Alexandra39

Well, turns out Medicare has still not made final decision. I have to wait at least a couple of months to have it. All my paperwork is in, I'm ready to go but the wait is killing me!

Thank You.

I'm still eaiting for Medicare to approve & pre-authorize payment for surgery I've been waiting about 7 months now. My Dr. is Ren at NYU. The waiting has got me a bit down, I was hoping to get surgery before Fall, but looks like that will not happen. I was keeping my Diary on Fitness Pal, and I have a fit bit (pedometer) to keep track of my activity. I have slacked off on both watching what I eat and walking. I feel like once I have a surgery date, I'll get back on track. I'm going through some issues with my ex, so that had made me more anxious and hungry. I hope they approve soon.

So my long awaited surgeon's appointment was today. I have the Medicare; so I have all 6 months worth of progress notes completed, met with the nutritionist for the first time today, all documentation is ready to go (except for a letter I still need) I'm almost there and I was excited because I thought I would actually get a surgery day today. I've read the posts here about how Medicare coverage has been approved nationally on a case by case basis. I was told by my doctor's surgical/insurance coordinator that NY is still awaiting a decision. They had submitted paperwork for another patient and that's when they were told this news. So I am waiting another month until I meet with my surgeon again. I have a strong preference for the VSG, however, if it seems like it will be too long of a wait for Medicare to decide...then I'll go ahead and get the lap band. It's so difficult to wait when you're so mentally ready for this though. Let me know how it has gone with Medicare for all people in NYC. I have Medicare as my primary and Medicaid as my secondary. Good Luck everyone!

Hi and Thanks Well, that's good to hear....at least they are not thinking the wait will go beyond 3 months. I hope it goes through, I really do...Although from what I hear the last review here in NY wasn't so promising. I agree, Bummer that we still have to wait

During the past 6 months as I have been meeting with the doctor to fill out progress notes I also have been keeping a food diary which started through FitnessPal.com (a great site) and then Fitbit (a neat little device; pedometer being one of its features,) that I won through Dr. Oz. I have to say I think it was during the 2nd month of this process that I was able to lose 7 pounds in one month by just keeping the food diary with Fitness Pal. It's a great site, I input all my information, height, weight, activity level, water intake, etc, and I opted for a regimen that would allow me to lose a pound per week. For me, that was 1500 calories a day. I followed it pretty well. Rarely did I go past that number of calories and if I did, not by much. My doctor and I were really happy by this progress. When I received my Fitbit in the mail, I began using it and I must say that although I love the pedometer feature, and the fact that Fitness Pal syncs information with it...It is a little confusing sometimes. I think the caloric suggestions for each of these sites (Fitbit has a site too) is not the same. Fitbit is a newer site and the food database is not as extensive. I've had more cravings for sweets lately, especially ice cream or chocolate. I try to get the lowfat but I love, love Carvel ice cream and I've been eating it even to replace a meal sometimes. I know, I have to try to stop. I am just thinking that once I get surgery I will no longer be able to able to have this, so I am enjoying it while I still can. I ended up regaining from 217 to 219 in one month, then to 223 in another month, now I am 222.8. It's a bit discouraging but I am not giving up. This is a process and I am getting used to limting myself. I am not doing what I used to do and trying to change my eating habits drastically because of course that didn't work...it's anxiety provoking....for one. I did cut out soda a whole lot. I barely drink it anymore. I don't like diet so there goes that idea. My daughter told me that Pepsi Next is great tasting so I might try that. I am enjoying water though because since it is summer it is refreshing. Well, let me know if anyone is on Fitness Pal or Fitbit and maybe we can add each other for suppport.

