Alisa_S

Oh thank you! I didn't think of that and you're really talking me off of a ledge right now! That's what I'll do, knock out the 6 month diet, then have the tests done in January and hopefully surgery soon after!

Nope, she thought it was cool, but that's it.

And I just came to a SAD realization! I'll get all this testing done and have to shell out my full deductible for it all $4500, then IF I get scheduled for surgery in January (6 months) I'll have to pay it AGAIN because my deductible will start over. 😭😭😭

Oh my gawd!

4 hours ago, SleeveToBypass2023 said:

That's exactly the stuff you want to tell your pcp. That might be enough to cut that 6 months way down or even out completely.

Sigh 😩I told her all that & gave her my weight chart from Dec 2022 to present and she still said "Mmmmm....I'm still going to need to see you monthly for 6 months."

Then added sleep study, EDG, and cardiac appt to the 6 month supervised diet with documented failure of weight loss.
Documentation supporting the "reasonableness and necessity of a Gastric Restrictive Surgical Service being required, and significant clinical evidence that weight is affecting overall health and is a threat to life."
Psych eval & Nutritionist counseling that I already have to do.

Sleevetobypass2023 - I've mentioned it a little & I have months and months of weight charts on my Carb Manager account. I used to track all my meals there when I was doing Keto & Low carb. I got tired of tracking all the meals and started just tracking my weight on there a couple times a month. I think I'll print that out and take it to my PCP. Can't hurt I guess.

I did hCG diet back in 2010 (too long ago). In the 90's I did fenphen / phenfen - whatever it was, & dang near got a divorce because I got really mean. Tried just the phentermine about 6 years ago & it affected the same (my boss finally asked me if I wanted to work somewhere else-I quit taking it that day). Been fooling with keto or low carb off & on for the last 8 years. sigh. Through it all I just keep losing and gaining the same weight, over & over. Gosh I'm tired of it.

WEIGHT LOG.pdf

29 minutes ago, JennyBeez said:

Good luck with your PCP today!

Thank you!

1 hour ago, GreenTealael said:

You may want to let the PCP know that you have been dieting unsuccessfully for x amount of time and what you have unsuccessfully tried to manage your weight so they can note it in your chart in case that is a requirement needed to receive the referral/insurance approval.

Good Luck!

Yes, it's requirement.

6 month supervised diet with documented failure of weight loss.

Documentation supporting the "reasonableness and necessity of a Gastric Restrictive Surgical Service being required, and significant clinical evidence that weight is affecting overall health and is a threat to life."

Psych eval

Nutritionist counseling

sigh

I have an appointment with my PCP tomorrow to let her know that I want bariatric surgery & get a referral for my surgeon.

Are there any certain things I should bring up to my Dr? I have no doubt she'll be on board with the surgery. Anything in particular I should say, or ask for?

I've been told that I have sleep apnea by other Drs after having gall bladder surgery & colonoscopy, so I will ask for her to get a sleep study scheduled. I just assume I'll need one.

I spoke to my insurance, United Healthcare Choice Plus, and was given their list of requirements for approval 😕 & I will provide her with that list. I don't want to forget or miss anything that I should discuss. I appreciate any tips/suggestions. Like everyone else, I just want this to go as quickly & smoothly as possible.

Sleevetobypass, thank you! I am relearning what I previously knew about bypass.

Spinoza I really appreciate your input. I'm much more comfortable with the sleeve. I'd rather not rearrange my intestines.

2 hours ago, SleeveToBypass2023 said:

No. I didn't have gerd at all until I got the sleeve. It was the sleeve that caused my gerd and all the complications.

Oh wow! That sucks! Guess I'll start researching bypass again. I first learned a lot about it probably 15- 20 years ago. Then when the sleeve came out I was all excited.

Hopefully the bypass has improved since I first read about it.

