Sleevie WonderLand 41 Posted June 16, 2011 I'm going through alot of emotions right now because this surgery thing isnt looking so definite for me. According to my doc, I'm 100 pounds overweight, but according to the BMI calculator and Empire Blue Cross Blue Shield (EPO), I'm not big enough to qualify for VSG. I dont quite meet the 40 requirement and because I have no co-morbidities (blood tests show that I'm "pre-diabetic", I'm not a viable candidate, unless i'm slowly dying in my sleep. So now in addition to world peace, I have to pray that my sleep apnea study will be so horrible that I'll qualify for surgery. I'm pissed off because the whole point of losing this weight is to get more healthy, but yet the insurance co isnt willing to let me have access to this tool that has proven to be the best method for someone like me to get the weight off and possibly keep it off for a long time. So now after 2 years of retraining my fat brain to make healthier choices (which helped me to lose a little weight, but nothing significant) I have to go back to eating junk and lots of crap so that in six months time I can have a 40+ BMI and therefore qualify for surgery. I dont go for my apnea consult until July 5th; they will then schedule the actual study which I hope will be sometime soon after. I've only been on this Quest for WLS for about a six weeks, but already Im tired and getting increasingly discouraged. Anyone have any advice? Apnea tips/tricks that'll help qualify me (lol)? Suggestions? Share this post Link to post Share on other sites
mnbsleeve 87 Posted June 16, 2011 Hi Bee, so sorry to hear about all the run around! I had a very similar experience. I know not everyone has this option, and I'm very fortunate to have it: after a great let down, I had a heart to heart with my husband and we decided to finance it. I just could not believe the craziness of the insurance crap. I am 48 years old and frankly I just did not want to waste more time. As soon as I decided this, I saw my surgeon and three weeks later I had my surgery! That was 6/6!!!! I'm recouperating well and moving on. When I think that at this point I would still be running around jumping throught hoops, I feel so fortunate I was able to do this. Hopefully you will have the "crappiest" results possible on your sleep test and the insurance will finally cover you!!! Just don't give up!!!!!!! Worst case, you could post here and ask what other options people used for financing/self pay. Best of luck. I'm rooting for you!!!!! I'm going through alot of emotions right now because this surgery thing isnt looking so definite for me. According to my doc, I'm 100 pounds overweight, but according to the BMI calculator and Empire Blue Cross Blue Shield (EPO), I'm not big enough to qualify for VSG. I dont quite meet the 40 requirement and because I have no co-morbidities (blood tests show that I'm "pre-diabetic", I'm not a viable candidate, unless i'm slowly dying in my sleep. So now in addition to world peace, I have to pray that my sleep apnea study will be so horrible that I'll qualify for surgery. I'm pissed off because the whole point of losing this weight is to get more healthy, but yet the insurance co isnt willing to let me have access to this tool that has proven to be the best method for someone like me to get the weight off and possibly keep it off for a long time. So now after 2 years of retraining my fat brain to make healthier choices (which helped me to lose a little weight, but nothing significant) I have to go back to eating junk and lots of crap so that in six months time I can have a 40+ BMI and therefore qualify for surgery. I dont go for my apnea consult until July 5th; they will then schedule the actual study which I hope will be sometime soon after. I've only been on this Quest for WLS for about a six weeks, but already Im tired and getting increasingly discouraged. Anyone have any advice? Apnea tips/tricks that'll help qualify me (lol)? Suggestions? Share this post Link to post Share on other sites
june13sleever 223 Posted June 16, 2011 I paid for it. Insurance didn't cover it even if I was approved. Some companies don't include it to keep costs down, And what would happen if all the fat people in the world stopped eating Mcdonald's and corn based products. No one wants us to be healthy. I financed through Care Credit. Zero percent for 18 months. Oh well. I will somehow make it work. Share this post Link to post Share on other sites
Jax 2 Posted June 16, 2011 I was also self-pay...first with the band and now the VSG. I think by self-paying, it has really helped me focus about making this lifestyle change. I also hope you have crappy results with the test! Share this post Link to post Share on other sites
Sleevie WonderLand 41 Posted June 16, 2011 If it were an option for me, I'd be on the first thing smoking to Mexico. Unfortunately, we're still trying to recover from my husband being laid off, losing our home, and everything else the rest of our country is going through. Our credit score is probably lower than my BMI. I'll still research it some more, gotta resesarch all options... Share this post Link to post Share on other sites
Heatherr 149 Posted June 17, 2011 If you're that close....er.....get weighed again....and maybe have some ankle weights or arm weights hidden under your long sleeve shirt that you have to wear because you're so cold....and.....well....because you're so cold, you may have to wear leggings under your heavy pants and an oversized thick sweatshirt.....and that fashionable medallion necklace you love so much...you know...the one with the 4 pound medallion on it. 2 Sleevie WonderLand and JourneyOfAFatKid reacted to this Share this post Link to post Share on other sites
Heatherr 149 Posted June 17, 2011 ...and the keys in your pocket.....you know the one that has the 25 keys on it for the office building. Share this post Link to post Share on other sites
thinoneday 445 Posted June 17, 2011 Hate to be a downer here but this is happening for a reason. Maybe this isn't your year for surgery. . . with all the problems you listed with hubbie down and out, house lost, etc maybe realistically this isn't the time for you to have this surgery. . . maybe you need to look into something else for now. . . start saving a little here and there and when everything has leveled out then you could try again and get it done. Just my suggestion Share this post Link to post Share on other sites
