lkcraig316

I'm having my surgery at Baptist Hospital in Nashville. Albert Spaw is my surgeon.

Believe it or not, approval took 3 business days. They faxed the paperwork to Aetna on Thursday and I got the call that I was approved today. I was prepared for it to take quite a bit longer. As far as the 90 days, I do know that my first appointment with the surgeon was 1/6 and my final appointment was 4/6. I assume the scheduler set it up that way to make sure it was exactly 90 days. I think the approval time depends on how busy they are with pre-certs. If you have a great insurance specialist at your surgeon's office, like mine was, you shouldn't have to wait too long. Best of luck to you!

I am excited and scared! I have had 3 surgeries in my life and each time I get more and more scared. The last one 2 years ago, they had to give me some heavy duty stuff before they even took me into the OR. I just get SO nervous about the anesthesia. But I'm so excited about the new life I'm embarking on. I just wish I had done this years and years ago.

I got the call this morning! I have been approved by Aetna. They could have done the surgery as early as April 25, but I really wanted to wait until my daughter is done with her exams and home from school. So we've set the date for May 2. I am his first case of the morning, so hopefully no long wait in holding. I'm doing my Upper GI, pre-op class, and hospital pre-op testing on April 18. That's also the date I start my two-week pre-op diet. Wow, I can't believe that's NEXT MONDAY! These three months have just flown by and now here I am. Anybody else May 2 or close?

CONGRATULATIONS!!!! I got approved today too. I could have done it that last week of April, but I wanted to wait until my daughter finished her exams and was home for the summer. So I'm doing May 2. We should follow each other as we go through the process. You will be a few days ahead of me, so I can probably learn a lot from you!

How awesome for you! Way to go!

Thank you for sharing your wonderful story. It is so encouraging to those of us who are just beginning the journey.

How exciting that you and your sister can do it together! Best wishes to both of you!

Congrats!!! My paperwork is being submitted this week, so I hope I'm right there with ya!

I had my last appt with the surgeon today. He went over the hospital stay, what to expect, etc. I saw the nutritionist and the exercise physiologist one last time before surgery. As soon as the insurance specialist gets the approval from Aetna, the wheels will be in motion. I have to have an upper GI, but other than the typical pre-op blood work, that's all the testing I have to have. I'll have a detailed class with the nutritionist regarding the schedule/plan for moving ahead with your diet after surgery. I'm pretty sure my surgeon does 2 weeks clears, 2 weeks full liquid, and 4 weeks mushies. Before surgery I will do a two week pre-op diet: 2 protein shakes + one frozen meal (from their list) each day for the first week, and 3 or 4 protein shakes a day for the second week. Clear liquids only 24 hours before surgery. I can't believe this process that I started in December is now to one final hurdle. I can't wait to hear that I've been approved and get that date nailed down!

Hey, Lisa. Another Lisa here. I also have Aetna Open Choice II PPO. How long did it take from the time your doc submitted your paperwork to the day you heard that you were approved. My stuff will be submitted this week, and they said Aetna says up to 30 days. Did it really take that long?

Wow, I am so impressed! The Grand Canyon!!! Well, I'm not going to set my sights that high, but just to be able to walk for extended periods of time will be great. Since I am not even close to bone-on-bone yet, I hope to see a LOT of improvement. Arthritis runs on both sides of my family, so I know it will be something I will eventually have to do something about, But I sure hope to delay it as long as possible.

Thanks so much for all your experiences and encouragement! I was getting so down, because I knew if I couldn't exercise AFTER the surgery, I would be limiting its success. We bought a house with two sets of stairs (there's a bonus room halfway between 1st and 2nd floors) 18 years ago. My mother said then, "You're going to regret not getting a single-level home one day." Boy, was she right. But at 30, I had NO idea. Now I try to limit going up and down the stairs as much as possible. I try to get everything done downstairs before I go up to bed in the evening, and vice versa in the mornings. It is to the point where I just don't want to have to go up or down at all. As soon as I'm eligible for another cortisone injection, I'm going to do that. Hopefully that will get me through surgery and maybe I'll only have to have one more before I lose enough to start seeing a difference. You guys are all the greatest and I'm so thankful that we have a place like this to come to for help and support. Oh, and on a happy note, my final surgeon appointment is this Wednesday and then my paperwork goes off to Aetna! Wish me luck! Lisa

I actually work for joint replacement surgeons, so I should already be checking into those injections. I did have a cortisone injection in my right knee back in January and it helped SO much, and I think I can get another one this month. Our docs do Synvisc, Hyalgan, Supartz and Euflexxa. I don't even know which one to ask for. My dad did the Synvisc series and my mom did the Euflexxa series, but neither one seemed to get any better. HOWEVER, they were both bone-on-bone. I am not nearly to that point. Until our neighborhood pool opens in mid-May I really don't have access to a pool. I will decide in the next week whether to do another cortisone, or move up to something stronger. But the pool will definitely be an option when the weather warms up! Why do we wait until we are falling apart to do something about it? I should have considered surgery years and years ago.

