elforman

Doctor told me when I have my sleeve (late May-ish) it will be done outpatient as a surgical center adjacent to the hospital. If something goes wrong they'll take me to the hospital and admit me so I should have an overnight bag prepared, just in case.

Hi all. I'm on schedule for mid-May, no date set yet, but it's looking like I might have to push it back a little bit because my wife is going to have a knee replacement in late April or early may herself. We have to wait until the kids are home from college so they can stay with her while I'm at work. I'll probably wait until three weeks after her surgery before I have mine, so we'll be laid up together for a while. Neither of my kids drive, so my daughter will have to take me to my surgery in an Uber. It's going to be done outpatient so she'll have a long day sitting in the surgical center. I'll probably have to explain to the staff multiple times that while my daughter looks 15, she's already 21. Also fortunate is that since both my wife and I will be laid up together, both my kids can cook. As for what I'm looking forward to after surgery, mostly it's not having to do my laundry every few days because I've refused to buy any more clothes once I figured out how much I've spent in the past two years as I continued to expand. I don't want to go out and buy new clothes, I just want my old ones to fit again. (Also, as a guy, I'm fine with ordering shirts and pants on Amazon, so it's not like I'm going out to buy them now either.)

My mutant superpower is the ability to accurately measure food weights and liquid volume without a measuring cup or scale. My wife says it freaks her out how accurate I am. She's currently doing weight watchers and after two months of me telling her much something weighs before she weighs it, she's just put the scale away.

I liked your quote better before you fixed it. Granted, I'm an atheist...

In my case everything you list as out of pocket is still covered by Cigna, they're just not included as part of the cost of the bariatric procedure. Everything is subject to the regular co-pays and deductibles, of course. I've got Cigna as well (Open Access PPO) and the only thing they don't cover is the psychiatric consult from the psychiatrist my surgeon recommended. My surgeon told me the psych exam will cost $400 because and there are no psychiatrists in-network in the area who do this type of evaluation. Honestly, I'm not entirely sure about that and I will be calling Cigna to confirm that. Also, I can do it over the phone, which means I don't have to take any time off from work and drive who knows where, I might just go ahead and pay it.

Hi there and welcome aboard. I'm still a few months away from surgery (though I'm a male with two college age kids though many of our concerns remain the same) but I went through a similar process of tallying the positives and negatives myself. The fact that you're able to list them so clearly is an excellent sign that you've got a healthy grasp on the situation. Your positives are all spot on. Regarding your fears, I've managed to overcome mine through lots of research and introspection, so I'll address yours one at a time. 1. The fatality rate from weight loss surgery is exceptionally low and in the rare event when it does happen it's often a result of an undiagnosed condition. That's why they do extensive pre-op examinations. 2. Complications are certainly a possibility. You have to compare those risk to the health issues you'll certainly encounter if you do not address your weight. For most of us the small risk of complications is a much better gamble than waiting for diabetes. Also, try to avoid reading stories of other peoples' bad experiences, especially if they're second hand reports like "My friend's plumber's wife's astrologist went in for a gastric sleeve and she woke up with a tail!" And yes, after the surgery you will feel like crap after the surgery, you are likely to vomit a lot and have random pains. Those are all absolutely normal. 3. You need to turn your fear of limitations at social events into a positive. So many events revolve around food and that is one of our problems. What's the point of losing all of the weight if you're just going to put it all back by pigging out on pizza at a party. Once you get to your goal weight you'll be able to eat mostly normally again. Remember, people at healthy weights get to eat everything they want as well, they just don't overdo it and that's what we need to learn to do as well. And as for what others have to say, you just have to learn how to tune them out. Dismiss them with a simple "Thank you for your opinion," or, if they're particularly rude about it "I'm sorry, I don't recall asking for your opinion" then change the subject, If they persist, ask them where they got their medical degree. Find the strength to end a conversation if someone is not supportive of your decision. I hope that helps. I've always been the rather stoic type, quick to dispassionately analyze a situation instead of getting emotional. I know that puts me in the minority here and it also results in me giving advice that can be rather blunt, so please don't think I'm discounting your emotional concerns: Others can help you with that stuff.

Just some unsolicited advice: There is a psychiatric examination required as part of the process where they make sure that you understand everything you'll be going through and you are emotionally stable enough for the drastic lifestyle change it will require. Not everyone will experience vomiting and you don't want them to think that you feel aversion to vomiting is something that will help keep you on track in your recovery. You've already got your other medical conditions as motivation to lose the weight and keep it off, so stick with that in discussions.

