dust

today i paid the psych out of pocket and obtained the evaluation. that's the last item that i was waiting on for a complete package, so insurance submission should happen soon. my insurer told me it is a 5-10 day approval period, so hopefully in a few weeks i'll have an answer and can schedule surgery. wish me luck!

yet another quick update last week i visited the support group. frankly i wasn't expecting to get much out of it and i had it in my head that i was only there to meet the doc / insurance requirements.. that said, it was very informative. i met lots of people, many with the sleeve, who had major success. seeing it here is one thing, but shaking hands with guys near my age who have been through it and changed their lives is different altogether. case / point - i met a guy who lost 230lb in 12 months (!) with the sleeve. he was very encouraging and honest about everything surrounding the surgery. i met another guy a few years older than me who was 2 weeks post op, -30lb, and feeling great. the first 40min or so of the meeting included a presentation from a plastic surgeon who discussed the implications of extreme weight loss and the potential for tummy tucks, breast work, etc etc. we watched his slideshow which was mostly bariatric patients who had skin removed, tummy tucks, and breast lift/augmentation. i told my wife that i was thinking "well, at worst i got to look at pictures of boobs for 40min!" and was pleasantly surprised when i was able to spend some time chatting with the sleevers of the group. anyway, it was encouraging and it added more confidence to my decision to move forward with surgery. so, as of now, i have done everything i need prior to insurance submission. i am waiting on an insurance company appeal to cover my visit with the psychologist. if they deny then i will just pay out of pocket (~300) so the surgeon can submit my paperwork. my only concern is that since the behavioral management arm of my insurance company denied coverage for a psychologist and requested that i do the eval with an outpatient psychiatrist that they will deny my surgery if i pay out of pocket and submit based on the psychologist's report. luckily my company has an "insurance concierge" law firm with a single point of contact for all insurance issues. the lady i deal with is an HR / insurance lawyer, and she is chasing down all the issues for me. hopefully i will know what course to pursue by the end of this week so the surgeon can submit next week. with a 5-10 day approval period i hope to be in the OR by the end of february. wish me luck!

jacobn what city are you in? also, Isopure clear Protein drinks give a whopping 40g/bottle.

i guess i'm at the top of the heap then since i rarely leave home without my sidearm

there are some guys bouncing around, but women vastly outnumber us on this site. re: the diet.. it's hard to tell. i'm still pre-op as well but i have some experience with a very low calorie / low carb / high Protein diet. it is likely that you will lose some strength in the initial phase, mainly because you'll be out of the gym for 4ish weeks. my surgeon recommended the sleeve to me because of my concerns with muscle wasting, saying that as long as my protein intake is sufficient i shouldn't have to worry too much about muscle loss AS LONG AS i keep up my activities on the mat. if anything a lighter body will increase my cardio endurance and allow me to work harder. muscle growth is not impossible with the sleeve, but you have to plan well. do you train bjj now?

my advice? DO IT! we have some 40+ novice white belts at our gym. we also have some 40+ purple and brown belt headhunters. the key is to find a gym that doesn't have the big ego thing going on.. most gyms that train MMA with a BJJ program on the side are going to be loaded up with guys looking to wreck people. it will be rough, you'll get beat up, and you'll quit. if you find a purist gym that is BJJ focused (most of them have some cardio/crossfit classes on the side too since it helps pay the bills) then you'll have a much friendlier, more technical, focused atmosphere. most purist gyms have beginner and fundamental programs where you only train with guys at your skill level, so you can learn without getting destroyed every time you're at the gym. it helps with the potential ego issues

search youtube for "Gracie Challenge" and watch Gracie BJJ players own guys that try all that fancy kung fu stuff if someone is close enough to punch you then they are close enough for you to get then on the ground and end things. Rickson Gracie, one of the best BJJ players ever, was quoted as saying "The ground is my ocean. I'm a shark and nobody else even knows how to swim." not that i'm some serious BA who can win any fight... sorry, not trying to be contentious.. i just believe in BJJ and have a distaste for traditional martial arts.

