What does it cost to eat a primarily animal protein based diet?

Okay, the protein thing. Here's a look into my shopping cart at Costco, Wegmans and the commissary and how it works out for protein intake:

--a pound of beef jerky, around 160 grams of protein total, which I usually eat 20 grams (2 oz.) at a time as a snack-- about $11, or about $1.38 for 20 grams of protein
--a 2-pound package of sliced cheddar cheese, 3 slices for 20 grams of protein, about $8, or $.73 for 20 grams of protein
--a package of salmon burgers, one burger for 20 grams of protein, about $14 for 12 burgers, or $1.17 for 20 grams of protein
--a package of steak for sandwiches, 1 steak for 20+ grams of protein, about $10 for 14 steaks, or $.72 for 20 grams of protein
--a package of tilipia filets, 1 filet for 20 grams of protein, a luxury item at about $15 for a package of 10 or so filets, or $1.50 for 20 grams of protein
--a package of precooked bacon, 7 slices for 20 grams of protein, about $11 for a one pound package containing about 10 servings, so $1.10 for 20 grams of protein
--a package of two beef roasts totaling about 5 pounds for about $15, figured at 4 oz uncooked for 20 grams of protein, about 20 servings, so about $.75 for 20 grams of protein
--ditto for a package of boneless pork loin, so also about $.75 for 20 grams of protein
--a rotisserie chicken for $6 that generally gives me 4-5 4-oz. breast meat servings before I cook the carcass and turn the rest into rice and beans for my husband's lunches. That's 28 grams of protein per serving, but I can't really price it out per serving
--jumbo eggs are about $1.69/dozen at the commissary, lots cheaper than civilian stores. 3 eggs for 20 grams of protein, so $.42 for 20 grams of protein
--a pound of fabulous hard salami is $5 at Wegmans, 3 oz. for 20 grams of protein, so just under a buck per serving
--a package of beef taquitos, 3 make 20 grams of protein, for about $12, 13 servings per package, so just under a buck per serving

Okay. From that list I might eat in the course of a day:

--a snack of jerky, $1.40 = 20 grams protein
--cheddar cheese and salami to equal 20 grams of protein, about $.80
--a steak for sandwich (actually usually fried with peppers and onions and served with some rice),  $.72 for 20 grams
--a tilipa filet, $1.50 for 20 grams
The last 20 grams are usually a combination of things nibbled out of the fridge or gotten from a burger on the road or whatever, so I guess stick another $2 on there for an average.

Total: $6.42

Some days are more expensive, other days are less. That doesn't take into account the other foods that I can eat now that I'm further out and have more room. If I were sticking to pretty much only protein foods, that's what it would look like.

When I have a "small belly day," that last 20 grams has to come from a supplement, costing around $1-$3 depending on which supplement I use.

Last month I received a precious gift: I got to spend almost a full week at the home of Diana Cox and her husband in California, along with several other DS'ers from various parts of the country. Diana was the only one of our bunch I'd met in person. It was pretty darned brave of her to open up her home to a bunch of Internet friends. You never know when some weirdo might be lurking behind a screen name! Oh wait, we all resembled that remark.... ;-)

This was my first trip of any length since several years before my DS. My lousy health had rendered me unable to fly and unable to travel anywhere without arranging for an oxygen supply at my destination. And let's face it, when you can't walk more than a few feet at a time, there's not really much fun to be had in traveling.

The WOW moments were innumerable. From carrying my own suitcase to being able to walk as far as I wanted without pain or fatigue, to the many new sights and experiences....The list could go on for hours. I cried when I found I could sit in the center airplane seat and CROSS MY LEGS! Ah, the things so many people take for granted :-).

I'm working on a photo chronicle of our fun and games here:  http://www.angelfire.com/mt/lovelylovely/renegadesretreat/ (please copy and paste the URL in a new window if the link doesn't work).Comments and captions are still under construction, but the pictures are up for all to enjoy!

Yesterday I decided to make the doctor happy (the endocrinologist, who is fretting that I might get "too low"), so I stopped by the office and hopped on the scales. Then I got back on the scales twice more, certain they were malfunctioning. 

185 pounds?!?!?! *falls over in a faint* 

The last time I weighed 185, I was perhaps 15 or 16, and you would have thought the world was coming to an end the way the people around me fussed about how "huge" I was. Oh, if only we could reach back through time eh? I was perhaps thirty pounds overweight, OH HORRORS. 

This is definitely not what 185 looked like in 1980 :-p. But I'll sure take what I've got now! 

The 18-month labs are in, and things are looking better than they did three months ago. My PTH has dropped quite a lot and my vitamin D is up to the bottom end of normal, so we're headed in the right direction. I'll be staying on the 100,000 IU of dry D daily for the foreseeable future. A is up several points, too, but not enough to reduce the supplement dose. My poor endo doc's head is spinning over this stuff, because according to what he learned, I should be toxic by now. He's a good guy. Now that he's seen firsthand that the "rules" don't apply to us DS'ers, he's no doubt researching like crazy, trying to get his head around the "whys." He doesn't take "just do it like this" as an answer. I like that :-). 

