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My Gastric Sleeve Pre-OP Requirements

So I had my first appointment with my doctor yesterday. I absolutely love him! He's very blunt and to the point, which I found hilarious. I brought my mom with me because she was not supportive of this surgery at all. She thinks I can just diet and lose it on my own, but I have tried dieting for 3 years now, and I always fall back into gaining weight. I am 24 (25 in a few weeks) and I'm sick of wasting my young life being overweight.

My surgeon got straight to the point and said, "This surgery has a 90% success rate of keeping the weight off for the next 10 years. Without this surgery, you will most likely gain the weight back." My mom asked him questions about my Pseudotumor cerebri and he said, "This surgery will absolutely help." He also said it will probably cure my PCOS. That conversation convinced my mom that this surgery is probably my last hope. I am so pleased because now she is no longer rolling her eyes at me every time I bring it up. She's actually saying that my sister probably needs it, too.

Now about the requirements that BCBS has given me... They are pretty stupid. Even my surgeon agrees. He said that BCBS gives us these requirements because they think we will give up trying to get everything together, because they don't want to pay. That is believable.

1. I have to get records together proving that I have had a BMI over 40 for the last 3 years. (This one isn't so bad. Since I have been overweight for the last 7-8 years, this should be fairly easy to obtain.)

2. I have to be put on a diet by a DOCTOR for 4 months. (That means, the 4 months that I have been put on a diet by a Nutritionist are worthless in this situation.)

3. I have to have a Cardiac Evaluation. (This is understandable. They have to make sure my heart is strong enough to handle the operation.)

4. I have to have a sleep Disorder Test. (Also understandable. I'm having one July 29th. They said there's a possibility that I may have Narcolepsy. Let's hope it's just sleep apnea.)

5. I have to have a clearance letter written by a doctor. (This one is kinda stupid. I'm pretty sure my surgeon is more than able to know I need the surgery. I'm worried my doctor may charge me to write this letter.)

6. Psychological Evaluation (This is bogus, too. But I guess it's also understandable. They must want to make sure I'm not an emotional eater. I can already tell that's not the case. I'm just hungry, dang it! Lol. The oral steroids they put me on years ago started this.)

7. I have to see a Nutritionist. (I hope the one I'm seeing is good enough. They are so against me getting this surgery, though. I know it's because they're worried about losing me as a customer. Those scumbags...)

8. I have to schedule a 4 hour nutrition class. (I guess this won't be so bad.)


I have 7 months to do all of this. I really wanted to have the surgery before next year, but I guess it's worth the wait.

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  • Author

Some people say that (depending on insurance) if you don't lose, they will deny you. Generally my insurance BCBSIL doesn't require a weight loss study at all, but my specific plan, through my dad's employer, does. I haven't been able to get any hard info on what they're requirements are. My doc said that they just want to see you try and see if you will drop out of wanting surgery. I'm just afraid that they will say that I DIDN'T try and deny me. It's been giving me a lot of stress since I'm already done with it and there's nothing I can do about it now. I just don't want to have to do all of my appointments again and another study. I think I would seriously cry for days.

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That's what Dr. Miles said to me, too. He said the insurance companies are hoping you will get sick of waiting and making appointments and eventually give up on having the surgery. But please don't give up! Will your doctor vouch for you and say that you tried?

  • Author

How cool! We're you sitting in a corner by chance? I was along the wall near the column in the lobby. I got my cardiac clearance this afternoon. Just waiting for the word to reach the office and hopefully a date soon after! How are you doing? Good news back after Dr made the call for you?

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Yes I was! I was the short girl with the red t-shirt asking all the questions, lol! I was with my mom. She came with me because she was so against the surgery at first. After we left, she was convinced that I needed it. I think I remember you. We're you with your husband? I think I saw you sitting next to the wall closest to the entrance door of the room. I remember you smiling at me. :)

Congrats on your cardiac clearance! I got my surgery date very soon. They actually got me approved 8 days after that first appointment. I am now on my 3rd day of the liquid diet. So far, it's not as hard as I expected. I'm obviously hungry, but I'm not completely miserable. My surgery date is August 4th. :D

How are you doing? :)

Yes, that was me. I dragged my hub to the appt with me so he'd hear for himself what support I would need without a debate later. I remember feeling like I was in a room full of people that could understand me, whereas often times I am not. That was an unexpected but pleasant surprise for me. I remember seeing you reading the binder and saying to your mom "..this is why I have to have this surgery..". I understood you were making your case to someone who wasn't sure about it even though you were. It was refreshing to see your confidence facing a major life event. Honestly, when I doubt myself I think back to that moment and remind myself of all the reasons why I have to have this surgery. I am so happy you're mom learned a bit more about it and came around! And so happy for you that Dr Miles moved it along to help save your sight. My sis in TX had hers early this month. She's doing great and she pointed me to this group.

