SummerShadow

Mine is scheduled for November 9, 2017.

I'm estranged from most of my family, all but for my kids and grandkids. My kids know, but I don't talk about it. My husband knows of course, but that's no help, sadly. I don't have a support network other than him, but I'm not telling anyone else I know. It just feels private, you know? Especially to tell people I don't know very well. My life has been nuts till now, kind of still is, so I don't have any real friends. Moved too much, was isolated for many years (long story). And i don't want a ton of negativity coming my way.

Wow, Mellymel... :/ I'm sorry you have to go through that. My surgery is on the 9th and my husband is NO help. That's another talk show that I'll leave for another day. He's my only support network as my kids just look confused (they're grown with kids of their own) when i talk about it. I officially start my liquid diet tomorrow (Nov 2), but I tested the waters a bit today to see how tomorrow would go.. and failed terribly. It's so confusing to me, keeping up with all this stuff, to be honest. SO confusing. :/ Hang in there! I'm sure you'll do just fine! And you already get full from the shakes.. which I found I don't. I'm hungry hungry and can't seem to nip that in the bud. ***hugs***

My surgery date is the day after yours, November 09, 2017. My surgeon only has us on a one week liquid diet, which I start tomorrow. I'm incredibly, INCREDIBLY confused about the diet. Overwhelmed, to be honest. Hope you're handling it better than I am.

Hi everyone. I've posted in the gastric sleeve section and have that listed as my surgery in my profile. How do I change that? The reason I ask is that I just found out that the sleeve isn't going to be an option for me due to my having mild reflux. Looks like bypass will be my only option that won't make that worse. Bypass, from what I've read, actually helps in most reflux cases. So my question is two part: 1) How do I change my surgery in my profile to bypass, and 2) Have any of you been approved for bypass with reflux or GERD? Oh, and I looked everywhere to see where I change my surgery in my profile and cannot at all seem to find out how I change that. Thanks so much in advance for your help.

I'm at step one of this process & have my appt with the surgeon next month.... so I'm brimming with questions, concerns, etc... with regards to what insurance requires and what may or may not count. I have BCBS AL..... My question about the diet thing is this: My Endocrinologist (not my PCP) told me to lose weight (because I'm pre-diabetic) and to follow the plan on a paper she gave me. I went back later, and it wasn't every month because she didn't ask me to do that, and I'd gone from 328 to 280 (was a very restricted diet), and it was literally over 6 mos time from when she told me to follow the plan and when I saw her last (about a month ago) and I'd lost that weight. I know my weight goes up and down because it's unbelievably difficult to stick with such a strict diet when you've not had surgery (for many of us it's difficult anyway). I wonder if that would count as 6 mos of doctor supervised diet since it was a plan she gave me and I followed? The only thing that didn't happen was monthly weigh-ins with her. She's an hour and a half away so monthly weigh-ins would've been a royal pain but she also didn't require or ask me to come in once a month to weigh in. Any thoughts? With regards to comorbidity requirements: My BMI is WAY up there, like 50, so I guess I don't NEED to have a comorbidity of any kind to qualify in that respect, but.. I do have the following and wonder if this helps approval? Pre-diabetes Arthritis HBP (not on medication though) sleep apnea (Can't use CPAP due to intolerance and causing bruising and pain so use an oral device) High cholesterol High Triglycerides Fatty liver (NASH) Stroke risk (Had a TIA in 2013, heart ablations in 2014 for AFib, SVT, and Atrial Flutter). Thanks for your patience with all my questions. I'm having difficulty getting my PCP and my former PCP to get back with me about records showing my weight, BMI etc. I've NO idea what I even need from them but trying to be proactive (suggestions?).

I was remarking on the CPAP issue, not the surgery issue.

I was one of those people who ended up with bruising and rashes, etc. on my face from CPAP machine use (tried every mask available and all bruised, leaked, etc). No tolerance whatsoever. My doctor referred me to a dentist who specializes in the oral device, which I have and am using. It's mainly better for someone with mild to moderate sleep apnea and may not be the best treatment for severe SA. If someone is intolerant to the CPAP machine, an oral device may be indicated, but that's up to the doctor of course. My husband had the surgery, which worked for a few years until he gained weight again. Now he's back on a CPAP. Surgery isn't foolproof or long-term, from what my husband was told. I imagine that if someone's insurance requires they use the CPAP machine a bit then it will likely fall into the time frame for doctor supervised diet program so I wouldn't think it would extend the waiting time. Just guesswork on that, of course.. I'm no expert by any stretch.

