Boldilocks

From Ireland - living in upstate NY now. Sent from my LG-H830 using BariatricPal mobile app

Hello! I am halfway hrough my 6 months of hoop-jumping and was just given a surgery date of Feb 5th 2019. I imagine the time will go quick enough - it doesn't feel like I'm halfway through already (more actually - I did my consult in June but couldn't start my weigh-ins until August because I go home every year for the summer to Ireland). I will have all my extra appointments to keep me busy (nutritionist, psych eval, EKG, etc), plus this is a busy time of year anyway. I'm trying to think back to when I was 6 months pregnant and had 3 more to go - all that waiting, and trying to make use of the time left. I have started a major purge of my house so that it'll be a lot easier to keep clean for my family as I recover (though they suck at helping, I'll probably just hire a cleaner. But at least my mess will be less embarrassing). It's a sort of enforced nesting really.

I have United Health Care, but it is through my husband's job as a NY State employee. It's also called the Empire Plan, and I believe BCBS for hospital coverage. If you have read above, you know that I find this insurance malarkey very, very confusing! 😀

Hi there - I don't know quite how to word this, but I feel like my surgeon's office is stringing me along and like perhaps I won't get approved and they know it? My BMI is on the lower side at 36 - but I have diabetes, high BP, high cholesterol, and PCOS (poly cystic ovarian syndrome). My Dr and I discussed it and she is fully on board with me having WLS. All those other co-morbidities are actually being caused by my PCOS, and she gets it because she has it too, and had WLS herself. She wrote down the name and number of the surgeon's office I should call - so I did and set myself up as a new patient. They are well respected - and I personally know 4 other people who have had WLS through them with no complaints. I went for my initial consult back in June - they ran my insurance (UHC Empire Plan - my husband works for the State of NY and apparently we have great insurance, it even covered all of our IVF 100%. I mention this not to "brag" but in case it's helpful - I am not from the US myself and the whole health insurance process really confuses me. We have universal health care in the UK where I'm from). So anyway - at the consult my insurance was run, I was weighed, talked to the surgeon. I was told that they handled all the "other stuff" in terms of requirements for insurance. Was told I needed to come back every 30 days to be weighed and that I should come back in July. That was a snag - I told them I go home to the UK for the summer, and wouldn't be back until the end of August - they said that it was fine and just come in again "at some point" after I get back. I went and weighed in on Aug 21st - they asked for my insurance card again and one office person said to another that there was a "flag" on my account. I was weighed and nothing was mentioned about any problems. I didn't ask because I am clueless and also a big wuss. I went and weighed in on Sept 21st. I asked about additional appts - psych eval, nutritionist, etc. and was told that it would all get done nearer to the time when they apply to the insurance. Wasn't the insurance application already made? Why am I feeling like I'll get to the end of the 6 months and be told that I'm not eligible? Is it because it's just not what I'm used to? Is there stuff that I should be doing on my end that they're assuming I'm doing? I had looked up our insurance and it said about covering surgery with a BMI of 35 as long as there was a comorbidity (and I have several). My surgeon comes up as covered under our insurance - but the hospital he practises at doesn't? Even though it's the same hospital I had my breast reduction surgery in and it was covered. I don't know. I just feel like I'm traipsing along to these weigh ins and am not really part of things. I'll be halfway through my 6 months in a couple of weeks, but I still feel like absolutely everthing is up in the air and wishy-washy. I suppose the real answer is that I need to grow a pair and ask some questions, but it feels good to voice my concerns.

Hi there! I'm 3 months into my 6 month supervised plan, so we should be having surgery around the same time! I was just given a surgery date of Feb 5th 2019 this week. I also cannot lose any weight - my insurance doesn't go by just the starting weight either. I am at 36 BMI right now, and the cut off is 35 with co-morbidities. The nurse told me this weight in that I need to make sure I do not lose ANY weight. I've been eating 1300 calories or less and walking 10,000 steps daily for 3 years now and haven't lost any weight (due to ploycystic ovarian syndrome) - I think I'll be fine, LOL.