As I approach my 2nd meeting with my surgeon, I am getting more excited but anxious too. I will finally have all the paperwork ready when I meet her on the 27th. She will then submit it to Medicare and hopefully I'll get approved very soon. I really want to get this done already. I am concerned about a few things though. First, sagging skin I worry about it on my chin since I have a double chin now maybe even triple, lol,...I hate it and I hope it disappears with the weight loss. I'm very self conscious about it. Of course, my stomach, arms and thighs are also a concern for the loose skin. Besides walking and exercising how soon until that is resolved. I want to be able to wear a bathing suit without wanting to hide all the time. Anyway, second thing that I've been reading is that some of the people that have had this surgery feel blue/sad/depressed afetrward. Why is that? My concern is because I already have a history of depression so I am on meds and I am afraid of the mood swings or being more depressed because it will not help me when I am trying to help myself in the recovery process. My doctor told me that sometimes Gastrci Bypass patients need less medication after surgery and some even stop needing it. Also, how will I know when I am well enough to be active. I know I must walk even a little bit each day after surgery but when I can walk up a flight of stairs, when can I exercise on a treadmill or bike at the gym, when can I do exercise to strengthen my stomach muscles, light weight lifting, etc. When would I be able to be intimate with my partner again? That is something he really wants to know. He doesn't even agree with the idea of me having this surgery, but I do it for my health mainly. If anyone can tell me their experiences and what they've read from others, please give me some input. I would like to know and I would really really appreciate it. Thanks so much everyone. Hope you're all having a good summer. Mari

Hi, Has anyone heard if Medicare is approving VSG in NY? I heard the final decision would be made today. It didn't look good last time I called from what they said about the previous review. It's so frustrating that they accept it in other states but not here. You'd think NY would be one of the first places to have it approved. I am afraid to call...but I will sum up the courage to do so... I hope it's approved! I'll be done with my 6 month paperwork next month so I'm ready!

I guess I have been on a losing and gaining roller coaster for the past couple of years. I have sagging skin in my lower abdomen already and I haven't even had the VSG yet! I also have the horrible extra skin under my chin, I've had it for years and I'm only 38. I hope that when I lose weight it diminishes or disappears I hate it, I am very self conscious about it, it makes me feel old. Anyway, I know there will be a lot more loose skin in my lower abdomen after surgery, and I know it will be a problem for my back. Even now I have lower back pain when I walk too much...I don't get why insurance (Medicare and Medicaid) doesn't cover this excess skin removal since it basically completes the process of weight loss. Just having the weight loss surgery alone doesn't help if you're going to be left with a huge flap of sagging skin that is not only going to weigh you down, but also cause you pain and extra fatigue making it much more difficult to work out. This skin does not easily go away by working out only either. Not having enough money for skin removal and being stuck with this problem can also lower your morale; it defeats one of the purposes the surgery.

Hi, I live in Jackson Heights, Queens. I think it would be good if we could all meet up one day. Let me know when and where. I have to see my PCP for my last progress report which completes my 6 months and the rest of the paperwork which he will do that day. Then on Friday, the 27th I meet with the surgeon and hand in all the paperwork. I'm not sure what will happen then but I am hoping I get a surgery date or at least pre-testing appointments! I'm nervouse but excited!! Keep cool today!!

I hope I am covered but if not I'm still having the surgery because I agree I really need the weight off.

Oh, same here...when I spoke to the insurance coordinator she told me they still have to figure out how to make claim before surgery because they don't want me to be stuck with a hospital bill. Even though it will be a slower process than I would have liked, (it's gonna be rough getting to and fro the hospital if we have a bad winter) I am still glad that they approved. I meet the criteria so I should be approved (hopefully) Yes, I also thank everyone who has posted all the information. It's comforting to know we're all in this together. I hope you get good new VST Addict

I'm so happy!!

So, after being so optimistic about this entire thing...I call my surgeon today to ask a few questions about paperwork and she tells me that my isurance (Medicare) does not cover sleeve gastrectomy. What?! I have printed material given to me by her office that states that it is. What's the deal? I'm so confused. Not to mention the insurance coordinator wasn't the friendliest person I've met. So I have an appointment on Wednesday to see the nutritionist first (to whom I have to pay a $250 fee non-refundable) followed by an appointment with the surgeon. I think I will ask to see the Doctor first and get things cleared out with her insurance coordinator. All the insurance coordnator told me was that it is not approved and that is it pending approval possibly by the summer. This is frustrating. I called Medicare to ask and they said sleeve gastrectomy was not on their list of approved procedures. I asked if there was any information in their system that states the status of approval or something of the sort and they had nothing. Does anyone know where else I might be able to find out? Does anyone know anything about this? Please let me know if you do. Thanks.

