patient

The best place for information about keto is probably Ketogains.com. They have a facebook group and a webpage with a very good macro calculator. They're very science based and won't take any BS. They don't promote macro percentages or super high fat. Instead they track their macros in grams. Essentially keeping carbs below 50 grams per day or rather 20 grams will put your body into a ketogenic state. Then you have to have your adequate protein. Not too much, not too little, actually their protein recommendation is the same as the bariatric one. If your body is already high fat you don't need to consume extra high fat. Which is also pretty much the post op bariatric diet anyway. Eat your protein first, then have some vegetables and in the case of keto, if you have room left in your post-op sleeve/pouch, you fill it with good fats, not starches. Some olive oil or butter for cooking the vegetables, meat or eggs, half an avocado, a handful of nuts or olives etc. I'm keto since 2013 and I find the true and real keto very healthful and good nutrition. The problem is, keto has become very mainstream and lots of people want to make money on it and start spreading these absurd versions of keto that won't get you closer to your goals. "Eat fat to lose fat." You really don't have to eat 85% fat to make ketones aka be ketogenic, you just have to limit your carbs, eat adequate protein and non starchy vegetables. For example my macros today, 8 weeks after having the sleeve are 21 g carbs, 94 g protein, 48 g fat, 896 kcal. 37 lbs lost so far.

We kind of hijacked your thread. Did you receive any clarity? You will usually have to mention that you've had wls in the ER, but your PCP will already know and prescribe accordingly. Mostly non slow release until the greenlight from bariatrics. Asking your team about things often and ahead of time will help VSG2017 HW 249 SW 238 CW 167

Three-quarters of severely obese patients had unhealthy, not very diverse gut microbes (low microbial gene diversity). This unbalance was associated with a greater tendency to have a high-fat mass in the trunk of the body and an increased likelihood of having type 2 diabetes, hypertension, or more severe versions of these comorbidities. According to the researchers, more work is needed to determine "whether specific interventions (specialized diets, prebiotics/probiotics, or gut microbiota [fecal] transfers) may be useful to consider prior, or post, bariatric surgery in severely obese individuals." "This is "an exciting field" of research… one day we'll probably have the perfect combination of gut organisms in a fecal pill form.”--Samer G. Mattar, MD, president of the American Society for Metabolic and Bariatric Surgery (ASMBS). https://www.medscape.com/viewarticle/899158

A study suggests that people who undergo a momentous life event such as weight loss surgery may possess a “bias to action,” -- meaning they may be encouraged to make additional life changes, like getting a new job, getting married or divorced, or moving. https://www.everydayhealth.com/diet-nutrition/bmi/getting-bariatric-surgery-unexpected-way-your-relationship-status-may-change/

And M-L.S. I'm going to hang around 5 more years with you so we'll find out for certain, won't we? My surgery will give me a renewed lease on life and I may live a long long time!😝👍😝

Nearly 9 percent of bariatric surgical patients who did not take opioid pain medications until their weight-loss operation, or the month before it, report that they are still using prescription opioids one year postoperatively, according to the results of a Michigan study, presented at the American College of Surgeons Clinical Congress 2017. http://www.bariatricnews.net/?q=news/112870/bariatric-surgery-patients-vulnerable-opioid-dependence I was an opioid (morphine) pain patient before my gastric bypass surgery, btw.

@Tealael. What couldn't you find out... whether she's a pharmacologist or a PharmD? Now that I think about it, if she works in a hospital, she has to be a clinical PharmD. Pharmacists require a license to practice pharmacy. While PharmD's also study pharmacology, that is not the focus of their expertise. My daughter studied for 5 years plus one year of residency at a Veteran's Hospital. I'm very proud of her. Again, you're lucky that your program makes a concerted effort to help their patients with as many meds as they are able, despite the lack of data available for bariatric patients. I remember when I first brought up the topic of medication malabsorption at my first surgeon appointment. I could tell from Dr. S---'s expression that he didn't like how specific my questions were, and then, he surprisingly changed the subject. I knew then that I'd have to figure out my meds pretty much by myself... with the help of my kids and other health professionals whose egos allowed them to admit that there's not much research out there to go on. As for your questions about the requirements for COE certification, I found this link (below). I'm not sure, but I think a hospital can be a COE hospital independent of being COE certified for every program they're involved in. I don't think the hospital I had my bypass in was COE certified for bariatric surgery, even though it was a COE-certified hospital in other areas. I had two full knee replacements at this same hospital, and I don't know if they were COE certified for knee and hip replacements either. Too late now. Maybe if I have to have a brain transplant someday, I'll make sure it's at a COE-certified hospital for brain transplants! https://www.obesitycoverage.com/insurance-and-costs/pre-approval-process/center-of-excellence Some of the programs that a hospital can receive COE certification for include: bariatric surgery knee and hip replacement maternity care spine surgery transplants Oh, and I'm happy to have a new case-study buddy (aka someone who enjoys researching medical and scientific articles too!)

