gabby_abby

Has anyone used St Alexius NewStart and or Dr Follwell?

Hello, I am new here. I have been researching WLS for a couple of years and I am finnally going for it. I have gotten the referal from my doc. I have had the blood tests and appt that are required from my insurance. (chess xrays, ekgs ect.). I have my first appointment with my surgeon on the 13th of July. I am very excited. I would like to lose 150 lbs. Currently 315ish and would like to get down to 165. I am having a hard time getting the PSYCH to sign me off. I had marriage issues in January and she does not believe that enough time has passed for me to go through such a change. The marriage is doing fine and is back on the right track, if not better. I have made another appoinment with another doc. My cousin told me not to tell the truth and just to tell them what they want to hear. I do not want this hanging over me. I feel like I am being punished because I got help when I needed it. (Military spouse, and the miliatry looks down on mental health still)

Has anyone out there used Tricare to pay for VSG?

Nope I am in Illinois. There is no major military hospital here anymore, we get farmed out.

Here is what i found on line. https://www.hnfs.net/content/hnfs/home/tn/common/benefits_a_to_z/gastric_bypass/gastric_bypass.html/pp/content/hnfs/home/tn/bene.html Gastric bypass, gastric stapling, gastroplasty, vertical banded gastroplasty and laparoscopic adjustable gastric banding are covered benefits when the following conditions are met: The patient is 100 pounds over the ideal weight for height and bone structure (per the most current Metropolitan Life Table) and has one of these associated medical conditions: diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome (and other severe respiratory diseases), hypothalamic disorders and severe arthritis of the weight-bearing joints; or The patient is 200 percent or more of the ideal weight for height and bone structure (per the most current Metropolitan Life Table), regardless of associated medical conditions; and InterQual® criteria, which is used during the authorization process, confirms the requested surgery is appropriate and medically necessary. (InterQual® is a widely used product of McKesson Corporation that provides evidence-based clinical decision support for health plans, hospitals, government payers and various other organizations.) A pre-operative psychological evaluation and psychological testing, six hours or less, are covered benefits as part of the initial assessment to determine if the individual meets the requirements for surgery. This psychological evaluation as part of the psychological testing does not count towards the initial eight (8) outpatient behavioral health visits. Cost Information Prior Authorization Requirements TRICARE Prime beneficiaries require prior authorization for all weight loss procedures. For TRICARE Standard beneficiaries, we recommend providers submit a TRICARE Service Request form to determine if TRICARE requirements are met. Services Not Covered Office visits solely for the treatment of obesity Non-surgical procedures for treatment of obesity Biliopancreatic bypass (jejunoileal bypass, Scopinaro procedure) (CPT codes 43645, 43845, 43847 or 43633) Gastric bubble or balloon Sleeve gastrectomy (CPT 43775) Gastric wrapping/open gastric banding (CPT code 43843) Unlisted procedures (CPT codes 43659, 43999 and 49329) (This list is not all inclusive.)

now I can not even get the tricare.mil site to come up so see what they say about it. I will be so disapointed.... Double Grrrrrr

My Surgeons Office is going to submit everything today. So I guess I will find out. If not I guess I will have to figure out a back up surgery as self pay in any country is not an option. RNY seems so dramatic and risky and the lap bad is just well there is something inside of me FOREVER, which may have to be taken out. grrrr...

That is awesome! I am glad it worked out for you!

I have my first meeting with the surgeon on the 13th. I already have insurance approval. I am wondering if it is too early to start weaning myself into a liquid diet. My patient advocate sAid it could be 30-90 days from the time the insurance approved to when the surgery takes place depending how long it takes me to get everything together. I was thinking just breakfast for now and working myself into more as time goes by. What has everyone else done? I am getting super excited!

I love all the positivity on this board. We do not know eachother, have one thing in common, and there is nothing but good ju ju and encouragement going through the threads!!!! YOU GUYS ROCK!

I have read else where that when people go thorough a major stall they go back to basics, the post op diet and even mushy food for a week or two and it jump starts them. Good luck! 82 lbs is AWESOME!

I have read on here that a lot depends on the bougie size your doctor uses. What in the world is a BOUGIE?

Awesome! thanks for the reply

That is awesome! I just got my first appointment with the surgeon and I am super excited, i can only imagine how you feel!!!

I have hair extentions (white girl) and I love them. I have not had the surgery yet. When they glue them into your hair they glue them to like 10 strands of hair. if a couple fall out then the rest still hold on to the extention. I lost a lot of them off the start (total maybe 12). I have had them for 5 months now and they still look great. I went in for a trim, and did not have to have any added. They cost A LOT to get put in, but in my opinion they were worth it. I love mine.