Need personal docs help?

[Chrissylynn80 7]

Five people in my and my husbands family have gotten WLS. They all had their doctors document the issues and the weight loss plans. I am so worried about being approved because the said gout and bleeding ulcers don't count for co-morbidity. So i put weight on to get to a higher BMI. I call my doctor about help because this extra weight feels awful and they told me to just deal with the weight loss surgeon that they can not help. Why did everyone i know need help from their doctors to get is passed but mine says i don't need it? Has everyone here who has had it have help from their docs? Thanks for any help!

[Lanie992 168]

I didn't have any help from my primary care doctor. I went straight for a consultation and the surgeon recommended the sleeve for me after reading my health issues... after that I had to see a dietitian, get a letter of approval from my psychiatrist and pass an EKG & stress test to get approved by my insurance.

My personal doctor was never involved.. I told her about it at my appointment soon before my surgery but she had no involvement in it.

[Chrissylynn80 7]

Thank you. My sister swore she needed her docs help but maybe that was just her case. She was at a smaller weight but had health issues. I do not have proof yet of my issues due to avoiding doctors and the scale lol. yeah that was dumb but i am ready to face this finally and i am scared i will not get help. I feel i can never be better. I do not picture it happening for me. Maybe that is normal?

[Lanie992 168]

3 minutes ago, Chrissylynn80 said:

Thank you. My sister swore she needed her docs help but maybe that was just her case. She was at a smaller weight but had health issues. I do not have proof yet of my issues due to avoiding doctors and the scale lol. yeah that was dumb but i am ready to face this finally and i am scared i will not get help. I feel i can never be better. I do not picture it happening for me. Maybe that is normal?

I thought 100% I would be denied. I procrastinated making an appointment for like 2 months -- (which makes me sad because I could further along if I hadn't). I just thought there is no way.. and it was actually easy to get approved. Find a surgeon with good ratings and reviews.. and if you're going to try to get it paid via insurance- make sure they take your insurance, then call and make an appointment!

[NovaLuna 710]

I guess I was lucky as my PCP had gastric sleeve a few years ago and her son had RNY two years ago so when I brought up WLS she was a fountain of information and advice. She's actually been the guest speaker at my bariatric support group meetings twice. From my understanding, other than giving you the referral most PCP's don't get that involved in your weight loss journey until after you've had your surgery and occasionally will order labs for you if they feel you need them to check your levels.

[Chrissylynn80 7]

Sounds like my sister got lucky. Her doc helped her through all of the getting approved part. My biggest fear is they will fight me and i will be stuck this way, Disgusted and hiding from the world. I just need to see what the surgeon says and go from there. I appreciate you guys commenting and helping me.

[tarotcardreader 196]

3 hours ago, Chrissylynn80 said:

Five people in my and my husbands family have gotten WLS. They all had their doctors document the issues and the weight loss plans. I am so worried about being approved because the said gout and bleeding ulcers don't count for co-morbidity. So i put weight on to get to a higher BMI. I call my doctor about help because this extra weight feels awful and they told me to just deal with the weight loss surgeon that they can not help. Why did everyone i know need help from their doctors to get is passed but mine says i don't need it? Has everyone here who has had it have help from their docs? Thanks for any help!

After all the basic stuff your read about here (nutrition egd sleep study etc) in order to have the surgery i had to have a preop clearance physical. This exam included ekg and chest xray within 30 days of the operation and is generally done by your primary care physician but you can sometimes get a walk in clinic to do it. I was able to get an appointment in time with my pcp so didnt use clinic. Surgeon also had Pcp refer for egd to be sure it would be covered

ulcers might be contradiction for bypass definitely ask to see if those r okay for sleeve (to save time). Ultimately up to whatever surgeon is comfortable doing

[Chrissylynn80 7]

Oh no. My ulcers will be a problem. I did not even think of that. No. I can not live this way. I can not be stuck like this. Oh God.

[Arabesque 6,970]

Having a supportive GP does help when you’re on this journey. I’m sorry yours isn’t. In Australia we have to have a referral from our GP before seeing a specialist so if your GP isn’t on your side you can’t even get to the surgeon.

I’m very fortunate to have a GP who wants the best for me & has been extremely supportive. She’s been my doctor for more than 25yrs so she knows my struggles well. She weighs me at every visit, checks all my blood work results & orders extras so she can pick up any variations in between surgical team visits. She also keeps in contact with my surgical team.

[BayougirlMrsS 3,933]

13 hours ago, Chrissylynn80 said:

Five people in my and my husbands family have gotten WLS. They all had their doctors document the issues and the weight loss plans. I am so worried about being approved because the said gout and bleeding ulcers don't count for co-morbidity. So i put weight on to get to a higher BMI. I call my doctor about help because this extra weight feels awful and they told me to just deal with the weight loss surgeon that they can not help. Why did everyone i know need help from their doctors to get is passed but mine says i don't need it? Has everyone here who has had it have help from their docs? Thanks for any help!

You biggest obstacle my be yourself. And it's not just you, but lots of people feel the way you do. But if you want this SX you probably need to see the phyc dr. first. Without get your emotions fixed you are for an uphill battle.

First place is to start with your insurance. If they do cover, ask what the requirements are. If not, you may need to look into self pay. Every person's insurance is different. I didn't have to go to my primary dr at all. The WLS RN called my GYN and had them send over my last few years of weight history. I showed a steady climb. I also had been on WW for a while and show that in all the months going i had only lost like 2lbs... I had no co mobidity. My insurance required a 40bmi with no co's. or a 35+ with two. I was the 40+. That was for the lapband.

Sleeve i only went to the WLS.... i was considered a "revision" even though my band was removed 2.5 years before. Plus i was a cash pay. (14K)

Be positive.... and start to do things for you that makes you feel proud to be you.

[ms.sss 15,173]

15 hours ago, Chrissylynn80 said:

Oh no. My ulcers will be a problem. I did not even think of that. No. I can not live this way. I can not be stuck like this. Oh God.

Sorry you are having a rough time getting started. Though remember, you always have options. Even if you are not approved by insurance, there is always self-pay...and you won’t have to jump though any hoops to get it.

[Chrissylynn80 7]

19 minutes ago, ms.sss said:

Sorry you are having a rough time getting started. Though remember, you always have options. Even if you are not approved by insurance, there is always self-pay...and you won’t have to jump though any hoops to get it.

Self pay is no option at all for me but thank you. My husband's health went down seriously the last couple years and he can not work. My credit is shot. This is my only option .

[CAKEGIRL86 18]

My pcp had me do 1month of monitored weight loss then I went to a dietician who recommended the WLS (which I was on the fence about). Talked to my PCP at my physical, she ordered my sleep study and wrote my referral. She did some follow up labs and just checks up on me. She had to write a letter stating i have tried to lose weight 4 months before meeting with the surgeon.

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