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I'm going to my first appt at my doctors office on the 16th to bring up bariatric surgery. Any questions I should ask or things I should mention?

So I have done almost a year of Nutritionist visits. I have lost 26lbs. I went Wed for my psych bariatric eval and passed. Then yesterday I went for orientation and my consultation with the surgeon. Everything went well, they said I should be able to be approved. They gave me a checklist of things that both the doctor and possibly my insurance would require. Nutritionist eval and documentation 6-12 months ^done Psych bariatric evaluation and recommendation ^done Letter from me outlining why I want surgery and what I am suffering from ^done Cardio clearance- EKG, stress test Gall bladder Ultrasound Blood work Endoscopy sleep study and pulmonolgy clearance ^need referral and scripts for the above from PCP My surgeon is in Ocala, my PCP is in Clermont and I live in Orlando. I decided to stop in my PCP office on my way back to grab the referrals and scripts (he works in a walk in clinic) and he asked that I get written documentation from my INS company of what they wanted to have submitted for approval of surgery before he sends me for clearances to have the surgery. Called insurance company and NO one will give me written info because the procedure is only done in times of medical necessity and each case is decided on a case by case basis. I go back in with the PCP and he says he will not give me any referrals or scripts for tests until I am approved for the surgery through my INS company. INS company verbally said I had to have "6-12 months diet documentation from a nutritionist/physician, Comprehensive pre/post op plan with a Bariatric program, clearance from Cardiologist, Gastroenterologist, Documentation of No Endocrine issues that could be causing the morbid obesity and a BMI of over 40, documentation of any co-morbidities". They said if all the appropriate documentation is not submitted it is an AUTOMATIC Denial. I told the doctor this. I showed him the emails between me and a supervisor at my INS company with telling me that "There is no written procedure to follow for a MAGICAL approval". I have the option of changing my INS plan with a good enough reason. Should I just change it, find a new PCP and INS? I already checked with my surgeon and they take all of the other insurance options I have to switch to. Ugh I am so frustrated. I feel like no one wants to help me. :-(

@KarmaNina I just got off the phone with my nurse and I discovered that part of the reason for the discrepancies is because my employer is self-insured, thus my policy isn't really a traditional health insurance policy. Chances are most of our policies are self-insured (something like 60% of large companies self-insure). As a result, my policy requirements are more strict. ugh! I also learned I have a lifetime max of...wait for it...$15,000.00! I know that it is after insurance discounts, so I'll probably be fine, but OMG! I work for one of the largest auto insurers in the US and they are CHEAP! Good to know I guess...I'll just keep letting them pay for my nursing degree so I can quit (honestly, they've paid $25,000 for an education I'll only use after I leave the company, but they limit the amount they'll pay for bariatric surgery?! Ridiculous!) I'm annoyed (maybe even a little bitter), but what can I do? I also found out that since I've been (virtually) going to WW for the last 3 months, I can count that towards my 6 months my employer requires as long as I see a nutritionist or physician twice in the next three months. EASY. DONE. OKAY. WILL DO. All this said, my BRS nurse was super nice and really seemed to want to help me get approved for surgery...no hate her way, just issues with my actual employer.

For me i had to have a psych eval, venous and abdominal sonogram, stress test, heart echo, pulmonary consultation, sleep study, endoscopy, 6 mo visit with nutritionist, 3 bariatric support groups and a letter if necessity from pcp

I received a lap band in 2009 (had complications with it and had to have it removed in 2010) and now getting a sleeve on the same date, July 9. I can tell you from experience, the pain is minimal. If you do experience discomfort, you will be given pain meds to minimize it. Gas pain is probably the biggest cause of discomfort from this type of procedure, although not as common as in years past. If you experience this type of discomfort (pain in your chest, shoulders, back, etc), walk as much as possible. This helps to disperse the gas. I can tell you that this surgery is a very safe, not only as a patient, but as a medical professional. I am a Surgical Technologist and can attest that this procedure is extremely common and safe. There a many abdominal procedures that use a laparoscopic approach and patients tolerate it well. Your experience will most likely be a good one. When you return home, you will have a new life to ahead of you. This is my third trip to the operating room (as a bariatric patient) and it's well worth it! I am so grateful to have this second chance. Good luck to you all and God Bless!

