mmcclure

It's amazing how every doctor seems to be different. I thought I had to give up caffeine 2 weeks before surgery, but after 2 days of no coffee, I called and they told me that it is okay for me to have it. It does seem smart to stop before surgery though, if only to prevent the headaches. Now if I could just stop the people where I work from either coming in sick or bringing their sick kids to work with them, I would be a very happy camper. I will be unbelievably angry if I have to postpone my surgery because I get sick, especially since I don't know if they could fit me in by the end of the year and I am not picking this insurance up again for next year. Why do people go to work when they are sick or take their kids with them? I'm talking about professors and or department chairs who have tons and tons of sick time accumulated! Surgery in 8 days! Marilee

My daughter and I are having VSG on November 12th. I originally told my boss that I would be back on November 29th, which would give me 2 weeks to recuperate. Now I'm wondering if I was being a bit hasty. I am 55 years old, have diabetes, high blood pressure and MS. The diabetes and MS already make me tired and I've been getting the idea from people that this surgery takes a lot of your energy out of you. Do you think I should plan on taking some extra time off to get on my feet? I have the time (and short-term disability), so that isn't a problem. But, I am sure my boss would be happier if I came back to work. Oh, and BTW, I have an office position - sit at a desk all day - but it is a long way to the bathroom (I keep hearing about liquids in, liquids out)! Thanks! Marilee

I know that this topic has been around - how many times I'm not sure, but I'll bet it is plenty - but maybe this is a question that no one has asked before and it has been on my mind for several days. My daughter and I are having VSG surgery on November 12th. We had to do a 3 month low carb diet for insurance purposes and now we are supposed to be on a two-week high-Protein diet consisting of meats, green veggies, eggs and cheese ONLY, staying under 20 grams of carbs per day. We started a day early (THAT was a mistake! LOL) but have been religiously following it since with the exception of having a Protein shake (Premier Protein with 30 grams of protein) for lunch instead of one of the listed solid foods. Tomorrow will be one week. My question is - what would it harm if, after the pre-op visit (which takes place 3 days before surgery), we went out and had a nice dinner and possibly dessert? I am soooo hungry for fajita nachos, I can't stand it, and that is something that I might never be able to eat again simply because of the bulk of the chips, lettuce, peppers, onions, cheese and chicken. I know that, if someone goes to Mexico to have surgery, the surgeon makes them follow a two-week liquid Protein diet and then they get to have whatever they want to eat the night before surgery. So, what would it hurt to have one meal a couple of days before the surgery? Our livers can't possibly get slippery or large again that quickly, can they? Please don't slam me with the, "you aren't taking this surgery seriously enough...you aren't ready if you can't follow the diet..." and so on. Believe me, we are definitely ready for the surgery. My daughter has lost 34 pounds in a little over 3 months and I have lost 18 (she weighs more than I do and is a lot younger). It is just that fajita nachos are my most favorite thing to eat (with the exception of pizza), and I can't understand how two days before surgery could impact the liver all the much. I'd ask my doctor but I kind of don't want him to tell me no and then be suspicious the day of surgery that we may have cheated. Does anyone know if the liver can change that quickly? Did anyone cheat just a couple of days before surgery with any consequences? Thanks. Marilee

I am kind of going through the same thing. I found out my surgery is on November 12th and my pre-op visit with the surgeon is November 9th. I will have to be on a no/very low (less than 20 grams) carb diet for 2 weeks prior to surgery. Well, this past week and weekend, I kind of went nuts, mostly with Mexican fajita nachos and some Chinese food. I had been on a three-month diet and lost 12 pounds. Once that was officially over, I relaxed a bit and had already put on 5 pounds before the weekend. Then, much to my horror, when I got on the scales this morning, I found that I had gained 14 pounds since my last doctor's visit!!! (Note - this is a 9 pound gain within 4 days!) He is very very strict about not gaining any weight before surgery and will even postpone it if you do. I am praying that the low carb diet will take this weight off of me in time. Another thing I am stressing about is the fact that my primary physician just changed my blood pressure meds, taking away the diuretic. That means that I am about to puff up like a frog, on top of the weight gain I have already had. If I gain weight from that, I don't think it should be held against me, but I don't know what will happen. I can't believe that my surgery will be in 20 days! (Well, if I can get this stupid weight off again, that is.) Worse part of it is - there is a pizza shop across from where I work that keeps calling my name. I know that, once I have the surgery, I will be fine. It's just that there are a couple of things that I feel like I am really going to grieve over if I don't get it out of my system beforehand. I feel like a little kid in a candy shop who is being pulled out by the arm screaming! :pizza: :hurt:

