LisaDM

What did you have to do, just keep appealing the denial? If you don't mind me asking, what are your stats? Are you over 40 BMI or over 35 with comorbidities?

Ok, so not quite a million appts, but it feels like it right now. I had my first consult with my surgeon last Friday and it went very well. I am now trying to schedule all the pre-op appts and tests needed. I I am worried that I won't keep everything straight and will forget a step. On top of the stress of all these appts (making and going to them) I am supposed to try to lose 5-10 lbs. So far I haven't really started anything new. I luckily already have my 6 months at Weight Watchers, but I did not do very well as a whole with that, so I need to show my insurance company that I am dedicated and lose some before I go back to see the surgeon. I also have to talk to my director at work about everything. I have decided to be honest at least with my department and tell them what surgery I am having. They all know about my struggles with weight loss and I am hoping they will be supportive. The problem is my surgeon requires 8 weeks with a no more than 5 lb lifting restriction. With my job I can not work with a restriction like that. Gotta love working in health care! So I will have to take short term disability and take that whole time off. I was hoping for only 4 weeks, but my surgeon is strict about it, which is good I guess. I don't want to go through the surgery and then screw it up by lifting something or someone heavy. Well I have already made my group nutritionist appt (I need one group and one individual) as well as an appt with my gastroenterologist cuz of course they want an office visit before scheduling the endoscopy. I also have paperwork to get blood work and an appt to see my PCP about the blood work and get my letter of medical necessity. I also have a sleep study marked off, but need to clarify that because I don't snore or have sleep apnea. Did anyone have to do a sleep study without already having sleep issues? I really am hoping to avoid that one. Oh and of course I need to schedule my psych eval as well. Hoping to get that the same day as the NUT since they are close to each other but far from me. My surgeon also requires I attend two bariatirc surgery support groups which of course are only available at really awkward times as far as getting off from work to get there. Anyone else out there feeling a bit overwhelmed by all that requirements from the surgeon as well as insurance? I just want to get through it all smoothly. I just really hope after all this work that my insurance approves me. Otherwise it will be a huge waste of time and money. I am going to stay positive for now. I meet all the requirements, so it shouldn't be an issue. But you know insurance companies will find any loop hole they can to save money!

Thanks for the encouragement. I am stayin pretty organized and I already have a few things scheduled. I am strewing because I would hate to have my insurance deny my claim because I missed something or did something wrong. I am sure my surgeons coordinator will mke sure everything is good to go before submitting though. I am just trying to get things done quickly so we can figure out a surgery date. I need to give my work plenty of notice since I will have to take an extended time off. I can't work with a lifting restriction and my surgeon does 8 weeks no lifting over 5lbs. >_<

OMG, you poor thing! I would have curled up at died right there on the side of the road! So sorry that happened, but I appreciate you sharing your story so that others can learn. I have issues with creamy soups and dips sometimes now, and I haven't even had surgery. I can't eat at those japanese steakhouses anymore cuz I can't stay away from the seafood sauce (yum-yum sauce) but the last time I was there I didn't even leave the restaurant before I had to run to the bathroom. So I will need to be extra careful after surgery. Test new foods at home only! haha

I had my first visit with the surgeon, Dr. Steele yesterday. Went well and they seem positive at this point. I just hope EHP does too! Still many more appts to go through and tests to take. Good luck!

I have the same problem. The surgeons office said my insurance wants to see loss during the 6 month period of weight management but if I lose more than about 8 lbs I will go under the required bmi. Also if I had no problem losing, I wouldn't be doing this surgery. <sigh> Silly insurance rules.

I have my consult on June 14th. No insurance approval yet, but a list of other appts to start making. My worry is if I make all these appts and then get denied its a lot of time and money wasted. Of course I would appeal, but still. I also need a letter of medical necessity, but haven't even spoken to my primary care doc about it. My insurance doesn't require referrals for any specialists so I didn't even think about it. Good luck with your appt, I hope everything goes smoothly!

I am still at the very beginning of this process, and just got the appt for my consultation with the surgeon. I spoke the assistant on the phone about everything I can begin working while I wait for my appt in June. The problem is my insurance is apparently a "nightmare" according to her to get approval. I am currently 5'10 and about 250 lbs which puts my BMI at 35.87, but also have high blood pressure, GERD, and back problems. So I meet the requirements. I have been doin weight watchers since January and have actually managed to gain 5 lbs. >_< I lost weight with a clinic using phentermine last year, went from 270 to 237 then after I stopped the meds (cuz of my blood pressure) went back up to 245 before beginning weight watchers (again). My concern is she said my insurance wants to see loss for approval. If I didn't have trouble losing weight I woildnt be considering surgery. Also if I lose more than 6 lbs my BMI will be just under 35, which no longer qualifies for VSG. Maybe it seems silly to be worried that I won't weigh enough and should just be thankful, but the last ten years I have spent my life gaining and losing weight. Basically, I am asking advice from those who have gone through the approval process. I would hate to go through all this stress and spend so much money on various doc appts and such just to say, good job but now you can't do it anyway. Was anyone else in my boat? Lower BMI, but terrible weight history? Any advice would be appreciated.

