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Spent hours researching and still no clear answer... help please

ascott0322

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ascott0322    2

ascott0322
Posted

Hoping you all can help as I've tried calling the insurance company, my primary care and bariatric surgeon's office and haven't really gotten a clear answer.

Just some background....

I started my 3 month supervised diet on 10/31/2016. I weighed in at 255/6 (39.5 BMI). The nurses aid told me to not worry too much about the BMI (try not to gain too much or lose too much). They scheduled a sleep study to test for sleep apnea but I havent received the results back yet. I visited my primary care and she wrote a letter of approval and stated that I have a BMI of 39.21 (for some reason my height in her office is higher than the bariatric surgeon confused.png ). Im currently in Month 2 of the 3 months required nutritionist visits. I'll have to weigh in two more times in December then meet with surgeon at the end of December/beginning of January.

So enough babbling... my question is about insurance approval and BMI. I have a feeling that - although I snore like a hibernating bear after an orgy- i may not have sleep apnea. Why do I believe this to be the case? Well I heard that if I stopped breathing in my sleep that they would stop the sleep study and put on the CPAP machine. Although I woke myself up a few times either by snoring or just being crazy uncomfortable, I was never switched to a machine. My assumption is that I'm just a snorer.

If I do not have sleep apnea hence having no co morbidity, when do I need to hit the 40 BMI? Will they look at my starting weight and 39.5 BMI? If I gain, wont my insurance company deny me because I didnt lose on the supervised diet? Should i fluctuate my weight but make sure that I am 40 BMI at the time of my last weigh in? It sucks that I have to go through all of this over 2 lbs. Had I known about ankle weights, I would've definitely threw them on with a weighted vest and a big ole Dolly Parton wig just so my initial weigh in would be recorded as 40. Im just confused because I remembered by surgeon saying "do not go over your current weight"... sooo im puzzled. Lady, I need to be about 2 lbs heavier to get the surgery mad.png

Any help you all can give is greatly appreciated. Thank you all i advance!

SN: if I have sleep apnea... this whole book that I wrote is probably going to be a waste of time LOL

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heidikat72    935

heidikat72
Posted

my sleep study came back indicating i hadsleep apnea - very mild but still able to be listed as a diagnosis of sleep apnea. and they definitely did not wake me up and put a CPAP on me during the study.

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ascott0322    2

ascott0322
Posted

my sleep study came back indicating i hadsleep apnea - very mild but still able to be listed as a diagnosis of sleep apnea. and they definitely did not wake me up and put a CPAP on me during the study.

Thank you!

You have renewed my hope!!! (thats so sad that you have to hope to have a chronic condition in order to use insurance that you pay for every two weeks)

Its weird that for years my parents and I thought I had it but now that I tested, im on the fence. I have all of the signs (fatigue in the daytime, waking up multiple times a night, heavy snoring etc). Thanks again for your reply.

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erica2185    84

erica2185
Posted

I never in a million years thought I had sleep apnea!! I mean I snored a little and never quite get more the 4-6 hours of sleep I thought it was normal...it was not until I started the journey for surgery and per my insurance requirements got a sleep study and found out yes I do have sleep apnea!!! Now waiting on my cpap machine.... My bmi alone qualified me but now adding that to my list I'm pretty much guaranteed approval... The only time being fat worked in my favor lol.

Sent from my SM-G530T using the BariatricPal App

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theantichick    2,204

theantichick
Posted

They don't always stop the study, unless the apnea is severe. I had moderate apnea, and didn't find out for weeks after the study. Then I had to schedule another night at the sleep clinic for them to calibrate the CPAP. And another couple of weeks to get the machine ordered. If the apnea is not immediately life threatening, it can actually move quite slow.

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paunchy    4

paunchy
Posted

I have mild apnea as well. They want me to wear it to help treat the condition and get better sleep. They didn't wake me up during my first study.

Sent from my LG-H910 using the BariatricPal App

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BubblesOhSoSleeved    129

BubblesOhSoSleeved
Posted (edited)

Hi, Im kind of late but do you know if other peope in your family have sleep Apnea?? Although I dont think I have it my bmi is over 40 but my mother had it which qualified her for her Sleeve. Also My entire family on that side of my family has sleep apnea, so you could use the surgery as a preventative...thats how I'm trying to get a first approval...although my bmi is over 40, diabetes, hypertension and sleep apnea run on both my paternal side and maternal side...Good luck!!! :)

Edited by BubblesOhSoSleeved

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GoingRogue    53

GoingRogue
Posted

I was not woken during my study to have a CPAP put on. I did go back for a second sleep study where i wore a CPAP so they knew the pressure I needed.

sleep apnea is sleep apnea and it needs to be treated. Lack of sleep hurts your body in so many ways. It's hard on your heart, the lack of sleep means we are lazier, in other words heavier, etc, etc, etc.

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ascott0322    2

ascott0322
Posted

Hi, Im kind of late but do you know if other peope in your family have sleep Apnea?? Although I dont think I have it my bmi is over 40 but my mother had it which qualified her for her Sleeve. Also My entire family on that side of my family has sleep apnea, so you could use the surgery as a preventative...thats how I'm trying to get a first approval...although my bmi is over 40, diabetes, hypertension and sleep apnea run on both my paternal side and maternal side...Good luck!!! :)

thank you for this! even though im slioghtly under 40BMI im hoping the family history and possible sleep apnea will get me the approval. I still have two more nutrition classes to do this month so we'll see soon. