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I live in Fort Lauderdale Florida and Im having a huge problem getting a letter of medical necessity writtem correctly from my Primary care Doctor. I really dont understand him because he was the one that referred me to a Bariatric Doctor for wls. I've done everything that is required of me to get the sleeve. I'm in need of a pcp in Fort Lauderdale or near that accepts Humana so that I can get a letter of medical necessity so that I can have my procedure done.

Thanks for answering! I am following the program but I was constipated too and went to the ER and gain some weight without eating anything!,, I think it was something that they put on my IV that has a lot of proteins and vitamins ( they call it the bariatric fluid) . I will be more patient!!! Thanks

Congratulations! That's so exciting that you'll have the surgery right before the new year. What a blessing! I'm going through the process and hope to have my surgery in March or April. I've only told three people: my husband, mother and a good friend. Of course they're worried about the surgery; there's a risk with any type of surgery and this procedure is no exception. So I'm sure your mother and grandmother will be concerned as well. Just assure them that you've done your research, have spoken with your doctors, and that you feel this will be, in the long run, a great benefit to your health and improvement to your life. They'll probably have a lot of questions, so be prepared to answer them, tell them approximately how many bariatric surgeries are performed every year and the average success rate, etc. In the end, you have to do what's best for you and your quality of life. And if you are content and excited about your decision, I think they'll be on board, too!

I can't believe it's almost here. I have done the best I could with the pre-op shakes. I feel like a failure almost because I couldn't drink as many as recommended. A week and a half in I had to swap over to sugar free Carnation Instant Breakfast because the meer sight of the Bariatric Advantage shakes made my mouth salivate in preparation for vomiting. I am so ready to get it over with. I don't even feel anxious or scared. That may change when I'm stripped down to nothing but a gown lying on the stretcher waiting. All I can say is viva la Versed! I was told in pre-op that I had to stay in the hospital gown the first day. Good luck with that happening. I don't care how many holes they put in me or how doped up I am, as soon as I roll up to the floor, my pajamas are going on! I see myself being the patient nurses dream of. Out of bed and walking by 4 hours post-op, urinating on my on accord (without being cathed), and requiring minimal pain medicine. We shall see.

im not at all worried about the procedure or anything like that, in fact i cant wait! i have a great bariatric surgeon at a grade a+ facility. i just dont understand why theres always the "debbie downer" in every group? i guess theres always the experts out there no matter what the surgery is, just gotta give them their minute to speak and ignore what they may say lol

Okay, so my PCP referral came through on Saturday for the bariatric surgeon and I had to work on my patience to wait until Monday to call for an appointment. The surgeon had an opening on Wednesday morning, so I am headed there tomorrow to do my intake appointment. The nurse said it will take 2-3 hours. Can anyone help me with what to expect?? I am so nervous, I don't want to mess it up somehow. I know I am a "good" candidate (High BMI, T2D), and I want to have the surgery so badly. I am just afraid of being turned down. Anyone have any tips, or even words of encouragement??? I haven't told anyone about this journey yet, so I am sort of out here alone. Thanks!!

I'm taking the chewable Centrum - got them at Walmart. Quick dissolve B-12 and Biotin I found at Walgreens (they often have buy 1 get 1 free sales on vitamins and that's when I stock up). I tried the liquid calcium from Wellesse, but it made me a bit queasy. The calcium chews from Bariatric Advantage are pretty good, but a little pricey. I finally found some lemon flavored chews that another user recommended and ordered them from Amazon - Calcet is the brand name. Those are my favorite - it's like a little lemon dessert after dinner!

Myocardial ischemia occurs when blood flow to your heart muscle is decreased by a partial or complete blockage of your heart's arteries (coronary arteries). The decrease in blood flow reduces your heart's oxygen supply. Myocardial ischemia, also called cardiac ischemia, can damage your heart muscle, reducing its ability to pump efficiently. A sudden, severe blockage of a coronary artery may lead to a heart attack. Off hand, although I am not an expert, I suspect the answer might be yes. One of the individuals in my support group had made it through the pre-op tests and had a surgery date scheduled. He received a call from the surgeon to check into the hospital immediately for a heart operation. He had the heart surgery performed. About a month or two later after he recovered, he then went it and had the bariatric surgery operation done. He is alive and well and doing fine. I think he has lost over 100 pounds.

