windyacres_2000

Intro - My name is Edie and I'm 54. I've been waiting for this surgery since 2008. FINALLY BCBS North Carolina stopped calling it investigational. I've finished all my pre-op testing and the doctor's office submitted it to the insurance company. Now I wait in suspense. I think it could happen pretty quickly once they get approval. I had to have a colonoscopy and upper endoscopy and some samples were sent for biopsy so that could take a couple weeks - I don't know if they will wait for those results before scheduling me. The GI doc said everything looked good and that he was going to clear me for surgery. After waiting all these years, it doesn't even seem real. My surgeon has done MANY bariatric surgeries, but only about a dozen sleeves. He seems very comfortable with it though and I am comfortable with him and the reputation of the practice. I was tested up one side and down the other!

How did you find out? My therapist told me to get on the ball and start working on the process. So I checked the website ONE MORE TIME and there was the policy change! The only thing I was unhappy about was that the surgeon's office didn't call and tell me. I had started pre-op stuff last year, planning to buckle down and appeal, but I just didn't have the heart for it. Now all my pre-op is done and the surgery is submitted for approval. I am holding my breath! I've been waiting for this since 2008!

How did things go with Dr. Pirello? Do you know how many sleeves he's done? Was his office helpful with insurance issues? Edie - trying to move to NC

I'm a surgery wanna-be, but I have been reading this board for a long time, and while the complications scare me spitless, they are a remote possibility. The comorbidities I have because of my obesity are here and now, and I think they are even scarier. Definitely worth the small risk associated with the surgery in my opinion.

If you have any supply issues, there is a wonder product (liquid) called More Milk Plus. You can buy it at Luckyvitamin.com I am a midwife - I had a client who had insufficient milk supply with her baby. After that baby she had a mastectomy - so only one breast. When she got pregnant again, she didn't know if she should even try to breastfeed. With More Milk Plus she had enough milk for her baby. Edie

Thanks Joy. Edie

I want to talk! You can PM me if you don't want to post to the board. I am curious if you had your surgery in the States or in Mexico. If in Mexico, who was your surgeon? If you were self pay, who paid to treat the complications? Having to pay out of pocket for any complications is my big fear. Edie

I would like to lose 70 - 75 pounds. How did I ever get this heavy?? I am so jealous of you with surgery dates. I need to sell my house for the $$. I refuse to take out another loan! I plan to try for the end of March. Edie

I was looking into the band through Humana and when I realized they would not pay for it for me, I looked into the sleeve. I am so thankful that door was closed. You might want to look at what all your out of pocket costs will be using your insurance. If something is not covered, that does not become part of your maximum out of pocket. For me, for example, visits to the dietician (required by the surgeon) would not be covered and I would have had to pay. I think my out of pocket costs would have been pretty high. It just doesn't seem like that much more to go to Mexico. The only problem is that if there are any complications once I'm home, I'm sure Humana won't pay for anything. I sure don't plan to tell them when I have surgery done in Mexico! Has anyone tried to use flex plan money for surgery in Mexico? Edie

Why Mexico? My surgery will pay for the LapBand if I gain more weight. I want to do the surgery because of co-morbidities, not because of weight, and I REFUSE to gain weight to do this. I am blessed, because being forced into being self-pay made me do more research, and I discovered the sleeve surgery. There is no one in my area doing this surgery, including the large university hospital. I can't even begin to imagine what it would cost to do in the states. I had some diagnostics done in preparation to do the LapBand and the costs were staggering. Mexican surgeons have a ton of experience. I am worried about the possibility of developing complications at some later date and running up a big bill back here in the states, and I KNOW my insurance co. would not pay for complications. I don't plan to tell them anything about it, in fact. Told my PCP NOT to chart anything about going to Mexico! Sorry, I'm rambling... Edie in Wisconsin

I'm with you on that one - 100 percent!

Who in the states does the sleeve for the same cost as the Mexican doctors? I can't even imagine this. I had a esophagram in preparation for lap-band surgery at my local hospital, and was billed by three different entities! Are you talking just the surgeon's charges? Or all labs, radiology, anesthesia, nursing etc.??? I just want to know who in the states does all this (VSG) for under $10,000

Sorry for all the questions - you said you barely made it to be approved at 260 - did you doc say you had a large frame? That chart is so confusing!

I have Humana Preferred.

Regarding the Met Life scale - can you help with this? It shows a range of weight for my height. If I am 100 pounds over the bottom of the range, do I qualify?? Apparently we have a somewhat unique policy, terms set by the employer. Thanks!