PCP Visit To Discuss WLS

[DivaSoBlessed 97]

I finally decided to pay a visit to my PCP to discuss me having WLS. I am sooooo nervous! I have only been with this doctor a few years and although he is all about getting physically fit and being healthy I don't know what his thoughts are about having surgery. I started feeling unsure about this appointment and I thought about canceling. I thought that in order to prove my attempts at weight loss I would have to hunt down old medical records from previous doctors. I don't know why I did this but last night I came across a couple of boxes that have been in my closet for almost 3 years. Low and behold..... I found old receipts from LA Weight Loss that closed its doors four months after my husband paid for the program in full. I also found old food diaries, old appointments from a weight loss program that I attended back in 2004 when I first attempted to have the surgery, as well as old ER discharge papers from when I had complications due to my PCOS. This could have been nothing but God because I have not gone into this closet in quite some time. My appointment is within the next few days. I am wondering is there anything that I should mention to him or ask him about specifically in terms of discussing my wanting this surgery? I have PPO so I don't technically think that I even had to pay a visit to him but I chose to anyway. Any advice you can give would be much appreciated. Thanks In Advance.

[animallover1247 249]

I wish you luck! I've had some awful experiences. My PCP refused to supervise me and i have diabetes, high blood pressure and sleep apnea.. I think it had to do with the fact he had never done and it didn't know what the h*** he was doing. So i had to find another PCP.

Then last week i had my psych eval and the psychiatrist, who was morbidly obese herself, was obviously against the surgery and said she would do it herself if it wasn't so "dangerous and risky."

However, from reading these forums I think the overall consensus is most people did not have any issues with their PCP.

If he seems to be reluctant to supervise you or even refuses, just ask him why. Besides the only thing he really has to do is talk to you about diet, exercise, nutrition, etc. and complete the documentation.

[DivaSoBlessed 97]

@@animallover1247

Thank you for responding. I don't think that BCBS requires the six month supervised diet anymore but I am praying that he is on board with me wanting to have the surgery. Sounds like you made the right choice in choosing another PCP and as for your psychiatrist it almost sounds as if she was trying to scare you out of doing the surgery. As long as she sent you an approval status for your surgery I would pay her no mind. Congratulations on getting this far into your journey and I am wishing you a much better experience from here on out. Lets keep in touch to see how you are doing with your progress and I'll update you on mine. I knew going into this that there would be some opposition but I am ready to fight through it all. As I sat going through old documents from surgeries, emergency room visits, wls dietitian appointments, I counted that I attempted my journey in 2004 and was defeated by change in insurance and doctors not being very helpful. Today is a new day and I am fighting for it. I'm not taking NO for an answer.

[shriner37 249]

I think a lot of challenges folks have with their PCPs is that the regular doctors don't have a whole lot of experience with WLS patients. My PCP has been a friend since his Med school days and he's been in practice for 25+ years. When I consulted with him about my upcoming surgery he mentioned that he had one other patient who had WLS. He was supportive but I actually think I educated him more on the surgery and process than he did me. I'm not sure he was even aware of the sleeve gastrectomy procedure before I brought it up to him.

Keep in mind that a PCP is basically a generalist; they have to know a reasonable amount about a lot of different medical issues. They are trained to refer to specialists for detailed diagnosis and treatment. Weight loss has it's own specialty - bariatrics. A smart PCP will refer an obese patient to a good bariatrician just like they would make an apporpriate referral to a gastroenterologist, oncologist or other specialist. Unfortunately too many PCPs abide by the old "eat less and you'll lose weight" mentality and don't recognize that bariatrics is a valid specialty practice unto itself.

[Kitty112415 5]

My doctor was very good when I first went in to talk to her about it. She literally went over every option available to me from different weight loss drugs to all the different surgeries. She was concerned that I know all options before making a final decision.

She was very supportive throughout the whole process and when I went to her last week for my medical clearance she told me with a wink that now I was going to be one of those skinny b**ches she hates! Lol

My surgery is tomorrow, can't wait!!!

[WorkinOnMe 596]

My PCP was actually the one to suggest WLS to me. I had diabetes (uncontrolled), high blood pressure, high cholesterol, and sleep apnea. I also have BCBS ... call and ask them to email you the coverage and requirements for medically necessary WLS under your plan. This will help you prepare what you need for your PCP and make sure you have any other documents you need. My PCP supervised all my attempts over the years so I didn't need to prove that, but she has also been my Doc for almost 10 years.

