Subaru

11 minutes ago, briae13 said:

@BeTrue83 did you have to take the survey thing? So annoying, felt like I had legit just answered allll of the same questions
@Subaru I have a ppo, but I would think 2 would be the minimum. The first visit she asked different questions about how I ate and then gave me "homework" on how to eat differently. Second visit was mostly just checking that I was (mostly) following instructions and see if I made any body composition progress. The class is something the NUT has to schedule you for. I think mine is @12:30 or so? But there was another earlier, there's 2-3 others who attend at the same time. Tbh I kinda wished I had more time with my NUT, it's scary to think I saw her twice and now won't see her again till post op lol

Thank you! That's kind of what I was thinking (2-3 weeks) and I'll certainly be checking with my surgeon's office regularly (should I call insurance company itself though?) also do I pay deductible before approval or after? Lol so new to bcbs

How far apart were your NUT visits scheduled? I’m going to seriously lose my **** if this adds two months. 😳

Also, yes, I would call your insurance company once you know the drs office has submitted for approval.

9 minutes ago, BeTrue83 said:

Update I had my psych clearance today....all of those freaking questions!!!!

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Congrats!!

The *** were for “H M O.” For some reason the site masked that.

20 minutes ago, briae13 said:

@Subaru yes the group meetings, I took the online seminar then went to 2 in person meetings. I had 2 appointments with nutritionist (Kim) and then there's a class I'm going to on the 20th (she said it's where they go over what you'll need for surgery) and after the class all my pre op requirements are good and can be submitted for approval. It definitely sounds like we're on the same track! I think the six months is dependent on when you can get the NUT, psych, & sleep study done tbh. I was able to get them done sooner than expected though.

My only question now is what my time frame looks like as far as how long it takes to hear back once it's approved. Anyone know? I'm hoping I can get my surgery date at least a month prior to the day of it in order to set things up with work for time off...

Briae13, is your bcbs a PPO or an ***? I’m asking In hopes that you have an *** and that’s why you had to go to the nutritionist several times. I’m hoping I only have to do the one visit. Nobody said anything about a class, but that would make sense. What time of the day is that class on the 20th? If I have to go to one of those classes and I can squeeze getting in on the 20th, I will certainly do it!

In terms of how long insurance approval takes, I have heard that it can take up to three weeks. However, I suspect that if you are proactive in following up with Blue Cross it may push things through more quickly. I’ve certainly read plenty of posts were people said it took a week or even less. I think the three weeks is their outside timeline.

25 minutes ago, ItsMyTime1985 said:

Do you know the name of the Miriam bariatric Facebook support group? I heard it mentioned at the support group I went to in September but I forgot the name and tossed the handouts. I joined another facebook group but there is a lot of negativity and it would be nice to connect with people closer to home.

I can't think of the name of it. However, the newsletters are available on the Miriam Bariatric page and they usually list the Facebook group. I think (?) I joined or requested to join but I don't know as I've read that page or posted to it yet. Good luck!

43 minutes ago, briae13 said:

Didn't get a chance to read all the replies here so I hope I'm not repetitive, but I'm going through Miriam as well (dr. Stafford) I also have BCBS. I called before starting the process to see requirements, there was no six month observation just the deductible & a referral from a primary (though I was told by surgeon's office process takes 6-9 months). I had my consultation 8/26 and have completed my psych, sleep study (which you can now do from home!), required meetings, & have one class for nutritionist before I'm all set with that then I wait for approval! Once approved I'm told I need to do an ekg, blood work, & swallow test (which can be done in one day at Miriam). You do have to pay your copay for each visit (specialist copay). Hope this helped and good luck to you all! If any of you ri sleevers want to get in touch lmk!

That's great info! In terms of required meetings, do you mean the group meetings? I don't have to do a sleep study since I've had one in the last year. According to the woman in Dr. Stafford's office, once I get NUT clearance (which I am hoping is just this one visit this week), they will submit to BCBS. Once they get approval they will schedule me for my pre-op with the surgeon (often within the same week as approval). At that visit we will schedule surgery and discuss any other questions/outstanding stuff. Between then and surgery will be the pre-op testing that you referenced, and I have to go to the several hour long pre-op seminar. (Held on Thursdays at 3:30 btw.) From the sound of things, I'm, 6-8 weeks out from surgery.

Dr. Stafford also told me that the process typically takes 6 months. And then he flipped through all of the test results I'd already had sent to him and told me that since it seems I'm on top of things it would like be faster. I told him I was targeting early January and he thought that was very reasonable.

When do you have your NUT appointment? It sounds like we're on a very similar track!

On 10/19/2017 at 1:36 PM, Subaru said:

That's fantastic! It's moving along smoothly so far! I see the NUT in two weeks and also go back to the psych to go over that report. Then I don't really know what happens!

