azsenior

Yesterday I had a nuclear cardio stress test. It was not requested by my WL surgeon, but by my PCP because of a fainting spell several months ago. He just wanted to rule out heart problems. This test is in place of the treadmill test, but instead of huffing and puffing on a treadmill they inject a substance that causes the heart to beat fast. They take a CT-like scan before this injection and then afterwards to show the impact of the "exercise" on the heart and surrounding vessels. My mother had a stroke and my father had heart disease, but I I have not as of yet been diagnosed with any problems. Of course being morbidly obese with diabetes and high BP, I was really afraid I would have a heart attack during the test. They didn't have to take me outta there in an ambulance so I guess my results weren't terrible, but I will find out specifics next week. There were two cardiologists available in the office and they had me hooked up to an EKG and BP was taken every minute. Once they injected me with the stimulant material, I immediately felt dizzy and a little discomfort below my breastbone. They had warned me of these possibilities and also a headache which came a little later. I would say it only lasted 6-8 minutes. The technician told me people who are in better shape take longer to get their heart up to maximum capacity. I read that the nuclear version has a better rate of picking up problems. Also, it is preferable for folks with knee or foot problems. I would love to hear from others who had this test. It was not as bad as I thought it would be.

Nurselisa, that sounds fantastic. I love egg salad and tuna salad. Will keep that in mind to try when I get my sleeve, hopefully next month.

OCDgirl, keep plugging on the insurance. I am a NJ state employee retiree. I have Medicare Primary and Aetna Secondary. Medicare does not cover the sleeve yet, but I was told by five different Aetna personnel that they would pick it up once Medicare declined. Aetna covers all three procedures with the high BMI and comorbidities. The insurance clerk who works with my surgeon was furious that I was relentless about wanting her to apply to Aetna for the sleeve. She said I was wasting her time. She went on a medical leave. The new clerk made the application to Aetna and I was approved within a few days. I don't doubt the wealth of experience the surgeons and clerks have, but sometimes they might know as much as they think. Keep pushing. When you get a denial in writing, then you can pursue it through the channels. Suggest that you check out the insurance thread on this forum. There are people there who can help you should an appeal be necessary. Good luck and keep us posted!

Hi AMo! I also am a September sleever. Just got word today. Started the process in February. I will get my surgery date after I complete the pre-op testing and get my PCP's clearance. I wish you the best. This is finally going to happen for us!

Just got the phone call from Banner Bariatric Center saying that I am approved. Once I get PCP clearance and the pre-op testing done, they will give me a date in September. My surgeon's testing includes blood work, upper GI, chest x-ray, EKG and pulmonary function test. I had a real fight on my hands to get the insurance clerk to even submit for authorization. Medicare is my primary, but I have Aetna for secondary. She felt like I should settle for the band and not waste her time--her words! Fortunately for me, she took a leave and her replacement got the authorization in a week! I have lost 30 pounds since I started the journey with my three month supervised diet requirement. The center has three support group meetings each month that I have found very helpful. I agree with others who have said that this period is very productive in that there is time to process all the information and emotions. So, now I have to come up with name for my sleeve. Maybe Samantha

Is it available in retail outlets anywhere or only by mail-order?

My sister is not quite ready to pursue WLS. She had part of one foot amputated in April (diabetes) so she is still recuperating. She had a bypass about 30 years ago that had to be reversed. I think it was practically experimental. She ended up with such severe malabsorption issues she had to have it reversed and she gained back all the weight and more Not sure she would be candidate, but if she can get this wound healed she may be giving your doctor a call.

Received a phone message yesterday that even though Medicare declined, my secondary, Aetna, had approved!!!! I have completed all the prerequisites except the lab work. Am hoping for an August surgery date or September at the latest.