That's great! Congrats! Good Luck. Hope you don't need to wait too long for your answer.

I just called Medicare. So far they do not have anything updated on their system stating that Medicare did approve VSG. There are only still 3 approved surgeries on the list. The Gastric Bypass, The Pancreatic surgery (sorry I forget what it's called) and the Lap Band. I think I am just going to wait until I see the surgeon on the 6th to know for sure. One way or another, I'm getting surgery! I can't take the waiting anymore! I'm so mentally prepared for it and I don't want to lose my determination.

I am going to call. I am almost afraid to. Same feeling with my surgeon's Insurance coordinator. I feel like I am annoying her if I keep calling when she already told me it did not approved. This is really frustrating. Also, the fact that there is a lot of confusion because it is a state by state thing. I did make an appointment with the surgeon anyway for July 6th. So even if they don't know, I figure they'll be sure by then. I hate this waiting.

Just Breathe, pleas try to relax. Focus only on you right now and don't worry about anyone or anything else. Everything is going to be okay, you need to have faith. This surgery is life changing and it's a big deal. Your entire body is adjusting as we speak. I suffer from depression too. I am on three different meds for it. I have taken Wellbutrin before and I am not on that now so it must not have worked for me. I've been on so many (like a guinea pig, lol) that I really don't remember what effect it had on me. Maybe you need a different one now or a lower dose. You should definitely talk to your surgeon and let him/her know what is going on. Let the doctor know that you are talking painkillers much sooner than you should, make sure you tell the doctor all you think is not normal. Also, you may want to talk to the doctor who gave you the Wellbutrin about the way you have been mentally feeling. It's important for all these doctors to be on the same page and collaborate. Remember, this surgery took a part of the stomach which contains hormones that are linked to hunger and cravings. All these hormone level changes have a link to your brain (obviously) so all these changes you are feeling are not totally uncommon. Try to remain calm and seek the support from your doctors. Don't panic. If you need to go back to the hospital to be monitored until you are more stable then so be it. You'd be in good hands. If the doctors don't think it's necessary, then you just do the best you can at home. Try to stay calm though. One day at a time. God Bless.

I called my surgeon's insurance coordinator yesterday at about 3:20 pm or so and she told me that Medicare did not approve I had spoken to my Primary Care Physician (the same doctor to referred me to this surgeon for Lap Ban Surgery) and he and I basically thought that if Medicare denied this time around it would take a while before they reviewed the VSG again. I actually want the Laporoscopic VSG, as a stand along surgery. After the initial talks with my PCP, I did my research and I thought the VSG would be the best option for me. First of all, it is a more aggresive approach I need to lose about 100 pounds. I am 5 foot 1 inch and currently weigh 217. Second, I think it is much more "doable" for me. I tend to get cravings for sweets often and I think the fact that this surgery removes the part of the stomach that produces the hormones linked to hunger and cravings is great! I also am a little hesitant about the idea of having something foreign placed inside me. My doctor whom I trust has reassured me that the Lap Band is safe and the surgeon who he recommended is among the top surgeons in the country. That is the only reason I would consider it. I lost 7 pounds last month but was not able to lose any weight this month. My daughter had some health issues and it just through me off my focus on my eating habits and I had stopped keeping my food diary on Fitness Pal. I actually thought I had gained weight but was pleasantly surprised (more like relieved) that I did not. For the first time, my pressure was normal at this visit. I am taking pressure medication and aspiring though. I also don't drink as much soda as I used; I drink more water so I am sure that helps a lot. Anyway, getting back to the insurance issue...Does anyone from New York know what the deal is? I read the info on the link and it does sound like it is up to the surgeon to make the call. When I first visited the surgeon, I went in to consult what she thought would be the best option for me; Lap Band or VSG. After asking me some questions about my medical history, she suggested I go for the VSG even though she specializes in Lap Band. She believed that the number of medicines I take and the size of some these pills would not be possible for me to take given the fact that with Lap Band you cannot swallow anything larger than the size of a tic tac. I also think she took into account my BMI which is quite high and she thought it VSG would allow me to lose the most weight. I trust her with either surgery but like I mentioned before, I do prefer the VSG because I believe it is the best choice for me. I think I will call Medicare myself today to ask and will also call the surgeon's insurance coordinator depending on what I hear from Medicare. If anyone here in NY has any info about the decision for NY...please let me know. Good Luck to everyone who is waiting...hang in there, I know it's not easy...To those who replied a big thank you and I am aso keeping my finger crossed for you all.

