vovo2013

Hi all! I was wondering if anybody has interview different surgeons to see which one is the best pick for the surgery? I have three main picks in the Houston area.
One surgeon made me wait a hour and he was very cocky! Very bad manners and decided to NEVER go back to that surgeon. The second surgeon, was a complete 360 and love him and the hospital that he works at. The third surgeon was the same at the second one however I notice Cigna does not cover the hospital on where he is going to preform the surgery. So, I had one main decision and went with the middle one because he cover all the requirements that I had and there bariatric program at the hospital is 5 stars!
What did y'all look for in the surgeon that you went with?

Hi all! I was wondering if anybody has interview different surgeons to see which one is the best pick for the surgery? I have three main picks in the Houston area.
One surgeon made me wait a hour and he was very cocky! Very bad manners and decided to NEVER go back to that surgeon. The second surgeon, was a complete 360 and love him and the hospital that he works at. The third surgeon was the same at the second one however I notice Cigna does not cover the hospital on where he is going to preform the surgery. So, I had one main decision and went with the middle one because he cover all the requirements that I had and there bariatric program at the hospital is 5 stars!
What did y'all look for in the surgeon that you went with?

I had saw a surgeon a few years back when I had Cigna as my insurance and he seemed nice enough but also made me seem like just another patient for him. He was the first one to suggest going with the DS which I appreciate. I went to a seminar for the program I ended up going with and the surgeon I went with was the one to run it. Just from that seminar alone I knew I wanted him to be my surgeon. He made everyone feel comfortable and went through each surgery in detail. I am very glad I went with him and the DS.

vovo,

That scale you are referring to is called a sticker. You can create one when you create your profile. Its located there.[emoji4]

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How did you get the cute scale of your BMI? I would like that! I am also a newbie...

I haven’t met the surgeon yet. Getting ahead of myself I guess. I’ll meet him in 3 weeks which seems like forever since I’ve wanted this done over 20 years ago. My insurance covers it finally!!

I'm still in the pre-op process, but my insurance is Anthem Blue Cross (California - even though I live in Texas). My only requirement is to complete 6 monthly dietician visits and a psych eval although we'll be doing an EGD (esophagogastroduodenoscopy) to check for any existing stomach issues and H. Pylori. My first surgeon meeting on 12/03/18 counts as my first dietician visit so I should be ready to submit by early May. Not sure how long the wait will be from approval to the O.R., so I'm curious about that as well.

I have Cigna and have my first appointment on January 9th. I’ve already talked to my patient advocate and he warned me that once I start my three month diet, if I gain a single pound, I will be denied. He also said if you lose too much, they also deny you because “you can do it on your own.” Basically, you want to be no more than a few pounds away from your starting weight. Ugh, I am more nervous about those three months than the actual surgery.

