RuralNurse

You may want to call your doctor's office and ask to speak with his/her nurse (I say that because it can be really hard to get the doc on the phone). Tell her you are struggling with the double cost because there is a charge for both dosages and ask if they have samples. Let her know that you may want to change at some point due to poor insurance coverage but want to stay on it for now. Doc's are more likely to give samples if they feel it is not being used as a long term solution. Also many of the drug companies have "Co-pay" cards that help with the cost above what insurance covers. If I had a pt that was on Brintellix but cost was an issue I would (barring allergies) put him/her on Lexapro (Escitalopram) because it is a good SSRI with few side effects. After being on that for maybe a month I would add Wellbutrin (Bupropion). That medicine is an NDRI which is norepinephrine and dopamine. Brintellix works on all 3 and combining is not exactly the same "recipe" as Brintellix but it is close and much cheaper as both are generic. Wellbutrin is known for weightloss in many people. It is more activating and helps with focus as well. Is you doc a psychiatrist or a family practice generalist? Some FP docs get worried about mixing anti-depressants because they don't really understand the way they work and the neurotransmitters they effect. Good luck!

I am a psychiatric nurse practitioner and prescribe these meds to people daily. Although some people do gain weight on citalopram most do not. Escitalopram (Lexapro) is the newer "cleaner" version of citalopram (Celexa) and I see even fewer people gain weight on it. When they do research on these meds they have to document EVERY possible side effect. I believe that much of this is people that are very depressed lose weight and when they begin to take these meds they "gain" weight but really are just getting back to a normal weight. Brintellix is a good medication but is a newer one and much more expensive (and less well covered by insurances than citalopram). Also it work on serotonin, norepinephrine and dopamine, where citalopram works only on serotonin that is more implicated in anxiety (where the others are more implicated in depression and anxiety combined). The psych meds that are really bad for weight gain are the atypical anti-psychotics like Zyprexa, Seroquel, Risperidal, etc. These can be used for psychotic conditions and, more commonly, bipolar disorder. But not everyone gains weight on them. Anxiety meds that are worse for weight gain - paxil, remeron, sometimes prozac. In my opinion if you have uncontrolled anxiety you are more likely to "self -medicate" to feel better. That may be with food, alcohol, marijuana, other drugs (prescription or illicit), gambling, etc. Good luck!

Nicotine does impede healing, it is a vaso-constrictor...meaning it constricts blood vessels. So in your stomach where they have stapled it back together, those vessels are trying to repair themselves and they would be constricted and less likely to heal. It also causes lots of other issues. For everyone that smokes...it is incredibly hard, but you are going down a path that will be hard, this is not "the easy way out" by any means. You are all doing this to improve your health and save your life. Take this opportunity to stop smoking forever. It is a new you!

I am a lower BMI person. My insurance covers WLS pretty well but the lowest BMI they will cover is 35 and only if you also have diabetes with that lower BMI. So I am going to go to Mexico and be self pay, my date is 1/101/16. But even with that they said I MUST show up with a BMI of at least 30 of they will not do surgery. I have found only a few posts or YouTube videos on folks in my situation. What if I lose too much on the pre-op diet? Will the surgeon make my sleeve "bigger" because I'm not as heavy as most? How does weight loss go after the surgery? Meaning we know that heavier people in general can lose weight more rapidly on the same "diet" as those that are light, so what can we expect? Are the complications the same such as chance for dumping syndrome, chance for acid re-flux, chance for needing gall bladder removed later, etc? I am sure I am not the only one with these questions and think that we could support one another and give info on our journey that may help others in the future. If there is a section on this forum that I missed specifically for lower BMI WLS please feel free to move this post.

Hi, I know you posted this awhile ago, but one great thing about forums is someone looking this up even years from now may get help. First I am a hard follower of Christ. I believe every good gift come from God. I am a nurse and have seen some amazing miracles done in the hands of doctors and nurses but it was clearly the hand of God that led them (even if they were not Christian and did not know it!). I believe anything that helps us (medications, treatments, surgeries, therapy, etc) was allowed to be discovered because our Father in Heaven loves us and wants us to be healthy and happy. If there is any time in your future that God sends someone to you and He wants you to witness to them about the surgery you will know it! He will whisper to your spirit and you will know that He sent this person to you. You may even become a mentor for them as they go down the same path. And at the same time, we should not cast our pearls before swine. There are so many people that do not understand obesity and "we" as Christians can be some of the most judgmental and harsh people on the planet (despite our instructions not to be). I am telling no one except my mother that had one of the first weight loss surgeries in the 1970s. I am not even telling my husband of 33 years..and before you judge me, remember you don't know me or my relationship. I feel complete peace about my decision. You can always chose to tell people after if you feel led, you can never "untell" anyone. Take it to Him in prayer, He will never led you astray!

Ask her for the morbidity rate of diabetes, hypertension and dyslipidemia? I have been a nurse for 15 years and am dual certified as a family nurse practitioner and a psychiatric nurse practitioner and I am doing this and have no fear. This weight loss surgery is a tool and if you look at it that way and not as a cure you will be fine. The next time someone comes at you with negativity plug your ears and say, "La La La La" and walk away.

When I first began to look into this surgery I went to the class that my hospital provides and to meet the surgeons. I found out that because I do not have diabetes my insurance won't pay for it so I began to look at alternatives. As a nurse I pay close attention to medical issues. I read about the surgeons in Mexico and they do perform this way more often than the 2 surgeons that do it at the hospital where I work. I had eye surgery in Canada years ago because it was cheaper and when I got there and met the surgeon I found out he TAUGHT the surgeons in my state (Montana) how to do this new procedure. And he did the surgery every day, not just a few times per month. Yes we have great medical care int he U.S. (if you can afford it) but that does not mean our hospitals are the only place to get good and safe care. I have not one fear about my choice to go to Mexico except the normal fear that anyone would have with a medical procedure and anesthesia. Good luck to you OP and thank you Dr. Altamirano and all of the surgeons that make this available to folks that would otherwise suffer.

Hi, My receptionist just had this in March of this year and she was out for a week. Of course she sits most of the time. I am not telling anyone I am having this (so can't take a bunch of time off) and I plan to take one week off. I too am an NP but do out patient psychiatry so I am not doing very physical stuff. I have mine scheduled for January 10th so we will be on a similar path!

It is nice to have a place for nurses! I think we are a special breed, taking care of everyone else except ourselves. I am an FNP and a Psych NP,working full time in psych, one day a month doing public health and one term per year of teaching nursing students (psych nursing). I have just scheduled my surgery in Mexico in the first weekish in January. My insurance (which is good) won't cover my surgery because my BMI is too low and I don't have diabetes so I am paying out of pocket.

I am new here. This just confirms my decision to tell no one in my family except my mother (she had gastric bypass in the early 70s when it was in it's infancy). I will not tell my kids (mostly adults) nor my husband nor anyone I work with. I do not want the skeptics or naysayers. I don't want anyone to tell me "no" or my husband to sabotage me. This seems like a good place to get support so keep coming back here. Good luck!