LindsJ83

Hi Theresa - This is my opinion and best educated guess: Because your current insurance plan does not cover bariatric surgery, there is a very real possibility that when you switch to your new insurance plan during the open enrollment they will require you to start from square one. There are two distinct scenarios here and I will give you both: Scenario 1 - Your insurance is effective January 1, 2014 and you have done mostly all of what you need to do. Your surgery will be scheduled soon after. Scenario 2 - Your insurance is effective January 1, 2014 and you have done mostly all of what you need to do. Then, you find out you have to start all over again. All insurance companies won't lay things out for you so that's really why you need to rely on your surgeon and his office to take care of your stuff so that 1rst letter of approval will come through. Do you have a surgeon picked out already? Have you gone to an informational session? More importantly, seeing a nutritionist is a wonderful thing to do however, most surgeon's offices have an on-site RD that you are REQUIRED to meet with at least once before your surgery. As far as photos go - the more ammunition you have for the insurance company, the better. But, keep in mind that your visits to your PCP MUST include your documented weight/health at the time of the visit. They need to be for at least 6 months in conjunction with your PCP and/or RD. You sound a LOT like me when I started: I am a planner, I don't like surprises and I like to get as much out of the way as possible. So, it practically killed me knowing I had to wait...and wait some more...and more. This is what I can definitely promise you: As each day passes, you will be more sure in your decision to do things. My surgeon's office said the quickest they have seen someone go through the process has been 3 months. Insurance approval is completely separate from what a surgeon's office asks of you. They are all different. I have heard someone having to write 5 or 6 different essays, contacting post-op patients, etc. You will also need clearance from multiple doctors in different areas of specialty. For most patients, they need an upper gi series, an ultrasound, an endoscopy. Some need pulmonary, cardiology, sleep testing. For all patients, they need labwork. All of these obviously go beyond insurance requirements and approval. The best thing you can do is: Pick a surgeon if you haven't yet, go to an informational session, support groups, find out about this new insurance as much as possible so that when January does come - you are at least 10 pounds lighter (you will need to lose weight anyway before surgery so your liver is the healthiest it can be) and you have ammunition for the surgeon/insurance company. Unfortunately, there is no real yes or no answer. This is a life changing decision, so remind yourself every day that it will take some time to get everything figured out. I hope this helps a bit! And, good luck and love to you. All my best. -Lindsay

Thank you for this post! I go for mine on the 1rst and I'm REALLY nervous. I just had my upper gi series done and it was horrendous. I have a strong stomach and I gagged and almost threw up multiple times from the barium. So, I'm NOT looking forward to anything else going down my throat!

My insurance is slightly confusing as it is. My husband's plan recently went from Connecticare over to Oxford however, It is United Healthcare BY OXFORD - I guess it is still considered to be Oxford?? Very strange. I've been working my butt off on getting all the paperwork filled in for my surgeon's office. I have my appointment with him at 10am tomorrow! I'm so anxious but sorta nervous too. I'm hoping (more like sitting on the edge of my seat and crossing my legs and fingers and eyes) that he tells me my letter of med necessity that my dr has written, a patient statement, 4 pages in length of dieting attempts and logs from 6 months will be sufficient enough. It will be a bummer if he says I have to wait but I know everything happens for a reason. How are things going with you??? KD and Kailie??? What about you girls? Any news on the homefront???

I had my seminar tonight! I love love love my surgeon. I'm calling the office tomorrow to make an appointment with him. I really need to call my insurance company again and get squared away on this "verbage." They say and/or in a lot of their requirements for bariatric surgery. I just want to get the ball rolling! Have to keep reminding myself to sloowww dowwwwn. KD - that is amazing news about your surgery! You will have to let us know when you do!!!

Hero where are you from and what program at what hospital is it???

P.S. I say this because I stepped on the scale today and was the same weight I was 2 weeks ago - before I started trying to eat better and at least walk every day.

Mine is around a 53. I was just thinking that about 5 minutes ago before I logged in. It's funny that you said that because I was going to ask that question. It has only been a week. I cut out soda about 95% (I had a Diet Pepsi yesterday) and I've been concentrating on walking but I just feel SO DEFEATED every time I try to lose weight or even get healthy for that matter. It brings me to tears to be honest. Which is one of the reasons I want to do RNY to begin with. I just have SO MUCH to lose and it's hard to even exercise. I get frustrated easily and all I want to do is give up!

So jealous! Have you lost any weight before the surgery? I started about a week ago and I'm already down 8 pounds!!!

May83Gem - When are you having the surgery??

KD - I think that is normal. It is all based on your weight. But, definitely let your nutritionist know and see what they have to say. I was a little surprised I was getting that much as well but it adds up quick!