I am going to have VSG in November. I already take the maximum dosage (30 mg) of Prevacid, once a day and have for years. I keep hearing that many (if not most) people who have VSG need to take a PPI after surgery to not only help with the GERD but with hunger, at least for awhile. I also read from someone that, if you are already on a PPI, you may need to have your dosage adjusted after surgery. Does anyone have any suggestions about what I should do after surgery if I am experiencing any of the typical GERD and hunger symptoms and am already at the max for Prevacid? I know that this is something I will probably need to address with my surgeon, but I'd like to be prepared just in case he doesn't think I need anything and I do... Thanks!

My daughter has been very overweight much of her entire life. She has seen the same PCP for the past 3 or so years pretty regularly so should have a record of her weight... BUT, his scales only go to 300 pounds so they have been unable to weigh her. What happens in a case like this? She only went to the GYN/OB once during that time so, essentially, she doesn't have any weight records (I'm not even sure if their scales went any higher). Can the doctor state that her BMI had to be over 40+ due to the fact that their scale didn't go high enough? Will that be enough to fulfill the weight record requirement? Thanks!

While I don't have to be on a liquid diet right now, I am doing a liquid protein diet with my daughter to support her while she tries to lose weight (has to get back down to her initial consult weight of over a year ago). That is hard enough, but I work at a university and there is a sandwich shop on the bottom floor of the building I am in that cooks bacon in the morning and bakes bread and cookies all day. For some reason, the odors rise to the floor I am on and I am about to lose my mind with the smells coming into my office! Sigh...

Check out: Obesity Surgery. Although it looks like everyone with Aetna has to meet these exact guidelines, from the posts above, I'm not sure exactly how it is determined. Also, not every Aetna plan covers bariatric surgery. To find a good surgeon, you might want to look for a support group or two in your area and attend a few meetings. I'm sure you will find people willing to talk to you about the doctor they used. Good luck! Marilee

I'm confused about this. I, too, have Aetna and my surgeon's office said that the three-month multidisciplinary program consists of the nutritionist, psychologist and the dietician/doctor visits in their office. Although it says in the bulletin that a supervised exercise program is required, she said that this was all we had to do and that the psychologist would monitor our exercise (we would talk with him about what we were doing as part of the behavior modification. She also said that they would keep track of everything themselves and get updates from the nutritionist and psychologist. My daughter and I are going on our third month and I do not want to find out now that we were supposed to be doing a supervised exercise program. Does anyone know exactly what is required? I've had people say all kinds of things.

I am in the process of doing the three-month intensive diet/exercise/behavior modification requirement for Aetna. Does anyone know if this means that I have to see the psychologist and nutritionist a total of 4 times or 3? I know that this seems like a silly question, but the psychologist says it is only 3 and the nutritionist says it is 4 (1st visit, 2nd visit after one month, 3rd visit after 2 months and 4th visit after 3 months). And, does it matter if you go over or less than 30 days in-between visits?

I know that I have one because, when I had my gallbladder out years and years ago, the doctor saw it but said it wasn't bad enough to fix (huh?). I have horrible GERD now so I'm sure it hasn't improved, but it did not show up on the endoscopy I had. When I asked my doctor about that, he said that they can slide in and out and aren't always visible.

