Mattymatt

My brother is getting married in August. I'm still single so I'm looking forward to being all GQ in my tuxedo and maybe scoring with a bride's maid.

Nice!

My surgeon and endocrinologist are 100% positive that the diabetes will go into remission, they're not sold that it will be a cure. They're 100% on hypertension going away. I also have sleep apnea but only time will tell with that. I have a friend that is 150 pounds soaking wet and he has sleep apnea. If that doesn't go away, I'm fine with it. I'll use the CPAP because I sleep so well.

This particular story is clearly fake news.

No, we don't have always have to stay in the hospital but this is major elective surgery. I think an abundance of caution is wise, reasonable, and prudent.

Welcome Janet! Medicaid varies greatly from state to state because it is a state-administered program. Federal money gets disbursed to states for Medicaid. There is a StayWell handbook available at https://www.wellcare.com/Florida/Members/Medicaid-Plans/Staywell. This may help.

I would also advise to work with a major hospital system and not a clinic. At one point I considered looking at Barix Clinics and I was alarmed to discover that they only keep their patients in the hospital 1 day post-op. The post-op care was also unimpressive so I quickly crossed that one off of my list. My surgeon says that I'll be inpatient a minimum of 3 days. She said, "And if I even have the slightest thought that more are necessary, you'll be there." Of course she smiled as she said this and it really made me feel like she cares.

Insurers are discovering that the medically supervised diet requirement is really superfluous. Since traditional diet/exercise programs haven't worked in the past, the likelihood of them working now is not very high. Recent research shows that only 10% of those that lose weight this way keep it off. I'm one of the 90% that failed. The chances of success of weight loss surgery go up by an order of magnitude to 65%. This could result in statistically significant long term savings for the insurer.

Each insurance company has its own set of requirements. Consider yourself extremely lucky! Your new insurance is great. Since I am disabled, I am on Medicare. Medicare's requirements for medical necessity include: (1) BMI > 35, (2) an associated co-morbidity like diabetes, sleep apnea, hypertension, (3) and a documented history of failed attempts at medical weight management. Yet, Medicare does not specify how many attempts and over what time period. It turned out that I could use documentation from 3 years ago. Also, each insurance company operates at its own pace. I heard back lightning quick. I applied on Dec. 27th, approved electronically, and was told by my provider today. We even scheduled today.

Diabetes sucks. I have to take Lantus insulin, Meformin, and Victoza. I was on Glipizide but there was concern that Glipizide might actually be making hungry. Victoza sucks but it seems to work. Numbers improved even more. :-)

Since, I am a diabetic I had to start my modified diet back at the end of October to lower my A1C. As of Dec. 27, 2017 I got my A1C to 7.8%, enough to be safe for surgery. In an effort to make things better, my endocrinologist put me on Victoza. Two weeks before surgery, I have to do an Optifast pre-op diet.

Wahoo! Let's git 'er done!

I just got some bad news that will require me to put surgery on hold. Being a typical guy, I don't complain about the things that I probably should. Well, I had a routine follow-up with my sleep doctor and he referred me to a cardiologist. I told him that I was feeling short of breath lying down and sitting upright sometimes. I always just chalked it up to being overweight. Today, I had an echocardiogram and the result has made me feel hopeless. There is a problem with the mitral valve in my heart. This will need to be corrected before I can undergo bariatric surgery. For now, my cardiologist increased my blood pressure medicine to ease some of the stress on the vascular blood vessels. The next discussion is surgery to repair the valve. Given that I have not had a heart attack, the recovery period will be somewhat shorter but still will be a while. I feel really sad .... for every step forward, it seems that there are two steps backward. Anyhow, thank you for listening.

Shoot, just even for a woman to notice me would be a win. But I am a long ways away from surgery. First, I have to get a heart valve repaired.

Thank you for the words of encouragement. I am facing my own mortality and it's both sad and scary at the same time. These were things that I never thought about in my 20s and 30s. I let my health go and living with the aftermath of my decisions simply makes me sad beyond all reason. If I could go back in time, I would tell myself that when I lost weight the first time to get the help treating depression so food would not become self-love. I was shamed and bullied all of my life for being overweight. It is a continuous and vicious cycle. I am not one for prayer at all but I have to maintain some kind of hope that things could at least get better. But I am struggling to muster hope.

My guess is that your surgeon wants to be certain that your liver shrinks enough so that he or she can safely and effectively perform the surgery.

I am not thin just yet. In fact, I am still pre-op but I will never forget from where I came.

So I'm having a really bad patient care experience with Penn Medicine's program and it has lead me to lose complete confidence in my surgeon, Dr. Gary Korus. His staff have been unfriendly, dismissive, and act put out when I have legitimate questions and am confused. If you are considering Penn Medicine to have your surgery done, I would reconsider. The whole program has been less than professional, almost from the beginning. I am lucky in that I found Christiana Care in Delaware and they're more than happy to let me transfer in and I don't have to wait for fscking months on end - I've got an appointment on Thursday, November 30th.

I am going by the chart. I am 6'4" so I should be about 190. I will get as close to that as is possible.

Keep positive. This time you'll get it done.

Being as heavy as I am, I miss my two loves: backpacking and cycling. I've been heavy all of my life, but at the times that I've been less heavy, I was able to ride 100 miles and backpack about that same distance. So, I'd really like to be able to shake the dust off of these hobbies. What do you miss doing that you would like to be able to do?

^^ This. My program offers several support groups across the Greater Philadelphia area. I went and it was nice to be in good company with other people in the same condition as my present one and to meet with others that have had great success and could offer meal planning advice.

If it helps any, I understand. Sometimes it feels like for every step forward, I take two steps backward. Hope things get better soon, but as bad as things might feel, you're still 30 pounds lighter. To give you an idea that's 2 15 pound bowling balls lighter!

First let me say that you've done incredible! Rather than worrying about the plateau, bask in your success. Second, see if you can just do some walking after work. You'll probably feel pretty good after it's done.

Try using an app like loseit to estimate the amount of calories, carbs, etc before you give in to the chocolate craving. I think once you see that the numbers are clearly not in your favor, you'll make the right choice. This helps me immensely.