i love the article title - "ultimate first-world solution to overeating"

there are plenty of tough looking 6'1" guys walking around at 190-200lb. don't sweat it. who cares what you look like as long as you can back it up. krav is good, but it's very hard to find a good, high level instructor who really knows what they are talking about. as you can see from my avatar i train in brazilian jiu jitsu, and i happen to train with some of the baddest dudes on the planet. literally - i train with multiple guys who hold world championship titles, and the alliance team has won the team worlds 7x. so while i'm a bit biased, i think BJJ is the superior martial art. 4mo of basic BJJ training and you could win most every bar fight you could find yourself in. add a little striking to the mix and you're way ahead of the game. use your brain and don't get into fights unless it's absolutely necessary and you're unstoppable. some of my training partners don't look like anything special but would completely, utterly destroy anyone who made the unwise decision to start something. that said, go check out a krav class. i think you might be a little disappointed in the actual "workout" aspect of the classes as the ones i have tried have never been very cardio or strength intensive like BJJ is. judo workouts are intese as well. neither one is as hard core as your typical wrestling conditioning workouts, but they are still great. if you decide to get into BJJ then there are tons of opportunities to compete, which is addictive and provides a huge motivation benefit.

quick update. labs are back. everything is fine except for a low Vitamin D count. doc told me it won't hold anything up, but I need to be on 50k iu/week for 12 weeks so they can redraw. if the count is back within spec then i go to a standard 1k iu/day dose. ive also had a good bit of insurance trouble with the psych eval of all things.. the insurance company refused payment because they want me to see an outpatient psychiatrist rather than the psychologist recommended by my surgeon. i'm attempting to work it out, but if it doesn't happen then i'll just write the doctor i saw a check and get it over with in the interest of time. i have a feeling it will shake out in my favor, however. this week i will make my support group visit, and after that is complete i won't have any more responsibilities before the doc submits to insurance. hopefully i'll have an update soon with some positive news!

i can assure every one of you ladies that your man WILL NOT care if the aesthetics change as long as you keep the stairway to heaven open for business

here's a guy's perspective.. if it ends up making a difference to him then you'll have to ask yourself if he's really the right kind of guy to be with.. if you're worried about it then tell him. get ahead of the issue, explain, and don't let him generate any ideas on his own before you talk about it. good luck and congrats on the wl!

good post my friend. as i move toward surgery i haven't had too many concerns, but i'm sure i will second guess it at some point. keep up the good work and you'll hit that goal. i hope to join you one of these days!

dont forget that all the extra exercise is building muscle, which is heavier than fat. your body can be changing while the scale still shows the same number. keep your head down, work hard, and you'll get through the plateau. have fun with it!

glad to have you on board. i'm working myself through the process as well and looking to it. is that your bike in the profile photo? if so i'm sure it will be a lot easier to ride without a belly in the way every 20lb you lose makes a seriously noticeable difference in how fast a motorcycle will get up and go.. trust me! good luck!

what a whrilwind the past few days has been! on saturday i visited the shrink. she was really, really wonderful. if you're in Atlanta and looking for a psych consult I must recommend Dr. Carole Kant. i left with some great advice and a thumbs up from her. today i did my labs at the hospital. barium swallow upper GI, a whole host of blood work, EKG, and an O2 sat. i also visited my new PCP today who is bariatric friendly. we chatted for a long time - about 45 min - and he had some great input. he said he has no reason not to sign off, but he wants to see the lab work results before he sends in the letter. at this point i'm just waiting for all the reports to get to their proper places. all i have left to do is hit up a support group. i'll keep y'all posted

thanks for the words of encouragement. it has been fast, but i have been thinking about WLS for years. i am well informed after tons of research and feel comfortable with the risks. my surgeon is top notch and has a great track record, and that alleviates many of the typical concerns. i know that it's a game of odds and statistics, and that there is risk, but i feel i've done a good job minimizing it by choosing a great surgeon and a great hospital. i'll keep updating as the process moves forward!