I also asked this question when I started out researching the various ways and means to get VSG. I even called the insurance company. They told me that, no, if the surgery is not covered then any complication would not be either. On the other hand - it is my impression that, after time has gone by, it would be very difficult for the insurance company to differentiate between a complication from WLS and something else. So, there is a chance that if a complication were to arise farther out from surgery, it would probably be covered. One thing I am doing is getting a referral from my PCP to my surgeon for hiatal hernia surgery. At least that part will be covered if he finds one and fixes it while he is doing the sleeve. And, God forbid a complication arises - maybe it would be caused by that and not the WLS. :thumbup1:

Ok, so this all makes sense now. The person I know that got Protein poisoning didn't eat rabbit, she is overweight and ate almost exclusively protein (animal, I'm sure). For all I know, she sat there and ate steak after steak and nothing else. My daughter and I are doing a modified carb diet, I guess you would call it. Not Atkins, but trying for 60-80 grams of protein minimum and low carbs (not really counting but all sources are low in carb count). The protein is from varied sources, including soy (protein bars, tofu, etc.), chicken, fish, milk and some beef. The carbs are almost exclusively vegetables, salads and limited whole wheat bread. Once a week, we are allowing ourselves something that we really really want (hey, we have to do this for three months before surgery). We are losing weight and I think this is pretty healthy. This is pretty much what our diet will be like after surgery, once we are on whole food again, right? Thanks!

One thing that really relieved my mind was the fact that the hospital we are going to will bill us and set-up payments for whatever the amount ends of being - interest free. When I asked the billing department what would happen if we owed a lot more after they billed the insurance company, she said, "we will work with you and set something up, unless you want to pay interest to your credit card company or on a loan" and then she laughed. Whew - that was soooo good to hear. BTW - this is one of the top hospitals in Georgia, too.

I don't know if this has been brought up before but, I wondered if anyone has suffered from Protein poisoning since WLS and a high protein diet? I never knew this existed until a friend of mine's mother got it and ended up in the hospital for a week because she was on Atkins! Everyone keeps talking about how low our carbs have to be in order to lose weight and keep it off but at what point do we put ourselves in danger if we eat too little carbs? I have been following a high protein diet for over a week now (on a three-month intensive diet/exercise/behavior modification program) and I have already lost quite a bit of weight. However, I've done this before and I know that, just as soon as I start eating carbs again, I'll start gaining. On the other hand, I don't want to endanger myself (or my daughter who is doing this with me). If I simply do a calorie counting thing, I seem to be hungry all the time because so many of the diet plans consist of a lot of carbs.

This brings up something else - if you have an insurance policy that covers 80%, don't they still have to go by the allotted amount if they have that hospital / surgeon as a in-network provider? I'll be using a limited insurance policy that only covers up to a certain amount, so I am sure that I will have out-of-pocket costs above the 80%. It is certainly more reasonable if I end up paying what's left of an allotted amount than what the hospital or surgeon charges out-of-network providers. I think I've spent months trying to figure out the best way to accomplish this surgery and the best insurance to use (of the ones available to me at the beginning of the coverage year). I've almost had total meltdowns several times!:thumbup1:

