New to WLS!

[Mari01 0]

Hi everyone, I have just entered the world of WLS. I first visited my primary doctor (10/2018) and asked about WLS. He then referred me to a surgeon within the same clinic. I visited the surgeon (11/2018) to discuss WLS options and steps it takes to have surgery:

1- Referral to "Lighten Up Program" which is 3 or 6 month weight management program (I am required to do 3 months for insurance BCBS)

2- After completion of the program Health Ed will fax documents of program to their office

3- Authorization for physiological eval

4- Psychological Eval

5- Primary Physician Clearance (cardiac and pulmonary clearance if required)

6- Schedule an appointment with Physician to discuss procedure

7- Authorization for surgery and Approval from insurance

I am one month into the weight program. Already lost 9lbs (too much?)

My question is, do I have to schedule my evaluations or will I be contacted? Any tips? How long will everything take?

Stats:

25 years old, 5'1

HW: 271, 50 BMI

CW: 258, 48.7 BMI

GW: 150

[batty_vsg 100]

First of all, congratulations on your first steps into weight loss surgery! Everyone's journey is a little different, but I'll try to answer what questions I can:

How much weight can you lose pre-op?
You are a bit above the 40 BMI required for surgery without a comorbidity, so I wouldn't worry too much about being less than a 40 BMI by the time insurance checks your weight progress pre-op. My program advised that I could not gain any weight, but a weight loss of 10-15lbs (even 20) is pretty acceptable (especially during the infamous pre-op diet.) Weight loss wasn't a huge focus during my nutritionist classes, it was more about starting to learn the tools that I would need to be successful post-op. It wasn't a weight management class, you know?

Scheduling Evaluations:
I was lucky in that I did not need a whole bunch of evaluations. I had a psychological evaluation that I scheduled myself. However, if you ask your team (surgeon, or nurse), they can recommend specialists that work with them (just make sure they are in-network for you! the evaluation was expensive for me, even though my provider was in-network.) That one, once the evaluation is done, they send over the information and know WHO to send the information to. I would assume the same goes to any cardiac, or sleep specialist. You will have to schedule these own appointments, but it helps if it a practice that works alongside your program.

My nutritionist appointments were through the hospital themselves and those were scheduled with the dietitian herself.

How long did it take?
I talked about WLS with my PCP around the middle of April. My first appointment with the surgeon was 4/30/18. My surgery was scheduled for 12/12/2018 (though it could have been a week sooner - I had exams so I rescheduled.) My insurance only required 3 months of nutrition classes (though I actually went to 4 because it had to be a total of 90 days.)

Any tips?
Be your own advocate! Realize that most medical professionals work M-F, but don't allow anyone to drag their feet on getting information back to you, or to others. Also, follow up on people! If someone was supposed to receive paperwork, call them the next business day and make sure they received what they needed and ask if there is anything else that they need. I did this and I sincerely feel that it helped make things SO much easier.

Get your work FMLA and short term filed as soon as possible. FMLA was possibly the most difficult aspect of paperwork during the entire ordeal, my supervisor dragged his feet and I ended up nearly close to the deadline.

Hope this helped.