Advice from the experts please? :-)

[Amie Hickey 2]

For Bre- our surgeon tried to talk my husband out of the DS and go with the sleeve also. We had done all the research and had the same statistics and reasons that you do. He probably isn't TRUELLY against the DS, but it is a more time consuming, intensive procedure! He probably wants to make sure you are well informed. Also, compliance to the massive amounts of specialty Vitamins MUST be a way of life, and so many people don't follow through! Just tell him that after further thought and research, you have decided to go with the DS. as far as the insurience just make sure your employer has the rider. Otherwise, can't help you there as we ended up paying ours ourselves. I just had my surgery Jan 5, 2015. Good luck, and if I can help, let me know

[scstxrn 213]

For people planning to get pregnant after the sleeve who haven't been pregnant before - I don't think I could handle pregnancy at this point.

My pregnancies consisted of morning noon and night sickness for the first 5 months... I think the nausea would have been unbearable were I not able to keep crackers on hand... and at least at this point post sleeve any bread like thing except a tortilla chip causes severe GI distress.

Things I've read says it takes 6 months for your stomach to heal inside... I wouldn't want to repeat the early months of pregnancy for at least a few months after that, and I wouldn't want to deal with the heart burn of the final 3 months for awhile either.

Good luck - you women are braver than I!

[Folly 308]

Hello everyone! :-) This is my first post here. I was recommended to check out this site after posting on OH.

Some info about me: I'm 25 years old, female, 5 feet tall and 263 pounds. I want the DS surgery. So far I've had my surgeon consultation and first dietitian appointment. I have all my other evaluations scheduled in the next month.

My first issue I'm hoping for advice with: I went to my consult adamant that I want the DS surgery. Unfortunately I am NOT good at standing up for myself or disagreeing with doctors. When the surgeon asked what surgery I want, I said DS and he basically said that I do qualify at my BMI, but he would recommend I do the sleeve because I'm young and have a long time ahead of me to deal with the side effects and deficiencies that come with the DS. He said that if I'm not successful I can always have the 2nd part done and convert to a DS. He asked me what I thought about that and because of my shyness I said okay to the sleeve. After coming home and doing even more research, I'm even more adamant that I want the DS for many reasons:

1. I want to lose 120 pounds and KEEP IT OFF. The DS has the best results and least chances of regain, which I have a long history of. It looks like the average weight I can expect to lose with the DS is at least 90-100 pounds, while with the gastric sleeve I would probably only lose about 60. While losing 60 pounds would of course be wonderful, I would rather have the surgery that can take me to my total goal.

2. I have heard that the DS lets you eat the most normally.

3. I want to have the best possible surgery now, one time. I don't want to have to go through surgery again.

4. On the same note, getting a second surgery approved will be extremely difficult and probably denied, so if I don't lose enough weight or if I gain a lot back, I will have to self pay which I cannot afford.

5. Taking Vitamins and committing to blood work and follow-ups is not a problem to me. I look at it this way - I can have this surgery, take daily Vitamins and go to the doctor regularly to check levels; OR, I can not have the surgery and continue to have weight issues, take daily medicines for co-morbidities and go to the doctor regularly for my health problems.

So, I plan to call the office today and let them know I have changed my mind and want the DS. I'm worried that my Dr. will be offended or something, because I have known a lot of doctors that can be arrogant and hate being questioned. At my consultation he was extremely nice and didn't give me any indication that he was that type of person, but I'm still nervous!

So my question is: what do you recommend I say to the doctor to support why I disagree and want the DS? If for some reason he refuses to do it for me, can I transfer the evaluations I've done to another practice/surgeon without having to start all over?

Next issue: I had my first dietitian appointment on Monday and I'm very worried that he doesn't know and understand my insurance requirements. My Cigna plan requires 3 months (so 4 consecutive monthly appointments) of a physician or dietitian supervised weight loss program. When he mentioned I would be seeing him one more time, I told him that my insurance requires 3 months of visits. He went and got a packet with a description of the requirements for all the different insurance companies and said I was right about that. He then said that I could just see my PCP for some of the appointments. I said I want to do the 4 appointments all with him because it is supposed to be with the same doctor and I do not want to do ANYTHING that could get me denied. He said that was fine and we could meet monthly. Another concern of mine is that my monthly weight loss program requires documentation of my weight, dietary program and physical activity. He recorded my weight and taught me about the 1200 calorie diet plan he is prescribing for me and gave me papers with all the details and recommendations, and he taught me about the Protein and other diet requirements for after my surgery. The appointment was very informative and helpful, but we never touched on a physical activity plan at all. Maybe I am being paranoid, but I'm very worried about problems with insurance after the horror stories I've seen in the forums. I want to make sure every detail is perfectly followed.

So what I was thinking of doing is seeing my PCP every month on top of the dietitian appointments, just in case it's not done correctly by the dietitian. My PCP is great and strongly supports my surgery. I'm positive he would do the weight loss program with me and follow all my requirements. Do you guys think this is a good idea? Could seeing both the doctor and dietitian at the same time for the weight loss program possibly be a problem for any reason you can think of?

Okay, now one more topic! I am really sorry for this incredibly long post, I just have so many questions and concerns.

I have checked and confirmed my bariatric surgery coverage in a few ways. I call the Cigna customer service line twice to confirm that my specific plan covers weight loss surgery and both times was told yes, it is covered. But I just don't trust the people on the phone to always be correct. I also signed into my account on the Cigna website and used the cost estimator for my plan, and it said that I can expect to pay a $300 co-pay for bariatric surgery. Lastly I read the coverage booklet posted by the employer providing the plan. The only mention of bariatric surgery is in the exclusions section, but this is what it says: "Payment for the following is specifically excluded from this plan: .... • for medical and surgical services intended primarily for the treatment or control of obesity. However, treatment of clinically severe obesity, as defined by the body mass index (BMI) classifications of the National Heart, Lung and Blood Institute guideline is covered if the services are demonstrated, through peer-reviewed medical literature and scientifically based guidelines, to be safe and effective for treatment of the condition."

Is it just me or is that a bit confusing? I'm thinking this means that the plan does not cover any obesity treatment for those who do not have "clinically severe obesity". A BMI over 40 or between 35-39.9 with co-morbidities is defined as clinically severe obesity. So I definitely meet this requirement with a BMI of about 52. I'm also thinking that the last part about treatments that are peer reviewed and scientifically shown to be safe and effective means that the 5 procedures covered in the Cigna bariatric surgery coverage policy are all covered (gastric Bypass, gastric banding, RNY, vertical banded gastroplasty and BPD/DS for those with BMI over 50).

I just find it odd that weight loss surgery is ONLY mentioned in the exclusions section. This booklet may be outdated - the "effective date" in the beginning is February 2009.

Well, if you made it through this post, I appreciate it and applaud your patience! :-) Thanks so much for any advice or insights you can provide.

I am seeing this thought repeated over and over by people who are doing research and want the most effective surgery. What seems to be lost in translation is that no matter what surgery you have, eventually you will reach a point where you have to work at it to keep momentum going. Surgery is a tempory fix, an effective separation from your addiction, a marvelous tool but eventually you have to deal with all of it. People much larger than I was have had great success because they deal with the triggers and issues that caused the obesity. They are mindful of what they put in their bodies. They exercise. They take vitamins....it's work we all have to do. No easy fixes.

.

[LPSteven 22]

what is great that you are really focused on what you want to do. Personally Lap band I did 6 plus years ago as well my wife and will never look back. Amazed and we have been successful for over 5 years now. Insurance did cover the lap band and kinda likes lap band a little more since the risk aren't as much with the side affects. We haven't seen our doctor in almost 4 years now, once in a while he will give us a call just to see how is number one success couple is doing, but other than that we both did the nutrition program 4-6 months prior to surgery. I really like the fact that with lap band , it can always be removed and non of my internal organs was altered in any way. Now , don't get me wrong my mother has the Sleeve , yet her situation (age, weight, health) did require her ideally to work with the sleeve.