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Sorry to hear that. I don’t have a hiatal hernia (thankfully). I don’t know where you are in CT but I’m sure there are other surgeons you can talk to. I was under the impression that most surgeons would fix it during your Bariatric procedure. Keep your head up, I’m sure you’ll find someone to accommodate you [emoji6]

The hiatal hernia has no impact on insurance approval. As another poster said it "could" lower the cost if youre a self pay and your doctor helps you out. It has almost no impact on the surgery being done. Typically adds about 10 minutes to the length of the surgery, unless you have an extremely bad/large hiatal hernia which is rare/unlikely (and if you did youd suffer from severe heart burn) Weight loss will not make a hiatal hernia go down. It will reduce the chances of you getting one, but it will not make one go away. The organization I work for I would say probably 30-40% of sleeve gastrectomy patients have hiatal hernia repairs during their sleeve, its extremely common. I had a hiatal hernia repair during mine, its no big deal. I have absolutely no idea why your surgeon doesnt do sleeve gastrectomy on patients with a hiatal hernia, it makes zero sense to me. Its extremely common. Not wanting to do a sleeve on a patient with reflux/bad reflux I could understand (and instead recommending a gastric bypass for them) is perfectly normal and acceptable. But saying I dont do bariatric surgery on patients with hiatal hernias makes zero sense to me. It would be like a thoracic surgeon saying they wont do lung surgery on patients that ever smoked (which is the majority of them)

Find someone more experienced. Most bariatric surgeons that are current and practice with centers of excellence...are very familiar with hiatal hernias and their management and repair. Rather than thinking less of your surgeon for not being willing to fix it...think well of him for admitting his limitations and not doing surgery he doesn't feel confident in. Takes good character to admit your weaknesses and not take unnecessary risks. There are lots of doctors out there who have the experience to face your surgery with confidence and competence. There should be no issue finding one and getting both done safely and effectively. Good luck!

Hello! After 7 years of telling myself I would get myself back to a healthy range, I finally admitted I just can't do it on my own. I've started the process with Mount Auburn Weight Management Center in Waltham/Cambridge MA, and am suddenly terrified that everything will go wrong. I contacted my insurance company (Harvard Pilgrim) and confirmed that They do cover Bariatric Procedures There is no condition requiring a certain amount of time on a program There is no waiting period from entry to surgery date However I just have this feeling that I am going to go through the whole process, only to be told that my insurance denied it and requires me to wait or something. Did any of you run into insurance issues? What are some best practices that I may be able to do to ensure things run smoothly? When I spoke to my insurance, they claimed that *I* didn't have to do anything, that it was all on the docs... but it just can't be that simple! Help and advice would be most appreciated! Anyone else on here have Harvard Pilgrim? Kind regards, Kay

Have you already spoken to other bariatric doctors? It would make me nervous too that he said he wouldn't touch someone with a hiatal hernia. That just sounds so unusual. I guess he won't be doing your surgery. Maybe you can find a great doctor who will put you at ease and take care of both the sleeve and your hernia - like most bariatric surgeons do. There's really no need to worry. I think you're making the right choice and now you need to move forward with someone else.

3 weeks into a bariatric program. Hoping for my sleeve surgery in May. 7 pounds lost in 3 weeks. HW 411 Diet starting wt: 370 CW 362 GW 140 HT 5'3" Expected surgery May 2018 Sent from my SM-J700T using BariatricPal mobile app

Both of these comments are comforting to know.. that I’m not the only one . I was bummed that the bariatric surgeon said he wouldn’t touch patients with it.. so that makes me sick to my stomach knowing that I’ll probably have to go on another to yo yo diet. I’m already being active (much as I can be) recently I’ve been having knee pain and bad back pain (most likely related to my weight) and have cut back on a lot of calories and increased my protein just need a little bit of help keeping it off and I believe this tool will help me do that. I’ve gone done 11.4 lbs thus far [emoji57] *sigh* I’m staying positive though [emoji991] Instagram: milaalmodovar [emoji317] SC: almodovarmila

