SummerShadow

lol Now THAT'S the spirit! I'm going to go toe to toe with my insurance company too, I'm betting.

Wow. I hate that. I'm waiting, and will over the weekend, JUST to get an appointment with my old PCP since the new one has staff that never answers the phone (just rings and rings). Always one the weekend, right? And like the waiting isn't long enough as it is. Keep the faith... and please let us know how things go!!!

A friend of mine just had RNY bypass and she has Hashimoto's. Is your doctor helping you sort this out? I hope?

Aaahhh... good point. Reflux is one thing, thyroid another. Wouldn't that be awesome, though, to be able to do it without surgery!?

Hi everyone. I've posted in the gastric sleeve section and have that listed as my surgery in my profile. How do I change that? The reason I ask is that I just found out that the sleeve isn't going to be an option for me due to my having mild reflux. Looks like bypass will be my only option that won't make that worse. Bypass, from what I've read, actually helps in most reflux cases. So my question is two part: 1) How do I change my surgery in my profile to bypass, and 2) Have any of you been approved for bypass with reflux or GERD? Oh, and I looked everywhere to see where I change my surgery in my profile and cannot at all seem to find out how I change that. Thanks so much in advance for your help.

I'm really new to this so not sure, but I think that the basic criteria is the same (BMI etc). I like the idea of the sleeve better as well, but since I do have reflux I'm sure they'd deny me for sleeve.

You may have seen my last reply by now, but it's likely due to the sleeve procedure having a very high risk in causing GERD/reflux in people who don't have it, and also making it much, much worse if you do have it, even when mild. Seems there's a corrective surgery that may have to be done if one develops reflux/GERD after the surgery, or if it becomes worse. Maybe bypass would be approved for you since you have mild reflux. I'm having to change my focus on that as well since I also have reflux.

Okay, just did a bit more research. Bypass actually HELPS, and in some cases CURES reflux/GERD but that gastric sleeve, lap band... etc.. could make it worse or even cause it if you don't have it to begin with. So, guess I'll be changing my option to the only one I have left, which is bypass. I hope you can get some resolution with your situation. Has to be so frustrating.

So sorry to hear that. How frustrating! May I ask which surgery you're trying to have? The reason I ask is that I've read on many medical sites that one of the 'co-morbities' that may be accepted AS a co-morbity was reflux. Also, when reading about the different types of surgeries it stated that lap band wasn't advised if someone has reflux and gastric bypass and sleeve actually HELP with reflux. This is all so confusing, really, isn't it?

Thank you. Insurance companies are so fickle and vastly different from one kind and state to the next. But, I guess once I have that first appointment I'll get some pointers, hopefully, on what to do on my end next. I was hoping the diet that my Endo put me on would count as I just got a weigh in a couple of weeks ago. Maybe with it being that close, who knows? Or, I may have to start from scratch and wait 7 months.

I'm at step one of this process & have my appt with the surgeon next month.... so I'm brimming with questions, concerns, etc... with regards to what insurance requires and what may or may not count. I have BCBS AL..... My question about the diet thing is this: My Endocrinologist (not my PCP) told me to lose weight (because I'm pre-diabetic) and to follow the plan on a paper she gave me. I went back later, and it wasn't every month because she didn't ask me to do that, and I'd gone from 328 to 280 (was a very restricted diet), and it was literally over 6 mos time from when she told me to follow the plan and when I saw her last (about a month ago) and I'd lost that weight. I know my weight goes up and down because it's unbelievably difficult to stick with such a strict diet when you've not had surgery (for many of us it's difficult anyway). I wonder if that would count as 6 mos of doctor supervised diet since it was a plan she gave me and I followed? The only thing that didn't happen was monthly weigh-ins with her. She's an hour and a half away so monthly weigh-ins would've been a royal pain but she also didn't require or ask me to come in once a month to weigh in. Any thoughts? With regards to comorbidity requirements: My BMI is WAY up there, like 50, so I guess I don't NEED to have a comorbidity of any kind to qualify in that respect, but.. I do have the following and wonder if this helps approval? Pre-diabetes Arthritis HBP (not on medication though) sleep apnea (Can't use CPAP due to intolerance and causing bruising and pain so use an oral device) High cholesterol High Triglycerides Fatty liver (NASH) Stroke risk (Had a TIA in 2013, heart ablations in 2014 for AFib, SVT, and Atrial Flutter). Thanks for your patience with all my questions. I'm having difficulty getting my PCP and my former PCP to get back with me about records showing my weight, BMI etc. I've NO idea what I even need from them but trying to be proactive (suggestions?).

I have BC/BS of AL as well and am just starting this journey. My very first appt is in March with a surgeon, my very first step, but... my PCP sucks, and the last one sucks even worse (they're ratings online are spot-on). I'm a little outside of Montgomery and use Montgomery docs, but it's SO hard to find a PCP who isn't indifferent and with a crummy and often incompetent staff (I don't say that lightly either). I'm scared because I have to either stick with the doctor I have, who is one of those who speaks with you for a couple of minutes with his hand on the doorknob, office staff that won't answer the phone half the time (No menu or option to leave a message) and doesn't even let you know he's left the exam room for good until a nurse comes in to usher you out to pay. I'm trying to be pro-active and get letters that I need before my surgeon appointment next month, but it's like pulling teeth. I called to see if I could get a letter from my previous doctor, because he's who I saw at the beginning of 3 years ago... and was transferred to a nurse who interrupted me mid-sentence and left me on hold for 10 minutes before coming back and telling me someone will have to call me back from "New patients" in order to make an appointment. Thing is, I told the nurse I just wanted to see if I could get the doctor to write a letter and/or suggest the appropriate medical records to show my weight and BMI dating back when I first saw him in Jan 2013. She didn't listen and told me my account is inactive because I haven't been his patient since Sept 2016, then sent me to records. I don't want to go back there, it's horrible, but my current doctor isn't much better. I also feel that NOW isn't the best time to find a NEW doctor as they'll have to do records requests etc. I honestly don't know what to do. Already this stress and it's just the beginning of this journey. :/ Sorry my first post is nothing but a rant, but this is completely frustrating for me to already have a mess just trying to get a letter and records to show my weight and BMI. No one has called me back yet either and not sure when or if they will. Such is the nature of the beast with these two offices. Thanks for reading. Again, sorry for the rant.