Searching for my Surgeon!

[beingdina 64]

I’ve finally decided to go through with it. I want
To have the Sleeve Gastrectomy because it’s middle of the road risk, though I wish it had the results of the Bypass. I’m scared I’ll die after the surgery and I’m scared I’ll die if I don’t. I’m 39, f, married, mom. I know if I don’t do it I’ll continue to be miserable and risk immobility. And if I do have the surgery, it could be the best decision I’ve ever made. I’ve lost partaking in my son’s first 13 years and refuse to miss out on any more! I’m in Oregon. Considering Bay Bariatrics with Dr. Tersigni as a cash pay patient. My insurance says the surgery is an exclusion but I’m hoping to find a surgeon that will try to fight it for me. Hoping to make some friends and learn a lot from the veterans and cheer people on!

[Matt Z 4,139]

13 hours ago, beingdina said:

I’ve finally decided to go through with it. I want
To have the Sleeve Gastrectomy because it’s middle of the road risk, though I wish it had the results of the Bypass. I’m scared I’ll die after the surgery and I’m scared I’ll die if I don’t. I’m 39, f, married, mom. I know if I don’t do it I’ll continue to be miserable and risk immobility. And if I do have the surgery, it could be the best decision I’ve ever made. I’ve lost partaking in my son’s first 13 years and refuse to miss out on any more! I’m in Oregon. Considering Bay Bariatrics with Dr. Tersigni as a cash pay patient. My insurance says the surgery is an exclusion but I’m hoping to find a surgeon that will try to fight it for me. Hoping to make some friends and learn a lot from the veterans and cheer people on!

At 402 lbs and 5 foot 9... you should qualify for the surgery though (most) insurances... not sure what insurance you have... but I've never heard of any insurance not covering at least some of WLS with a BMI of 59.4... You are actually off most of the BMI charts... and are classified as "Super Obese" bordering on "Hyper Obese".... there isn't anything over "Hyper Obese"....

That said, you might be too big to get Sleeved, have you considered or discussed Bypass surgery with your insurance/Doctors/etc?

[mitch22622 21]

At 402 lbs and 5 foot 9... you should qualify for the surgery though (most) insurances... not sure what insurance you have... but I've never heard of any insurance not covering at least some of WLS with a BMI of 59.4... You are actually off most of the BMI charts... and are classified as "Super Obese" bordering on "Hyper Obese".... there isn't anything over "Hyper Obese"....

That said, you might be too big to get Sleeved, have you considered or discussed Bypass surgery with your insurance/Doctors/etc?

My insurance has a whole section in the employee handbook that excludes WLS and any expenses related to weight loss. There's no way to fight that.

Sent from my SM-N950U using BariatricPal mobile app

[beingdina 64]

I am considered Morbidly Obese occurring to the various online seminars I have completed for all the different bariatric surgical centers. Specifically my insurance lists weight loss surgery as an exclusion. So my employer chose to buy a policy that will NOT cover it. I do not believe I am too large for
Sleeve Gastrectomy. I am 100% mobile, work full time, can be on my feet for hours as needed and am nothing like those on My 600 Pound Life (which is kind of how you must be imagining me). I’ve been told more than once that if it’s an exclusion, it will NOT be covered. So I will be paying cash as many people do I’m learning.

[Matt Z 4,139]

Just now, beingdina said:

I am considered Morbidly Obese occurring to the various online seminars I have completed for all the different bariatric surgical centers. Specifically my insurance lists weight loss surgery as an exclusion. So my employer chose to buy a policy that will NOT cover it. I do not believe I am too large for
Sleeve Gastrectomy. I am 100% mobile, work full time, can be on my feet for hours as needed and am nothing like those on My 600 Pound Life (which is kind of how you must be imagining me). I’ve been told more than once that if it’s an exclusion, it will NOT be covered. So I will be paying cash as many people do I’m learning.

There are categories of Morbid Obesity (I didn't know this either until more recently).
My comment about maybe being too big for the sleeve isn't based on anything other than the numbers you've posted and others I know personally that were close to the same size that couldn't... or had to lose 100lbs give or take before they could be sleeved. Not trying to give you anything other than information... no judgments... and I've never seen a single episode of "My 600lb Life"...

[beingdina 64]

Fair enough Matt. I’ve not met with the surgeon yet (that will be in the next month or so) and I will see what he says. I absolutely can’t afford Bypass so this is my only hope.

[Ylime 453]

16 hours ago, beingdina said:

I’ve finally decided to go through with it. I want
To have the Sleeve Gastrectomy because it’s middle of the road risk, though I wish it had the results of the Bypass. I’m scared I’ll die after the surgery and I’m scared I’ll die if I don’t. I’m 39, f, married, mom. I know if I don’t do it I’ll continue to be miserable and risk immobility. And if I do have the surgery, it could be the best decision I’ve ever made. I’ve lost partaking in my son’s first 13 years and refuse to miss out on any more! I’m in Oregon. Considering Bay Bariatrics with Dr. Tersigni as a cash pay patient. My insurance says the surgery is an exclusion but I’m hoping to find a surgeon that will try to fight it for me. Hoping to make some friends and learn a lot from the veterans and cheer people on!

Welcome to the forums! You'll find a lot great resources and support here. It's natural to be scared of this surgery, it's a major surgery and a major life change. But you've got all of us to lean on!!

2 hours ago, Matt Z said:

At 402 lbs and 5 foot 9... you should qualify for the surgery though (most) insurances... not sure what insurance you have... but I've never heard of any insurance not covering at least some of WLS with a BMI of 59.4...

If your insurance plan/employer specifically excludes WLS, it doesn't matter what your BMI is. Mine also excludes it. It wouldn't matter if I had every co-morbidity under the sun, my employer won't pay for it so I have to pay for it myself.

[Bryn910 519]

I know you said you can’t afford bypass but the risks really aren’t different between the two surgeries. And I have had both sleeve and bypass

Good luck to you

[beingdina 64]

Most things I’ve read said it’s less risk than bypass and more risk than lap-band. I like the idea that if necessary I can move into a full bypass down the road if something comes up or it’s not quite as successful as I need. I’m hoping for September surgery. Thank you!

[newmebithebypass 713]

Can you apply for a policy thru your states market place

[beingdina 64]

On 06/13/2018 at 02:54, newmebithebypass said:

Can you apply for a policy thru your states market place

Hi :-) That would be a solid idea if I didn’t have mostly amazing insurance. Super low co pays and super low deductible and 90% employer paid. For what a marketplace would cost me in deductible ($15,000) I might as well pay cash.

[newmebithebypass 713]

Ah ok