Luigi5144

I had my consult with the bariatric surgeon on June 30th. He recommends the sleeve and I agree. My insurance requires 90 days of medically supervised weight management by either a physician or a reg dietitian. I'm using a dietitian. I had my first appointment ONLINE with her on July 15th. My next one is scheduled for Aug 18th. I'll have another Mid-September and likewise in Mid-October. My insurance requires recommendation from my pcp as well as a pysch eval and clearance from a psychiatrist. I had the psychiatry appt this morning (7/24/14) and spoke with my pcp about it in another appt this afternoon. Psych has to score my tests and will let me know. PCP thinks its a great idea. That'll take care of my insurance criteria. However, I have active auto immune disorders right now. I need them to be under control before surgery. I saw my rheumatologist a week ago (7/17) and she said that she doesn't think the surgery is a good idea right now. Right now priority should be getting my lupus under control. I agree. I've been taking my meds as directed right from the get go (saw her for first time 5/20). I told her that due to the insurance criteria, surgery wouldn't even be possible until the end of the year. I see her again in 2 months and she said we'd discuss it again, then. Meanwhile, I'm on daily steroids, immuno-suppressant, and blood thinner. I really hope these meds do the trick and put me back into remission. fingers crossed. But, I'm using the time now to really work on me.

@@MS_Science_Sleever I'm glad to have someone to virtually walk through this journey with. I have cigna insurance? Do you have the same?

@@Jersrose43 You mentioned that you work at cigna. I'm wondering what the difference would be that the decision would need a medical director review? TIA

@@#9grammy same here. Should be right around 10/15 for my last registered dietitian appt. I'm really hoping for a November surgery, as well.

I've started the hoop jumping, as well. Had my WLS consult 6/30/14. First dietician appt online 7/15/14. I have my psych eval tomorrow morning (7/24/14) and pcp visit tomorrow afternoon (7/24/14). I also have the 90 days of medically supervised weight management as an insurance requirement. My next reg. dietician appt is Aug 18. I had an appt with my rheumatologist last week. My surgeon told me that he wants clearance from her as well. She said that she doesn't think it's a good idea right now, until my lupus is under control. I am religiously taking all of my meds, because no one wants to feel better more than me. I explained that I have the 3 months of weight management anyway, therefore the surgery wouldn't be until the end of the year. I go back in 2 months to see her and she said we'd talk about it again, then. My deductible and annual oop has been met for the year, so ideally I'd like to have my surgery in November. fingers crossed

Woohoo! Congrats on your date!

@@penman53 What an incredible year for you! You look wonderful. Congratulations on your new lease on life!

I am still pre op. too. in fact, I start my 3 month medical weight management on Tues. I began on my own though this past week. I am currently taking daily steroids for autoimmune disease and I am starving from sun up to sun down. Here's my thoughts on my last big grocery shopping last week. When shopping healthy, you pay more for convenience. Meaning the less you have to do when you get the food home to consume it. I still had to get the little things for my Autistic texture sensitive 9 yr old that I don't eat or drink. But, I bought the bulk boneless skinless fresh chicken breast package ( i get 8 big chicken breasts in it) and a ton of veggies and some fruits. When I got it home, I put each chicken breast into a freezer bag and put them into the freezer. Now, We generally eat more than a chicken breast between the three of us, but I've found that by freezing them individually, they thaw quicker. Which in my house can be interpretted as one less excuse to just get fast food. They are thawed in time to make for dinner. The veggies and fruits, I immediatly started washing, chopping (or tearing for the greens) and putting in variety of sized baggies, For example, a head of lettuce cost me under $1. By washing and tearing it up myself, I had a very stuffed gallon sized baggie full of lettuce ready to go. I tuck a paper towel in with it to keep it fresh longer. But, Our fave bagged salad is $3.88 per bag and you get half the amt. I got a bunch of celery. I washed it, and tore off all of the leaves and put them in a baggie in the fridge. The stalks, I made nice thin match sticks out of. Those I put into snack sized baggies. I probably made 12-16 snack size baggies of celery sticks. Same with the seedless grapes. I washed, plucked and scooped half cup size portions into snack baggies. I washed and chopped up two heads of cauliflower. I LOVE roasted cauliflower. I just toss a bunch of popcorn sized florets onto a cookie sheet. spray them lightly with some cooking spray and sprinkle them with dried italian seasoning. I bake until they brown just a bit. Anyways, same with the cucumbers, berries, zucchini, broccoli, and squash, etc. I spent less and did more prep at home, but as my Granny often says " I've got more time than money". LOL. It stretched my same grocery bill with same spending into what is now grab and go healthy food. We typically eat fast food or the likes of fast food 3x per week. Between my health issues and my special needs child's issues and therapy schedules, it's just become a way of life. We haven't eaten out since last Sunday. And we haven't gone without either. You'll have to factor in Protein shakes for your future. My husband is a work out nut. Seriously goes to the gym 7 days a week, plus runs. He goes thru a lot of Protein Shakes. But, I'd guess he spends about $40-$50 a month on the big things of Protein powder. I plan on saving that money for myself every week just by skipping the fast foods and the cokes or dr peppers here and there. I hope this helps a little.

