LorettaLynn

Hi from VA, looking at surgery at the end of the year

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Hi, I’m LorettaLynn from Virginia.  I began my 6 month process with Dr Nain at the Inova Fair Oaks on 6/6/18.  I have completed a psych evaluation, 2 sessions with the nutritionist, consult with exercise guy, etc.  I am concerned that my Aetna (Foreign Service Benefit Plan) is not going to pay as my weight is not going down and fluctuates a bit so I am preparing myself to have to pay out of pocket and travel to Mexico if needed.  I have given up carbonated beverages since 6/6/18 and have increased my water a lot.  

I am 5’6 and weighed 277 at my highest in May, wearing a 22W dress.  I have high cholesterol, fatty liver and Nonalcoholic fatty liver disease, my A1C is prediabetic, and my hormones have been out of balance since at least 2016 with estrogen dominance and PCOS.  My beloved father died of liver cancer at 63 and my mother is a Type 1 diabetic.  

I am hopeful that RNY or DS will help my health turn around and give me the energy that a 40 year old should have.  I’m enjoying this forum quite a bit as the folks seem a lot nicer than other forums I’ve looked at.  

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Hello and welcome! Mostly I think insurance companies do the 6 month weight loss program preop requirement to test commitment to the process.  Many of us don't lose much weight (if any) during those 6 weeks.  That is different if your liver size is such that it makes surgery difficult or dangerous; in that case they may postpone surgery until enough weight is lost that liver size is suitably reduced.  Whatever the case is, I'm wishing you the best as you begin the journey to your new gloriously healthy life!

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Welcome to Thinner Times! Hopefully your prep goes smoothly and your insurance covers your surgery. I think giving up carbonated drinks is a great first step. Good luck with everything! I hope you find the support you’re looking for here.

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Welcome to the group. I hope all goes good with your insurance and the new journey you are on.

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Hi @LorettaLynn. Welcome to the forum. I had surgery last year in Mexico and had a fabulous experience. I am a Type 2 diabetic in remission. I no longer have sleep apnea or blood pressure issues.

The only thing I would do differently is to have done the surgery in my 30’s. I have much more energy and better health than I did ten years ago. Life is much sweeter. 

I wish you all the best. Let me know if you have questions about surgery in Mexico. 

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Welcome! 

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On 8/14/2018 at 7:47 PM, LorettaLynn said:

Hi, I’m LorettaLynn from Virginia.  I began my 6 month process with Dr Nain at the Inova Fair Oaks on 6/6/18.  I have completed a psych evaluation, 2 sessions with the nutritionist, consult with exercise guy, etc.  I am concerned that my Aetna (Foreign Service Benefit Plan) is not going to pay as my weight is not going down and fluctuates a bit so I am preparing myself to have to pay out of pocket and travel to Mexico if needed.  I have given up carbonated beverages since 6/6/18 and have increased my water a lot.  

I am 5’6 and weighed 277 at my highest in May, wearing a 22W dress.  I have high cholesterol, fatty liver and Nonalcoholic fatty liver disease, my A1C is prediabetic, and my hormones have been out of balance since at least 2016 with estrogen dominance and PCOS.  My beloved father died of liver cancer at 63 and my mother is a Type 1 diabetic.  

I am hopeful that RNY or DS will help my health turn around and give me the energy that a 40 year old should have.  I’m enjoying this forum quite a bit as the folks seem a lot nicer than other forums I’ve looked at.  

Hi @LorettaLynn

You should qualify for surgery based on having a BMI > 40, your lipid issues, and a family history of diabetes with you being prediabetic. Many insurance programs will approve surgery if you have BMI > 40 and any 1 other condition (in your case either the lipids or the family history of diabetes). I would find out now if your insurance requires you to lose some weight ... or if it simply requires you to have participated in a supervised weight loss program for 6 months. Mine required the supervision but not the weight loss. @michiganmilkman did his 6 months, gained a pound or two, and was denied by his insurance ... so he appealed and won, had surgery, and has been doing well. 

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I am now finished with the class portion of the 6 month process and after being told various conflicting instructions about the rest of the timing and losing confidence in their aftercare, I’m debating whether I should stick with an RNY from this bariatric practice, or pursue a DS procedure in Mexico.  When I first began my research DS was the most appealing to me.  But when I decided to try to have the surgery on my insurance’s dime, I went with my second choice RNY.  I truly believe I need the more drastic operation.  Paying $3800 in copays locally for RNY or $10000 for a DS in MX are the choices I’m debating, and not wanting cost to be the decider, nor settling for my second choice when I have qualms about it.  Ugh, what to do.

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My understanding is that DS is most suited to those with a BMI >50. It is such a drastic surgery and does a real job on your gut. With the right frame of mind and a good commitment to your post op diet plan, you'll do really well with an RNY. Without commitment,  even the more drastic DS won't work in the long term. Of course the choice is yours. RNY surgery has been around for decades now, surgeons have pretty much perfected the process and know it works. It's also reversible if medically necessitated,  whereas the DS is permanent so far more difficult to deal with certain complications. DS is also a far newer surgery, and that's likely one of the reasons  fewer surgeons do this procedure, and insurance companies often don't cover it. Just some food for thought.

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