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Starting the conversation today with PCP



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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 by Garifab

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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 by della street

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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?

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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.

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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!

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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 by Garifab

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

Edited by della street

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

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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.

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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.

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    • 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
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. 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!

    • 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
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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