I'm not great at the whole rah-rah, we're all in this together, positive thoughts, you'll do great stuff. I'm 110% pragmatic. But given your age, what I can offer is this: You can't be afraid to ask questions of anyone, particularly the doctors. Do not just sit and nod when the doctor tells you something you're not 100% certain about: Repeat it back to him/her. Be your own advocate. You have to own this whole process. Success or failure is all on you. Do your own research on reliable medical websites and make sure you and the doctor are on the same page. Do not read anecdotes here or hear stories from family and friends and accept them as fact. Do not get paranoid if you read about problems some people report here and think you're going to have the same problems. Get over your avoidance of doctors immediately. They are on your side and unless you also have a medical degree, they know what's best for you. If they tell you that you need to do something you fear or will make you uncomfortable, just suck it up and do it. They're the experts. Don't obsess about how you got to where you are. You've made the decision to correct things, so focus on that. Prior to being approved for surgery you will have to have a psychiatric evaluation. Based on the findings they may recommend steps you can take to avoid returning to unhealthy behaviors, possibly individual therapy or groups like Overeaters Anonymous. Accept whatever help they offer. Finally, this is going to be hard work and a major lifestyle change. Everyone in your life is going to have an opinion and most of them, unless they've gone through this themselves, will be completely uninformed and possibly even dangerous. If there's someone who isn't unconditionally supportive, ignore them as much as you can. And if it's from someone you can't ignore, invest in some good noise-canceling headphones...

Whether the doctor believes in something or not is irrelevant. The only real question is whether WLS is medically indicated for you. And also important is whether the doctor said anything else about why she thinks you are specifically not a good candidate or if she just thinks it's not warranted for any of her patients. If you don't mind sharing, do you know your current BMI? (If you don't you can find an online calculator.) The general rule of thumb, at least for sleeve, is 1) minimum of 40 or 2) between 35 and 39 if there are other complicating medical conditions such as diabetes or severe sleep apnea. If you don't meet either of those criteria you might not have a case. But if you do and the doctor refuses to submit a referral, you could go over the doctor's head and contact the medical director where the doctor practices to report her. You can also contact your insurance company and let them know that your doctor is failing to follow proper medical protocols.

My wife tried to claim that she goes shopping for the exercise. I reminded her that in a single shopping trip she tends to spend at least three times the cost of a monthly gym membership and rejected her claim.

When it comes to being nervous, I'm actually rather stoic about the whole thing. I know there are many things that can potentially go wrong but I just don't obsess over stuff like that. I've always thought that worrying is a waste of time. I just try to control the things I can control and learn as much about the things I can't so I'm prepared. Stay calm until there's a legitimate reason not to. And if for whatever reason there's a delay or glitch in the process, don't obsess over what went wrong, just start doing what you can to fix it. You'll be fine.

Hi @daizeoh. Here's more information than you asked for. I'm just a thorough kind of guy, The insurance company will only deny you for these reasons: You do not meet the criteria. Failure to follow the pre-op protocol. Not passing the psychiatric evaluation. Not being covered for weight loss services. CRITERIA: I'm pretty sure the standard rule of thumb for eligibility, at least for males, is a BMI of 40 or up or a combination of BMI of 35-40 with other complicating factors like severe sleep apnea. It may differ for women. PROTOCOL: Each insurance company has different pre-op protocols regarding things like pro-op dieting. Your doctor's staff will know what your insurance requires. There are reports of requirements of pre-op diets ranging from zero to six months as well as other things like endoscopies and other pre-op exams to ensure you're healthy enough to endure the surgery. The doctor's staff will all handle checking with the insurance company to find out exactly what you need. It's probably better to let them deal with the insurance company than doing it yourself since they know exactly what to ask. PSYCH EXAM: If you do not pass the psych exam you may be able to get a treatment protocol to follow that would help you get past that hurdle. The psych exam includes things like not having drug or alcohol addictions, so if you've had that recently they'd require you to be sober for six months. If they determine you have undiagnosed or untreated depression they might recommend seeing a therapist weekly until the therapist believes you have a handle on it. The psych exam also ensures that you have a good support system in place for your recovery period, so if you live alone with twelve cats but have no local friends or family, you're a poor candidate. NOT COVERED: Not all insurance policies cover weight loss services and bariatric surgery. This is something you could call and ask about yourself. If you have coverage through an employer and these services are not covered, it's because your employer decided not to include the coverage, which can be done to keep premiums lower. The most important thing is to ask questions. You'll get a lot of advice here, often confusing and conflicting. In addition, all doctors are different: most will do the surgery in a hospital and have you spend the night, some will do it outpatient and you'll be home by 4pm the same day. Some will require a pre-op liquid diet, others won't. No two people will have a similar experience, so just because one person says they have the same insurance company as you does not mean you'll have the same requirements.

Having read through this board before meeting with the surgeon for the first time last month, the pre-op diet was one of my biggest questions. He said he doesn't require it. After that the nutritionist at the hospital gave me a booklet with all sorts of directions to follow and that document says I have to do the two weeks liquid diet. Fortunately for me, the doctor told me what he says goes when I checked with him afterward. He said the hospital's guide is good for the post-op regimen it details, but his word is final for pre-op.

No, my straps were fine. It was the pressure they had to adjust. I also had them turn the heat off since I'm in SoCal and it's not cold enough to need it.

