Starting out! - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

On my way K · 08-26-2005, 06:43 PM

[FONT=Fixedsys]Hello everyone,

I have been reading this forum for several weeks now, and finally have the courage to participate.

I have attended the first education seminar and received a call from Dr. Callery's office today that I have my consult on September 23rd.

I have so much admiration and respect for the people who have willingly shared their experiences with this group. So many things that have been swirling around in my head are the very things discussed here . . . thank you.

I have been thinking about this surgery now for 2 years, but never acted upon it. Partly I was concerned what my family would think. I should never have doubted their support. My husband, while very surprised when I finally got up enough nerve to have "the talk," was so incredibly wonderful. With each passing day he shows his support. My mother called me "brave." While my sixteen year old daughter was frightened at first (about the surgery) she is starting to understand how happy this will make me and she is celebrating the decision with me. I haven't told my ten year old son yet, because I don't know how long the process is going to take. I will tell him when I get my surgery date.

I do have a few questions I would like to put out to you . . some might seem repetitive to early questions asked by others, so I apologize ahead of time.

My biggest concern is that my insurance won't approve - although I have a BMI of 49 and documented sleep apnea. I had a friend who underwent this surgery about 4 years ago and she had a devil of a time with Healthnet (which is my insurance). Can someone share a more recent experience that was positive?

Another question - from the time of the consult- how long does it take for you to get a surgery date? We are now at the end of August - is it realistic to hope that I could get the surgery sometime in the November timeframe? I am trying to figure out the best time to work this around my job.

Those are the two biggest concerns I have at this point. I appreciate any advice you can provide.

Again, I want to say I have the utmost respect for all of you that participate on this forum -- you are awesome

Sincerely,

"On my way K"[/FONT]

gramamarc · 08-26-2005, 06:48 PM

Welcome to the forum.
Unfortunetly it is hard to predict cause every one is different. You may need time consuming tests or you may not. Personally mine was from late march with surgery on 7/15. That included a 2 month delay from my psyc evaluation. You will probably be able to predict a little more after your consult. The Doc will give you a list of tests that must be performed before submitting to the ins.
Good luck and keep posting!
M

veroniquetalk · 08-26-2005, 07:05 PM

You qualify for the surgery according to the standards that have been set by the medical community. Whether or not your insurance covers the surgery is another matter. For example, my daughter qualifies but her insurance doesn't cover the surgery. It took me about 3 months from the time I made the decision for the surgery to when I had it. But, I had already had a medically supervised diet and an established relationship with a counselor that did my psych eval. If I hadn't already had the supervised diet it would have taken me 6 months longer.
You won't regret this decision!

Cinerbelle · 08-26-2005, 07:44 PM

A lot of insurance companies are now requiring a 6 month medically supervised diet. I am now in the process of taking these classes. Good thing I didn't want the surgery until next spring anyway! I am glad I looked into it well in advance as my classes won't be finished until January...then after that I have to have all the testing done. I will start doing the testing in early Jan. in preparation. Hope this helps, the first step is talking to your PCP and they will guide you.

On my way K · 08-26-2005, 07:59 PM

Thanks for the speedy replies!

What does the 6 month medically supervised diet involve? Did your primary physician oversee the process? What if my doctor and I have had ongoing "counseling sessions" over the years - to no avail? Couldn't that count if he was willing to provide documentation to that effect? Does it have to be a 6 month diet under someone eles' supervision?

Thanks again for your help!

"On my way K"

veroniquetalk · 08-26-2005, 08:05 PM

If your doctor is willing to provide documentation that you have been trying to lose weight under his/her direction my guess would that would be ok. My insurance didn't specify what kind or who as far as medically supervised diet went. I just happened to have done Optifast 2 years before I started looking into the surgery and that qualified.

sUzYzPLaCe · 08-26-2005, 08:11 PM

just a little tip about the medically supervised diet. I was a really bad girl, and made up a journal consisting of a 1200 calorie diet. I just got on the web and for six months documented a diet. The insurance company approved me faster than I could have imagined. Just a way to get around the system some. Suzy

On my way K · 08-26-2005, 08:44 PM

Sorry to appear a bit "thick" - but just want to clarify . . . . you documented that you underwent a 6 month diet . . . but didn't actually "wait out" the six months to submit it -- right???? (Sorry to be so blatent!!) -- This is such a "stressful" hurdle for me right now!!

Thanks for your advice :O)

On my way K · 08-26-2005, 08:49 PM

Sorry to appear a bit "thick" - but just want to clarify . . . . you documented that you underwent a 6 month diet . . . but didn't actually "wait out" the six months to submit it -- right???? (Sorry to be so blatent!!) -- This is such a "stressful" hurdle for me right now!!

Thanks for your advice :O)

Red Feather · 08-26-2005, 09:23 PM

to NOT do what you are asked to do. Here's my take" I spent 32 of my 47 years MO. Been on every diet, program, liquid, you name it. When i was denied because i hadn't done the 6 mos. plan I plain told my Dr. I refused to.
Who better knows, the one living it, or the one reading about it? I gave up the idea of having the surgery, too stubborn I guess. So I joined the gym, watched everything i ate, quit drinking, etc. Because of a pre-existing problem with my thyroid I saw my PCP every month or two. She is the one that first made the suggestion (crushed me). But I started looking for information about it and thinking of all of the things that it involved. I wasn't in favor of it, period. Nine months at the gym no less that 10 hours per week, I'd lost 40lbs. Started having major periods and was unable to continue. It was during this 5-6 month period, I gained 30 of the pounds back. I saw my dr., she again asked if i would be interested in the surgery. By now I could practically perform the surgery myself. I had been spending several hours a week reading, on line, going to support groups, etc. Really checking it out. So, I said yes, and here's how you do it. (this was to my dr.) We had prior attemptes too. (much like you) She wanted this for me more than i wanted it for myself! (?) If you can show that you have tried to diet in the past - check stubbs from Weight watchers, Jenny, etc. If you can show that you participated in getting nutritional guidance, get my drift. You "might" not have to do the 6 mos. Just a word of caution. You OWE it to yourself to spend as much time as it takes. I would NEVER encourage someone to "rush" into this, it is far too much work, a total committment, and (if you plan to be successful) a major life changing event. You will go places you can't even imagine. I'm not trying to scare you, not at all, but do not approach this as something that has to happen now or ? Sorry for the length of this post, I don't usually get so involved, but i feel that there are many folks who didn't have a full understanding going in this and have the most difficulty trying to survive and many don't succeed because they didn't take the time to REALLY understand. Best of luck to you, patience is a virtue

Oh, and welcome