My daughter and I recently found out that we have to do the intensive diet and behavior modification program for three months in order for Aetna to cover any part of our surgeries. (This after we were told repeatedly that we didn't. - Sigh). When we saw the nutritionist (I think that is what she is) in the surgeon's office, she told us to go on very high Protein, low carb diets. 60-70 grams of protein a day for me and 70-80 grams for my 21 year old daughter. She also told us to make sure we drink 32 oz of skim milk a day and a total of 64 oz of liquids (water making up most of the rest). She said that it is really important that we start upping our protein now and it will also help us get in the right mindset for after surgery. Then, later that day, we went to see the nutritionist that the doctor's office recommends for the 3-month diet counseling. She did a practically 180 degree about-face and told us to follow a 1200 - 1500 calorie diet and her diet meal plan (that only shows 5 days worth), has a lot of carbs in it. When I said something to her about the other person's diet, she only looked at me and kind of shook her head yes. So - now I am totally confused. It has been a week since we saw both of them and my daughter and I are trying to do a higher-protein diet with limited calories and carbs. I need to work harder at getting all of my liquids in but my daughter is doing great with her milk and Water. I know that everyone seems to get a different pre-op to follow but, if you were asked for your advice on doing a three-month diet prior to surgery and losing some weight in the process, while getting two conflicting diets to follow, which one would you do? BTW, I did call the surgeon's office and asked them which one we should follow and was told, "the nutritionist" (meaning the one NOT in their office). However, the five day diet really isn't much help, especially since Breakfast and lunch are kind of prohibitive since we are both out of the house for 10 hours a day, 4 days a week and are usually in a hurry to get out the door in the morning and neither one of us really likes to eat breakfast. We certainly don't have time to put together the meals she has listed (and they can't be made ahead). However, I suppose we could try to improvise if we need to. So - votes, please. Follow the high protein, low carb easy to do diet, or the "usual" balanced diet of protein, carbs, fruits, etc that you usually see from nutritionists? Oh, and BTW, not that this should make much difference, but the high-protein advocate said that, if we really wanted something, we could have it once a week. Those of you who were required to do the three or six month pre-op diets for insurance approval - what kind of diets were you told to follow? Thanks! Marilee

My daughter and I are having surgery using a very limited insurance policy that has a definite yearly cap (and it is not very high). I have an HMO that is fantastic, but they don't cover WLS nor any complications from it. I've been worried about this as well. But, I don't want to change jobs because I love the one I have and the benefits (other than not offering WLS) are wonderful (and I can retire with them). My husband's employer (full-time one; he has two and we are using the insurance from the part-time one) covers WLS but has a rule that, if your spouse can get insurance, they have to take it. That would make mine primary and his secondary so the way insurance works, there would be no WLS coverage (their argument is that if the primary doesn't cover a procedure, there is nothing to pick up, therefore, no coverage for that procedure). Yeah, they have all their bases covered to their benefit, certainly not ours. It all came down to whether or not we were willing to risk having the surgery vs. the bad health and risk of NOT having surgery. I pay over $125.00 a month just in co-pays for my medicines, plus I can see where my health is getting worse every year (I am 55). My daughter is only 21 and already has asthma and knee problems. She is a beautiful girl, but has low self-esteem and is worth soooo much more than what she is experiencing now. I just posted a post about being nervous about the surgery and that is true - I am. But, in answering this question, I guess I am also reaffirming why we are taking this risk. So - God willing, we will have no complications. But, in any event, we will take that risk because the benefits far outweigh the risks. Money is just that - money. Your health and well-being are everything.

I have a dilemma. I have a limited benefits insurance company that I am going to use for sleeve WLS. It has caps on the amounts it will pay for certain hospital charges, etc. Going round and round with the insurance company and hospital has pretty much gotten me nowhere since no one wants to commit to an amount. I can understand that, but I also need to know what I might possibly be looking at in terms of what this is going to cost me out of pocket. If anyone has an itemized bill for their surgery and would be willing to share the information with me, I would really appreciate it. I know how much the surgeon will cost; it is the hospital charges I need to know. For example, how much it cost for the operating and recovery rooms, meds, medical and surgical supplies and devices, lab tests and x-rays, etc. I know that your amounts won't be exactly the same for me, but at least it might give me an idea of what to expect. The surgeon requires a two-day hospital stay. What I especially need to know is what the hospital billed the insurance company - not self-pay. I have Aetna and this is a preferred provider, but the policy isn't a traditional Aetna policy because of the caps (I also do not need nor will they do preauthorization). So, while I'm assuming that there are allowed amounts, I have no idea what those are. Any help would be greatly appreciated! Thanks.

Just a quick note - the Wellbutrin generic you are talking about also comes in a 150 mg dosage that is MUCH smaller. Could you perhaps take two of those? Just have your doctor prescribe two of them and get 60 at one time for a month. If you have a co-pay, it will be the same. As a matter of fact, some of the insurance companies actually advocate for this.

