Bufflehead

I would guess it is the acidity. But definitely ask to be sure.

I love nuts, but I make myself keep raw nuts on hand and then roast a tiny batch for a snack. If I keep pre-roasted, pre-flavored nuts on hand, I have trouble stopping when I should!

The latest scientific evidence seems to show that if you are used to drinking caffeine, it won't dehydrate you -- not any more than water will. Technically it is a diuretic -- just like water is, with very similar effects and results -- and no one would say stop drinking water because it's a diuretic. http://www.nytimes.com/2008/03/04/health/nutrition/04real.html?_r=1& http://www.webmd.com/balance/caffeine-myths-and-facts?page=2 http://www.bbc.com/future/story/20140402-are-coffee-and-tea-dehydrating http://www.npr.org/blogs/thesalt/2014/01/13/262175623/coffee-myth-busting-cup-of-joe-may-help-hydration-and-memory

I've been thinking more seriously about running. I have had bad knees for a while but they are getting better and better the more weight I lose. I think I am going to start with Couch to 5K (maybe a few months from now) and once I do that, move on to the Zombies, Run! app. I'm not good with doing smart phone things and moving at the same time either, but I gather this one is pretty simple. https://itunes.apple.com/us/app/zombies-run!/id503519713?mt=8

I second the recommendation for the Quest bars. I only use them for emergency meal replacements, not a normal thing. But they are really good and the numbers are great. My favorites are the vanilla almond cruch and strawberry cheesecake flavors.

I was afraid my doctor would not be supportive, and was nervous before my appointment. I could not have been more wrong! So first let me say, don't borrow trouble However, I have seen other people posting here about their doctors who didn't support wls. All of them found other primary care doctors. Your surgeon's office should be able to refer you to a supportive primary care doctor who is within your insurance plan, if that is an issue. Your doctor doesn't own you -- move on if he or she is not providing the care you need!

Thanks everyone for your input! Is it crazy that I am starting to not really care if the insurance company approves me or not? The cost difference won't be that great with all the deductibles, co-pays, surgeon plan etc., and I am really sick of jumping through their hoops. Taking matters into my own hands and telling Cigna to kiss off is sounding more and more appealing.

Hi all, I may end up in Mexico as a self-pay (long story with possibilities of insurance coverage etc. omitted here). My preference is to go to Tijuana because if I do, my sister might be able to come with me as my support person. She's a physician and speaks fluent Spanish so I figure she'd be good to have around. So I am doing a little preliminary looking around. So far I am considering: Dr. Kelly, Dr. Ponce de Leon, Dr. Fernando Garcia, and Drs. Alejandro Lopez & Jacqueline Osuna (they work as a team). Obviously I want someone who is an excellent surgeon. I'm also looking for: a smooth running experience (people who are on time to pick you up at the airport etc.), a real hospital with a blood bank onsite, access to surgeon or associates for follow-up questions and advice via email/skype etc. If you have any input, either good or bad, on any of these surgeons I would love to hear about it. Also if there are any other Tijuana-based surgeons who you think I should consider I would love to know about them too. Thanks! I have gone back and read several different topics about different Mexico surgeons but just wanted to see if anyone wanted to chime in (or chime in again).

I've seen people call it Twunderland. I'm so close it's driving me crazy!

I had to do protein shakes for a couple of weeks once after an ugly accident involving my mouth. The ones I liked best that I thought were relatively low-cal were EAS Advantage Carb Control. They have five flavors -- my favorite was Cafe Caramel. I know a lot of other people like their two chocolate flavors but I don't really like chocolate very much, so I'm not the right person to comment on those!

My favorites are Fage and Brown Cow.

thanks everyone for the kind words and good tips. Hopefully all this worrying will be for nothing!

So, I'm going to use this forum a bit to vent about my anxiety regarding coverage. I have Cigna coverage, but the plan is managed by APS Health. It's one of those "partnership" plans where you get a discount on your coverage for participating in health coaching, getting regular health screenings, etc. I only started considering bariatric surgery when my APS health coach said I should. She told me to call Cigna and ask for their policy and information on bariatric surgery to learn about coverage. So I did. When I talked to Cigna, they had my account number and member number and said they were sending me all the relevant information on bariatric surgery under my coverage. Cigna sent me their policy, which was changed in May of this year. It requires 3 months supervised diet (supervised by any physician or RD), PCP clearance and recommendation, typical BMI stuff, and a psychologist screening. So I get to work on these requirements. I am 2/3 of the way through my supervised diet (run through my surgeon's office), have done the psych eval, and have an appointment to meet with my PCP next week. BUT last week I was looking around on the APS website for something else and stumbled on a separate document of their own on bariatric surgery. It says that they require: 6 months supervised diet and not supervised by a bariatric surgeon, and 5 years of documented history of obesity. So I panic and call Cigna and the rep there assured me that APS was wrong, and I just need to follow the current Cigna plan. Relief. Then I got a call back this morning from a higher level manager at Cigna who tells me that in fact the APS document might be right and Cigna is researching it for me. I'll hear back from Cigna later this week or early next week. I'm really terrified. Forget the fact that I've wasted my time and money on the weight loss program that will no longer count, and paid for psychological testing that my insurance doesn't even cover. I can't meet the five year requirement. For about three years I did not see any doctor at all. I did not go to Weight Watchers or anything else that documented my weight. I definitely was super-morbidly obese or whatever they call it, but I can't prove it unless they'll accept photographs and copies of receipts for ordering clothes in gigantic sizes. Believe me I am very grateful to have insurance at all in this country, and hope that mine will end up covering this surgery. I can't afford Mexico or any other self-pay option. I really hope that I am panicking over nothing. I don't think I realized how much I want this surgery until this came up and I understood that I might not be able to get it.

