Yesterday, I saw the nut and the doctor for my second monthly appointment (out of 3). I am right at a BMI of 39.9 (it was 39.7 last month) which is not enough to be approved by my insurance since I apparently don't have the co-morbidities they look for with a BMI less than 40. They said that RA doesn't usually count (only regular arthritis) and other than that I only have GERD.

I asked the nut about feeling like I'm in limbo, since I can't really work on losing weight yet or I may not get approved. And apparently I need to gain a little instead. She said she doesn't want to tell me to gain weight by next appointment, but to bring a big bottle of Water with me and drink a lot right before I weigh in. I'm of the opinion that I will get a few rolls of quarters and put them in my pockets:) LOL Also she said they want me focusing on changing behaviors in preperation for how I will need to eat for the surgery (ie drinking all my water and without a straw, no carbonated beverages, etc.) during this 3 month "diet" imposed by the insurance rather than dieting.

Surgeon wants me to do an upper endoscopy prior to the surgery since I have GERD to check for a hiatal hernia. Apparently that can cause the reflux problems and he can fix the hernia during surgery (yay!). Not looking forward to the endoscopy - I'm scared of the gagging and feeling that something is going down my throat, but he said that I will be out of it (he will do the endoscopy). It won't happen until after I'm approved. Good news - he said that I will only have to do a 1 week liquid pre-op diet. MUCH better than 2 weeks.

He also said that I should be able to continue taking the Plaquenil for my RA since it isn't a strong immuno-suppressor, but to check with my Rheumy doctor just in case. That is all - now I just wait.

The process is daunting, isn't it?

I can't believe how many people say that having this surgery is the easy way out. It is anything but easy. It is such a big deal - a big decision about time, emotions, and fiscal consideration! And having RA just adds to the burdeon of the process.

I hope that you have good luck in your pursuit - and that you keep remembering that it's just necessary stuff to do!