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I had a full tummy tuck in July 2020 which was covered in part by insurance, as others have mentioned. Typically, the panniculectomy is covered when it's pre-certified, and then the excess fees to convert to abdominoplasty are paid out of pocket. At my very first consultation with my plastic surgeon, the first words out of his mouth were 'If I do just a panniculectomy, you are not going to be happy with the results. I very rarely anymore just do a panniculectomy.' He explained the difference to me: the panniculectomy is the removal of the apron of the hanging belly, or the pannus. The abdominoplasty goes a few steps further and tightens the loosened abdominal wall, and also includes liposuction. It also improves the appearance of the upper abdominal area and the belly button, as well as helping with posture and abdominal strength by tightening the abdominal muscles. However, in the insurance world, they are concerned with the functonality part of the skin removal, and the conversion to the full tummy tuck is beyond what is considered 'medically necessary.' I am pleased with my tummy tuck and my surgeon is very talented. He works closely with bariatric patients, and I felt comfortable with what he was telling me and knew that he knew what he was doing.

Is the surgeon a bariatric surgeon? If so, maybe go see a GI specialist specifically for the GERD and go from there?

Wow, dating at first was very challenging. There were a couple of men I dated who I did not feel comfortable sharing with, and for me, that’s how I knew it wasn’t the right fit. I met my now husband when I was 5 years post-op. We were introduced by a mutual friend and his co-worker. I told my husband pretty early on about having had RNY. He is a counselor, and was in the Air Force and had EMT/medic training and was familiar with bariatric surgery. I was a little rare in the sense of skin removal/plastics. I did not have my first skin removal surgery until I was almost 7 years post-op (mainly because I was single with only my income and could not afford plastic surgery). In July 2020, I had a full abdominoplasty which we were able to get covered by insurance (I work for the government and our plan is pretty solid). In July 2021, I had an arm & thigh lift done together. My husband has been remarkably supportive. He knew me with the extra skin and now sees me without it. He said it hasn’t changed his view of me at all, he just wants me to feel okay in my own body. 🙂 I can just say that when you’re ready to talk about having had the surgery, the right person will be there in support. 🤗

Thank you for your response. I haven't gotten my GERD checked out for a couple of years, but I know it's getting worse. Part of the regain issue is due to binge eating disorder. I'm still getting treated for that and learning to do other things besides eating. It's been helping, but not really a lot of weight loss (3 lbs since last month), but I can't really get below 220 at all anymore. I'm on HBP meds since last Friday and managing to get it down. I'm totally self-pay for now and the surgeon can correct the gerd, but it won't cover anything dealing with bariatrics under my insurance plan. I guess his office doesn't know how to get it to clear the insurance. I have insurance it just won't cover me for surgery.

I can't change my PCP until November. I like his office because they get me in quickly or even call meds in for me. My PCP referred me to the pain specialist because I have previous cervical fusion(2007) and now have a herniated disk below it.. I had an epidural steroid injection yesterday. I have daily headaches and am trying to find a treatment that works. I have a mechanical heart valve and take blood thinners but have had 2 surgeries when I had to stop them and get the shots and didn't have a problem. My heart has been stable since 2015 and got cardiac clearance for bariatric surgery with no problems. I can't believe he is sending me to a neurosurgeon only because of the position my neck will be in during surgery. I am so let down but am writing out notes for my letter.

Hmm, the decision is solely yours and your wife's. I am also in my 30's with no kids and we are financially very comfortable but I feel like the reason why is because we don't spend 18K when we don't NEED to. Get my point? The point of the insurance requirements are to get you focused, prepared and starting the process of your new life long requirements. If you start to make the changes that will be required after surgery, you will not spiral while you wait. You will however get more prepared and ready for your new life. I had a 6 month process that was "fast tracked" and surgery at 4 months. With that being said, I learned a lot about what to expect. I already knew how to eat healthy and how to read nutrition labels etc. (Which both were part of my classes) But what I found most knowledgeable was what to expect after surgery. I have heard stories from people I know who went through WLS but I found a lot of their information was false or they just didn't understand what they were actually being told. Two other people I know had the exact same surgeon at the same bariatric center and have the same support team through the center. (Including the same Dietician) yet both of them had different understanding of things. The best thing I could have done was take those classes myself and get the answers directly from the providers themselves. It is like in Elementary school when we all sat in a circle and the teacher whispered a statement in the first kids ear and by the time it was whispered 13 times, at the end it was completely different. I also have lost and gained over 100 lbs 4 (i think) times before having surgery. Worked with a trainer, bought exercise equipment...etc. I still lost 40 lbs in the pre-op process just by making VERY TINY changes that they suggested starting with. ok ok, I said a lot and probably boring you now. My opinion from a financial standpoint and from a learning/preparation standpoint would be to go through insurance. But really, you just have to make this decision yourself.

