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Hi I am a teacher too :bored:. I am in S. Florida and our insurance does not require a 6 month supervised diet so I made my pcp and nutritionist appointment in Feb, psych appt in March, and pre op in May, and was approved May 29th just in time for summer..I hope everything goes smoothly for you. I got a good surgery day with summer vacation and all. I know some teachers who came to work right after other bariatric procedures and I do not know how they were able to do it!

I am in the process as well. I had my first consult with the surgeon August 5th and my first weigh in was August 11th. My surgeon's bariatric program is 4-6 months long. Since Tricare Standard does not specify how many months u need for the medically supervised diet/weigh-ins, I am going with 4 months. I have read on other threads that some people sent in previous medically supervised diet/weigh-ins to the insurance and they were approved. Others only did a month or two and were approved. Good luck with your journey!

I saw Dr. Gayle King and she was AWESOME!!! She specializes in eating disorders so she had a very unique take on the whole situation. Dr. Cotton is who Dr. Fusco uses and he charges $150.00 for the visit- He doesnt have much personality but if you are not planning on going to regular counseling I don't see how that would matter.. Your insurance company should provide you with a list of providers that do bariatric counseling... Hope this helps:smile:

Southwest Bariatric Surgeons - Lap Band & Gastric Bypass Weight Loss Surgery - Austin, TX located in austin

Hi everyone! I'm just starting my process. I received my referral from my PCP and have an appointment for the seminar and a "bod pod" test on March 2nd. I did call me insurance who gave me their requirements. I see that alot of you had to see several specialists. Is that a requirement of the surgeon? I have BCBS of IL and it states I need a psych eval, but not cardio, etc. Also, this is a part of requirements for surgery thru insurance: Documentation of active participation in a comprehensive, non-surgical program of weight reduction for at least six (6) months, occurring within the twenty-four (24) months prior to the proposed surgery and preferably unaffiliated with the bariatric surgery program. (NOTE: The initial BMI at the beginning of a weight reduction program will be used to meet the BMI criteria for the definition of morbid obesity used in this policy.) A program will be considered appropriate if it includes the following components: Nutritional therapy, which may include medical nutrition therapy such as a very low calorie diet such as MediFast and Optifast or a recognized commercial diet-based weight loss program such as Weight Watchers, Jenny Craig, etc. Behavior modification or behavioral health interventions. Counseling and instruction on exercise and increased physical activity. Ongoing support for lifestyle changes to make and maintain appropriate choices that will reduce health risk factors and improve overall health. I have been seeing my PCP every month since OCtober and my weight has always been discussed and she gave me her advice on how to lose weight, etc. Will that qualify as the first 5 months in 6 month participation or is more required?

My life has been moving at a very fast and stressful pace the last couple of days and I did not get the opportunity to detail my first visit with the doctor this past Monday which now has become a slight blur after a day of meetings and the training of 2 new assistants. But the details are simple..the appointment was longer than expected mostly due to waiting..I saw the bariatric doctor first and she gave me a full examination and a clean bill of health to proceed with getting the procedure. That was no surprise since I have been blessed to live all these years with extra weight and none of the health problems usually associated with being obese. She asked me how much weight I was looking to lose and agreed I would be a great candidate for lapband. The nutrionist came in next and spoke with me about alot of the same things she had discussed at the seminar I attended a week before and little tips on how to "practice" what will become my new style of eating. I kinda felt like she probably did the same speel with everyone and could do it in her sleep, but like everyone on the staff, she was really nice and it probably was more me, than her feeling like there was nothing this woman could tell me about how to eat properly, the food pyramid, reading labels and exercising...I knew the rules..I just did not apply them to my life. The surgeon met with me last with his plastic stomach replica to show me how the band actually works and also touched base on my concerns about blot clots since I had a clot last year. He was very patient with my questions and made me feel at ease. The fact that I had checked him out online when my primary doctor gave me the referral, helped alot. By the time I left (3 1/2 hours later) I was exhausted and starving :biggrin: but smiling brightly because I had my appointments scheduled for the necessary tests all patients have. My sleep study was the only thing not scheduled but with another 6 weeks before I return to see the doctors, I will wait to hear from them for my appointment. On a good note...I met my angel. Despite some distractions she had that morning, she managed to meet me and sat with me while I waited to be seen. She was just as beautiful as a person as I imagined and having her there for support was truly special. She is highly opinionated on some things, but I like her spirit. On a quasi bad note..I have been smoking. Considering the fact I am doing it sans any smoking aids and for the first time ever since I started smoking at age 20, I think I am doing pretty well. I bought a pack on a very stressful morning when I couldnt "bum" one and found myself reaching for them as my stress continued. I smoked about 8-10 cigarettes a day before I decided to quit, now i have been smoking about 2-4 a day. I will not give up. I will just continue to try because I know I have had enough and have been tired of the habit for a long time. Its just been a really long and stressful work week. (and its only Wed) Its no excuse..but its the truth. On another good note..I weighed in at my appointment at 270. That was a 8 lb weight loss since I saw my doctor last month with no real effort. Just small changes to my diet and doing those little things like walking a little further and just getting off my ass. My appetite has also decreased because I have cut back but today I felt as if I really cheated myself because despite the intent to have a heatlhy lunch that I bought to work, I rushed when I finally got a chance to eat without being abel to savor my food and of course ate more than I would have when I got home for dinner if I would have been able to eat what I took to work. I am truly trying to embrace my life and I am looking forward to process ahead of me simply because I know as I complete each phase, it is just taking me closer to getting banded and the road to making positive changes in my life.