Anakin Jay 39 Posted June 17, 2011 Hate to be a downer here but this is happening for a reason. Maybe this isn't your year for surgery. . . with all the problems you listed with hubbie down and out, house lost, etc maybe realistically this isn't the time for you to have this surgery. . . maybe you need to look into something else for now. . . start saving a little here and there and when everything has leveled out then you could try again and get it done. Just my suggestion I kind of disagree... with so many things going wrong in life, this would be an easy time to start turning to food for comfort. What better time to limit the amount of food you can actually eat? *especially* if insurance will cover it. Plus eating less = less money wasted on food. I know right now I can eat a whole large pizza for a meal, post-sleeve I expect to only be able to eat a single slice, making that same pizza last for days. Share this post Link to post Share on other sites
StacyS 20 Posted June 17, 2011 Alright, alright... listen to what Heatherr said!! Put on some ankle weights at 5lbs each!! That will add 10lbs w/out having to lose it later! I was in the same boat you are in and I decided to happily put the weight on and gained 25lbs to qualify for surgery!! I wish I had thought of the weights before hand but I didnt and boy did things slow me down at 25lbs heavier! So, my advice to you is to put on the ankle weights and step on the scale again. Then, when you have your surgery, the Dr will think you magically dropped those 10lbs during the pre-op diet!! I couldnt self pay either. It wasnt an option!! So, I had to gain the weight. It was fun doing it, but it really took a toll on my body! Share this post Link to post Share on other sites
Sleevie WonderLand 41 Posted June 17, 2011 @Thinoneday.... I soooo deserve this surgery right now, and if I can have it done at little to no cost, why shouldnt I? It's the light at the end of the tunnel for me. So I too disagree with you, but I appreciate you sharing your suggestion. Hate to be a downer here but this is happening for a reason. Maybe this isn't your year for surgery. . . with all the problems you listed with hubbie down and out, house lost, etc maybe realistically this isn't the time for you to have this surgery. . . maybe you need to look into something else for now. . . start saving a little here and there and when everything has leveled out then you could try again and get it done. Just my suggestion Share this post Link to post Share on other sites
singand_dance 8 Posted June 17, 2011 How close is your BMI? How tall are you? If you're an inch shorter at the same weight, your BMI is higher. Share this post Link to post Share on other sites
weho 103 Posted June 17, 2011 Before insurance approved my surgery for high blood pressure, I thought my approval would come down to the sleep apnea diagnosis. I was confiding in a doctor that I work with about this and he "suggested" that I go into the sleep study sleep deprived. He basically told me to stay up the night before the study. I got notification of insurance approval before my sleep study so I just went into it normally (yes, I still had to do the stupid thing). I am sorry that you are going through this! I really wish more insurance plans would be more liberal concerning weight loss surgery. I am already off of my blood pressure pills (one week after surgery!) And I think of all of the stuff that I am heading off by living a healthier life style: heart attack (dad), stroke (mom), diabetes (sister), and so on. Don't give up. I was kind of in your boat...if insurance didn't approve me, there was no other option. Share this post Link to post Share on other sites
Sleevie WonderLand 41 Posted June 17, 2011 Thanks a bunch Holly. I was totally wondering if being sleep deprived would work in my favor. My husband actually suggested it (everyone has these good sneaky ideas!) and it is definitely a part of my evil VSG plan *insert villain laff here* Before insurance approved my surgery for high blood pressure, I thought my approval would come down to the sleep apnea diagnosis. I was confiding in a doctor that I work with about this and he "suggested" that I go into the sleep study sleep deprived. He basically told me to stay up the night before the study. I got notification of insurance approval before my sleep study so I just went into it normally (yes, I still had to do the stupid thing). I am sorry that you are going through this! I really wish more insurance plans would be more liberal concerning weight loss surgery. I am already off of my blood pressure pills (one week after surgery!) And I think of all of the stuff that I am heading off by living a healthier life style: heart attack (dad), stroke (mom), diabetes (sister), and so on. Don't give up. I was kind of in your boat...if insurance didn't approve me, there was no other option. Share this post Link to post Share on other sites
Sleevie WonderLand 41 Posted June 17, 2011 Oh, and congrats on the no-more-blood-pressure-med status! That's so awesome! Before insurance approved my surgery for high blood pressure, I thought my approval would come down to the sleep apnea diagnosis. I was confiding in a doctor that I work with about this and he "suggested" that I go into the sleep study sleep deprived. He basically told me to stay up the night before the study. I got notification of insurance approval before my sleep study so I just went into it normally (yes, I still had to do the stupid thing). I am sorry that you are going through this! I really wish more insurance plans would be more liberal concerning weight loss surgery. I am already off of my blood pressure pills (one week after surgery!) And I think of all of the stuff that I am heading off by living a healthier life style: heart attack (dad), stroke (mom), diabetes (sister), and so on. Don't give up. I was kind of in your boat...if insurance didn't approve me, there was no other option. Share this post Link to post Share on other sites