Hi Guys,

I have my first appointment with Dr. Jack Rutledge in Chattanooga, TN on Thursday. I'm trying to get everything in order and everything together before I go see him so the process will be smooth and fast.

Tomorrow is Monday, and I need to call my primary care physician for a "medical necessity referral." Joy. I'm new to Tennessee, only been here a year, so I have only seen this doctor once. He seems very conservative -- in fact, when he told me he wanted to see me lose some weight, he mentioned that his wife worked at the local Weight Watchers. I just don't know if he will do it, and plus I don't have a "five year history" report from any doctor about being overweight.

Did anyone else stress out about this as much as I am? Did the referral letter not end up being that big of a deal?? Please say so!

Mallorie

I had to get a referral from my doctor and since I hadn't had a physical in over ten years, I'd never met her before. I put together a book with photos showing my weight change over the years, all of the different diets I've tried, all of the many many many diet books and workout videos I own, all of the pills I've tried, all of the diet food in my pantry and freezer, and the mountain of weight watchers materials I have from the four different times I joined - including the time I made lifetime. I also had an essay about how my weight has affected my life, what I expected to get out of the surgery, what research I'd done, etc. (The essay was required by a different program that I wound up not going with.) Basically, it showed that I've been there, done that, and that I'd really put a lot of thought into this. Maybe it was overkill, but in the face of all the evidence, I knew there was no way she was going to try to put me on a diet. She was very impressed by everything, but I think she would've referred me without it.

Mallorie,

Meeting with the PCP was the HARDEST part of my band journey to date. I hadn't been to the doctor in a long, long time, and had moved from TX to NYC in the interim. I technically "had" a PCP through my insurance, but I'd never seen her before. I spent way too much time stressing over that and I bet you'll feel that way once it's behind you too!

What I did was this. I called my PCP to introduce myself and to tell her what I'd decided (LapBand surgery). I said I knew she couldn't tell me whether she could support it for me without seeing me first, but I wanted to know if she had a general predisposition for or against it for a patient who was morbidly obese. We had a very conservative conversation and she told me she didn't recommend it in every case, but that she wasn't opposed to surgery if the proper prerequisites were there. With that, I felt a little better and went on and kept the appointment.

Since then, she's been my biggest cheerleader. Maybe you can call your doctor's office and speak with a nurse (or even the doctor) to see if you're wasting your time seeing him (i.e. if he doesn't support WLS surgery generally)? Even if you don't decide to do that, just remember that if he says no, you can always find another PCP who will support you. This is YOUR journey and you need a PCP who doesn't discriminate against the disease of obesity.

Good luck to you.

Mallorie,

I have to say that it wasn't stressful for me at all. I've had the same PCP since I was 18 and I am now 36. I would complain to him about my weight issues for years, he gave me meridia at one time, it didn't work. About the letter, it was odd to me. I asked the Dr. for a referral to a nutritionist and at that time I asked his thoughts on WLS. He said that the Lapband would be a great choice for me, but he'd support the bypass if I chose too. ANYWAY back to my point. I went to the weightloss Dr. that he referred me too and that was pretty much it for me. I never heard about a letter of referal or anything else. This hospital did it all for me. SO as you asked.. was it that much of a big deal?In my case, it wasn't. My nutritionist, surgeon, Psych. eval and exam were all located in the same area of the hospital. They all worked together and got me approved, in a short period of time. Obviously, I had to have the insurance requirements met.

I also wrote a letter explaining why I'd be a good candidate for surgery. My struggles of weight loss and gain, diets, pills, books, exercising history and all I could think of. What I did was made a timeline from my adolescent yrs. until now. It consisted of what I weighed, how active I was, any weight gain or loss within the time frame and so on. I gave every person involved in my WLS a copy. When I turned the timeline in to my nutritionist, she stated that this is awesome to send along with the papers to the ins. comp.. That way, they can read what your thoughts and struggles were/are. Sometimes when they can read what you have been through and hear a voice through your letter, they soften up.. more likely if their decision is on the fence. (so I was told).

Anyhow, don't sweat the PCP. That, to me, was the easiest step of the whole process. Best of luck

mcw12985......Don't worry I had exactly the same problem as you. I was terrified because I hadn't seen a doctor in 4 years then we moved to another state and I had NO Primary Care Physician.

Finally I bit the bullet and rang four doctors in my area, all but one of them had no problem with recommending me for a WLS consultation.

Be Brave .......it WILL be worth it!