since I had my initial consultation with the surgeon yesterday, I guess I have officially begun my "journey." I am still very apprehensive about the surgery, but feel like I am at the end of my rope now and that this is the only viable option I have for a healthy life. I know this is a somewhat different attitude than most of you whose posts I've read, but I am just being honest.

The surgeon I consulted only does VSG, but his partner does others, like the RNY...after doing research, I think VSG will be my best option, and my doctors seem to agree. I had some hesitation (1) because the procedure is a lot newer than RNY and (2) I wasn't sure that a restrictive-only WLS would be effective in not only weight loss but helping resolve some of my issues like type II diabetes. A lot more people have had VSG since I first started considering it, and the research shows that VSG has almost as high of a success rate in not only weight loss but resolving issues like diabetes as the RNY does.

The good news from my consult was that the surgeon believes he will be able to do my surgery laprosopically. I was afraid that that would not be possible since I had abdominal surgery with a resulting skin graft about 3 years ago. He won't know for sure until I have a CT scan of my abdomen, but the chances look very good. Also, he seemed quite confident in his skills and ability to perform the procedure, and he (knock on wood) has not had any patients with such serious complications as leakage. He explained the procedure to me graphically, and that helped me.

The bad news is mostly that my insurance definitely will not cover the surgery. I have made some previous posts in the forum about that. My concern is not so much thte initial cost of the surgery (I have been saving up for a while with thoughts that I would have to self-pay). I am just worried about unexpected complications and additional surgeries that could happen and that also wouldn't be covered by my insurance. From past experience, I know that such bills can build up rapidly and to levels well over $100,000. That would be a financial nightmare for me. I keep telling myself, though, that I just need to pray and have faith.

It is difficult for me to talk publicly about my weight and related stats, but others have been honest about it on this site, so I feel it might be helpful and supportive for me to also be honest and open about this. I am 5'2", and yesterday at the consultation, I weighed 277 lbs. and had a BMI of 51 (per my recollection). I turned 50 years old this year. I have several comorbidities, including type II diabetes, high blood pressure and poor circulation. I would be happy just to lose 100 lbs. but my goal would be more like a 125 lb. loss...I think I would be comfortable weighing around 150 lbs. More important, though, is that I would be able to get my a1c levels below 7 and be able to get off of insulin and maybe most of my other meds.

Because I will be self-pay, I don't have to meet any insurance company requirements and paper work. My doctor requires one visit with a NUT before scheduling surgery and then a follow-up visit with the NUT. Also, I need a letter from a mental health professional as to my psychological readiness for WLS. I have a therapist I have been seeing for many years, so I will discuss this matter at my next session. I am not sure what factors she will consider when making the recommendation.

The only other question I am having some difficulty with is the "when." Because I am self-pay with no insurance red tape, the surgeon said the decision of when would be up to me. Here are some of the factors I am considering. The earlier I have it, the less likely I am to lose my resolve, and the sooner I will begin the path to what I pray will be a healthier life. I also have this fear that I will have some more serious complications from my diabetes if I wait too long. The downside to me personally is simply the time of year and overall timing. Fall is my favorite season, and really the only season of year I enjoy. It is also the time when I take my vacation and any personal trips. I am scheduled for a trip to San Francisco in mid October, and I've already paid the deposit for a Caribbean cruise over the Thanksgiving week. I know I could cancel both of these and reschedule for next year, but I was looking forward to these trips. Plus, in trying to be realistic about the future, I don't know how long it could take me to recover from the surgery itself, especially if I should have unfortunate complications. If I delay the surgery until after Thanksgiving, then Christmas is upon us. Christmas is my favorite holiday, and it does sadden me to think of having surgery around Christmas time. I am leaning towards a January surgery date...the new year, new beginnings thing appeals to me. Really that is just about 3 months away so it's not a whole lot of prep time. Perhaps I need that long to prepare.

Sorry for such a long opening post. Any feedback of any type is welcome. I am thick-skinned and can't be offended.

Not trying to be nosy, but why would your insurance NOT cover it if you have other co-morbitities? Your BMI is well within the required ranges and every morbitity is one more reason for them to cover it....Mine wouldn't because I had not co-morbitities and I didn't "weigh enough"... I self paid and other than some adhesions that had to be removed internally, I have had no surgical side effects..

I have come to appreciate my experience and the 6 month waiting period that I had to go through. This is something that you really don't want to jump too quickly in to. You are the only one that can make this decision for yourself.

I hope another self-pay will post about an available post-op insurance that will cover any complications. I can't remember the name but I know I have seen it. This may be a great option for you to avoid that $100k burden you fear.