To Jenni80 - actually, it wasn't your post that upset me all that much. It was much much earlier in the whole thread. I do appreciate your apology and good wishes, however. It takes courage to apologize and I really commend and thank you for it. Thank you also to Swiftflow and Tiffykins for your kind words. I do appreciate the kindness and support that is shown in other areas of this forum. As I am sure all of you know, this decision is so very hard to make in the first place, and then to go through it is another huge emotional and physical process. It just concerns me when I see attacks like this, for whatever reason. I've been on other boards before so I'm not totally ignorant of how some people can be, but I guess I just thought that people here would be a bit more understanding and tolerant. I don't know why I thought that way, but I did. Anyway, I got it all out and feel much better now. :-) I hope to become "friends" with a lot of you in the coming months. I'm sure I will be on here asking for both advice and emotional support and it is really good to know that there are good people on here who care. Thanks again.

First of all, let me preface this by saying that I have not had surgery yet but, if I hadn't been able to get my insurance to pay for at least part of it, I would probably be going to Mexico to get it done. However, that isn't what I am about to address. What I would like to speak about is the fact that people are being way too judgmental, nasty and mean to people who are giving their opinions. I do not understand why it is necessary for someone to attack another person on this list when simply responding with your own opinion and/or facts would be sufficient. And, before you write back saying that you have tried that - I don't care. Try again. Do you really need to stoop to hurting people or starting a fight over something? I do not know the history that people may have together or perhaps ill feelings they may have towards one another. All I (and other newbies) see is judgmental posturing that is either backed-up or egged on by others or others attacking them in response. Who cares if someone says that they wouldn't go to a Mexican doctor? Those of you who react so strongly to statements such as this insult the rest of us who are quite capable of making up our own minds and doing our own research. True, we came here for information; however, I am more inclined to listen to someone's advice if I do NOT see them attack someone else in another post, no matter what the subject matter is. By mocking someone or downright insulting them, you make me feel like getting off of here before I get attacked as well. Which might hurt all of us in the long run because then we can not learn from each other. None of us are responsible for other people's choices, nor do we have the obligation or right to influence that choice. We can say how we feel about OUR experience or we can state FACTS with citations to back them up. We do NOT have the right to attack others because they state what they feel. Instead of attacking the original poster, why couldn't you have responded with a post that spoke of the reasons why you WOULD go outside of the United States and then let it be? Let people decide for themselves. Let people say what they would do. You have absolutely no right to attack someone in an open forum such as this. I don't know if I will stay on this board. I really wanted to, especially since my daughter and I will be having surgery at the end of June and we could really use the support. I am sure we will have questions or issues that we would really appreciate some help dealing with. On the other hand, we have had enough mean things said to us when we were overweight. We don't need more of it from people who should understand how that feels. We are looking for trust, acceptance and kindness. Certainly not what I have seen here.

Congratulations and best of luck on your journey! You are lucky indeed to have been able to get such a quick approval.

I just looked at the Aetna site again and it still hasn't been updated. I have a doctor's appointment on April 9th and I think they are going to go ahead and start all the tests that the surgeon wants my daughter and I to have. Hopefully, when the policy is updated in mid-April, we will have already gotten a lot of the tests done and can schedule the surgery. My Aetna is a bit different than most; I don't have to get pre-certified. So, apparently, I don't have to go through the 3 or 6 month supervised diet thing. But, Aetna itself still has to cover the procedure before the insurance will pay anything. I sure wish they would hurry and get their policy updated. I can't find out how much our out-of-pocket costs will be (it is a limited insurance policy) until they have an allotted amount with the hospital for this procedure and the hospital can tell me how much it will be.

I apologize if I have offended anyone. That certainly was NOT my intention. I am just trying to be as thorough and cautious as I can. Like I said, Dr. Aceves will be my choice if I go to Mexico (I'm dealing with an insurance issue right now and whether or not they will cover the VSG and what my co-insurance amounts will be is my deciding factor). I know that there have been a lot of people on here who have given Dr. Aceves praise, as I am sure he deserves. I just wondered how anyone could truly know if something is the truth about a doctor (ie, no leaks). I didn't intend to sound as if I were giving criticism.