A bit down... (Cross posted to Oregon Forum)

I haven't really introduced myself but I have responded to things. I am 5'5, 34 years old and started my journey at 309 lbs. I am an apple with diabetes, mild sleep apnea and was well on my way to heart disease My "Real Age" (see realage.com) was 63 when I took the test last year. I have a wonderful hubby and 2 dogs that are more like children than pets. I live in Vancouver WA and working in Portland OR. I have been on the HMR (hmrprogram.com) Shake diet for 6 months now. I have lost 61 lbs and weigh what I did when I was a senior in high school. I have met all prequalifications for my insurance and my surgeon sent in all the paperwork to insurance 16 days ago (12 business days) ago. I was initially told tha*****pically took 2 - 3 weeks to make the determination for approval via Aetna. Today I was told basically not to expect an answer for at least 30 business days. Anticipation is killing me... plus I was hoping it would work out well with my work schedule that my absence would not be too big of a problem. February was about the only month that would be possible. An acquaintance asked me today why would I risk my life with an elective surgery when I am doing so good on my current diet and with behavior modification. I had no real answer to that except there is no way I can stay on a liquid diet for the rest of my life just to loose and keep off weight. It is bugging me though. Not that he asked and that he has an opinion but that I couldn't give a good answer. Any insight?

Hi! I also live in Vancouver and work in Portland, and have Aetna insurance. I am 5'4", 47, and started at 271 lbs my first visit to my surgeon. First of all, congratulations on your weight loss so far, that is terrific! My surgeon says that any weight you can lose before surgery is a bonus, because whether you lose a little or a lot before surgery, most people still lose about 100 pounds in the first year after surgery. I had Dr. Paul Dally do my surgery - who is your doctor? Try not to get discouraged with the insurance isue. I was also told that it would take about 30 business days for an answer. The first time, they turned me down, because they did not think I had met the qualification of a 6 month doctor supervised diet and exercise program. So I worked with my surgeon and we did the 3 month multi-disciplinary pre-op program, and resubmitted. The 30 days were almost up when we contacted the insurance company, and were told that they only had one submission from months before, which had been denied. They had lost my file (or at least claimed they did - I have my doubts since a number of other people have told me that their insurance companies also "lost" their files and they had to resubmit). My doctor's office resubmitted again, and it was only a couple of weeks before I had my approval. So hang in there, it will come. As far as your friend's question - You are right, your weight loss on a liquid diet cannot be sustained, and you can not continue on it forever. Statistics show that anyone who is 100 lbs or more overweight has an extremely small chance of losing the weight AND KEEPING IT OFF with diet and exercise. Losing the weight is not that difficult, keeping it off is the problem. And as we all know, when we gain it back it is almost always plus some. YoYo dieting is even more dangerous to our health than being obese in the first place. But with the surgery, we have a very good chance of losing the weight and keeping it off, as long as we don't sabotage ourselves (which we can do if we try hard enough). I don't remember the exact statistics, but it was something like 5% or less that are successful through diet and exercise programs alone, and 80-85% that are successful with the surgery. And why would you not do something that can improve your life and your health, rather than risking your life staying morbidly obese? The surgery itself is much safer than it was even 10 years ago. The most important piece of that is to choose a surgeon that is experienced in the operation - the recommendation I have heard is someone who has done at least 100 of the surgeries that you are going to have. From what you have said above, it sounds to me like you have a very good chance of getting through the surgery with little if any complications. You are young, and you don't have serious heart disease yet. Just listen to what your doctor tells you to do, take the conservative approach when it comes to food after the surgery, and you should do just fine. My surgery was 11/17, and I have not really had any complications yet. My surgery ended up being 3 for the price of 1, as my surgeon discovered a hiatic hernia when he got in there, which he repaired, and some lesions on my liver, which he biopsied (benign). That made it a little more uncomfortable in my recovery - I didn't manage to get up to wal****il midnight the day of my surgery, normally they would have had me up by around dinnertime, I think. I stayed home two weeks from work, and was a little tired when I went back for the first few days, but not too bad. I am feeling much better already. During my pre-op insurance approval process, I went down to 240 lbs, and then I had a 1 month pre-op diet where I got down to 221 the day of surgery. I am just over 2 months post-op, and this morning I weighed in at 190 lbs, and am wearing my mother's size 14 jeans now. I am very pleased with my progress, and how I am feeling, and very happy I made this choice. Yes, eating right now is a challenge at times, finding the right things I can eat, and remembering to eat mindfully - not mindlessly like I have in the past. But I am getting better with it every day, and able to eat a larger variety of foods all the time. Best of luck to you on your insurance approval process, and with your surgery! (sorry, didn't mean to write a book!! ) Lori

Thank you very much! I have also chosen Dr. Dally. He seems to be a very nice man. I at least know they haven't lost anything! I am afraid if I call again they might though! Congratz on your loss! That is almost wierd to say. When I see the scale hit under 200 I will freak!

