PCP Visit To Discuss WLS

[DivaSoBlessed 97]

Thank you @@Nurse_Lenora

I am experiencing so many emotions right now that I don't know what to do with myself. I'm excited too.

Edited November 24, 2015 by DivaSoBlessed

[The Candidate 3,215]

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.

One hurdle down on the way to a whole new healthy life! At times it will feel like you're standing still, and surgery day seems like a far away unattainable dream. But I promise it's worth everything you have to go through to get there! Congrats!

[DivaSoBlessed 97]

Thank you @ThePostOp. It felt as though a huge weight had been lifted off my shoulders. As you said. One hurdle down, and I am ready for the next. I debated attending this information session a day before Thanksgiving because usually we are home prepping for the holiday but I want this enough to give an hour and fifteen minutes of my time. I weighed in at my largetest eeight ever last night 361. I can feel the difference too my stomache feels awful after I eat almost every time that I eat. I went to bed in mild pain while trying to nurse my type II diebetic husband through a tooth ache. Thank goodness for clove essential oil. That stuff works like a charm. I will keep you posted on my progress.

[livvsmum 2,369]

That's great! I'm so glad that the appointment went well and he is supportive of you moving forward with surgery. Good luck on your journey! It's going to be a lift changing one for sure! :-)

[DivaSoBlessed 97]

@@livvsmum Thank you! I am looking forward to this journey. It certainly has been a long time coming. I am prepared to fight for a better life now than more than ever. The pst few hours have been quite emotional. I still have to get approval from my insurance but I am hopeful tht it will be approved. I had them send me a copy of the requirements for medically necessary surgery and without even thinking about my comorbidity's my BMI alone is high enough for approval but I also have a few other ailments that make me eligible. So now its on to the required information session. [emoji4]

[Nurse_Lenora 903]

If you haven't already you can call your insurance company and request a Bariatric surgery informational packet. It should tell you the requirements you need to meet for them to approve you.

I should also say that not all insurance companies have a Bariatric information packet but a lot do its it might be worth a call!

Edited November 24, 2015 by Nurse_Lenora

[DivaSoBlessed 97]

Thanks @@Nurse_Lenora,

I called yesterday and they emailed the policy with the requirements to me. After reading everything over it looks like I qualify based on my BMI alone I am above 40 at a 53. I also have hypertension. So I am guessing that the next step is this information session in order to be able to meet with a surgeon to discuss my options.

[animallover1247 249]

I am so glad you didn't have any problems with your pcp because it did create a lot of stress for me wondering if u could find another one. GREAT NEWS

[FocusOnMeNow 599]

I'm in a PPO which unfortunately did not cover bariatric surgery but I also don't get how a PCP would "supervise" you. I went to mine to get cleared for surgery and gave them the list of labs and x rays that they needed to order and review in order to clear me for surgery. I got this list from my surgeon. Beyond that my PCP had nothing to do with the surgery but I'm sure will be pleased when I go back for my annual physical next year and I have dropped weight.

@@DivaSoBlessed congratulations!

[DivaSoBlessed 97]

I am so glad you didn't have any problems with your pcp because it did create a lot of stress for me wondering if u could find another one. GREAT NEWS

@@animallover1247 I had that same worry and stress. I don't think that I had to really pay him a visit simply because with PPO you don't need a referral to see a surgeon but as stated earlier in this thread its good to have your PCP on board because well beyond surgery you ultimately have to at some point pay a visit to your PCP. I did it because I know how strongly he feels about me getting healthy and I wanted his opinion. If he had said that this is a bad idea I probably would have still pursued having WLS. No more worries my friend. Now the next step is this information session. I will keep you posted. [emoji4]

[DivaSoBlessed 97]

I'm in a PPO which unfortunately did not cover bariatric surgery but I also don't get how a PCP would "supervise" you. I went to mine to get cleared for surgery and gave them the list of labs and x rays that they needed to order and review in order to clear me for surgery. I got this list from my surgeon. Beyond that my PCP had nothing to do with the surgery but I'm sure will be pleased when I go back for my annual physical next year and I have dropped weight.