Ask your fill doctor or your PCP for a referral to a nutritionist. They're trained for this kind of question. I had to pay out of pocket for 6 visits and each visit was only $40. It's more than worth it! Try to make sure the nut is very familiar with bariatric surgery? tmf

I'll be starting my two week liquid diet on May 29 also. The dietician I saw at the bariatric center gave me some recipes for some shakes that don't sound half bad....some of them even have strawberries or banana in them, and I'm also allowed to have a salad or steamed veggies if I get too hungry so I think I can manage that. My aunt did the same identical diet and lost 15lbs. in the two weeks before surgery, so I'm hoping that I can also. I know I can do it, but it won't be easy so I'll definitely be leaning on you guys for some support!!! Good luck!!!

My surgeon required attendance to his seminar. It was rather informative, and there was a woman who spoke of her personal experience and it brought many people in the room to tears, myself included. I don't know of anyone who has had WLS so it was good to see. Attending seminars are usually free, and for me it was so helpful. The Bariatric office I am going thru has 2 surgeons, and I could see the differences in personality and it helped me choose the one who best suited my needs.

You would be amazed at how many surgeons are doing bariatric surgery but aren't certified in it........

I Have United Health Care And They Have A Rider In Our Policy That Says No Bariatric Surgury Is Covered

I had to do the six months diet. It is in their criteria for bariatric surgery. I dont know any way around it but to do it unless you hire a lawyer to help you. Good Luck

You all have made me feel so much better. I never thought I would have this last minute fear because I had been waiting so long for the surgery. I started with my first visit to the bariatric center in March '07 and becasue of unforseen problems I didn't end up with the actual surgery date until June 18th, 2008. When the realization hit that it was only a week away -- WOW-- it hit me! I'm still nervous, but I believe I'm ready. My pre-op visit yesterday went well. I was even told that after a few months I could have a little diet Pepsi, my fave. My doctor's office says that they've been reviewing the diet soda thing for a long time and see no evidence that it causes any harm. But it also has no nutritional value, so I intend to try to not have it, but it makes me feel a little better knowing later on I can try some if I want. I also met a really nice nurse that had adopted a little girl from China, like we have, and we talked about how much more I would be able to do with my kids. My husband and older daughter went hiking in the Adirondacks a few weeks back, and I didn't go because I knew I would just hold them back. Next year, I'm going!! Thanks for all of the encouragement!! --Gail

I changed jobs and my new (crappy) insurance doesn't cover anything bariatric- and on top of that, my doc decided to stop practicing. I found a new doc, and for self-pay patients he has you pay $500 flat for a whole year of fills under fleuroscopy. You might shop around for something like that- and you could pay that out of an HSA or flex spend account. I went in to see him, and one fleuroscopy later he discovered I had a hiatal hernia, which I had surgery for about a month ago. Previous doc didn't use fleuro. If you go with the lower priced insurance, maybe you can use some $ for HSA or flex spend for out of pocket expenses. Good luck! Nicki

My insurance took a good month and a half to clear - mostly through mix-ups ( I had to keep calling my insurance provider and the bariatric office to keep the ball rolling). So while I was really hoping for a July surgery, I ended up with an August 18 surgery. Just realize it's not always quick!

If i were you I'd find out First what is going on with the Band, a Revision to sleeve doesn't have be done at the same time a band is removed. Also if your Surgeon is saying he thinks the band has eroded, Then a Sleeve revision MAY NOT be possible? Then your going to have to consider another form of WLS. personally I'd start researching all the options (why wait). The literature states that a Loss of restriction is a sign of erosion, and epigastric pain, where others experience nothing. What happened that you Failed the Barium swallow? Did the Surgeon see the flow of Barium going somewhere other than through the esophagus/stomach? OR were you just unable to tolerate drinking the Barium? I ask because this is a Concern for allot of Banded ppl. Any information can be helpful. In regards again to the Revision, Get on the Phone call the Insurance company, then get them to send you a hard copy of the policy to explain your Bariatric coverage, it varies greatly and you can't always trust the person that answers the phone to explain it correctly. BMI isn't the only factor that the insurance approves a revision, if Co-mobidities are present those are also factored in the decision. Good Luck!! So Sorry that your having band complications, Please keep us Posted and i hope all works out in your Favor!!

