sassyfrass23

I am loving all of these responses. My family is very supportive, but it's nice to have a place like this to talk things out. It helps me to feel like I'm not annoying my loved ones when I have questions, thoughts, etc. Since deciding on the bypass, I have learned that I was a bit more nervous about losing part of my stomach than I realized. I now have 100% peace with my WLS decision. Now to only get through the insurance approval process which is my only barrier. I will be completely devastated if denied since I clearly can't afford to pay for this out of pocket. Thoughts and prayers as I am nearing the paperwork submission step would be greatly appreciated As I originally stated- my employer has been 100% supportive. He only wants me to be happy and healthy. Friday he asked me if I had asked my doctor what life would look like in 20 years after the bypass. A valid question in my opinion. But I couldn't help but to respond with "I can only imagine my life looking better in 20 years WITH THE surgery than without." My father had 3 heart attacks..with his last one resulting in 5 bypasses. All of his brothers and sisters (6 total) have had heart attacks. And the same situation on my mom's side with the exception of her, who has not had any heart issues, thank God. My surgeon stated it best- my genetics are against me and have basically set me up for failure. So in all honesty- the odds appear to be more in my favor when I am 47 if I don't go forward with the surgery. As much as I long for children- my desire to live a longer and healthier life is much more at this point. At the rate I am going- I don't forsee myself living past 50. And I'm not ok with that. I gained an all new perspective of age/life when I began working in Healthcare and 50 is FAR from old. This is how I plan to take control of my life, much like everyone else here. And I. Can't. WAIT!

My doctors office doesn't think this is the case for me either. Unfortunately- a good bit of the reps who work for insurance companies don't exactly understand the policies so I have faith that they're misunderstanding my policy as well.

I haven't even met my surgeon and I am already overwhelmed with excitement about my possible "healthy" future. I am totally trying not to get my hopes up since you never know what insurance will do and that will be my largest hurdle. Please tell me I'm not the only one acting like a 12 year old school girl sitting next to her crush!

Thank you bugsy!! When is your surgery? I've read how patients literally walk out of the hospital without having to take some of there meds anymore. If I can get off metformin, I will be one happy lady. No matter how long I take it, my tummy does not do well with it.

Thanks for your response! Honestly- when I compare RNY to the sleeve, there's not a huge difference in severity. If anything- I feel more at ease not having 85% of an organ completely removed from my body. My biggest concern about RNY was pregnancy. I suffer from infertility which is caused by my PCOS- but my surgeon reassured me today that pregnancy is still safe after 18 months and nothing for me to fret over. The rerouting of my intestines is a little nerve wracking as well. He also said the recovery times were the same. How long were you out of work? I was originally anticipating 2 weeks for the sleeve. My employer is a gem and has been incredibly supportive of my journey so far, but I would hate to tell him I need more time off. BUT- I'm 27 years old and I need to get my life together before it's too late. When discussing my family medical history with my surgeon today, he was absolutely flabbergasted at the amount of heart disease. My father alone had 3 heart attacks which required 5 bypasses with his last one. He basically told me that with my genetics, I've been set up for failure. Lol. I laugh- but it's really not funny. It scares the heck out of me..

That's awesome news! Congratulations on your progress thus far. I too believe the surgery will benefit me due to my eating habits and love for sweets as well.

I honestly believe that my biggest set back with this decision is myself. I've never been a risk taker. I've always tried to make calculated decisions. So having surgery 30 minutes down the road with a surgeon and his staff available at all times before and after the procedure is more comforting. However- it may not be in my cards. So I plan to sit down this weekend and really do some research about Tijuana. My family and friend responses when mentioning it were less than ideal. But I believe that stems from their lack of education. Hopefully I can gather enough stats to pull them to my side. I don't need their approval or "blessing" if you will, but having them 100% supportive would most definitely be the ideal scenerio. I appreciate all of your responses. I do find comfort and support from this site. To be surrounded by newbies to veterans...it's comforting. I'm learning things about this entire process, from start to finish and it's refreshing.

