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Hey@Trixie82 and @AlFxRnY, I had my psych appointment today, yeah the one I had been dreading, was certain things were going to go against me? They didn't, Dr Kramer was WONDERFUL, if anyone in the future wants to,go to Ohio State University hospital for their Bariatric Surgery I wholeheartedly recommend him for evaluations. I passed I passed I passed! Anyhoo I have to meet my case manager, dietician and nurse practitioner on May 24th, so that puts me into June at the soonest. I❤ my Feb-March-April -May buds but in the words of the 60s song Baby I'm Yours, and I know you'll be happy to have me.🌞and🌹ahead for us,no sorrows no pains, just smooth sailing!⛵

THanks all. Alway learning. I have had some great tips from other bariatric patients.

My program is St. Peters Bariatrics in NY. Surgeon is Mehul Trivedi, Surgical PA is Tyler Chenel. They are wonderful charismatic skilled professionals. I don't See Trivedi often and I'm cool with that. I prefer he works on maintaining his skill level by going to conferences, updating training, clocking surgical hours etc. That is his craft and I'm thankful for it. No complications not even nausea, it's like I never had surgery at all. Chenel is wonderful, also highly skilled and friendly. 10/10 recommend. HW 270 SW 238 CW 182 VSG 11/7 [emoji146][emoji146][emoji146]

I just jumped through my last hoop with the Bariatric Program. The next step is to contact the Highmark BCBS for approval. Is there anything I should or could do to monitor / move that process along from my end?

I have been with two programs through this process, which will hit the three-year mark in mid-May. The first was at Memorial Weight Loss and Wellness Center in Springfield, IL. I was with that program for right about two years and got nowhere fast. I got bounced around from practitioner to practitioner (they have a high turnover rate for nutritionists, especially) and I think I saw at least seven nutritionists, a nurse practitioner, two physical therapists, two physician's assistants (including one I went to high school with), a bariatrician, and a social worker. Everyone SAID they were on the same page, but I would get different recommendations from every nutritionist and different goals from every medical provider. I never saw a surgeon; they wouldn't even consider surgery until I got down to a certain BMI, but depending on the practitioner, that varied from 60 to 65 to 70 (I was at roughly 75 when I started). After a lot of nonsense and setbacks and them refusing to talk about me with the PA who saw me every month at my PCP's office, I switched programs, and my PA is no longer referring patients to them (she said she'd had problems with them before, but the way they treated me was the last straw). It got to the point that we were both pretty sure they were just milking me for my money, since I had to pay them a $70 copay (plus whatever my insurance didn't cover) for every appointment other than physical therapy and nutrition, and I had at least three appointments most months, because they wanted me to see a medical provider, nutritionist, and physical therapist every month (sometimes I also saw the bariatrician or social worker). I ended up switching to the Washington University bariatric surgery program in St. Louis, MO, (the only one in STL that my insurance would cover), and I am SO happy with it. I went to their introductory seminar in June, had my first appointment in late July, got all my clearances out of the way (my insurance requires six months of medically supervised weight loss, and I already had that from the other program) by November, and had a surgery date scheduled by December with Dr. Arghavan Salles, who has been a DREAM to work with. Surgery was Feb. 15 at Barnes-Jewish Hospital in St. Louis. Before surgery, I had one appointment each with the physical therapist, nutritionist, and psychiatrist, plus a couple with the nurse practitioner, as well as one support group meeting. Since surgery, I'm only required to follow up with Dr. Salles; I have the option of scheduling follow-ups with the nutritionist or physical therapist, but I haven't chosen to do so (my PA at my PCP's office is a registered dietician, so I just go to her with any questions because I see her more often -- though not monthly anymore -- and she's only 15 minutes away vs. over an hour). After being on these forums, I have noticed that my program advances through the food stages more quickly than many do -- water only day of surgery, clear liquids the next day, liquids until one-week follow-up appointment, purees for two weeks, soft foods for two weeks, then regular foods starting at five weeks, with no restrictions on certain types of foods, like raw vegetables (basically, if I want to try it, I can, and just play it by ear with how my stomach reacts).