The overall nutritional status is creeping upwards, and it's about time, because I'm running out of room to keep losing, get this, *drum roll* an average of 2.6 pounds per week! It's time for things to start settling in a lot more than they've been till now. 

My new protein goal is 150-180 grams a day, because 120 grams a day just is not enough. I've added a probiotic and a lot of carbs in the past month. We shall see how that fares. If necessary, I'll start adding some digestive enzymes in a couple of months. 

Let's see, other news since I last updated.... The not so great news: My shoulder is in disarray. Probably a torn rotator cuff, with the usual arthritis type garbage. OWIE. I foresee a surgical fix in the future, because the function is declining way too fast. Playing the piano is getting to be a bit miserable, and we can't have that. The doc will tell me about the MRI results and make recommendations when I see him again in a couple of weeks. At least he's a nice fella and easy on the eyes ;-). 

Sheesh, you'd think I was a former athlete or something with all the bits and pieces I have falling apart LOL. 

In much better news: I'm moving forward with plans to go back to school. The goal is a masters-plus in counseling psychology, to become eligible for licensure as a Licensed Professional Counselor (LPC). That's the only therapist-type license that's available to masters level graduates in New Jersey. The state vocational rehabilitation department will hopefully be assisting me toward this goal. 

This Monday I'll be registering at the chosen institute of higher learning. All that will be left to do after that is to beg and plead my alma mater in Germany to FINALLY get a transcript to said instution, so we can figure out how many credits I really have and plan a course of study. (My degree in Germany is not from a school that's accredited by USA standards, much to my frustration, so it's all rather complicated.)  

All of this must then be submitted to the Voc Rehab folks, and then I'll find out if the plan will be approved. Wish me luck :-).

I'm sorry to reiterate this old news, but: TriCare DOES NOT COVER THE DS. 

It has come to my attention that there are surgeons around who sometimes attempt to circumvent an insurance company/policy's non-coverage of the DS by submitting under CPT codes like "general abdominal surgery" or something similar. 

I cannot speak about any insurance carrier other than TriCare, for it's the only one I know well and with which I have (unfortunately) regular contact. When it comes to TriCare and this type of submission, however, it is considered to be an act of fraud. No ifs, ands, or buts. And remember, TriCare is government insurance, aka our tax dollars at work. 

If a surgeon "doctors" his submissions to TriCare in this way, s/he is risking, at the bare minimum, loss of network membership and whatever other sanctions might be applicable. It's a lot more likely that s/he is risking civil and/or criminal prosecution as well. 

You, the TriCare beneficiary, however, can ALSO be held liable for fraudulently submitted claims, even if you didn't file them yourself. At minimum, if you are held liable, you will be required to repay TriCare=the government=the taxpayer every penny for your procedure. And because they are a government agency, they are able to have your assets seized to do this. 

Please, if you are bound and determined to "get one over" on your insurance, think about it very, very carefully. The exlusions SUCK and should IMNSHO be made unlawful yesterday, but as of now, with TriCare at least, it's ironclad. Trying to get around this could be the most expensive mistake you ever make, a hell of a lot more expensive than paying cash for your DS would be.

The GOOD NEWS about TriCare is that your preop testing will be covered if you have even one comorbidity that gives the testing places/doctors a different CPT/diagnosis code to use. Even some "rule out" codes can be used to get these tests covered. 

Also, if you have any complications of any kind, those will be covered. The ONLY things that are not covered by TriCare are those things that fall under the DS surgery code. If you get a wound infection, treatment is covered. Post op pneumonia? Covered. Funky heart rhythm that makes the docs want to keep you in the hospital longer? Covered. 

Even things that the docs expect in advance are generally considered "complications" and are covered. For example, I spent about 36 hours in ICU immediately postop because of my pulmonary hypertension and right heart failure issues. It was "merely" for monitoring with the usual equipment and they knew it would be necessary, but for TriCare it qualified as a "complication" and was submitted under a different code (the pulmonary hypertension code). I also needed the services of a diabetes specialist while inpatient. That was billed as diabetes treatment, not under the DS code, so it was covered.

Your postop care, including lab work and any *prescription* supplements (assuming a diagnosis of a nutrient deficiency), are covered. Those things are not submitted under the DS procedure codes, therefore they are covered. 

The exclusions apply ONLY to those things directly connected to the DS PROCEDURE, like the surgeon fee, anesthesia, hospital costs for your postop stay, etc.

If you go out of country for your DS, NOTHING that happens outside the USA will be covered, UNLESS you are the family member of an active duty person who is assigned to whatever theater you happen to be living in and you see a TriCare approved surgeon. For example, if you're in the European theater, you could see Dr. Weiner in Frankfurt, Germany. The same coverage rules apply. 

But if you live in the USA and you go see Dr. Ungson, for example, nothing that happens in Mexico, including complications, would be covered by TriCare. If you have complications once you're back in the USA, yes, they would be covered. You wouldn't be excluded forever just because you had surgery outside the USA.