Trinn

Hey, so, here's my situation. All the various people have signed off, so now it's just off to insurance. I talked to the team member doing the insurance submissions, and she said her goal was to submit to the insurer Blue Shield of CA, not BCBS) by the end of business yesterday.

My insurer has a 5 business day turnaround for responses on bariatric pre-auths. So, here's my question: is it okay to call the insurer and ask if it's been submitted? Can I call after the five days? I ask because we're trying to get me on the schedule before the end of August, but they can't schedule my pre-op apt and surgery until they get the approval. I'm going on vacation for part of August, so if I'm going to be on liquid diet then (my doctor will do 2 weeks) then I will need to be doing that while on vacation. I am putting all that into place (have to have my preferred Protein shakes delivered to my hotel, etc...) but I'm maybe a little impatient about the approval. :-)

Do you all call your insurer a lot? Is it okay to do it?

I'm a costumer and SF fan. I am looking forward to costuming "Doctor Girlfriend" from the Venture Brothers series. *grin*

To follow up, I'm not gonna lie. If someone says to me, "Did you have WLS surgery?" I'm not going to lie -- but how I respond will depend on who is asking. If a classmate or professional peer asks, I will probably say, "Yes, but I consider that a really personal question! I don't tend to discuss my health issues!" If one of my closer friends (like one of those folks who does burlesque) asks, I will probably says, "Yes. I am pretty private about it because I know it's a really charged issue for a lot of folks. If you ever want to discuss it, we can try, but I'm not making a big deal of it, because I know it's just one choice."

What in the world is sex-positive?

*laugh* It's a very Northern California term, and I think really, what I meant here was "They're all very northern California people." I'm a student and a peer educator, and a lot of what my friends and peers educate about is body positivity. So, when I say "sex positive" I mean, "I have fat friends who do things like dance burlesque, teach other fat women hip-hop, teach intimacy skills for bigger people, and for them, WLS can be a hot button issue, because they're putting so much effort into teaching and leading and modelling happy healthy sexy body image as big folks."

I will start off by saying to each his/her own. I work with 2 women who choose not to tell anyone they had WLS. One of our coworkers ( they are all supervisors) came to my office and asked me about my surgery, to which I am very open about. She spilled the Beans about the other 2 women who have had it and are keeping it a secret. Even one who is my supervisor with whom we have discussed on several occasions WLS and how she said she was going to Mexico to get it done one day. She keeps it a secret as well. I could care less if she or anyone wants to share. I can say that I feel that I find it deceitful to want people to think you did this without our new "tool". All of a sudden your workout and eating habits that were never successful before all of a sudden are working great. Some fear that they will be judged for having surgery, others really want people to think that their miracle diet is working. Its bull in a handbasket, and I am proud that i had WLS. It saved my life. Lies are hard to keep up with. No thanks.

Hey, thanks for writing this. I see what you're saying. In my case, people don't see me "dieting" because I don't "diet" -- I have tended to eat very low carb, but just all the time. And they don't see me working out, because I'm disabled (arthritis and injuries). I don't expect anyone will think I'm engaged in some miracle diet. My honest concern is that I am just not interested in having people say things I'm personally going to find offensive that they think are compliments. Like the other day, I was leaving the house and my partner said, "You look so cute in that dress, and you look cuter every day!" He was trying to compliment me on my work at sticking to my eating choices and losing 20 lbs over the past two months, but I stopped him and asked that he not frame this like that, that language doesn't feel good to me.

And really, my weight and my health choices are my business. My disinterest in sharing is part of my enforcing that boundary. If someone were to suggest to me that it was some "miracle" diet that changed -- though I don't know how they would -- I would just say, "I have been working with my health care providers to address concerns I had." And I'd give them my sweet-but-firm "Not your business" look. *grin*

I'm hoping to be. My nutritionist signed off on me on Friday, and now they need to file for the insurance. I'm hoping for an August sleeve around August 24, but it's going to depend of course, on the insurance (Blue Shield of CA) and the available dates. However, my impression is that the surgeon is not way booked up, and there might be available time then. I've already all of my other pre-visits and tests and bloodword -- just need my presurgical once we have the date.