1) My insurance had a 'no wt gain' stipulation and it was from my starting weight and I had 6 months required supervision. 2) My insurance approval was sent in after my last NUT appt. , I already had my physical clearances but had not had my surgery labs and EDG - those are scheduled after approval. 3) N/A - had Humana 4) If your insurance requires PCP approval, then yes a PCP can be biased and could stall your chances. BUT you can change primary physicians, or fight through the PCP's supervisors - everyone answers to someone. This has happened to people on bariatricpal, and they changed to another PCP. Mine wanted to send me to a Humana bariatric physician 2 hours away and I said NO. I will petition my insurance to go out of network - at in-network cost because that is a burden to go that far and it was approved. Good luck.

Hello Everyone! Just starting my journey. I had my initial consultation yesterday and my BMI was 39.7. I dont have any of the "main" comorbidity described in the medical policy of my insurance (high blood pressure, diabetes, sleep apnea or cardiovascular disease). I do have osteoarthritis in knees and lower back and Acid reflux issues. I am wondering if anyone has been in a similar situation as mine. My BMI is so close to 40 that I wish I had gained a couple of pounds and this would have not been an issue. Any recommendations? So far, I have made an appointment with my PCP to ask him to help me document my situation for insurance purposes. The bariatric doctor seemed concerned about my approval, but started me into the program.

I did not have time for multiple food funerals. I got approved for my surgery on April 2nd and my surgery date was April 18. I literally had 12 hours to do my last meal before starting on two weeks of liquid protein drinks. I do wish I had eaten more savory things that last meal. I am sick to death of the super sweet taste of the Bariatric Advantage.

Trust your gut. I would switch they are centers of excellence for a reason they are kept to a higher standard. In my state the only hospitals that do bariatric surgeries are bce also there are such things as blue dot centers. Mine is one of those they are kept to an even higher standard and some insurances not only make you go to a cofe but blue dot. Sent from my SM-T380 using BariatricPal mobile app

Yes! So the referral will read healthy weight program-bariatric surgery. I only know this because I am a kaiser clinic nurse and see the referrals a lot lol. Is your orientation 5/7 or did you do that part already? How exciting! I will be at the South Bay med center. How about you?

https://www.healthcentral.com/article/divorce-rate-after-bariatric-surgery-is-high-my-bariatric-life https://www.reuters.com/article/us-health-obesity-surgery-relationships/weight-loss-surgery-tied-to-increases-in-divorces-marriages-idUSKCN1HA2G6 There's a reason bariatric surgery is often called "divorce surgery" It can make a good marriage better...but it can amplify problems in a troubled marriage. Can be a tough time for couples, for sure.

I have to laugh at myself. How many bariatric patient become health/nutrition nut's? I never imagined I would be this interested in researching healthy eating and exercise in my lifetime.

I am 58 with fine but relatively thick hair that’s a little below my back bra strap. I am 3 months post op and my hair and nails are growing much faster due to the combo of quality bariatric vitamins (Watch the stinking fillers), collagen (put in your tea or smoothie) which gives you 11 grams of protein with few calories and the extra biotin. Lastly, my scalp and skin have been extraordinarily dry so it’s a struggle to stay hydrated— I gave my scalp an oil treatment and it really did help texture. Hey, if you are gonna do this weight loss journey you must exercise self care — in my opinion this entails changing many habits into best practices so you can be the best version of yourself possible.

My PA...who had bariatric surgery....said that she didn't lose anything on her pre-op diet. Not a single pound. And she did all shakes and clears. She has type one diabetes and was going through menopause at the time, but she mentioned it twice in seminar...... If you don't lose much during the Pro-Op diet, it doesn't mean you're broken. Be patient, be consistent, you'll get there. She lost a tremendous amount of weight, has most of her health issues resolved, and looks terrific. Took her two years of patience and consistency, but she got there.

This is the one I use and it’s getting hard to find. I don’t want to go on living without these. Enough protein and very little carb and can be eaten even while commuting. https://www.target.com/p/wild-friends-protein-chocolate-peanut-butter-packet-1-5oz/-/A-50442031?ref=tgt_adv_XS000000&AFID=google_pla_df&CPNG=PLA_Grocery+Essentials+Shopping&adgroup=SC_Grocery&LID=700000001170770pgs&network=g&device=t&location=9031170&gclid=CjwKCAjwiPbWBRBtEiwAJakcpJbYIrKWlZxGsN4o780Efow3BFFbLZapXSLJPygzMnhsA8K3v1U0CBoCTpIQAvD_BwE&gclsrc=aw.ds if you find these anywhere get some. It seems like both these and Buff Bake are stopping being made and I feel these are literal lifesavers for Bariatric patients. They add protein to the peanut butter so it really is a perfect snack that can be in your car or bag even on a super hot day, and it stops the shaky hunger and is very tasty and satisfying. Check out the protein vs sugar and carbs.