So, today I had my barium swallow test and come to find out that the mild heartburn I was having is a hiatal hernia.. the dr that diagnosed me says that this is typical in patients that are 50 or older (I’m 36) of course my size doesn’t help it any CW 280.. My question is.. how does the hiatal hernia affect insurance approval? (If any) and how does that impact the surgery being done? I’ve read some mixed messages and I have been so down and sadden by the diagnoses. Trying to stay positive in hopes that maybe a little weight loss will make it go down?.. idk, but the Bariatric surgeon made it clear that he does not like to do surgery on patients that have or have had hiatal hernia. Any thoughts? [emoji991] Instagram: milaalmodovar [emoji317] SC: almodovarmila

My surgeon's group has a lot of free info on their website for bariatric patients including sample diets, education, etc. I was annoyed at first having to go to classes before I was allowed to schedule my surgery but it actually has been really great preparation for the next steps. https://www.rexbariatrics.com/ My breakfast is a Special K Egg White Omelet sandwich with a piece of Morningstar Farms sausage added to it. It keeps me full without feeling like I'm missing out. My two cents...

Please honeyed life, don't leave. Many of us have abuses in our lives, mine were not as rampant as yours but I too have keloid abuse scars in my inner being. I don't trust, especially men and men of my abuser's age range least of all. Yes I know all men are not inherently evil but this was a person of trust in my community and a family member as well. I went through the threats of killing my pets, my parents and the constant reminder no one would believe me anyway. The adult me realizes how empty the threats were, the little child me could not and believed this person of trust was not lying. You are a Phoenix ,honeyed, you have risen from the ashes of a life few could survive. You are such wonderful person, your now life shines like a beacon forth for me, I need you here and so do the rest of us on Bariatric Pal. And a giant hug and let me give a big box of Kleenex for both our tears. KkN- my real initials [emoji8][emoji7][emoji7] Sent from my VS880PP using BariatricPal mobile app

BariatricPal is excited to announce our exclusive partnership with DEKAs Bariatric Multivitamins . DEKAs Bariatric Multivitamin has been created by the same developers that created the wildly popular Bariatric Advantage Advanced EA Multivitamin ! It uses the same delivery technology as Bariatric Advantage Advanced EA Multivitamin. Read more below about why DEKAs Bariatric Chewable Tablets are the most potent and technologically advanced Bariatric vitamin in the world! DEKAs Bariatric Chewable Tablets are a multivitamin and mineral supplement for the dietary management of bariatric surgery patients. DEKAs Bariatric Chewable Tablets are the next generation of multivitamin and mineral dietary supplements for enhanced absorption utilizing a delivery technology that helps bariatric patients overcome micronutrient malabsorption and lead healthier lives. DEKAs Bariatric is pleasant tasting chewable tablets with an orange-peach flavor that is easy to take on a regular basis. How does DEKAs Bariatric Chewable Tablets compare to Bariatric Advantage's Advanced EA Multivitamin? Same developers of Bariatric Advantage Advanced EA Multivitamin Same delivery technology as Bariatric Advantage Advanced EA Multivitamin More vitamin D (patients have been shown to need more) than Bariatric Advantage Advanced EA Multivitamin. More Thiamin than Bariatric Advantage Advanced EA Multivitamin (consistent with the new ASMBS guidelines that say “At least12mg/d” – “Prevalence of TD post-WLS ranges from 1% to 49% and varies by type of WLS and post-WLS time frame.” Free of artificial flavors But most importantly it tastes better!! Why Choose DEKAs Bariatric Chewable Tablets? They utilize a clinically tested delivery technology to enhance absorption of fat-soluble vitamins and nutrients. They are a comprehensive multivitamin & mineral supplement tailored for the nutritional needs of bariatric patients. They meet ASMBS Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient, 2016 update. They are pleasant tasting. DEKAs Bariatric’s Fat-Soluble Vitamin Delivery Technology It’s True, oil and water do not mix! Certain nutrients, such as vitamins D, E K and A are oils as found in nature and are often referred to as the oil-soluble or fat-soluble nutrients. In order for fat-soluble nutrients to be absorbed and used by the body, they must be made to mix (emulsify) into the water in the digestive system. Ordinarily, the digestive system accomplishes this emulsification with enzymes from the pancreas and bile salts from the liver. When there is a problem with the digestive system so that the enzymes or bile salts necessary to emulsify these nutrients are not available, a condition called malabsorption is the result. Malabsorption occurs when these nutrients are not absorbed and this often leads to a deficiency of these nutrients which can ultimately result in serious adverse health outcomes. DEKAs Bariatric’s Delivery Technology DEKAs Bariatric is formulated with a delivery technology that overcomes the lack of bile salts and pancreatic enzymes so that these fat-soluble nutrients can be absorbed. This clinically proven technology helps to emulsify the fat-soluble nutrients and deliver them to the gut so that they can be absorbed. Recommended Dosage: 2 tablets daily or as directed by a physician. 60ct bottle Usual Dosages: Gastric Bypass – 1 per day Gastric Sleeve – 1 or 2 per day RYGB/DS – 2 per day Click here for more info and to purchase DEKAs Bariatric Multivitamins.

