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What hoops did you have to jump through before surgery?



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Hi Everyone!

I'm just starting to look into WLS, and already I've heard that people have to wait months or even a year to get surgery. What takes so long? Are they requirements of your surgeon or your insurance company? How long did it take before you could get surgery?

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My insurance required 90 days of dieting and weight loss.

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My insurance required 12 consecutive months of a physician monitored diet program where I had to meet with the nut every month. I think most insurances are 3-6 month programs. Mine also required 2 mental health evaluation from a psychiatrist and a psychologist. My initial consult appt. was December 2014 and my surgery is coming up February 3rd.

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12 months?! I'd go crazy. I'd fail the psych eval for that reason alone.

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7 months supervised diet, 7 months of education classes, 2 visits with a Nut, psych eval, 2 visits with a Physiologist, EGD , upper GI, medical clearance from PCP, documented sleep Apnea.

Yup I think that was it :)

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Six months of a supervised diet with my PCP which required monthly visits, consecutive. Chest x-ray, EKG, nutrition class, psych eval, and letter of support from PCP. Surgeon requirements were a seminar, blood work, endoscopy, test at the end of the nutrition class, and a pre-op class.

Edited by animallover1247

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My heart seems irregular and I has to have an EKG, a stress test and finally a cardiac cath, all for them to tell me my heart was normal <_< . I had all those things completed in about 4 weeks. It took me 8 weeks from first Dr visit to surgery. If you have an open schedule to setup pre-op testing appointments you can move the process very fast if all you have to do is testing. If you have a job you have to work around, I don't know how people do it.

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6 months of physician visits and with the NUT, weigh ins each time,(no weight gain), EKG, Stress Test, Complete Lab Panel, complete Gynecologist exam within a year, (r/o any possible CA) EGD, sleep Study, (documented sleep apnea) PCP Clearance. Sheesh...I believe that's it. I still need to do my Stress Test. I'm almost at 4mo. I'm expecting an April/May date. Hope this helps. Also this is what my doctor wants. Not what my insurance wants!

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Initial appt at end of October 2015 (meeting with surgeon, psychologist, and nutritionist, and lots of blood drawn for testing and EKG). November sent to cardiologist because of a false reading on the EKG, had an ultrasound. Early December had an endoscopy with biopsy and met with another nutritionist because the first one the appt center sent me to cannot clear patient for surgery. Received call in January to schedule surgery date, February 2, 2016. I thought the process was long but reading the other comments about the length of the process, I guess I should stop complaining. Not sure if it is normally this quick with my insurance or if it is because they found a hernia in my stomach that needs to be fixed with surgery so I am getting 2-in-1 (hernia repair and WLS).

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My process would have taken much less time, but my insurance changed their requirements and didn't do a good job of communicating that, so there were some delays as I had to educate everyone along the way.

So in order:

1. Initial appt. w/ PCP to get referral.

2. RD consult

3. Psychologist eval

4. Initial consult w/ surgeon

5. Visit with gastroenterologist to schedule EGD and upper GI

6. Visit with pulmonologist to schedule sleep study

7. Labwork

8. Upper GI X-ray

9. EGD (duodenoscopy)

10. sleep study (to rule in/out sleep apnea)

11. Second appt. with surgeon to review results of labwork and diagnostic tests.

My insurance doesn't require these, my surgeon does. Before I had my initial PCP visit, I attended an orientation session, and I'm attending a monthly support group of pre and post op bariatric patients. It took nearly a month to get an appt. with the gastroenterologist and with the psychologist, because the holidays got in the way.

The truth is, it's hard to be overprepared if surgery is your choice. Long-term success is all about the choices you make postop. The preop process can be nerve-wracking, time consuming, and all of that, but all along the way, you're forced to face that this is a serious, life-changing decision.

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I've seen that lots of people are required to have a sleep study. What changes if they find out you have sleep apnea? Is your treatment plan different in some way?

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No, it's good information for the anesthesiologist to have, and if insurance is paying, sleep apnea is a qualifying comorbidity for most insurance plans.

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Wow a lot of people had to work to have this done! I went to their website and did some research. They required u watched a presentation on their web page and take the test after. I called and made my appointment to meet the surgeon. After that I had to meet with a nutritionist get an ok with my pcp do some blood work and journal my god intake for a few weeks. Complete my psych veal and attend my liver reduction class. That was all. It took me a year because getting in all my stuff and offices were scheduling out farther than usual.

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