You can have your appointment with your bariatric doc, but unless he knows what it is, go to your regular G.P. -- I have found through life that specialists, if it is not in their narrow little field, tend to not be as helpful as you might think. Besides, it is good to play "catch up" with your regular doctor.

Hi all, so I’m having a bit of a dilemma and I was just curious to know what others would do in my position. My wife and I currently have Kaiser insurance here in California. Based on their program, it would be 10 classes (2.5 months) and then I would have to wait to get on the books for surgery, the person I spoke to said it could be up to a year wait. BUT, I have zero copay and the surgery would essentially be free. On the other hand, there’s the possibility of taking out a Care Credit loan at for $18.5k 0% APR and I could get the sleeve at Blossom Bariatrics by next month if I wanted to. I know it seems like a no brainer to just be patient and wait. That is the smarter financial decision. We do have to put a new roof on our house (or we could wait until next year) and we are definitely worried that if I take out an 18k loan… that our financing of our roof would come with a stupid APR and would ding our credit. We are in our 30s… no kids… live comfortably financially but not well off-which is why the 18k seems a little crazy, although the monthly payments are totally doable for me. On the other hand, I’m almost prediabetic, high cholesterol, feel like my eating habits are spiraling each day. I am genuinely upset that I feel like I’m turning to surgery as a last resort and tool. I’ve tried every diet, every app, every diet pill from my Doctor, I have spent thousands at this point for personal trainers, my mind is consumed with the state my body is in, I feel exhausted, not healthy and I also feel like it’s holding me back from progressing in my life/career. My confidence level, well, it doesn’t even exist at this point. I feel defeated and the amount of energy I use thinking about losing weight/getting healthy is maddening and exhausting. I feel as though one can’t put a price tag on health. I feel like the gross amount of money I spend on eating out nearly every day, buying food, paying for this diet or that gym equipment… would also be eliminated to an extent if I have surgery. So, I kind of feel like even spending 18k… I would SAVE in the long run. I have a ton of goals I’d love to accomplish over this next year… and I feel like the thing holding my back is my health/confidence/lack of energy. My wife is wonderful and we have long, real discussions about all of it. She’s kind of the financial whiz of our life and we are both wondering what the best option is. Spend the money… get my health on track ASAP… save money in the long run because I’m not eating out multiple times a day or buying whatever I think will help me finally get on track. (She also feels like this would help her as my eating habits are starting to wear off on her she says)…OR Wait a year stuck in this loop, possibly gaining more. But I'll pay nothing. There’s so much that can happen in a year… but I don’t want to remain stagnant, spiraling for a year… I want to jump start it and move forward and get this over with and move on. But I can’t figure out what the best choice is. Further, I'm so afraid that even using the sleeve as a helpful tool, that'll I'll just fail at that as well. Thanks for reading my vent. Would love to hear some of your thoughts.

Hi everyone. I hope I’m posting this in the correct place. I just wanted to get some insight or any prior experience. I had RNY on 9/9/13. Down from 311 pounds to between 170-180 now for maintenance. Prior to surgery, I was on Metformin, Protonix, and HCTZ. I was off all three meds within three months of surgery. Surgically, I had to have my appendix out and gallbladder removed many years ago, so neither are causing my current issues. About a month ago, I started getting wicked heartburn and reflux. My appetite is diminished. No vomiting, but zero desire to eat. I have cut out spicy foods, I’m not a smoker or tobacco user, and I do not drink alcohol. I’m 38 years old and in otherwise good health. I go to the gym 3-4 times a week. I have tried OTC Omeprazole, baking soda, Tums, and all the antacids. I started drinking decaffeinated chamomile tea in the morning as well. Does anyone have experience with heartburn, GERD, etc. coming back many years after RNY? What ended up being the cause? I have my annual followup with my bariatric surgeon on October 11, but I’m wondering if I should move the appointment up. Thank you in advance for any insight!

