LAN2k

Just read your post Elisabeth and want to acknowledge it as sound advice as well. Based upon research, self knowledge and exhaustive observation (through a number of internet WL forums and message boards) of pros and cons of the other surgical options, I have made my decision to go with the VSG. The surgery is scheduled for Sept.15. I'm meeting with my surgeon this week.

I appreciate this thread very much since I am approximately 4 weeks away from having a VSG. It has been a journey of lots and lots of research and soul searching and reading from a number of WLS threads is really helpful. I too find myself wondering if having this procedure will finally offer me what I need to change my unhealthy relationship with food. Thus far I think I have made the right decision. But being so close to actually having the surgery I'm getting the jitters. Thank you WASa and HH for your sensible perspectives. Reading your posts has helped me with this pre-surgery anxiety I'm encountering.

Has anyone used GHI PPO plan, if so do you know what their preapproval requirements are and which procedures are covered?

Does anybody know if GHI Medicare covers the Sleeve Gastrectomy? I am nearly done with all the pre-testing clearances but straight medicare will only cover the band (which I definately don't want) and the Gastric Bypass and I'd really rather the Sleeve. I am having a GHI rep. come visit me this Tuesday, they don't seem to be able to answer my questions about WLS over the phone. If anyone knows if GHI covers the sleeve or can point me to a site that can provide that info. I'd really appreciate it. I checked the GHI website but could not find that information. Also can anyone tell me if I will jeapordize my chances of getting approval if I ask GHI if they cover the sleeve procedure. I'm so anxious about this and fear I will settle for the GBP, even though I am convinced the sleeve is the better procedure for me.

Thank you MacMadame. I am realizing that this will not be easy. Surgery is serious and I will not likely wake from it with ease. I have been on YouTube watching people that have made in hospital post-op videos. Besides the potential for nausea it appears that there will be painful gas stuck in the chest or shoulder which will have to work its way out...even taking a full breath appears to be difficult due to pain. And a painfully dry throat seems also to be inevitable. To be honest I am terrified to tears at this moment. It's equally as terrifying to abandon the plan of having WLS, since I am physically deteriorating from the excess weight. At this point I think I'll just cry myself to sleep. Sorry for being such a coward.

Well that is a relief. I'll let my worry go for now. Thanks again Oregondaisy :thumbup:

Thank you thank you thank you...something in my IV...I will ask my doctor about that.

I experienced it for a couple of days at best but there is the rare person that can deal with it for months however I've only met one on the boards that had a long term problem but hers did go away... Thank you. Can you tell me if there is any effective nausea medication that will work immediately post op and during the healing and dietary adjustment period? I had my gallbladder removed in 1976. It was before laparoscopic surgery existed. I had a shockingly painful recovery and recall the nausea was so intense that I would dry heave and wretch in excruciating pain, (since sutured inside and out), from stomach contractions. I have to say (with the exception of child labor), waking up from that surgery was the most painful encounter I've ever had, and the nausea was so severe I thought I'd die, literally. I was in the hospital post op 2 weeks. I think of this and it really causes me great anxiety. :thumbup:

I was wondering if the nausea that many have had following sleeve surgery is a result of anesthesia, revision in stomach size or both? Is this something I should expect for a few days/weeks...post op?

I know this may seem crazy but now that I see how difficult it is to get insurance coverage for WLS, and now that I realize how long a process this will be I feel obliged to gain weight! Now that I have resigned myself to this mindset, I am not desiring the foods that I so crave when trying my best to lose weight. So I think, hmmmm I can damn eat anything now since I benefit the higher my BMI....so what should I eat....and I really haven't desire for anything at all. In any event I make a decision, pizza, sub, whatever it be....but I find that whether I prepare it here at home or get take-out, I am not enjoying it. I think it's time to see a shrink.

If I were not in such dire straits financially I would not hesitate to pay for this surgery out of my own pocket. I fear this is going to be a steep uphill journey. I had hoped for surgery early this summer but with what I am learning, it looks like it may not happen...another reclusive summer in hiding and hating my painfully uncomfortable body.

WDW Luver, You've given me an additional tool. I so appreciate your feedback with this~:wink: Thank you. I was at my heaviest today whilst sitting across from the doctor today (my mother at my side) in his office. With outer clothing layered and loose, boobs and hips were unusually large and heavy. The discussion lasted over an hour (which was great) but I began to think I would not be examined or weighed after all. And then he brought me to the exam room to be weighed and examined...Right after I stepped off the scale, I had to go potty, and UNLOAD! I returned for the rest of the exam. So far so good. But this is only the first step....now I've got a load of tasks to accomplish and then we've got a fight ahead of us in order for me to be approved for the sleeve. God how I pray for a miracle.