Hi Christine, I just recently had VSG surgery by Dr Aceves in Mexicali, on September 23. I highly recommend him. My insurance does not cover the surgery so I was self pay, and heard about the more affordable options in Mexico, so I did a lot of research for several months on physicians and facilities there. His program was my choice for a lot of reasons. First, because of his extensive experience with this particular surgery, and the fact that he does other surgery as well. He has performed over 600 VSG's. There are very few surgeons who have done this many. The research that I read in professional journals states that once a surgeon has performed over 300 of a particular operations, they have seen everything there is to see and their complication rate goes way down. His complication rate is lower than national averages that are reported in the literature. I did not want to see a surgeon who was "learning" on me! Secondly, the number of years he has been operating in general was important to me. He has 0ver 18 years experience with laparoscopic surgery and 10 years with bariatric surgery. Third, the surgery takes place in a full-service hospital, not a "surgery clinic", which is the case with some of the Mexican surgeons. I am safety conscious, so in the event there is a complication, I wanted to be in a hospital that had an ICU, blood bank, full service radiology dept, etc. Fourth, Dr Aceves' program also provides an internal medicine evaluation, and he has an assistant surgeon who also sees you regularly. You are visitied MULTIPLE times each day by the physicians. I have never seen such attentive care by physicians in US hospitals, and I have worked in many of them since I am an RN for over 30 years. Dr Aceves and Dr Campos in particular were outstandingly kind and attentive. Fifth, Dr Aceves does 3 leak tests before you leave. These are tests to be sure there are no leaks in your new sleeve, which is one of the more serious complications that can have. Some physicians don't do this number of tests. Dr Aceves is conservative about this and I was glad to learn it. His post-op diet is also conservative compared to many, because a more conservative approach can help prevent post-operative leaks. Sixth, the program was so user-friendly. They assign you a coordinator at the beginning who answers all your questions via phone or email. Their driver picks you up at the airport in San Diego, transports you to the hospital where pre-op labs/xrays/ekg are done; they drive you tor a nice hotel room that first night, they transport you back to the hospital for surgery the next day, you stay in the hospital for 4 days and then are taken directly to the airport on that 4th day. All this is included in the fee, which is about 1/2 what you would pay in the US. You pay your own airfare. When I missed my connecting flight due to weather, I immediately called my coordinator and she re-arranged my pick-up time, transportation, hotel reservation, and lab schedule and took care of everything. It was so easy, I did not have to worry one bit. I found the hospital to be very beautiful, and cleaner than any hospital I have ever been in. It is a private hospital, and has decor more attractive than any I have been in here in the USA. The staff are very nice, most of them speak good English, and they are very kind and attentive to your needs. If you have any questions or concerns at all, Dr. Aceves is right there to answer them and he truly listens, as does his assistant, Dr. Campos. They are especially concerned about pain control after surgery, and I have to tell you, I had very minimal pain after the surgery. I've had 3 prior surgeries in the US and the kind of pain management in this program was the very best. I received spinal anesthesia as well as general, which is recommended in some of the research literature I had read prior to deciding. It truly was amazing for pain management. It is important that you do your own research until you are comfortable with your own choice, and you can read a lot about various physicians and facilities on this website and the obesity help website too. At OH you can research how many surgeries various physicians have done. Read, read, read before you decide, so you are really comfortable with it. Best of luck to you!

Bariatric Surgery makes new life out of Nothing At All ( with thanks to Russell Hitchcock and Men At Work)!!!

Will you're my bariatric Godmother 😍😍 you're amazing!!

Thanks for the info Teresa. I'm in Hillsboro, Oregon. Sorry to hear about Dr. Eubanks' troubles. I can call him and check for updates if you have the number. (He doesn't come up on obesityhelp.com's list of bariatric surgeons in Oregon). A friend of mine with a lap band has had fills in Mexico and fills in the states. She said they are MUCH more generous with the fills (and cheaper of course) in Mexico. They just go for it and give you a good tight fill. Here they want to give you drips and drops and overly cautious about it. :0( Which ends up not as effective, and more expensive with all the return visits to get a little more. So . . I think she gave up on the Washington doctors and will just return to TJ mexico for fills. I'll still stay open to finding someone who is closeby if I can find a good one. Otherwise, will just have to head back to mexico too, if I want to make progress on this weight thingy . . :0)

I have thought the same thing. I know I am going to loose some good poundage on the preop diet. My Insurance BC&BS won't cover any type of bariatric surgery so I am an out of pocket payer, but I am still going to go with the surgery. I always loose on a diet, and there in lies the problem. I loose weight, feeling great and then slowly start overdoing it, and before I know it I have the weight back. This time I am taking measures to prevent that from happening. The "Sleeve" shall set me free... lol,, sorry I get a little over zealous at times.

