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A New World

Hello! I'm new to this community. I'm 27 years old, 5'5" tall, and I weigh in around 230lbs. My highest RECORDED weight is 268lbs in Dec of 2015.

I'm looking to have the Gastric Sleeve surgery done, hopefully before this year is out. Luckily, my insurance does cover WLS, but I'm looking to have it done before the year ends due to having a high out of pocket deductible. Because of other medical issues I've had this year, it would greatly reduce my share of the payment.

So far I've gone to the WLS seminar and a support group meeting. My Consultation with a surgeon, nutritionist, fitness coordinator, and first psych eval will be done on Sept 20th.

My MiL and SiL had the Gastric Sleeve done in April or May of 2016. I thought it sounded too good to be true, and wanted to have it done back then. My husband recently developed foot and back problems and has decided to look into surgery and is going through the process as well to have the VSG done.

It took me 3 days to finally decide that WLS was right for me. I had to battle with my unhealthy relationship with food, as well as my fear of failure. I still have moments of doubt, but all of the online research of articles and YT videos has so far overruled my nerves.

I am still nervous about being approved, though. My BMI is only 38.3, and the seminar noted that you needed to have 1 co-morbidity and needed 2 co-morbidities in 2 different places. The only co-morbidity I have for sure ATM is sleep-apnea. I suspect I have PCOS, but my near constant taking of BCPs has the clinical symptoms under control. I also have GERD, and I read somewhere that GERD could be considered a co-morbidity, but I've only seen that once and am not sure. Does anyone know if GERD is considered a co-morbidity? I know it's a frequent side-effect, but that doesn't help me. lol. I'm also worried that I won't pass the psych eval. I am bi-polar and am on a few anti-depressants, as well as go for Electro-Convulsive Therapy (ECT). I'm worried that with being hospitalized in Nov of 2014 and Nov of 2015 for psychiatric reasons, as well as being a current ECT patient will weigh against me. Any thoughts/experiences in this area would be great to hear about.

And here's my husband's and my faces for you. Picture taken in Summer of 2013.

post-300177-0-27819200-1474078928_thumb.jpg

Edited by nmf0318

  • Replies 19
  • Views 2k
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  • James Marusek
    James Marusek

    Find a copy of your insurance plan or go online and find one and look up the part that discusses bariatric surgery. Many health insurance plans are similar. This is what my plan says: •Surgical tr

  • Im quite sure gerd is not a comorbidity. It can be a side effect of the sleeve. Sent from my SM-N920P using the BariatricPal App

  • katie09/21/2016
    katie09/21/2016

    Hello I can tell you a bit about my experience with the psych side of things. For me, I was just completely honest during the eval (I have PTSD, agoraphobia, anxiety and a bunch of other related ment

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Hello! I'm new to this community. I'm 27 years old, 5'5" tall, and I weigh in around 230lbs. My highest RECORDED weight is 268lbs in Dec of 2015.

I'm looking to have the Gastric Sleeve surgery done, hopefully before this year is out. Luckily, my insurance does cover WLS, but I'm looking to have it done before the year ends due to having a high out of pocket deductible. Because of other medical issues I've had this year, it would greatly reduce my share of the payment.

So far I've gone to the WLS seminar and a support group meeting. My Consultation with a surgeon, nutritionist, fitness coordinator, and first psych eval will be done on Sept 20th.

My MiL and SiL had the Gastric Sleeve done in April or May of 2016. I thought it sounded too good to be true, and wanted to have it done back then. My husband recently developed foot and back problems and has decided to look into surgery and is going through the process as well to have the VSG done.

It took me 3 days to finally decide that WLS was right for me. I had to battle with my unhealthy relationship with food, as well as my fear of failure. I still have moments of doubt, but all of the online research of articles and YT videos has so far overruled my nerves.

I am still nervous about being approved, though. My BMI is only 38.3, and the seminar noted that you needed to have 1 co-morbidity and needed 2 co-morbidities in 2 different places. The only co-morbidity I have for sure ATM is sleep-apnea. I suspect I have PCOS, but my near constant taking of BCPs has the clinical symptoms under control. I also have GERD, and I read somewhere that GERD could be considered a co-morbidity, but I've only seen that once and am not sure. Does anyone know if GERD is considered a co-morbidity? I know it's a frequent side-effect, but that doesn't help me. lol. I'm also worried that I won't pass the psych eval. I am bi-polar and am on a few anti-depressants, as well as go for Electro-Convulsive Therapy (ECT). I'm worried that with being hospitalized in Nov of 2014 and Nov of 2015 for psychiatric reasons, as well as being a current ECT patient will weigh against me. Any thoughts/experiences in this area would be great to hear about.

And here's my husband's and my faces for you. Picture taken in Summer of 2013.

Im quite sure gerd is not a comorbidity. It can be a side effect of the sleeve.

