Northern Virginia

Thank you kbmerritt84! I didn't know that. Did CIGNA also require you to be on a strict diet for 90 days prior? I am scheduled to meet with the dietician at Dr. Fitzer's office next Tuesday. Kind of nervous about that part. Did/do you use any of the pschologists that Dr. Fitzer's office recommends or did you use a list from CIGNA? I appreciate anything you know. This is a huge step for me.

SO Cigna requires that you are on a 90 day supervised diet. It's not a strict diet.  They use that 90 days to talk about what you are eating and what changes you will have to make going forward.  You will be given instructions to start changing your behavior.  For me it was: eat 3 meals a day, DO NOT skip breakfast, etc. As you go, you talk about the kinds of foods you eat, what will and will not be ok after surgery, etc. THe most strict thing is that you absolutely CANNOT gain ANY weight during that 90 days. Your first weigh in and last weigh in must be the same or less. But not so much less that it will put you below 40BMI (or 35+ comorbidities).  That has been the worst for me. Trying to keep my weight around where I was while making changes. You can't gain an ounce. Very frustrating.

I have a psych & therapist that I see regularly so I didn't need to use his list.  They do provide you a list though in case you need it.  

I love his office staff.  They are truly very kind and no-nonsense.  They will joke with you and take care of all your needs, but they're not going to sugar coat anything.

You will be meeting with Either Tej(the interim dietictian) or Jenny next week.   I am not a fan of Tej but she is only there a few more weeks.  Jessica will be returning from Maternity leave soon.  She is the practice's staff dietitian.   I've heard great things about her.  

My last diet visit is on the 25th of June. Then I just wait for approval.  I have a tentative surgery date of July 14th.  I am so excited and ready to take on the new life.

This is a huge decision and the good thing is that you can always change your mind.  Nothing is set in stone.  

I'll be happy to answer any questions or meet with you if you would like :) 

Interesting...My appointment is with Jessica :) So does the 90 days begin when I meet with her? Dr. Fitzer also asked I lose 10 lbs prior to surgery. If it's 90 days from when I meet with Jessica, that will bring me to August 31. I'm looking forward to hearing more about your journey as time gets closer to your surgery date and afterward.

I have to have an EGD (endoscopy of some sort) done too since I'm having issues with digesting meat (all meat) and Dr. Fitzer wants to make sure there's nothing serious.

Thank you for your quick responses. I find it difficult to read through some of the threads here since they're not from NOVA. One of the first questions I asked Dr. Fitzer was about protein shakes that I kept reading about here. I was supposed to have WSL a few years ago but didn't like the surgeon I was referred to at that time. I really like Dr. Fitzer and his staff. They seem so nice and genuine and very friendly bed-side manner, which I think is very important.

Thank you again and please keep me posted!

Yes, your 90 day period starts the day you meet with Jessica (who is wonderful!).   you will need to have 3 diet visits(one per calendar month) with the last one being at least 90 days after your first.  Then they send in your paperwork to insurance for approval.  It can take 2 weeks to get approval. during that time they will set up a surgery time and do the pre-op appt with you that way as soon as you're approved, you can move forward. 

 I am exceedingly lucky in that I am a lightweight (BMI of 42) and have no other health issues so for me it's a matter of maintaining my weight and waiting out the 90 day period.   Certainly get all of your testing done ASAP though.  It can take weeks for reports and letters to be sent from other physicians.   

Well, at least these 90 days will give me time to accrue more personal leave at work. I have -3.6 hours right now since I was sick right after returning from a cruise in March/April. Had the Sleep Study done a week later and getting the machine this week. Heather did mention there were some things not covered by insurance and the dietician visits was one of them.

Do you live close to Fair Oaks hospital? I'm in Centreville. From your reply, it looks like my surgery will be mid-September then if paperwork goes through end of August. My 20th wedding anniversary is 30 September so I'm hoping some of my weight will be lost so I can look special on our special day. We have no idea what we're going to do yet though.

I am in Leesburg so if I take the toll road, not too far.

The diet visits are not covered.  They are a total of $550 for the 3 before and the 6 after. 

If you are having surgery mid-september then you will probably be relaxing at home for your anniversary.   at 2 weeks you MIGHT be on pureed food. 

There is a support group at Reston Hospital on the first Monday of the month that is specific to his practice.  They are really nice.  I will be there on Monday!

I was planning on going on Monday, but my 9th grader has her Band Banquet that same night. Since my husband is working on Monday, I can only be at one place at a time. I do plan on going to it in July though.

I asked Dr. Fitzer about food and he didn't mention anything about puréed food. The dietician will go over all that I am sure. My teenage daughter (the 9th grader) sees a psychologist and psychiatrist regularly. I was going to make an appointment with one of them to get that out of the way.

I used to live in Leesburg in 2007-2008 right behind the Costco off of Battlefield Parkway. Very nice area. We also used to attend Church off of Sycolin road. It's just so hard to get out the door on Sundays with all the things the kids are involved in. My 9th grader volunteers at Lift Me Up in Great Falls now on Sundays but hopefully once school ends, she'll change to a normal schedule.

Nice to meet you all - I lived in Leesburg when I had the surgery.  I moved to San Diego, CA last August. My insurance did cover the dietician visits so it's really about your policy.   Dr. Fitzer and Jenny came into my hospital room to discharge me and said to me..."OK so, you can follow the program just as we provided for you or you can eat a piece of pizza next week and you will be back in here for me to cut your chest open to save your life"

Needless to say I followed his program to the very letter and I've had great success.  Talk to jenny about her opinion about carbs and protein and even coffee - it's very different from what you will hear from the vets on this site.  I've figured out that we are all very different and there is no long term plan that works for everyone.  Come here often, read and ask good questions then figure out what works for you and stay in touch with Jenny at Dr Fitz office.  She will keep it real for you.