I also had problems with this, and they probably want you to renew that sheet. I understand you have them all, but try to find out what they need again - you can let them know again that you have that sheet.

Hey everyone! I’m finishing up my Post Op Day 1, I had surgery yesterday. Pain was pretty bad yesterday, but managed with the IV medication that starts with a D (I’ve already forgotten the name). All I had by mouth yesterday was ice chips. Very tired. Walked around my room a few hours after being post-op recovery. Took loop around the floor later that evening. Didn’t sleep at all at night because they literally were in my room doing tests at all hours of the night. I was also very nauseous so they gave me zofran and I never vomited. Day 2 started with only ice chips until after my barium swallow study was complete. That barium fluid tasted exactly like what Harry made Dumbledore drink during the lake scene. Never have I ever tasted anything like that. My bowels took forever, so I didn’t start on clear liquids until late afternoon. 1 oz per 30 minutes. Lots of gurgling!!! Much less pain by the afternoon Day 2. They took me off the IV pain med and moved me to Percocet pills and they last longer in the system so that’s good. My surgery was at 7:30am so I’ll have been in the hospital Tuesday, Wednesday and at least the morning of Thursday. Looking forward to going home even though this hospital is so nice (it’s brand new with it’s only bariatric wing). i did a week of strict OptiFast shakes only and did a self prescribed bowel prep because I have horrible constipation and I wanted all that out before surgery. I lost 11 pounds in that week, so I was down to 251.1 on my surgery date. full liquid starting tomorrow. They want me to have 3 portions of 2 oz per day. There is no way I’ll come close to my protein goals. let me know if you have any questions!

Yes, I got sleeve. Bypass was not much of an option for me and my reflux before surgery was pretty manageable so I thought it was worth the risk. My sister works at a bariatric clinic, she told me the first month acid reflux was normal but I'm very hesitant when there are a lot of people who don't experience it at all. I hope mine goes away like yours too!

Hi everyone, I hope it's ok for me to be here. I just had my gastric sleeve yesterday. I had it done locally, so I'm back at home already. Trying to adjust to the liquid diet. Did everyone have to do a liquid diet before surgery? I did not. I just had to lose seven pounds before the surgery, which I did without going on a special diet. They suggested that people could do low carb or a diet with mostly crisp bread and lean, protein rich toppings, but that was just a suggestion and liquid diets were never mentioned. So, I'm trying a liquid diet for the first time today. Yesterday, post surgery, I drank water and gatorade at the hospital. Today, at home, I have had gatorade, water, chicken broth and propud. I have occasional pain, but I haven't thrown up since yesterday. I've read that people don't feel hungry after bariatric surgery, but I do feel hungry and I wonder if it's because I didn't do the liquid diet before the surgery.

Im having surgery the same day and I weight the same amount! Bariatric buddies!

