gabrielle2014

Thanks Jen - When I called the doctor's office to make an appointment she said that I know if I 'qualify' that first appointment and then got through the process and then need approval from the insurance company and then clearance from the medical tests. But I'm happy to know they will be able to help me through it and that everyone that has been there seems to really love them.

I'm in the same boat for my appt on 9/17. I've been eating a ton of salty fatty foods and for the first time in my life I'm not gaining. Today I started drinking Ensure - ugh. I have met a few people who literally wore ankle weights. That seems so hard core. Also another woman said she held her purse while they weighed her and bent her knees a tad to get her height down. It all feels so wrong but I figure I will easily end up gaining 10 pounds the way I'm going even when I try to eat well. Just a matter of time.

Jen - So you go through the program, if you qualify, and then you go for insurance approval? Did they give you an idea as to whether you would be approved by your insurance? I think you said they didn't?

I'm starting to worry and worry about this and thought I'd ask the question here for those that have gone through it. How tough was approval from your insurance company? I know all are different but I'm just curious in general how tough it was. BCBSRI requires a 40 BMI or 35 with one of the comorbidities. I'm very close to 40 BMI and actually trying to gain a few pounds to put me over it a bit but I'm unsure whether my Atrial Fibrilation would be seen as 'hypertension.' BCBSRI also said that they want to see that I've been morbidly obese for more than 2 years - which I haven't. Though I've suffered from Afib for at least 5. I do have severe arthritis in my ankle and am on beta blockers, etc. for my afib.They want to see my weight loss failures - so I have my dates from Jenny Craig and WW and from seeing a nutritionist but not anything like Medifast or Optifast. I'm just worrying out loud - and looking for any info folks have to share. Thanks.

I do have a really bad ankle that is filled with arthritis and has me with a handicap placard. My orthopedic surgeon wants to fuse it but I really don't want to because it is such a complicated and difficult surgery. I also suffer from Atrial Fibrillation and am on a ton of meds for it so they may consider that an issue. I see my cardiologist and my ortho guy the same time and I'm hoping to get them to at least write a recommendation - though they have both told me it is not directly related to my weight.

Yes it says documentation but someonen else that I met that had it out of Wareham and has BCBSRI said she just gave the doctor's office a list of her WW and other attempts and that seemed to be enough. She said Dr. Kruger's office handled everything for her. And she actually gained a bit, wore ankle weights, and the nurse even let her hunch down a bit. LOL! I'm thinking my afib and arthritis have to contribute to the overall case if I'm at or really close to 40 BMI.

Oh no LoriDee - that is tough. I'm so sorry.

I know this has been covered so I apologize if I should be searching for it more thoroughly. But I am getting closer to deciding to have WLS – I’ve done so much research and watched endless YouTube videos from folks who have been successful and those who have had complications. Two things worry me the most about having the surgery: First, I was feeling a bit worried about the depression after surgery. After so many years dealing with my emotions through food I think it will be a tough change for me and I will need to learn better coping skills. I’ve talked about this a lot with my therapist and she agrees and is excited for me to do something that will finally help me to cope in a different way. She says that she feels that I actually handle change well and that she and I can work through this obstacle. Second, and maybe even more worrisome is the sagging skin issue. I weight 231 and I’m 5’4”. I’m 44 years old. Up until 2012 I weighed 190 -200 pounds. But I know that if I lose 80 or 100 pounds sagging skin will be a real concern for me. I’m wondering if everyone has suffered with it and how big of an issue it is for you? The reasons I want to do this are really NOT vain – well maybe a little vain – but for the most part I have arthritis in my left ankle that literally brings me non-stop pain and I can’t walk well at all. I suffer from Atrial Fibrillation which I think is caused by my higher weight. I hate how I feel. And I do hate how I look. I know my problems won’t go away with WLS, but I think I’ll be on the road to a healthier lifestyle. Am I being so totally shallow by feeling discouraged by the sagging skin issue? How have others dealt with it? Is it really that bad?

Terry - Just curious if you had to provide records of your weigh ins for years prior?

Hey thanks Terry. I just called BCBS RI and they spelled out in a bit more detail what was required. I'm quite worried about approval. But it helps to know going into it what I'm looking at.

Hey Terry - I also have BCBS RI - I've read all the requirements - and I'm trying to gain 5 pounds or so to be sure I qualify. Did you have to go for alot of tests before hand for insurance approval? I suppose it all depends on your personal health situation. I'm just new to BCBS RI - not familiar with getting this kind of thing through. I'm 5 or 6 pounds awawy from a 40 BMI - but I do suffer from Afib (heart condition) though I'm not sure about hypertension.

Thanks everyone - that is DEF what I need to hear to stop being so ridiculous! LOL! THANK YOU!

ps. sorry to hyjack your thread since I haven't been approved.

I’m 5’4.5” and around 231 at the moment. I’m trying to gain a bit of weight so I can be sure I qualify at my first appt. on 9/17. I have horrible arthritis in my left ankle and suffer from Afib but don’t necessarily have high blood pressure (though I’m on a beta blocker for my afib). My understanding is that if you aren’t 40 bmi you have to have one of the three comorbidities – but its good (not in the sense that I’m happy to see that others have suffered) to see that others were maybe approved without having those qualifications.

I live in Falmouth on the Cape. I've heard from a few people that have gone to him that they totally know how to help you get approval from insurance. I was told that if you have a certain BMI - over 40 - Or you're over 35 BMI with the comorbidities that they feel they can get approval from insurance. When do you have to do the classes? You already had your first appt with him?

