Hello, everyone. This is my first post.

I've been tossing around the idea of VSG for about a year, and recently I finally found the nerve I needed to make the decision that, yes, I want to pursue this. I'm tired of being tired and achy and MISERABLE carrying around this extra 100lbs.

My insurance is an H M O (Keystone Health Plan East). I've called them, and VSG is covered, and not excluded by my husband's employer, so that is a relief. Today is my appointment (in an hour and a half!) with my primary doctor to get this conversation started.

I'm a little worried, because while I am morbidly obese by BMI-standards, I'm generally healthy. No high blood pressure, or diabetes, etc. So I rarely go to the doctor. So what I'm saying is, my PCP barely knows me. I've been there maybe twice. So I'm a little nervous that they are going to try to give me a hard time for some reason. I'm hoping it's just my anxiety over everything making me feel that way. I need to get this doctor to report this as a medically necessary surgery, and give me the referral so I can get started on the rest of the pre-qualifications.

Wish me luck.

Edited November 4, 201411 yr by Garifab

Best of luck! Even w/o other issues, the weight itself is considered an issue, so I would imagine your PCP will provide the letter you need. Just explain what else you've tried, that the weight is causing 'xyz' health issues, you're worried about potential health issues, etc. My surgeon's office provides a sample PCP 'letter of medical necessity', which I'd imagine most surgeons offer, and your PCP's office might very well have a sample they've used for other patients as well. Good luck and let us know how it goes!

Edited November 4, 201411 yr by della street

A hundred extra pounds IS an issue. My spine started to collapse (17 ruptured discs that need repair) because it cannot keep carrying the weight. Good for you that you have decided to take this first step. How did you appointment go?

best of luck and that first step is the hardest. I was similar to you. never went to dr. in fact, this was my first time meeting with my new pcp. she had no issues what so ever. few months later... bam... sleeved....8 weeks after that... bam.... down over 50lbs. so flippin happy.

welcome to the site and keep us all updated.

Agree, 100 extra pounds IS an issue. I don't know how old you are. You may be a "healthy fat person" today, (I fell into that category until I hit my 40's) but I can attest that as I aged, those weight-related problems crept up on me! A 100 pound weight loss will make a HUGE difference in your long term health!

Thanks for your responses, everyone!

Trust me, I am well aware that the extra 100 pounds is issue enough. My greatest concern, which I poorly expressed earlier, is that my primary doctor doesn't even KNOW me, so I wasn't sure how well-received my request for a referral for bariatric surgery would be since I have an H M O.

But I am happy to say, it went wonderfully. My PCP is a totally awesome person. I've never really gotten to talk to her prior to today. She was very supportive, and extremely down to earth and said I was doing the right thing for myself. Very reassuring! She's giving me a referral to two bariatric surgery groups, and told me to make a consultation appt. with both and see which one I liked better. First one is scheduled for 11/24.

It's very exciting to have finally started this process after mulling over it and thinking about it for SO LONG.

Edited November 4, 201411 yr by Garifab

Yea!! So glad to hear it went well -- if I can ask, what state are you in? I'm in AZ --

Edited November 4, 201411 yr by della street

Of course. I'm in Philadelphia, PA. I should go update my profile stats.

Great! Glad everything went well with your PCP today. I will be seeing mine Wed. 11/5 to talk more about the surgery and I will also let him know that I've started taking the Meal Replacements just to see how I handle them and to see how much weight I can lose. Has anyone taken the meal replacements prior to surgery on their own? If so how did it go? I know that my insurance will require that I do this prior to WLS.

Woooo hoooo for the appointment going so well!

I was also nervous about bringing the topic up with my PCP and I've been with her for 6+ years. She agreed with me, as long as I was going for the VSG. She though the bypass was too drastic for me and the band was not a possibility due to the high rate of complications, which is why my surgeon will not put them in. I had 2 other people I had to clear surgery with, my therapist and psychiatric nurse practitioner. I have bipolar type 2 and a lot of anxiety, both of which have been stable for a few years. I would not have gone through with the program if I didn't have their approval because I've worked with them long enough that I had total trust in their judgement. They were both very supportive. The nurse practitioner said she wouldn't give her blessing to most of her patients, but she did for me! Having a good professional system of support behind you is essential and I think it will also make people more successful in the long run.