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Frustrated

EJamiFan

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EJamiFan    7

EJamiFan
Posted

Once I make up my mind I am all about getting things done. I am beyond irritated with the process of getting approved for surgery. I have completed my psych eval and met with the nutritionist. Dr wants a sleep study before surgery. As far as I can tell it is the Dr requesting and not an insurance issue. I was fine having it done until my insurance denied it, saying I don't meet the required criteria. Honestly I think the nurse of my primary care Dr didn't know what she was doing when she tried to get the precertification. She called me last week asking why I needed it, I explained the issue and she misunderstood and thought I wanted to do the sleep study it just to have the test. I told her I have had sleep apnea symptoms for years and that is why the surgeon wants the test ran but I think she still mucked the process up. Sorry to be so negative, but I am upset about it. I emailed the surgery center to let them know that my insurance will only cover an at home pulse ox monitor test, hopefully that will be good enough.

I am stressed about qualifying for surgery. I have BCBS, which is good, but my BMI is in the 38-39 range. I have HBP, takes meds for it and borderline diabetes. I know with comorbidities I could qualify with less than 40, but I'm not sure if they would consider the borderline diabetes or not.

My consult is next Thursday, I guess I will find out soon, just stressed about it all and am worried I won't qualify. I have spent the better part of 20 years obese. Diets worked to bring my weight down, but I never seemed to have enough willpower to stay on them once I lost the initial 50 lbs or so.

Thanks for "listening" to me vent.

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LaceSleeve    76

LaceSleeve
Posted

I know how you feel. Took me 2 years to get approved, worried the whole time I wouldn't qualify. But eventually I did, and it was all worth it. Keep your head up and don't give up, you won't regret it, I never have regretted the struggle to get approved :) good luck with your journey.

DrmBig4Evr reacted to this

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EJamiFan    7

EJamiFan
Posted

Thanks, I read what others have been through and I feel bad complaining.

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LaceSleeve    76

LaceSleeve
Posted

Don't feel bad, stories are different but they can be just as frustrating :) it helps to vent none the less.

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Lisa's Hope    421

Lisa's Hope
Posted

Don't feel bad. Just keep on trying to get approved no matter how long it takes. My insurance denied it out right and said it was one of their exclusions. I had no choice but to borrow the money and self pay for the surgery myself. I meant I was going to do this no matter what. I'm still making payments but don't regret it at all. So, keep trying. Don't give up. I think you will get approved. Even with me being self pay, I still had to jump through a lot of hoops to get the surgery. It is just a process and sometimes a looonnng process. Good Luck! :)

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vlb4vols    16

vlb4vols
Posted

EJamiFan .... The exact same thing happened to me! After I didn't qualify for a sleep study (only the home study) my Sleep Dr. wanted me to stay over night to be "titrated" for my sleep Apnea machine ... I waited till 2 weeks for my apt. and they called me and said my insurance would only approve me to have a self pap from a company to take home myself .... I called my Dr.s office after my home study was read and they went ahead and sent my information in for approval based on the diagnosis of Apnea ... I have a BMI of 40.7 anyway. Maybe your Dr. will do the same...it only took 3 days for my home study to be read.

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vlb4vols    16

vlb4vols
Posted

I go Friday to pick up my Cpap machine but already heard back from my Insurance with approval for a surgery date of April 25th :)

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EJamiFan    7

EJamiFan
Posted

Thanks for the info! I am sure I am stressing too much about it. Kind of had a crappy day and I have been down about the possibility of it not happening, or not as soon as I would like it to.

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vlb4vols    16

vlb4vols
Posted

II was so frustrated I cried about it ... I felt like if I had just kept my mouth shut about maybe having sleep Apnea I would have been approved a month ago but it all worked out ... Be sure to ask if they will go ahead and submit your Approval when your home study gets read :)

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EJamiFan    7

EJamiFan
Posted

Oh wow, I have thought the same thing about writing down apnea symptoms on my paperwork.

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EJamiFan    7

EJamiFan
Posted

OMG!!!! So excited! Got my insurance approval! Now just waiting for surgery center to get me scheduled!

Home sleep study went well, PCP said I passed. Very glad I won't have to do the in lab one.

Can't believe I could be having surgery soon!!! Pinch me!

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • LeighaTR

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      Four days post surgery. I am sipping as fast as I can and getting NO WHERE near the goal of 60 - 80 grams of protein or the 64 oz of liquids. I just feel FULL. I don't know if it can still be the gas build up (I would think by now that would be gone) but it is a struggle to drink. And so far I have not had the nausea or spasms and don't want to wander into that territory by pushing too hard with liquids. I about passed out today as it was my most "strenuous" day. Went from second story to basement for shower and I was sure I was going to pass out. Looking back on my last few days I have had a total of less than 1000 calories. Am I just not getting enough nourishment in me? Once again a friday where I can't get ahold of the doc until Monday rolls back around so I am hoping maybe someone here has some experience on how to keep energy going. I do have fibromyalgia too and that may be where some added fatigue comes into play. How did you all fair with the goals the week after surgery?
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
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      1. Phil Penn

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        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

      2. Selina333

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        I'm in Houston so kind of near you and had the sleeve in Dec. Down 61 lbs. Feeling better. Was definitely worth it. I hope the everything is going well for you. Update us when you can!

      3. Doughgurl

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        I am back home after my bypass surgery in Tiajuana. I'm post op day 4. Everything went great! I guess I'm one of the lucky ones who have not encountered much pain at all, no nausea thus far and I'm having no problem keeping down broths and water. Thank you for your well wishes. I cant wait to keep up this journey and have a chance at better health and simply better quality of life. I know there will be bumps in the road ahead, and everything won't be peaches and cream, but at least I have a great start so far. 😍

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    • Doughgurl

      Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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      · 1 reply
      1. LeighaTR

        LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

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