My other suggestions is to ask questions .... even if your PCP can't answer them right away, it shows two things: 1. You are genuinely interested in knowing all the positives/negatives that might come up. 2. You are human and have concerns or questions. I also think it helps a PCP to see that they might need to brush up on the process if they don't know the answers. In general, it opens a dialog with you and the PCP to allow them to remain a part of the process.

Best of luck!

[The Candidate 3,215]

I had done a lot of research online as to what the requirements entailed, so after verifying that my insurance covered wls, I also made an appointment with my PCP. I had it my head that I would need a formal referral from him to proceed.

I went in with talking points firmly outlined in my head, and an unshakable resolve that I wasn't walking out of there without a referral in my hand, come what may.

Turns out I didn't even need one. He just gave me a phone number to call, and that started the whole ball rolling. And he couldn't have been more supportive. Seeing as you will be going to your PCP after surgery for any routine or surgery related issues, it's very important that you know where they stand on the subject of wls. Had he not been in my corner, I would have immediately requested another PCP. My life depended on it, as I felt, and still feel, that without the surgery I already had one foot in a premature grave.

Don't be afraid to fight for your right to a healthy life!

[DivaSoBlessed 97]

I think a lot of challenges folks have with their PCPs is that the regular doctors don't have a whole lot of experience with WLS patients. My PCP has been a friend since his Med school days and he's been in practice for 25+ years. When I consulted with him about my upcoming surgery he mentioned that he had one other patient who had WLS. He was supportive but I actually think I educated him more on the surgery and process than he did me. I'm not sure he was even aware of the sleeve gastrectomy procedure before I brought it up to him.

Keep in mind that a PCP is basically a generalist; they have to know a reasonable amount about a lot of different medical issues. They are trained to refer to specialists for detailed diagnosis and treatment. Weight loss has it's own specialty - bariatrics. A smart PCP will refer an obese patient to a good bariatrician just like they would make an apporpriate referral to a gastroenterologist, oncologist or other specialist. Unfortunately too many PCPs abide by the old "eat less and you'll lose weight" mentality and don't recognize that bariatrics is a valid specialty practice unto itself.

Hello @@shriner37,

I agree with that a lot of PCP's are generalists and may not have a lot of knowledge on a specialty such as bariatric surgery. I found a YouTube video of an interview that my doctor did for the hospital that he is affiliated with and his main points were about overall general health and fitness which he is into and has previously advised me to do. The problem is that I don't think that he is aware at the severity of me having PCOS. It doesn't matter how long I exercise and attrmpt to eat clean the weight that I lose always returns and more. I suffer daily from many ailments due to having this condition and from my research one of the best alternatives to effectively dealing with PCOS, high blood pressure, and pre-diabetes is gaving this WLS. I decided that I wanted to do the sleeve because I have seen that there are a lot of people who are having to go back in for revisions due to complications and outside of that there is too much maintenance with fills that I just don't want to deal with. I am also aware of the risks associated with getting the sleeve as well. I am going in knowing that he is either going to be supportive of my choice or that he may not be but I am not leaving his office until I get a definitive okay from him. Thank you so much for shedding some light on the situation because it helps me to remember some key points going in. I really appreciate it.

[DivaSoBlessed 97]

My doctor was very good when I first went in to talk to her about it. She literally went over every option available to me from different weight loss drugs to all the different surgeries. She was concerned that I know all options before making a final decision.

She was very supportive throughout the whole process and when I went to her last week for my medical clearance she told me with a wink that now I was going to be one of those skinny b**ches she hates! Lol

My surgery is tomorrow, can't wait!!!

Hi @@Kitty112415

First off Yay!!!!! Congratulations on your surgery. I am so excited for you. Please do keep us updated on your progress. I am praying that my doctor will be as supportive. It definitely helps when you are trying to go through the process. I am still a bit nervous but this is my life on the line so I am going in well prepared. I appreciate your response.

[DivaSoBlessed 97]

My PCP was actually the one to suggest WLS to me. I had diabetes (uncontrolled), high blood pressure, high cholesterol, and sleep apnea. I also have BCBS ... call and ask them to email you the coverage and requirements for medically necessary WLS under your plan. This will help you prepare what you need for your PCP and make sure you have any other documents you need. My PCP supervised all my attempts over the years so I didn't need to prove that, but she has also been my Doc for almost 10 years.

My other suggestions is to ask questions .... even if your PCP can't answer them right away, it shows two things: 1. You are genuinely interested in knowing all the positives/negatives that might come up. 2. You are human and have concerns or questions. I also think it helps a PCP to see that they might need to brush up on the process if they don't know the answers. In general, it opens a dialog with you and the PCP to allow them to remain a part of the process.

