vikingbeast

No, in California. I'm doing my own pre-op diet to step down rather than, uh, tumble down the calorie ladder. I wasn't thinking it was too hard until today when it seemed like all of my strength ran down the drain. I can easily carry a three string bale of hay in each hand over a hundred yards, and was having trouble moving one with two hands. Completely uncharacteristic. (It's also more than 100 degrees Fahrenheit, so there's that too.)

I have CIGNA, but they are just the coordinator (my employer self insures). The requirements they had were ridiculously easy: Letter from my PCP recommending me for surgery. New Patient Orientation / Post-Op Nutrition Education (combined into one) Surgeon Presentation ("This is what gastric bypass is... this is what sleeve gastrectomy is...") Psychological Clearance Attendance at one bariatric support group meeting About 20 pages of forms, quizzes, etc. I had to send in. That was it.

14th September here. There's no pre-op diet for me other than one day of clear liquids on the 13th and NPO the 14th, but I've been weaning myself off caffeine, sugar, and alcohol and reducing the intake so that I don't go from, say, 2,700 calories a day to 300 overnight. Hungry but not as hungry as I thought I would be. Covid test is tomorrow (seems odd given that it's still 2.5 weeks until surgery), labs and scans Monday, pre-op meeting is 2nd September.

A mixture of straight cardio (walk, run, row, bike, ski, swim...), strength training (weight lifting) and HIIT (high-intensity interval training). I do CrossFit (started when I was at my heaviest weight), but it is expensive and takes about a month to get used to the intensity. I have never been stronger, though. As an example, today's workout was bench press (10-8-6-4 reps at increasing weights), then what in CrossFit-speak is called an EMOM (every minute on the minute). Every 3 minutes, 15 calories on the stationary bike and 15 box jumps. Do that 5 times. It was probably only about 40 minutes worth of actual work including a 7-minute warmup, but it's intense.

My surgeon was booked out 3.5 weeks. My insurance came back with the approval in 3 days, so about a month after all my i's were dotted and my t's crossed.

Completely off-topic, but @Crick, you lost 150 lbs. in eight months? You're my new role model. ?

I am obsessively monitoring the case rates in my county, which have gone down a little bit, but school started. My VSG is scheduled for 9/14 and I am desperately hoping they don't shut things down. My spies in the ER say things are busy but not panic-inducing. All I can do is light a candle and pray to whoever the patron saint of fat people is.

So glad to hear you are getting support. Maybe she can thwap some sense into her son while she's there... if he were around here he'd get the chancla, no matter how old he is.

I'm "auditioning" protein shakes during my self-imposed pre-op diet. So far I really like OWYN ("Only What You Need"), except the chocolate flavor is disgusting. And it's 35g plant protein in 355 ml (12 oz), and it is still palatable at room temperature, given that I'm going to be sip-sip-sipping on it for an hour or two. Premier Protein is... just okay. (I hear the cafe latte flavor is good but it's also caffeinated which makes it a no-go). What else should I audition? I'm not planning to buy a ton of any one thing, knowing (from y'all!) that my tastes are likely to change post-op.

I could lose every gram of fat on my body and still be in the Obese category for BMI (yes, I know everyone says this, but I have receipts—and decades of powerlifting and strongman aren't going to suddenly disappear off my frame no matter what I do). It's strangely freeing, and allows me to use body fat percentage as a guide instead of the useless-to-me BMI. It was nice for the one moment where they needed my BMI to qualify me, but if I had 15% body fat I'd still technically qualify for surgery (35.8 BMI). I'm expecting lose some lean body mass—can't go that low-calorie and not—but this is all about reducing comorbidities and allowing me to get to a spot where I'm not tripping weight limits on things all the time. Today I imagined getting on an airplane and not having everyone scrunch their faces slightly ("please no please no please no please no oh thank god").

I found the most success (pre-op) when I combined diet with weight/resistance training. What about buying some dumbbells or kettlebells? You can find training programs online if you're not yet comfortable going to the gym (understandable!).

