Panda333

Hi Guys, I'm the original poster and I have an update. i sooo appreciate everyones comments. You have helped me more than you know. I hear you about not bothering to appeal but my sense of justice is rearing it's head, lol. I'm so mad and am just going to give it one more shot. I called Aetna and found a special concierge associated associated with my company. I work for a company with 50,000 employees worldwide. They actually found the paperwork where they originally told me the "IOQ" was not required. They seem to want to help me to get this surgery. I also think they are embarassed I've already spend $4200 out of pocket just on my pre surgery stuff. I also wrote a firm e-mail to the business office about how shocking it is for them to give up on this so easily and dismiss me as a patient and how it's bad for business. I copied in my surgeon. The Surgeon, who is amazing, called me back right away and told me he he has been made aware and the hospital's office is doing everything they can. He said even if they end up not covering they will help me find another surgeon. He even took the time again to talk to me about the surgical options and thinks I'll have better results with bypass, due to finding out I have some GERD on the upper GI. Anyway....more to come. I feel like I made a little traction yesterday.

It's all so confusing. My surgeon is listed for Aetna and is covered, but the hospital he does his surgery at is not covered. It's in network but doesn't have IOQ designation. sooo..I had an upper GI performed there but I can't have a bariatric surgery there. And my surgeon won't go to any other hospital. ARGHHHHH makes no sense.

Yes, my deductible is paid up! going to try to appeal but then maybe will take my files as others have suggested. Frustrating because I had bonded with my surgeon, etc.

Thank you....very good suggestions. Just need to process all of this..

No offense, but it's doable if you are a man. Men and women respond so differently to the surgeries hat for some topics we do need separate message boards.

I feel your pain. The doctor who did my EGD went on "vacay" the day after my procedure on July 11 so I'm stuck waiting for the results. I just want to get them back and for them to send to my bariatric surgeon......

It also depends on your age and gender. If you are over 40 it's gonna be a bit slow but the younger ones here seem to lose faster. I am still pre op for the sleeve and have that same fear, I just figure, I'll have the surgery and if my sleeve isn't tight enough I'll fool my self and not go over 600 cals a day

I agree, you still need to watch calories.

I would go with what your surgeon told you for your specific case. You probably did all kinds of pre-op testing and he/she knows what is best for you. My surgeon says 6 months btw.

I think this is a comprehensive list and i'm in the same boat as you. I "want" the sleeve due to the less complex nature of the surgery but so many people at least on this board seem to get GERD. Ii'm 48 and have never had that. Worried about the bypass not now but for when I'm older and the nutrution needs. following to see the replies.

I'm glad you posted this. I'm in the same situation. I think I want "the sleeve" due to the ease and lack of complications but my researching is pointing to the RNY, even though I think it leads to ulcer and vitamin issues. I think I'd rather by thin than have hair and nice nails.

i'm having to make the same decision right now. Surgeon suggested bypass but I went to him for the sleeve. I've had friends who've had success with both. The most I can figure is below from my own anecdotal research Sleeve Good for the most obese patients because it's an easy surgery for them to get through - They do the sleeve on 600 lb life Bad if you have GERD and you can get GERD after this due to the stricture Bad if you are a chronic overeater People that don't resolve their eating issues end up stretching the sleeve and getting bypass anyway All Calories and vitamins get absorbed Bypass Good if you have diabetes, cures it in one day Complex - intestines are rerouted, more complex surgery Good if you have other co-morbidities Slightly better weight loss sustained over the long term (more stats though) Gold Standard - Who knows what this means it's just been around longer Malabsorption of calories and vitamins means you will have to take vitamins every day but good news ,many calories you eat are also not absorbed. My pcp and my good friend say sleeve is for me and my surgeon and therapist are recommending the bypass. I think you have to be really honest of how you got overweight. I am not a person that overeats. I'm obese and my body likes it there even when I eat 800 calories. That is why I'm leaning towards bypass although I'm dreading having to take a vitamin every day. If I was a severe overeater I would do the sleeve. That's just what I'm thinking now.

That is so frustrating! You went through all of the steps and didn't get to have it? I'm one month in to my pre-surgery program and I also have aetna PPO. I just looked and AETNA PPO says surgery is covered. you should push back!

