2goldengirl

Deviled eggs. I taught my DSD when I taught her to make them that whomever brings deviled eggs is automatically the most popular person at any gathering.

My surgeon does a preop questionnaire that is a prescreening tool for undiagnosed sleep apnea. I was at the low end of likely, but she insisted I have a sleep study anyhow. I was completely skeptical, because I don't snore, never have. I met with the specialist for the results yesterday. Yup. Sleep apnea. "Severe" during REM sleep. Waiting to hear from the vendor about a CPAP. So the blessing in this is that once I have it (and get used to it), I ought to see an increase in my energy level, which should also translate to improved postop healing. And my surgeon totally knows what she's talking about. Good to know!

Agreed, you don't have to "explain" what you're doing on vacation!

Just a clarification. Insurance adjusters aren't the ones who make any decisions about whether anything is covered. Any health plan that is accredited by either of the two major national accrediting bodies or is licensed by Medicare has to have physicians and pharmacists making coverage decisions according to evidence-based clinical criteria. Employers who purchase insurance can (depending on the state and the health plan) purchase insurance for their insureds that excludes specific procedures, but if the State in which the coverage is sold requires a set of basic benefits, those basic benefits can't be excluded. Just as an example, many policies here in CA used to exclude coverage for infertility treatment. That isn't the case any longer, because companies that didn't provide it couldn't compete for qualified candidates for employment without it. Companies wanted to exclude it because it raised the cost of coverage for every single insured for that company, and they wanted to keep premium costs down so that neither they nor their employees were paying for coverage that a very small percentage of people needed to use. States can, and do, mandate benefits, but what proved to be the case here in CA is that for every mandated benefit, there is an incremental increase in costs both for premiums for the purchaser/consumer, and for the insurer to prove compliance with the mandate. One of the provisions of the ACA is to eliminate the "pre-existing condition" penalty in terms of someone's eligibility to become insured. I can only speak for the situation here in CA, but here, if you go out of plan for surgery of any kind, whether you see a local plastic surgeon or a cardiologist in Morocco, and you need care for complications, you're covered for those complications. It's the law.

Diabetes (according to NIH) is A1c > 6.5, fasting glucose > 126. Prediabetes A1c 5.7-6.5, fasting glucose 100-125 Normal A1c is 5 or less, fasting glucose < 100. The PCP's I work with are encouraged to check an A1c annually for any of their patients who have had a fasting glucose > 100 or who have other predisposing factors for diabetes, including obesity, sedentary lifestyle, and/or family history of diabetes. My A1c had crept up from 5.7 to 6.1, and that's a huge part of why I started considering a sleeve.

I foresee the insurance picture changing over time. I'm in CA, and coverage for bariatric surgery here is the norm, not the exception. I've worked in managed care for twenty years. Twenty years ago, nobody asked for, or got bariatric surgery. Ten years ago, it was rare. Today, it's routine. My PCP views weight loss surgery as "definitive treatment for obesity". That would have been a radical statement five or ten years ago.

In that case, there are large bariatric surgery centers at UCSF, CPMC (San Francisco); John Muir Concord (both Dr. Chin and his group, and Dr. Kwan and her colleagues; Valleycare in Pleasanton, and Alta Bates-Summit in Oakland (First Surgical). I believe there is also one down the Peninsula, but I don't know for certain. My PCP's office had such trouble with Dr. Chin's office staff that I was switched to Dr. Kwan and I'm very, very happy with both her and her staff. I manage a lot of clients who use both First Surgical and Valleycare, and they are happy with both. I don't have any first hand experience with the San Francisco locations or surgeons.

I dunno what a psychologist is doing quoting statistics anyhow, it isn't exactly their field. Tune out what you don't need. be willing to learn, and keep on with the goal in mind. Thank heavens your surgeon is more skilled than the psychologist seems to be!

I love it with a sprinkle of seasoned salt. I also love it with tuna on it, which seems wierd, but really tasty!

6 grams of sugar per cup.

Who you can see and where you can have your surgery may have a lot to do with who your insured by, and which medical group/IPA you're with if you have H M O insurance. Are you H M O, or P P O?

There are lots of Bay Area's in the US - could you be a bit more specific?

@@Babbs, I just have to give you a shout-out for the most entertaining threadjack evah.