I was self-pay in NJ. Total was $14,500 including 3 months of aftercare/fills and one night in the hospital. I went to Mehta Bariatric Center in New Brunswick. I live in south jersey and it only takes me an hour and 10 minutes to get to his office.

I had a adjustable laparoscopic gastric band performed in Glasgow at the Nuffield in February 07, I am a surgeon myself (trauma Orthopaedic) but I live in Edinburgh. At 118Kg the Edinburgh New Years Day Triathlon was my first Triathlon, I had not been this weight for 25 Years! The event consists of a 400-metre swim, 11-mile cycle ride and a 3.5-mile run. I finished slowly in just about two and a half hours. I completely run out of energy on the run and hit;the wall, an experience I've never had before. From my pulse rate I think I swam, cycled and run the whole event anaerobically! My heart rate monitor watch said my peak pulse rate was 178/min and that during the triathlon I used just about 5,000 calories (hard to believe?). I'm not sure anyone has any experience with adjustable laparoscopic gastric banding and triathlon? IF there is anyone out there please contact me. I guess being catabolic for most of the year my liver has little capacity to store glycogen, its said you run out of energy at about 90 minutes which is exactly what happened. I did take on isotonic Fluid and a banana at the end of the cycle but I guess not enough carbohydrates (I've ironically avoided carbs all year!). I would like to do another triathlon at some point, I would be better being less than 100Kg I guess. Today luckily no joint pains and just a bit stiff. Thanks for all those who came out to support me. The finish was a fair bit emotional. I have run a blog at Chris Oliver Blogspot this was intended to relay my experiences, I hope it will be useful to other bariatric surgery patients and help the development of bariatric service in Edinburgh and Lothian both at the Murrayfield and on the NHS.

Lyn, both surgeons will be doing my op which is cool. As for WW been there done it. I've found the only thing that works for me is calorie counting. Lew, currently there is at least 120-150 referrals waiting on initial appointments in Edinburgh on the NHS, but because there is no bariatric service as such, they are not given the same status as other referrals ie you are guaranteed an appointment with a specialist within 18 weeks. After discussions with people involved in securing NHS funding for bariatric surgery, I chose to go private as I would wait at least a year to even see Mr Tulloh/Mr de Beaux on the NHS and another two years for the op itself. The last I heard is that funding should be in place in April 08, the new financial year for around 50 operations a year. So far less than 5 patients were seen at a one off clinic. No NHS bariatric clinic is running at the moment in Edinburgh unfortunately. Hope this helps a bit! Sadie

I was told the shortest possible time would be about three months (I did my six-month supervised diet before I was formally admitted to the bariatric program, though. Although that was a requirement of my insurance company, not the bariatric clinic). I had my surgery about six months after starting in the bariatric program.

Bariatric Advantage has an unflavored protein shake. It is not cheap at $60 for a large container.

Thank you for telling us, I,for one, feel honored you shared this secret with us. I am waiting for my surgery, maybe May, after curves and a threatened derailment of my journey on the weight loss road , I am fighting what seems an uphill battle to secure a RnY . Started my battle in August 2015, now ready to proceed with program # 2 at bariatric center#2 for hopefully not a 3rd set of requirements, I should have clairification after April 25th 2 hour meeting with OSU psychologist Dr Kramer in Columbus Ohio. There are days I toy with the idea of novacaine, a box cutter and 30 wt fishing line and doing my own . I have begged, pleaded ,jumped through hoops, crawled through minefields of quasi regulations, slithered across broken glass, had various portions of my anatomy scanned, prodded ultrasounded and groped to no avail. Every portion of my gastrointestinal system is there except the appendix and gall bladder I gave up 30+ years ago.[emoji10] I have answered questions, allowed my psyche to be probed, and presented myself in abject humiliation to have surgery and it still has not happened. If this is truly a journey I have gone around enough hairpin turns to last me until infinity.But I have resolved not to let it triump over me, I will subdue the Bariatric dragons in my path with my Rightness sword. And surgery will be mine![emoji7][emoji626] Sent from my VS880PP using BariatricPal mobile app