Hi Everyone, I'm really, really early in my weight loss journey. This board has been invaluable. Still in the insurance phase. I was initially all for going to Mexico because a friend went and had great results as well as the attractive cost and basically not having to wait and deal with red tape. I also feel the drs. in mexico are just as good. I did find out my Aetna PPO will cover in the USA - Hurray. I have a choice of 6 month nutritional counseling or 3 month nutritional and primary dr. visits. I'm opting for the 3 month obviously because I'm an impatient person. I really wanted to go to Jacksonville Florida to the Mayo Clinic. But the Mayo clinic bariatric said I wasn't covered. I showed them the info that I was covered and we went back and forth and I finally gave up. I felt sad too because I know Mayo Clinic is top notch and I've had other surgeries there. So after leaving messages at several bariatric providers in Florida, Florida Hospital actually now Advent Heath in Celebration called me back and assigned me an advocate. I know it's not the mayo clinic but its still a good hospital. I gave them my insurance info and what do you know, I'm covered! (Just like I thought) So...just starting my 3 month journey but this post is to let people know to not give up. I have a full time job and it felt like just scheduling and doing this research has been a 2nd full time job. I was willing to spend out of pocket $20k for this surgery in US. Then happy to find it was $4200 for mexico surgery. Now Advent Heath told me my co-pay will be $476.00 I'm elated and plan to use any extra money towards any skin removal surgery, even though everyone says why bother you are in your 40s. I don't care, lol!

Ha....I am finding out there are more "hidden" charges than I thought. My advocate made it sound like I may $476 after my $2200 deductible is met but there are many more charges as others have listed. Nutrition, bloodwork, tests, psych eval, and I'm sure numerous hospital fees.

Hello, I'm still in pre-op with a bmi of 54, aged 48, no co-morbidities. I met with the surgeon yesterday and he said that people that have the bypass have better long term results and suggested that to me rather than the sleeve which is what I was originally set upon. He did say that folks still have good results on the sleeve but not as good as the bypass. He said he would do the sleeve on me as well if I wanted. I was pretty much set on the sleeve for the slightly lower risk factors, and the vitamin absorption issues. Anyone have a similar experience?

HI Folks, I'm about 3 months away from my surgery, I see the nutritionist next month but I'm curious what you did during the 3 - 6 months before surgery, not pre-op. Typically meals, calories, and how many times a day did you eat? Thanks.

I don’t think you were rude at all some people are very sensitive and don’t understand tone in the written word

Glad you posted this! My doctor suggested RNY for that reason because so many "sleevers" have regrets and get revisions and don't have good results. But on this board i hear of many sleevers that have good results. I don't know if doctors are pushing the sleeve but consumers want the sleeve. I think it's an "easy" surgery. I'm still on the fence about the sleeve or RNY. My surgeon says I can think about it and will do either surgery.

I'm glad you posted this topic, there are others like me! Like other posters I knew I was bigger and plus sized, I also knew my weight...I looked at myself in the mirror daily, etc. I had an overall confidence. but....occassionally.... I would see a photo of myself or maybe a glimpse in a window and wonder who that person was. I would even talk myself into the fact someone got a bad angle. I totally didin't realize how I really looked to other people and no one ever told me. We can really play tricks on ourselves. You always here about the people that are 130 lbs feeling so fat I was 300 lbs just thinking I'm a "big girl" No, I'm obese, and that is not to be mean to myself just trying to be accurate. When I got over 280 lbs I needed a seatbelt extender. Funny how you can talk your self into the fact that maybe "xyz" airline just has shorter belts. Anyway..... Happy on this journey and finally putting myself first. Embarrassed how "judgy" I used to be to people who had WLS. I always felt like it's the easy way out. Now that I've researched it I know much better. I have about 3 - 4 more months ahead of me and thankful for everyone posting, old or new. I've been inspired by posts as far back as 2013.

This post seems old, has anyone talked to the original poster?

I also have pcos, I’m 48. 5’2” and weigh 299

I have the same fear. I hardly eat anything just to maintain at 300. I gain at 1200 calories a day when they showed me the pre-op diet I’m like I have to eat all this food?? I fear I will get the surgery, hardly eat and stay the same. HOping the surgery really does do a magic metabolic trick to my body.

I wasn't told that but gtk. I suggest getting a wax anyway about two weeks before surgery. Treat yourself to the waxing and you won't have to worry about shaving for 6 weeks. The new hard was doesn't hurt at all.

I'm also pre-op and have this question. I plan on taking a week or a week and a half of vacation, then go back to work. I have excellent disability and FMLA but honestly I don't want the questions and I don't plan to tell people I have weight loss surgery. The people judging me for taking the easy way out...arghhhh. Just going to say I am eating less and moving more, which is the truth.