lovealways

My sister had her hiatal hernia repaired while having her VSG procedure done....however, her insurance covered both. We live in NY and have a great surgeon. I am not sure the cost of VSG in NY or NJ =\

Hmm. I'd like to know too. Some people say they go by your first ever weigh-in at your consult with the surgeon but idk

Wrong. Those foods are mushy, yes, but loaded with tons of carbs/fat/sodium and 0 nutritional benefits. Were you explained by your surgeon in detail what is acceptable and what's not? Pasta is a no-go, practically for all of our WLS life from here on out lol. Good luck

I had a great experience with UHC. They did however tell me multiple times they only cover one weight loss surgery. Hopefully not the case for you. I was confused when they told me that but it was before I knew many people with bands had problems.

My UHC plan is great too...but they also only cover one weight loss surgery as well =\ That's better than nothing though!

What are your stats by the way? BMI? Maybe they can look past the whole age thing if they see that it's medically necessary right now.

I didn't realize we live basically pretty close to one another. I live in Mineola on Long Island. I have similar insurance to yours....United Healthcare Community Plan, which is also a medicaid plan. I was so dead set on having VSG surgery, but found out MOST medicaid hmo's like ours ONLY pay for gastric bypass since the VSG is a newer procedure. I would call your plan to see if they cover VSG and what the requirements are. I would check out Dr. Barkan or Dr. Brathwaite at Winthrop Hospital bariatrics. They are amazing and MAY operate on you despite your age.

Are you from NY by any chance?

Ricooo Suave!!!! Woohoo!! ::whistles::

We only get ONE BODY in this lifetime. That says enough. Who would want to hurt their bodies like that on purpose AND after a major surgery?

My sister is 6 days post-op and 8 lbs down. She is still on a clear liquid diet...tomorrow she can finally introduce Protein Shakes, sugar free/fat free pudding and some sugar free/fat free foods. After that, she goes on to the pureed stage of mushy foods for 7--14 days, then slowely introduces solid foods, but very carefully. No fruit/veggies for months post-op, and no bread for months, if ever. She also walks 1/2 a day. Every surgeon's idea of a diet post-op is different, but maybe you are moving a little too quickly post-op! Strawberries are high in sugar! Bread, even whole grain, is high in carbs and empty calories! Maybe try to stick to Protein first! Good luck

I've been every weight under the sun due to chronic yo-yo dieting. At my highest, 265, I now wear a 20 in lane bryant. At my lowest, 127, I was wearing a size 9. At 165, I used to wear a 12/13. I'm 5'4". I know for sure I'd probably never be a size 3 lol.

Congrats!

This is confusing to me as well. My BMI is 46 from my first weight with PCP and surgeon. If I lose weight and drop to a 40, is that ok? I always hear they go by your first weigh in with surgeon.

I have UHC and was dead set on getting a vertical sleeve. I researched it, was excited, and found out they don't cover any type of WLS unless it's RnY bypass. I've researched RnY and I'm now okay with getting it, but just check with UHC on their requirements and coverage. Every UHC plan is different.

I keep getting mixed messages too about requirements, etc. No one seems to know much. I have UHC Community Plan. I'm doing all the pre-op work now...but geez...some answers would be nice.

Usually those with a BMI of 50 or greater will have to do luvenox injections. My sister gets hers twice a day for a week.

I did from day one ' date=' my dr gave me pills for nausea. it will go away.[/quote']

Thank you thank you

Is it normal to throw up post-op day 3? Not a lot, but some nausea? I think painkillers would make the nausea worse, right?

Re tracey' date=' I know some pain and swelling is normal but I question what exactly is going on to keep her in icu? Abnormal swelling? Was there a complication? Don't be afraid to ask questions until u feel satisfied w answer. Sounds like something more is going on, but I'm not really in a position to say. Just my opinion. Please keep us all updated . Thoughts and prayers w u.[/quote']

Thanks so much. She has now been moved to a regular room and has been walking. Swallowing test came back fine, no leaks. Thanks for the help she's doing great now!

Tracey is doing ok. She is in surgical ICU still with very much pain. They are keeping her in ICU because her stomach is very swollen? Is this normal? =\

Here's an update on Tracey (I'm her sister) ... She is all set and ready for surgery and should be going in within 15 mins. Doctors found a hiatal hernia and will also repair that. We'll keep you posted! Good luck to everyone else having surgery this day!

I have UHC also' date=' and didn't have to do a 6 month program. All three procedures were covered under my policy, so I hope they can do it for you! If not I think appealing it couldn't hurt![/quote']

Hmm that's really good all 3 are covered for you. I don't see why my UHC would only cover just one procedure =\

Thanks so much for the help, guys. This forum has been so, so reliable and helpful.

I'm not even sure where I heard that if VSG is not covered by insurance, and only gastric bypass, then an insurance company would make an exception fo the sleeve based on medical necessity. Either I dreamed it, or something, because I don't know where I read or heard that! hahah. Like I said, wishful thinking. At this point, I know I would consider gastric bypass since VSG is not covered. I would hate to have to go through the process of appealing, etc.

So if I call my insurance company and give them the code they would be able to better assist me in seeing if VSG is covered? So far, two reps I've spoken to said only the gastric bypass.

Does anyone know if there is a forum like verticalsleevetalk for gastric bypass patients? =/

I would give a call to your insurance!

Need some clarification, please! So I called my insurance company (united healthcare community plan) and they said they only cover gastric bypass. I wanted the sleeve. I heard that some surgeons are able to actually get the sleeve covered, but it is a little bit of extra work. Is this just wishful thinking?

Also, I had my first consultation with my surgeon. So far, no one knows if I need a 6 month supervised diet since the patient advocate was out on vacation. I called my insurance 900 times and they said they don't see anything about a 6 month diet and that the only requirement is pre-auth. Should I go ahead and assume I don't need it or just go ahead and do the 6 months anyway??

Ahhhhhh. So frustrating! Thank you!!!! :)