Yep. Or if you recognize that you cannot control this type of behavior over time, to seek bariatric food counseling sooner rather than later to deal with the food issues?

I would get in to see your bariatric doctor next week, if possible.

My urology appointment is the end of April and my 6 month appointment with my NP at the Bariatric center is in June so I'm hoping to work with them both to determine the best actions. Sent from my Z981 using BariatricPal mobile app

If you have a genetic predisposition for calcium oxalate stones, you should probably be considering increasing plant based sources of protein in your diet, and cutting your protein down to the minimum required by your bariatric doctor. I wouldn't wait 6 weeks. I'd call my bariatric doctor tomorrow and get in ASAP to talk about diet and vitamin strategies.

Wow this topic is like a few years old... but who cares. Anyway I wanted to respond because I just got approved for stage 2 with Molina... and I am just feeling like why even bother at this point. I don't care about the 12 visits with each of the providers. I can jump through those hoops no problem, if they were all local hoops... but they are telling me that the mental health provider has to be one that specializes in bariatric stuff... and the nearest one to me is a 3 hour drive away. They expect me to drive 6 hours a week for 12 weeks to see this therapist? It's insane... My nurse at my doctor's office said that. I am trying to double check this information with Molina themselves but like.. there's no way my health would permit me to drive that much. Just no way. Does anyone here know if this is true? I thought the 12 visits with the mental health provider could be with literally any mental health provider as long as they write up an assessment at the end. I didn't know it had to be with some specialized one that has certain credentials. But the nurse at my clinic is adamant about it. She says it's that way even with private insurance and is acting like she sets these things up all the time. I said that might be the case with the psych eval, but I can't imagine that's the case for all 12 visits with the therapist. I don't understand why I can't just see a local one... She might as well just be telling me to throw in the towel right now. Does anyone know anything about this? I am so stressed out right now...

Really, Tracy too! That’s too crazy[emoji6]. Yeah, I was at the same point with the Protonics, I told the Bariatric Dr I was fed up and we needed to figure it out. That’s when he did the GI to check my sleeve and found the hiatal hernia. He said it was definitely the cause of my pain, it’s pretty big. When are you going to back to the Dr?