So- I'm just about fed up with insurance and all of their semantics. They make this entirely too difficult. Therefore, I'm strongly considering Mexico. Especially since I would still come out $6k cheaper even if my insurance does decide to cover their 80% here in the US. I'm looking for experiences. Good or bad. And processes. Do you have to travel to Mexico prior to surgery to be evaluated? Or is everything done online/over the phone and they complete any tests, etc when you actually arrive for the surgery? I'm not a risk taker. Surgery alone is causing some nerves to rattle. And the thought of traveling out the states for a surgery is really causing some anxiety. But- I want to be happy and comfortable for once in my life. I'm hoping you can share your experience and put my mind at ease, should I choose to go this route. Thanks!!

Thank you for your response. It's been nice reading everyone else's positive experiences, but the fact that there are still people who have unfortunate events occur during or right after surgery makes me uneasy. Like you said- if there are complications, it would be nice to have insurance assist with those costs. As long as it's available, I believe I'm going to fight to get it until I receive an official "no." And if I am denied- I'll look at options within the states myself. Being gone for that many days with a 7 hour flight plus 2 hour drive home from the airport doesn't sit well with me. And I know many doctors are hesitant or are completely reluctant to touching patients who have had surgery outside of the US. I commend all the folks who have gone this route though. But my anxiety just will not allow me to make this decision with all of the uncertainty. I wish I would. The price tag is so so so much better.

Looking for testimonials from the ladies who have been sleeved and had PCOS? Anxious to see how the surgery affected your PCOS symptoms!

Looking for anyone with UHC that has already been approved or are currently working towards approval from UHC? I'd like to pick your brain!

42 lbs is fantastic! Many kudos to you!! Yeah- I'm already worried about the Fluid intake. Lol. I'll do what I have to and can follow directions...but I haven't always been the biggest "drinker." I typically only drink at meals. So, this will be a huge adjustment for me.

Oh, wow! Thanks for all of your information!! These responses have put me at ease already. How long ago did you contact them and inquire about the surgery? I guess I'm asking to see how long it actually took you from start to finish (being surgery date). And did you choose the date in december or was that first available? Do you know what they send you home with as far as medications? Pain meds or antibiotics? I believe I saw the post with all of those pictures right before I created this. The hospital did look a little dated, but my biggest concern is cleanliness and infection rates. And 3 surgeries a day is great. I don't want one who spits them out every few minutes and operates long days. One big concern is the 7 hour flight home. I don't know if I'm more concerned about how well I'll do being confined to a small place for such a long period or how I'll feel for 7 hours straight with all the gas pains I've been reading about and the importance of getting up and walking often. Also- my husband just started a new job and I can't ask him to take off so soon, so my mom will probably be accompanying me. She has a bad back, so I'm a little concerned about her sleeping on a cot. Maybe you could get a picture of that? Lol. I would LOVE for you to stay in touch and keep me posted on your surgery and recovery. How much time are you taking off from work for recovery? I'm wishing you the best as you approach this new journey!!!!!

Hi! I'm new here and hoping someone can give me peace of mind. I am almost finished with my 6 months of supervised diet and exercise. My last weigh in is actually in November. I meet the 40 BMI criteria with a 41 and have one co-morbidity although not required unless I am below 40. However, I have spoken to UHC 4 times in the past week and am so confused about when I can actually have surgery. After I receive authorization, which will hopefully be in December, I was told by one rep that I have to wait 6 months from approval date to have surgery. When I called back, the next rep said she'd check with the clinical reps, which she did, and they told her they didn't have any stipulations on their side that required an additional 6 month waiting period. It's not even for dieting/exercise purposes. Just simply waiting. And then tonight- another rep said I do have to wait, per a different clinical rep he spoke with. Has anyone experienced or even heard of this waiting period? I would think all tests/evaluations/data would be out dated after 6 months.

Thanks for the information!! How has your recovery been? And how has your progress been so far? I'm happy to hear that the surgery and traveling went well for you!!!

@@shellyd88 I'm glad I have pestered the heck out of my insurance company. I spoke with the insurance coordinator for the surgeon's office last week and discussed my concern. She had called the day before to verify my benefits and was completely unaware of the additional 6 month waiting period when I mentioned it to her. Stated that she was not aware of nor did she believe that was the case. When I called and spoke with the care coordinator team from UHC today, they stated that I MUST schedule surgery 6 months out from my precert and if I were to have surgery before that 6 month period, there's a huge chance that the claim would be denied and I'd either be stuck footing a $50k+ bill or the office would have to write my claim off. I plan to call the office tomorrow to run this back by them and make sure they note it everywhere in my chart so that it cannot be missed, no matter who I work with when scheduling is done. I would rather wait 6 more months than be in debt up to my eye balls from medical bills. If that were the case, I'd just assume go have the surgery and not even worry about jumping through the insurance hoops.

