stricksleeved

Hey everyone out there! My Primary Care Physician (PCP) told me that I was a great candidate for the sleeve, since he saw my weight spike in the last two years (e.g., stress and menopause). As of Monday, I completed seven months of weigh-ins with my group (started in late August) and met with all of the required doctors (psych eval, cardiologist, pulmo, nutritionist, sleep study, PCP review, & two meetings with the surgeon). I have GHI (New York), and so now, I have been told that it could take between two to three weeks to hear about an approval / denial from the insurance. Surgeon was hesitant to promise approval, since I am at the cusp of the cut-off point. I am BMI 39.3 with no other issues (e.g., diabetes, hypertension, sleep apnea). I was really hoping that this would be a "done-deal"now, because I was over BMI 35 - but I didn't know that I needed other issues in order to qualify. Has anyone else with GHI been on the BMI border? How did it go? My stats are: gender: female, height: 5'7 weight: 242, age: 50, ethnic group: Black, ACTIVE

I have NO comorbidities. I am VERY healthy. And, let's be clear, I am very happy to find this out. I am blessed. And so, this means I have: No high blood pressure; No sleep apnea; No diabetes; No high cholesterol; and No fatty liver. I am 40.11 BMI as my last weigh-in. But all for the weigh-ins before the last one (since August), my BMI was between 35 progressing to 39. I was told that IF after the peer-to-peer, I am denied and I decide to go for an appeal, the bariatric clinic has encouraged past clients to "do a couple more [monthly] weigh - ins". But, here is the thing; I am not trying to STAY this heavy weight to satisfy some insurance threshold. It just goes against my personality. Thanks for the encouraging words. Tristi

When I went in, I found out that my bariatric center’s scale is off by three quarters of one pound. I guess if you are on the other side, that is good. My new BMI IS 40.11, and this new BMI is what the doctor will use to argue his case for me. He is out this week on vacation, and so I’m not sure if he or someone else in the group will do the peer-to-peer. Wanting this step to be done already.

Congratulations! I was denied last week - I have GHI in New York. MY BMI was 38.9 which was wrong. This time, I am going to "help" the nurse to calculate the BMI. I am told that they barely know the formula. They just punch in the numbers and then expect the BMI figure to "appear". Today, I am going in to be weighed again as part of my doctor's "peer-to-peer" or doc-to-doc process which is something that is supposed to happen before making a formal appeal. I hope to be like you with an initial denial but then a positive outcome in the end.

Thank you. Trying not to go stir-crazy. Just anxious to get back on track.