I wish I had good news!! Long story short...appeal Kaiser's 24 weeks in San Diego program. Reasoning is the OC is only required 12 weeks. I did 12 weeks much to my dismay as the entire class was like a bad sorority meeting weekly and I had also lost my job. Appeal was approved and basically Positive Choices BS'd me and sent me to Pacific Baritriatric knowing full well that the surgeons would make me finish the whole classes. Waited 5 weeks to get the surgery consult and in the mean time was told I could not continue the classes until the surgeon decided when they knew full well that the surgeon would would say return to classes. Pacific Bariatric is a mess!! They are unorganized; rude; condisending; they forgot to give the surgeon the notes about my appeal so I started to leave there thinking I was moving forward when the doctor didn't even know he had to appove my appeal!!! Basically the office staff is punishing me because I appealed. The doctors reasoning is that Kaisers long program is successful. So I said "you see multiple patients with all different kinds of insurance correct"? he said "yes that is correct". "so are you saying that all the other patients you see don't have the same success rate as the Kaiser patients because we have to wait a year?" Or rather, "that the Orange county Kaiser patients are less successful than the San Diego Patients even though they cover the same exact material in 1/2 the time?" I left in tears...I swear I wanted to slap the girls at the front. It was really ugly how they were basically treating me like I was cheating on a test or something. I was being punished because I exercised my rights to the same level of care as the people kaiser patients that live to the north of me!!! I am so upset!! I was soooooo excited thinking I may be able to change my life soon all to be let down and told I have to attend a class of bickering nasty women in order to get the care I need. It just makes no sense to me!!!! NOW I AM BEHIND EVEN LONGER - IT SEEMS LIKE THEY DID THIS TO ME ON PURPOSE!! Many hours of driving for nothing!!

I totally agree with renewed hope!!! You've got to take care of yourself if you're going to continue to take care of your family. Best of Luck!

My first appt. was with the bariatric doctor in April and I had one in May, June and July. I didn't go to a PCP (didn't have one) until June and she sent me for the blood work and did the EKG, etc. She also signed the required letter stating she recommended me for the surgery. Keep in mind, if your insurance is like mine, you have to have 90 days elapse between the 3 physician visits before submitting. For example, you can't go for the first on June 30th, next on July 30th and last on August 1st. I am thinking you will have to submit in Sept which is right around the corner. My surgery is tomorrow. Woo Hoo! Good luck to you and stay positive!

Your mom may be legitimately hungry as some people dont feel satified on the early stages of the diet. Things change however with firm/dense protein intake. Also some people still want to eat solely for the joy or comfort of it, so that may be a factor as well. Reflux (which may mimic hunger pains) should be considered and meds usually given early post op to help. Is she taking anything? Also a drastic change in lifestyle and other medications entering and leaving the system can affect sleep and mood as well. Start or stop anything recently? Also a reasonable amount of time to completely heal and return to normal is important. Some people don't bounce back quickly. Patience is important but be aware of sudden declines as people should get better with time. When you say she drinks a lot of water (but cannot urinate) i think in excess of the recommended 64 oz daily. Is this what you mean as well? Is there a way for you to track exact amounts (good info for doctors to have) ? Perhaps it's time to split up her questions to different doctors besides her bariatric surgeon. They only handle the one thing. Perhaps speak with the Primary to see if there is a need for a visit to the Urologist and also mood/mental health referrals for a Therapist. If I was someone going through this I would ultimately just want to feel completely supported. Try to be patient and tolerant, let her journey be self guided but advocate for her when she needs you to. Good luck💖

I was thinking the same thing...lol. Even about pre-op stuff. I had heard so much about liquid dieting to shrink the liver before surgery, but when I mentioned that at one of my visits they (the surgeon's office) was like "oh my goodness, no we do a 24 hour clear diet the day before surgery and that is it. We feel like longer than that is cruel"...so then I asked about my liver and they said "oh it is fine" ...so go figure? I agree with Ellisa, just do what they say to do, even though there is a big difference among surgeons within the bariatric community.

Be sure to work with your doc on your meds before surgery. Some work, some don't and some we just don't know. Meds for depression and other mental health issues are unpredictable enough without the WLS aspect. Please google your meds with the type of weight loss surgery you are having and take your research to you doc. Hopefully you can put a plan together in advance. At least that will be one thing off your mind: http://www.newlifebariatricsurgery.com/uncategorized/medication-absorption-after-bariatric-surgery/