I wish you the best on your journey!

thanks for the feedback, suegirl and Jonathan

my insurance specifically excludes coverage of any type of bariatric surgery for any reason--no matter if it is medically necessary or not...I work for the State of Louisiana (the obesity capital of the south outside of Mississippi), and none of the insurance plans offered to state government workers covers any type of bariatric surgery...it is ridiculous since the benefit payments they have made to cover all of my comorbidities from the diabetes and obesity are staggering...go figure

Base on my experience, I would say think about all your plan before scheduling the surgery. if you have all that trip scheduled already then do surgery after that and use this time to be on diet,

I had surgery in 1.5 months after having my first appointment with surgeon, I lost 22lb before surgery and I started with 277lbs as well and day of surgery I was 255.5 lbs ( actually 279 but start my ticket at 277) last 8 lbs was from liquid diet 1 week pre op.

Just remember it would be hard to try to be on diet on the trip but if you really want it you can do it.

I personally like to keep moving with things so I am really glad that I end up with surgery as I wanted on 9/7 instead of 9/21.

Hi TigerBelle, Welcome to VST!! I'm thrilled to see that you've started your journey and that you're considering VSG. IMO, VSG is the number one weight loss surgery, but I may be a little biased.

I was sleeved August 30, 2011, at 337 pounds, down from 352 thanks to my preop diet. I'm 5'8, so my BMI was mid-50's. (It shows on my ticker I think). In just over a year, I'm down nearly 120 pounds and I have a whole new lease on life. VSG saved my life. My comorbidities read like a med students worst patient ever: arthritis, sleep apnea, DVT, pulmonary embolism, joint problems, asthma, etc. Almost all of those are resolved now, although I do have to have my gallbladder out in the next few days.

If I were choosing a date based on your travel plans, I think I'd move the October trip to next year and be sleeved now. Yes, you enjoy those trips, but your health is SO important and you'll enjoy the trip more when you've dropped a chunk of weight and are able to move more freely. If you're sleeved in early October, you'll have your honeymoon period over the holidays and get to enjoy this year's holiday season by dropping a ton of weight. What a great Christmas present to yourself. You could feasibly be down 30-50 pounds by Christmas and New Years, just in time to buy a great new dress to flaunt your slimmer figure. Perhaps Valentines Day of 2013 could be the best one of your life!

Good luck, whatever you choose!

It sounds like you and I are at the same point of our journey and facing some of the same issues with regards to the surgery itself. I had my consultation today. I'm also self-pay. Weighed in at 284lbs at 5'4.5" this morning. My BMI was 47-48. I want to lose about 120lbs.

I also have a vacation planned for the week of Thanksgiving. An all-inclusive, out of the country vacation and I'm far too nervous about 1) not being on solids yet and/or 2) having complications while I'm so far from home. In order to even consider doing it before my vacation, I would have to start my 2-week pre-op diet this Monday and have surgery in 2 weeks. There is no way I'm ready for that.

I've been beating myself up about the fact that I'm leaning toward doing it after vacation I feel like I'm making excuses so I can binge at the resort and I'm just going to spend the next 2.5 months getting bigger. But as I talked to my husband about it today, he reminded me this is a hugely life-changing decision. If my choice is to do it now or do it in 2.5 months, 2.5 months may be the wiser choice. Especially when I consider having to schedule time off from work, gathering finances, mentally preparing for the pre and post-op diet, beginning a solid exercise regimen, etc. This needs to be a permanent change and I think making the changes bit by bit in preparation for the "big event" is going to be the best course of action for me, personally. Perhaps for you as well. So, I'm looking at a December 10th surgery date. Yes, it will be a bummer to be that fresh out of surgery during Christmas, but I'm kind of hoping all of the craziness of the season will help keep my mind off the fact that I'm not eating real food!

Regardless, good luck with your decision. Hopefully we can compare notes and success stories in 2013!

I live in louisiana and I was self-pay as well (thanks BCBS of Louisiana!) ha! I literally had my first appointment on Aug 22, and had surgery on 9/4- I didn't waste any time... Sometimes I wish I had thought more, but I'm fine now I went back to work after one week and have All of my strength... Every person is different though, I had an excellent surgeon and he was cheaper than most I am very happy with my decision, the only hard part for me is realizing what I can't eat-- sometimes too late haha it's okay though, I'm learning and will continue to do so! I am on my 3rd week (as of Tuesday) and I'm on vaca in Miami... I took a 3 hour nature tour earlier and I'm fine. I think you'd be okay to have a good time on your trips. But that's just me I guess, there are risks of complications, but there are also huge risks with diabetes- I think you'll have to pick the lesser of two evils there :/ good luck to you!! I'm from outside of Baton Rouge, if you need anything let me know

thanks for the feedback' date=' suegirl and Jonathan

my insurance specifically excludes coverage of any type of bariatric surgery for any reason--no matter if it is medically necessary or not...I work for the State of Louisiana (the obesity capital of the south outside of Mississippi), and none of the insurance plans offered to state government workers covers any type of bariatric surgery...it is ridiculous since the benefit payments they have made to cover all of my comorbidities from the diabetes and obesity are staggering...go figure[/quote']

I worked for the state too until January. I had LSUfirst insurance which of course would laugh if you asked about coverage for WLS. Luckily when I changed jobs my husbands insurance picked me up and that is the reason I was able to have the surgery. I completely understand your fears. I was VERY scared and cried often during my pre-op period. I have a four year old and my biggest fear was leaving him without a mom. In the end I decided I'd rather be that mom who was healthy enough to keep up for years to come.

My dad is having the sleeve done in October. His insurance also does not cover this although his case is very urgent. He has many co-morbidities and needs a heart procedure done. But the heart doctor told him the procedure cannot be done until he gets the weight (atleast 75lbs of it) off. My dad is 63 and I am terrified for him BUT I know without this I may not have many years left with him.

I cannot give you advice toward which way you should choose. But these are our stories and why we chose how we did. I would really love for my dad to see my son graduate high school... and much more!

I'm in Louisiana, too, but I'm very, very lucky to have fantastic insurance that will cover the surgery (if I can get through the awful wait for approval!!).

I just to tell you that there is no "wrong" choice. You have to set aside what you think you should do and just listen to your gut. (Pun intended!)

It took me 3 years to finally be mentally prepared for the surgery; for some people, it's a month! Just trust yourself and do what feels right for you.

Good luck!!

I'm in Louisiana, too, but I'm very, very lucky to have fantastic insurance that will cover the surgery (if I can get through the awful wait for approval!!).

I just to tell you that there is no "wrong" choice. You have to set aside what you think you should do and just listen to your gut. (Pun intended!)

It took me 3 years to finally be mentally prepared for the surgery; for some people, it's a month! Just trust yourself and do what feels right for you.

Good luck!!

I am about the same as you as far at stats go. I was 278 decision weight 261 surgery date and at the 3 months out mark I was down to 235. I would say talk to your dr about the travel and see what he says to wait post op. If I were you I would try to schedule it right when you get back from San Fran. I was good to go by the 6 weeks post op and at 4 weeks out feeling good. How do you deal with pain? Also how was recovery from any other surgeries?

I can't say what will work for you, but I was also self pay and once I made my decision I was ready to take action. Three months seems like a long time to spend knowing that you have a major life altering event coming up... I felt much more comfortable making my decision and getting the surgery behind me ASAP. It allowed me to start my new life quickly, rather than spend an extended period of time saying goodbye to the old life. I just didn't enjoy all those moments of thinking about the fact that it was my last this, that or the other. And to do that for three months would have driven me crazy. But, you know how YOU will handle it, while I can't begin to guess. But I do know that I was so relieved to be on the other side.

Hi Tigerbelle I am also in Louisiana. I have great ins that will pay for wls. But first I have to go to 6 mth of nutrition classes and have a physc evaluation. I went to my first meeting today and I really am glad that the ins demands this because there is a lot you need to know before having wls. I believe my biggest thing will be not drinking while eating and no carbonated drinks lol but I have 6 mths to train myself. Give yourself time and I dont know what your A1C is but it should be 7 or lower before surgery. My A1C is at 10 so I have 6 mths to work on that also. I can't wait till I can have my surgery but I also want to be as prepared as possible so to have as little as possible complications

I'm going to throw in my 2 cents. I would wait until January and part of the reason for this is to work on a diet now so that you are use to eating less by the time of the surgery. My insurance covered my surgery and didn't require any type of 6 month diet beforhand so the only restriction on my date was getting in all my pre-op testing. March 27th was my initial consult and my surgery was June 4th. My surgeon required a pre-op diet 30 days before surgery which basically was 30g of carb or less. I started the diet the day after my consult and went from 258 to 229 the day of surgery AND learned about eating on a low carb diet. I'm so glad to have had that time because I think it might have been more of a struggle to go from eating like I was to eating like I do now without the chance to ease into it. Anyway, that's just my 2 cents - you have to do what feels right for you.

I'm self pay as well. My insurance has a writer in it that says they will not cover any type of WLS nor anything related to WLS (ie doctor consults, psych consults that are leading up to WLS)

I am looking into an insurance extra called BLIS. For a little less than $1500, they will cover complications Should they arise. Perhaps something to look into.