My bypass was 6/8/22. Here’s a quick update. I went into surgery at 208 lbs. I had started the liquid pre-op at 222. I came home from surgery on 6/10 at 223… IV FLUIDS from the hospital caused that. On 6/30, I weighed 192. It was my 3 wk visit with the surgeon. We talked about stalls and not weighing every day. Today is 8/10, 2 months 2 days post op and I weigh 178. Historically I am a slow loser, so I’m over the moon at how this is going. I’m averaging about 1/2 lb loss a day. I found meeting my hydration and protein goals challenging and I had to focus to meet them. It took me a few weeks, possibly 5 weeks even. I made sure I made hydration goals first and then I focused on protein. I found that large amounts of anything with artificial sweeteners (crystal light, etc) stalled my weight loss. Except for 2 s/f ice pops per day, I steer clear of artificial sweeteners. I stopped drinking protein shakes when I made the connection between stalls and artificial sweeteners. I put PRO-T (17 G protein) in a bottle of water a few times a day to meet my protein goals. I buy it on Amazon and I used it after cosmetic surgery a few years ago with great results. I was slow (intentionally) to progress through food stages by choice. I have not been hungry, I have to remind myself to eat (I’m thrilled), and I eat what I feel like eating if it’s something allowed I go through phases: cucumbers, hummus, soup, zucchini, pickles, egg salad, tuna, peanut butter. A couple of bites and I’m full. I walk 3 miles a day, 4-5 times a week. I take vitamins my surgeon has prescribed. I am always drinking water. I have one cup of coffee a day and have essentially lost my love of it. UNPLEASANT: I’ve had 3 vomiting episodes. All my fault because I ate too fast. They were basically uneventful and I was immediately fine. One dumping episode. I didn’t realize buttermilk has sugar in it and I made a dressing for zucchini spirals. I never needed pain meds in the hospital post op probably because I was given a 3 day nerve block in the abdomen by the anesthesiologist. I NEVER had a single gas pain. Ask me any questions: I will try to organize this info and perhaps make it easier to follow. In no particular order, my go-to foods are: ricotta cheese, lettuce with skinny girl dressing, tomatoes, zucchini, chicken-crust pizza (recipe from Sugar Free Mom-Google it-its TDF), many recipes from Bariatric Kitchen on fb. There are SO many recipes…more than I could ever hope to prepare in my lifetime. LOL My attitude has reverted to what it had been most of my life: eat to live. The emotional eating is an issue I have dealt with personally and I dealt with it by removing myself from the kitchen and drinking a bottle of water. When you are sipping, it takes awhile to drink a bottle of water and that’s a good thing. Good luck and feel free to ask me any questions.

Some ideas here perhaps, but a lot depends on tolerance to certain foods at this stage, but if she can't tolerate now, she may in another week or so or even a month down the track. https://www.upmc.com/services/bariatrics/surgery-process/post-surgery/diet/pureed https://www.taylorbariatric.com/bariatric-surgery-guide/first-few-weeks-after-surgery/diet-stage-3-pureed-foods

I don't think you should be at all concerned with doctor shopping - we look at different cars/dealerships, different realtors when we buy a home. A doctor should be no different. But it looks like you have made your way through and yay for getting a revision! I had the Lapband in 2011. I never really felt restriction after my pouch healed (2 weeks or so) and I lost 60 lbs. I've kept it off but every time I try to lose more weight I end up gaining it right back. I've gone vegan for 2 years, then went keto and promptly had to have my gallbladder removed last summer - doc said it was directly related to keto. I've lost 40 lbs on my own and gained it right back. So in July I decided that since my insurance now covers bariatric I'd see what could be done. Boy have things moved fast. I went to my PCP (also a NP and I love her) and she referred me to a bariatric surgeon. I had my first consult with him on July 12th and he scheduled me for all the tests. I got them done in record time, sometimes two doctor appointments a day, and got done last week. Had my 30 day follow up today and although they're just submitting to insurance now, he's confident they're going to approve so I have my surgery date for October 24th. Here's to revision and another chance!

Hey guys!!! I'm new here, honesty had no idea that Bariatric Pal had a Forum haha. I am 6 weeks post-op, RNY on 6/27/02022. I am down 33lbs since the surgery date and am in an awful stall!! is anyone else going through a stall?

These are theprotein ones I use: 1) AGN Roots Grass-fed Whey from Amazon - you can heat it in soups, or blend into smoothies, too and it does not have any flavor https://www.amazon.com/AGN-Roots-Grass-Whey-Protein/dp/B07X9V8718 2) Pre-protein liquid protein - You have to make sure that it has the L-Tryptophan ingredient in it to be a complete protein. Bariatric pal sells it here on their website and it is available on Amazon. I have been running into out of stocks lately because it works so well. I dissolve it into my water and it actually tastes good instead of that funky protein flavor. I also dissolve it into my jello. https://www.amazon.com/Pre-Protein-Predigested-Hospitals-Nutritional-Grape-Flavor/dp/B09JBDGKBW/ref=sr_1_5 They also have cherry and peach flavors. I like them all. Since there are out of stocks on a few items, I have just recently ordered ProSource Neutral Flavor to mix into my jellos and waters. I sure hope that helps! I am still in pre-op clear liquids, but I can easily average over a 100 grams of protein a day with the help of the liquids and unflavored versions.

