Peggy D

The reviewers have 2 weeks to complete the process. Depending on the work load, it could take that long although most are done much quicker. There are a lot of services other than bariatric surgery that require review & anything life-threatening or urgently needed will take precedence over elective procedures. I know, I worked as a nurse reviewer for over 7 years.

Lose It!

I bounced around the same 1.3 pounds for 12 days but just kept "keeping on" & have dropped 2.3 pounds in the last three days. I knew from all of the posts I've read on these forums that it would just take time. I did do measurements as others suggested & I didn't lose any more inches that I would have expected for the 7.5 pounds lost in the 4 weeks since the previous measurement.

Tagamet is cimetadine. The OTC cimetadine did help some so I called my surgeon's office today & I got a new prescription for Prevacid. It's very expensive but, since I've reached my out-of-pocket maximum, it's completely covered by my insurance. Already I can tell the difference.

We were told in the pre-op class to take Prevacid or Prilosec, OTC or prescription, for 30 days post-op. I finished that 5 days ago & for the last couple of day have had an uncomfortable lump-like feeling mid-chest after swallowing most anything. I went out & bought some generic cimetadine today & I'll see if that helps. If it does I'll be calling my surgeon's office on Monday to get a prescription for something. I've never had any problems with acid or reflux in the past. Here in the US, omeprazole is available OTC.

What does your surgeon suggest? My surgeon just says a multi-vitamin three times a day before surgery & then four times a day after surgery. The packet suggested several brands, all commonly available. His ARNP told us in the pre-op class that which one you chose wasn't important but to not change brands unless they tell us to. Because each brand will be different, it would be difficult for them to make adjustments to supplements based on our lab work.

I was told in my pre-op class that swallowing pills would not be a problem. If you are one like me who has never had a problem swallowing pills of any size or number, it shouldn't be a problem. Before surgery I could swallow quite a few pills at a time, often without water. I don't know if I still could, but I do take my time & take small sips. There are many pills that should not be crushed or even split, so check with your doctor or pharmacist.

Try the unflavored protein powders & add a sugar-free syrup for flavor or add it to any liquid or soft food. I had to give up on the flavored protein powders post-op because they were too sickly sweet. I got some at GNC to try & then ordered some Now Sports unflavored whey isolate from Amazon. The GNC stuff was a bit thick but the Now Sport powder is much better.

I was given a prescription for 1000 mcg injection once a week after my initial lab work done 3+ months before surgery & am to continue until I have lab work done again 3 months post-op. It only costs $11.08 with insurance, $13.19 without, every 4 weeks. It's not a problem giving myself injections as I've given myself insulin injections for 20+ years.

My surgeon said that removing a healthy gall bladder was frowned upon. I was very happy to find out that my abdominal ultrasound showed gall stones so my surgeon would take out my gall bladder at the time of my sleeve & then I wouldn't have to worry about it later. I wasn't familiar with the symptoms of cholecystitis, so I don't know if I ever had any of them. I may be a nurse, but I worked NICU & didn't work with patients with cholecystitis. It turned out that my gall bladder was huge & had obviously been inflamed for years. It was so adherent to my liver & surrounding tissues that it took over an hour to free it up. It had at least 4 large stones & several smaller ones. I was told they had to cut it into 3 pieces to get it out & still had to enlarge the incision where they removed my stomach to get those pieces out.

I'll be 64 next Tuesday & am almost 5 weeks post-op. But having loose skin is not something I'm really concerned about since I know things can be done. I know I will need a panniculectomy once I get to goal. I've had a very big "apron" for as long as I can remember. It's not getting any smaller, just flattening. But I don't think that I'll want a full tummy tuck where they tighten up the abdominal muscles (unless my insurance will pay for it). My hope is that losing this huge abdomen will help with the chronic pain I have in my right sacroiliac joint. I know that the pulling by my apron makes it worse. I lost 44 pounds before surgery & 11 since & I do notice an improvement in the pain, although the last couple of days it has been acting up, but nowhere near what it was 55 pounds ago.

Congratulations!

I lost 44 pounds in almost 4 months pre-op. But in the 1 month & 1 day since surgery I've only lost 11.2 pounds & none in the last week. I keep hoping that since I've finally moved on from clear liquids to puree (4 days ago) I'll start losing again.

After two weeks of clear liquids & protein shakes pre-op & another 4 weeks after surgery, those pureed foods are wonderful. Of course, I'm full on 2-3 ounces. It's only been 4 days so I haven't tried a lot of different things but I have had pureed refried beans with low fat cheddar cheese, pureed Stagg chili with the cheese & pureed tuna & hard-boiled egg mixed with Walden Farms honey mustard mayo. I have had some greek yogurt with sugar-free syrups for flavor, but I'm just not a big fan of yogurt.