I haven't bought anything - I only just got my surgery date and it's at the beginnng of Feb 2019. BUT, I have started making a sweater in a size 34 chest. Let me explain, I'm a knitwear designer, and I have to make the samples for the designs I publish, to be photographed for the front of the pattern. 34" is the norm, and it's not easy to find models locally. Today, I started a sample in a size 34" in a beautiful olive green that I know will suit my colouring, with the intention that I will model it myself for the pattern pictures. I am only a 38B bust right now, but that's because I had a breast reduction 5 years ago. I used to be a 44H. I may as well be bigger than I am, because my belly sticks out furhter than my boobs at this point. Not loving the eternal 9 months pregnant look, have to say. I have always been too embarrassed to model my own designs. I am hoping that by this time next year I'll be a 34B, with the rest in proportion, and I can save myself a lot of time and money and angst looking for models. It will be such a proud moment for me, I can't even express how much.

Och, what a sweet thing to say!

https://www.nytimes.com/2016/12/27/health/bariatric-surgery.html "Most people believe that the operation simply forces people to eat less by making their stomachs smaller, but scientists have discovered that it actually causes profound changes in patients’ physiology, altering the activity of thousands of genes in the human body as well as the complex hormonal signaling from the gut to the brain. It has become clear that bariatric surgery changes the entire setting of a complex, interlocking system. There is no one place to tweak it. To show what is involved, Dr. Kaplan reports that surgery immediately alters the activity of more than 5,000 of the 22,000 genes in the human body. " I found this article really enlightening, and it was really the catalyst that made me decide to go this route. It's the one I will show to my husband when I tell him what I'm doing - I will not tell him yet as he will try to prevent it. He is one of the naysayers. I have extreme hormonal and metabolic issues, which are not going to go away. Yes, I "barely" qualify at my current BMI - but this is because I eat 1300 or less a day and do 10,000 steps. Have lived like this for 3 years now. Have not lost any weight - all I can do is avoid gaining. And it's exhausting. So what happens in 10 years, 15 years - when I can't keep this up anymore? The way I see it is I'm future-proofing my health. Your loved ones should be proud of you for putting your health first, unfortunately there is so much fat-shaming around.

I haven't even had my surgery scheduled yet, but I have thought about this. Being as I expect to have to buy a new wardrobe anyway, I am planing on treating myself to having my "colours done" - you know, you meet with a consultant and they tell you what colours you should be wearing on your body and next to your face during the different seasons, what make up shades you should wear, and jewellery colours. I'm a very pale green-eyed redhead but with ruddiness in my face due to rosacea. I'm in the fat-trap of wearing black and I know it's not doing much for me. Of course I gravitate towards greens, but I would really like to have a whole seasonal colour palette laid out for me. My best friend had it done, and it took years off her instantly.

I wanted to check in with an update because so many people were good enough to chime in and offer reassurance. I had my 3rd weight check of 6 yesterday, and it was a nurse I hadn't seen before who was chattier than the others and offered some info without me needing to ask. She took my weight and it was up 0.4 of a lb from last time, but still down overall about 2 lbs. She said that she shouldn't really be saying it, but not to lose any weight for the next 3 weigh-ins because I am so close to the limit. I am at 36 BMI, and my insurance allows a BMI of 35 with an added comorbidity (not an issue, I have 3). She told me that with my insurance, it is not the initial weight that is taken as the qualifying number - if my weight falls below 35 BMI at any subsequent appointment, it will disqualify me. She also said that between the 3rd and 4th weight checks is when they start scheduling other appts and the surgery date itself, so that they should be calling me with that in the next couple of weeks. Incidentally, with my insurance, apparently they are real sticklers for the weight check being every 30 days. Day 30 would be this Sunday for me, and I called ahead and said I wouldn't be able to come in Monday, so would Friday be OK. They said it was - and when I was there I asked if my next weight check should be 30 days from that day, or 30 days from the day it was supposed to be. She said 30 days from yesterday - and that it's better to be a day under than a day over if the day lands on a weekend or holiday, or you can't otherwise get to the office for weigh in on day 30.

