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.

I had my first stall at three weeks and was quite discouraged. However, I could tell that my body was changing, so we took some measurments. I'd lost a total of 12 inches from my waist, hips, chest and arms. I highly recommend taking your measurements and tracking them along with your weight loss. It was a huge motivation for me to see that even though the scale was not moving as quickly as I wanted I was still losing. I still have periodic stalls, but if I up my Protein and Water, I start to lose again.

I went shopping this weekend to take advantage of the bra sale at Lane Bryant (how can you pass up a buy 2 get 2 free sale on bras, right?) I also purchased a pair of jeans - size 14. I went on the website today to grab two more pairs in the online sale and then cut up my Lane Bryant card. Since size 14 is the smallest size they sell, I never have to shop there again. Bye bye, Lane Bryant, it was good while it lasted.

I'm a big fan of tuna! I get the Starkist Lunch-To-Go kits and leave out the crackers - 19 grams of protein. Greek yogurt - Oikos, Non-fat vanilla is my favorite (I mix in 1/4 to 1/2 a cup of Kashi Go Lean cereal - 13g protein per cup - but I'm further out, you might not be able to tolerate that yet) Chicken salad, egg salad - both staples for me. And cheese - Cheese Heads light string cheese by Frigo - 8 grams protein

The policy posted by morethan is the WellPoint coverage criteria. It is used by Anthem BCBS and HealthLink, among others. HCSC, the parent corporation of BCBS Illinois, Texas, Arkansas and New Mexico approved the sleeve in July 2010. Here is the link to the BCBS Illinois policy. If you look in the insurance section of this forum, you will find several links to well-written appeal letters. Good luck to you!

I just had it for dinner and it was really good. Next time, I'll probably remove some of the broth before I add in the milk and then blend up a portion of it before I add in the cheese. It is a little thin when prepared as written, but still very tasty!

I bring home 1/2 to 2/3 of everything I order out. I could feed the neighborhood on my leftovers! A lot of restaurants have "light" or "heart healthy" or "low carb" sections on their menu, and that is the first place I look. Well, if there is no shrimp cocktail on the appetizer menu. I love that Red Lobster will let you order the "add on" order of crab legs without actually "adding" it on to another entree and I almost always choose some sort of egg dish at places that serve breakfast all day. I'm a big fan of the veggie omelet with salsa. I tend to stay away from beef items. They sit heavy in my sleeve and can be too tough when reheated. But chicken and fish items always work well for me. My family loves to eat out, so I've gotten good at breaking down a menu item into what I can/can't, should/shouldn't eat and ordering only what I want. I used to get annoyed at people who made special requests when they ordered, but now I'm one of those people. I've yet to run into a server or a cook, who was anything less than accommodating.

Double check with your doctor and./or dietitian, but I think as long as it is blended to a smooth consistency, it would be okay.

Anthem, as a whole, covers the sleeve as of November 18, 2010. They follow the Wellpoint utilization management guidelines for their medical policy on bariatric surgery. General requirements are: :: BMI over 40 OR :: BMI between 35 and 39.9 with additional co-morbid conditions (diabetes, hypertension, hyperlipidemia, cardiovascualar disease, severe cardiopulmonary disease) :: History of non-surgical weight reduction attempts :: Psych consult :: Medical Clearance :: Pre- and Post-op Diet and Nutrition Counseling :: Ongoing follow-up and support/education/counseling resources That said, every plan is different and some employers/plans may specifically exclude bariatric surgery as a whole or my put additional requirements in place. It is always best to call the number on the back of your insurance card and ask specific questions and ask for a copy of the medical policy (it is usually available online). I've worked mostly with Anthem Ohio and Anthem Kentucky, and the predetermination/pre-certification process is fairly painless as long as your doctor submits the required information. I think their predetermination process takes a week or less, but don't quote me on that.

I finally found the recipe I was looking for a few days ago! Ingredients 3 lbs fresh broccoli, chopped with stems discarded 1 Tbsp extra virgin olive oil 1/2 tsp black pepper 1 tsp garlic powder 2 cups fat- free milk 1/2 cup reduced – fat cheddar cheese, cubed Method of Preparation 1. Place broccoli, extra virgin olive oil, black pepper, and garlic powder in 4-quart or larger slow cooker and add enough Water* to cover. 2. Cover and cook on high for 1 – 2 hours. 3. Add milk and continue to cook for 15 minutes 4. Finally, stir in cheese and continue cooking until cheese is melted. * To add more flavor, try using a store bought low-sodium chicken broth. Makes 6 servings Nutritional Information Calories 190, Protein 14 grams, total fat 7 grams, carbohydrates 20 grams, dietary fiber 6 grams, sugars 8 grams, sodium 280 milligrams

A few weeks ago, while trolling for recipes, I found a Bariatric-friendly Broccoli Soup recipe that is prepared in a crock pot. I bought all of the ingredients and lost the recipe somewhere between the store and my house. *sadface* All I remember is that it calls for three pounds of broccoli, some garlic powder and cheddar cheese...and that it cooks in 2.5 hours. Does this sound familiar to anyone? I'd be so grateful for a link. Thanks!