SpecialK92

I'm Oct 5th, RNY. but Oct 13th is my birthday! that's a really lucky day, you'll be fine! 😁

My time is pretty much up, my date is on 10/5 and I am getting so anxious/nervous! I've never had surgery before, so that is also adding to my anxiety. I trust my surgeon, but the preoperative anxiety is so real. One minute, I feel ready. The next, and I'm like "what are you doing?!" I know what I'm feeling is normal, but I'm naturally a worry wart and so nervous but I'll be the case with complications and/or regretting my decision. The unknown is the worst.

woohoo!! I really like Fairlife! Congrats on the date, mine is 10/5!!! You got this!

my BMI is on the lower end (41). My surgeon isn't requiring one for me, My date is 10/5. Good luck!

PP is on the approved list at my clinic, but they did advise that they were seeing an influx of patients complaining of increased constipation w/i their three months using Premier. Not sure if it has to do with the protein blend vs. whey isolate factor or not.

thank you!

does anyone know if you were to weigh-in on surgery below the BMI that you got approved with, if insurance will deny the surgery? When I started this process, I was 252 at 5'5, just barely qualifying with a 41.7 BMI. I am waiting on my surgery date (pre-op nutrition class is tomorrow) and I just weighed myself and I am at 245.7 which is a BMI of 40.9. I'm worried that if I drop too low before surgery, that when the surgery is actually submitted to insurance-it will be denied. I was approved already, but anyone else go through this or do they just use your starting weight? Thanks in advance!

@JomaraElizabeth girl, if you have ANY kind of reflux now, go with bypass!! You got this. Let me know how you make out!!

I had my heart and soul set on the sleeve, but my endoscopy showed bile reflux so I opted for bypass. I was freaking out, but after I did more research on RNY- I felt more secure in my decision. I didn't want to risk the chance of needing a revision later down the line if I developed reflux with the sleeve. Also, the overall weight loss of RNY is greater long term. Check out the revision group on here too and maybe ask them their thoughts as well. Most will say they wish they would've went with bypass from the beginning. I know folks that have had success with both surgeries, both excellent tools- but my best advice to you would be to do more research and then go with your gut. You got this, and good luck to you on your journey babe!!

@themonk4u I'm going through the same thing with my insurance. My surgeon requires 2 nights, and my insurance says that it can be done as Outpatient and that I can spend those two nights in "observation", which is still in hospital, but not admitted. Idk, it's weird but I think it's a common thing, try not to stress. I'm sure if you need more time, your office will go to bat with the insurance.

I just found out today that mine has to be taken out at the same time. Ultrasound from February showed chronic inflammation and my HIDA scan from this week showed that it was "hyperkinetic." I'm getting bypass, but due to GERD is what swayed my decision.

@lyladyp yeah see this is my concern. Are you on any PPIs?

@Phoenix20 I completely get it. Me too. Sleeve me please! Keep me posted and good luck!

@Phoenix20 I feel the exact way. I am now torn between a sleeve or bypass. My final weigh-in is Monday before submitting to insurance. The rate of revisions I'm seeing is not comforting, but I had my heart set on a sleeve. Acid Reflux terrifies me because I'm a singer. UGH. Good luck to you and your decision.

@TexasHeathen did they look at your gallbladder during your endoscopy and determine you needed it out then prior to surgery? I have my endoscopy next week and am wondering if they see it during that procedure.

I'm not sure if I should be stressed or not. I have a three month weigh-in/nutritionist visit requirement from my center. My insurance requires BMI 35-39 with only one comorbidity OR BMI of 40 and above with the following guidelines: -Pysch Consult -Past weight loss attempts aka documented failure of weight loss attempts. Here is my weight loss so far. Starting BMI taken at info session: 41.76 1st nutritionist visit- 41.70 2nd nutritionist visit- 41.26 3rd isn't until July 6th. All other clearances are done with the exception of my EGD, which is on 6/11. I still have to take a COVID test, which the date for that is currently pending. I am SO paranoid and worried now that since my BMI has decreased slightly, that I will be denied by insurance. For reference, I have Highmark BCBS. Has anyone else been in this predicament? Am I overreacting? The center I'm using doesn't seem worried, but I didn't really ask in detail today at my second weigh-in either. I have no plans to drop below a BMI of 41, but I'm just so scared this will disqualify me now under the guideline of "documented failure of weight loss"

@RNY4ME2020 that's a relief! and congrats to you! how long did it take for you to get your approval?