so i saw the doc, he confirmed that jits, judo, really anything was acceptable 4-6wks post surgery. now i'm really looking forward to hitting my goal weight and competing with the little guys

quick update... psych eval is scheduled for Saturday hospital labs are scheduled for 12/26 primary care physician appt to obtain letter is scheduled for 12/26 as well once that is complete i'm looking at a 5-10 day approval time frame after it's all submitted to my insurance provider. i have no idea what the surgeon's workload is like, so i don't want to make any guesses as to a surgery date.

had my first appointment today. it went very well. i am confident in my surgeon and he was encouraging. we spent a good bit of time discussing options and answering more questions. i'll talk to my wife again tonight but i'm pretty sure i am going to go for it. my insurance is surprisingly lax in requirements. in fact, the doctor requires more than the insurance company does. it all goes well i should be able to submit to the insurance company shortly and after 5-10 days get an answer, which i expect will be a yes due to their lenient criteria. we'll see how it goes!

i don't think it's particularly fair for us to judge whether or not someone else is ready. that's between me, my wife, my surgeon, and the head shrinker. i appreciate the concern, but i'm planning to strike while the Iron is hot and get it done asap. after my appointment today i'm fairly sure that i am going to go this route. once i get some miscellaneous items taken care of (labs, psych, etc) it will be 5-10 days before insurance approval and then i will get a date. still need to talk to the wife about it tonight and go over everything the doctor said, but it's looking good.

blue cross blue shield direct access. it's the cadillac of all insurance plans.. amazing coverage and my employer bought pretty much all the coverage. it will be very easy to move through the process and do it quickly. im pretty sure i don't even need a pcp letter. tomorrow i see the doc and the nut. i will have to do psych and an EGD as well. not sure what else is required appointment-wise. the doc does require that i visit a post surgery support group before it's a go. i'm not 100% sure because i still have some specific questions for the doc. i want to be well informed before i do it. hopefully i will have what i need to make my decision after the appointments tomorrow.

i'm headed in for my first appointment tomorrow. most of the insurance is already worked out as i found out i have amazing coverage with pretty liberal bariatric care requirements. i'm still not 100% decided on the surgery, but tomorrow will go a long way toward my decision. good luck!

back from the dead.. i too have wondered this. i've been training for a little more than 2 years now, and the plan is to pour myself into it like never before to help with the mental part of the surgery (should i choose to do it.. jury's still out). i spoke with my doctor at the seminar briefly and he said 4-6wks later i would be able to get back on the mat. i will cover it with him in more detail this thursday when i see him for my first visit. i'll probably stay away from takedowns and knee on belly for a while after the initial 4-6wk period just to make sure things are 100% good luck! maybe we'll meet on the mat one day in some other class besides pesadissimo

thanks for the advice. i have talked to a head shrinker in the past and i know what i'm up against there. the insurance plan (and the doc) require a psych consult, so i'll definitely be doing that. from my experience i know that once things start "clicking" i can obsess about something else and not worry so much about the emotional/habitual eating, but the danger will always be there. regarding muscle loss.. the last time i did a low carb ketogenic diet i lost a LOT of weight. i had a DEXA scan before the diet and at two more points throughout the diet. i lost a little bit of muscle mass, but it came back as my level of exercise was increased. so i'm counting on an initial loss just due to the lack of food intake. but 4-5weeks after surgery when i can get back at the gym (minus a few pounds!) i'll be able to get things going again, stop the muscle loss, and build it back. Protein, protein, protein. i lift weights and work out a good bit, so i have good muscle mass and can afford a minor setback as things settle out. i have a lot floating around in my head about this and hopefully i can clear it up with my doctor on thursday. thanks for all the well wishes!! i'll post up on thursday after my appointment.