If I don't manage to get in in August, I have to wait until December, after my school semester ends.

BCBS of CA takes 5 business days or less to approve, mine was submitted July 1 and approved the 7th even though they were closed 7/3. It does take them 48 hours after approval to fax it though

Well, the NUT said that the team nurse/insurance coordinator might be a little backed up, and so she probably would not be able to submit it immediately. Also, I don't have BCBS. I have Blue Shield of CA, slightly different provider structure. I don't want to pester the coordinator asking if she's submitted yet -- I suspect it will take them a few days at least.

I love the lemon. I tasted all the flavors of a couple of dozen forms of Calcium, and the lemon Bariatric Advantage were my favorite. I just sit and chew and chew and chew them while I do course reading or read email.

Wow, superinteresting question! I don't have a surgery date yet, but I've been doing a lot of medical stuff, and for two months, I've been on a mostly liquid diet (shakes, with one small Protein only meal a day). This has caused a fair amount of attention, because I spend a lot of time in spaces where there aren't healthy food options for me, and where my dietary habits have been really noticeable. (Lots of Jewish retreats and events, where I can't bring in food and the food is all "dairy", which means mostly carbs.

And what I say when someone pokes at it a lot is, "My doctor and I are trying to get to the root of a digestive problem I have." :-) If they push me, I say, "I am trying to finally resolve a problem that's been bothering me since I had my gallbladder out."

And after that, I don't discuss it. If someone says, "Oh, so you eat Atkins? " or "Oh, are you gluten free?" I just smile and say, "Oh, right now, I'm eating what's healthy for me, until we work out what works better. You don't don't want to hear the details!" And then I make a little face, that ever so slightly suggests it would be TMI.

This, is, in fact, mostly true. I have had a problem since I had my gall bladder out after acute pancreatitis over 10 years ago -- I have "bile salt diarrhea." And you know what? My BSD is completely gone when I just eat Protein. :-) I'm not interested in discussing my weight.

But other than that -- I am basically surrounded by fat-positive and sex-positive friends, and I am more concerned that one of them will get upset and feel a need to tell me I'm being a "traitor" or something else for having WLS. I also don't want to hurt the feelings of people I know who are too sweet to ever say that, but who are at my weight or higher. So, I have told 3 friends I'm doing this -- the ones I will probably need support from when first have surgery. I've told my children. But other than that, I am just "working on a health issue."

I know at some point, I will have lost enough weight that someone will be like, "Whaaat has happened?" in which case, I'll just say I finally addressed a health problem that was bothering me. I don't want to hear "you're looking better" and stuff like that. I look great now. I will look great then. I am more than the number of pounds I'm carrying. :-)

I'm hoping to be. My nutritionist signed off on me on Friday, and now they need to file for the insurance. I'm hoping for an August sleeve around August 24, but it's going to depend of course, on the insurance (Blue Shield of CA) and the available dates. However, my impression is that the surgeon is not way booked up, and there might be available time then. I've already all of my other pre-visits and tests and bloodword -- just need my presurgical once we have the date.

If I don't manage to get in in August, I have to wait until December, after my school semester ends.

Re: Premier Protein shakes -- I am a big chocolate person, and I usually never even bother with vanilla flavored anything, but I have to tell you, the PP vanilla shakes are really good. I like them more than than the chocolate, which I never would have guessed. Also, you can make them flavored for variety, using Mio drops -- Tangerine Mio + PP Vanilla = Creamsicle flavor! I also got a big box of strawberry to try, but they're my least favorite flavor. I don't hate it, I just don't love it.