The only reason you would need to have the band removed would be if it was medically necessary. When I had to have mine removed due to infection my insurance covered it 100%. If the doctor reports it as medically necessary, it is covered even if your plan does not cover bariatric surgery, like mine does not. When I got sick I was scared to death that the removal surgery would not be covered, but my new doctor reassured me it would be covered. As far as your choice, if I were young and planning to have children in the future, I would factor that into the equation and discuss it with my doctor. I too chose the band, because the only other alternate at the time was bypass. I had my band done with 8 of my coworkers and none of the others have had any problems. I am the only one who picked up a staph infection and we all saw the same doctor for the surgery and the fills (except for one). Of course, at this point because of my problems, I can only recommend the sleeve. __________________ Originally posted at www.lapbandtalk.com

So you cheated a little on your post-op diet. When you were supposed to be on liquids, you had a few spoons of mashed potatoes or a swallow of yogurt, both nice and soft. Maybe you ate a few Cheez Doodles, but what’s the big deal? They’re like eating flavored air, aren’t they? And the McNuggets you tried during the puree phase? You chewed them really well, and you could only eat three instead of your pre-op portion of six – isn’t that great? No, it’s not great that you could only eat three McNuggets. And yes,cheating is a big deal, and I’m going to tell you why. You’re not going to get away with this one. Miss Jean has eyes in the back of her head. She sees the cookie crumbs on your face and the neon orange faux cheese film on your guilty fingers. SOME DEFINITIONS OF CHEATING The word “cheat” has two main connotations. One is cheating in the sense of lying and deceiving. It’s intentional dishonesty. You know what you’re doing is wrong, but you do it anyway. The other connotation of “cheat” is unfaithfulness. Unfaithful to a vow or promise you made to another person or to an organization. When someone cheats you, do you just shrug and say, “Oh well, he was having a bad day”? Let’s say you bought a car that you thought was brand new, and later discovered that the dealer had fiddled with the odometer and charged you full sticker price for a car with 1200 miles on it. Would that be okay with you? And what if your spouse, the person you trust with your life, cheated on you by sleeping with your best friend, would you be able to just shrug that off? If your child got a B+ grade by cheating on a test by copying answers from the student at the next desk, would you be proud of him or her? And what if you found out that a coworker betrayed you by using the great idea you confided to him or her and taking credit for it when it worked out splendidly? Would you still be eating lunch with that coworker? Or what if you donated money to a political candidate who you admired, and he or she spent it on a vacation in the Bahamas instead of on re-election expenses. Would that be okay with you? Would you vote for that candidate ever again? I’ll take a guess at your answers to these questions. In none of the situations I’ve described would you be happy or proud. In fact, you’d be disappointed and angry. So just how can you think it’s no big deal to cheat on your post-op diet? EXCUSES, EXCUSES I can hear grumbling in the room. I think I just heard someone saying, “I had to eat that mashed potato. I was so hungry and miserable and cranky from being on liquids for a week, I couldn’t stand it another minute.” I do understand very well how you felt, but in the big picture of world hunger, where babies die because their mothers eat so little that they don’t produce enough milk for nursing, your and my hungry misery is a big So What. And someone else is whispering, “My best friend’s surgeon let her eat mashed potatoes on her third day post-op, so it must be okay for me to do that too, even though my surgeon told me to wait until my 15th day post-op. It’s not my fault that every surgeon has a different post-op eating protocol.” While it’s true that surgeons’ eating instructions vary widely, you signed on with your surgeon, not your best friend’s. Presumably you chose your surgeon because you and/or your insurance company believe that he or she is well-qualified in laparascopic bariatric surgery. During your psych evaluation, you affirmed that you understand what the surgery involves and that you can and will follow instructions. You nodded when the shrink asked if you’re ready to make all the lifestyle changes needed for success. You nodded when the dietitian asked if you understood your pre- and post-op eating instructions. You scribbled your own name on a sheaf of release papers to indicate that you were