???????

Whey protein isolate?

Oh! Also...an interesting part of the visit was their scale. Apparently just 86lbs of my 245.5lbs is fat. The remaining 159.5 lbs is bones, muscle, organs, etc.

Yep, just saw that here https://www.medicinenet.com/nonsteroidal_antiinflammatory_drugs/article.htm

Hmmmm, I can honestly say I haven't taken aspirin in a very very long time. Not sure if it'll work with cramps, but I can test it out in the next few days! So aspirin is OK with bypass? EDIT: Welp, here's a list of NSAIDs...aspirin is #1 on the list https://www.medicinenet.com/nonsteroidal_antiinflammatory_drugs/article.htm

Yikes...well, I have a copper IUD for birth control because I can't take BCP's. I'm estrogen sensitive or some crap. Every inch of my face, chest and back break out in tiny pimples, no matter the type of pill. This is definitely something that will come up in my next visit.

Great!!! Love the surgeon. He's really straight forward, informative and a smidge goofy. Excellent combo. Until my new insurance cards get here in a few weeks, they can't check the policy for the detailed requirements. As far as what's next...all I need to do is an in-office psych eval (no matter if insurance requires it or not), EGD, cardiac stress test, and possibly just one more nutrition visit (depending on insurance requirement) that they already scheduled for 01/14/19. New insurance and FSA account will be in effect 01/01/19 sooooo...anyone have a time machine so I can fast forward this torturous waiting game?! LOLOL

In my surgeon consult yesterday he told me that once I have surgery, I must avoid NSAIDS at any and all costs because the potential to cause ulcers. Pardon the pun, but this was a tough pill to swallow LOL What in the world do you do when you have a headache or period cramps? Tylenol has always been 100% ineffective for me especially with period cramps. Headaches are rare for me, but cramps...those are a definite once a month occurrence and they show no mercy except when I toss back about 4 Advil

At some point in my life I heard "The 6 P's"....Proper Preparedness Prevents Piss Poor Performance. That has always stuck with me LOL I am the Proactive Queen which makes me extremely annoying to some people LOLOLOL

Yes ma'am! A very awesome trade-off!

Thank you!!!! I'm definitely super excited. I've been talking with the dietician on and off via email since early November. She's so nice, very prompt, informative and respectful. There was never a question that she denied giving me an answer to. I think this place will be great!

Awww, thanks! Girl, it has been a long road on my own. That 55ish lbs has taken 2 years on a ketogenic/LCHF "diet". I've fallen off many times. Part of the struggle has been trying to heal my metabolism due to years of taking Adderall. It destroyed my ability to keep my weight under control after I stopped taking it. This fall, my company was bought out by one of our partners and our insurance benefits changed. For the first time in my adult life, I have a job that will pay for bariatric so I jumped on that boat with a quickness! LOLOLOL The policy won't change until 01/01/19 so I won't know the particulars of the plan for a couple weeks like how many required nutrition visits, etc...but I'm just happy to finally have some hope. No matter how long it takes ?

No ma'am....this is just my first surgeon office visit

Today marks the beginning of my journey...and my guts are in knots....poor thangs

Nice! That’s pretty quick. Who’s your insurance company?

Ohhhh gotcha. Was it some kind of blood/lab test? How do you test for nicotine? Way to go on quitting! I quit too, back in early 2016.

Interesting! Thanks for sharing that. What's a nicotine test for?

I'm curious what steps everyone had to take from their first surgeon visit to approval/surgery date. Did you do certain testing, if so, when was it determined you had to do it? No need for major detail unless you feel like it. I'm thinking something like an easy to read timeline... Example: [date] 1st Surgeon Visit> [date] blood work , stress test, psych test, etc.> [date] insurance approval> [date] start pre-op/liver shrink diet> [date] Surgery date The reason I'm asking this is because #1 I'm marginally impatient, hate surprises and I'm trying to manage it. #2 My insurance policy that covers bariatric won't begin until 01/01/19 and I go to my first surgeon appointment this coming Monday 12/03. I'm just wondering what all I can squeeze in and get done before that 01/01/19 date. Thanks, folks! EDIT: My nutritionist person just emailed me and said the only thing I can do prior to my new insurance plan is stress test, EKG and nutrition. Everything else will have to be done closer to surgery date which is TBD.

WOOHOOOO!!!

@FluffyChix and @Hrsnjs — I wanna know the outcome of ya’lls experiments ??