Approved!! 🤩
My surgeon submitted paperwork to Cigna on Thursday afternoon and I received my approval Monday evening. I'm impressed with how quickly it was approved. I even received a letter yesterday stating that Cigna needed more information (it clarified that the letter was not a denial, just a request for additional records).
Here is a recap of my insurance approval process for anyone who is curious how it went:
Surgeon - Alisa Coker
Johns Hopkins Bayview
Baltimore, Maryland
SW: 192
Height: 5'0
BMI: 37.5
Procedure: Laparoscopic Sleeve Gastrectomy (aka sleeve or gastric sleeve)
Comorbidities: Diabetes, Hyperlipidemia (High Cholesterol), Hypertension (High Blood Pressure) **Worth noting, I take one medication for diabetes, and one low dose medication for hypertension. The hypertension medication I actually stated taking during this process.**
Requirements-
BMI = or >40 or = or > 35 with at least one comorbidity
3 Months of medically managed weight loss with primary care or registered nutritionist/dietitian (4 visits total - first was Dec 5th and then one each month Jan, Feb, March) **I have since read the verbiage change in Cigna's requirements and they have removed the 3 months of supervised weight loss. This may still me a requirement by your surgery team though, but it doesn't hurt to ask**
Upper Endoscopy - Standard test that checks for GERD, stomach ulcers, infections, and anatomy. This was an outpatient procedure. I was in the hospital for a total of 3 hours from arrival to departure. I was completely asleep during the procedure (they give you a top shelf iv cocktail) but recovery was much less than that of general anesthesia.
sleep Study - For sleep apnea and/or other weight related sleep disorders. Mine was an at-home test that was easy as pie. It was a wrist watch that connected to a few nodes and a sensor on your finger.
Psychological Evaluation - I went to a doctor who specializes in evaluations for bariatric surgery. It was probably the most nerve wracking of all the appointments because there's a strange looming in the air that these evals are hard to pass. **Tip - Tell the truth (your insurance will look at your medical records so if you have been treated for mental health but lie about it during your eval, they may deny you coverage) but don't unload your whole tragic life story on them. I have been treated for and hospitalized for bipolar and it didn't prevent my approval. They are basically trying to determine if you have a clear understanding of what the surgical procedure is and how your lifestyle will need to change. They want to make sure there isn't anything major that will intellectually challenged your results (major or unaddressed eating disorders, lack of understanding of the diet requirements, lack of motivation to lose weight), that you have a good support system at home, and that you are aware of aftercare requirements for life, possible complications, and after affects of weight loss on yourself and your relationships. In a nutshell, they need to know that you're aware of what you're getting yourself into, you are of sound mind, it was your decision to have surgery (not having the procedure against your will or at someone else's insistence), and you are equipped with the knowledge you need to be successful afterwards.
Nutrition Consultation - I was required to see the nutrition team at Johns Hopkins for a 90-minute appointment. We covered every aspect of the diet requirements from the two week pre-op, day before surgery, day of surgery, and each week after surgery until the 8 week mark. This appointment was very helpful. It was the most important component, in my opinion, because it really showed me exactly how my diet and lifestyle would change. I left that appointment with zero questions about how to be successful.
Letter Of Recommendation - A letter from my primary doctor (it had to be a doctor unaffiliated with the surgeon or surgeon's team) stating that I was physically able to have surgery, that I failed to maintain weight loss via medically assisted management, and that weight loss surgery was being recommended and was medically neccessary. This letter is very important as I have heard/read stories about insurance denials because the verbiage wasn't correct or one of the listed components wasn't included.
Blood Work - Usually done by primary care. This served as proof of hyperlipidemia and diabetes.
Once all of these were completed and the surgeon's coordinator received the paperwork, she compiled it into a package for review. She handed it over to a nurse on staff who double checks that everything is there and that it is in the right format with the right info. **Most surgical teams are well informed about what insurance companies look for. They will make sure your information is submitted correctly to prevent delays and denials.** Once the nurse gave her seal of approval, the coordinator submitted the precertification request to Cigna on Thursday.
Monday afternoon I received a letter that said additional information was being requested from my surgeon. I contacted Cigna to find out what additional info was needed (I was curious...and antsy!) They told me that the surgeon would receive a letter as well which would include details of the request. Well, that didn't satisfy me so I probed on asking if those details could be disclosed to me, since it is MY medical record. The Cigna rep (Charline) was extremely helpful. She contacted the precertification department for details and called me back that evening with news that I was approved. Johns Hopkins had provided the requested information pretty much immediately upon receiving the request. Low and behold, I checked my myCigna account and the black, in-progress status had transformed into the prettiest green APPROVED:)
Big props to Marie Day and the team at John's Hopkins for their attentiveness!!!
And that, my friends, is the super drawn out, nitty gritty process of getting approved for bariatric surgery via Cigna!
I know when I first set out I had a million questions so I tried to provide all of the info I always looked for but couldn't find. If you have any specific questions for me please let me know. I'm not a medical professional, this is simply info from personal experience, but I'm happy to offer peace of mind if I can!
Happy sleeving, y'all!

Dr. Bonner in Katy has been taking care of my Husband. He works at Memorial Hermann Memorial city. He took my husband in after he had a complication from his sleeve in Mexico. What a dedicated meticulous man! I spoke with all the nurses and even anesthesiologists who jave worked with him and they all say the same thing. He is dedicated, very particular about his method, and thorough. I have five kids and am happy to know I have such a doctor working on my husband. Btw...Marvin, Ponce, TLC wouldn't even talk to me when I called to see if they could help my hubby. He was hospitalized for over 51 days...Dr. Bonner was the first to take the time and help.