informed about the risks involved and despite those risks, gave your surgeon permission to perform surgery on you. In addition to all of that, you spent weeks or months jumping through hoops to prove your need for bariatric surgery. Perhaps you suffered through a six-month pre-op diet. You had lots of medical tests and evaluations, most of them not much fun, because you were so eager to get your weight loss show on the road. You had surgery, suffered some degree of discomfort from your incisions and gas, and finally heaved a sigh of relief because all the struggles are over now. But then you discovered that there are still more struggles to survive because of that stupid post-op liquid diet. Yet despite jumping through all those hoops, in less than 60 seconds you blow it by popping a Cheez Doodle in your mouth, and justify that with the aforementioned misery excuse. And man oh man, that must have been some really serious misery, because evidently it drove out of your mind all the very good reasons for faithfully following that post-op diet progression. You forgot that one of the most common causes of band slips is the patient’s failure to follow the post-op diet. You forgot that food can get stuck in the stoma or esophagus and cause an obstruction or vomiting. You forgot that vomiting can disturb the position of the band, especially when you’re a new post-op and your stomach is still healing from surgery. You forgot that in order to move mashed potatoes or Cheez Doodles through your digestive system, your esophagus and stomach must expand and contract, which can disturb the position of your band and cause it to slip. You forgot all the promises you made to your bariatric team and to yourself about healthy eating and weight loss success, because you were so miserable and just a few little cheat bites are no big deal. I’ll try to give you the benefit of the doubt. Maybe you thought that being able to eat the Cheez Doodles without having any uncomfortable side effects or complications like a stuck episode, a PB, sliming, chest pain, esophageal dilation or spasms means that it’s okay to eat the Cheez Doodles. Well, I’m here to tell you that’s a wrong assumption. Cheating eating can cause problems without you ever knowing it until it’s too late. Cheating eating is just plain foolish. YOU’RE NOT ALONE Now here’s the good news. You’re not alone. Nobody enjoys the post-op diet progression. If any of us were good at following diets, we might not need bariatric surgery in the first place. And only infants enjoy a liquid diet. But in a sense, as a new post-op you’re a bariatric infant who must consume liquids because your body isn’t ready yet to handle anything else. Cheating on your post-op diet is cheating your health in a major way. If you already cheated once or twice or ten times, that’s not a good reason for continuing to cheat, so don’t do it again! I believe we should begin any project as we mean to go on. If you can’t follow your post-op diet, exactly when are you going to begin your healthy post-op lifestyle? Are you going to wait until after your first fill, or your second fill, or at some hazy time in the future? If so, don’t come running to me when your scale stays stuck on a number you hate. NOW is the time to begin your healthy lifestyle. NOW is the time to practice good band eating skills and making good food choices and controlling portion sizes. Doing that may not be easy, but it’s not impossible either. Losing a massive amount of weight is a big, tough project, but if you respect your band, it's going to be easier than any of your past weight loss attempts. Let me clarify that: it's going to be easier if you follow instructions. In addition to that healthy lifestyle, there’s another very good reason to stick to your diet. At some point you’re going to have to face up to your past and acknowledge that food and eating have been a major problem for you. The fact that you’re struggling with your post-op diet is a symptom of that. There’s no shame attached to that struggle. As mentioned above, if we didn’t struggle with eating, we wouldn’t need bariatric surgery at all. So I suggest that you look at the post-op diet (and your pre-op diet too, for that matter) as a rite of passage. During this rite, you’ll be painfully aware of just how many food devils you possess, because without food to shut them up, they’re going to be jumping up and down and screaming for your attention. But their wish is no longer your command. You’re going to send them a clear signal: that you’re not going to submit to their demands any more. From now on, you’re going to follow your surgeon’s and dietitian’s eating instructions no matter how much commotion those devils make. You’re in charge now. As the saying goes, today is the first day of the rest of your life. Do yourself a favor, and make it a day without Cheez Doodles!

