AlwaysCruising

Guuuuuurl, that is rough 😞 I love Atlanta, but I would not want to drive from here to there daily (hubby does). Orlando is thick now too, no safe place (she lives in Winter Park for now). Wave at us in a few weeks as we whip through Tampa (long reach, I know LOL). I am so glad that things are getting fixed for you! Did you ever have a way to contact Star by phone or email directly? Messaging them through that website doesn’t seem to work at all (In fact I almost didn’t use them because I had filled out the paperwork and kept messaging /emailing them and nobody ever responded).

Super interesting on the insurance flying you around! Isn’t it amazing the random differences in health insurance! I saw Gorjala, apparently my endo (a woman I very much trust) brought him to town (don’t know the back story) and thinks a lot of him. She also likes Lin and the two at John’s Creek (the latter is far too far!). I agree though, overall the requirements are not on the bad side (he doesn’t require a sleep apnea test for everyone which is good and is flexible for those driving in (me me me LOL - it’s a long way across metro Atlanta anywhere near rush hour). sounds as if I might be near the same diet - my BMI is 35 (well rounded up). I am 5’7” (truthfully 5 7.5) and 222 (although their scale weighed me in boots etc at 236?! so assume they took some off that, still wow!). Because I had so much weight loss before and got a tummy tuck, I also have very little stomach (they took 11 lbs of skin during thatm egads). Honestly, I just pray it means they won’t pump a lot of gas is me as during my hysterectomy that was the bad part! What section of FL? My sister is in Orlando (doc there) but leaving for CO soon, family also in Sarasota and we cruise out of there often (Tampa next).

I know this was a few years back, but I really would love to know which are those requirements were insurance ones - I live an hours drive away and each time in is a day off work. The first surgeon that I saw allows me to meet with the dietician 3 visits (2 can be by phone) - wondered if that was Emory or insurance requiring that. 😊

Strangely I like liver. But unless I make it I wouldn’t have it and well... that isn’t happening! But beer or wine? 🤢🤮🥴 no worries on me being a drunk for sure. I was just relieved to know I was not simply a freak for not looking water (Splenda changed things in such a good way for me, Equal also, saccharin is horribly bitter and I cannot have it in any food/drink). Remember Tab and Fresca? I would have died of thirst before drinking either one. At least we are freaks together if we are freaks 😂🤗👩🏽‍🤝‍👩🏼

I just am coming off a really bad 2 week cold (yes, many last that long) and no joke, I can’t imagine not being able to breathe through my nose and coughing my head off after surgery. I couldn’t work for a week. A few colds are a week only, but it is just hard to predict the course. Hopefully it will/did work out!

I always hated water too. But I was early in on DNA testing (15+ years ago) and have run it through several scientific data bases. I was not surprised to find out I am what they sometimes call a “super taster” - someone who has a gene that results in tasting bitter tastes far more strongly than others. I would bet you have the same gene. So alcohol? Bleck! Black coffee? Not happening. And I never liked water, it has a slight bitterness. Explained a lot I thought since what covers bitter coffee taste? Sugar and cream and lots of it. I cannot drink water plain so I was delighted she the water enhances (SF) came out. They make all the difference for me!

I keep looking at those huge metformin pills for my PCOS and think boy I hope this surgery helps my insulin resistance because these 3 add up bulk wise to more than a day’s worth of food 😫

P.S. I had to dictate the post above quickly and it clearly failed me 😂🤣 I apologize for it being butchered in terms of spelling, grammar, and black holes - sometimes I think my iPad is plotting against me! 😭

That was quite a drive for you! Usually insurance still levies requirements unless in some extremely rare case where it’s done on an emergency basis. But I really am taking about on the surgeon’s requirements 🙂. Do you remember if it specifically said EKG or it just said cardiac clearance? The paper I have says Medical or cardiac clearance but the info itself doesn’t specify particular requirement (as to certain test) on that (since there are many cardiac tests that can be done of different complexities). Do you mind sharing with me how old you were at the time? Thanks! (PS thank God I stopped smoking more than a decade back - I have two insurance policies but their requirements aren’t bad at all and I already had a sleep apnea and scope set up for my own knowledge so at least not a huge and horrible list)

Hi!! Could you tell me what the requirements were that the surgeon asked for (vs. the insurance company)?