I'm worried about losing my boobs after surgery - I've heard it can be pretty depressing for someone that is used to larger breasts and also I'm over 40 - those things look scary already.

Hi everyone! I just joined yesterday. I have my first appointment with my surgeon in September. I've been seriously thinking about WLS for the last 10 months or so. At first I thought about the Band and then did enough research to determine it was no the right fit for me. Now I'm thinking about Bypass vs. the Sleeve. One thing I see different accounts about is what you can eat after surgery. And I'm curious what can you guys eat? It seems you can eat anything you want just in smaller portions? For those that struggled alot with a carb/sugar addiction before surgery has it been a struggle for you now as well because you know you can have it? My food addiction is pretty severe - and I struggle with quantity and types of food. I'm also one to like and sometimes seek out that feeling of being so full you feel sick. SO I feel worried that maybe the Sleeve isn't the right choice. I do have a great therapist and she and I are working on these things. Just looking for feedback from anyone that was like that before surgery and how you're coping now with the Sleeve? Thanks!

Hey Jenn - I'm going in on Sept 17th to meet with Dr. Kruger in Wareham. I've gone to the free workshop. His appt secretary told me yesterday that the weight they take at your first appt. is the weight they need to seek qualification. I've met a few people who have had surgery with Dr. Kruger at Tobey and they said that the office really helps you deal with the insurance process. Can you speak to them in the office about insurance and getting it covered before you have to sign up and pay the fee? Helpful to know that that is coming for me when I see him on the 17th. I’m in the process of trying to gain some weight to qualify. Ugh! Neat to ‘meet’ someone else that will be going through Tobey. Maybe we’ll meet at one of the classes. BTW the people I met that had hiim (3 so far) say he's great and the office and hospital is really good.

I'm dealing with this now. I went to my workshop last December but I was 25 pounds away from qualifying and no comorbidities. After a bad breakup and losing my job I gained 10 pounds and so now I'm around 15 pounds away from my 40 BMI with my first appt with the surgeon on Sept 17th. The appt sec at his office confirmed that this is the appointment that would determine if I qualify or not. So i'm now trying to gain weight. I feel so disgusting and I haven't gotten on the scale yet but I assume I can get up there. I have also heard of wearing an ankle weight to boost it up a bit and heavy shoes. it feels so wrong to me but I know that in the long run this will be what is best for me. I'm very nervous about the insurance process but I hear that BCBS of MA and RI are pretty good. I have RI now. So fingers crossed. I've spoken with a few people who have had WLS and two of them said they had to gain a bit of weight and one wore ankle weights just to be sure. My therapist agrees with me - if I don't have the surgery I will far surpass the qualifying weight within the next few years. So I have to keep my eyes on that and not on how wrong it feels to gain to lose.

Thanks Miss Mac ... I think that is what I'm most interested in. How has the Sleeve changed the way you eat and is it enough on its own physically to be that 'tool' everyone mentions and HELP motivate you more than you were before surgery??? It seems for you it has which is great and helpful. Thanks.

Thanks Yasman! I appreciate your thoughtful answer. I hope no one misunderstood the title of the thread or my sentiment that I 'want' to eat until I get that bursting/sick feeling from being full. Or I should say, that is what I am working on in therapy. I know that distracting myself with that feeling is what has made me close to 240 pounds and I know it is what keeps my addiction alive. Its destructive and I hate it. In reality I don't do that often but I know that at times when something becomes too intense I'll seek food and that feeling to take my mind off the uncomfortable emotion. I KNOW - I truly do know - that the only way either sugery will work is if I work on my deep rooted emotional eating issues. But I also know, and my therapist agrees, that I need some help with this. And I do believe that WLS is what will help me reset and stay on track. So I hope no one thought that I was saying 'gee I want this surgery so I can eat whatever I want afterwards' - I'm actually feeling like maybe Bypass would be better so I have a stronger reason, aside from getting heathly, not to eat the wrong foods. I've spoken with 4 or 5 - I think 5 - people who have all had the Bypass and they say it is very hard but very worth it. That is the best thing they have ever done. anyway - thanks so much for your thoughtful and honest responses. I really appreciate it.

This is really interesting and scary to me at the same time. I don't want the surgery to be another failure for me. I know that its only a tool and motivation and not the be-all to cure my issues with food (thank god for my therapist) - but I'm nervous, knowing my attitude about food, etc., that I will fall into the same old habits of being able to eat the same foods. Alot of soul searching to do - hopefully my doctor will be able to guide me with this decision too. So many people have been so successful with the Sleeve and I assume there are many like me that have struggled with losing weight and eating unhealthy foods. So there must be a big motivation in doing this surgery and being able to deter you from returning to unhealthy patterns. I'm assuming - yes??

Jaime - that is a really good point. It is something that has bothered me as well - the idea of never having a slice of pizza again. So thanks - its really something for me to consider. Thanks Jane - I think that if I could just get ahead of my weight for a bit that feeling so much better would motivate me to maintain a bit more. I've just read some scary stories about people that don't have too much restriction with the sleeve. But honestly if I was going to do this - I would see my therapist throughout. She specializes in WLS so I think she and I would continue to work on my eating issues and that would help me as well. I'm really leaning more towards the Sleeve. Jane - you've had amazing results - Congrats!

Thanks Jane - that is my main worry as well. Where it seems with Bypass I will have more 'incentive' to not have that feeling bc the types of food I would eat would make me so ill. If i understand correctly, most that have the Sleeve can eat whatever they want?