Hi Denise, thanks for replying. The No way was because they don't cover any bariatric surgeries. They just throw the request letters away. Don't even read them (they told me that.) I had hoped to do both surgeries at once to save money, but I guess they have a contracted charge with the hospital, no matter what. It wouldn't save us any money. Plus the Dr. recommends waiting on the hernia surgery until I can lose a bunch of my weight. She'd rather I lose all of it first, but if i do it at the end of the year my deductible is already met. The surgery is "only" costing me $15,500 with all pre-tests and post fills included. Not bad since other hospitals in the area charge $25,000. It just so happens that is exactly what I have in my retirement account. So this way I get to actually REACH retirement and I'll still be able to go back to work in a couple of years to put more towards my retirement. :frown:

Hi Candy! Welcome! Getting healthy for your children is awesome. My understanding is that if you are self-pay they process moves along quite quickly. It sounds as though just the timing of the tests and your required weight loss are the only things holding you back. Was the no-way just because your insurance doesn't cover bariatric surgery? Can you at least take advantage of the anesthesia of the hernia repair and have the band placed then? Sort of like a 2 for 1 discount? Best wishes for a smooth surgery and speedy recovery!!

Well I have my psych eval on Thursday the 24th that the bariatric surgeon requires. Now my insurance company doesnt require this stuff..but I just was able to make an appt to get in to talk to my PCP about seeing if he would recommend the surgery as well. I also called my ob/gyn that diagnosis me with PCOS and Insulin resistance to write a letter also. So I'm covering all my basis before I send this in to the bariatric surgeon along with my packet they want me to fill out about my medical history etc to get a consult. I'm making sure there wont be any question of me getting this surgery. That way the insurance company has no problems seeing that I have issues and need this surgery. My PCP has seen me more times than I can count about having chronic bronchitis and just being sick all the time and my asthma getting worse. I am also quitting smoking...I'm down to 4 cigs a day. Mostly at work and on the drive home. Of course you realize with quitting smoking I'm gonna gain more weight...which will also help with the surgery not that I really need any with being over 250 now and only 5'5! So whatcha think..have I missed anything that might be required?? My insurance co and the surgeon dont require the 6 month weight loss program...just lots of diet history with the packet you send in. Is there anything else that I havent thought of yet? :rolleyes2:

I got Sleeved on May 12th as well. I am very happy I did this. I already knew that with a Sleeve the weight loss isn't as fast as with the Band or By-pass. That's OK with me. It gives my skin time to adjust. I didn't have any nausea & almost no pain. I started this process at 294 lbs & I'm down to 269. What I have really noticed is the difference in my clothes!! I need to stop weighing myself every day & I should measure myself. I didn't & wish I had done this. I've already given away my 3x size shirts. Yay!! I can wear my 2x shirts without the buttons being stretched. LOL. I would do this again. BTW, when I had my 2 weeks pre op diet I couldn't drink another Premier Protein shake - chocolate. I ordered their strawberry shake & love it. I also bought Protein powder from nectar & unjury. Really like both. The Unjury chicken broth is good. Also, I put 1% milk in the powder shakes. Using Water made me gag. It will increase your calorie count but I can have 800 calories a day so that's not an issue. The milk will add protein also. I tried the Isopure flavored water. It was so bad I had to pour it out. It totally turned my stomach over. Some people love this stuff. If you buy it I would only get 1 bottle to see how your stomach tolerates it. I bought 3 ($4 each) & couldn't stomach any of those flavors. I have also found that when my instructions say THINNED for pureed/soft foods then you should thin it. I tried avocado all mashed up & should have thinned it. My stomach felt so overloaded that it made me feel really rotten for about 3 hours. I thin everything now!! Well, except scrambled eggs. The Unjury brand you get on-line & the Nectar brand you can get at The Vitamin Store or on-line. I get my multi Vitamins & Calcium chewable from there also. They also carry a liquid vitamin & calcium but it's a lot more expensive than the chewables. The Vitamin Store has a lot of the products you need for any of the Bariatric surgeries. They sell individual servings of Nectar so you can try different flavors before you buy a large container. My new motto - Onward & Downward. Good luck with your Sleeve everyone.

I had a great NSV today and thought I'd share. My surgeons nurse called me today and said she had a favor to ask of me on behalf of my surgeon. He is giving a presentation the end of this month on bariatrics. So he would like me to come along as a living before and after! I am not yet at my goal, but have lost 60% of my excess weight, so a sucess in there eyes! Not only will I present and discuss my journey thus far, but he would like me to be in a publication for the bariatric center for the hospital! Hard part is going to be finding a before picture since I avoided the camera like the plauge!! Wow is that a motivating event! Thanks for reading. Crystal

Hi-I went to a seminar back in January, which was free. I went to my first Bariatric Center consult about a month ago. It cost $100 plus my $20 co-pay. It included a video, nurse consult, nutritionist and psycholgist consult. I see the surgeon this coming Friday, and at that time they will collect $250, which will be put into an account to go towards any more pre or post off office visits. If I don't use all of it, the rest will go towards any hospital or Drs fees that arent' covered by my insurance. The hospital co-pay will be $200. I'm sure that there will be more fees somewhere, but for me, my health will be well worth it. I have United Heathcare Insurance. The best advice I can give you is research, research, research! One more thing-Have faith!!! Hang in there, and good lick!

That really stinks! I am sorry that you are having to consider more surgery. I know there are a lot of people on this site that had revisions to bypass so hopefully you will get your questions answered. Many of them have done fantastic with bypass. I can tell you that from what I have read, the initial weight loss is much slower but I have seen folks get to goal. Personally I am so thankful I went the bypass route because it put several illnesses into remission for me. One of them was very severe Gerd, I have not had a single bout of heartburn at all. My diabetes, high cholesterol, high blood pressure, sleep apnea, anemia and stage 3 kidney disease are also all in remission. Do you still have the same insurance? You might want to give them a call to better understand coverage. I had Medica United Health Care and I was only allowed 1 Bariatric WLS surgery in my lifetime. Now I have a completely different insurance and they cover nothing. It really depends on your specific insurance. I wish you the best of luck!