Just tried that! Without shoes if I stand normal I just measured at 5'9". Do the surgeons generally go by your word or do they do their own measurements? Cuz my paperwork I already sent says 5'10".

A friend of mine said kinda the aame thing, but my weight is in record with weight watchers and the insurance requires those records. It's not like I haven't been trying with weight watchers I just haven't been able to stop my terrible snacking habits. I don't really know how the whole process works. Maybe I can just go from my weight at the appt and lose some before surgery.

Oh geez! 250 lbs! What a typo. Never been 150 in my adult life. I fixed the error, thanks

My name is Lisa, I am 29 and from Maryland. I have battled my weight my whole life, but especially struggled in the last 12 years. My highest weight ever was 270 lbs, but I am currently 250 lbs at 5'10". In muy early 20's I was able to get down to 180lbs, but in a very unhealthy manner, using diet pills and horrible eating habits. In the past 8 years I have yo-yo'd my way to my highest weight last year, then went to a physician assisted weight loss with phentermine last year and got down to 235. That only worked for a few months, though I took it for a full year. I have since developed high blood pressure and my doc advised me to stop taking the phentermine if I stopped losing weight. I have a friend who got the sleeve last year, it was the first I had heard of it. I had heard of gastric bypass and the lap band and knew people who had had those procedures. Neither seem appealing to me. The bypass seems way to invasive and the lap band I know someone who had repeated complications and dumping syndrome. I have though about it somewhat secretly for a year, and have recently started really discussing it with my husband and doing heavy research with my insurance and with my work. One big concern is the lifting restrictions I work in health care and there really is no form of "light duty" in my line of work, but luckily I have short term disability. I also keep having second thoughts about not being to eat what I want for the rest of my life, but then I think that just shows my addiction that I am scared to not be able to eat crappy food. My husband has said he will support my decision, but I also don't know what I want to tell others. I almost feel embarrassed to tell friends and coworkers, like I failed all other weight loss pathways. I have never felt that way myself toward others who have there surgery, because it really is a big commitment to weight loss and healthy eating. But there is still a part of me that wishes I could handle it without surgery, but my history shows that I can't. So I guess my main questions to those who have had VSG are: 1- Have you had and major complications from the surgery? 2- How long were you on restrictions from lifting? 3- How long were you in the hospital after surgery? 4- What did you tell friends and coworkers? 5- Do you have any regrets about having the surgery? Thanks for any support you can lend to me! :-)

At this point I have only told my friend who had the sleeve, my husband and my sister that I am considering VSG. For me, it would be hard not to tel my coworkers, at least the ones in my dept. We are a somewhat tight knit group and with being out of work for a few weeks, they will be very curious. They are all aware of my weight loss struggles though, so I my just let the ones in my dept know what is going on. I talked to my manager and she is talking to HR about light duty. I am a physical therapist assistant at a nursing facility so I spend much of my day lifting people. Even if they give me the high level patients, there is always the risk that I will need to lift or assist a patient if they being to fall. I don't want to put my patients at risk and I am sure my work won't want to be liable. But I will see what comes of that and be thankful I signed up for short disability last year. And hey there, fellow marylander! I have done an online seminar and quiz, but have not set up a consult yet since I was making sure my insurance and work wouldn't be an issue. I will most likely have to wait until the fall due to finances, so I am not sure if I should go ahead for the consult now or wait a bit. I hate waiting for anything once I make a decision to go for it. haha Good luck with your journey!

Thank you for your answers! That all seems very promising. The only concern is no lifting for 6 weeks for me means no working for 6 weeks. Which with short term disability is ok, I just hope my employer is ok with it. But you are so right about yo-yoing for more years. I know it is hard on my body and just leaves me feeling miserable. Then second I get a step ahead I take 2, sometimes 3 steps back. I am just so tired of it and ready to be healthy and stay healthy. I know that I will probably need the counseling more than just prior to surgery, but to help get me through at least the first few months. I know it won't be easy, I am not expecting a simple solution. Just a tool to help me control myself. One other question for ya. I have read and watched blog about hair loss, and that worries me. I have heard taking Biotin and niacin helps to lessen the hair loss. Have you had any issues with that at this point? Again, thanks for your help.