Hi all! I just had VSG last Wednesday. I was really nervous leading up to it, but am incredibly grateful that recovery has been amazing! Like...dare I say, almost seems too easy? I haven't thrown up, was really only nauseous the following day, pain has been completely tolerable without any pain meds, I'm down 5lbs and i only get gas pains a couple times a day. I'm hitting my protein goal through shakes and bariatric soup and today I even had unsweetened applesauce. Took me a bit to eat, but I had no problems thereafter. I'm not complaining, but I guess I assumed recovery would be more difficult and I would be turned off by food (or thought of food) completely. So many people say how they have to force themselves to eat and it's just not my case. Has anyone else had a similar recovery? Did you still get great results? Is this something I should be worried about. I know this question probly seems silly..and again let me reiterate, I am fortunate and grateful to not be having any serious issues.

Here's a list of the ASMBS approved surgeries. https://asmbs.org/patients/bariatric-surgery-procedures If you're planning to have something done that's not on this list, I'd recommend asking your surgeon why they want to do this different surgery. Keep in mind too that insurance companies likely won't pay for it. They want proven techniques. FYI, if you scroll all the way down to the bottom of the list of forums, there is one for "Mini Gastric Bypass".

I work from home, so at first I was thinking a week at max. I asked the United Healthcare Bariatric Program nurse this question (she works exclusively with bariatric surgery patients), and she recommended 2 week. She said it wasn't due to pain, but just because I'd be extra tired and likely would be suffering from brain fog if I tried to start back any sooner. Hopefully that works, but I won't know until next month!

I think only your health care team can advise you, but I doubt it will be worse post surgery? One of the most common reasons for acid reflux is overeating. Certain medications such as NSAIDS can also lead to reflux. Having reflux at night is very common. When laying down, it's a lot easier for the food/acid to overcome gravity. Many people that have this issue find they need to sleep propped up to get the problem under control. It's also possible that one of the contributing factors to your reflux is something called a hiatal hernia. Up to 40% of bariatric surgery patients have this issue pre-surgery. This is where part of the stomach actually pokes through the diaphragm. Heartburn is a common symptom of a hiatal hernia and is something your surgeon will fix during your procedure. Best of luck.

My program allows straws right away (I’m still pre-op, surgery is the 16th) - but I asked them about that because some days I just drink better with a straw. We were given a list of several vitamins to choose from. I opted to start with the Flintsones Complete (or the Walmart brand version - both are on the list) because I knew I could tolerate the taste and I prefer chewable or ez-melts (my b complex is an ez-melt - I was taking that long before my bariatric program vitamins, along with a chewable vitamin C). My program doesn’t recommend starting calcium until after the surgery, once I have blood work done. I’m hoping I don’t need that one - but I will have to look at the list to see the options. I remember my mom taking a chocolate chewable one that wasn’t to bad. I thought about the patch vitamins, but my program doesn’t allow those.

I had Celebrate Multivitamin with Iron chewables, Celebrate B12 and Calcium chewable until 6 weeks post op. I didn't take the calcium chewable because they just made me nauseous. Now I'm taking Celebrate Multivitamin with iron capsule (warning it's huge), Celebrate b12, Celebrate Calcium tablet (another not so small pill and I take 3-2x a day separate from my multi) and Bariatric Fusion B-50 complex. I haven't had any nausea but I have to be careful with my night dose of Calcium because it's also with my meds and I've learned it needs to be at least 2-3 hours since dinner or I'll be uncomfortable for a 30 minute to an hour because it's a lot. I'm off most of my medical meds but I have mental meds, Progesterone, colace and the Calcium and that takes like 4-5 swallows with a couple pills at a time. I think I'm doing well on them though. I've had better energy and not as tired as pre-surgery.