Read more about the program at http://www.mexicalibariatriccenter.com/ and http://www.obesityhelp.com/morbidobesity/bariatric+surgeon+profile+Alberto+Aceves+lpc.html

Great question and equally great replies! As many of the respondents mentioned, gastric sleeve surgery is much less complicated than many other types of bariatric surgery… Your digestive system is not rearranged, unlike gastric bypass surgery or duodenal switch surgery. It also differs from the more complicated procedures by being primarily restrictive in nature (makes you feel full sooner rather than directly causing your body to absorb fewer calories). There are no foreign objects implanted in your body as with gastric banding or vertical banded gastroplasty. Because of these differences, the gastric sleeve has a reduced risk of: Vitamin deficiency/malnutrition Dumping syndrome and other malabsorptive-procedure (i.e. gastric bypass) side-effects Long-term gastroesophageal reflux disease (GERD) vs other restrictive procedures. Another consideration: with gastric sleeve surgery, a large part of the stomach is removed, so afterwards your stomach may secrete fewer hormones that make you feel hungry (i.e. ghrelin peptide-YY). To be fair, gastric sleeve surgery does have a few negatives vs other procedures: It cannot be reversed (not necessarily a bad thing) A relatively long staple line is created during surgery which may increase the risk of staple line leaks and/or bleeding It is a newer procedure than Roux-en-Y gastric bypass and other surgeries. As a result, it has fewer long-term studies to support the short-term results. Some critics fear that the pouch could stretch over time (although there are a few relatively quick and safe procedures that can tighten up a stretched stomach pouch). A couple of studies that directly compared gastric sleeve surgery to other procedures also suggest that weight loss may be similar or better than weight loss following Roux-en-Y gastric bypass surgery or duodenal switch surgery. Good luck with your decision and with your new life! Bariatric Surgery Source Gastric Sleeve Surgery - Evaluating & Comparing Its Effectiveness and Outcomes

Hi I am 35 with a bmi of 38.1 I have horizon bcbs. They require a 6 month period with a nutritionist, therapist visit, bariatric seminar yadayadayada. Well I have been doing all of the requirements.. And then I was told by doc that bcbs prob won't cover me. Here's the worst part- I have 2 degenerated discs no gallbladder fatty liver planters fasciutus achey knees elevated cholesterol boarderline diabetic not to forget IBS and now stress incontinence from this heavy hanging fat roll! How sick do I need to be?? So I have a choice-gain 15 pounds and feel even worse or god knows what or stay this weight and continue jumping through their hoops to just be denied in the end! I wanna scream! I don't have money for selfpay! Any advice?

My lunches usually contain a variety of the items below. I usually bring more than I will eat, so I can have what I feel like and then just repack the next day what I don't eat. I'm still adding new items to this list as I progress with trying/handling new things. it proves a challenge for me to pack lunches as I use to just eat out every day pre op. I have had a few things from fast food, but it's hard to find anything that you can eat. Jimmie Johns can makes all of their sandwiches into an Unwich, no bun - lettuce wrapped. I tried the turkey/ham and it was fabulous... it took me all day to eat 3/4 of it, but my pup was happy to get the rest at the end of the day.. also you can order a side of beans at taco bell which satisfies if you have no other option. My lunches contain an assortment of: 2 oz tuna salad (fixed as if it was going on a sandwich) deli meat or some other sort of meat hot soup in thermos olives pickles light string cheese cherry tomatoes apple orange P3 (deli isle) meat/cheese/nuts pistachios 2-4 oz lowfat cottage cheese 2-4 oz yogurt 2-4 oz protein sf jello (unjury.com has recipe) 2-4 oz vegetable, I like green beans 2-4 oz dole no sugar fruits I ordered some of the bariatric pal protein chips in a variety. I liked about half of them, but will not be attempting this again until I reach maintenance stage. I found myself eating more than one individual size bag a day or grazing through more than one portion at a time. It brought out old habits in me, and I don't need that kind of struggle with self control right now. Be careful with these my nutritionist also says they are slider foods, that dissolve fast and slide right through to the intestine, more calories for less satiety.