I think the anxiety is healthy to an extent. to me, it means you are taking this surgery and the new lifestyle changes that come with it very seriously. You're looking reality square in the eyes. But, as you already know from being a Mama, life is unpredictable. You can't worry about things that you have no control over. You look at the risks, the probabilities and plan around those. Talk to the dr about flying home alone. I was told by my dr to have some back up for parenting for the first few days home. And, if the anxiety is getting so bad that it's impairing your daily life, maybe ask for something to take.

I've had several abdominal surgeries due to endometriosis. And honestly, the thing that I found helped the most was a folded up sheet stuck in a pillow case. The weight of it was perfect and was obviously easy to clean. A nurse showed me this post op many years ago.

For those of you with Cigna, I'm wondering how you did the 90 day medically supervised weight management.

My initial consult date is scheduled for 6/30. And while I know that my surgery is not going to be until fall, I have my mind set firmly, now. I was browsing the Tj Maxx tonight. Not looking for anything. Typically, I love just running through the women's plus racks. I flipped through them and didn't see anything I liked well enough to buy to wear until fall. Next I went over to the PJs section. I didn't see anything in plus sizes. Only XL and smaller. And, you know what. I didn't feel bad. I found myself thinking, " if they are still here this fall/winter, they'll be cheaper when they fit". lol I know it's the littlest things. I've also found myself not talking to anyone about it anymore. Well, except for one friend who is having the sleeve done in July. Clearly, there are no judgements or anything from her. When I told a couple of friends that I was considering looking into the surgery to see if my insurance covers it etc, I got warnings from my one plus sized friend and then shock from my size 10 friend. I havent spoken to them about it since. Now, I'm just on an inspired high. I can't wait to get through the initial consult and start my 3 month weight management program.

I haven't been sleeved, yet. I am just beginning my journey. I have my surgeon consult on 6/30 and I will start my 3 month weight management the same day. I just have to weigh my exact weight on the day on consult to qualify as 40+ bmi, so that my insurance will cover the surgery. Anyway, I also have RA, Lupus, Sjorens, and antiphospholipid antibody syndrome. Right now, I'm just on Imuran for the lupus/RA/Sjogrens and I'm on eliquis for the ASP. all autoimmune. The lupus/ RA have played a major part in my not-so-active lifestyle. I am a special needs Mama, and honestly, after I've taken care of him, I'm just give out. I know that lupus/ra etc, won't be cured by the weight loss from surgery. I just hope that by losing the weight, I've done everything I can do to not add to the risks I face from these diseases. My special needs son is going to need his Mama for many many more years. My mother passed away the day after her 48th birthday. I was 24. I don't want the same story ending.

I finally have my initial consult appointment. It will be June 30th. The weight management insurance requirement is all online, they said. Even the registered dietitian. I have no idea how that works... But, I can start that the same day. And that's for 3 months. I'll schedule my psych eval for after that appt. I'm excited

I think the dietician's diet for the insurance requirements is the optifast program. Does anyone have any experience with optifast that could shed some light on it?

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf here is the link to the current Cigna Bariatric Surgery Coverage Policy

@@Luvin_Life125 my hopefully future surgeon's insurance girl told me that cigna requires previous 2 years worth of medical records to prove bmi was steadily 35-40, I thought that was strange. I called cigna and asked specifically. They told me that that wasn't the case. That what the coverage policy states are their only criteria and the only records they request. And, he told me that it was updated in May, so it's current

@@Luvin_Life125 Did you have to submit last two years worth of medical records to cigna?

@@Jersrose43 Thank you for the tip. The bigger hospital in town is a Cigna Center of Excellence.

@@Luvin_Life125 That was So detailed and helpful. Thank you. I have one more question for you. Is cigna one that they just consider your starting weight at the initial appt? Or do they base it on your bmi at the end of the 90 days?

Hey Yall. I'm new to getting this ball rolling as well. I called the surgeon's office last Monday (5/26). I wanted to ask if they are more of a center Like where they have the dietitian, psychologist, etc all in house. Or if he refers out to anyone or someone specific. I also asked for an initial consult appt. They called back next day and collected all of my info and answered some questions. Said they'd call my insurance etc. The dietitian I think they said is in house and then the medically supervised weight loss thing is online. (which I don't know how comfortable I am with that, but I'll wait to decide until after I hear all of the details). The psych is dr so and so and told me which office they are in. I'd already called my insurance, found out my policy covered WLS and what their criteria is. I still haven't heard back from them. I'll call again tomorrow afternoon. I've had some other health stuff going on with new meds causing terrible nausea and managed to lose 4lbs over last week. Which normally, I'd be elated for but I was at 223lbs which is just 3lbs shy of a bmi of 40. Meaning, I wouldn't have to prove other comorbidities. And at 223, the three extra pounds at the initial consult appt would be worth that.

@@rensterness Can I ask if your antiphospholipid syndrome effected the surgery process? pre-op, during and post-op?

Hey Yall. Has anyone had or is going to have weight loss surgery in the Wichita Falls, TX area?