Sounds like a great reason for a trip to another state. Wow, Florida.

I'm still three weeks pre-op but I felt every word of your post in my bones. And all I will say is that, now that I've committed to do this for myself, I wish I'd had the courage to do it 15 years ago. Too young? No such thing. They do it for teenagers. And if you're young, your skin is more elastic which could mean less issues with loose skin.

My surgeon specifically mentioned that the sleeve would reset my metabolism (wrecked from decades of overeating)... I'm hoping that's the case.

Today I was walking through the center of town (closed to cars) and was people-watching... how easily they moved, how energetic they seemed to be. I'm having a lot of trouble reconciling the idea that a year from now, if I stick to the plan and keep working the way I know I can, I could be that way. I've been so obese for so long that I can't imagine a life where I can just... go to a store and buy pants. Or just... decide to sleep somewhere else without having to pack up my CPAP. Or just... run for the sake of running. I literally cannot imagine it. It should be a source of motivation, but it's impossible for me to wrap my mind around it. And then I get all overwhelmed. I've failed so many times before, that I don't dare let myself hope.

Also, if you are denied, talk to the benefits coordinator at your work, because in many cases they can overrule denials, especially for larger companies that are self-pay.

I'm also using this time to try the various kinds of protein shakes and see which ones I like now. (I'm aware that my tastes are likely to change afterwards.) I can say that while the OWYN shake has 35g of protein, it tastes like that cheap chocolate the kids flog outside stores ("World's Finest", my hind foot.)

On my insurance (CIGNA) it was under coverage and then precertifications.

I'm such a control freak (I'm a project manager!)... I actually discovered the hidden place on my insurer's website where I could track it. I actually knew about the approval before my clinic did ?

My clinic doesn't require any kind of pre-op diet other than liquids only the day before surgery and NPO the day of surgery. Am I weird for wanting to do kind of a step-down diet over the next three weeks, just so that it's not all just one "AARGH!"? My thought is to replace one meal a day with a protein shake this week, reduce fruit, and step from 2 cups coffee a day to 1 cup (and no sugar in the coffee, which is about the only place I still eat sugar). Then the second and third weeks, replace two meals a day with protein shakes, and eliminate fruit and coffee entirely. If I get too hungry, I'll have something protein-y like plain skyr. (Skyr is a dairy product that's like yoghurt but is made from skimmed milk and is higher protein than regular or Greek yoghurt.) Any other suggestions from veterans? What was hardest for you post-op that you wish you would have dealt with pre-op? I have been practicing "sipping" for a couple of weeks and it's annoying as H-E-double hockey sticks but not undoable.

Also, just from (very) recent experience, make sure your bariatric clinic's insurance coordinator knows their stuff. I got a letter from my insurance after they submitted saying "hey, we need X, Y, and Z before we can determine," except I know for a fact X, Y, and Z were submitted. So when I called the insurance coordinator, she said this is normal, what happens is they open a request online which generates an automatic letter to be sent with what's needed, but it happens before the process allows them to upload the clearances, so it appears "missing". I had my answer back in 3 business days.

Congratulations!! That's a huge difference, you can really see it in your face.

Good Lord. What are you supposed to do if you're "lack toast and told her aunt" (LOL). Even I, not really lactose-intolerant, would be sick on nothing but milk for two weeks.

You are 100 percent worth it! Just make sure you have all the support you need—medical, nutritional, psychological, and if needed, addiction treatment. You absolutely can do this.

And that is one reason why I did get vaccinated—because I can, and the sooner we reach "herd immunity", the sooner it's safer for the immunocompromised like you and a very, very close friend to go back out into society. Did I have misgivings? Oh, yeah... but as an obese person, that thing has got its sights set on me and I decided the benefits far outweighed the risks. (Not here to preach! If you have questions or concerns, talk to a doctor you trust.)