That's highly possible. I'm no doctor or nutritionist, but 60g is my max for the day. Only difference is I haven't had surgery yet. The higher end of that spectrum is generally reserved for people that lift heavy and need the extra protein for recovery. Here's an awesome read about hair loss from a local Dallas Bariatric surgeon https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ It might give you a little different perspective on the cause of it and how to prevent it the best you can. 3rd big bullet point on the Dr. Kim site: As far as the protein intake goes, dial it back a little. Give the scale 2 weeks to move. Shouldn't take much longer than that especially since you already had the surgery. If the numbers don't go down, even by the slightest, your stall might not be directly related to your protein intake or it could be a combination of other influencing factors. Also, remove sugar (even the alternative sweeteners) as much as you can and be aware that just because a sugar alternative is zero calorie doesn't mean it won't cause an insulin response or a glucose spike. This site about sugar and sugar alternatives is excellent! Be aware of the glycemic index. http://www.sugar-and-sweetener-guide.com/glycemic-index-for-sweeteners.html For example, Maltodextrin. It's worse than straight glucose! 10pts higher on the glycemic index than actual glucose. It's nuts! You'll see it in many "sugar free" products but you might as well eat a few tablespoons of granulated sugar, because it's no different. One other thing you might begin to look at is your electrolyte and liquid intake too. Up that. You can supplement electrolytes via capsule or liquid. Check Amazon for Reviver electrolyte capsules or Hi-Lyte liquid. Sometimes a few Powerade Zero's a day isn't enough. I hope you can figure out what's causing your stall ?

11 years ago, before I was well-versed in how insurance worked, I went through all the testing and medical approval process with a surgeon for LapBand just to find out that there was an exclusion on my policy for weight loss surgery once they submitted my claim to the insurance company. That news was absolutely devastating. I dropped the phone and ugly cried at my desk at work very loudly for a few minutes. SO...in an effort to prevent history from repeating itself, I've triple and quadruple checked everything with HR and they've confirmed, for sure, that bariatric is covered. I think surgeons might've done things differently back then or something...kind of bass-ackwards if you ask me. Nowadays, your eligibility is confirmed before you start. Who knows...maybe my surgeon's office back then was just crappy. I just completed open enrollment yesterday for the new policy so once that's goes through, I'll feel much more comfy about things. since the surgeon will have a way to confirm all the details. I'm curious to see how things work out with you too so keep in touch!!!

I have a feeling your story is me in a few months! First off, we're human, we've struggled and we certainly can be our own worst enemy. I get in my own way ALL the friggin' time Be an advocate for yourself and learn all you can. Read, read, read! Just remember, there's no reason to "chug" protein shakes, if you do, only chug the ones with minimal to no sugar and don't go over your daily protein macro set by your doctor. For women especially, just about anything that raises your blood sugar and causes insulin responses can trigger your body to store fat. #1 thing responsible for that is glucose and it comes from several different places, not just what you eat. We are 100% commercial grade, fat storing machines meant to survive and populate the world in all circumstances LOL There is such a thing as too much protein. Protein metabolism, handled by your liver, has a limit. Our bodies make glucose from 2 main sources, #1 the break down of fat in the form of triglycerides in your blood and, you guessed it, #2 proteins...in the form of amino acids. Proteins are strings of amino acids. If you eat too much protein, that protein will become the preferred source of gluconeogenesis...in simpler terms, that's process of your liver converting those aminos to glucose, which in turn can cause blood sugar spikes, which in turn can trigger fat storage, which in turn can lead to dreaded weight loss stalls and gains (like you already experienced). OMG all the science! LOL I haven't had surgery yet, but I'm speaking from the multitudes of knowledge gained while following a keto/LCHFMP diet for nearly 2 years. If you want to put your mind at ease, kill it with knowledge. The more educated you are, the less there's a need to freak out. No matter your diet, bio-science such as protein metabolism is the same for all of us (mostly). Don't forget....YOU GOT THIS!!! ?

I am SO glad I met you here! We're literally in the same kind of boat We definitely need to keep in touch. It's awesome to hear that diet consults are no longer required for your BC plan! Do you remember where on their website you found that or did you have to call? Only thing I wish they had was online chat. UnitedHealthcare had great support chat, but that was about it LOL My new insurance plan is through Anthem Blue Cross. I'm in Texas, but my company is based out of California so we get the same coverage that they do. Even though I can't log in to the Anthem BC site yet, I have my entire plan's documents and not one thing about dietary evaluations is being mentioned as a requirement for approval. Not even in the EOC which is the most detailed document of all. Only requirements mentioned in the EOC are these (see screenshot below)...this is the full section on anything Bariatric Surgery under "Covered Services" in the entire 191 page document. There's some stuff scattered elsewhere regarding the required type of bariatric surgery facilities and travel coverage for bariatric services, but nothing else for the surgery requirements itself. Next section is Transgender Services, which awesomely, are covered. This policy is beyond generous. Thoughts?

Nice to meet you too! I see my surgeon for the first time on Monday 12/03. My new insurance that covers bariatric won't go into effect until 01/01/19 so depending on if I need nutrition visits or not, January would be the soonest I could have surgery. I think that's too quick though. Won't truly know until my plan enrollment is complete and the surgeon can run the claim (or whatever they call it LOL) to find out the minute details. I've been part of this forum for 10 years, back when it was still called LapBandTalk so being able to FINALLY do this surgery is a long time comin'! ?