Interesting! I met with my surgeon yesterday. I have a shorter list, in part because I had recently had a lot of bloodwork done as part of an annual physical. I had the first NUT visit at the beginning of June, and she gave me a mess o Vitamin and Protein samples, and basically laid out what they wanted me to do for food. The team strongly recommends a low carb diet, and that's what I'm comfortable doing. I would actually be really uncomfortable if I were asked to have that much fruit/veggies and grains at meals. She also strongly recommend a partial shake/partial food diet, and that's what I've been doing, mostly because I enjoy the shakes.

My surgeon said one thing I found interesting -- he said, "Even if you lose 80 pounds between now and your surgery, I will still do the surgery for you, because it's about keeping off the weight, not just losing it. So, don't feel you have to 'fail' at losing while you're waiting for approval."

I am a shake newbie, but I got some Premier Protein and I've been happy with them. I initially had the chocolate flavor, then tried out the vanilla. I don't think of myself as liking plain vanilla things, but it's become my favorite, in part because I use it as a base for other stuff. I also got the strawberry flavor because I heard it was amazeballs, but I am not that impressed.

The best price for them is at Costco; I don't have a membership but a friend got them for me. $25 for an 18 pack. Safeway had a sale for a while, $20 for a 12 pack, but now it's back to being far too expensive.

I have the chocolate in the morning. I have not given up caffeine yet -- I may be months away from a surgery date -- so I make a mocha shake using Starbucks Via. I take a single Via packet and add an ounce of hot/boiling Water (maybe a shot worth?) You have to do this because the Via doesn't dissolve in cold Water. Then I open up my icy cold PP chocolate, take a big swig to make room, and add the Via shot. I seal it back up and shake it well. MOCHA! :-)

For the Vanilla, I add Mio drops to change the flavor sometimes -- orange Mio drops added gives me a creamsicle flavor. I have also blended the vanilla with fresh blueberries I put in the freezer (the whole container, just popped it right in and let them freeze!) and a little ice. It makes a great smoothie.

I admit to not having tried other brands because I've been happy with these. I do prefer them cold; I carry some with me when I go out in a little insulated lunch bag.

I'm definitely going to call them; I couldn't today because I was at the dentist for most of the day. :-) Tomorrow I have a round of calls to make, including scheduling my psych eval and upper GI xray.

Hi! I'm very new, and this is my first post. In researching for VSG, I discovered the other day that my insurer, Blue Shield (not BCBS) has a new set of requirements starting today. Until today, they required 6 months of nutrition visits etc. Starting today, they appear to be much more flexible. Instead of the list of requirements, they have the following paragraph:

"Patients should have documented failure to respond to conservative measures for weight reduction prior to consideration of bariatric surgery, and these attempts should be reviewed by the practitioner prior to seeking approval for the surgical procedure (e.g., Weight Watchers, Jenny Craig, Optifast, MediFast). The timing, intensity and duration of the preoperative timeframe should be individualized and left to the discretion of the patient and provider. However, given the elective and life changing nature of these procedures, and the necessity of proper education and instruction in the lifestyle changes inherent in both the immediate and long term postoperative management, it is recommended that three months elapse between the initial bariatric consultation and the date of surgery."

So, my question is, has this rolled out elsewhere? How has this affected you? Yesterday was my first meeting with the surgeon. He didn't even talk about time frame, other than saying the nutritionist has to sign off on me. The assistant, however, looked at this new wording (she had never seen it) and said, "Oh, now they require three months." I responded that I didn't think it said three months, that it was flexible with a recommendation of three months, and she said, "No, that's never how it works."

Experiences? It's an issue for me because I'm a student with a long commute, and I will have to do surgery either before the semester starts Sept 8 (with enough time for some recovery), or after the semester ends December 20 or so. I was hoping to get a grant for an overseas language class in January, so this timing affects that -- the grant application has to be in long before a December surgery.

A link to the full revised policy guidelines: https://www.blueshieldca.com/provider/content_assets/documents/download/public/bscpolicy/Bariatric_Surgery_CU.pdf