NLWC.Christa

Grilled chicken and fish, lean cuts of beef and pork. Just bake or grill everything, or saute in a little bit of broth, wine or a spritz of Pam. Steamed veggies are great. Also, sugar free Jello is good. Tuna or chicken salad with fat-free mayo or fat-free plain greek yogurt. Greek yogurt with fresh berries or sugar-free flavored syrups, maybe. These are my staples before and after surgery. Also, start using a food log like fatsecret.com to keep track of your food.

Perhaps ask your doctor to submit all of your information just prior to March 15. At least that way you have it on record and a review number assigned prior to the change date (if it changes) and then they would just have to submit your final progress note when you finish on April 1. It is worth a shot and could save you three months if the policy does change.

Wow! I really hope they are not making the change back to six months. I speak to BCBSIL at least 3-5 times a week and it has never been mentioned that the policy would be changing, though i can tell you that the reps are the last ones to know when policy changes are handed down. (When I submitted my surgery, they tried to deny based on the fact that my 3 month non-surgical weight loss was not "physician supervised" even though the policy hasn't said "physician supervised" since 2008. lol) As for the weight watchers thing, I submitted copies of all of my weekly meeting booklets that discussed exercise, that seemed to work. I'll be calling first thing Monday to see what I can find out! Also, I routinely submit predetermination packets to BCBS. I always fax on Monday or Tuesday and I ALWAYS have an answer by Thursday or Friday of the same week. They always say they take 14 days, but I've never had one go longer than a week.

Every insurance is different, as others have said. Some take 15-30 business days, some take 48-72 hours. You could always call your insurance and ask about the status...at least then you wouldn't feel like you were "bothering" your surgeon's office too much.

I have to admit that I've been pretty lax about attending support group meetings after surgery. But, tonight I went and I have to say, it was such a fantastic reminder of how important it is to be surrounded by a group of people who have "been there, done that". If your program offers a support group, or if there is one in your area, I hope you all attend. Our group is a great mix of pre-op and post-op patients, a mix of surgeries, some are patients of my doctor, some have had/are seeking surgery at other facilities...there is so much information and support and encouragement flying in all directions! I remember before surgery being so inspired hearing the post-op patients talk and now, it is such a rush seeing the faces of the pre-op patients talk when they hear about everyone's success. Being able to learn from people who are years out from surgery and offer hope and understanding to those getting ready for surgery is incredibly rewarding. I always walk away feeling like I have gained as much as I have shared....I can't wait until the next one! (BTW, if you are in Southern Illinois and would like to attend our sessions, just send me a PM and I will be happy to send you a schedule!)

Perhaps talk to the instructor about how to get the most out of the class while not killing yourself the first time out. I'm sure he/she has some advice for getting started. Also, I think you can actually purchase padded panties like pro cyclists use. Perhaps that will help.

My guidelines say that anything non-carbonated with no sugar counts as clear liquids. That includes water, decaf coffee and tea, crystal light, sugar free jello, chicken, beef and vegetable broth. Just remember that some clear liquids do have calories, so take a look at where you might be adding unnecessary calories. Whenever I hit a stall, I make sure to up my fluids and increase my protein and I can usually get through it. Good luck to you.

You can find the BCBS-Illinois medical policy regarding bariatric surgery here: http://medicalpolicy.hcsc.net/medicalpolicy/home?ctype=POLICY&cat=Surgery&path=/templatedata/medpolicies/POLICY/data/SURGERY/SUR716.003_2010-07-01#hlink Their requirements are: BMI greater than 40 OR BMI greater than 35 with two of the listed co-morbid conditions that have not responded to conservative medical treatment Documented Three month supervised, comprehensive weight loss program which includes counseling in dietary, physical activity and behavioral changes. Phsychological Evaluation and Clearance Be sure to confirm with BCBS to make sure that your plan follows this medical policy. There are some plans managed by BCBS-Illinois that are self-funded and are able to set their own criteria for medical necessity.

In most of the program literature I have seen, the diet progression and allowed foods for sleeve patients is pretty similar to that of gastric bypass patients, so perhaps your dietitian can provide more direction from that perspective? Our program focuses on Protein. We don't have any hard carb limits, but a strict rule of consuming protein first, 2-4 ounces per meal, and then vegetable or fruit only if you have room after you've eaten the protein. Any grains should be whole grains, so bread, cake, Cookies, crackers...pretty much out. Tuna is a soft food, yes, as are most fish items. Canned chicken is also a soft food. Not sure as to why scrambled eggs would be left out as that is considered a soft food by my program. My standard foods during the soft phase are: greek yogurt, eggs, tuna, canned chicken, string cheese. Beef still feels very "heavy" to me even six months out. Speaking strictly to bread, my surgeon does not recommend it for band and sleeve patients as it is too doughy and can sit around in the stomach for too long. Also, I sent you a message. Hope that helps some.

Lettuce sometimes has that effect on my lately, and I'm almost six months out. Some days I can do a bite or two, other times, not so much. Fried foods, on the other hand, always have that effect. Perhaps it was a combination of the two.

Is it wrong that I think of my sublingual B12 as a treat? I buy the 2500mcg version by Spring Valley (found at WalMart) and they taste so good! Bariatric Advantage makes a Multivitamin in crystal form that you mix with Water. The taste is not bad, but I find it doesn't stay mixed all that well. I usually fill my water bottle with a full day serving and shake-sip-shake-sip throughout the day. I was advised that chewable Vitamins are the way to go as those that you swallow dissolve slowly and can irritate the stomach (I only heard this re: Multivitamins, not other meds or supplements). I take my Vitamin D and magnesium in normal pill form.

I'm going to be traveling to visit a friend in Montreal in two weeks. I'm going to have crazy long days at the airport on both ends of the trip, so I'd love some tips on what to pack and prepare so that I can get my Protein in without giving in to the temptation of airport food kiosks! (It is a cruel joke that California pizza Kitchen and Vosges Chocolates are located in the same terminal I fly out of!) What are your best and most effective travel tips?

Early on, when dining out, I opted for breakfast items (if they were available) or seafood. I could easily do a scrambled egg with a little cheese or a shrimp cocktail. I know I've mentioned it in other threads, but Red Lobster will let you order the "add on" portion of crab legs without ordering a normal entree, and crab is soft, easy to digest and full of protein...just skip the drawn butter! Most fish items are soft enough for five weeks out, too, I would think. I find that most chicken/beef/pork items at restaurants are overcooked and I feel like they sit heavy in my sleeve. At almost six months out, I still look for eggs or fish when I'm dining away from home. My other trick is to pack a ready-made Protein Drink that I can pour over ice (I like the Pro Joe drinks from Bariatric Advantage) I'll have that as soon as the server takes our drink order and then I'll sip some soup or have some steamed veggies.

I'd love one! christamccoy@gmail.com Thanks!

I can eat about 3 to 3.5 ounces of Protein and maybe a bite or two of vegetables, and that's about it. It really depends on the texture/density of the protein though. I can eat 1/2 cup of yogurt with a little kashi go lean Cereal mixed in with no problem. Soft Proteins like tuna salad, I can eat 3 ounces and two or three crackers. Grilled chicken, pork and beef, three ounces and that's about it. If I'm eating something other than fish, I don't often have room for anything else. Soups, like Wendy's chili, I can eat four ounces. I'm 5 and a half months out.