PinkFish

I just got back from the hospital and I feel somewhat accomplished. I went in this morning and had bloodwork done, an EKG, chest x-ray, venous duplex, RUQ ultrasound, and the UGI test done. I finally managed to attend a Nutrition class and have my first one-on-one visit set-up and know all I need to know to make it to my surgery. I'm still waiting to hear when my upper endoscopy will be, a date for my psych eval, and to have my sleep study and pulmonary function test on October 8th. Once those tests are completed I will only have nutrition classes ahead of me and to achieve my pre-op weight loss goal of 30lbs. I am so excited to be on my way, though it seems to be taking suuuch a long time!

My consult on July 30th went pretty well, though I did feel that the doctor was kind of pushing gastric bypass. His reasoning was that patients see better results from the bypass than they do with the band. I told him that I wanted the band and I would never get gastric bypass. At the end of the appointment I was given a list of things to do before they would request authorization from my insurance company. I was told that my insurance requires patients to have 6 months of nutrition classes before surgery and they only pay for 3 months, which irritates me. It will be at least January by the time I am banded, if I even get approved. I was really hoping it would be sooner. Back in May I attended a seminar for the program that denied me and the new program is making me attend theirs as well, which seems a little pointless to me, since I have met the doctors and nurses and am pretty well informed about the procedure already. I was planning to attend the August seminar, but so many different things made it so I was unable. And the nutrition classes are on Fridays, which I usually work, I have been scheduled for two so far and have had to reschedule. It seems that I won't be able to get any pre-op things out of the way until I attend the seminar and at least one nutrition class. The next seminar is in September. This is all making me so impatient and frustrated. I want to start working on the new me already!

So I may have to pay for 10% of the surgery out of pocket, but I got health insurance through my employer now, which covers the procedure! I immediately called my PCP and had her put a new referral through to a different program and just a couple days later the office called me to set up an appointment! Yesterday I received a bunch of questionnaires to fill out and my consult is on the 30th! I'm glad they got me in so quickly, I'm so ready for this to get going! I'm having issues with my husband's lack of support for all of this. When I told him about my consult next week he said I was wasting my time and being stupid. He said the same when I was filling out my paperwork. I'm not sure what his problem is, but I would think that he would be happy for me. I hope he comes around. Anyone reading this have the same type of problem?

I went away for vacation last week and when I got home I found a denial letter sitting in my mailbox. Strangely, it was from the WLS program that I was going through and not my insurance company. Apparently after researching my case the nurses didn't find any qualifying co-morbid conditions. My doctor had documented severe joint pain and severe psychological, but apparently those don't count. The letter stated that, because they are denying me, my account was being deactivated. They wished me luck with my weight loss and that was it. A little harsh if you ask me. My insurance only covers WLS if you have a BMI >35 AND two co-morbidities. Doesn't matter that I have a a BMI of 47. Ugh. Coincidentally the next day I got a letter stating that I was no longer eligible for health insurance through them. Yesterday I called HR at work and finally signed up for health insurance there. I'm wondering if there's a waiting period of any kind, before I can use the insurance. And I need to find out how much of the procedure and visits would be covered, etc. I work at a local hospital, which has a bariatric surgery program, but I wanted to avoid having anything done within the same network, to keep it all discreet. But now with this health insurance, a higher percentage of the procedure and visits will be covered if I stay within the network. Enough rambling for today, I need to get making some phone calls!

I'm so irritated! I saw my PCP back in May and she put through a referral for the lap-band®. I got a letter in the mail in early June, instructing me to fill out an online questionnaire for the program, which I did right away. Just now I received a letter from the program saying that my insurance requires me to have a BMI greater than 40 and at least TWO co-morbidities. My BMI is 47 and my PCP documented that I have joint pain and psychological effects from being overweight, but I guess neither of those two issues count, because I was denied. One thing that irritates me about this is that the speaker at the lap-band® seminar said that the social workers in the program will work with you in any way possible to come up with ways to get you approved, yet the denial letter stated that my "account" was being deactivated and basically good luck losing weight without us! Thanks a lot.:thumbup: Anything I read about co-morbids usually says "Sleep apnea, hypertension, diabetes, etc.." but it never gives any ideas as to what the "etc" could be. I'm so upset that I was denied and it makes my weight loss goals seem impossible to reach now. I feel like giving up, but I can't. I don't know where to go from here or if I should even bother with WLS anymore. Any advice would be greatly appreciated.

I am going insane waiting to find out the next step of this process! I attended a lap-band seminar on May 18th, and my PCP put in a referral for the surgery the next week. A couple weeks later I received some paperwork in the mail, instructing me to fill out an online questionnaire. I haven't heard anything since! I'm dying to get things moving. Even though I've only just begun acting on the plans, I've been researching lap-band for over a year, and have definitely decided that I need this tool! Well, just had to vent! :smile:

I have been researching lap-band for about a year now.. and attended a seminar last week. I called my PCP to get a referral for the surgery, but the soonest they could see me was August, which is insane, so I am going this Friday to a different doctor (who will be my new PCP) who also sees my mother. I am pretty sure I won't have a problem getting a referral from her, as my BMI is around 47, but I am embarassed and nervous about discussing wanting the surgery with a doctor. Did anyone have any issues discussing weight loss surgery with their doctors? Also, my insurance requires you to have a BMI >40 AND two co-morbids to qualify for the surgery. I don't have any problems documented in my medical records, but I have severe foot, knee, and back pain, which I'm sure is related to my being obese. Will this count? At the seminar I attened, the speaker mentioned GERD over and over again... does this also count? I really want to qualify for this surgery and as soon as possible! Any advice would be greatly appreciated! :tongue2: