Update

[pookie 0]

I sent in my paperwork to see if I qualify on May 25, and I received a letter today stating that they need me to get a sleep study and also need a copy of my medical records regarding my PCOS. I have Kaiser insurance, and I have heard that they are hard to get approval from. I went ahead and scheduled my sleep study for July 2 and after the study I have to make an appointment for three weeks after that. As far as my PCOS, I am kind of confused because all of the information should be in my chart, so I am waiting to hear back from the lady who sent me the letter. I don't know if they need a letter from the doctor or what. Anyways, I supposedly have to get everything squared away by 45 days from now, so I am hoping I have the sleep study results by then. Let's just hope after all of this I get approved.

[JDUB0414 0]

Pookie,

I'm just starting my 6 month weight loss plan for insurance purposes....I know it will be a long a dragged out situation, but I'm excited. It seems like you will be fine once you get those two things in. Were you able to make the sleep apnea test earlier?

Good luck!!!

[Vicki J 0]

Pookie - Where are you from? From what I'm finding out the Kaisers are different as to how they do things. I'm from Northern California and my PCP reverred me and then they scheduled me for an orientation. The next step will be an appointment with Dr. Stiles in bariactrics. They seem to be pretty easy to get through although the process takes 3 - 6 months to get through. They suggest you get a sleep apnea test if you think you have it. Otherwise

[Vicki J 0]

Oops...hit the wrong button. LOL

Anyway, otherwise you don't have to get one. We do have to loose some weight prior to surgery. There is two reasons. One is that they want to make sure you can follow the plan and the other is that it shrinks your liver so that they can move it easier to get to your stomach and so that the insturments will be long enough. At So. San Francisco you will be told how much you have to loose by how you're built. People who carry more abdominal weight will have to loose more. Pear shaped people will have to loose less.

If they gave you a phone number to the bariactric surgery unit, I would call them for any explainations. They required us to get an EKG prior to orientation if we hadn't had one within the last 6 months. I called and told them I had had a full on stress test just a month or so before but was told they couldn't access that. So, I had to get an EKG.

I hope everything goes well for you. Keep in touch.

[pookie 0]

<p>Thanks, the weight management nurse met with the medical director and they agreed that I do have PCOS. To be eligible, however, I need two major medical conditions as a result of my weight. I have bad foot pain and she mentioned that if I have osteoarthritis as a result of my weight that would be considered a major medical condition; however, I had a foot x-ray done today and it came back normal. So, it is looking like my sleep study test will make or break whether I qualify for this procedure. It is scheduled for July 2, that is the earliest they can fit me in. My DH is actually doing it with me because I know he has sleep apnea. I have been bugging him for years to get a study done, and he agreed to do it with me. I really don't think I do have it, but at the same time I know I don't sleep as good as I used to and have started snoring at times, so maybe I do have it. The weight management nurse said that even if I have it just a little, I will qualify. It's pretty sad that I hope I have sleep apnea, huh? If not, I can always file an appeal, but I don't know how that works.</p>

[allwright 0]

Pookie, I had to have all the test done. I called the insurance company and ask what they needed for me to be able to have the band. They gave me a list and I wrote quickly as they talked. I then got a letter from my regular primary physician stating how I would benefit from the surgery. I had been to a neuro for back pain...and ask him if he thought I would benefit from the surgery...of course he did so I ask for a prescription to say he recommended the surgery. I had my dr. to order the test they said I would need. sleep Apnea, EKG, stress test, x-rays, H-pylora, thyroid profile, psych eval, dietician consult, 5 years of my medical records showing the many attempts at weight loss(which replaced the pre-op diet) list of meds....ultrasound to rule out blood clots(I had them in the past from a fall) and diagnosis. I had arthritis, high BP, weak ankles, and back pain.