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Hi all! My name is Mimi. I am 31 from NYC. I have been overweight, obese or now morbidly obese my whole life. Three years ago I was diagnosed with Moyamoya disease after having several "mini strokes.". I have endured countless evasive tests as well as a brain bypass so I'm not about to let my weight kill me. It's time I get serious about my health so I can live the long happy life I was meant to.

I am scheduled to see a Bariatric surgeon next week, so I am still very early in the process, but I have my mind made up -- I want the band. I decided on the band because of the short recovery process as I hope to be able to return to work within one week.

One thing that worries me is the insurance process. I have Oxford United Healthcare. Does anyone have experience in dealing with them?

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  • KristinsMommy
    KristinsMommy

    Good luck my first consult is next Friday . I'm super excited also

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I wanted to be very clear about my insurance company's bariatric policy so I went into my visit with a copy of it and some questions. I don't see how they can deny me, but if they do I will be armed with a lot of info and ready for appeal.

Re: the two week diet. The doctor said he wants the liver to be as small as possible on surgery day thus he puts patients on a two week diet of Protein bars/shakes and clear liquids only. I think the specifics vary by doctor. Just thinking about those two weeks gives me hunger pangs as I sit here reading this mountain of info. I feel like I'm studying for the LSAT again:)

I did the same thing, I printed up all the insurance papers and took them with me yesterday.

I talked to the Dr. for almost 45 minutes about everything, which was surprising and great! But afterwards, was talking with some lady about insurance & what's next and she went over some checklist which I can't for the life of me remember...I should've got a copy. The 2 week pre-op diet was on it, but wasn't in depth. I'm gonna definitely have to find out much more about it! Only liquids for those 2 weeks, here I come!! lol

  • Author
Mimi' date=' what hospital are you going to? I'm also in NYC. I went to NYU.[/quote']

I will be having it in Connecticut at the Stamford Hospital. My whole family works in healthcare in NYC including my mom, but she's the only one I'm telling. I don't want any of the others to find out yet.

When was your surgery and which doc did you see?

Mimi, sorry I did not see your questions about WW until today. Glad your appointment went well!!!

I see you said later than your insurance does not required a 6 month program. Did you hear that from them or from your surgeon? Check both ways. Trust me, surgeon's offices make mistakes, not on purpose, but it happens.

I do not know if WW keep an archive of the records. You might be able to submit credit card records of having paid them? I would recommend starting to keep a food journal now. Work with the nutritionist to develop a plan for pre-op, just in case they come back and say you DO need to do the 6-month plan. Your first meeting would have been the consult this week. As you go through your testing, time marches on, and you'll most likely see your surgeon during that time, each month that ticks by will count toward a 6 month program if you talk about what you are eating and you weigh in.

From when I saw my surgeon to when I finally was in surgery, 6 months had gone by. So my having gotten it waived didn't really save me much.

A two week pre-op diet to shrink the liver is pretty standard. Some surgeons don't do one. It is not fun. You don't have a band to help you, but it is very worth it!

Mimi, I had my surgery in the beginning of Aug. Dr. Schwack is my surgeon from NYU. I kind of wish I didn't tell as many people as I did that I had surgery. I feel me I'm always under the eye of some people which can get really annoying. Definitely think about who you want to tell and who you don't. I made the mistake of telling too may people. I'm in Staten Island. What about you?

  • Author
Mimi' date=' sorry I did not see your questions about WW until today. Glad your appointment went well!!!

I see you said later than your insurance does not required a 6 month program. Did you hear that from them or from your surgeon? Check both ways. Trust me, surgeon's offices make mistakes, not on purpose, but it happens.

I do not know if WW keep an archive of the records. You might be able to submit credit card records of having paid them? I would recommend starting to keep a food journal now. Work with the nutritionist to develop a plan for pre-op, just in case they come back and say you DO need to do the 6-month plan. Your first meeting would have been the consult this week. As you go through your testing, time marches on, and you'll most likely see your surgeon during that time, each month that ticks by will count toward a 6 month program if you talk about what you are eating and you weigh in.

From when I saw my surgeon to when I finally was in surgery, 6 months had gone by. So my having gotten it waived didn't really save me much.

A two week pre-op diet to shrink the liver is pretty standard. Some surgeons don't do one. It is not fun. You don't have a band to help you, but it is very worth it![/quote']

My surgeon's office told me, but I also emailed my company's rep to verify. BMI over 40 does not require it -- 35-39 even w/ a comorbidity, requires the 6 months.

Very good advice though! If I have to do the 6 months I won't be too disappointed. 6 months will go by in a flash.

Did your surgeon give you a weight loss target during the 2 week diet?

  • Author
Mimi' date=' I had my surgery in the beginning of Aug. Dr. Schwack is my surgeon from NYU. I kind of wish I didn't tell as many people as I did that I had surgery. I feel me I'm always under the eye of some people which can get really annoying. Definitely think about who you want to tell and who you don't. I made the mistake of telling too may people. I'm in Staten Island. What about you?[/quote']

I'm in Harlem.

I understand what you mean about not telling anyone. I made the decision early on not to tell anyone except my mother and maybe one of my sisters. I don't think I'm going to tell my sister, but I'll tell my mother after I've gotten the final approval. I am a private person by nature so its a no brainer for me to keep this under wraps. I lost 60 lbs by starving myself when I was 21 and people thought I had WLS. Damned if you do, damned if you don't.

I don't think you made a mistake by telling people. You did what felt natural for you. They are wrong for scrutinizing your choices.

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