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Does anyone know if I can get WLS with a history of pulmonary embolisms? (And other questions)

I mean... that's not my reason for getting WLS, my BMI is 40. I (should) qualify.

I'm just curious if my history is going to prevent me from getting the surgery. Has anyone else had this problem?

Also, what happens if you're on the border like me? I don't have high blood pressure, my blood sugar is tolerable, etc. I don't have a medical reason, I just have the 'over 100 lbs overweight' reason and a desire to have my life back. If they put you on a medical diet and you lose to below 40, can you still have the surgery? Or are you SOL?

Has anyone had surgery under a medicare HMO? It *looks* like I only have to pay $250/day in the hospital, which almost seems too good to be true. I wonder if anyone else knows for sure?

Am I crazy to be considering this with a BMI of 40 and no real medical reasons?

Thanks for any/all help!

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It edits out the abbreviation for Health Maintenance Organization? Really? Why?

Hi Menelly,

I wish I could answer your specific question about the PE, but I'll leave that to other medical professionals here. I'm just an optometrist, so I like to joke that I'm a doctor from the bridge of the nose up the the eyebrows! :)

As far as the comorbidities (obesity related health issues) are concerned, a lot of us underwent sleep studies to look for signs of apnea, which is very common condition in obesity that often goes undiagnosed. Sleep apnea is extremely damaging to the heart, and a common sign in snoring. Waking up tired is usually a symptom. The diagnosis of sleep apnea pushed my insurance into approving me. I never did start with the c-pap machine, however. I figured I would give the weight loss time to clear up the apnea, and I believe it has.

You are in no way crazy to be considering WLS for a BMI of 40. You have your head on straight, for sure! If you are ready to change the way you eat, the way you exercise, the way you dress, the way you feel, and the way some people feel about you (bad & good, believe it or not!), I am 110% enthusiastic about having that weight GONE. Heck, I can't believe I've lost nearly two full bags of mulch! Those things are a BEAST to haul around in a wheelbarrow for 30 seconds, and I was hauling that weight around on my precious, God-given body 24/7!

  • Author

I'll ask for a sleep study. Thanks! I know I snore, my husband says I do.

  • Author

But from what I can tell, my insurance will cover if I'm over 40. I just don't know if that's before the weight loss from the doctor, or after. >.<

I've always understood the bmi to be from the first visit with the surgeon. After that first visit they may ask you to lose weight. My doc has only asked for 10 pounds. I think it varies from practice to practice. You should be okay if you are at 40 at your first visit. I also noticed at my visit my height was rounded down just a little, but enough to get me to 35 and qualified (I also have OSA so I'm covered at that bmi). All my best to you on your journey. I'm in the middle of getting approved myself.

I can tell you, as a survivor of TWO pulmonary emboli, that you can have VSG surgery. I had my first PE in 2011 and my second in spring of 2013. My VSG surgery was in October of 2013. I did have to go through extra clearances to be approved for surgery. First I had to get an ok from my vascular doctor and then from my hematologist. The one requirement they had was that I have an IVC filter, which had already been placed following my second DVT/PE last spring. To prep for the surgery I had to go off my oral Warfarin (which I now take for life) approximately five days prior to surgery. I had to do Lovenox ( or equivalent) injections for four days prior and three days post op. They resumed me on the oral Warfarin the day after surgery. I did have to make everyone aware of my situation given I was a higher bleeding and clotting risk, but I had no real issues occur. The "worst" related thing that happened was one incision did not want to close. I was told it was because the subcutaneous tissue was "mush" from the blood thinners and the inner stiches were not holding. They finally used medical super glue to close the wound and I had no further problems. So I can tell you that it IS possible to have VSG after PE. Just go into it knowing everything you can and telling all the medical staff your situation. Good luck!!!

  • Author

Thank you, Roo, that gives me hope! :) I'm not on Warfarin for life, because we know mine was induced by the Nuvaring, but I assume I'll be on Coumadin afterwards to make sure everything is good post surgery.

Thanks for sharing your story, and I hope all is good now! :)

I believe it is your bmi on your first visit. My doctor said she has not had any patients penalized for losing weight prior to the surgery approval. I do not think you are crazy because you are a ticking time bomb for high blood pressure, diabetes, sleep apnea as well as knee pain. It would be nice to get this done before any of those things happen. Good luck!

I had no issues with PE before the surgery but ended up with a PE as a result of the surgery. The surgeons told me that if I had a known predetermination for blood clots before the surgery the protocols would change. The surgeon can tell you what would need to be done, but I agree with the earlier comments. You can still have surgery but the preparation for surgery is different knowing clots may occur.

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