My endo recommended Dr, Gorjala. I can also tell you that Dr. Ryland Scott in Rome is extremely nice and Dr. Lin at a Emory (midtown) has a great reputation.

Such a great idea!!!

Great info! I have an a lot of people that felt that their taste changed after bariatric surgery. I know one who really could not stand the taste of water enhancers afterwards. Of course people have such a variety of preferences, but it is nice to get some consensus (saves time and money!).

I am so sorry about Ginger. I have no idea why people don’t realize how much we humans can love an animal and how much they can love us. If you ask me, things with fur make life worthwhile. And how lucky she was to have you ❤️

Unfortunately insurance is as variable as snowflakes. But if you know your insurance basics (like the deductible, percentage paid after deductible, and out of pocket maximum) you can get at least a rough idea of the cost.

Honestly I am very happy that my BMI is 35 and not 40, it’s less distance that I need to go. If it weren’t legit, insurance wouldn’t approve it so maybe that is one way to look at it!

I wouldn’t tell you what to do, but there are a lot of people who had bands in the past having them removed or revised to another type of surgery. It is based solely on restriction (while the sleeve and bypass use restriction but also go further in that other factors such as gastric variables also come into play in assisting with weight loss).

I was told by my nutritionist that I could have carbonated beverages after the sleeve (the only one that I ever drink is diet ginger ale). She said the reason some prohibit it is that some people get stomach pains when drinking soda. I am curious as to which of you react badly to it and which of you tolerate it well? I can live without it, it’s just nice having an alternative to flavored water.

When my endo about jumped off her stool in horror when I mentioned gastric bypass 😟

Not really. That is the truth. Moisture is always good advice but nothing will stop your skin from sagging. Who would be a lot better I think if people could just except that is what it’s going to be and either resign themselves to it or understand they will need surgery. I lost 100 lb by eating super healthy and working out a LOT and I did it slowly (as that is the only way it comes off after 50 when you have PCOS and thyroiditis!) - and I had skin of my stomach, arms and upper thighs that was bad and it was very crepe-like most everywhere else. I decided to do my stomach (11 lbs of skin) and my arms O6 lbs) and as for my thighs I don’t wear pants that show it if at all possible. this is a before and after of my arms - the plastic surgeon said “well you got all the fat out of there!’ 😂

Here are some basics that I hope will help you - there are two basic kinds of plans. 1. You have a straight copay ( there may be different amounts for your pcp and specialists) and 2. A deductible and then a percentage (for a few lucky people that is 0, but usually it’s between 10-30%). When you have a deductible, that means that every year when it turns over, that’s usually in January but for a few companies it can be in the fall, do you have to begin again and meeting your deductible. Remember that you aren’t paying the full price of a provider service but I instead you pay a discounted rate based on your individual insurance carrier (providers contract with each insurance company for a set rate and those usually very across states and whether it’s in a metropolitan or rural area), how much ”usual and customary” price/rate. You pay the usual and customary rate until you meet your deductible, but once you meet that you only pay a percentage of the rate (this is called co-insurance). Once you meet your out-of-pocket maximum, then you pay zero. But all of that starts over when you get to the turnaround time each year. An example. Let’s say your deductible is 300 (wouldn’t that be nice, mine is 6,000!) then a 25% co-insurance. Then you visit your doctor and the usual and customary rate for each visit is $100. So, once you go 3 times you will have met your deductible and the 4th visit and those after for the year would only be $25 each. Don’t worry that you don’t understand all this, lots of people don’t. And there’s no reason you would without a lot of experience with either doctors offices or medical billing. Good luck!

do you mind my asking what your BMI was and any co- morbidities? I just talked to them today and they only list the big ones, without latitude it seemed. The rep actually said to me the fact it was so set suggested they would have to give some... who knows. She recommended having my endo send a request in.

Curious - I am just looking for info at this point. We have two policies, but my BMI is 35 snd I don’t want to have to get a diagnosis of diabetes (currently have PCOS and borderline diabetic and that is bad enough. Not sure if Tricare is less picky about co-morbidities than BCBS of Illinois so despite double coverage I still may have to pay. I was wondering what the cash charge was for the surgery part alone (I mean minus pre-op workup which my insurance should cover).