I have arthritis underneath my kneecaps. Walking is painful, especially up and down steps. I'm having a really hard time trying to get into an exercise habit right now. Even the recumbent bike hurts. I don't have anywhere near enough arthritis to even consider knee replacement. But I wanted to know of other people's experience. As you lose the weight after surgery, does the knee pain abate? I am 48, 5'4", currently weigh 232, and am hoping for insurance approval within the next month. If any of you, especially any near my age , had knee problems beforehand, please let me know how you are doing as the weight drops off. Lisa

Proud of you! Great job!

That is so FANTASTIC!!!! Congratulations!

Wow, that DOES sound like a long time. I feel like now that I've done my 3 month program, I am ready to have the surgery NOW! I just hope there are no delays because something is filled out wrong. Good luck on the 11th! I wish you a smooth surgery and comfortable recovery. And then a beautiful new life!

Wednesday I went for my last PCP appt. before surgery. He doesn't want to see me anymore until I have been released by my surgeon. So . . . now all my paperwork is with my surgeon and I go to see him on April 6, at which point it will be submitted to Aetna. I have my countdown to the 6th on my calendar, but I have no idea about the time frame between paperwork submission to Aetna and approval. Any ideas??? It would help tremendously at least if I knew an average window of time from submission to approval. I'm getting SO EXCITED!

I went to see my PCP a week after I saw my surgeon for the first time. He has been great at encouraging me and making sure my surgeon has what he needs to submit to insurance. Aetna does require a letter and 2 years of records from my PCP, so I didn't have much choice. But I'm glad I made him a part of the process.

So, I am now TWO WEEKS AWAY from my paperwork being submitted to Aetna. The closer it gets, the more excited and NERVOUS I am. But any kind of surgery makes me EXTREMELY nervous, so I know it's not second thoughts. My surgeon's office has now started a support group exclusively for Sleeve patients. I went to their first meeting last Tuesday night and it was so interesting. There were lap banders considering the revision to sleeve, people doing their insurance program like me, a guy only 2 weeks out, and another guy 1 year out. And lots of people in between 2 weeks and a year out from surgery. When they all talked about the ups and downs post-surgery, they talked a lot about getting in Protein shakes immediately afterward, gas pain, hating the chewable Vitamins, etc., etc. But one thing I never heard anyone say was that they missed their favorite foods. I was so relieved to hear that because I wondered if I would struggle with cravings and have a hard time staying away from those foods. I feel VERY encouraged by that.

Congratulations, AutumnLily! Can't wait to join you on that bench.

I second what sunshine6855 said. I went to my cardiologist, thinking that he could put a stop to it if he felt it were dangerous (I have a bicuspid aortic valve--it was there from birth). He said I was no more high risk than anybody else having the surgery. Because of my valve problem he wants to be sure I am on antibiotic while in the hospital, but he said it was standard procedure for ANYBODY to have antibiotics. And he also said that all the risks from morbid obesity (high blood pressure, diabetes, heart disease, etc., etc.) were much more dangerous to me than the surgery. So, just remember, the risks of being morbidly obese FAR outweigh the risks from the surgery. I have had various surgeries before, and I was honestly petrified before each and every one, no matter how routine the procedure. In fact, in one case I was so freaked out in the holding room that they had to give me something early just to calm me down. But don't worry! YOU WILL DO FINE!! Please update us when you feel like it! Lisa

Another request. I would love a copy if you have time to send it . . . 4craigs@comcast.net.

Hi! I was in the same boat as you. I decided I wanted the sleeve back at the end of November of this last year. My employers' coverage through BlueCross does not cover WLS at all, so I made plans to switch to my husband's Aetna coverage on January 1, 2011. My surgeon's office offered a free consultation with their insurance specialist. I took my husband's card and the insurance specialist was able to go by his coverage to tell me exactly how much was covered, what my deductible would be, my maximum out-of-pocket, etc. However, I was not allowed to make an actual appt. until after Jan. 1 when I was officially added to the policy. You might try that with your surgeon's office. At least you would know where you stand BEFORE you go into the 3 month program. It goes by faster than you think! It's hard to believe I am already halfway through!! Good luck and let me know how it goes. Lisa