Do i qualify for the surgery ?

[jessicasantana28 6]

Hi everyone , My name is Jessica and i have been obese most of my life . My fathers side of the family all suffer from obesity (300+pounds) . During the last 5 years i had 4 kids and my weight became worst. I have tried exercise , diets and when i do lose some weight i would regain twice the amount i lost in a day ... i feel like such a bad mother because of my weight .I cant do much with my kids because my body is just so tired .I'm 5 ft tall and last time i weight myself 5 months ago i was 220 pounds . And i know i have gained weight . I'am so ready to be "normal" but i also don't know what to expect , or if i even qualify ... what do you guys think ?

[Daisee68 2,493]

Your BMI will likely qualify you. If you have any other co-morbidities (diabetes, high blood pressure, etc.), you will be surely qualified. Realize that "qualified" based on your doctor's standards does not mean covered by insurance. You story is much like most of us here. I thought about getting the surgery for many years and am so glad I took the leap last year. Keep reading and researching these boards. It really helped me prepare and make an informed decision.

[Pinkgirl1234 761]

You are morbidly obese definitely qualify.Do it (WLS) for your well being...your kids...your life

[Djmohr 6,965]

You will qualify for sure. The best way to get started with this is to call your insurance company and find out their requirements.

Many of the larger ones require that you use a Bariatric center of excellence.

Your insurance company can provide you with what facilities are covered and what your requirements are.

Please don't be surprised if they tell you that you have to go through a supervised duet for 3 or 6 months. That really is the norm but I promise you it is well worth the time you put into it.

Once you have the name of the Bariatric center of excellence or a doctors office that handles Bariatric surgery get yourself to a live information session right away. You need to learn everything you can about the surgeries so you can make an educated decision about which one to go with for your health concerns.

Then, spend time on different on line forums learning from people who have had experiences with either the sleeve or bypass. There are tons of threads on this site comparing the two surgeries.

Leverage your doctors knowledge of your health to help you decide.

Good luck! By the way the only thing I regret is not having this surgery sooner. I am 52 and my obesity caused very severe arthritis of my spine and other joints. That cannot be undone.

Sooner vs. later!

[jj7481 363]

Insurance is always a great place to start in regards to specific requirements. Another place to start is your PCP. Get records of how long you've been obese and any co-morbidities. See what your PCP has for recommendations for a weight loss center, but make sure it's BSCOE and accredited by MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program).

[jessicasantana28 6]

Thank you all for the replys .. I just called My insursnce and they told me they only need a letter from the surgeon . No other requirements needed. I'm going to a seminar on feb 9 . Anybody tell me how long did they process take between the seminar , surgeon , & diet ? Thank you.

[ocgirl15 667]

It will all depend on your insurance. I was 5 ft and 213 (40 or 41 BMI) and was approved. I didn't have any obvious co-morbidities by insurance standards. Find out your insurance criteria and program requirements. Good luck. 5 weeks out and I already have more energy for my kids!

[dhrguru 1,238]

Thank you all for the replys .. I just called My insursnce and they told me they only need a letter from the surgeon . No other requirements needed. I'm going to a seminar on feb 9 . Anybody tell me how long did they process take between the seminar , surgeon , & diet ? Thank you.

It differs for every insurance company and surgeon. 6 month supervised weight loss is pretty standard, pre-op testing and then surgery.

In my case I had no supervised diet requirement-- I was about 6 weeks from consultation to surgery.

[jessicasantana28 6]

Thank you all .. i asked my insurance if there is a requirement of a diet and they said no . Just the letter .i made an appoiment with the surgeon and nutricionist but have to attend to a seminar on feb 9th. Did anyone atten the seminar and can tell me a little about it .

[Miss Mac 6,262]

Hello and welcome to the forum. Here are 1, 255 reasons why the rest of us took the leap.

http://www.bariatricpal.com/topic/219831-what-was-your-final-straw-that-broke-the-camels-back/page-125?hl=%2Blast+%2Bstraw#entry4051747

[NikkiDoc 312]

The information seminar is normally a power point presentation to a group of people that are interested in WLS. One of the surgeons in the practice normally goes over obesity and the risks of obesity, the various surgeries that practice performs (sleeve, bypass, band, DS), the normal outcomes for each surgery, the risks of each surgery.

They will normally discuss what else is available through their program such as Nutritionist (NUT), support groups. Frequently they will have a former patient come in to talk about their experience. Then a Q&A session.

There is normally a coordinator there with handouts and they will take you name and number to follow-up to see if you want to schedule an evaluation appointment.

The surgeon will likely have a few requirements prior to scheduling surgery. Most of them will be to make sure you are healthy enough for surgery: blood work, pulmonary clearance/sleep apnea test, Upper GI/endoscopy, EKG, PCP clearance, cardiologist clearance. Not all surgeons require all of those. It depends on the surgeon and your individual co-morbities. Many surgeons require a psych eval and may require you to attend pre-op support groups.

Please do not rush from the first visit right to surgery. Take your time, do your research, make sure you really understand what changes you will need to make to your eating habits and your lifestyle. IMO the posters that come to this board shortly after surgery and are surprised about how hard it is, don't know about the 3 week stall, don't really know what they are supposed to be eating/not eating are normally the ones that saw the surgeon and a couple of weeks later are having surgery.

As much as I was impatient with the 6 month supervised diet and the pre-op clearances it gave me the time to really start my new habits early. It gave me time to spend on Bariatric Pal reading about what worked and didn't work for people. It gave me time to really think about the whole process and how i was going to have to change my life to make this work.

I don't have children so I don't have that complication. But having small children and needing to cook for them, shuttle them around, clean up after them while you are trying to heal and change your eating habits may make it harder. Your kids and husband are not going to want to drink that Protein shake with you. You may need to be cooking them food you shouldn't be eating.

Having the time to really process that mentally before the surgery is a good thing.

I don't want to seem like I am trying to dissuade you. I am not. This surgery was the best thing I have ever done for me. I am saying take your time to learn and to research. Go to a couple of different surgeons/practices. Find the one you are comfortable with. Don't pick the first one you go to because you are impatient to get on with your new life and your new you.

I think insurance companies or surgeon's practices that have no pre-op requirements can be setting many patients up for failure. (Somehow Mexico is different since that is a different model altogether.)

[Tosha-248 21]

Hi everyone do anyone have information about michigan molina medicaid the insurance company would not. Give me any information until my doctor send the medical necessity form for surgery so can anyone help me I'm 5ft 5in 250 in pounds and bmi 41.8 with high blood pressure I just want any info on what to do next. Thanks.