After getting the expected denial from Medicare last week, my surgeon's insurance director said she would try Aetna, my secondary insurance. I got home this afternoon and she had left a message saying that Aetna had approved my surgery. She asked me to call her. Of course, I was only able to get her phone mail box. I am actually scared to get too excited because I am afraid that she will tell me she called the wrong person! I feel that mainly because it was sooner than I expected to hear anything, but mostly because the woman (now on leave) who I had dealt with earlier got really angry with me because I was insisting that she move forward with a request for the sleeve. Several Aetna agents had told me that she should get the denial from Medicare and then go to the secondary.. She practically screamed at me that I was wasting her time and should just settle for the band. (For medical reasons, I am not a candidate for the by-pass.) I know that Medicare does not approve the sleeve yet, but I kept thinking that they could then go to the secondary and I knew that I met all the criteria for Aetna. I have lost about 30 pounds in my 3 month medically supervised program, have been exercising and am really psyched and ready to go. I do know that there are about 30 people they are trying to schedule in August, but I would love to have an August date! If it does turn out that she left the correct message for the right person, I want people who have a Medicare Replacement Plan to know that there my be hope for a sleeve, if the secondary approves. In the meantime, I will have to be on pins and needles all week-end.

Congratulations, GF! Looks like things are getting done in the BG offices! I have heard from Cara a couple of times by phone and email. Medicare, as expected, declined the VSG. She has now submitted it to my secondary insurance, Aetna. I do not expect a positive response so I will probably be faced with taking the band or waiting until Medicare approves the sleeve. I can't wait to hear everything about your journey!

I had open gallbladder surgery (big scar!), a complete hysterectomy and two years later hernia surgery so I delayed investigating WLS because I thought I would have too much scar tissue. My surgeon asked if mesh was used on the hernia, but when he examined me, he said where he needs to go in is all "virgin" territory and he did not expect any of those surgeries to present a problem. So, I would agree, it will depend on where your hernia is. Wish I had gone sooner now! My surgeon's office is submitting my application to insurance this week. Hope it works for you!

I think Water aerobics is very good in combination with other exercise. I have done it at the Y with good instructors along with the water barbells and either boots with wings or cuffs and i don't think anyone, even the most fit, called it easy. We were moving the entire time quite strenuously. I am doing it now in my home pool and I find that without that good leader I do not keep a fast enough pace, but I plan on finding a program at a gym as soon as I am cleared after surgery. Maybe just jumping around in the water without the resistance equipment is not much of a workout?

Rhonda, thanks so much for that info. I think I need to wait until I get a denial. Assuming that happens, I would definitely go for the peer to peer strategy. Would like to get the name of your surgeon, though. My sister is on ACCHS and is interested in WLS. ]

I think I have read all the Medicare posts on this forum and others, but I have not seen my particular situation so I would like to see if there are others like me. I have had an Aetna plan for quite some time as part of my pension benefit from the state of NJ. When I turned 65, I was required to also pick up Medicare. It is my primary and Aetna is my secondary. When I first started at the Banner Gateway Bariatric Center, the insurance clerk told me that I would not be able to get the sleeve since Medicare did not cover it. Even when I told her that I also had Aetna, she was very firm in her answer. I called Aetna four different times and was told by their agents that I would be covered. They had my card number that says I am Aetna Medicare. The original insurance agent is currently on leave and her replacement says they are requesting approval for the sleeve. Guess I will find out the answer sooner or later, but I would love to know if anyone else has this type of Medicare policy. I do not want the lapband and I am not a candidate for bypass. I have a "belt-line" which would make movement of the lap instruments difficult and open is just not an option given my age and previous surgical scar tissue. Would love to hear from other seniors in my position. Thanks!

Greetings all. I am a 65 year old woman living in Mesa, Arizona who is in the second month of a three month preoperative period. Medicare will not cover the sleeve and because I have a short torso creating a "belt line" I am not a candidate for lap RNY. Age and scar tissue make an open RNY out of the question. Guess I am saying that I come to the Realize Lap Band by default, not by choice since I need to lose around 100 pounds. I am looking forward to learning from all of you!