I met with the surgeon today for the first time and he weighed me and recorded my weight. I am wondering if I will be weighed again by him at a future date or will this weight be the weight used to submit to insurance co. once he gets all test results in. Anyone know?

That is GREAT:thumbup:, congratulations! I too bought weights to conceal under clothing for my weigh in with a prospective Gastric Sleeve surgeon, tomorrow. My question is however, if the scale I am weighed on is one of those scales that measusre your body mass breakdown in fat wt., Water wt. and muscle wt., will the concealed additional lbs. I have under my clothing even count since they are none of the above, (fat,water,muscle)?

"My surgeon and PCP just had regular scales..." You were fortunate then! I actually weighed in today (a surgeon for Lap Band), with an additional 5lbs under my clothes :laugh: but I realized later that it was one of those scales that you stand on barefoot because the skin contact enables it to breakdown your entire body composition. I wonder if the scale didn't register that bogus 5 lbs and if it did it would not measure as body fat or Water or muscle or would it? Anyone got this figured out? :ohmy: My next appointment is Friday, with a perspective surgeon who is willing to do the Sleeve on me if I qualify! :laugh: Oh God this may indeed mean I will have to actually gain about 7 more lbs damnit!:thumbup:

I'm in NY, my insurance is medicare, I did call medicare to find out that I am able to switch if necessary to a medicare advantage/HMO plan IE...oxford medicare, among others. Today I spoke with someone at NYU's dept of bariatric surgery and was told that I should stick to medicare but be prepared to have a fight to get the sleeve...I was told that I'd need to go on a 3 month medically supervised weight loss plan/diet etc. as one of the requisites under medicare. Another facility told me the exact opposite, that with medicare it is not necessary at all to do that since medicare says it is already implied that an obese person seeking weight loss surgery has tried dieting, etc...Two other NYC facilities told me that Oxford Medicare covers the sleeve IF I qualify. Comorbids also vary according to procedure and insurance specifications. Mine include, "mild sleep apnea" osteoarthritis, and high cholesterol but since I very much prefer having the Sleeve procedure, and it is still considered "experimental" by most, the odds are stacked against me. I have been on the Internet and on the phone so much that my neck is stiff. One facility tells me one thing and another says something contrary!.. In any event, I am relieved to have read this thread since I was feeling sneaky and awful at the notion of gaining lbs in order to BMI qualify. It's sad that the guidelines are so inflexible. I actually feel absolved of any sort of guilt now and will be shopping for those weights used for fishing tomorrow!

Well congratulations it is an important step in the right direction.

What if you had weighed in at a BMI of 35 (with co morbids) in 2000, were under medical treatment (not surgery) for weight loss, lost weight and got down to 150 lbs...and then put the weight back on from 2005-2008? I am now back up to a 35 BMI only older and more disabled from the regain. So would this mean, according to most ins. co's...that I will need to stay obese for a couple of more years in order to qualify for surgery?????!

Hi, I am considering which WL procedure I prefer...Lap Band high on the list. Can you tell me how one would handle nausea with vomiting when your band is not unfilled?

If a request is made to insurance company for the Lap Band procedure and it is approved but before one has the actual surgery one decides to submit a request for approval for the Sleeve instead with a different doctor, will the insurance company consider the change in procedure for approval?

Wow got it! If anyone else is interested for insurance coverage inquiries, the procedure code for the Sleeve Gastrectomy is 43659.

Would anyone here happen to know the Procedure Code for the Vertical Sleeve procedure? I have contacted Oxford Medicare to make inquiry and need the procedure code.

Although I don't know yet if I will be approved, I do have comorbids. Although my BMI is a 35 the weight is stifling my health, livelihood and well being. For the first time in my life I am realizing the ill effects my excess weight is having upon my body, inside and out. I really would like hold out and have the Sleeve Gastrectomy and not have to undergo a revision surgery, which I think would be enivitable if I were to have the band initially. I am still searching facilities and weight loss surgeons in the NY vicinity that do perform the Sleeve surgery to see if possibly medicare or a medicare plan will cover it. Your feedback is very much appreciated. Thank you.

Elisabeth, thanks for sharing your experience. I do have a dilemma here to grapple with. I very much want to get it right the first time. I just don't know how much longer I can hold out, which is why I am continuing to learn as much as I can. I am very glad you were resourceful enough to take care of your needs as you did. I hope to have the privilege to follow your progress. Thanks again.

Thanks I will.