I just had my first consultation this last Friday! I was so anxious and excited I could barely sleep the night before but the actual appointment was very basic, not at all what I had worked up in my head . I met with the surgeon’s physician assistant and filled out a lot of paperwork and discussed how the surgery was performed, length of time in the hospital (2 - 3 days), nutrition, she asked me some questions about my obesity history and current health problems, I took a short quiz and she also asked me why I wanted the surgery. After about 20 to 30 minutes she sent me to talk to the girls who deal with insurance and they sat me down and told me the requirements of my insurance. I have California Anthem Blue Cross Medi-Cal so my personal insurance requirements were to get primary doc’s approval, a tsh test, see a nutritionist and a psychiatrist and get them to state I was fit for surgery. Most insurance also want a 6 month doctor supervised diet although that was not the case with mine. As soon as I got out of the appointment to the car, I made my nutritionist and psychiatrist appointment. I just finished them both yesterday and I feel so relieved!!

The meeting with the nutritionist I paid for out of pocket because it takes insurance a while to get around to approving you to go. I met with her Monday and the cost of the appointment was 65.00. My particular registered dietician was very pleasant. When I arrived I had to fill out the diets I been on and what I ate the last 24 hrs. It took a while for me to recall the info. We spoke for an hour and a half. She had lots of children’s play food and empty bottles of protein shakes and vitamins which she used as props as she went over the new way I would be eating. It was very helpful seeing the portion sizes while we talked since I had no idea what small amounts I would be able to consume. She asked me questions about how much I usually eat, the kinds of foods and when. Most of the time was spent with her telling me about the different stages of food intake after surgery and reinforcing over and over chew at least 20 – 30 times, no water with meals or up to an hour after, and the importance of protein and vitamins. At the end of the session she tells you whether or not she will recommend you for the surgery and then has to create a report (can take up to two weeks for her) to send to your surgeon. By the way, she never asked me what surgery I was getting and assumed it was for the gastric bypass. Make sure you tell them on arrival you are getting the sleeve! Our appointment ran over 30 minutes because she had given me bypass info.

I went to see the Psychiatrist yesterday. I also paid out of pocket to get in and be seen sooner. He was the least expensive at 150.00 but some of them went up to 450.00. I spent around 45 minutes there. I will share something with you; I wasn’t at all nervous about seeing him but as soon as he seated me in his office and went to go get paperwork for me to sign, I had an anxiety attack. I wanted to get up and run out of his office for no explainable reason. I knew if I didn’t get his ok for surgery I couldn’t get it so I am not sure if it was self-sabotage or if I just put too much emphasis on the importance of the meeting. Either way, he was gone long enough for me to pull myself together and as soon as he started asking me questions everything went really well! The majority of the appointment was him asking me questions and I realized my answers were too long based on how he kept cutting me off! I’m sure you can tell by this, I am all about the details. Better to keep it short and sweet with the psych since they have so much information to cover. The questions were about where you grew up, family relationships, have you seen a psych before, medications you have been on, any history of trauma, are you an emotional eater, what’s your stress level like, hobbies, do you have a support system, what you expect from the surgery and why do you want the surgery. He then gave me a survey to take home of almost 400 questions which ask about drug/alcohol abuse, violent or suicidal tendencies and self-esteem. (I did the survey in my car outside the office to cut down on mail time to send it back.) At the end of our appointment he told me he would be recommending me for surgery! What a relief

Now I just have to play the waiting game and wait for the registered dietician and the psychiatrist to send their reports to my surgeon and hear if my insurance approved the surgery! If the surgery approval comes through I will take a four hour pre op class and that’s it!!