We have a HUGE selection of protein powders at different price points. Bariatric Advantage and Bariatric Fusion both are very popular. We also have a multivitamin and protein powder in one here.

very well said and very positive about Bariatric surgery. I do love me some Ted Talks

Obesity has been officially categorized as a disease for four years now. The categorization of obesity as a disease puts more of the burden on doctors to help you lose weight, but some people are still wary of the title. Who cares what obesity is? You might wonder whether it matters whether obesity is a “disease” or not, especially if doctors have not managed to help you lose weight, except, possibly, your bariatric surgeon. But, the name actually does make a difference. It gives obesity and obesity treatment more attention. It can help remove the stigma surrounding obesity. It gives doctors a mandate to treat you. It could lead to increased medical insurance coverage for obesity treatment, from diet programs to bariatric surgery. Here is why obesity is a “disease.” Obesity meets a definition of disease comprising three criteria: "an impairment of the normal functioning of some aspect of the body;" (changes in organ function, for example) "characteristic signs and symptoms" (excess body weight, for example) "harm or morbidity” (obesity-related complications, such as diabetes and arthritis, for example) The American Medical Association, the American Heart Association, the American College of Cardiology, and The Obesity Society are among the respected organizations who agree that obesity is a disease. Obesity is not only a disease but an epidemic based on the number of people it affects. It affects 35% of American adults, not including the other 30% who are overweight and at risk for obesity. Nearly one out of five children are obese. Healthcare providers can take charge. One point of calling obesity a disease is to allow and even require, healthcare providers to treat it. No longer should they simply tell you to lose weight, or, worse, ignore the “condition” in the first place. Instead, they should provide care for obesity, including developing treatment plans and following up with you to discuss progress. Now there is a roadmap. Now that obesity treatment is in the realm of medical professionals, there needs to be a standard approach to treating it. The American Heart Association, along with the American College of Cardiology and The Obesity Society, have published clear guidelines for treating obesity. Identify at-risk patients and patients with obesity using BMI, and monitor them at each appointment. Enroll patients with BMI of 30 or over in a medically-supervised weight loss program (note: this is not the same as your doctor telling you to eat less and lose weight on your own!) Keep weight loss surgery in mind for patients with extreme obesity and an obesity-related condition). Weight loss surgery is a recognized treatment for obesity. The third prong of the roadmap is especially important if you are considering weight loss surgery. The recommendation to consider it when treating high-risk patients has a few effects. It reduces stigma, from primary care physicians and your other regular doctors, surrounding WLS. It increases the number of patients who may have WLS covered by insurance. It encourages patients and professionals alike to learn about WLS. No longer is weight loss surgery considered to be an extreme or fringe approach. The ASMBS states that experts who agree that bariatric surgery has a role in obesity treatment also include the American Association of Clinical Endocrinologists, the American Diabetes Association, Centers for Medicare & Medicaid Services (CMS), and the National Institutes of Health (NIH). Further progress is needed. There is still much to be done in the medical arena. Healthcare professionals aside from bariatric specialists are often still in the dark about recognizing obesity and treating it. Worse, many still have stigma or bias against overweight patients, and still, engage in patient-blaming. Obesity almost certainly has genetic components along with lifestyle factors. While it may be a disease, it is also a disease that you can work to treat. Now that it has officially been recognized as a disease, let us hope that patients and healthcare professionals can work hand-in-hand, each doing their part to fight obesity.