For any other Aussies who need to avoid MSG and Aspartame (it triggers nasty headaches for me) or just want to avoid it when having protein supplements, especially during pre and post op liquid phases, I can recommend the following: Choc-Hazelnut Formulite meal replacements are Stevia Sweetened (34g protein per serve is almost double that of Optifast, with fewer carbs). NOTE: I can't stand the honeycomb one, but I assume it's something in the flavour as the choc-hazelnut is fine. I have a sample of vanilla on it's way to me to try soon too. https://formulite.com.au/ Bodie'z clear protein waters are Stevia sweetened. Available in ready-to-drink bottles from some supplement stores and Chemist Warehouse. RTD flavours are kiwi fruit, berry (both 30g protein) and orange however sadly the orange is only 20g protein and has caffeine and guarana included so I avoid it. The RTD drinks are very smooth and easy to drink (taste like cordial/gatorade) and I'll be bringing some of these with me to hospital for post-op. Their powders are available as sample sachets and larger tubs in unflavored/unsweetened (though it still has a weird flavour, am hoping it will be ok in soups at least!), berry powder and an orange powder (the orange powder doesn't have caffeine or guarana added and I'm hoping it tastes like orange gatorade! I have a sample sachet to try soon). https://www.supplementyourhealth.com.au/bodiez https://www.pharmacyonline.com.au/search/go?w=bodie'z&ts=custom I've also just found today a second Aussie-made protein water option called "Protein Perfection" which appears to be Splenda/Sucralose sweetened and you can order a sample pack of 7 sachets of the different flavours available for $15 with free shipping (I've just ordered the sample pack now!) Flavours – Wild Raspberry/ Pina Colada/ Lemon Lime/ Mango/ Passionfruit/ Strawberry Kiwi / Icy Lemonade https://costpricesupplements.com.au/products/1-protein-perfection-protein-water-sample-pack-6-different-flavours/ And the same brand makes a protein jelly in 5 of the flavours https://costpricesupplements.com.au/products/1-protein-perfection-protein-jelly-5-servings/ I plan to order myself a pack of jelly and one or more larger tubs of the protein perfection powders once I've tried the flavours in the sample pack (they sound awesome!) Cheers and best of luck to my fellow Aussie bariatric buddies!!!

hello ChynaDollMUA id love go on this journey with you and maybe share some experiences......... i have my bariatrics workshop on Wednesday of this week the 25th i am excited and nervous.... does anyone else have people making them feel less than for going this route? i feel i need to do this and every time i lose the weight i gain it right back and most of the time even more than before

Did he/she appear,to be aloof or approachable. Do they welcome questions? Will they be accessible or will you be palmed off on ED doctors who are not familiar with Bariatrics? Do they practice in a partnership or are they lome doctor for this speciality.? Are their admitting privileges at a Center of Excellence hospital(in US) or with a teaching hospital.? Does his hospital routinely book in private or semi-private rooms? How long his patients remain in hospital or does surgeon do only surgery on an outpatient basis? Is surgeon board certified or merely board eligible? When are visits booked presurgical and postsurgical? How many surgery done yearly, how,many daily? Do they have a favorite surgery or they willing to discuss it with the patient? Are all surgeries laprascopicaly or are there occasional open procedures done?

We only have two bariatric surgeons in our state (Alaska), but both of them have stellar credentials.

I think it’s pretty reasonably priced too. It’s $50 for a 90 day supply. My other chewable Bariatric Vitamins were $27 per month. And it’s only 1 pill a day vs trying to remember 4.