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So your husband was somewhat against this surgery? If so, I hope he's understanding now. Awww! I'm so glad being there made you feel that way. I definitely understand you! I was so confident when I walked in because of all the research I've done and because I joined this group. :) That's so sweet of you to think of me when you doubt yourself! I'm so glad I'm able to help people, even in small ways. :D That's great to hear about your sister! How much weight has she lost? Is she feeling hungry?

My mom used to think that dieting on my own was just as successful. What she doesn't understand is that our stomachs are stretched out, and that make it harder for us to keep the weight off. I feel like this surgery is going to help us start over on a clean slate.

Edited by Hiraeth

Oh yes, my Dr is phenomenal. Ferrin Bayles is his name. I actually had to switch pcp's when I started this journey bc mine that I had been seeing for years just kept pushing Adipex at me. I lost 100lbs on that stuff, and gained back 120lbs when I stopped taking it. Terrible stuff.

But yes, my Dr wrote a note in my study paperwork that he thought that I was an excellent candidate for surgery and that it would likely save my life. I'm certainly not giving up, I'm only 25, but I know that if I don't get this now that I won't be around at 40 to enjoy kids and grandkids one day. I want to be healthy more than I want any food ever. If they could remove all of my stomach, I'd tell them to! Lol!

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  • Author

Oh yes, my Dr is phenomenal. Ferrin Bayles is his name. I actually had to switch pcp's when I started this journey bc mine that I had been seeing for years just kept pushing Adipex at me. I lost 100lbs on that stuff, and gained back 120lbs when I stopped taking it. Terrible stuff.

But yes, my Dr wrote a note in my study paperwork that he thought that I was an excellent candidate for surgery and that it would likely save my life. I'm certainly not giving up, I'm only 25, but I know that if I don't get this now that I won't be around at 40 to enjoy kids and grandkids one day. I want to be healthy more than I want any food ever. If they could remove all of my stomach, I'd tell them to! Lol!

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Adipex is an amphetamine. It's a lot like Adderall. So, basically, it's like medical meth. I'm glad you stopped taking it. The long-term affects are probably not good for your heart.

That's great that your doctor wrote you an approval note! I'm almost certain your insurance will approve you because of the note. I think this surgery will make you so much healthier! I'm 25, too! And LOL! You sound just like me. I'd rather be healthy and thin than ever want food. I've realized how much I'm missing out on in life by being overweight. Being this big is the number 1 reason I'm not completely happy.

Yeah, Adipex is nasty stuff. It's just legal speed. When I found out now bad it was for my heart I almost immediately stopped taking it. I was taking a double dose every day, by drs orders, and with my dad having congenital heart failure, it wasn't something I felt that I could risk.

I am really hoping that I get approved. They initial denial in November almost made me give up, but in the end I just doubled down and decided that I had to get healthy. Also that sooner was better than later, seeing as at 26 we lose our parents insurance and being a student I didn't know if I was going to be able to have surgery any time soon if I put it off lol.

I wouldn't say that I'm inherently unhappy, I'm too medicated for that XD I take a few different meds for a pre-existing mood disorder, but I am hoping that will improve as some of the weight comes off. I know my self esteem will go up, so that should help ????

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  • Author

Yeah, Adipex is nasty stuff. It's just legal speed. When I found out now bad it was for my heart I almost immediately stopped taking it. I was taking a double dose every day, by drs orders, and with my dad having congenital heart failure, it wasn't something I felt that I could risk.

I am really hoping that I get approved. They initial denial in November almost made me give up, but in the end I just doubled down and decided that I had to get healthy. Also that sooner was better than later, seeing as at 26 we lose our parents insurance and being a student I didn't know if I was going to be able to have surgery any time soon if I put it off lol.

I wouldn't say that I'm inherently unhappy, I'm too medicated for that XD I take a few different meds for a pre-existing mood disorder, but I am hoping that will improve as some of the weight comes off. I know my self esteem will go up, so that should help

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Oh god... Yeah, that's scary, especially since your dad has that condition. :( I'm glad you did the smart thing!

I'm so sorry that you had to go through all of this; the denial letter and wanting to give up. I dreaded that feeling, but I'm so lucky that my insurance approved me, especially so quickly. I hope they approve you. I will seriously be pissed if they don't, lol! Please let me know what they say!

Oh, I'm not unhappy either. But I'm not as happy as I want to be. I'm on Lexapro, so it helps me a lot with my OCD. I used to be severely depressed when I was thin. Then when I started taking Lexapro, I got so much better; almost as if I were never sad to begin with. Our self-esteem will definitely improve once we lose weight! :D

I will absolutely keep you updated! Hopefully everything will be sent off this week and insurance will approve me quickly!

