tigerbelle

I hope all works out for everyone...just to make you all feel a little better--at least you have the chance to get approval and coverage...my insurance (State of Louisiana) does not even consider coverage of bariatric surgery, so I will be paying myself for the entire process

tigerbelle...my beginning stats were very close to yours, I am 5 feet and at the same time last year, Sept 2011 I was at 276. That was so much weight to be carrying on my small frame and it was simply no longer tolerable for me, I prayed for the strength and the options available to me to be able to lose this excess weight that has been holding me down. I re-joined Weight Watchers and got back on plan.
Shortly thereafter I heard from someone that my ***, Kaiser Permanente covered WLS. I had always thought that only PPO insurance covered this kind of elective surgery, and had never thought to even ask my primary about my options for weight management, other than doing the approved, but expensive medi-fast program. I was hoping for the lap-band at this point, not RNY which I felt was too drastic.
I scheduled my annual physical with my primary as I usually do with the intent of asking if I would qualify for the lap-band. At the conclusion of my visit, I brought it up, and she quickly agreed that this would be an excellent option for me and with a BMI over 50 and high blood pressure and high cholesterol, I easily met the criteria for acceptance into the bariatric program. She referred me to the program that afternoon.
Kaiser's program called "Options" is a mandatory 12 week program with weekly classes and structured weight management obligations. The group classes were held in the evenings once a week, back and forth, one week with a behavioral therapist, the next with a nutritional counselor. We were asked to participate in a calorie controlled diet and exercise program with a mandatory weight loss expectation of 10% before being scheduled for surgery. This included daily food and exercise journaling and weekly weigh ins so there was definately the accountability factor. I got a huge notebook of information, learned so much about nutrition and handling the emotions that come with a life change like this, and I am so glad that I had the time to study up on the surgery and really ready myself. I started the program 9/27 and finished up just before Christmas, and mind you, I had to be on a diet all Fall, through Halloween, Thanksgiving and Christmas/New Years, but once I was committed, I found the strength I needed to stay on course. I was referred to the surgeon in early January and met the criteria of pre-op loss at 27 pounds lost and completion of the 12 week program with all logs completed and adherence to the process.
I knew that I had some things pending early in the year, I had to move on March 1st and I had a huge conference commitment at work on 4/4 and 4/5, so when I saw the surgeon for my consultation, he asked if I would like the surgery in late January or early February and I elected to delay the surgery for 3 months knowing that I might not have the strength to get through my move and work commitments if I ran into complications, or not knowing if I would be extremely weak. The doctor said no problem, with the directive to not gain any weight, and in fact lose a bit more if I could to shrink my liver even more before the surgery.
I had VSG (the best option I chose for ME) surgery the day after the conference 4/6/12 and I truly believe this was the perfect timing for MY life. I felt comfortable with changes to my diet, I was already on board with exercise and my move went without a hitch. I was ready.
5 months post-op and in total I have lost 86 pounds and my petite but curvy body is coming back, I've gone from a 3X-4X down to a 14 and I feel so much better. My surgery went well without complications and I feel happier than I have in decades.
This was the best decision I ever made for myself!! You decide when the time is right, but if you opt to delay, use that time to study up and start eating in a manner that is closer to what your post-op diet will be like, you can easily start by limiting your calorie intake to 1600 for about 4 weeks, then 1400 for 4 weeks, then 1200 for the remainder, but of course allow for your holiday splurges...we all have them, as long as you get right back on program. Try to lose what ever you can before surgery, and walk, walk, walk and drink at least 64 oz of water/sugar free drinks and take a multi-Vitamin as well.
Good luck on your journey...I hope it works out well and feel free to contact me if you have any questions!!

I started my process mentally last January and decided to go self pay route in Mexico in May-June. My surgery is this Tuesday, 9/25. I needed time to prepare myself and that included several food funerals! I know that puts my weight up some before my surgery, BUT I am now completely at peace with never having another pepsi or junk food again because of those food funerals. And I am happy to say I have lost 20# from my pre op full liquid diet! :-)

I'm self pay as well. My insurance has a writer in it that says they will not cover any type of WLS nor anything related to WLS (ie doctor consults, psych consults that are leading up to WLS)
I am looking into an insurance extra called BLIS. For a little less than $1500, they will cover complications Should they arise. Perhaps something to look into.

as a taxpayer, this is the kind of thing that angers me...not that medicaid covers WLS but that people like me--who work in State government--have insurance plans that do NOT cover WLS...so I am working for the government and don't have coverage...but my taxes that I pay as a worker are being used to cover WLS for those who aren't contributing taxes...unfair to the max

as a taxpayer, this is the kind of thing that angers me...not that medicaid covers WLS but that people like me--who work in State government--have insurance plans that do NOT cover WLS...so I am working for the government and don't have coverage...but my taxes that I pay as a worker are being used to cover WLS for those who aren't contributing taxes...unfair to the max

thanks for the advice, angeleyes...that is something I will talk with my insurance company about
judysart: I hear ya...what makes me so angry is that it is proven that the long-term costs of treating complications from diabetes, for example, far exceed the cost of the WLS...I don't understand why insurance companies don't recognize this

thanks for the advice, angeleyes...that is something I will talk with my insurance company about
judysart: I hear ya...what makes me so angry is that it is proven that the long-term costs of treating complications from diabetes, for example, far exceed the cost of the WLS...I don't understand why insurance companies don't recognize this