Psych clearance today. NUT next week. Onward and upward!

12 hours ago, BeTrue83 said:

Thank you so much... You should be able to meet with the surgeon after that

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I did meet with him already. It's not clear to me with my program if I will see him again until just shortly before surgery. I guess I'll find out!

6 minutes ago, BeTrue83 said:

Good afternoon the appointment went well I meet with the surgeon December 11 for my date .

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That's fantastic! It's moving along smoothly so far! I see the NUT in two weeks and also go back to the psych to go over that report. Then I don't really know what happens!

16 hours ago, ItsMyTime1985 said:

I'll look into some fb groups, can you recommend any? My journey started with my PCP suggesting it to me, and it hit me like a ton of bricks. But I figured I should explore it and make the most informed decision possible.

Let me know what you find out about the private room. I've never had any type of surgery so this is all new to me.

The two that I most follow are "Gastric bypass support Group" and "Gastric Sleeve Support Group." I find they can be good places to help you think through your decision, get motivation, and be part of your overall research. That said, remember that everyone's experience is different. Some people do post their horror stories. Only you can decide what is best for you.

Here is what led me to the decision to go with bariatric surgery: I've struggled with my weight on and off my whole life. I have had successful weight loss attempts before. However, I am now 52 and have high blood pressure, sleep apnea, severe (though well medicated) GERD, and high cholesterol. I need another tool to aid me in this journey and I can't wait any longer for me to "get motivated." This will help force me into motivation and, hopefully, be a tool to help me stay on track.

1 hour ago, ItsMyTime1985 said:

Yea, I have started with Miriam as well. I got assigned to Dr Siva Vithiananthan (glad I could find that name to copy and paste. I'm not even sure how to pronounce it! haha), my first appointment is November 16. I did go to the support group in September as I knew it was a requirement and I thought it might help me make a decision, but it didn't. They mostly just talked about moving more and eating healthy and wasn't much different then what I've heard at countless Weight Watchers meetings. I was kind of disappointed the surgery itself wasn't discussed much. Good luck to you too!

I've just done tons of research and made the decision before I ever went to one of the groups. (I was at the September group as well.) There are also a couple of good Facebook groups where you can get decent feedback. A bit of drama in them, but overall I've found them to be helpful in solidifying my decision.

Dr. V. is supposed to be very good. I have a friend going to him for a revision.

I'm also trying to find out how much extra $ it would cost to have a private room at the Miriam. My ex had a private room after a kidney surgery, and that was the standard on that floor for the kinds of surgeries that folks have. I think the bariatric surgeries tend to all recover on the same floor in double rooms. But I don't want to deal with someone else's whining in the midst of my own so if it's something I can afford to do I'm looking at it.

1 hour ago, ItsMyTime1985 said:

I see you're in RI, what hospital/surgeon are you using? I am still struggling to decide if surgery is the right option for me. It's a scary step, and I wish I could do it without surgery...but I am afraid I can not.

I'm going through The Miriam Hospital's Bariatric program. My surgeon will be Dr. Todd Stafford. I didn't choose him. When you do the online orientation and request a consult they schedule you with someone. He seems very nice! As near as I can tell, the program and Miriam and at Roger Williams are both pretty good but I have an old hatred for Roger Williams. The Miriam has monthly support groups for pre-op patients (that go toward the required visits) so you might want to check that out. It's a touch decision for sure. Good luck!

5 minutes ago, BeTrue83 said:

That is awesome!!! It sounds like you are on top of things. I am hoping for January date but I am not sure I will have more info for you on Thursday.. Any other questions you would like me to ask when I go Thursday just let me know

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Nothing in particular, but I'll be interested to hear how it goes. Best of luck!

On 10/14/2017 at 8:50 AM, BeTrue83 said:

Hey hun I am in the same exact boat on have BCBS of NC and it's also a PPO. I was told they recently changed the stipulations for the better on our end which means you no longer have to do 12 months. I had my initial consult 9/28 was given a pre cert form for my medical doctor to fill out and a list of labs and test. I was also given my appointment for the NUT and my psych eval. I go back to the surgeons office Thursday. My appointment to see the psych is in November and I also go back to the NUT in November.

Have they given you any sense of other requirements or how long you'll have to visit the NUT? I was able to complete my psych eval in two back-to-back sessions (allowed by this insurance plan but not all I gather). I also had some homework that I dropped off the next day. The Dr. is writing my report and I'll meet with him in 2 weeks to review but then I'm done with him. At the time of my in-person visit he didn't see anything to that point to stop me from being approved. My NUT visit is in two weeks. My surgeon said after they have both signed off they submit to my insurance and then after that approval it's about a month to surgery date, with other assorted tests in between.

I'm hoping for a January-ish surgery date. The surgeon told me it's usually a 6 month process but given how motivated I seemed to be (based on all the documentation I already had sent to him prior to my appointment) he thought January was a reasonable goal.