I agree! I can't get the patient advocate to return my calls, and she's the ONLY one in the office who can tell me if my doctors sent in everything needed. It's frustrating, but that surgery center is the only one even remotely nearby (1 1/2 hours away) that has experienced, qualified surgeons. I was told by a tech who did my stress test that my surgeon has done a ton of the gastric sleeve surgeries and he was a great choice. But I can't even get to the person who can tell me if they received everything required from my doctors. :/ I'm stressed beyond belief right now.

Thank you.

This is what I found online from BC/BS of AL They really don't make it easy at all. And, it still doesn't say how much weight I'm supposed to lose in that 6 months.

Thank you for the input, Middus. BTW, love your avatar. It seems the requirements vary so much from state to state that it's incredibly confusing, overall. But then, that's the way it works anyway... one state vs another.

I will try that, Outside. Thank you for the suggestion. The patient advocate at my surgeon's office, the one who knows the insurance requirements, etc... was the one who told me I had to do the 6 months of dieting. I wish I understood why it's so hard to get approved for this surgery. Can't just be the cost, because there are a lot of approved surgeries that are approved all the time.

I'd been seeing an endocrinologist for pre-diabetes, but now my numbers have slipped a tenth of a point below the cutoff between normal and pre. My Endocrinologist told me to go to my GP to get the process started, and she was one of 3 doctors who suggested I think about getting this surgery. I think my endocrinologist isn't as great as I initially thought.

That's great that they did that for you! I have reflux and sleep apnea, and I still have to jump through all the hoops to get this approved, and that's with a BMI of 48. So glad they did that for you!!!

Wow. You're lucky! Here in AL they require 6 pos of doctor supervised dieting. I thought it was 7 months but found out at my visit with the surgeon that it's 6 months. I didn't realize when I'd already left the appointment... that they didn't tell me how much I had to lose in that 6 months, and I've been trying to reach the person who handles this for about a week and a half now with no return calls. So I'm still pretty much in the dark.

Hi everyone. Well, I had my first appointment with the surgeon on April 18 and all went well and quickly, which surprised me. The surgeon knows, and we discussed briefly, that I was diagnosed with NASH last year. He was non-plussed and said that would improve with weight loss, mentioned nothing about it posing a problem during or after surgery. However, a co-worker of my husband had the banding done, is having to have it re-done (whatever that means), and he told my husband yesterday that his surgeon told him that if he found a fatty liver that he would terminate the surgery. So then I went online to read about NAFLD and NASH (which is what I have) and gastric sleeve surgery. Confusing confusing confusing information..... A couple of research papers said it helps and doesn't pose too many complications unless the person has cirrhosis and/or portal hypertension. As of my biopsy last year I have neither of those. But other articles, etc say that the liver will "Shred" or "Tear" and bruise due to it's larger size due to the fat. There wasn't any mention by my liver specialist, nor was it in the copies of the biopsy results, that stated my liver was enlarged. BUT... which of the information is true??? Will my liver shred or tear if it's fatty and they try to do this surgery, or.....???? Anyone else have fatty liver, and if so... what was your experience?

I am SO glad to hear your liver is better!!!! Wow! That's a blessing for sure! As for my liver.... my enzymes were elevated, sending me to a specialist. Blood work showed the score for probable NASH, then I was scheduled for biopsy... where they go in through the jugular. Results were NASH with no fibrosis, cirrhosis, nor portal hypertension. I was put on prednisone (was on it a horrid 3 months) because my specialist thought I had/have autoimmune hepatitis, though the biopsy results showed NO interface hepatitis. I really want a second opinion on that as none of it made sense due to the lack of the defining factor (interface hepatitis) and any antibodies in my blood work. There was also no indication whatsoever in the biopsy results that my liver was enlarged and, in fact, said it was normal size. I'm assuming, then, that things will go well. I did read one research paper that said (and I knew this already) that rapid weight loss can cause inflammation, etc. in the liver. One risk vs another, I suppose. What you said makes perfect sense to me, and unless they see something different during the surgery I'm sure everything will be fine. Thank you so much for the info, Patient, and I'm so so SO glad the surgery helped with your liver issues!