I think that Dr. Dally and his staff, especially Ann, are absolutely terrific, and I would recommend him to anyone (I already have!). From what I have seen on these boards, he takes a pretty conservative approach in terms of pre-op and post-op diet, but I think that is a very good thing in this case - the pre-op diet helps to shrink your fatty liver, making the surgery easier and therefore less chance of complications. And the post op diet gives your new stomach time to heal. Have you attended any of the Pre-OP support groups? If not, I would highly recommend it. They usually have at least Jackie, her husband Michael, and Steve there, all of which have had the surgery at least a year ago. They will answer any questions you have based on their experience. It is also amazing to see Steve's befoe pictures - it is hard to believe it is the same person!! You can also check out the post-op group, even though you are pre-op. But it will be more of a place for the post-op folks to ask their questions. I know it is hard to wait for the insurance, but hang in there. If you run into any snags (like they lost it) Ann can help you get it resubmitted with all the proper information they are asking for. I also may have some clothes you can use as you continue to lose - you are about where I was a month before surgery. I have a bunch of clothes I am getting ready to get rid of. Hang in there, keep the faith, God takes care of us all! The approval will come at the right time. Feel free to contact me with any questions you may have, and let me know when you get your insurance approval and your surgery date! Lori

Actually, in December I attended the seminar, the pre-op group and the post-op party. I found Steve's story to be amazing! I am wearing baggy clothes now and bought some 2x's and a few XL sweatshirts that I wear. Clothes would be great! Luckily when he felt my liver he said it was small enough he would allow me to stay on the shake diet. I know I need to lose more weight though. I am also working on behavior modification.

Hi! I'm another Lori in Vancouver! As far as the precertification for surgery, I think a lot of insurance companies are being bombarded with a variety of requests. It is, after all, the first of the year and some people are just getting insurance for the first time. It is your first real test of patience. Get used to that, lol! Look at it this way, you're half way in to the 30 days +/-. And for the acquaintance. You didn't say friend. Its none of his business. And you're right. There is no way you'd be able to stay on a liquid diet and remain compliant for the rest of your life. He doesn't know your struggles and effort that you've gone through as well as you do. I think he's trying to express his concern and I commend him for that but it isn't his life. To his credit, you should really research the surgery options available to you. (I've met Dr. Dally years ago when he filled in for one of his collegues who did a different surgery on my husband. Nice guy.) You could also let him know of all of the research you have done. The risk of dieing is always there for any surgery. But it is also there for a heart attack or many of the other complications from obesity. You just need to reassure your friend that you have taken all of the information into consideration. This is a big step. You should be honored that he cares. Lori

I actually am honored that he cares as much as he does. I pretty much figured it out today that the reason it bothered me so much is I respect him and I don't want to disappointment him. I also know I need to please myself and I am still working on that one.

Brandy, I hope you don't have too much of a struggle getting approved. The wait is tough, hang in there. When I was stocking up on Isopure at GNC before my surgery I got into a conversation with the counter guy and he began trying to talk me out of surgery. You just can't make someone who is fit and probably has never had a weight problem understand why surgery is necessary for some of us. Any of us can go on a diet and be successful for a time...but those of us with these built-in tools have more of a fighting chance. Like Lori said, you can sabotage yourself but it is hard and takes determination. It is much easier to pick yourself up, dust off, and get back on track with WLS if you have had a bad eating day. I love not having to worry about losing that fervent diet zeal that keeps one going when you start a new diet. It doesn't last forever, but this tool does! I figure that right now, at 7 weeks post-op, I am in cruising mode. Can lose weight without really trying too hard and don't have to do anything more than just follow instructions. The REALLY hard work is going to begin prob. at about 6 months post-op and get harder when I can eat more and more and have to be really good about exercising and measuring my portions. That is when this built-in tool is going to be so critical. (that and my local support group!!!!) Good luck to you! Molly

I think if he could have tried to talk me out if it he would have. It's just so happens he is my boss and that would be pushing it. I told him I understood we were just chatting on a friends level and I understand where he is coming from. I definately need to do it for myself! Since I have absolutely no clue what protein I should get I am thinking of ordering a sampler case. Glad your first 7 weeks have gone so smooth