I love Tony Bennett so..... In San Francisco (home of the World's Most Beautiful Ballpark), when the Giants win a home game, they play "I left My Heart in San Francisco". And in answer to your question: "Sh-boom" by the Crew Cuts. We can't have our Babbs being sad!

Naw you ain't. I was a teenager when "Respect" was #1.

Your purees may be too thick. Try thinning them down. Keep up your fluids, get in your protein, and take the purees slowly.

Appeal. Now. Blue Shield of CA H M O doesn't require six months any longer, and they haven't since July 31, 2015. You should never have been denied in the first place. So long as your surgeon and/or PCP documents your previous attempts to losewweight, that's good enough. Here is the link to Blue Shield's medical policies: https://www.blueshieldca.com/provider/authorizations/clinical-policies/medical-procedures/policy.sp You'll find the policy for bariatric surgery under "B". Your medical group or IPA may be unaware of the change, but they should have looked it up online before denying you. Blue Shield didn't do a good job of letting their groups know of the change. It delayed my process as well. It's your group that did the denial (Blue Shield contracts with them to process authorizations), but appeals are handled by Blue Shield directly. Good luck!

Hmm. I have lactose intolerance and I'm able to handle the premixed Premier Protein shakes without any trouble. Have you tried chewing a lactaid when you use the whey?

Congratulations! Do something nice for yourself to celebrate: flowers, a pedicure, a new lipstick - or all of the above!

Your surgery date is almost two weeks from now. Most colds don't last that long. Rest, fluids, decongestants. You'll be fine!

@@1Cor2:9, "Shame" is a highly-charged word for most of us. It may have a different connotation for you, but for many of us, shame has been accompanied by feelings of worthlessness and hopelessness. Those are feelings we work hard each day to distance ourselves from. What @@VSGAnn2014 wrote is spot on. Setting ourselves a goal of "I will lose X lbs by Y date" is an invitation to set ourselves up for those feelings, which is why I stay away from them. Life happens. Multiple crashing deadlines, little gnats in the yogurt of life, flat tires, and bad hair days happen. None of us is perfect at the new behaviors we're practicing. If I may, here's what I tell my clients who are working on these kinds of goals: Set behavioral goals. Instead of losing a given number of pounds, that you will keep to your food plan for so many days of the week. Instead of expecting to hit the gym a maximum number of days each week, set a goal that's reasonable for the week that you've got. It will be different on some weeks than others - and that's perfectly OK. Some weeks you'll blast your goals out of the Water. Yay, you! Some weeks it will be a struggle to meet the minimum you've set for yourself. Yay, you! Each one is a success that you can stick in your pocket of successes, big ones and little ones. Over time that pocket of successes becomes a set of healthy habits. Feeling bad is one thing, feeling you are bad is quite another. Congratulations on your successes!

I love this thread! I think fat shaming is wrong, just like any other form of bullying. And everyone deserves to be treated with respect and dignity simply because as humans, it's something we all deserve from one another. I think everyone needs to love themselves as they are, and not constantly hold themselves up to someone else's yardstick of "worthy". Most of us here can tell hair-curling stories of being treated as "less than" because of our weight, and I'm all for anything that ends that. However, there are medical realities that can't be escaped from living an obese life. We all know this or we wouldn't be here. Just as we need to accept that we're worthy no matter our size, we need to take responsibility for treating the one body we have with love and respect. I do see a disturbing aspect of the movement, that is, the individuals who take license to frankly abuse their bodies with food and label it "fat acceptance". That's just sad.

I'm preop, but if I'm really out of sorts and upset, eating anything really doesn't appeal to me. My brain is always too jangled to choose anything, I guess. When all my senses need a collective hug, I go for a cup of not tea, maybe with a slice of lemon (I love the scent of lemon, and the scent of a frshly cut lemon always makes me smile). I snuggle into the softest jammies I have and under a blanket and curl up with a good book. I put my cel phone in another room and escape into the pages.

Complications occur in <1% of bariatric surgeries. Possible? Yes. Likely? No. I also disagree with the statement that the sleeve is "too new" to have long term outcomes data. People have had similar surgeries for decades, but not for the purposes of weight loss. Before we learned that most stomach ulcers are actually caused by bacteria, people with stomach ulcers used to have partial gastrectomies. Gastrectomies are also used to treat certain forms of cancer. It's normal to worry pre-op, it's part of the process. I encourage to discuss your concerns with your surgeon.

Thank you!