@catwoman7 YES! I was thinking omg, I lost two pounds, so that will look like I can lose weight on my own and maybe that will disqualify me. I wasn't too sure what they look at as "past weight loss attempts." If it's weight history, I think I'll be fine. In my adult life, I've never had a BMI below 41, so I don't think it will drop below that for my last weigh in on July 6th. The office had told me from the very beginning to just maintain. Thank you so much for this!!

That’s amazing! Yeah, I was not expecting to be two pounds lighter, so maintaining this weight until my final weigh-in has me a little nervous. I’ll make it work though. Thank you for replying

did you take the whole day off of work for your EDG? Mine is next week and I'm trying to anticipate what to expect.

Hi Ya'll! ! I'm from Harrisburg, PA and am looking for the same thing. I'm in the pre-op phase still. Hope both of your surgeries were a success!

Hey All! I'm a newbie here, but I've finally decided to start the process and get information about VSG. I feel mentally ready for it and that it's time, as I've been going round and round with the decision for years. I go back to my new PCP on 3/10 of this month to discuss it more and get bloodwork. I gave her a head's up at my initial consult that this was something I wanted, and she said let's see if you are a candidate at your next appointment. I already made my appointment with the weight loss center for the information center on 3/25. They advised they do not need a referral from my PCP, but to have my most recent labs sent over. When I called the weight loss center, I was advised that after the information session, you will be contacted within a week for the actual consult with the surgeon. I've been doing a ton of research so far, and I see a lot of folks have a 6-12 month supervised diet mandate with the insurance. After contacting my insurance company, they sent me the policy and advised that they have lifted their 6 month restriction. My policy states the following is needed for approval. BMI 40 and over or BMI of 35-39 with co-morbidity. Individuals should have documented to respond to conservative measures for weight reduction prior to the consideration of bariatric surgery and these attempts should be reviewed by the practitioner prior to seeking approval for the surgical procedure. HOWEVER, following that statement, it says "As a Result, some centers require active participation in a formal weight reduction program that includes frequent documentation of weight, dietary regimen, and exercise. However there is a lack of evidence on the optimal timing, intensity and duration of non-surgical attempts at weight loss, and whether a medical weight loss program immediately preceding surgery improves outcomes." HELP- what does this mean? Psych consult I'm pretty clear on the other first and last requirement, but the 2nd one has me spinning my wheels slightly. When I called my insurance to ask for clarification, I was advised that a letter of support from my PCP would likely suffice. My only hesitancy is that I just started with a new PCP, and I'm wondering if she will approve me off my BMI alone, or want to try conservative measures first since I am new patient there. If she doesn't provide letter of support, will the nutrition classes that the surgeon will inevitable require satisfy the letter requirement, can he be the one that writes it or does this text indicate that it needs to come from my PCP? I plan on calling the center during their business hours to ask if they've encountered this insurance wise tomorrow, as they were closed today. Any one run into this issue with their insurance policy? Any insight or perspective offered would be awesome.

and yours is right around the corner! how exciting!

Yeah, I called the weight loss center earlier and spoke to their insurance person and she was wonderful. She told me not to stress at all and that they work with my insurance all the time and that it should be no big deal getting it approved. I feel a lot better, thanks everyone!

Will do!! I’ll call the insurance again today! I’m hoping I can get by the end of this year, since I’ve already met my deductible for the year. I spoke to the center earlier and since my insurance doesn’t have time restriction, they will do three month supervised diet with clearances. I don’t have an appointment yet for the consult, they will contact me after the session on the 25th I’m told. I’m excited to get the process started!