I'm in Rosenberg. I'm scheduled for the 14th at Methodist by Dr.Tariq. I'm on the pre op diet now.
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You can look up BPD/DS..Right now, I have a gastric stricture. Not one dr has concluded this yet, but extensive research I have done for last week has led me to this conclusion. Newbies in the honeymoon stage hate me. Think I'm being negative...no, being realistic. Do you think my bariatric surgeon told me all of the possible complications - of course not, this is what he does for a living. Luckily, he is a good surgeon so I hope he didn't make my opening too small. Praying for last hour, as it took me, not the three doctors I've seen, to diagnose myself. Even an experienced nurse in a Bariatric Surgeon's office said I was anorexic and needed a good dietician. I am not anorexic! How did I get so fat? And struggle to keep the weight off for 7 years, and suddenly develop anorexia...total nonsense. I am literally getting unable to eat, it nauseates me and I can hardly swallow. My bowels are shutting down.. But I know hospitals can screw up. God, this is overwhelming. So, I'm praying and claiming, I'm right, I'm getting to the right Bariatric Surgeon or right ER doctor, etc. Praying I have no complications from the correction, dilation of the stricture. I may have to have multiple dilations. I may develop a bleed during dilation. Hope you get the drift how complicated this is. Please don't take this the wrong way, but if I asked, May I ask what a DS is, you are not a good candidate for DS. You can fight serious health complications, requiring many hospitalizations, or even death. May not happen, but may. And you cannot be revised from DS, If surgery is available, any responsible surgeon wouldn't do it If you can't lose the weight at this point, get intensive therapy before making such a lifetime commitment. From your pic you don't look that old. This is for the rest of your life!!! Bariatric practices are going to tell you about all of the successes, not the failures. I would be considered a huge success, maintained my weight for 7 years, and now losing....how exciting....wrong...I may be dying. Praying for Divine Intervention. I'm not ready to check out yet.

I haven't had DS. But the hunger factor would be controlled by your sleeve surgery (which is actually stage 1 of a DS - but you've already had that part of it). It cuts out much of the part of the stomach that produces ghrelin. So that piece you've already had. What the intestinal part (stage 2) will give you is malabsorption, which will also help with weight loss.
The malabsorption you get from a DS is greater than what people get from RNY, which means you'll need to be even more diligent about taking your Vitamins. Vitamin deficiency is more of a risk with DS than it is with RNY, so you will really need to keep on top of this for the rest of your life. Another thing to keep in mind is that a lot of primary care doctors are familiar with the sleeve and the RNY, but not the DS, so you may have to "teach" them and become your own health advocate.
other than that, there are a lot of people out there who are very happy with their DS. Although I do agree with the above poster that at your weight, I'm not sure I'd consider it. It's a pretty radical surgery and probably more appropriate for someone with a TON of weight to lose.

I watched a ton of weight loss surgery videos on YouTube and got a lot of my information from them. When it came time to see the surgeon I didn’t really have any questions for him. I do, however, wish I asked more questions about the post op diet as far as calories and Protein since they don’t stress on protein goals until you are eating solid food. My best advice is to relax and take advantage of the required supervised diet. I only took advantage of it at the end. I wish I also took my measurements before surgery as the only ones I have are not at my highest. Take before pictures and progress pics. Your surgery will be here before you know it.

Good evening, Everyone
Happy Mother’s Day to all you mothers out there.
I am new here and I really appreciate this forum. Thank you all for your open and honest shares.
I have my first appointment with the surgeon on Thursday. I have made it a point not to stress about this process. Despite all the reading I am doing of late, I am still not sure what to expect. I am both nervous and excited to start this journey.
I hit 300 lbs and have not been able to move from there. Just thinking of dieting puts on the weight. In October, my primary care doctor's best advice (after chastising me for putting on the weight I lost last year) was to eat 1200 calories a day - no more. I have had sleep apnea for many years and high blood pressure and for the last year, I have been on Diabetes meds. They just added a THIRD one in March. I am looking at retirement in a few years and do not want to spend that time immobile due to my weight. Deciding on surgery has NOT been an easy decision.
So, here are my question(s):
From your experience, what do wish you would have asked in the beginning and what do you feel is the best advice to give someone heading in to this process.
Thanks in advance for your thoughts.
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