From the Port Huron Times Herald: St. Joseph Mercy Port Huron hospital is branching out into bariatric surgery by teaming with the Michigan Bariatric Institute. Two local surgeons who had worked at Port Huron Hospital are the first onboard. Dr. Zubin Bhesania and Dr. Anthony Boutt will be moving the bulk of their bariatric practice from Port Huron Hospital to St. Joseph Mercy this month, although both will do surgeries at Port Huron Hospital when necessary. "It's a huge thing for the community," Bhesania said. "At St. Joseph Mercy, we will be able to network with fellow Michigan Bariatric Institute surgeons. It is a good synergistic move for us. We are bringing a lot of bariatric experience with us." The Michigan Bariatic Institute is part of the St. Joseph Mercy Health System, the parent of St. Joseph Mercy Port Huron. Bhesania founded Port Huron Hospital's Lap-Band Center of Michigan and has been serving as its director since it opened in 2002. Boutt also has been on staff since the center opened. Patients will be able to have both surgical and medical bariatric treatment at the new center, which Bhesania said is a big improvement. Port Huron Hospital's bariatric center only offered surgical treatment, which excluded some patients from care. "Not everyone qualifies for surgical bariatric weight loss," he said. "If your (body mass index) is 29 and you have high blood pressure, you wouldn't qualify, even though you would definitely benefit from being able to lose weight." Medical weight loss combines dietary changes, medications and exercise to achieve weight loss, Bhesania said. The bariatric center at St. Joseph Mercy Port Huron will be on the main floor, near the emergency department. It will open Jan. 23, and the first patient education seminar will be 5:30 to 6:30 p.m. Jan. 26. Registered nurse Tammy Kwarciak has been named director of bariatric services for the new center. Officials with St. Joseph Mercy Port Huron said they are excited about the chance to start a bariatric program with Bhesania and Boutt. "We are very fortunate that this important service will be provided by two highly experienced and professional surgeons who have completed more than 3,000 bariatric cases over their extensive careers," Peter Karadjoff, president and chief executive officer of St. Joseph Mercy Port Huron, said in a news release. "Alignment through the Michigan Bariatric Institute will provide Dr. Boutt and Dr. Bhesania access to health system resources not available before, offering the ability to more readily expand their scope while improving service to the entire southeastern Michigan community." The surgeons aren't the only ones moving to St. Joseph Mercy Port Huron. Bhesania said most of the staff at Port Huron Hospital's Lap-Band Center will be following the surgeons to the new center at St. Joseph Mercy Port Huron, and he expects patients will do the same. "We are intimately involved with the care of our patients," Bhesania said. "I expect that they will follow us." "We'll be the same people with a different roof over our heads." The news comes one month after Port Huron Hospital announced an expansion of its Lap-Band Center of Michigan. In December, the hospital said surgeons would do gastric sleeve and gastric bypass surgeries in addition to Lap-Band. The hospital also said it would add surgeons to the center. Officials with Port Huron Hospital said the center has earned accolades as a Bariatric Center of Excellence by the American Society of Metabolic and Bariatric Surgery during its 10-year center. "Port Huron Hospital's Lap-Band Center of Michigan is considered one of the most experienced programs in the state," Dave McEwen, vice president of operations, said in a statement. "In the next few months, the center will expand to include additional surgical procedures and welcome two additional bariatric surgeons to the program."

For a little background info, I was diagnosed with Crohns in 2011, have been asymptomatic since 2012 and stopped my crohns medication in 2013 due to loss of insurance. I started my WLS journey 9 months ago in July. At my first appointment my surgeon thought I may have been misdiagnosed and recommended I have a colonoscopy as WLS is contraindicated for people with Crohns. He seemed pretty sure I did not have Crohn’s since I had very mild symptoms before being diagnosed. I wasn’t able to get a colonoscopy until the end of October, and it came back still indicating I do indeed have Crohn’s. My GI doctor wasn’t sure why I wasn’t having symptoms, but did see inflammation which was contained to my colon. She put me on mesalamine and wanted to do calprotectin labs to check inflammation in February. I returned to my surgeon and was informed that he did not feel comfortable performing WLS with this condition. I was pretty devastated but wasn’t going to let it get me down. I had lost 20 pounds (10 pounds more than the goal he had set for me) and accepted the fact that I will have to do this on my own. A month later I was called back into the bariatric clinic and my surgeon had went to a bariatric surgery conference in DC and proposed my case and spoke with other surgeons and all of a sudden he was able to offer me the sleeve. He advised against RNY due to if I ever became symptomatic I might require addition surgery as it could spread. I was looking to do full RNY due to the possibility of having dumping but I would take the sleeve over nothing. The catch was we have to wait until the inflammation in my colon goes down. 3 months was basically wasted on the mesalamine. Nothing changed. My GI doctor started me on a 2 month prednisone taper. Prednisone is the freaking devil. I gained 23 pounds but had the labs re-done and my inflammation went down from 374 to 81 and normal was Now my VSG is scheduled for 5/31! Does anyone else have Crohn’s? Have you had problems?

