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Tobeornottobe

Gastric Sleeve Patients
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Posts posted by Tobeornottobe


  1. I have Ky medicare, medicare humana and also Anthem. I have a band that has failed and needs removed. I really want to do a sleeve. Medicare guidelines say I have to do a 3 month diet trial. This is a blanket rule for barbaric surgery. Does not make sense to me, a diet trial?? I have a band... has anyone else had this issue?

    Health insurance companies have their rules for surgery. It is something they require for approval. We've all had to follow those rules unless we are self-pay.

    Use the 3 months to research and prep. It doesn't hurt.

    Good luck.


  2. I went to my first appointment with my surgeon today. I missed the BMI of 40 by 0.8 pounds! 0.8lbs! I thought I was going the hiatal hernia route to bypass insurance, but Cigna requires me to use my bariatric benefits. Had I known that, I would have worn some ankle weights. I'm so upset! I have high blood pressure that I'm on meds for. That should be a good enough co-morbity right? Did anyone with a BMI less than 40 and the hypertension co-morbity get approved? The Cigna policy is vague so I called them and they were no help. Surely they don't want people to walk around with uncontrolled hypertension. I'm probably going to just start over with another surgeon. I can't be stressed out for the next 3 months over 0.8lbs.

    I have Cigna and was approved with a BMI of 35 with co-morbidities. If you're under a 40 BMI, Cigna requires at least one co-morbidity and hypertension is a co-morbidity that qualifies.

    By the way be careful with the 90 days. As far as the medical management part, I wanted to be very careful so I did 100 days to be sure. I've seen people get denied over the time thing and have to start all over.

    In the meantime, I would advise you to start all the required testing.

    Good luck.


  3. First, congrats on your weight loss.

    Second, she may be genuinely concerned. When our loved ones are used to seeing us a certain size and we start losing, we may indeed look sickly to them.

    I guess it can also be a bit of jealousy as well since you said she needs to lose weight. Maybe you can use this as a opportunity to bring it up to her.

    Again, congrats!!!


  4. My worst experiences would have to be with the bariatric coordinator at the office. She would not return phone calls or emails and if you were able to catch her, she acted like it was a HUGE bother to answer your questions. I finally got fed up enough to threaten to report her to the office manager. Things got a bit better after that. When I was in the hospital waiting, my surgery was delayed and no one informed me as to what was going on. I finally lost it on one of the nurses who apologized profusely. The anesthesiologist was a bit of an ass who did not acknowledge my presence. The nurses were pretty great except one. I was in extreme pain and it was past the time for my pain meds. I called and she told me she would be back in 5 minutes. Thirty minutes later, she still wasn't back. I ended up getting a new nurse for the duration of the shift.

    The best: the surgeon did an amazing job. I had minimal pain from gas (walking as soon as I was able after surgery and as often as possible) and minimal pain from the incisions. I have not had any issues with throwing up. I was back to exercising and back to work within a week. I would deem it a success. Please note: I'm only a month out.

    The most annoying the On-Q pump which i was grateful for in hindsight and the Lovenox shots (needle phobic).


  5. Have you called them? They can usually email you the policy. You wouldn't necessarily have to start over but if the requirement with the new insurance is 6 months, you will have to do the additional 3 months.

    I did a quick search and found this: https://www.capbluecross.com/wps/wcm/connect/8c81d245-cf36-42fc-bee7-a19a9a2cf2f8/Bariatric_Surgery_11-2-15.pdf?MOD=AJPERES

    I would still call to confirm this is correct.

    Good luck!


  6. That sucks that your spouse isn't supportive. I didn't have that problem. My S.O. was extremely supportive, went to every appointment with me and sat in the hospital with me although I told him to go home and the doctor would call him.

    Maybe you can invite him to attend a seminar with you. It could be motivated by fear. Fear of the unknown is scary for most people.


  7. It does get better everyday. The pain from the gas was probably the worst. I walked a lot and that helped immensely. That pain was gone in 4 days. I'm definitely sore, it feels like I did a million sit ups. I am been blessed as I have not experienced nausea or throwing up. I hate taking the Lovenox shots daily.

    I have no problems getting my Protein or Water in.

    All in all my experience has been mostly positive.

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