2goldengirl

This is one of the protections with an H M O plan - we can't be balance-billed like this. I think a payment plan is the only way to solve this. I'm sorry!

No, that isn't it. Employers may exclude the benefit, but they aren't allowed to dictate medical policy. And in five-plus years, I've yet to handle a Blue Shield of CA case that excluded the benefit. We did have one health plan (self-funded by a county for county employees) and they excluded bariatric surgery as a "cosmetic procedure". Oh, and this was a county with one of the highest obesity rates in the state. go figure. Ask to speak to the office manager for your surgeon's office. Ask her or him to find the policy on Blue Shield's website, no password is required to view medical policies. Ask that they do this while you are on the phone (or standing there!). Understand that patients do sometimes lie to get what they want - this is why most MD offices are reluctant to accept the notion of change if it hasn't come down to them from proper channels.

I think the first thing you need to find out is: is there a BMI cutoff to pass the physical. There very well may be, and a BMI >50 may put you out of the running at this time. I did some checking online and evidently the fitness test for firefighters is standardized. This link may be helpful: http://home2.nyc.gov/html/fdny/html/units/recruitment/cand_prep/5_fitness_standards.shtml I do notice they mention "very low body fat". Honestly, I'd focus on getting healthy this year, and take the test next year.

The three month period is suggested, not required. Big difference. the three month period is to allow for preparation and education - things like preop testing, sessions with an RD, that kind of thing. Do you have H M O or P P O? Just be aware, many surgical offices CALL Blue Shield to verify that you have the bariatric benefit and to verify requirements. Unfortunately, many of their Provider Services reps don't both to look up the policy and will say you need to do six months because that's what they're used to. Demand (politely) that the office refer to the policy online directly for policy requirements.

I've authorized dozens of bariatric procedures and an assistant surgeon has never been requested. Whether or not an assistant is covered is based on standarized criteria, meaning that it's either necessary for everyone or nobody, depending on the surgical code requested. I'd definitely do more checking, call around different practices and ask whether their surgeon's require an assistant or no.

In terms of grams of Protein, 1 large egg is the same 7 gm of protein as 1 oz of lean meat. Hope this helps!

A lot depends on what they expect in the physical. is this a physical to gauge your overall health, or is it a fitness test"?

I buy beef bones at the supermarket, usually packed about 2 lbs a package. They make especially good broth if you brown them in the oven first. Get yourself a package of chicken wings to make chicken broth. It's just Huz and me at home, but we typically buy bone-in chicken because we like the flavor of bone-in better.

At this stage, I wouldn't worry overmuch about the carbs. Remember how little you are getting in in a day. Far, far less than you used to.

Go for it. So long as you don't end up getting a cold or an injury, the worst that happens is you walk more than you planned.

Honestly, I don't think you need to worry. I've had two Goldens and they're so attuned to their humans that they really know when something isn;'t right with you physically. Our first Golden was a moose of a dog, 27-1/2" high at the shoulder. He and DSD adored one another and she regularly greeted him with enough enthusiasm that roughhousing resulted. She had surgery on her wrist & her mom was concerned that the dog might bump into it. DSD came in the door from the surgery. He walked over, sniffed very delicately at the wrappings on her arm, and sat at her feet, wagging his tail. This same dog was an absolute angel when I broke my right arm and had pins in it for six weeks. He never left my side, unless I said "move". Our current Golden was wonderful with DSD when she had her wisdom teeth out recently. He didn't tackle her. He was very polite, and made sure he stayed close by her for the weekend she stayed with us. I think they smell changes in our body chemistry when we're stressed or hurt and they respond extra gently - at least, the Goldens I've known have done.

@@Kristin7676, you are definitely not getting enough calories for both healing from surgery and weight loss. See if you can't gradually up your intake. One really easy way is with avocado. It has the texture you're on at this stage and is a healthy fat. Half an avocado can up your intake by 160 calories, and it's full of potassium and B Vitamins as well.

I agree, you may not be eating enough. Do you track your food in something like Sparkpeople or MyFitnesspal? How many calories are you getting? An hour a day pool workout (depending on whether you're swimming laps or doing Water aerobics) can burn a LOT of calories. Your body has also had to heal from surgery. I disagree with the adding muscle argument - you aren't eating enough to gain muscle, the best you can hope for is to keep your lean mass while you lose. You actually need a calorie surplus to gain muscle.