@@DivaSoBlessed congratulations!

Thank you @FocusOnMeNow. Yes I am finding that which policy covers different procedures depends on a number of factors. If it is insurance through your employer they may elect to not pay for this kind service. My policy they cover bariatric surgery but they will not cover anything that involves treatments for infertility. As for the supervised diet they no longer require it for my particular policy but I have heard of PCP's supervising 6 month diets especially if ultimately a patient would need a letter of necessity from either the surgeon or the PCP. My policy states a reqiured letter of medical necessity from either. I'm so happy for you that you got through all of the testing in prep for your surgery a congratulations are in order to you. How far post-op are you? [emoji4]

Edited November 25, 2015 by DivaSoBlessed

[KarenLoh 128]

You are lucky you don't HAVE to have your PCP on board, but you are right that it's good to do so. I had the best PCP ever - I mentioned the desire for surgery (58 years old and 417 pounds) and she jumped right on it. Wrote a letter to my insurance to get precert for the weight loss program at our affiliated hospital. I did that for a year and was finally ready for surgery. I am so sad that that PCP (who was there just when I needed her) is moving away with her husband to a new city. It's a huge disappointment.

And my insurance didn't cover bariatric surgery until THIS YEAR. I got the surgery in August and now my employer is changing insurance companies and I don't know if it will be covered next year. I feel so blessed. Love your name by the way. :-)

[DivaSoBlessed 97]

You are lucky you don't HAVE to have your PCP on board, but you are right that it's good to do so. I had the best PCP ever - I mentioned the desire for surgery (58 years old and 417 pounds) and she jumped right on it. Wrote a letter to my insurance to get precert for the weight loss program at our affiliated hospital. I did that for a year and was finally ready for surgery. I am so sad that that PCP (who was there just when I needed her) is moving away with her husband to a new city. It's a huge disappointment.

And my insurance didn't cover bariatric surgery until THIS YEAR. I got the surgery in August and now my employer is changing insurance companies and I don't know if it will be covered next year. I feel so blessed. Love your name by the way. :-)

Hi @@KarenLoh Thank you for that wonderful compliment. Yes I wouldn't have it any other way. I found some YouTube videos of my PCP talking about why he went into his field of practice and how he dedicated to helping his patients achieve optimal health fitness. He's stern, young, and funny, and he will call you on your crap if he feels that you aren't truly trying to get healthy. He is just what my husband and I need. I simply had to have him on board. He truly shows concern for the both of us.

I know how you feel in terms of losing a good doctor. I'm still trying to recover from losing my GYN. She was the best doc ever. She knew all about PCOS and would also tell me about herbal medicine to treat my symptoms. She moved her practice closer to home and I miss her dearly. It sounds like you had quite a journey going through the process before your WLS. I am sure looking back that you can appreciate how far you've come. Congratulations my friend.

[Chelle Bean 51]

Congrats on making that step. Honestly I was honest when I went and found my PCP the very first time. I told her exactly what I was asking from her. Gave her a brief history of my past fails with seeing a diet MD and taking Rx for weight loss for years. Explained to her that I could no longer put my body or my pocket book through taking these medications monthly and not getting results. Thankfully she was very encouraging and had even done the process for her other patient before and knew exactly what I needed to do and what she needed to do for my visits with and her approval letter. Good Luck , all I can say is just be as honest as you can and tell them exactly what you want and need from them. If the one you see is not able to help you , ask around and see if anyone you know has a PCP that has followed someone before and is willing to do so. Good Luck.

[DivaSoBlessed 97]

Thank you @ChelleBean! I had a long talk withy PCP on Monday along with my husband and although it turned into a grilling session to see what I had done more recently in terms of attempts to lose he agreed that WLS was the best option. This past Wednesday I attended a information session which is required before you can meet with the surgeon for a consultation. I should be hearing back from them on Monday after they verify that my insurance covers WLS. I will then have to take a 4 hour nutrition class that costs about $400 and take 3 tests before they can give me a surgery date. I'm excited and afraid at the same time.