Sent from my SM-N920P using the BariatricPal App

  • Author

Hello! I'm new to this community. I'm 27 years old, 5'5" tall, and I weigh in around 230lbs. My highest RECORDED weight is 268lbs in Dec of 2015.

I'm looking to have the Gastric Sleeve surgery done, hopefully before this year is out. Luckily, my insurance does cover WLS, but I'm looking to have it done before the year ends due to having a high out of pocket deductible. Because of other medical issues I've had this year, it would greatly reduce my share of the payment.

So far I've gone to the WLS seminar and a support group meeting. My Consultation with a surgeon, nutritionist, fitness coordinator, and first psych eval will be done on Sept 20th.

My MiL and SiL had the Gastric Sleeve done in April or May of 2016. I thought it sounded too good to be true, and wanted to have it done back then. My husband recently developed foot and back problems and has decided to look into surgery and is going through the process as well to have the VSG done.

It took me 3 days to finally decide that WLS was right for me. I had to battle with my unhealthy relationship with food, as well as my fear of failure. I still have moments of doubt, but all of the online research of articles and YT videos has so far overruled my nerves.

I am still nervous about being approved, though. My BMI is only 38.3, and the seminar noted that you needed to have 1 co-morbidity and needed 2 co-morbidities in 2 different places. The only co-morbidity I have for sure ATM is sleep-apnea. I suspect I have PCOS, but my near constant taking of BCPs has the clinical symptoms under control. I also have GERD, and I read somewhere that GERD could be considered a co-morbidity, but I've only seen that once and am not sure. Does anyone know if GERD is considered a co-morbidity? I know it's a frequent side-effect, but that doesn't help me. lol. I'm also worried that I won't pass the psych eval. I am bi-polar and am on a few anti-depressants, as well as go for Electro-Convulsive Therapy (ECT). I'm worried that with being hospitalized in Nov of 2014 and Nov of 2015 for psychiatric reasons, as well as being a current ECT patient will weigh against me. Any thoughts/experiences in this area would be great to hear about.

And here's my husband's and my faces for you. Picture taken in Summer of 2013.

Im quite sure gerd is not a comorbidity. It can be a side effect of the sleeve.

Sent from my SM-N920P using the BariatricPal App

Thanks for the input!

Welcome and good luck. As for as if your insurance will pay, it doesn't hurt to try!

Edited by laceemouse

Find a copy of your insurance plan or go online and find one and look up the part that discusses bariatric surgery. Many health insurance plans are similar. This is what my plan says:

•Surgical treatment of obesity (bariatric surgery) is covered only if:

- eligible enrollee is 18 of age or over

- clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following:

• Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).

• Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications.

• Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications).

• Obesity–induced cardiomyopathy.

• Clinically significant obstructive sleep apnea.

• Severe arthopathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity.

- Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration.

Since you have GERD, it would be wise to focus on RNY gastric bypass surgery, because sleeve surgery will only make this condition worse.

Welcome and best wishes. I don't know the answer but the surgeon definitely will!

Gerd is definetely a commorbitity and you may find that the VSG may not be the right surgery if you already have it. The sleeve can make that condition much worse resulting in a revision to bypass down the road.

I ended up having RNY gastric bypass instead of the sleeve due to Gerd. Bypass cured this disease for me along with sleep apnea, type 2 diabetes, high blood pressure and high cholesterol. It also put my kidney disease into remission.

I wish you the best of luck, just follow up with the surgeon on the commorbity and they can help you through it.

You would also need to understand the required supervised diet. Many times it is 3 to 6 months and that would mean it would be next year. Once you are through the diet, then it takes some time for the insurance company to approve and then they need to find an open slot on the surgery schedule. So, that being said, it just might take you a little longer to get through it. For me, I had a 6 month supervised diet that began on 12/26 and I had surgery on 9/29....nearly 9 months.

Welcome and good luck! My insurance doesn't require the 6 month supervision, I began with my first inquiry appt the 1st week of Aug and I am scheduled for a bypass on 10/5. I also have GERD and it was highly recommended by my surgeon to go with the bypass. However, GERD was not on the list as a co-morbidity, but Barrett's esophagus was and I do have that. My BMI is 42.

Sent from my iPhone using the BariatricPal App

Hello! I'm new to this community. I'm 27 years old, 5'5" tall, and I weigh in around 230lbs. My highest RECORDED weight is 268lbs in Dec of 2015.

I'm looking to have the Gastric Sleeve surgery done, hopefully before this year is out. Luckily, my insurance does cover WLS, but I'm looking to have it done before the year ends due to having a high out of pocket deductible. Because of other medical issues I've had this year, it would greatly reduce my share of the payment.

So far I've gone to the WLS seminar and a support group meeting. My Consultation with a surgeon, nutritionist, fitness coordinator, and first psych eval will be done on Sept 20th.