My question is how you settled on the sleeve as the best option for you. Have you consulted any doctors for their advice on how you can reach your goals other than sleeve surgery? There are many reasons it's normally only approved for people with a much higher BMI. It certainly doesn't sound like your health is in danger so I really get the idea that the sleeve is not for you and that you should be exploring other avenues with a professional.

When I think of replacing bad habits I always come back to this:

I'd be amazed if any of those bills were paid at more than 35%. The anesthesiologist would be lucky to get $600 under contract. Reimbursement rates may be higher in some areas of the country where there are provider shortages and those providers can leverage that into higher rates.

I'm only two weeks into my three-month pre-op diet, but it wasn't a difficult decision to kick off the process. I've dieted before and done quite well on them but always had problems keeping the weight off. I'm also currently wracked with injuries to my back, feet, knee and shoulders, so any kind of strenuous exercise is out of the picture, and the only times I've lost weight in the past was when it was accompanied by rigorous workouts. I had problems sticking to good eating habits when things got stressful, so combine my son coming down with a semi-debilitating disease and my wife being seriously injured in an auto accident, and my weight ballooned. Now that things have calmed down in my life, I realize that I would benefit from the lifestyle change the surgery would require, so I'm going for it. So good luck tomorrow and all that stuff.

The real question is if that bill is the amount she owes after the insurance company paid their portion or if that is the total amount that hospital/surgeon billed the insurance company. That's a significant difference. Another problem could be that while the doctor is in the insurance network, the hospital /surgical center may not be. If it's not in network then the insurance company is going to pay a lot less and in many situations it's a separate out-of-network deductible as well that will be much higher than the standard deductible. My orthopedist scheduled me for an epidural for my back problems. He's in my network but the surgical center he chose is not. An in-network center would cost me a few hundred dollars, while the out-of-network center would be a few thousand, so I cancelled that and told them to find an in-network center or I'll find another doctor.

Don't go by what the hospital and surgeon's bill say. Those are like sticker prices on a car and private college tuition: Nobody except the ignorant and desperate pay that price. Hospitals and surgeons almost never collect 100% of what they bill. Contracts with insurance companies these days usually pay around 30% of billed amounts. Note that the rates are pre-negotiated, so the hospital/surgeon don't get more if they bill more. When a bariatric surgeon quotes you a cash price it's usually near the same amount they would collect from insurance companies and it includes a pre-negotiated split with the hospital. I was quoted $17,000 for the all-inclusive package for gastric sleeve in SoCal, but fortunately I have good insurance coverage and don't have to pay cash. If I drove 30 miles to Beverly Hills I'd get a quote of twice that price from doctors who do not accept any insurance.

Turn the oven off now and don't use it for the next six days. That'll be one less thing to worry about.

If you have insurance coverage through your employer there's no guarantee that bariatric surgery is covered. Your employer gets to pick and choose what's covered and if they want to save money on premiums they may exclude things often considered non-essential, including bariatric surgery. I discovered last October that my company's PPO policy did not cover it, so i complained to HR and they got it included in the plan effective our next open enrollment date, which was Jan. 1. There may often be exceptions made if your doctor says your life is in danger if you don't have the surgery, but those are rare. So if your insurance says they don't cover it, go to HR immediately and ask them why it's not included in your coverage.

I only just started my three month pre-surgery diet and won't have surgery until mid-May or so, but I've got bone spurs in both feet, a bad knee, a bad back and two severely arthritic shoulders, so ever the thought of exercise fills me with pain. I explained that to the doctor and when it comes to exercise he said simply "Just do what you can and maybe after you've lost some weight it will be easier," but he wasn't going to reject me because I couldn't work out.

I can sympathize with you somewhat. I'm allergic to alcohol so it's like having a built-in two drink limit. I HATE parties and events where people go primarily to get smashed. I've skipped my best friend's birthday party most years because they're all centered around drinking. There is nothing worse than being the only sober person in the room so I find I'll go to some events like that and leave early before I'm surrounded by incoherent morons. As far as handling things when things are centered around food, I'll be OK since I can at least still carry a conversation while others are eating. I'm already the last one to finish eating, not because I eat too much, but because I like to talk during meals to make them last longer.

I've always loved what other people often interpret as inappropriate humor. There's just something cathartic about it that makes me feel better though I have enough compassion to ensure it's never directly at the expense of others. It can be a fine line. I can be very, very dry and people aren't even sure when I'm joking when I'm talking to them, so when it's just in text form I have to be even more careful. If anyone is serious about this type of humor, I strongly recommend checking out both The Aristocrats, a documentary about the filthiest joke ever told, and Gilbert, a documentary about comedian Gilbert Gottfried whose career was derailed over a few tweets about the Japanese earthquake and tsunami were not well received. I know Gilbert is currently available on both Hulu and Amazon Prime but I don't see the Aristocrats on any service right now.