Daisee68

Surgery date that is. June 4!! I got approved by Cigna less than 24 business hours! (Filed on Friday at noon. Approval Monday morning.) I was so surprised! Now I am finally anxious because it is real! It was just sort of an idea up to this point. 4 weeks from today - I am sure it will go by fast...

UPDATE - My endocrinologist recommended me for the surgery. He said it is going to affect some of my other medical issues but that we can deal with them as they come up. Had my last nutritionist visit and surgeon submitted to Cigna on Friday at noon for approval and drumroll please.... Cigna approved me!! Already - less than 24 business hours! So, now I am waiting on call from surgery scheduler. Excited and nervous!!

AHH! I have the same problem! Seriously trying hard not to, but I called the surgeon's office today with a question and they said "do you even have a surgery date yet?" Um no I don't but my last nutrition visit it Friday and then they will file with insurance so I am assuming surgery date by June, right? I felt stupid for calling. It's only the 2nd question I have asked (and the 1st one was just calling to find out results of sleep study and make sure I didn't need a CPAP - I did not...) My question today was about stopping estradiol. I had a hysterectomy Oct. 2013 and am on hormone replacement. My endocrinologist told me last week that they would take me off estradiol temporarily due to potential of blood clots. That will put me in to instant menopause, so I wanted to know for sure if they were going to do that so I could call my OB/GYN to see if there was another solution (topical cream, etc.). Anywho, with the response, I felt like I was over-obsessing. BUT FYI, it is WAY better than it was in January when I first started this journey! Opposite of you, I have told just about everyone I come in contact with that I am going to have the surgery, so I am sure all of my friends, co-workers and family are completely sick of me! They just think I am annoying know. Imagine how I will be the week before surgery when I am / have been on a liquid diet AND am suddenly menopausal! They will really hate me then!

My surgeon requires the sleep study to rule out apnea but says most of bariatric patients have it. I did the test but did not have apnea thank goodness. BUT I had a home sleep study. My insurance required a home study because it was cheaper. The equipment was sent to me, I hooked it up and turned it on and went to sleep in my own bed. It is cheaper so insurance companies prefer it and I was able to sleep better. If you have to do the test, ask if home study is an option.

That seems a little longer than most but I suppose there could be mitigating factors. See link below which is a very long post of details about what you need for the hospital. http://www.bariatricpal.com/topic/181994-the-official-what-you-will-need-for-your-upcoming-weightloss-surgery-thread/?hl=pack I think most people sum it up by saying they didn't use half of what they packed. Good luck!

Congrats!! I have 1 more nutritionist apt next week then we submit for insurance approval. I am hoping for May surgery but betting it will be June.

Well I am certainly getting closer. Finally did the sleep study (at home). I DIDN'T have sleep apnea which I knew all along but dr required it. (One of the few conditions from being obese that I don't have! ). I have my last nutritionist visit on April 29 and then they should be able to submit for approval. One of my NUT appts was too close together (only 2 weeks instead of 4 weeks) so I bet Cigna makes me have 1 last appt. (Frustrating. I told that person I was supposed to wait 4 weeks, but they wouldn't listen. Still using the same surgeon but now a different location where there are different nutritionists and patient reps, etc.) Still seeing counselor - mostly once per week. Having some doubts about the surgery right now, but I think it's just cold feet. I have an appt with my endocrinologist tomorrow to discuss sleeve vs bypass to make sure I meet requirements for bypass. (I have a lot of other medical issues that won't go away with RNY and need to make sure RNY won't affect those health issues by keeping me from using the correct supplements, meds, etc.) Will feel more certain after I talk to him I think. Anyway, long story to say, thanks. I am still moving forward.

I haven't had the surgery yet, so I don't know if my dr requires or not; however, my dad had to do this after his knee replacement. He was terrified but got used to it very quickly. Its not quite as bad as it sounds because it just goes under the skin, so you pinch skin on your abdomen and then insert the needle. It goes very quickly. Do you have someone else that can do it for you if you can't? I had to help with my dad's a few times and then he just had to figure it out.

Well, best of luck to you with your decision(s). Does the $50 dietician fee mean than all the other pre op tests usually required for the sleeve are also required for hiatal hernia repair (except for dietician)? If you don't mind answering, since you already indicated how much you paid for the EGD - how much was the sleeve going to cost you? You don't have to answer if you don't want to. I was just curious. But again, I hope things work out for you. I have a friend who just went the same route with the same surgeon. No nutritional counseling or psychological testing prior to surgery required because they are not using insurance to cover the sleeve portion of the surgery and these requirements are just insurance requirements for some. This surgeon is known to be an excellent surgeon but not sure good at cutting means good at long term success. Just my opinion and why I have chosen another doctor. Having said that, my friend is doing very well (only 6 weeks out). It may work for her just fine. For me, without the counseling, I will never be successful at this.... (PS - the sleeve was done on an outpatient basis - home same day - first appt wasn't for 3 weeks - not the way I want to go). This isn't a post against Dr. Nick. Just to say it not the best choice for me.

@@MsAlaineus - I had my 6th counseling appt today (also with someone specializing in bariatric patient). I actually said to her that given the ups downs I have had in just 6 weeks dealing with food issues (and I haven't even started a pre-op liquid diet yet!), that I cannot imagine how people are successful with this surgery without counseling. I am currently dealing with acceptance of being a food addict. It's tough to accept and a word I don't like very much but somehow / someway, I know I am going to get to the other side of this - and counseling may be as big if not bigger part than the actual surgery! Best of luck with your counselor. If you don't hit it off with her, look for another one. That relationship is very important.

Congrats! Diabetes is a big reason for me to want the surgery too! Great advice on this website and I am sure you will find it helpful. Best wises with your journey!

Congrats!! Glad to hear all went well!

Sleeve is definitely becoming more mainstream and a lot of people are going that route, but I was told they only have about 5 years of real results from it. I have seen a lot of folks gain their weight back afterwards (but of course, that can happen with any of the WLS). Biggest determining factor for me was reflux. It can get much worse after sleeve. My dr strongly recommended against that for me because I do have reflux. Having said that, from sleeve you can always have a conversion to bypass if needed later. Still not sure what age would necessarily have to do with it. Good luck with whatever you decide! Agree that you can't make a bad decision here. Seems from the veterans the only bad decision is not doing anything.

@@drmeow Great advice! I needed to hear that. Thank you!

I am sure this is somewhere else too, but I haven't located it so I thought I would start a new one. I had a counseling appointment today and one of the things we talked about is understanding my reasons for doing this surgery. (I am still pre-op.) Not just the generic reasons - smaller clothes, healthier, etc., but really achievable and measurable reasons. My counselor said I need to solidify these so that that when I want to give in to that head hunger, I have something to combat it with. So here are my top few for now: 1) Functional "cure" of diabetes / off metformin 2) Never over a weight limit again - attic ladder, swim park slides, chairs! 3) Able to to have my picture taken and not turn away from the pic when I see it - no longer in full denial that I actually look like that! 4) Fit in airplane seat with both arms down. What are some of your reasons?

I went in asking to have the sleeve but was experience bad bout of acid reflux that day and she said she really did not recommend the sleeve because it can make the acid reflux worse. It took me a while to come around to the idea of bypass, but I am finally there. I really don't want to have a revision later either and plus I'm tired of the acid reflux and given bypass can essentially cure that, then I am ready to go with bypass. (PS - those I have known that had the revision was due to either reflux and/or weight gain.)

I don't know if this has anything to do with the WLS, but when my thyroid is messed up and I am hypothyroid, I have severe RLS. Do you have thyroid issues normally? If so, maybe you need an adjustment in your med? I am told it may change after surgery as we may have trouble absorbing the synthroid.

@@TMG1980TMG - Funny you should ask! I actually just got the equipment and am supposed to do the sleep study tonight. FINALLY!

How about taking measurements? Sometimes you are losing inches when not pounds and it helps. Or go to the store and pick up a 25 pound bag of dog food and you will suddenly realize how much 25 pounds is! You are doing great and can't wait to join you! (And you can quote this back to me when I am asking why I am stalled... )

Not sure what insurance you have but I have Cigna and specifically it says " "Medical management including evidence of active participation within the last 12 months in a weight-management program that is supervised either by a physician or a registered dietician for a minimum of three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly documentation of ALL of the following components:  weight  current dietary program  physical activity (e.g., exercise program) Programs such as Weight Watchers®, Jenny Craig® and Optifast® are acceptable alternatives if done in conjunction with the supervision of a physician or registered dietician and detailed documentation of participation is available for review. " You might ask your insurance company for a copy of their requirements, but it is likely fairly similar - in that you will have to have it verified by a physician or dietician.

I'm in Dallas. Still a few months out from surgery. Best of luck to you next week! Let us know how it goes!

Perhaps addict isn't a fair description for everyone but for me it is. First thing my counselor said is that I will always be a recovering food addict just as a alcoholic is in recovery the rest of their lives even when they stop drinking. And so yes, the surgery doesn't stop you from being an addict and I think that's the whole point. I didn't get to 326 pounds because I was eating like an "average" person. So if I don't deal with the addictive behaviors upfront then the surgery, for me anyway, is nothing more than a quickie diet. I may lose the weight but I will eventually gain it back if I fall into old patterns. Learning the surgery is only a tool to aid in the weight loss and not a "cure" for obesity has been key for me. And my counselor has been great. We aren't necessarily spending the hour bemoaning a bad childhood, etc. We are just figuring out why I turn to food and then she brings every single thing I say back to the food and my control issues (or perhaps lack thereof).

I wonder the same thing every single day several times a day. I keep telling myself though that I can change my mind right up to the point they put me under. Our wait is only 3 to 6 months though not 2 years. If I were you I would put my name on the list and then try the other things too. Hey, if the 1 more diet / 1 more trainer works, then you don't have to go through with it. (Assuming it is not something you have to pay for to get on the list.) One thing that has been super helpful for me so far as I go through the pre-op process is counseling, and honestly several times a day I think "maybe with her help, I can do this without surgery". In fact, I have an apt with her tomorrow and was already going to ask her what she thought. Sigh.... You know what I think she will tell me? "It is possible but at this weight you need something drastic and in typical addict fashion, you are lying to yourself again. " Who knows. Maybe she won't. I'll let you know what she says...

Oh wow! I am so sorry! That is awful. Have you called them yourself? I know there is a written appeal process for most insurance companies. Have you tried that? While it is supposedly covered under my plan, Cigna has been very difficult approving other things, so I fear in the end they will decline as well. Oops. just saw you already mentioned the appeal. Really so sorry...

Sorry you seem to be struggling. I am sure that will be the same for me and certainly is for many. I have been going to a counselor in my pre-op preparation and I find it very helpful. Have you had a chance to do that? Even if just a few visits. I have been stunned as some of the issues I have uncovered / realized in just 1 short month. Don't get me wrong! I cannot even pretend to understand what you are going through right now so I am not discounting your feelings at all! Just wanted to say glad you came here and I am sure you will get lots of encouraging feedback from others in your same position (and which I will hopefully look back on for advice in a few months myself.) Best wishes!!