I have a terrible phone phobia, so I def feel less weird about asking questions at the surgeon's office! 😀

Also - I reread the literature from my consult, and it says that the other steps will start 2-3 months out from surgery date. Doh. Sent from my LG-H830 using BariatricPal mobile app

Thank you all so much for your replies it seems a bit clearer to me now. FluffyChix - I know that I have to kep my appts consecutive - I hope I didn't come off like I was trying to sneak my trip home under the radar. They explained to me at my June consult that I would start my 6 months of weigh-ins when I came back to the US in August. Going home every summer is necessary to my mental health, so I was willing to take the 2 month hit. What's 2 months in the grand scheme of things anyway? Also - I have the criteria from United Healthcare and I am fine at 35 BMI as long as I have 1 co-morbidity. However, now I am worried about falling below 35 during this 6 months, and no longer being eligible. I will be mindful at that and ask that at my next weigh-in - thank you! Mousecat88 - this makes a lot of sense to me the way you explain it. Kind of like running your credit card when you check into the hotel, but not charging it until you leave, LOL. So I think I'm on the right track, and I just have to "trust the process." I'm not a control freak - but I just hate it when I don't understand why something is or isn't happening. When I'm comfortable in the facts, then I'm fine. MegPRN - I didn't even think of that at all, but you may very well be right! Especially as the "flag" was mentioned at my first visit back to the surgeon after a 2 month absence, but wasn't mentioned the next visit. Thank you! I am definitely going to ask about the timeline for my other steps at my next weigh in! I'm not in a rush - I knew that the 6 month countdown would start in August not in June, as this was explained to me before I went away on vacation. Now that I am thinking about it, during my consult the insurance people at the surgeon's office did talk to UHC to see if they would allow me to do weigh-ins at a doctor's office in the UK, but the answer was no. So I knew I was starting weigh ins in August and having my last one next January. Thank you all again - this has been really helpful!

I am so confused about all the insurance stuff - and I know that this isn't the best place to get specific help, but I'm hoping that it can just be made clearer for me. I'm not American - I'm from the UK and we have universal healthcare, so the insurance thing has always confused the feck out of me! I live in upstate NY, my husband works for the State and therefore has very good insurance. It covered our IVF and my breast reduction surgery 100%, for example. It's United Healthcare - but is also apparently the NYS Empire Plan. But it is Blue Cross Blue Shield if there is a hospital stay involved?? Anyway - I went to my primary care doctor. She has the same problems as me (PCOS - an endocrine issue, one of the main symptoms of which is weight gain with the inability to lose, and ultra low metabolism). She has had weight loss surgery herself, and so was quick to recommend it. She gave me the name of a surgeon, but didn't give me referral letter. I signed up as a new patient on his website, completed the mandatory seminar, and set up an initial consult. I went for the consult last Thursday (06/07/18) and they weighed me and took a history. The nurse said my insurance requires 6 months of weigh ins, which have to be done every 28-30 days. This threw a spanner in the works, because I go home to the UK for the summer, leaving early July. Because I am not back until the middle of August, I was told that I would have to start in September - I wanted to come in August, but was told that it had to be in September because it goes in 4 weekly blocks. Maybe she meant from the date of the consult? So they said I would have to see the nutritionist, have an endoscopy, a psych eval, an EKG, a colonoscopy. I pretty much expected that as I had looked up our insurance plan's rules for surgery: https://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htm I am right at 36 BMI and the policy for BMI with co-morbidity (I have PCOS, diabetes, high cholesterol) is 35. I was not told to lose weight - but what will happen if I fall under 35 while doing the weigh ins? Also, they said that after the 6 weigh ins and other procedures, they forward it to the insurance. Does that mean that it could still be denied? Am I essentially doing this blind right now? I read about people hear calling their insurance - am I supposed to be doing that? Do I need to get prior authorisation for this, or is the weight loss centre supposed to deal with it? Again, I'm sorry if Im being really dumb - I just want to understand the process.

I'm glad you've come to an understanding with him Bobbie - it'll be much easier that way in the long run I'm sure!

