“To eat is a necessity, but to eat intelligently is an art.” ~ La Rochefoucauld

My first meeting with Gretchen, the dietitian, was in August. She challenged me to lose 12 pounds before surgery, 10% of my excess weight. We talked about a balanced plate and that I should strive to eat my protein first, my veggies second, and my carbs last (and only if I’m still hungry). This was important to practice because I have to focus on getting enough protein into my tiny new stomach after surgery. OK – I could do that but then she rocked my world. She asked me to replace my daily breakfast cereal with a protein shake. WHAT?! NO CEREAL?! I have eaten cereal for breakfast every day of my life. Frequently, I eat it for dinner too. Sometimes, I even have it for a snack. According to Gretchen, cereal is worthless to me now because it doesn’t have enough protein. I was so sad. She gave me a list of protein shakes and told me to try some and find three that I liked before I came to see her again. As if that wasn’t enough…she then told me I had to also give up pop. POP. That meant DIET PEPSI. This was almost too much. Apparently, the bubbles from carbonation can cause the tiny stomach to stretch back out after surgery so carbonated beverages are a no-no. Wow. Limited carbs at meals. No cereal for breakfast. No pop. What have I done?

I saw Gretchen again in September. I had lost 4 pounds. I had replaced my cereal with protein shakes. I had given up pop. I was afraid of what she might ask me to do next but this time we just talked about vitamins. She asked me to begin taking a multivitamin each day, along with B12, and calcium citrate with vitamin D. I will continue this regimen after the surgery as well. I have never tolerated adult multivitamins well so she told me to try the adult gummy or chewable versions. Those have been fine and I have adjusted my morning routine to include my supplements. My second meeting with Gretchen coincided with my involvement with the BEST Start group and I found that the information from the group and the nutrition sessions really complimented each other which made following the suggestions very helpful.

My final nutrition appointment was in October. It was my very last appointment before my file could be submitted to the insurance company for review. I had lost 5 more pounds, for a total of 9 pounds in 3 months. I had taken my vitamins as required and maintained all of the other dietary changes made during the previous month. In this last visit, we discussed the diet I would need to follow leading up to the surgery, while I am in the hospital, and then during my recovery at home. I will share this in detail another time. At the end of the session, my file was electronically sent to the nurse to be prepared for the insurance company.

All in all, my favorite part of the approval process with visiting with the dietitian. It was the most educational and Gretchen was just so upbeat and positive and sparkly that I had to love her.

A little about insurance requirements…

My insurance policy requires two years of weight history to demonstrate longevity of obesity. This was easy for me to provide because I am involved in an intense love affair with the Cleveland Clinic and all of my doctors are there. My weight is thoroughly documented in their computer system going back several years.

I had to participate in three months of a supervised weight management program. It wasn’t a diet, per se, but the goal was to lose a little weight and begin to implement some good eating habits. This requirement was why I ended up meeting with Gretchen.

My specific insurance policy requires a body mass index of 35 or higher.

All of the appointments I have described thus far in my blog are supposed to be covered by my medical insurance (according to my specific policy), with the exception of the visits with the dietitian, however, I am still trying to sort out two charges for which I am receiving bills. I have to pay for the three visits to Gretchen, which are roughly $90 each. The costs of surgery and the follow up visits will all be covered, except any follow up visits with the dietitian should I need them.

If you don’t know if your insurance policy covers weight loss surgery, also called bariatric surgery, ASK SOMEONE. Even if your insurance covers the surgery, they may not cover all of the appointments leading up to the surgery or after the surgery. They may have different requirements than my insurance company and policy. Every company and policy is different. I have Medical Mutual but even different policies within Medical Mutual are different. PLEASE, ask someone. It could save your life or greatly improve the quality of your life. Don’t be embarrassed to make the phone call. If I can do it, you can do it too.