LissaLou

fs_newme : We seem to have a lot in common, our weights/heights are almost identical and our surgery dates are only one day apart! (My surgery is November 5.)

I know that the Last Supper idea is very tempting, but my bariatric nurse told me not to do that because it makes it so much harder to handle the liquid diet. Therefore, I'm trying to cut down on food portions and have even begun to have a protein shake instead of breakfast. I plan to transition to protein shakes for breakfast and lunch before I go on full liquid. I sure hope that plan will ease the shock of liquids only.

My surgery is November 5. I'm looking forward to sharing this journey with all of you!

My bariatric team has someone who is always on call. I'd call the office number and see if you can talk with someone. They can tell you what you should watch for and whether you need immediate care. Let us know!

So sorry! If you don't mind me asking, for what reason were you declined?

Did you get an answer?

I'm not sure if you are under doctor's orders to follow the diet you described or whether you are just trying to do it before you officially have to, but...I saw my bariatric team today and was advised to taper the diet before my mandatory 10 days of liquid only. For example: I should begin to replace one meal a day with a Protein shake. As soon as I get an approval from my insurance company/surgery date I should replace two meals a day with a Protein Shake. Then, when I have to start the full liquid diet at 10 days pre-op, it won't be a shock to my system. If you are all ready in the mandatory phase, I guess what I said won't be of much help to you, but it might help others.

My insurance requires me to fail a 6 month medically supervised diet and my surgeon's office told me to see my primary care provider once per month and document those visits for 6 months. However, I'm getting conflicting answers from employees at the surgeons office whether I'd have to go 6 times or 7 times to complete the 6 months. I'd like to hear from those who have all ready completed this requirement...how many visits did you have?

Posting an update - I called the surgeon's office today and it was confirmed that I only need 6 visits with my primary care provider. I went to my 6th visit today! So, I've apparently met all the requirements and am just waiting for them to call me to schedule my pre-authorization visit with the surgeon.

Just wondering if anyone has been successful getting PCIP to approve the surgery...please share your experience. Thanks!

Thanks for the replies. The surgeon's secretary told me 7 visits, but recently the surgeon's nurse told me 6 visits. And, to top that off, the person over bariatric surgeries with my insurance company told me 6 visits. Talk about confusing! I'll be making my 6th visit this week and would really like to be done with this long process, however, I want to meet the requirements before seeking approval.

Congrats on reaching some practical, yet exciting, milestones! Keep up the great work!

I understand your frustration. I've had complications getting all the requirements met, too. I did not have to pay to have my medical records sent to the surgeon, but I did have to pay $20 for a referral letter. I just paid the fee and considered it a means to an end...meeting my surgeons requirements and ultimately getting the WLS. Maybe someone from your surgeon's office would be willing to place a call to your primary doctor's office and help you get the records you need. Hang in there!

It feels good to be making progress on this journey, doesn't it? Don't stress the psych evaluation. Mine was very simple. I filled out a short questionnaire and then talked to the doctor for about 20 minutes about my health history (physical and mental). It really isn't as scary as it sounds! Just try to enjoy the conversation and the focus on your path to WLS and ultimately, a healthier body.

I'm scared of hair loss, too. My hair is fine and limp. I need each strand that I have on the top/front! My first pregnancy (20 years ago) was a boy and the dermatologist told me that I had male pattern baldness due to the male hormones. It never did fill back in. Sounds like I need to check into biotin before surgery!

Your surgeon/bariatric team should be able to give you a list of their requirements. PCIP can email you what they require - ask for the bariatric surgery criteria. Be sure you get the requirements from both parties (your surgeon and your insurance company).

My psych evaluation was so easy! I was nervous, too, but it was really nothing but a short questionnaire and then a chat with a man for 20 minutes about my medical history (surgeries, whether I've ever had depression or eating disorders), my family (if I had a support system), what diets I've tried and my understanding of the surgery risks. I expected him to really probe into my personal emotional/mental side, but he didn't. Relax and try to "enjoy" the conversation. Just realized that you posted this yesterday about today. Well, how did it go?

I'm not looking forward to the required pre-op complete physical. And, I've not been to a gynecologist in a LONG time due to lack of insurance and embarrassment over my weight. Anyway, exactly how do you prep your lady parts (beyond soap/water) for the exam?

My psych consult was with an independent doc, but I was given a list of docs to pick from. Yes, I am concerned about insurance after December 31. I'm just hoping that the PCIP program will morph into something similar and we will be offered that coverage. If that does happen, I'm wondering how much it will cost. When the program went from state-managed to federally-managed on July 1, my monthly premium DOUBLED! Have you been approved by PCIP for surgery yet, Monola?

What state are you in, Monola? I'm in NC. I have to do a 6 month medically supervised diet and exercise program. I am not required by PCIP to see a nutritionist or have a psych eval to get approval for coverage. However, my surgeon does requires those things. I guess I thought that PCIP was federally managed and that all states would have the same requirements.

I totally agree! I feel like this 6 month medically supervised diet and all the other hoops required of me are monopolizing my life! I've spent many hours on the phone over two weeks trying to find someone to do my pysch eval due to my rare insurance. I can't imagine having to do all this while working a full time job - right now getting WLS is my job! I lie awake at night trying to determine whether I have all my "ducks in a row" and whether or not I'm doing everything required of me to be approved. To add to the stress, my insurance will end on December 31 and I have no idea what, if any, coverage I will have then. So, WLS must happen before then! My bariatric team isn't the most helpful bunch. I always feel like they don't have time to talk to me. (I would use a different hospital, but my insurance won't cover it. The docs are the same at both hospitals, but the bariatric team is so much better where I can't go. Bummer!)

Yes, I'm referring to the Pre-existing Condition Insurance Plan (PCIP) that is federally managed. No one seems to have any idea about it including most medical offices. Sigh...

My insurance (PCIP) requires me to document my exercise during the 6 month medically supervised diet. I'm not sure exactly what they expect of me and am afraid of denial based on not doing enough, but at this weight...what do they expect? Has anyone else had to do this? If so, please give me some advice. BTW, this documentation is to be done by me, not my medical care provider - which sounds strange to me. Thanks!

That is a good thought, but I don't belong to a gym. I was told to document it however I want...daily, weekly, monthly. I'm just leery of not doing enough to satisfy them. Maybe they are just looking for a commitment like the 6 month medically supervised weightloss requirement (which they want me to fail so that I can be approved). Funny thing is...the exercise documentation necessity is not mentioned in my policy - only in the insurance company's criteria for approval (which they emailed to me at my request). Sounds like a loophole they are hoping I won't discover!