Who cares what obesity is? You might wonder whether it matters whether obesity is a “disease” or not, especially if doctors have not managed to help you lose weight, except, possibly, your bariatric surgeon. But, the name actually does make a difference. It gives obesity and obesity treatment more attention. It can help remove the stigma surrounding obesity. It gives doctors a mandate to treat you. It could lead to increased medical insurance coverage for obesity treatment, from diet programs to bariatric surgery. Here is why obesity is a “disease.” Obesity meets a definition of disease comprising three criteria: "an impairment of the normal functioning of some aspect of the body;" (changes in organ function, for example) "characteristic signs and symptoms" (excess body weight, for example) "harm or morbidity” (obesity-related complications, such as diabetes and arthritis, for example) The American Medical Association, the American Heart Association, the American College of Cardiology, and The Obesity Society are among the respected organizations who agree that obesity is a disease. Obesity is not only a disease but an epidemic based on the number of people it affects. It affects 35% of American adults, not including the other 30% who are overweight and at risk for obesity. Nearly one out of five children are obese. Healthcare providers can take charge. One point of calling obesity a disease is to allow and even require, healthcare providers to treat it. No longer should they simply tell you to lose weight, or, worse, ignore the “condition” in the first place. Instead, they should provide care for obesity, including developing treatment plans and following up with you to discuss progress. Now there is a roadmap. Now that obesity treatment is in the realm of medical professionals, there needs to be a standard approach to treating it. The American Heart Association, along with the American College of Cardiology and The Obesity Society, have published clear guidelines for treating obesity. Identify at-risk patients and patients with obesity using BMI, and monitor them at each appointment. Enroll patients with BMI of 30 or over in a medically-supervised weight loss program (note: this is not the same as your doctor telling you to eat less and lose weight on your own!) Keep weight loss surgery in mind for patients with extreme obesity and an obesity-related condition). Weight loss surgery is a recognized treatment for obesity. The third prong of the roadmap is especially important if you are considering weight loss surgery. The recommendation to consider it when treating high-risk patients has a few effects. It reduces stigma, from primary care physicians and your other regular doctors, surrounding WLS. It increases the number of patients who may have WLS covered by insurance. It encourages patients and professionals alike to learn about WLS. No longer is weight loss surgery considered to be an extreme or fringe approach. The ASMBS states that experts who agree that bariatric surgery has a role in obesity treatment also include the American Association of Clinical Endocrinologists, the American Diabetes Association, Centers for Medicare & Medicaid Services (CMS), and the National Institutes of Health (NIH). Further progress is needed. There is still much to be done in the medical arena. Healthcare professionals aside from bariatric specialists are often still in the dark about recognizing obesity and treating it. Worse, many still have stigma or bias against overweight patients, and still, engage in patient-blaming. Obesity almost certainly has genetic components along with lifestyle factors. While it may be a disease, it is also a disease that you can work to treat. Now that it has officially been recognized as a disease, let us hope that patients and healthcare professionals can work hand-in-hand, each doing their part to fight obesity.

I use ProCare Bariatric Chewable Vitamins. I take one a day and I am done. Has everything my Doctor wants me to have. Taste ok too

I really like ProCare Bariatric Vitamins. I only have to take 1 chewable a day and it takes care of everything that my Doctor wants me to have.

Check with your Dr. to see if you need a "stretched sleeve" revision surgery. Its rare. 19 pounds in a week is a medical concern. Normal for the sleeve to expand with thime. It's not "stretched" this is the progression out from surgery. The restriction is still there. After surgery your restriction is tight. The restriction will change. How much you can hold years out will be different for each of us. Surgery few oz Might get 600+ calories first few months 4 oz five months to a year 6 oz to 8 oz 1200+ calories One year out half a plate. five to ten years a full plate "Grazing" is usually the cause of weight gain. You have a new point of volume and sensation of full. If you eat high calories throughout each day . (calories can be combination of good and bad food choices) It's the same effect as if you didn't have surgery. An excess of 500 calories will cause you to gain weight. Medical professional explanation on misuse of the term "stretched sleeve" to back this up below: Dr. Matthew Weiner Published on Mar 16, 2015 "Stomach Stretching" is the term used by many weight loss (Bariatric) surgery patients to explain the changes in their appetite and food consumption after surgery. Dr. Weiner explains what's really happening and how to prevent it.

Hi!!! I am not a revision, I am 5 weeks out and I've lost 38 lbs total. I had 3 comorbidities... Diabetes, high blood pressure and high cholesterol. I also have Rheumatoid arthritis. All are resolved, no insulin or pills. I am so happy about that. I am in Burlington NC. My surgeon was Dr Jon Michael Bruce at Bariatric Specialists of NC. I do not regret my decision at all. I hope this helps you. Best of luck on your journey!!! [emoji1] Sent from my SM-G930VL using BariatricPal mobile app