The whole hair loss issue puzzles me. I've cared for postop patients for more than 30 years, including folks on long-term tube feeding for various reasons. And they didn't experience hair loss (save for the folks getting chemo) So hair loss can't be because of the stress of surgery - lots of surgeries are much more stressful for the body, but don't lead to hair loss. It can't be the Protein - even for folks who have trouble getting it in for the first week or two. I'm baffled.

Fantastic achievements! Keep on keepin' on!

I haven't thought about postop, but I do know I'm going to have a mani, pedi, and massage preop. Maybe a facial. No polish, just pampering. I never wear polish in the winter.

@@Kathy Coop, as a clinician, the term "addiction" is very specific and means (among other things) that the addict's functioning in life is impaired by their dependence. Addiction is a harmful dependence. It gets in the way of work, relationships, and life in general. While it's true that some people take healthy eating and exercise to extremes (e.g., that gets in the way of living other areas of their life), swapping an unhealthy relationship with food for healthier habits is not addiction. That's the basis for my comment.

I think lots of people find that things that formerly appealed to them, or that they didn't have trouble with, can cause issues after surgery. From what I've gathered, it's very, very individual. You'll just have to wait and see. My RD said to try only one "new" food at a time once I'm solids, just like a baby. Something doesn't work today, fine, put it aside for a few weeks, then try again.

I would not agree to the "every single person...ends up getting another addiction". Just because "never" and "always" are words to be wary of.

I have a Tanita body fat monitor It saves profiles (height, age, gender) for up to four people. I get my weight and a body fat percentage based on electrical impedance. I weigh first thing in the morning, and the body fat percentage isn't the most accurate at that time of day, but it's very good at telling me Water gains and losses, which is great. If I get on and my weight is up, but body fat is down, that's water. I've had it for about ten years. it consistently weighs 2-3 lbs. heavier than my doctor's offices (any of them) I'm totally fine with that. I think I spent about $80 on it and it's certainly more than paid for itself. They're less expensive now, and with more features.

That certainly could be it. Up the fluids, add some salt to some broth and get that in. Dehydration will also make you nauseous.

Homemade all the way. We make big pots of stock whenever the bag of stock makings in the freezer gets full, and we pressure can it. There are about 10 quarts in the pantry right now.

I've used Isopure Vanilla in coffee - I mix it in the cup with a bit of milk or Water first. Premier Protein ready to drink also works. If you throw a shot of chocolate PP and one of vanilla, you get a mocha. So "real" protein feels heavy. What have you tried? you might try fish, or shrimp, for something lighter. And don't forget to chew, chew, chew! I just had a snack of yogurt with unflavored protein powder mixed in. I didn't use a whole scoop, and you don't have to, either. You'd be amazed how many grams of protein you can sneak in this way. Milk. Fairlife milk has twice the protein and half the carbs of other milks, and no lactose. If the texture of protein shakes puts you off, thin them with this. If you add a half-scoop of protein powder to a glass of Fairlife, you get nearly 30 gm of protein in your glass of milk. Protein really helps curb hunger. What it won't do is keep you from reaching for your slider foods. That's a head game - why do you feel the need to sabotage yourself after you went through the work of getting the surgery? That isn't a question we need to know the answer to - but YOU do.

OK, that explains the "no medical group" bit, you aren't tied to one with PPO, only H M O. Do you have records from the 6 months you did with the phentermine clinic? Because that should satisfy the 6 month requirement right there. I wonder if your FSA won't also cover Mexico? A lot of us got into obssityland from not dealing well with frustration, and/or from wanting instant gratification. Keep aware of this part of your thinking as you proceed. And please don't hate your body, no matter what size it is. It carried and birthed your daughter and has carried through your entire life. It, and you, deserve more respect than that.

Firt, I am presuming you have an H M O plan. Look on your insurance card; your PCP's name and medical group's name should be on there. I can understand why you'd be tempted to go to Mexico and do this on your own timeframe, it's a purely personal decision. I'd rather same any $ I might have spent doing that because I will more than likely want plastic surgery in a couple years. Approval isn't a mystery. If you meet the criteria, you get approved. It really IS as simple as that. So. Have you participated, really done the job, for six months in the past two years? Do you have a BMI 40 or above? If your BMI is < 40, do you have any comorbidities?