I know Kailie. I agree with you! You girls have given me so much hope! I'm on Day 3 of "eating better." Haven't had soda or candy, chocolate, very little bread, no pasta. I went to The Vitamin Shoppe a few days ago because I know GBS pushes for protein and more protein. I bought Designer Whey in Vanilla. It's actually pretty good! If you guys are struggling with protein (I do) and as long as your nutritionist okays it (I haven't met with one yet but know I need to start losing weight now) I definitely recommend it. It's around $15 for a can. Yesterday I mixed 16oz of milk with 1 scoop and added 2 ice cubes. Tastes very similar to a liquefied vanilla milkshake. I've never been a breakfast person so I struggle with eating the right things early in the morning. The last 2 days I've had it and I make it to lunch without feeling like I'm starving. It's 18g of protein. KD you asked about My Fitness Pal - I think that is what is keeping me motivated as well. When you sign up, you input your weight/height/all your info and it tracks everything you eat. I love it because I don't have to read packages anymore. If I want to have something (within reason of course) I scan the barcode, it calculates everything for me (down to calcium and iron intake!) and deducts my calories. I have about 2200 calories that it set me at. If I exercise, it gives me credit for my calories burned. When you are finished for the day, you hit "finish this entry" and this amazing little note pops up and says "If every day were like today you would weigh ____ lbs in 5 weeks." The first day I did it, it told me I would be able to lose approximately 17 pounds in five weeks. Personally, I think it's really motivational. 17 pounds for a heavy person means not ever having to wear size 26 jeans again. 17 pounds for a heavy person means you can be one step closer to a healthy liver for a healthy and successful surgery. It's a free app too!!!!!

Hey hero! Welcome ; ) The four of us can be newbies (and be excited) together!! I go for my info session on the 21rst - I forgot to tell you KD! I found a new session that won't make me wait so long!!! Or maybe I did, I can't remember. Anyway, hoping to meet with the surgeon by the end of the month and get this thing going! I'm on Day 2 of "new way of eating" and it hasn't been as bad as I thought. I started My Fitness Pal. You guys should check it out if you haven't already. It is AMAZING. I love it.

That is unbelievable! I'm so jealous! I'm trying to get everything organized now - the amount of paperwork is crazy. Who do you have for insurance and what do they require? Mine is a letter of medical necessity, prior documentation and/or physician notes that total 6 months of attempts made and a psych eval. I have a journal of about 4 months worth of food and exercise from a few years ago. It's lurking around the house somewhere and I'm trying to find it!!! Haha...I'm SOOOO happy for you!!!!

So, I was able to register for another seminar that is only 2 weeks away! The benefit of this hospital is that the dr has performed the gastric bypass on one of my friends as well as 3 of her cousins and all have been incredibly happy. Started MyFitnessPal too so that I can get as much weight off as I can before I see the dr. It seems like this is all I can think about!!!!

I'm not quite clear if everybody has to have it (that'd be a good question for the masses who have already had the surgery) but I know that some people have had it done. I suppose it is up to your insurance. I know for mine it is 2 visits to the RD (registered dietitian) that is NOT covered and a psych eval. But, I imagine pre-op testing also consists of things like a stress test, blood tests, cardiologist and gastro so the surgeon doesn't run into any surprises. This is what is driving me nuts! I'm a clear cut person and like straight to the point answers and unfortunately, everyone is different and so are the answers. GRRRR!!!!

Oh, I see what you are saying! That makes sense...Do you have to have an endoscopy done as well? I'm not nervous about the surgery but I am if I have to have an endoscopy. Haha. Go figure!!!!

THAT IS AMAZING YOU GUYS! I'm so happy for you both ; ) I wonder if it is like that everywhere - my BMI is over 50. I'm around a 55 like you KD. That breast cancer statistic is scary. Holy crap! Are you private pay KD or do you have insurance?? I know after losing surgery I will definitely have copays but one step at a time I guess! We have to get healthy first. Is the $1500 something you have to pay before you have your surgery??

Oh and I meant to ask - HOW DID BOTH OF YOUR SEMINARS GO???

Hi again girls! I'm so glad the 3 of us are starting together <3 I'm about the same height and weight as ya'll. I'm 5'7 and 344. I'm in around a 26 right now (at least for jeans anyway) A few years ago (before I got married and had a baby!) I got down to about 240 or so. That's the smallest I've been as an adult. I was comfortably wearing a size 18. I felt wonderful but my regimen was so strict I could barely keep up. I'm surprised I made it as long as I did. I was a workout Nazi. I thought it was hysterical that I had to end up getting a cortisone shot in my foot because I was working out so much I was putting crazy pressure on my toes. KD - I know what you mean about looking at clothes and thinking "Oh my god! I can't wait to wear that!" I'm ready to get the surgery tomorrow but I know everything takes time. Like you, the thought of losing 200 pounds (209 would make me 135 pounds) is just really surreal to think about. Where are you girls from? I live in Connecticut, about 10 minutes south of Hartford.

Hi KD I'm just starting out too! We can be WLS buddies together. I have my meeting in approx. one month! But I've been so anxious to get the ball rolling that I already have my health forms for the dr filled out!