No - he can be a jerk, but he's not controlling that way. I have fingerprint protection on my phone anyway, and it is the only number I give out. The insurance company is always sending statements, and I open and discard them because he is not even interested in seeing them. I have my own business working from home - but I can pretty much do my own thing right up until 5.30pm on weekdays for appts and he would be none the wiser. My daughters know about the surgery and are very on board. They can keep a secret - we are always doing things without him knowing. They aren't all that close to him because he's not around all that much if he's binge drinking/binge exercising/binge online game playing - and often the 3 of us will just go off shopping, out to eat, to fairs, festivals, etc. I mean, it's pretty telling that we go off to the UK for 6 weeks in the summer and leave him behind... They are only 11 and 10, though - so I have at least 3 good friends that could take me to the hospital (including the 1 that had gastric sleeve last year). Once it's a done deal he'll be Ok with it - but I'm pretty sure he would do anything to stop it. Because he'll be worried that something will happen to me, yes - but also because he'll be jealous (having done his stupid yo-yo diets for 17 years himself) and because he is so much older than me and he dislikes me getting any male attention as it is (he's 66, and I'm 41 and don't look it). My BMI is not huge - at 36 with diabetes, PCOS, and high cholesterol I *just* qualify, so I have not been told to lose any weight prior. The surgery for me is more about future-proofing my health. For the last couple of years I have made sure to do at least 10,000 steps a day, and keep my calories around 1300. I have logged it all in MyFitnessPal going back to 2015. I should lose weight, but with the PCOS it is almost impossible. What I am looking to get out of the WLS is the complete reset of hormones and metabolism that follows. Because I don;t know how I could keep this up in 10 years, 20 years, etc. No joke - I already have a protein shake for breakfast and one for lunch, for 2 years now. He's used to seeing that. I have been vegetarian since I was a child and only use skim milk, etc. and cook healthy meals. I don't think he's going to notice much difference in my pre-op diet. Plus I can hide any odd looking stuff in my room - we have separate bedrooms.

I am brand new to this also - and have not even brought it up with my husband. I have a friend who had gastric sleeve a year ago and is doing great with it - and just the total scorn with which he talks about her and WLS in general, I know he will not be on board. She should just work out more, she's risking her life, easy way out, just lazy - all that regular ignorant BS. He is a little overweight himself - not much, though. He yo-yos up and down by binge-eating and drinking, and gaining weight - then exercising 2 hrs a day and eating 2 lean cuisines a day to lose it. He is an alcoholic, and definitely has addictive beahaviours and an all-or-nothing approach to other things in life too. He eats everything in the house, or he starves himself, he plays video games all day long, or he swears off them entirely. He's on the wagon for 3 or 4 montghs, and then he goes on a 2 week vodka binge. It's OK - I don't go to him for support in most things - we are in a marriage of convenience more than anything else. I'm from the UK and I moved to the US to be with him. If we were to divorce I would want to go home with our 2 daughters - but he would never allow that. So the way I see it, why divorce and go and live in some shitty apartment nearby and have to split time with my kids. I've put my time in (17 years) - why let some other woman get what I'm entitled to (it wouldn't be hard for him around here, there is a shortage of employed single men). I feel like I may as well be comfortable if I'm stuck here. He's also 25 years older than me, which plays into it as well. I can wait. And when he passes, I'll be free and with a good-sized pension to boot. ANYWAY - I have to do 6 months of weigh ins with our insurance, as well as the nutional appts, psych eval, etc. I had my initial consult last week, but can't start the monthy appts until September because my daughters and I go home to the UK for 6 weeks in the summer (see what I mean - couldn't afford that if we divorced). My biggest fear is that he will try to stop the surgery by cancelling it. There is history there - he tried to do this 5 years ago when I had my breast reduction surgery. He got drunk the week before and I actually caught him red-handed trying to get me thrown off his insurance, and also calling the hospital and trying to cancel the surgery date. Now, it didn't happen. I intercepted the calls. And he sobered up by the time surgery rolled around - but I had a friend lined up to take me to the hospital if he wasn't "available", and my mum had already flown in and stayed for 6 weeks to look after me. I really don't look to him for support. So I have NO PLANS at all to tell him until right before the surgery. Is there a way he would find out? This is a much longer process than the breast reduction approval, and I worry they'll call him with questions? Is he able to have me thrown off the insurance any time he wants? I am so terrified of him finding out. I can do all my appts while he is at work because I have free time during the day (again, I prefer my comfortable life), but I really want to keep it a secret as long as I can.

If your own surgeon has said that the surgery date will not be a problem, then go with that obviously. But if there is any question on it, then you could request the medical abortion rather than the d&c perhaps? It involves taking two pills and cramping and discharge like a heavy period. You're so very early, and so many women have losses at this stage that they just assume are periods because they didn't even know they were pregnant. I don't see how that could impact your surgery date? No judgement here - it's your body and your choice. I used to work at planned parenthood, and the highest demographic of women coming for terminations (and 93% of the work done there is contraception, health screening, pap smears, std testing - not terminations) were in their 30s, married, with 2 or more kids. They just knew that they weren't up to having any more for whatever reason - health, finance, domestic violence, etc. Sent from my LG-H830 using BariatricPal mobile app