You definitely want to see your doctor about boils and rashes that come up with sagging or folding skin. Usual treatments include things like antibiotics, prescription hydrocortisone, and steroid treatments. Keeping the area clean by washing gently with a mild soap and patting thoroughly dry can help, but this is something you want a doctor's help on, not to try to treat it with home remedies. Good luck!

Hi Jackie, I haven't had my surgery yet but assuming I get approved, I'm going for a sleeve, probably in late November/early December (I can't take much time off work before then). Good luck in your journey!

I know what you mean. I try to eat as much organic and natural as possible and stay away from Frankenfoods. I have been doing more of my own cooking. The parts of the diet (pre-surgery etc.) that require me to eat lots of artificial stuff with artificial sweeteners is going to be hard.

I ran this recipe through MyFitnessPal recipe builder and it says that if you make 24 bars out of the recipe, you'll get 14 g protein, 4 g fiber, 13 g fat, 26 carbs, and 265 calories per bar.

Definitely ask your surgeon's office for a referral to another pcp. And you may not have to do everything all over again. Most insurance requires that you do a supervised weight loss/regular check ins with a doctor or nutritionist and that you get a letter from your primary care provider recommending that you have the surgery and clearing you for surgery. But they don't HAVE to be the same doctor! For many insurance plans you can do your weight loss with one doctor and your letter of recommendation from another. Make sure all your records get transferred from your old doctor to your new doctor so that he or she can properly review them and refer to them in writing the letter. Of course, this is not true for every insurance company and you should check the requirements of your own plan. Good luck!

Just to follow up, I did talk with my surgeon and he said that while he isn't crazy about women staying on the pill for surgery, he doesn't require them to stop. I think I am going to talk to my PCP when I see her in a few weeks and see what she thinks about the situation, elevated risks, etc. Accidentally getting pregnant is not and will not be an issue for me so if I do go on bcp, it would be for the convenience only. So, I am going to talk to her about exactly how much that would elevate my risk for a clot/thrombosis and whether the trade-off is worth it.

Short layered haircuts with a side part are your friend if you are a woman with thinning hair. Also your friend: "hair make up" products such as Nanogen or Xfusion. They thicken your hair and help conceal if you have scalp showing through or anything like that. I have really thinning hair (without even having surgery yet) and these products are what made me feel confident about the way my hair looks. You can Google them to see videos of how they work/where to buy etc. One more supplement you might try is zinc. The standard dose is 50 mg every third day (do NOT take more without consulting a doctor -- too much zinc is dangerous). There has been a study showing that zinc can help with hair loss after bariatric surgery: Neve H, Bhatti W, Soulsby C, et al. Reversal of hair loss following vertical gastroplasty when treated with zinc sulphate. Obes Surg. 199;6(1):63–65. That said, many people do not tolerate zinc supplements well at all -- they can make you sick/vomit etc. And it really is important to not overdo it because it is truly dangerous to take too much zinc.

Hi Jackie, I am not in NY but if I were, I would at least look into working with this surgeon: http://www.bariatricsurgerynyc.com/ His practice is a Center of Excellence and he is a F.A.C.S., so those are good starting points. He is in Brooklyn. He has a profile page here on this site: http://www.verticalsleevetalk.com/surgeons/858-piotr-gorecki/ If you look on the left you can click "patients" and see his patients who are registered here. You could then see if they are willing to talk with you about their experiences. You can also search surgeons on this site by location using the "Surgeons" tab up towards the top -- at least you can on the web, not sure how it displays on your phone. You might find other, better options that way. Good luck!

I have thinning hair pre-surgery too. I use Nanogen or Xfusion to cover the thin spots. They work great! I recommend checking them out if you are self-conscious about your scalp showing etc.

I think it really varies depending on the practice. I had my first visit last week. --met with nutritionist and bariatric nurse to discuss diet plan (they want everyone to start on a 1200 cal. diet immediately); have BP taken, get weighed and measured --met with surgeon to discuss different types of bariatric surgery, medical history, answer questions, talk about required pre-surgery tests (in my case, just an upper GI for now, I think a chest x-ray prior to surgery as well) get poked/prodded/basic physical exam --have blood drawn to check vitamin/mineral/cholesterol levels etc. --meet with exercise physiologist to discuss exercise program and conduct h. pylori test --brief meeting with front-office staff to set up an appointment for psych testing & evaluation with their in-house psychologist (that's tomorrow) and make sure they have all my insurance info. That was mine -- it took about 2.5 hours.