I have BCBS PPO. When I've called they've said that my only requirement is the doctor to send over the pre-authorization request. I've called twice and spoken with 2 different people. I suspect that they have requirements for the drs office to include specific information and I'm being sent for a psych eval and to the NUT. The surgeon's office said they've never dealt with an insurance company that doesn't have any requirements. (I'm also going through the Miriam program.) As near as I can tell there is no 6 month nut requirement though.

The Miriam program does require attendance at two pre-op support group meetings (minimum). I'm guessing they also require the psych and the NUT because I'm scheduled for those. And then they do additional testing after they get approval. (In my case I will not need a sleep study because I sent them results of one from last year. No endo because they have results from one and seem to prefer upper GI/barium swallow test.)

Not all of Miriam's surgeons do things exactly the same way though. Dr. Ryder requires you to attend an in person orientation where all the other surgeons accept the online orientation.

Most insurances don't require co-morbidities if your BMI is 40 or over. If your reflux has been diagnosed as GERD, I believe that is a co-morbidity, as is hypertension and sleep apnea and a few others. I do not think a hiatal hernia is a co-morbidity.

Best of luck!

Two friends who have had WLS suggested I not buy or prepare too much of anything beforehand because, they said, one's tastes change after surgery and you might not be able to stomach the thought of what you have prepared. As a fellow planner that was quite disappointing!

I had put off being tested for sleep apnea for years because I slept well. Others had pointed to my snoring, etc and advised I get checked out, but like you, I was adamant about not wearing a CPAP and that I slept well. Two things changed my mind:

-I dated a guy with sleep apnea and got used to seeing the CPAP. It's been great for him. (And for my siblings.)

-I started suffering from anxiety attacks throughout the night that would wake me up and keep me awake. They started happening during the day as well. Racing heart, sweating, everything. I'd always had low level and not frequent anxiety, but this was bad. At some point my stupid brain connected my "anxiety attacks" with sleep apnea. I suspected what was waking me up in such a state was not breathing. So I did the study at home and started with the cpap when it was confirmed I have sleep apnea.

I also use the nasal pillows and they work well. The thing that holds them on your head is very loose. I did try other types of masks and determined that I could live with the nasal only if the pillows didn't work.

I have read of lots of folks whose sleep apnea resolves (or improves to the point of not needing a cpap any longer) after WLS. It's one of the reasons (co-morbidities) I'm going for surgery.

Best of luck!

I have no experience with Optifast. I would just suggest that vanilla flavor is easier to add flavors to if you don't like the taste. It's more difficult to cover up chocolate.

Resurrecting this thread in case there are any current RI WLS patients.

My first appt with my surgeon is in early October. I hope to do the VSG (or bypass depending on Drs recommendation) through the Miriam Hospital program. I'm curious to know the process with them for those whose insurance company has no pre-requirements other than doctor's approval/authorization.

Hopefully someone here has experienced that and will share. Thank you!

That makes perfect sense. It may well be the direction I end up going as I continue to research. The challenge for me is all this time before even meeting the dr means I just keep researching and thinking.

1 hour ago, Mhy12784 said:

Just my two cents because I'm in the same boat. Statistically Gerd will get worse with a sleeve, obviously it's no sure thing but the numbers don't lie.

If you had an esophageal ulcer I think its more likely they recommend bypass. I've had endoscopy in the past by regular GI guys and never had a Hiatal hernia. Had one by my future bariatric surgeon and he found a 3 cm paraesophagael. He says GI guys usually miss them because they don't fix them so they don't know what to look for.

Regardless I ultimately decided to get a bypass because I don't want to worry about reflux the rest of my life. It's more complicated and riskier than the sleeve but it does offer better weight loss and will cure my GERD. I'm certainly a little scared because I've seen first hand what happens when there's complications but I know it's the best thing for my health

Thanks for that feedback, especially your surgeon's feedback on hiatal hernias and GI guys. Very helpful!

Is your GERD well managed now, and on what medication if you don't mind sharing?

Thanks again!

Just starting this process myself (surgeon visit in October). I have GERD which is quite well controlled with rabeprazole with limited break through episodes which are typically triggered by specific food or drink/late eating/weight gain. I don' know about hiatal hernia, except that at my last endo in 2010 I did not have one. I formerly had an esophageal ulcer which has healed. I'd prefer to do the sleeve but will, of course, consult with my surgeon and ultimately go with what he suggests.

Has anyone with well controlled GERD noticed an increase in symptoms after VSG? Decrease? I've read a lot from people with GERD who, it seems, did not have it well controlled prior to surgery. Just wondering if that might make a difference. (I know we are all different. Anecdotes are helpful at this point in my research.)

Thanks all!

(First post!)