Sue: Hi my name is Shirley, I too am from S.C.S.. I went to Henry Fords. They really got the handle on all these surgeries. If you are haveing second thoughts, or problems I would call the Bariatric Surgery center in Detroit and get a second opinion. Especially if you are not sattisfied. I had hernia repair, scar tissue removal, Lymph Nodes removed, "whew" then the lap band on 10/31/06. All at one time! First 24 hrs were hard, but it's getting much better now. Surgeon was Jeffrey Genaw. Read about him on line if you want. All I can say is there whole team was great to me. Shirley...

My first step was to know this document forwards and backwards. Cigna Bariatric Surgery requirements mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

I arrived in Mexicali on Sunday afternoon, 10/2. I rode in with 2 other patients and we all visited and shared our stories. After our labs at the hospital, we were taken to the hotel and checked in about 4:30 pm. Since we were all really hungry, we met up in the hotel restaurant a few minutes later and had a really wonderful dinner. For a large plate of chile rellenos , Beans, rice, tortillas, chips and a margarita......my bill was $13.00! With a full tummy and a sleeping pill from Dr. Aceves, I had a very relaxing night at the hotel. Ernesto picked us up at 7:00 am, Monday morning and drove us back to the hospital. Since my surgery was the 2nd of the day, I was given a sedative to relax. The rest of the day is a blur. I remember people coming in to get me....blur........I remember looking up at the ceiling as I was being wheeled to surgery......blur.........I remember someone telling me to turn on my side and bend my knees for the spinal block....blur.....and OUT. I don't remember recovery at all. The next thing I remember is being back in my room, thinking it must be over and then falling back asleep again. I was in and out of sleep for the rest of the night, knowing that nurses came in and out, taking my temp and blood pressure, but not really ever becoming fully alert. Sometime early Tuesday morning, I told one of the nurses I needed to use the bathroom. Although I stumbled a bit, I made the trip successfully and immediately fell back asleep. Later that morning, they brought me those infamous 4 little cups of blue "apple juice." They weren't good, but they were tolerable. I sipped and slept, sipped and slept, sipped and slept for hours. Several times that day, Dr. Aceves, Dr. Campos and the nurses came in and told me to try to get up and walk. I'd answer "Sure, ok." with every good intention of doing it, but I'd always fall back asleep. I really had a tough time coming out of all that med-induced sleepiness. By late afternoon Tuesday, I finally got up and walked the halls. I was completely pain-free (yes, really.....it must have been the spinal block), but I felt unsteady on my feet and climbed back into bed about 5 minutes later. Tuesday night was pretty much the same as Monday night, but I woke up Wednesday morning feeling alert and energetic. I took a shower and even put on a little make-up! Wednesday, I walked several times, visited my neighbors, sipped tea and finally got a bowl of that wonderful chicken broth everybody raves about. Yes, it IS that good. By the time I left on Thursday morning, I felt pretty good - minimal pain and absolutely no nausea. It may have been this sense of well-being that caused me to completely overdo it on Friday. BIG Mistake! I met up with a friend Friday afternoon to do a "little" shopping that turned into a 5-hour shopping spree. I thought I was listening to my body.......I sipped Isopure all day........I took sitting breaks pretty often, but by the time I got home, I felt awful. My abdomen was completely swollen with Fluid and gas. I looked 9 months pregnant and felt equally uncomfortable. That was the first time all week I broke down emotionally. I remembered reading somewhere that Day 4 after surgery is the worst..........and that was definitely true for me! So, I sobbed myself to sleep Friday night and woke up Saturday with renewed energy and renewed resolve. I really took it easy that day. I stayed in all morning, sipping Protein and napping. By 3:00 pm, I felt good enough to take my son to a birthday party. It was a huge event, and EVERY single person there must have told me to eat......twice! But I politely told them I had eaten before I came and continued to sip on my bottled Water. The party lasted about two hours and I was definitely ready to come home by then. I went to bed about 7:30 pm, slept pretty soundly, and here I am at 5:00 am on Sunday, finally getting on the Internet for the first time since surgery. To sum up, I've really had a fairly easy recovery. Considering the mess my Band had made of my stomach and liver (Dr. Aceves told me it was NOT and easy revision) I've had very little pain except for the incision sights. I've experienced none of the shoulder "gas" pain I had with the Band surgery. I've had no nausea or stomach pain......just a lot of gas and gurgling. No doubt about it, those first four days kicked my butt, however, I think I'm over the "hump" now. I have one more week of recovery before I have to go back to work and I'm sooooo glad I didn't try to rush it and go back any sooner.