1 hour ago, SleeveToBypass2023 said:

I never had reflux or gerd so I was a fantastic candidate for the sleeve. And after the sleeve, the gerd was so bad I was on 80mg of Nexium TWICE per day PLUS pepcid for break through and TUMS if really needed (and I was always doing all of it, sometimes still with no real relief). I developed so many polyps from the incredibly high amounts of PPI over a long period of time that I needed 4 endoscopies to remove them. I also developed gastritis and esophagitis. I was told I had no choice but to have the revision to bypass. So 13 months after my sleeve, I was back in the hospital having the bypass.

The recovery was SO much faster and easier, the gerd was cured almost immediately, getting my fluids down was so much easier, my only real regret is that I had the sleeve at all. I just wish I had gone straight to the bypass to begin with. If you already have gerd, I STRONGLY advise at least thinking about the bypass instead of the sleeve. The bariatric surgeon may not even give you the sleeve as an option, so maybe start considering the bypass as a viable choice.

I'm so sorry you went thru all that! Wow! That's a lot to think about.

Did you have gerd due to a hiatal hernia? I thought that some surgeons repaired that while they are in there and that would take care of the GERD.

Glad to hear you are so much better after the revision.

35 minutes ago, catwoman7 said:

by the way, since you have acid reflux, did your surgeon suggest gastric bypass (RNY) instead? That's often recommended for patients who have reflux issues (I was one of them...). RNY usually improves if not outright cures reflux. With sleeve there's about a 30% chance of it getting worse. Some people are comfortable with those odds and have gone ahead with sleeve and lucked out. I wasn't comfortable with the odds.

I have not talked to a surgeon yet. I have one picked out, but figured I would see my PCP first on 07/19. I'm hoping they will just repair the hiatal hernia. I'd much prefer the sleeve over the bypass.

Thanks JennyBeez, I guess my concern is not so much my BMI dropping too low, as it is that the insurance will say, "See?? You can lose weight on a diet! Just keep doing what you're doing!"

Now that I've made the decision to have WLS & am waiting for my appt with my PCP my mind won't shut up! I know my insurance requires a 6 month supervised diet, but what if I lose weight on the diet and my insurance decides that I don't NEED to have WLS to lose weight since I was (theoretically) able to lose weight for this requirement? I was told after a colonoscopy that I have sleep apnea and need to have a sleep study done & that I should really be on a cpap, but what if sleep apnea is a reason to deny me the surgery? I take omeprazole for acid reflux because I have a hiatal hernia. What if that prevents me from having the surgery?

What if they just say NO? After making up my mind to do this, I just don't think I could take it. I'll be 60 in Oct & I'm 5' 8" - used to be 5' 9" - & I weigh 338 lbs. On my own I have fooled with hCG diet, Keto, low carb, etc, etc, etc for sooooo many years. I lose weight & gain it back. I know what I'm supposed to do, but can't stick with it. I need this. Period.

Thanks! I think my insurance requires 6 months supervised diet, psych eval, and nutritionist too. I do have a surgeon in mind.

My PCP appt is the 19th.

After many years, I finally decided to have wls.

I made an appointment with my primary care physician to talk to her about it and get set up for a sleep study for sleep apnea. Other than that, I have no idea what I need to do to get the ball rolling.

Does anyone have any experience with United Healthcare Choice Plus insurance and using it for wls?

Pretty much, yeah...

I found some info on it. It's only good for 6 months & then they have to remove it. You can have another placed if you want. All it is, is something to take up room in your stoumach so you don't eat as much. During that 6 months you'd have to train yourself in healthy foods, and Portion Control, and excercise and try to continue that after it's removed. It's mainly for people that don't have a high enough BMI for bariatric surgery, or for people that are SO big that they have to lose weight BEFORE surgery. It's just a temporary fix at best, but I was thinking it might be a jumpstart to weightloss. If I could lose 60 lbs or so in 6 months, then I'd be healthy enough to really excercise & hopefully be on the right track with foods...

Thanks for replying!

Anyone here know anything about the intragastric balloon? I'd like to hear about it...prices, success rate, problems, & such...