I am 4 days p.o. I had my sleeve done by Dr. Jorge Reyes Amendola, and could not be any more pleased. I did go through one of the scheduling companies, which I can not recommend, but I highly recommend Dr. Reyes and his team. When you find out about a surgeon you’re considering, research them directly, and not the touring company. I validated Dr. Reyes’s credentials online, read reviews about his medical practice (I didn’t want an MD who ran only Bariatric practice like a puppy mill). I knew no matter where I went, I wanted it done by a gastroenterologist, as they specialize in laparoscopic surgeries, which is most often the cause of complications from Bariatric Surgeries. Dr. Reyes does no more than 3 surgeries per day. On my day, I was the only one. I had full attention pre and post surgery, and recovery. I didn’t wait more than a minute if I needed anything, and I didn’t have to, because they were always checking in on me. I have to admit that the place wasn’t state of the art, but more than well equipped, and everyone spoke English. Lastly, I have direct contact with Dr. Reyes. I have his clinic phone number, cell phone for emergencies, and email. You can’t get that kind of follow-through in the US. Rule of thumb, be your own advocate.

I am half way through.. all my appointments have been one right after another and I’ve got maybe three appointments left(sleep study, sleep study follow up,and Echocardiogram) and the 6 nutritionist visits left (which I have only four visits left) Everything else has been cleared .. My original PCP (the one that retired) made the original referral and said it was medically necessary (that’s why she made the referral) but nowww the surgeon for Bariatric said that because it’s been over a year I need a NEW referral and a new letter of necessity for the surgery. [emoji991] Instagram: milaalmodovar [emoji317] SC: almodovarmila

Found an encouraging article online: https://www.sages.org/meetings/annual-meeting/abstracts-archive/band-over-sleeve-a-safe-alternative-to-achieve-further-weight-loss-and-reduction-of-co-morbidities/ BAND OVER SLEEVE: A Safe Alternative to Achieve Further Weight Loss and Reduction of Co-Morbidities Amy Banks, MD, R Harrell, MD, J Foote, MD. Grand Rapids Medical Education Partners, Michigan State University and Grand Health Partners. Introduction: The vertical sleeve gastrectomy was traditionally performed as part one of a staged bypass procedure in the super obese patient population. The weight loss achieved from this surgery alone is often substantial and frequently patients do not require or desire the second stage malabsorbtive procedure. The vertical sleeve gastrectomy is one of the most common weight loss surgeries performed today. Over time, however, weight gain often occurs and we present a new technique of using a laparoscopic placed adjustable gastric band (LAGB) over a vertical sleeve gastrectomy (VSG) to aid in further weight loss and reduction of co-morbidities. Methods: A retrospective review was performed of five patients who underwent LAGB placement following a VSG. BMI, weight loss from VSG alone and weight loss from LAGB plus VSG were reviewed. Percent excess body weight loss (%EWL) for LAGB alone and for LAGB plus VSG was calculated. Co-morbidities and their resolution as well as any postoperative complications were evaluated. Results: All five patients achieved further weight loss after placement of the adjustable gastric band over the vertical sleeve gastrectomy with an average of 40.4 lb (range 31-64 lb) and an added %EWL of 32.2% (range 12.7% – 44.1%). Total %EWL following VSG plus LAGB placement was 57% (range 43% – 67.5%). The average BMI decreased from 56.6 pre-operatively to 43.9 post VSG and down to 37.6 after VSG plus LAGB. No major complications occurred during the 31-month average follow up (range 15-46 mo). An average of 3.6 adjustments to the gastric band were needed post operatively. Several co-morbidities resolved after VSG, and there was even further resolution of co-morbidities after LAGB plus VSG. One patient was intolerant of the band and required eventual removal. Conclusion: This case series introduces a novel approach to add to the repertoire of bariatric procedures following a vertical sleeve gastrectomy. There are advantages to placing an adjustable gastric band over a sleeve gastrectomy in lieu of converting patients to a malabsorptive procedure such as Roux-en-Y gastric bypass or a biliopancreatric diversion with duodenal switch. We demonstrate that certain patients can achieve further weight loss from laparoscopic placement of a gastric band over a vertical sleeve gastrectomy without complications. Further studies still need be done to determine the efficacy of this procedure to provide long-term weight loss in this patient population.

Grew up in Northern California, born and raised going to Kaiser. That price is a little disappointing. I am going to Texas Bariatric Specialists surgical center in San Antonio. $9000.00 no insurance. Would be $12 or 13 if I needed to be in the hospital for the surgery. That number is strictly surgery cost and all follow up. Did not cover pre-surgery requirements. If I had kept my work insurance and not kept the VA as my primary my max would have been $7000 and my surgery would have been in a “teaching” hospital with a much lower success rate. My employer only pays half for the insurance (non-profit), so really same as paying out of pocket for me.