3 Mos Insurance Required Program?

[Aero Train 0]

Hi All,

I have been lurking here for awhile but today is the first time I'm posting. I started thinking about WLS surgery last summer, I officially started the process last fall. I have everything in order except for my psych eval and the 3mos interdisciplinary program required by my insurance (Aetna). I am 47 years young and have been 100+ lbs overweight most of my adult life. I have been successful losing weight but not in keeping it off. I have struggled and have come to a point where I need to make a change. I'm sure a lot of you relate to the process of becoming ready. My problem is that I'm totally frustrated in the program that I have enrolled in to satisfy the insurance requirement. I am in week 3 of the 12 week program. After changing everything I am doing over the last 3-4 weeks... eating better, planning meals & exercise, shopping, cooking, finding alternatives to handle stress ( which I have a lot of right now), all I seem to get is negative feedback from the dietician that a week ago seemed pro-baby steps and making small, permanent changes. This is not an easy process but I am doing astronomically better than I was. I want to quit the program and start over with a 6-mos program with my PCP who is incredibly supportive or going self pay. I need your support/advice... am I over-reacting? Should I just do what I have to to get through the next 9 weeks or should I seek out a more supportive route regardless of the financial implications?

I am at my wits end but I totally respect your opinions.

Thanks for listening!

[melissa45154 2]

I have Aetna as well. If I'm not mistaken. You only need a consultation with a dietician, and the rest is physician supervised which means your pcp. I had my surgery on Dec. 28. In November we discovered that while my doc was covered for surgery (i was using my surgeon for my monthly visits) the hospitals he was affliliated with was not. I had to switch surgeons 1 1/2 monts prior to surgery. My new surgeon just wrote a letter stating that they were taking over my care. This goes in the file. That way you don't have to start the program completely over. I would look into doing something like that. Also, were you assigned a case manager to help your through? Mine was wonderful at answering questions and helping me out. Just some thoughts.....

[Aero Train 0]

Melissa,

That is a great idea. I will call my patient advocate tomorrow. This is not a decision that I have made lightly and I am not looking for a fast track to surgery, I just want a supportive, positive process... maybe that is the optimist in me. Did you do the physician supervised program? I was told that would be 6mos vs 3mos with the interdisciplinary plan ( dietician, pyschologist, exercise specialist <can't think of the right term> ).

How have you been feeling since surgery? Have you been planning this for awhile?

Grace

[melissa45154 2]

I didn't take this lightly either. It took me 2 years to finally decide to take the step. I was lucky. I did the 6 month program in 3 months. Basically, my husband's employer is such an advocate of the surgery that in Feb 2011 they customized the Aetna program. Basically, they did away with the 2 year weight requirement, and took the 6 month program and cut it down to 3 months. I was very very lucky.

I'm doing ok now. Honestly, it was difficult the first couple of weeks. I have had 9 abdominal surgeries and have a lot of mesh in there. They docs had to peel some of it away and cut out some scar tissue. It was a little more difficult surgery. I also had a lot of trouble getting Water down (resulted in severe dehydration), but I used this site as a tool and found lots of people had problems with this. What ended up working for me was the sugar free popsicles, ice ice and ice (i hated before surgery), chicken broth, and putting a wedge of lemon in my Water made it go down better. I also couldn't get any Protein shakes down. I bought tons of them, but they all made me vomit. As a result I was very weak and not feeling well. Once I was allowed to eat scrambled eggs and such it was 180 degree turn overnight.....literally. I am 4 weeks post op tomorrow, and I'm feeling so well. I honestly was regretting it the first couple of weeks with all the problems, but now I'm glad. I am still stuggling mentally. I thought I had a handle on my addiction with food, but now I really do understand that addiction. I am taking it day by day and learning more and more. The best thing was I had to take my son on a cubscout trip this past Saturday. All my jeans were too big. I was wearing a size 20W. I went to Kohls to get an outfit to wear. I grabbled the 18W and 1x stuff.....IT WAS TOO BIG. I am officially in regular size clothes again in less than 4 weeks.....I'm just amazed. I sat in the try on room crying. Now, I'm starting to exercise and am happier. My kids are loving it too, b/c I'm starting to do stuff with them. I still tire out, but before surgery I didn't do anything, and now I am.......Hope this helps some.

[melissa45154 2]

also, i didn't really have a pre op diet.....just liquids 2 days before. so this weight loss really is all post op....the pounds do not do it justice. i've lost so many inches....i really suggest measuring yourself. I even measured my neck. i've lost 1 1/2 inches off my neck....crazy stuff

[Aero Train 0]

It helps tons! You are so brave and I admire that you hung in there until things started to turn around! This site is an awesome resource because of people like you that share. Thank you so much!

[Steve Demko 8]

Awesome!

[melissa45154 2]

You are welcome.....Thank you for your kind words and good luck to you

[fattymcfatterson 107]

Melissa- Who was your surgeon? 2 day pre op diet???? That sounds good!!!!! I Am looking at James Davidson in Dallas...

[Dooter 1,457]

Melissa- Who was your surgeon? 2 day pre op diet???? That sounds good!!!!! I Am looking at James Davidson in Dallas... :smile1:

Your pre op diet depends on yer belly. Some people don't have to do but a day or two. I have two weeks staring down at me! Gotta get that liver out of the docs path! There are a couple folks going to my same surgeon who don't have to do two weeks. So...it all depends on where you carry your weight.

[melissa45154 2]

Yeah, my doc does different pre-op diets for different people. I didn't even find out what my pre-op diet was until a couple of weeks before surgery. My doctor was Dr. Hamn out of Presbyterian Plano. Presby Plano is a hospital of excellence and one of the few that my insurance would cover. They were really great. He has actually trained other doctors in the Dallas area on wls. You stay in the hospital for 2 days with him. Also, while I only had a couple of days of pre-op. He requires all his patients to do 5 weeks of full liquids after surgery and then start the progression to soft, diced and regular foods. That I couldn't do. I did it for about 3 weeks, but finally had to start eating soft/mushie foods. I have a lot more energy since I started doing that. I just want to be careful. I will be 5 weeks post op next Wed. so not much longer. Good luck to you.