It wanted to make sure I understood you. hahaha. I feel like I'm having to do that with my GP. ;p No worries.

jb said.. "Have you thought about going to Mexico for surgery. It's about 4K " No. I'll stick with the US. Insurance will approve me, I'm pretty sure, but it's getting one of my doctor's to understand what's needed from him, paperwork wise. My BMI is 48... I don't think they'll deny me unless I or my doctor screws up the paperwork. Sorry this didn't show up as a quote from you jb. Not sure what happened so put your question in manually.

Well, after my first appointment it seems I cannot use my endocrinologist at all but my GP, and I have to have a letter from my GP (had two in 3 years time) stating I was overweight, what my BMI was, and listing any co-morbidities. I also have to have a letter from my dentist who fit me for my oral device for sleep apnea, and I have to have clearance from my cardiologist. It's all a giant mess at the moment as one of my GP's doesn't 'get' what I need from him. He mailed me a clearance for surgery letter but didn't include anything about my being overweight etc from when he was my GP (left him due to horrible nurse, that still works for him, and then went back after other GP was a total waste of time to see). Anyway, so the GP who I left actually knew what I needed and it was done, and I was able to speak to a human being at the office. Former and current GP... receptionist keeps putting me through to records, and records can't help me with what I need. *sigh* Now, my surgeon didn't require my losing any weight before my initial visit, and... he didn't tell me exactly how much I was supposed to lose to qualify in that respect either... so I still have to call them and ask. But they didn't require me losing any weight to see him the first time, and I'm suspecting he didn't because they had no idea if I were to qualify through insurance or not prior to that first appointment. I also thought I wouldn't be able to have Gastric Sleeve surgery due to having some reflux. As it turns out... I can, and that most people have improvement of that. So... GS it is if approved. I also read in my paperwork that they don't require a psych eval, and I thought that was pretty standard. But hey, I'm good with one less thing to do beforehand. Oh, and since I have sleep apnea and am being treated for it... my BMI has to be 30 or above. Currently... my BMI is a whopping 48. Yikes.

I have BC/BS of AL as well and am just starting this journey. My very first appt is in March with a surgeon, my very first step, but... my PCP sucks, and the last one sucks even worse (they're ratings online are spot-on). I'm a little outside of Montgomery and use Montgomery docs, but it's SO hard to find a PCP who isn't indifferent and with a crummy and often incompetent staff (I don't say that lightly either). I'm scared because I have to either stick with the doctor I have, who is one of those who speaks with you for a couple of minutes with his hand on the doorknob, office staff that won't answer the phone half the time (No menu or option to leave a message) and doesn't even let you know he's left the exam room for good until a nurse comes in to usher you out to pay. I'm trying to be pro-active and get letters that I need before my surgeon appointment next month, but it's like pulling teeth. I called to see if I could get a letter from my previous doctor, because he's who I saw at the beginning of 3 years ago... and was transferred to a nurse who interrupted me mid-sentence and left me on hold for 10 minutes before coming back and telling me someone will have to call me back from "New patients" in order to make an appointment. Thing is, I told the nurse I just wanted to see if I could get the doctor to write a letter and/or suggest the appropriate medical records to show my weight and BMI dating back when I first saw him in Jan 2013. She didn't listen and told me my account is inactive because I haven't been his patient since Sept 2016, then sent me to records. I don't want to go back there, it's horrible, but my current doctor isn't much better. I also feel that NOW isn't the best time to find a NEW doctor as they'll have to do records requests etc. I honestly don't know what to do. Already this stress and it's just the beginning of this journey. :/ Sorry my first post is nothing but a rant, but this is completely frustrating for me to already have a mess just trying to get a letter and records to show my weight and BMI. No one has called me back yet either and not sure when or if they will. Such is the nature of the beast with these two offices. Thanks for reading. Again, sorry for the rant.

lol I guess you're just ninja like that. ;p

Well, there's also the hunger factor too, so I'm assuming from what I've read that the bypass helps with that as well. And I mean actual hunger, not appetite.. the latter of which I'm also understanding is a thinking re-set thing. But yeah, slow and steady isn't a bad thing for sure.

Praying for you Keri. Think positive and, as you have already done, allow God to handle it. Please keep us updated.