From A-Z..I am going through Aetna and have questions.

wendy9032 · May 19, 2009

Hi,

So far I have had my appointment with my PCP who agrees I need WLS. She has scheduled me for 2 healthy For Life classes. From there I will go to a 6 month class called Lighten Up. This will be a nutrition class held once a week at the medical facility I go to.

Once I complete those I will see her again for the rest. Typically with insurance what are the next steps?

Upper GI? What exactly happens when you have one done?

Psych eval? What happens there?

What other testing or evals are needed or did you go through to have your insurance cover it? I realize all insurances are different and may not require the same things, but I'd still like to know so I can be prepared for the possibilities.

Thanks so much!!!:redface:

elgrad · May 19, 2009

Wendy,

I have Aetna insurance also and have completed most of what is required. I am doing the 3 month, multi-disciplinary tract instead of the 6 month tho.

I have had the psych eval. Mine was pretty easy. I went in and spoke with a RN for a few minutes. She asked me about my medical history, wanted to know if there were any folks in my family with mental health issues, asked me why I wanted to do the surgery and then we just chatted for a few. The doctor came in and simply asked me why I thought I wanted to have this surgery. It was over pretty quickly and was painless :redface:

The upper gi was more of a fright for me since I have had some issues with anesthesia in the past. Basically, they asked me not to eat after midnite the day before. I went in really early to the surgical clinic. They gave me the gown, put an IV in for the meds to sort of knock me out and rolled me into the room for the test. They did spray some foul tasting liquid in my throat to numb it for the tube but I really can't remember anything about the tube going in. The tube is designed to down your intestinal track to look for any signs of things that might become an issue when they do your surgery. Whatever drugs they gave me for the test worked because I have NO memory of the procedure at all. To this day, I don't remember much of the whole process, only that I came home and slept most of the day. It was not a major procedure, in my mind. I am glad that it is over with however. One more thing to check off of my list of "to-do's". I am one nutritionist appointment away from submitting everything to the insurance company.

Good luck!

Elgrad

wendy9032 · May 19, 2009

Thanks so much for your reply! I was thinking it would be the other upper GI where you drink the barium drink and then have an x-ray. I have had the other procedure (EGD) before a few years ago for a different reason and it was a breeze. I loved the stuff they gave me for sedation. I think it's called Versed. I wanted to take it home with me lol. I don't drink or do any type of drugs, but that stuff takes all your worries away. I need it for paying bills and such lol. I remember my whole procedure. I remember them spraying my throat and they gave me a plastic thing with a hole in it to bite down on. Then the camera went through that whole. It seemed like it was only about a 10 second procedure, but I know it had to be longer. I even remember gagging a little when they pulled the camera out. I was in such a happy land that I remember thinking "I'm choking....Oh Well!" LOL

This will be quite a journey for me because I am deathly afraid of being put to sleep. I want to over come that fear and I want to lose weight!!!!!

Thanks again for taking the time to help me out.

elgrad · May 20, 2009

You're welcome. That's what we are all here for, to help each other.

I, too, am a little nervous about the surgery part. I think that is a normal reaction for most folks. I just want to gain control over my body again so I am willing to undergo a little fear to attain some success. I know that this is the right course for me. Good luck!

Elgrad