I take a special bariatric vitamin.. and I take biotin too.. im experiencing hair loss as well.. but I think you need a different vitamin too.. make sure you are getting your protein and drinking plenty of water.. .dehydration can cause fatigue too...

I use a one a day chewable for bariatric patients. It's Procare Health. It's chewable and not awful, but you can also swallow it and receive all the benefits. In addition I take b2 and calcium (1200-1500 a day, spread out). I hated all the chewable calcium I tried, I finally went with a "petite" kind from Wal Greens.

If You Really Want to Achieve Happiness and Success, Especially with Weight Loss, Stop Looking to Other People For Approval and Applause, When God is Truly the Only Stand Ovation and Applause, that you Really Need!!! Romans 12:2 And be not conformed to this world: but be transformed by the renewing of your mind, that you may prove what is that good, and acceptable, and perfect, will of God.Love All of You!! Sharon

As you wrote your note, you're actually asking two questions: Does the band work? and Does the band work and remain viable for the long haul. You're going to hear the good, the bad and the neutral in response to both questions. In answer to the first, the band works if the owner works it, as "they" say in the street. It will not work for losing weight f not considered and used as an aid, a partner, so to speak. It usually takes a few adjustments to get it set as an optimal aid. Because it's fickle, adjustments to loosen or tighten may be needed from time to time; there's no way to predict. Then there are the band owners whose bands are just right for them out of the gate. Second question: The band isn't perfect and many have revised to other surgeries. They include those who had legitimate cause and I have no doubt that others just didn't work their bands or abused them. With a band, as with any of the bariatric procedures, regain is always a possibility. Maintenance for the long term is the individual's responsibility and demands vigilance. One downside with the band is that it requires pretty much life-long attention, e.g., annual esophagrams (a.k.a. barium swallows) to be sure it's in place and that liquids and food continue to move from mouth to stomach as they should. Slips are always a possibility; some can be avoided (by not gorging and/or eating too quickly and the like) and some not (perhaps a wrenching movement, which doesn't mean, by the way, giving up ice-climbing or whatever dare-devilry is your passion, which reminds me: No need to give up sex, either). One band star is @@Alex Brecher who founded BP. He had surgery about 14 years ago and has maintained his boyish figure since reaching his goal as far as I know. He's not your deciding factor, of course, but, if he stops in, may be able to give you perspective that I can't. I'm one of those who was doing wonderfully, with goal in sight, but was thrown by a life event and regained most the the weight I'd lost. I'm back on track now. For a while I thought my band might have breathed it's last, but my July esophagram was good and the band is doing its thing. I must take care to pay attention to the signals it sends -- again, that personal responsibility thing. To make a long spiel longer, I'll end by suggesting that you read your replies and compose a list of specific questions to pose to people at the surgery practice you're considering. Also attend its support group to ask and listing to people face to face. This last is not to advise you to abandon BP. All the best.

I'm really, really nervous about the timing of my surgery and I could really use some encouraging words or advice. I am currently on my parents' insurance and it covers the sleeve, but I get kicked off their insurance on November 1. My surgeon's office says I am likely to be going in for surgery in September. My problem is that I am getting married in January (January 28th) and going on our 3 week honeymoon immediately afterwards. Is it completely insane to have surgery in September and only have 4 months post op before the wedding and honeymoon? If I had the ability to wait for surgery, I absolutely would, but the insurance (through work) I would switch to on Nov 1 doesn't cover bariatric surgery so it is basically now or never.

Why cheese? If you are going to eat dairy, IMO yogurt is a healthier choice. And why fruit instead of green veggies? Green veggies are much lower carb. All that said, losing 1 kg in a week is great IMO. Does your bariatric team have a specific goal that you must meet? It sounds like it, from your post, but personally I think expecting more than 1 kg/week is a high and kind of cruel standard.

Welcome to the world of the banded. You have taken the first step. Work with your bariatric people & listen to their people. We will cheer you on & try to inspire you & wish you a future of good health & happiness! :wub:

I don't think it is insane at all, especially considering that your future insurance won't cover bariatrics. Just be sure you choose a dress with simple lines that can easily be taken in. You might want to consult with a dressmaker about which styles will not tailor well, since you are likely to lose 40-60 pounds by your wedding day. Sent from my iPhone using the BariatricPal App