Best of luck!

Hi @@WorkinOnMe

These are great suggestions. I thought that my appointment was tomorrow but its actually today so I am going to give BCBS a call asap. I am prepared with many questions and I almost feel like I need to write them down so that I don't forget anything. I also have paperwork for previous attempts at weight loss dating back to 2004 along with food journals that I accidentally found in a box on one of my closets. I am hoping that this will get him on board. I will definitely let you all know how it goes. Congratulations on the success of your journey. I know that having so many ailments before starting your journey were hard to deal with because I am there now. Stay tuned. Fingers crossed.

[DivaSoBlessed 97]

I had done a lot of research online as to what the requirements entailed, so after verifying that my insurance covered wls, I also made an appointment with my PCP. I had it my head that I would need a formal referral from him to proceed.

I went in with talking points firmly outlined in my head, and an unshakable resolve that I wasn't walking out of there without a referral in my hand, come what may.

Turns out I didn't even need one. He just gave me a phone number to call, and that started the whole ball rolling. And he couldn't have been more supportive. Seeing as you will be going to your PCP after surgery for any routine or surgery related issues, it's very important that you know where they stand on the subject of wls. Had he not been in my corner, I would have immediately requested another PCP. My life depended on it, as I felt, and still feel, that without the surgery I already had one foot in a premature grave.

Don't be afraid to fight for your right to a healthy life!

Hi @ThePostOp

Thank you so much for responding. I am at the same resolve that I am not walking out of that office without his being on board with me doing this surgery. Because of having PPO I don't think that I need a referral to see a surgeon but I do want his okay. That is simply because as you said he will indeed have to be the doctor that I see well beyond having surgery.

When I originally started this journey back in 2004 I went into it not being as prepared for all of the pitfalls that go with what is suppose to happen during the process of having WLS. Today I am well polished and I'm like a bowling ball ready to knock down any pins standing in my way. I am refusing to take no for an answer and if he isn't on board I don't have a problem switching PCP's. I would rather not do that because I really like my doctor and I can tell that he really is truly concerned with my overall health. My husband and I have the same doctor and I usually show up with my husband to all of his appointments and he usually shows up to mine.

Because he has type II diabetes and the doctor originally didn't believe that he was working out on a daily basis until he started seeing the weight loss for himself he wanted me with him as a witness. I didn't show up to his last appointment beacuse I knew that doc would be on me about my weight loss. He sent word back with my husband that he wanted to see me within the next 90 days. He hleven told my husband that he was going to piss me off and light a fire under my ***. Well he doesn't have to wait 90 days becauae I am going in full throttle with my shiny bowling ball for a strike lol! I have not contacted any surgeon yet but I know where I want to go for my surgery. I will go and see my PCP first and take everything from there. I will let you all know how it goes. Thank you for your words of encouragement. I truly appreciate it.

[The Candidate 3,215]

@@DivaSoBlessed Good for you! You definitely have the right frame of mind, and I've no doubt you're going to roll a strike with your first attempt.

Lovely support system you've set up with your hubby too!

Best of wishes!

[DivaSoBlessed 97]

@@DivaSoBlessed Good for you! You definitely have the right frame of mind, and I've no doubt you're going to roll a strike with your first attempt.

Lovely support system you've set up with your hubby too!

Best of wishes!

Thank you so much @ThePostOp! As for the hubby I couldn't go through this journey without him. He has been my supporter since day 1.

[DivaSoBlessed 97]

So after a grilling session with my PCP he agrees that surgery is the best option for me but only because I am turning 40 next year. He knows of my desire to lose the weight and start a family. I had a break down right there in front of him. This PCOS has me like a darn Water faucet all of the time. He told me that he had a 21 year old attempt to do it and he was thinking "get your but out of my office you are young and have time to lose the weight" . He finally said yes to writing her a letter and due to her age and maybe her BMI they denied her.

He is big on getting in consistent workouts and eating healthy but I tried to explain to him even on my most compliant days I would feel defeated because the PCOS makes it that much harder to lose the weight.

Anyway I am attending a information session this Wednesday which is required before you can even schedule an appoint to meet with a surgeon. This is the start of my journey and although I am nervous it feels good to know that my primary doctor is supporting my decision to do this.

Edited November 24, 2015 by DivaSoBlessed

[Nurse_Lenora 903]

Congratulations! So happy and excited for you!!!!