Do what is right for you. I just found that half of my co-workers have had some sort of bariatric procedure done. The one closest to me told me that I should go ahead and get a RNY becuase everyone else tried the VSG and Lap-Band and ended up having to get a revision. That is probably why his wife got one right off the bat (although I think she would have done just fine with a VSG because her BMI was a couple of points higher than mine). I just don't want any of the issues that come with RNY such as the very rapid weight loss and nutritional deficiencies. I see VSG as more of a tool and not a cure-all. My main problem is not being satsified when I have a meal; after researching which surgery was right for me, I decided that VSG, as opposed to Lap-Band was the way to go. I'm pretty sure that I could have gotten a Lap-Band, but I don't like having any kind of devices in my body.

If you pick a good shake that's has lots of vitamins and minerals I think it shouldnt be a problem. But again I'm not a Dr. I had to do a two week 4-5 shakes a day plus clear liquids. I started that around 316 and the morning of surgery (12/10) I was 300.1. So almost 16lbs in 14 days. The shakes they put me on were Bariatric advantage and I had to purchase the through my center. They were ok. They got kinda thick upon blending and yiu could doctor them up with fruits and sf syrups. But Dr said it definitely did my liver some good Good luck to you and always check with surgeon first.

As others have discussed, some of the supplements commonly taken by bariatric patients such as Biotin and B12 can cause acne breakouts or exacerbate existing skin problems. I have stayed far away from biotin since it caused a horrific breakout two years ago when I took it to try to speed up hair growth after a hair cut. My dermatologist told me that biotin and excessive B Vitamins can cause acne breakouts in many people. Hormonal fluctuations can also cause breakouts, and losing weight can cause your hormones to fluctuate. For the most part, my acne has gotten better since having surgery, though. I have PCOS and have struggled with acne because of that for a while. I was taking medicine that cleared up my skin, but caused weight gain. I gradually went off that medicine post-surgery, and had some breakouts along the way. Some things that have helped me - - Simplifying my skincare routine. In the past I was using so many different products in a desperate hope for it clearing up my skin that they caused more problems than they resolved. Now I use rose Water on a cotton pad to clean my face in the morning, and only La Roche Posay products. I use their Effaclar face wash at night, and the toner a few times a week. I put a very thin layer of the spot treatment on as needed. Overdoing it with these products can lead to peeling, so I've learned to be careful. I also use a serum and moisturizer by this line. - Being very careful with all vitamins and supplements. I read through the labels and make sure they don't overdo it with B vitamins. The ones I've responded to the best are Garden of Life's Vitamin Code Multivitamin and Flintstones Complete with Iron (one or the other, not both). I take a multivitamin, and Vitamin D, and peppermint oil supplement (for acne and other PCOS issues; you can find it on Amazon inexpensively). About 4 months post op I took a B-12 supplement for a week when I was trying to bounce back from being sick, and it caused a month's worth of acne. I've had very little hair loss. - Not using heavy makeup, creams, or anti-aging products. I'd been using some Lancome anti-aging products that came in a gift with purchase bag, and my dermatologist said it was far too heavy for my skin. He said to use lighter weight products and avoid ones designed to be anti-aging. - Using fragrances sparingly. At the advice of my dermatologist I use fragrance-free laundry detergent and fabric softener because he said they can cause breakouts. I avoid putting things with fragrances on my face. - Changing my pillowcases three times a week. I bought extra sets so I can change them out quickly. - Using SLS free products. SLS in toothpaste and hair products can cause breakouts in some people with more sensitive skin. Loreal has an inexpensive, readily available line, and you can find many other options as well. - Having a facial once a month by a reputable esthetician.