Thanks for the responses! To _Shane_, the office was able to help out to a degree, but the bariatric surgeon is located an hour away from me and the specialists he specifically referred me to are out of network for me, so I had to have them change the referral to someone local and in network.

I added magnesium citrate to my supplements. I had no idea that there were so many forms of magnesium. https://www.globalhealingcenter.com/natural-health/types-of-magnesium/ Despite, what is said in this article, when it comes to the bariatric community, the form that works best for us is magnesium citrate. Take magnesium with calcium for better absorption. My cramp hasn't improved yet, btw. I hope the magnesium helps soon if that's the cause for my pain.

@Tealael Visualization sounds like a worthwhile way to help me see myself as I hope to be. I think I'll send myself through a bariatric portal to Iceland. I love snow and all that is winter. Thanks for the inspiration!

@Tealael Most likely she's a PharmD, which is a Doctor of Pharmacy. My daughter is a PharmD. A pharmacologist is basically a researcher. They study the chemistry of drugs and how they work in our bodies. Drug companies hire pharmacologists. A PharmD can be a clinical pharmacist (works in hospitals or nursing homes) or a retail pharmacist (fills prescriptions at drugs stores like CVS or a mail-order facility). No, I have no qualms about her thoroughness. That's what PharmDs do. But that doesn't change the fact that little is understood about the interactions and malabsorption unknowns with the majority of drugs as they pertain specifically to the bariatric community. You're lucky that someone is hands-on with your meds, but she is basically working off what little is known and applying that knowledge as best as she can to the patients she serves.

Ultimately, this is one of those judgement calls people will each make on their own...hopefully with a little input from their doctor and nutritionist. I think it's important to remember that bariatric surgery and post bariatric surgical diet...in the grand spectrum of medicine...are in their infancy. The first laparoscopic gastric bypass, for instance, was performed in 1994! First sleeve gastrectomy, as part of a duodenal switch surgery...was done in 1988...it wasn't done laparoscopically until 1999! Diets and fads in dieting come and go. Doctors and nutritionists are all over the map with diet recommendations both before and after surgery. We're in a very grey zone here, folks. What one doctor will tell one patient will utterly contradiction what another doctor tells another patient. If you really want to make it interesting, look at the advice given to different populations around the world after bariatric surgery! You pay your money and take your chances. You do the best, healthiest diet you can, and try to protect your health. Hopefully, you get lots of exercise and keep moving, too. The most important thing your diet should be (in my opinion)....is sustainable. Something you can eat forever. Something with enough flexibility, you can live with it and not feel deprived. Something that doesn't damage your health over time, that leaves you with good energy, good labs, good quality of life, and a good outlook. Fluffy, I meant no offense, I know you're a passionate ketovangelist...and good luck with that. Sincerely. On a happy note, I'm one pound from goal, and inches from walking off into the bariatricpal sunset here pretty quick...so no one has to worry about my "all this protein will ruin your kidneys" rants before too long. LOL. I wish each and every one of you success...however you can find it. And long healthy lives free of illness as much as possible.

I can't say enough good things about my surgical experience with Baptist Bariatrics in Louisville. The process was simple, supportive, and my surgeon, John Oldham, is awesome. My recovery was extremely well managed and I felt so good that I even refused IV pain meds while in the hospital. He is extremely proactive in making sure that his patients are exposed to as little risk as possible. My labs have been great, and I haven't thrown up once. At almost two months post-op, I am already able to fulfill all my nutritional needs without protein supplements. My weight loss has been slow, but I think that's probably good. My energy levels are comparable to pre-op. Highly recommend!

Hello all! I met with the bariatric surgeon on July 13th for my initial consultation and am compleeeeetely overwhelmed. I am having an endoscopy done on July 24th and I will need to see a cardiologist, pulmonologist, psychiatrist, and get a letter of necessity from a family doctor. On top of all of that, I will need to do 6 months of classes. The surgeon said all of this is normal and is also usually required by insurance (BCBS EPO). So I guess I was looking to see if anyone else is this early in their journey, or any seasoned vets who have pearls of wisdom they would like to share. Thanks!