Hoping to get a "yes" answer.

[FattyCakes 0]

Hi everyone.

I'm glad I found this site.

I see my primary doctor on May 11th and I'm worried she won't submit a referral for me. I don't know why I have so much doubt -- I clearly qualify. Wondering how hard it is to get your doctors to agree with sending a referral.

Edit: So after being on here for hours, I may not qualify as much as I thought. I'm 5'0" and weigh 214 pounds. I would say I'm small frame b/c if I squeeze REAL tight the tips of my fingers overlap. Now, I would also have to have high-blood pressure for TriWest to approve me.

Edited May 2, 2010 by FattyCakes
Update

[palmtreegirl70 1]

Hi there. I, too, was scared to talk to my primary care physician about WLS back in October. When I brought it up, she said she couldn't support me having gastric bypass, but that she was 100% supportive of Lap-Band surgery. She has been one of my biggest supporters in my journey to surgery.

Talk to your doctor...be honest with your reasons and your hopes for not just weight loss for aesthetic value, but for your health.

Good luck to you!

[stargate713 0]

my PCP was a bitch....(but she is anyway) sorry to say. The day I went for my referral she had me in tears...but then she said "I'm still going to write you the referral". By the time I had my follow up appointment with her when I needed to get a letter for my insurance.....you would have thought it was all her idea from the beginning! As it turns out she was clueless about the lab-band proceedure...and I ended up educating HER. Don't let your doctor intimidate you...remember, he or she works for you. You are paying this person for their services.

Edited May 2, 2010 by stargate713

[Nean4488 1]

I didnt even see my primary about it.

[FattyCakes 0]

Don't let your doctor intimidate you...remember, he or she works for you. You are paying this person for their services.

Thank you for that little reminder!

[FattyCakes 0]

I didnt even see my primary about it.

I have TriCare, so I have to. :thumbup:

[FattyCakes 0]

Hi there. I, too, was scared to talk to my primary care physician about WLS back in October. When I brought it up, she said she couldn't support me having gastric bypass, but that she was 100% supportive of Lap-Band® surgery. She has been one of my biggest supporters in my journey to surgery.

Talk to your doctor...be honest with your reasons and your hopes for not just weight loss for aesthetic value, but for your health.

Good luck to you!

Thank you! It's become more about my health since hitting my 30's. Good job on your weight-loss so far!

[elcee 3,341]

My GP refused to refer me so I went to see the surgeon off my own bat! My GP told me that I wasn't fat enough and that Lap Banding is too dangerous as there are lots of complicatons. How about the complications from being FAT!

I am so glad that I had the "guts" to see the surgeon without the referral. I am now banded, normal weight, no longer have high BP and am very happy. If complications arise in the future I will deal with them.

[elcee 3,341]

Fattycakes your BMI is 41.8 - I can't see any reason why you wouldn't qualify.

[FattyCakes 0]

Fattycakes your BMI is 41.8 - I can't see any reason why you wouldn't qualify.

I guess Tricare doesn't go by BMI. You have to be 100 pounds overweight and have.... one of the following diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian syndrome, hypothalamic disorders or severe arthritis of the weight-bearing joints. Hypertension may be the only one I have.

I'm going to a seminar on the 5th, maybe they'll help me get accepted....

[elcee 3,341]

There is no logic to that whatsover. A tall person could be 100lb overweight and have a lower BMI than a short person. At least BMI is a relatively consistent measurement .

I don't profess to understand the US healthcare system and I'm not even going to try!

[FattyCakes 0]

There is no logic to that whatsover. A tall person could be 100lb overweight and have a lower BMI than a short person. At least BMI is a relatively consistent measurement .

I don't profess to understand the US healthcare system and I'm not even going to try!

I know, it doesn't. I think they are in the process of revising their policy or that's what I got from reading other posts last night. I went to Rite Aid and did the little blood pressure test, and it said I was only 124 over something... I don't remember, so that means I don't have high blood pressure.

[gsdosbourne 0]

I know, it doesn't. I think they are in the process of revising their policy or that's what I got from reading other posts last night. I went to Rite Aid and did the little blood pressure test, and it said I was only 124 over something... I don't remember, so that means I don't have high blood pressure.

I think you said that you have tricare. I do too. I was very scared to go to my PCM, I had already been to one already and she told me that I shouldn't do it yet. I have been struggling for 7 years now with my weight, why not yet? So I finally got to a doctor that was very concerned with my weight and how much my back was hurting from my weight and he finally referred me to Portsmouth to the Naval hospital. I wish you the best of luck with everything. I am really looking forward to going to the orientation on Thursday. I am hoping it doesn't take 6 months to surgery.

[Rsilversea 2]

Tricare doesn't make sense. But for those of us who have it, we deal with it. And yes, they are in the process of changing their policy but as with any federal program, who knows when it will take effect. I am 100 pounds overweight with no co-morbidities and am currently waiting on my appeal. I was not measured at my surgeon's office since they have never had to deal with this policy before. They took my word that I was 5" 3" (as have every doctor I've seen in the past 25 years). I was just remeasured at a military medical clinic and found to be 5" 1". That puts me well within Tricare's standards for "morbidly obese" (meaning I qualify) but now I have to wait for the appeal. And yes, they frustrate me (as if you couldn't tell). If you have concerns, talk to your PCM, your surgeon and your Tricare specialist. They will help you out.

[FattyCakes 0]

I think you said that you have tricare. I do too. I was very scared to go to my PCM, I had already been to one already and she told me that I shouldn't do it yet. I have been struggling for 7 years now with my weight, why not yet? So I finally got to a doctor that was very concerned with my weight and how much my back was hurting from my weight and he finally referred me to Portsmouth to the Naval hospital. I wish you the best of luck with everything. I am really looking forward to going to the orientation on Thursday. I am hoping it doesn't take 6 months to surgery.

Thanks. I see my PCM tomorrow. She's all into healthy eating and stuff, so I'm worried she'll tell me that's the ONLY way. I know I can do it that way, I just need this small little tool to help me.

Yes, waiting 6 months would stink. I hope the Naval hospital helps you out.