Gothikarose

I totally understand. Don't be afraid to be the squeaky wheel if you need to be! Once I finished my requirements I had to change the date of my surgery from mid December to ASAP and they were able to move it to Nov. 1st because I told them I needed to have another surgery before the end of the year (shoulder). I started my pre-op diet the next day. LOL A good practice will work with you to the best of their ability...

Thanks a lot. I'm hoping they will be understanding because the thought of losing coverage and then having to start all over again with new insurance hurts me.

I don't know the answer to this since I've worn a c-pap for years, so all they needed were my downloads of info showing compliance. I think you should talk to your doctor about your concerns and your timeline restriction. You don't have to hide the fact you lose coverage in the spring. Tell them so they can accommodate you! They may be willing to waive a requirement or give you a shorter time. Good luck!

I can't speak on this from personal experience as I went through my own insurance, but a friend of mine did hers several years back on Healthfirst Medicaid. She had to do 6 months of nutritionist meetings however she was already doing those prior to seeking out surgery. So between that and her other health issues (which is why they needed her to drop weight quicker), she was approved pretty quickly. She got the thumbs up that she was a good candidate in May and got her official approval in July and had surgery in September. I think it depends on how quickly you get the required appointments completed which aside from nutritionist meetings could be gastro, pulmonary, cardiologist and for sure psych, pcp and bloodwork.

My first one at the clinic (I had 12 prior as an insurance requirement) was just myself and the Dietician he asked me how I was currently eating, and told me he was glad my insurance required 12 prior visits with a dietician before getting to him, then he went over what eating after surgery would be like, showed me a portion size shot glass. Told me about vitamins, and recommended I try different kinds of protein shakes, so I would know what I liked when I got to the 2-week full liquid pre-op. He explained the order to eat my foods in, and to try and get a little of each, after the healing period, during the healing period he said it was more important to focus on protein. lasted about an hour
My second visit was virtual, went over the full liquid pre-op diet and was given my start date. My clinic gives you a book on your very first visit that has all of the information, so I was reminded what page the 2-week full liquid pre-op diet was on. lasted about 30 min
My third visit was virtual and in a group, we again went over the 2-week full liquid pre-op and over the 2-week post-op at which point there is an in-person visit, where we are evaluated and will be told how to proceed next with our diet. Again we were told what pages to refer in our book. lasted 1.5 hours

That sounds about average to me. I've met with a few different nutritionists on and off for several years as I was in the non-surgical side of my hospital's program for about 6 years before my doctor recommended starting to pursue surgery this past summer. This time around for the surgery prep meeting, I discussed my eating habits, asked a few questions, and we went over the stages of eating after surgery plus supplements, etc. But honestly, if they get the sense you understand how to eat healthily and there aren't any specific issues to go over, that's about it. Mine was about 45 minutes.

Mine was a class with other people. Took about 90 minutes, went over pre-op diet, post surgery food stages, and long term diet. It was easygoing. The dietician asked if any of us felt we needed individualized help with diet planning and a few people asked for private sessions but I didn't. I am pretty knowledgeable about nutrition and understand the stages and such. I have another session right before surgery (if they ever get it scheduled) to go over the first few weeks of the diet. And then I have another class before we transition to soft foods... It seems this practice prefers classes for most of their nutrition info. Though I have the dietitian's email if I have any questions or need a private session, so that's nice. I have found most dietitians/nutritionists to be pretty business-like and a little abrupt in their manner, so your experience sounds pretty normal.

I had fatty liver and it was one of the reasons they wanted me to have the surgery. I think the only thing they wouldn't continue is if you have an infection, like covid, pneumonia... Etc. Or if your doctor is adamant about nicotine, then you have to pass that test, or they postpone.

My surgeon just would send in a HIPAA form and request records for me so I got a copy of mine that way

You got this, I was concerned about Vit D deficiency since that is something I have struggled with my whole life, they told me to make sure and take a supplement before my labs. However I had been spending several months tanning at the time before my labs, and my Vit D was excellent (for the first time ever). So smart choice for the supplement, you could add a multivitamin. After I had my labs and saw the surgeon the nutritionist told me to start taking a multi-vitamin because 1. it's not going to hurt and 2. to get in the routine of taking one, since that will be the new normal after surgery.

My only vitamins levels that are low is Vitamin D, 25-Hydroxy. I should be at 32 and I'm at 19 so I'll take some supplements and eat more fish. I don't have a surgery date yet, I'm still preop but I am still worrying about this stuff

I think fatty liver is fairly common, esp in obese people, so that one for sure shouldn't count against. you.

I do not think so. I know that vitamin levels being too low may delay your surgery at least with my surgeon that is a thing. My insurance will not cover surgery if your blood work shows nicotine or cotinine a chemical produced by nicotine in blood/urine that sticks around longer. If you have Hep B they will very likely still do the surgery, they will just monitor your labs more closely. Fatty liver should not be a problem. If for some reason you are turned down because of your labs, make sure to ask why specifically and if there is anything that you can do to improve your labs for surgery.