Cautiously (Very Cautiously) Optimistic!

[hope4sleeve 17]

Last year I went through the process for VSG. Though I did not meet the minimum requirements my PCP, and other specialists felt that it would be beneficial for me to have Based on my other medical issues. I was not approved and I lost my appeal.

I gave up and decided I would lose weight on my own, I gained 11 pounds It is a long and boring story but in the end, my body is working against me and having this "tool" could work wonders for me and greatly increase the quality of my life.

After gaining the 11 pounds I decided to see a new surgeon. Part of the issue last year was the coordinator in the surgeons office said there was nothing they could do to help with the appeal. I had several conversations with her which were fruitless, I made several requests to speak with the surgeon or get an appointment with him and I was denied, this is where I gave up.

I did all the pre-op tests again and saw the new surgeon for the second time this week. At this point he had time to review my medical records and become aquainted with my other diseases. He very sincerely looked at me and while shaking his head said there is no reason the insurance should not approve this his exact quote was " you should not have to suffer every day when there is something I can do to help you, your body has been through so much".

He is ready to fight for me. This is not to say that I will get approved by the insurance, but it has given me some reason for hope

[kmwheel 127]

I think having a surgeon and staff who are willing to go to bat for you will make all the difference. I had a very similar thing happen to me, but I did not give up. It took me nearly two years to coordinate, but I ended up going self-pay in Mexico. I sincerely hope that you will get approval and be able to move forward with your life. Getting the sleeve is one of the best decisions I've ever made. The very best one, of course, was marrying my husband, who has always supported me and loved me no matter what! Let us know what happens!

[IsB 209]

It's ridiculous that you have to gain weight so an insurance company will decide to authorize a procedure to help you lose weight.

[hope4sleeve 17]

I think having a surgeon and staff who are willing to go to bat for you will make all the difference. I had a very similar thing happen to me, but I did not give up. It took me nearly two years to coordinate, but I ended up going self-pay in Mexico. I sincerely hope that you will get approval and be able to move forward with your life. Getting the sleeve is one of the best decisions I've ever made. The very best one, of course, was marrying my husband, who has always supported me and loved me no matter what! Let us know what happens!

I am looking into the Mexico option if this does not work, unfortunately my husband is not quite on board. He would rather remortgage the house and get it done in the US. He believes that the doctors who do the surgery in Mexico are very skilled at what they do but possibly not as skilled with my other issues and that makes him nervous. I guess we will hope for the insurance approval and cross that bridge if we come to it.

Thank you for your kind response and words of encouragement. Congrats to you on your surgery...... and for marrying a great guy