I, too, have tried & returned several different protein powders. I used Body Fortress chocolate peanut butter before surgery but it does have 7 grams of carbs so I tried the Body Fortress vanilla whey isolate & added sugar-free Torani, DaVinci or Walden Farms syrups. I tolerated it, but after surgery, the vanilla stuff was horrible & sat like a rock in my stomach. Of course, for the first week after surgery I was only allowed clear liquids, no protein shakes until day 8. I went back to the chocolate peanut butter stuff since I could handle it. But after another week or so, even that one turned on me. I bought some unflavored whey isolate protein powder & GNC & added my flavored syrups to that. The only issue I had was that it was a bit thick. I did a lot of research online & ended up getting some Now Sports unflavored whey isolate protein powder from Amazon. You can even get it in a 10-pound bag for the best value. It is truly unflavored & is not thick. Now that I'm on pureed foods, I add it to get my protein goals each day.

I found out in less than a week. I actually received a call from a case manager at Aetna first. Some how the info got sent to her directly from the medical director or review team rather than going to the department that sends out the notices to patients & providers first. I think it was a day or two later when I got my approval letter in the mail.

Now Sports unflavored whey isolate powder. Absolutely no flavor & it doesn't make things thick that I add it to. I can mix it with flavored water, broth, whatever. I add sugar-free Torani, DaVinci or Walden Farms syrups for variety. Now that I'm on puree foods, I mix it in those to get to my protein goal. The flavored powders I used before surgery now make me ill. I did try some unflavored powder from GNC while I waited for my order from Amazon. The GNC stuff did make things thick, but at least it had no flavor.

Exactly, gamergirl. I, too, think/know I'm losing very slowly. I will be one month post-op tomorrow & I am down only 11.2 pounds since the day before surgery. That other 44 pounds I lost was on the 3-month supervised diet & 2-week pre-op Clear Liquids. Never, never, in my life have I ever lost that much on any diet. The "best" I did was lose 38 pounds 40 years ago when I was 23. But, now I have this tiny stomach, have been on clear liquids & Protein Shakes for 4 weeks & just started pureed foods two days ago, so my heart & mind ask why isn't the weight coming off. It did when I was eating a lot more those 4 months before surgery. I'm not looking for anyone's suggestions. I keep telling myself that if I continue to follow my surgeon's plan the weight will come off but, for now anyway, I don't think I'm convincing myself.

I, too, had diarrhea the first week. Now, 4 weeks out, I'm sitting here trying to drink a bottle of magnesium citrate. There just doesn't seem to be a happy medium, does there?

I stalled for four days before I was allowed to start pureed foods at four weeks post op (two days ago). I then dropped 1.4 pounds yesterday but none today. I am enjoying my pureed refried beans & pureed Stagg chili. Greek yogurt, not so much. I think I'll puree a hard boiled egg & tuna with some Walden Farms honey mustard mayo for dinner tonight. I love Walden Farms - it's all calorie-free & tastes great!

No, I don't, sorry. I only know Aetna because that's the insurance I have & they sent me the link. You might try a Google or Bing search for BCBS bariatric surgery criteria, surgery for morbid obesity, medical necessity criteria & similar & see what comes up. I did find a few for BCBS when I was looking to compare criteria from different companies, but not Florida. Remember that this is medical necessity criteria, not insurance contract coverage. First, whatever the service is needs to be covered by the contract. Then, even if it is medically necessary, if the contract excludes it, it would not be covered. Unfortunately, bariatric surgery is excluded in the contracts many employers purchase. That was always one of the most difficult things to try to explain when I worked as a clinical review nurse. Hopefully, now that obesity is classified as a disease in & of itself, surgical treatment will be an option for many more people.

Here is the link to Aetna's bariatric surgery criteria. http://www.aetna.com/cpb/medical/data/100_199/0157.html

I've been using what we used to call "iced tea spoons." They're a bit smaller than a regular spoon & have a longer handle. I have some others that are even smaller. Considering I used to use the big tablespoons to eat, it's a big difference. It probably takes me 15 minutes or more to eat what I used to eat in one spoonful!

Being 5' 6¾" I, too, would really like to be able to input my height in quarter inches. Also, as many of us or our providers weigh in tenths of a pound, being able to enter weights accurately would also be nice.

We have a "high deductible" plan with a health savings account. My husband's employer contributes $2000 to the HSA, so our share of the out-of-pocket maximum was $4000. Fortunately, prescriptions count toward the maximum. I'd have to go back & add up what we've actually paid for my WLS process since some of the expenses were for other medical care. Since every thing is fully covered now through the end of the year, I'm going to have surgery on my right hand next week to release some scar tissue from a couple of trigger finger releases.