How far are along in the process? I wonder if the BMI during the 6 month supervision is based on your policy? I called and spoke with the insurance company today and asked the rep if I dropped, and only for a month, would I be denied? I also asked if an appetite suppressor would weigh on their decision to deny or accept? She very strongly said no and that both are indicators of my attempt to lose weight on my own, but prove that I obviously cannot maintain the weight loss. I've seen it go both ways...for multiple insurance companies. Everything is so convoluted. I understand it being a ton of money up front, but the cost they save in the end after surgery and the positive effects it has on your body/medical situation, you'd think they'd make the process a little easier. Either way- I'll just have to wait and see how it all works out. I wish you the best of luck in your process and hope it goes by as quickly and easily as possible!

That's exciting news. I'm happy to hear that all has worked out for you!! And good luck with your procedure I found out today that my policy states that after authorization is submitted, I have to schedule surgery 6 months FROM that date. I don't understand the additional 6 month wait. It's a bit discouraging. So much can change in a 6 month time frame, so it doesn't make much sense as to why they would require an additional waiting period once you've been cleared for surgery. Argh! I'm grateful to have it, but some times insurance drives me crazy!!!!!

Ok! 1- How easy are they to work with? Are they super picky when it comes to approving bariatric surgery? 2- In my 6 month supervised diet/excercise, I have fluctuated in weight. One month I was put on adipex (appetite suppresor) and dropped 14 lbs in a months time. This put me below the BMI of 40 with no comorbidities. But the next month's weigh in, I was back up a few pounds which put me back at 40 BMI and taken off the med as it no longer worked on me. Will my BMI drop for that one month be an issue? 3- I've done monthly check/weigh ins with my PCP, and they've documented my weight each time, but idk what else if much more info has been documented about my efforts to lose. Does UHC look for detailed descriptions about my attempts? 4- will the fluctuating weight be an issue? I've managed to stay 5ish lbs below my original weight, but I can't seem to drop anymore and actually keep it off.

Totally agree And also laughed at Mama Bear comment Haha! She looks so stinkin cute and innocent, but if you mess with her babies, there will be hell to pay. Making comments like that when someone is going IN to surgery and just coming out are so inappropriate. Emotions are all over the place and the last thing you need is your caretakers making you feel uncomfortable or causing you to doubt your decision.

I keep telling myself, positive thoughts = positive results. I really only see my insurance being a barrier since you never know what they're going to do. But I've met all requirements so I'm confident that they'll approve me. Just ready to get further in the process. My surgeon was going to be out of the office, which is why I had to schedule 3 weeks out. I imagine that once I get in there, things will quickly take off. Eeek!

I'm flabbergasted at this treatment! I would be tempted to file a former complaint with the hospital regarding all comments made. Thanks to technology, it wouldn't be difficult to find the names of those involved in your care as long as the facility used an EMR. Luckily, the surgeon I am using and the hospital he performs all procedures at have a bariatric floor. He's personally trained ALL staff on how to take care of patients like us. I certainly hope I don't receive any comments such as these. My mom will be with me as my husband just began a new job and I don't want him to ask off. So if they cross the line, Mama Bear will be quick to my rescue and they will certainly see her wrath.

I meet my surgeon exactly 3 weeks from today. I also meet the nutritionist while there. November is also my last month of the supervised weight loss program. So all I foresee myself needing to complete is the EGD, upper abdomen ultrasound and psych eval. I'm ready to get my papers submitted already!! Let us know what they say about yours! When did they submit your information? And what insurance do you have, @"Lexigurl82" ?

Your last sentence made me giggle ????

Well that gives me hope. I am hoping for so many improvements regarding PCOS after this surgery is done. What you described above is what I am hoping to resolve...and then some. All I can remember is when I was smaller, my PCOS symptoms were nowhere NEAR this severe. I honestly had no idea I had it until I started putting on weight randomly which I could not remove, and of course my inability to conceive after getting married. Fingers crossed for all these cysters!