Got the OK for Vertical Sleeve Gastrectomy - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

weza215 · 05-02-2008, 01:40 PM

Hello Everyone,
I got the OK to get the VSG yesterday and now I'm just waiting for the date of surgery. I was told that it would be either may 21 or June 3. My insurance is covering this proceedure. I was going to get the RNY but changed my mind I just feel better about the VSG. I'm so excited I can't wait! I feel this will be a new beginning for me. I feel like I've been waiting forever even though I just started this whole mission back in October of 07. I wish there were more people out there who had this done so I could talk with them. It would be nice to see a separate part for the VSG like the RNY and Lapband have. I just hope that I'm able to take the weight off and keep it off. My friend had the RNY back in February and she looks great and she hasn't had any major complications. All the best to everyone. Lisa

Toony · 05-02-2008, 01:47 PM

CONGRATS LISA!

May I ask who you have for insurance? Not many companies cover VSG...

Eric here has the vertical sleeve and is doing EXTREMELY well... I'm sure he'll be along to post when he sees your thread title.

Best Wishes!

katie

weza215 · 05-02-2008, 02:00 PM

I have Blue Cross Blue Shield of Michigan and their criteria is a BMI of 50 and above. I recently gained weight which little did I know helped. Lisa

OsoDelDesierto · 05-02-2008, 04:08 PM

Lisa, congrats on the approval - that's fantastic!

I have NO regrets, except for not doing this sooner!

MiladyB · 05-02-2008, 05:21 PM

Congratulations Lisa!! What exciting news for you!! I know my insurance will only cover VSG if there is medical reason why you can't have the RNY. I'm doing well with the RNY but if that option had been there when I had my surgery I would have seriously considered the sleeve.

It's nice to know that BC/BS of Michigan is covering it because it is still pretty hard to get it covered with Priority Health...though not impossible.

Godsblessedme · 05-02-2008, 07:14 PM

ok can you or Eric just fill me in on why the "sleeve" is a good choice i dont understand the difference is it something to do with absorption? Very interesting

CONGRATULATIONS!

weza215 · 05-02-2008, 08:17 PM

Deborah,
The sleeve surgery isn't any safer then the rny but in the long run there is a possibility of less complications due to no intestinal bypass. The surgeon will remove 60-85% of your stomach and totally take it out, the remainder of your stomach is like a sleeve or banana. You absorb your vitamins from food and you lose weight by restriction of food intake due to the small stomach, there is no malabsorbtion. In the past this surgery was used for patients that were too high risk to have the rny due to too high of bmi. This sleeve was the first process and after the patients reached a safer weight then the patient could have the second weightloss surgery like the rny or band or duodenal switch. Now, the doctors are finding that this surgery can work as the main weightloss surgery with close to the same results as the rny. In the future if I feel I haven't lost enough weight or if I start to gain weight I can still resort to have the rny or lapband. This surgery isn't reversible like the rny or lapband. I hope this has answered your question. Lisa

Godsblessedme · 05-02-2008, 11:25 PM

Weza, thank you so much yes that answered it perfectly! Good luck to you

Stimpy911 · 05-17-2009, 01:01 AM

Congrats on being approved. I also have BCBS of Michigan and they will approve the sleeve for me if it is written up as a 2 stage operation being the RNY or DS being the second half. Also, you have to have a BMI of over 50. However the doctor says many of his patients never need to have the second surgery unless they are having problems losing weight .

My only concern is the bougie size my doctor will use. He is using a size 46. What size is your doctor using?

Here is a criteria list from my doctors office for those with BCBS of Michigan. Not sure if it applies to other states or not you would have to check with your own insurance company to verify.

BARIATRIC SURGERY GUIDELINES OUTLINED:

BCBSM does not pre-authorize bariatric surgery procedures. As with any other covered medical service, we expect the physician to document in the clinical record the indications for and medical appropriateness of the procedure.

For bariatric surgical procedures this documentation should include:

1. Morbid obesity with a body mass index of 40.0 or more.

2. Morbid obesity with a BMI between 35.0 and 39.9 with significant obesity related comorbid conditons.

3. A thorough dietary history.

4. Documentation that the patient understands the pros and cons of various approaches to the contuinued management of his or her condition including continued medical weight loss and has made an informed decision to pursue bariatric surgery.

5. A psychological asssessment documenting psychological fitness and readiness to undertake this surgery.

6. Documentation of the patient's commitment to participate in the post surgical management program of the bariatric surgery program.

Sleeve gastrecomy: Sleeve gastrecomy is payable as the first stage of a multi-staged surgical approach to the treatment of obesity for patients with a BMI over 49.9. We continue to consider this procedure experimental in other patients or when it is provided as a definitive surgical treatment for obesity.

Blue Care Network also provides some members coverage for bariatric surgery. Look for information about their benefit in an upcoming issue of Network News.

Again I am only posting what was given to me. I would make sure you contact your insurance company or doctors office to confirm the requirements and criteria for your weight loss surgery.

Stimpy911 · 05-17-2009, 01:04 AM

Oh, I just realized we have the same doctor ha ha. Good luck to you. I hope everything goes well. I have my final appointment on Wednesday for my physical. Everything else is done and just waiting for the final approval from Dr. English.