Ready4change

I was one of those that viewed it but didn't respond--mostly because I am brand new to the boards and didn't know what to say. So I'm glad you wrote in your subject line that you were disappointed in the site because I realized that even though I'm brand new, other members still want/need to hear from me. First, I am so glad that you are okay and hope that the nightmares go away soon. And second, I want to thank you for posting in detail what happened. I am in the process of considering weight loss surgery and it's so important to hear the entire spectrum of experiences. Your experience sounded horrific. Thank God your mom was there and that they took immediate steps to bring you back. Please keep posting on your process and again, I am so very glad you made it back to tell your story.

Thanks everyone, for the information and the possibility that I can appeal and perhaps win. I am excited and anxious to meet with the surgeon in a couple of days to find out if he will support the decision to request a VSG in his letter to BCBS. I do remember him saying at the informational meeting that he believed in the future, the VSG would become the gold standard of bariatric surgery. I am a pre-anticipator (just made that up!) and am already mentally skipping ahead to either a "no" or a long battle with no assured outcome regarding insurance coverage; meanwhile, I feel strongly that I want to proceed with the surgery sooner rather than later. My weight continues to creep skyward (42.2 BMI) and I feel strongly that by next year I will have developed Type II Diabetes (I'm two points shy of it according to March blood work). When I think about traveling to Mexico to have the surgery, I don't worry about the surgery or going out of plan but about follow-up care afterwards and the possible attitude of my PCP (who does not know I am pursuing surgery--it's not required that I meet with her to get approval so I went straight to the bariatric center). I don't know what type of follow up is involved after the surgery. Do stitches need to be removed? I guess I'm afraid of being judged by my PCP. And at this point I'm making it all up in my head. LOL. For those of you who have had the surgery done outside of the USA, what has been your experience with your local PCP? Thanks!

Hi Jeani, Wow, I just read your appeal letter. Nice! I'm glad you won it and have your sleeve. I will bring up appealing to the surgeon when I meet with him on Wednesday. Our health issues are similar, although I don't have arthritis. I do have a chronic back problem and have no relief from any other OTC pain medication except ibuprofen. I can't imagine not being able to take ibuprofen--I've tried Tylenol, etc. and I might as well be eating candy. I'm curious if my BCBS plan will even consider an appeal, though. I just assumed if they don't pay for VGS, they won't consider it, period. It gives me hope, as it would be so much easier to have the surgery done in my own backyard and have all the follow-up care available and covered.

Thanks for the feedback! My insurance will not cover VSG's for any patient, even one with a 50+ BMI, as the VSG is considered "experimental." It may be that they will in the future, as it seems to be a trend that insurance companies are seeing the VSG as a great tool for WL. I'm not sure when that might happen, though.

Hi Everyone! I just discovered this site a few days ago and have been reading like crazy. Lots of great information. I have begun the process of getting approved for surgery in my hometown where there is a Bariatric Center of Excellence with excellent surgeons. My insurance will cover gastric bypass but will not cover VSG. I actually didn't even know about VSG until I started reading about it on another site last week. VSG feels like the perfect fit and addresses my most pressing concerns about having bypass surgery: what seems like mutilation of the natural process of digesting and absorbing with the bypass, Vitamin deficiencies, not being able to take NSAID's, dumping and vomiting (I've only vomited 10 or so times in my life and HATE it). I want the VSG. I have an appointment with my surgeon in a couple of days and feel sure he is going to push for the bypass. While they do VSG's, they require a BMI of 50 or greater. Mine is 42. So, I am almost positive they won't do a VSG on me. I have been researching VSG surgery in Mexico and feel very drawn to Dr. Aceves in Mexicali, Mexico (interestingly, about three years ago I was doing a web search on lapbanding and came across his site and really liked what I read). I have the ability to self-pay and am considering scheduling the surgery with him. Here is my dilemma: do I tell my current bariatric surgeon of these plans? I'd like his support but I feel like he will try to talk me out of it. Thanks for letting me process! Lisa