NorCalGuy

Already handled my psych eval, have my second appointment with the nutritionist next week, then go handle my labs, but otherwise I'm almost ready. Have a followup in mid-December with the surgeon, but he said January looks like it would be surgery time, since thats what works best with my schedule. Pretty exciting! I am a little concerned, though, that some of the info he gave me says only 60% of the stomach is removed; I thought it was closer to 80%? Just want to make sure its a sufficient amount to curtail my ability to consume, as I've got around 200 pounds to lose. He did say he had another patient around my age/ weight who had made it down to 190 in about a year, so that was encouraging.

After much consideration and research, I've decided to have a VSG. It seems like the best bet for me, after battling my weight for years. I'm 26, 6'2", and 370. Nobody else in my family is overweight, and I'm easily the fattest of all my friends. After I quit drinking a few years ago, I really began putting on weight (probably just switched one addiction for another) but even before that, I was heavy. It just wasn't until the last couple years that I really lost control with it. I have what amounts to a lifetime gym membership, and it feels like I'm dying after a couple minutes of cardio. Also, I have high blood pressure, but luckily no diabetes or elevated cholesterol (yet..). One new thing thats been scaring me is these weird, transient pains in my feet and legs; perhaps its just the hypochondriac part of me, but I keep getting the thought of blood clots and embolisms... I need to do something about this now. Another impetus for getting this surgery is the fact that next month I start at a nearby university, which provides medical insurance. It'll be the first time in about 8 years that I've had it, so i figure I may as well take advantage of it while I'm there. Its some form of Anthem, though not sure if its different being through the school, I see that there is bariatric surgery coverage, and understand that Anthem now covers VSG. But I'm curious... can a regular doctor (GP, or whoever I first see at the university health center) refuse to refer me to a surgeon? What I mean is, even though I more than meet the criteria for surgery, can a doctor, by way of their own beliefs against these types of procedures (or that I need to keep trying the same stuff I have been in terms of dieting), deny my request for referral? Also, anyone have good suggestions for surgeons in the bay area? I'm not sure which hospitals are "in network" for Anthem, until I actually get the insurance next month, but I think Alta Bates and UCSF are, and perhaps the California Pacific Hospital are.

Thanks guys. I'm fairly confident that whoever the doctor is, they'll do the referral, but I was concerned about that being a potential hold-up. Reading the insurance handbook, it does stipulate that weight loss surgery isn't covered unless its for morbid obesity, and since I meet that criteria, I should be alright. Also, if they refuse me, and try to say it isn't necessary, there is some CA state health board I can petition which will overrule the ins. company based on medical necessity. What does it mean when they say they want documented weight loss attempts? This seems to be pretty common across the board, for both insurance and the surgeon. Does my stack of diet books, my gym membership, taking OTC things like Alli and Adipex from Mexico, and doctor's orders from a year ago (from this free clinic I was going to at the time) count?