My MiL and SiL had the Gastric Sleeve done in April or May of 2016. I thought it sounded too good to be true, and wanted to have it done back then. My husband recently developed foot and back problems and has decided to look into surgery and is going through the process as well to have the VSG done.

It took me 3 days to finally decide that WLS was right for me. I had to battle with my unhealthy relationship with food, as well as my fear of failure. I still have moments of doubt, but all of the online research of articles and YT videos has so far overruled my nerves.

I am still nervous about being approved, though. My BMI is only 38.3, and the seminar noted that you needed to have 1 co-morbidity and needed 2 co-morbidities in 2 different places. The only co-morbidity I have for sure ATM is sleep-apnea. I suspect I have PCOS, but my near constant taking of BCPs has the clinical symptoms under control. I also have GERD, and I read somewhere that GERD could be considered a co-morbidity, but I've only seen that once and am not sure. Does anyone know if GERD is considered a co-morbidity? I know it's a frequent side-effect, but that doesn't help me. lol. I'm also worried that I won't pass the psych eval. I am bi-polar and am on a few anti-depressants, as well as go for Electro-Convulsive Therapy (ECT). I'm worried that with being hospitalized in Nov of 2014 and Nov of 2015 for psychiatric reasons, as well as being a current ECT patient will weigh against me. Any thoughts/experiences in this area would be great to hear about.

And here's my husband's and my faces for you. Picture taken in Summer of 2013.

Hello :) I can tell you a bit about my experience with the psych side of things. For me, I was just completely honest during the eval (I have PTSD, agoraphobia, anxiety and a bunch of other related mental health problems).

The person doing my eval passed me on the condition that I keep getting treatment and I just had to discuss & show my treatment plans. I think it's more of a problem if you screen for a mental health issue that you are not getting treatment for. Sounds like you have a solid treatment plan.

(I have had many hospitalizations for PTSD episodes).

Goodluck :-)

Sent from my iPod touch using the BariatricPal App

  • Author

Find a copy of your insurance plan or go online and find one and look up the part that discusses bariatric surgery. Many health insurance plans are similar. This is what my plan says:

•Surgical treatment of obesity (bariatric surgery) is covered only if:

- eligible enrollee is 18 of age or over

- clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following:

• Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).

• Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications.

• Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications).

• Obesity–induced cardiomyopathy.

• Clinically significant obstructive sleep apnea.

• Severe arthopathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity.

- Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration.

Since you have GERD, it would be wise to focus on RNY gastric bypass surgery, because sleeve surgery will only make this condition worse.

Thanks so much for your list and info on how to look up mine.

I know RNY us better for GERD, but I really don't like the idea of it compared to the VSG. I guess it'll all come down to what my surgeon reccomends.

Sent from my SM-G930V using the BariatricPal App

Welcome and best wishes. I don't know the answer but the surgeon definitely will!

Thanks! I guess I'll find everything out in due time!

Sent from my SM-G930V using the BariatricPal App

  • Author

Gerd is definetely a commorbitity and you may find that the VSG may not be the right surgery if you already have it. The sleeve can make that condition much worse resulting in a revision to bypass down the road.

I ended up having RNY gastric bypass instead of the sleeve due to Gerd. Bypass cured this disease for me along with sleep apnea, type 2 diabetes, high blood pressure and high cholesterol. It also put my kidney disease into remission.

I wish you the best of luck, just follow up with the surgeon on the commorbity and they can help you through it.

You would also need to understand the required supervised diet. Many times it is 3 to 6 months and that would mean it would be next year. Once you are through the diet, then it takes some time for the insurance company to approve and then they need to find an open slot on the surgery schedule. So, that being said, it just might take you a little longer to get through it. For me, I had a 6 month supervised diet that began on 12/26 and I had surgery on 9/29....nearly 9 months.

I've heard that RNY is better than GSV fot GERD, but honestly, the RNY surgery freaks me out a bit. I'm planning to see what my surgeon has to say about my GERD and the two.

I'm glad to hear that your surgery has helped with all those things!

With this program we just have to do the 2 week pre-op diet and most people can get through the routine process in two months.

I'll have more information once I have my consultation and speak with the surgeon!

Sent from my SM-G930V using the BariatricPal App

The doctor that did my psych evaluation said she has never had to deny anyone and that she is really only looking to see if you are capable of following directions.

Sent from my SM-G920V using the BariatricPal App

  • Author

Welcome and good luck! My insurance doesn't require the 6 month supervision, I began with my first inquiry appt the 1st week of Aug and I am scheduled for a bypass on 10/5. I also have GERD and it was highly recommended by my surgeon to go with the bypass. However, GERD was not on the list as a co-morbidity, but Barrett's esophagus was and I do have that. My BMI is 42.

Sent from my iPhone using the BariatricPal App

Thanks for the info and for sharing! Good luck on your journey as well!

Sent from my SM-G930V using the BariatricPal App

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