My surgeon's insurance coordinator told me today is the day that NY Medicare makes a final decision on the VSG. I am hoping and praying!! I met with my PCP yesterday and we agreed that if it doesn't approve, then to go ahead and do the Lap Band and he had suggested initially. Dr. Ren is one of the top Lap Band surgeons in the country and he is very confident things would go well with that. I'll just have to wait and see what happens today. I lost 7 pounds last month and keep my weight off this month. Given that it was a rough month and I didn't really try to manage my diet too much, the fact that I didn't gain any weight surprised me. I guess it's a good thing, my metabolism is cooperating. Even just those 7 pounds have made a difference. I can move around a little more easier without getting tired so quickly. Okay, will post later. Have a good day everyone.

It's a week before my time of the month and I have a feeling that is the reason why I have been craving sweets (especially ice cream and choclate) like crazy! It's driving me bute because I don't want to put on the 7 pounds that I lost so far. I know it's still early since it's pre-op and I am not even sure what Medicare will decide as far as approving my sleeve gastrectomy. I have been using my fitness pal to count calories and I believe that's what helped me lose the first 7 lbs. I need to lose at least 8 more pounds because it is recommended to make surgery easier. Any suggestions on what to do to control cravings and hunger? I am drinking Water, eating, fat-free Activia yogurt (70 cal) and eating Jello (10 cal) I hope I make it through the week. It makes me grumpy and anxious having to control myself

Thanks!

It's been a rough week. I think I went over my calories everyday except yesterday. I am not sure how much damage I've done. I hope I didn't regain the 7 pounds I had lost. I REALLY hope I haven't regained anymore than 7. I'll have to really get a grip this week and start drinking more water to fill up. I thank everyone for their advice. With regards to carbs, yes I am a carb addict, and I could try to cut down or quit cold turkey but it will be challenging to say the least. I need to get more protein in. And about walking and more activity, distracting, yes I know that once I get into an exercise routine the hunger will subside a bit more but it's been very difficult to be out and about lately. I've never been so heavy so I am really feeling the effect on my legs, feet and my back. With the heat and humidity it is really bad to get around it feels like I swell up more. especially my ankles and just a short walk wears me out. One day at a time, is all I can think of right now. Thanks and Have a good, safe and healthy Memorial Day

Oh Sugar free Jello Pudding! I forgot about that one. That should do the trick! Thanks.

Thanks everyone. I'm super happy about it. I think that FitBit Prize I won can work with this site too. I can use them together. That would be great. Right now, I use my an app on my daughter's IPOD as a pedometer but now with this I don't need to. I'll have one of my own! Yes, I am determined to lose thse extra 8 pounds. I hope I don't hit a plateau. I remember one of my attempts of losing weight, I lost 10 pounds in a month and then I wasn't losing anymore. I had to stop trying at that point because I needed surgery for something else and the docs told me to avoid strenuous activity until after recovery and I just never went back. It's true once you hit that plateau it does affect motivation a bit.