I understand about not being as happy as you want to be. 110%. When I lost all of that weight with Adipex I was extremely happy. So happy to be thinner, happy to be able to buy new clothes that weren't 3 and 4x. I'm searching for that feeling again I think. I know that I can do it if I have the right tools and if I'm not ravenous all the time! It's going to be hard at times, but I'm so ready for that. I'm ready for the chance to be healthy and happy and make the changes for life

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  • Author

I will absolutely keep you updated! Hopefully everything will be sent off this week and insurance will approve me quickly!

I understand about not being as happy as you want to be. 110%. When I lost all of that weight with Adipex I was extremely happy. So happy to be thinner, happy to be able to buy new clothes that weren't 3 and 4x. I'm searching for that feeling again I think. I know that I can do it if I have the right tools and if I'm not ravenous all the time! It's going to be hard at times, but I'm so ready for that. I'm ready for the chance to be healthy and happy and make the changes for life

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I really do hope you will get an answer soon. I know how miserable it feels to be anxious for something, especially something like this.

That's great that you were happier. Now you're probably even more motivated to feel that way again. This time, you will keep it off! I miss buying medium sized clothes, and sometimes even small. Now I'm buying 2x and it really sucks. :/ If this ever gets hard for you, please feel free to send me a message. Venting definitely helps! :D

Oh jeez, I've never in my entire life been a medium!! XL is the smallest I've ever been, and that was like 8th or 9th grade XD I'm sure I was some smaller when I was younger but I can't remember lol! I am hoping to get down to a medium someday, but I'd be happy with a large. I just want to be able to buy clothes ANYWHERE I DAMN WELL WANT! Not just Cato or Lane Bryant (which I'm currently too big for). If I don't lose weight and ate to continue to gain I would very quickly no longer be able to buy clothes in any store! I'm the biggest size in Cato right now, 4x or a 28/30. It's kind of terrible, but I'm working hard to change that and see those inches GO!

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  • Author

Oh jeez, I've never in my entire life been a medium!! XL is the smallest I've ever been, and that was like 8th or 9th grade XD I'm sure I was some smaller when I was younger but I can't remember lol! I am hoping to get down to a medium someday, but I'd be happy with a large. I just want to be able to buy clothes ANYWHERE I DAMN WELL WANT! Not just Cato or Lane Bryant (which I'm currently too big for). If I don't lose weight and ate to continue to gain I would very quickly no longer be able to buy clothes in any store! I'm the biggest size in Cato right now, 4x or a 28/30. It's kind of terrible, but I'm working hard to change that and see those inches GO!

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Well, hopefully this surgery makes you the size you wish to be. There have been people who have had this surgery and said that they have never been in a medium or small in their life, until after they lost a lot of weight. I mean, it's amazing the figure all of these people are hiding under all the weight. So you never know! :D I always used to be small. I remember my mom bought me a size small in the Pink brand sweatpants when I was in high school, and they always fell off of me. And even then I thought I was fat! I weighed 115, lmao! Girl, I am so sick of shopping at Lane Bryant... >_> I used to wear Express and Old Navy clothes. When I walked into LB, I felt so depressed. I wear a 16 right now, which is not something I'm used to. I am here for you through this process! If you need anyone to talk to, please send me a message. I love to talk! :D

  • 5 weeks later...

So how is everyone doing in their journey?

Sent from my XT1080 using the BariatricPal App

Well, everything is finished except preop class and payment. Submitted all paperwork on Monday and was approved yesterday morning! I'm shooting for December 14th! SO excited! How about y'all??? ????
  • Author

So how is everyone doing in their journey?

Sent from my XT1080 using the BariatricPal App

I had my sleeve on August 4th. I've lost 25 pounds since then. Things are going well!

So how is everyone doing in their journey?

Sent from my XT1080 using the BariatricPal App

Well, everything is finished except preop class and payment. Submitted all paperwork on Monday and was approved yesterday morning! I'm shooting for December 14th! SO excited! How about y'all???

Congrats! I'm now trying to get my mom and aunt to do this. :)

So how is everyone doing in their journey?

Sent from my XT1080 using the BariatricPal App

I had my sleeve on August 4th. I've lost 25 pounds since then. Things are going well!

So how is everyone doing in their journey?

Sent from my XT1080 using the BariatricPal App

Well, everything is finished except preop class and payment. Submitted all paperwork on Monday and was approved yesterday morning! I'm shooting for December 14th! SO excited! How about y'all???
Congrats! I'm now trying to get my mom and aunt to do this. :)
Thanks!!! They totally should!

So how is everyone doing in their journey?

Sent from my XT1080 using the BariatricPal App

Well, everything is finished except preop class and payment. Submitted all paperwork on Monday and was approved yesterday morning! I'm shooting for December 14th! SO excited! How about y'all??? ????
Awesome! So glad you were approved and are moving forward in your journey!

Sent from my XT1080 using the BariatricPal App

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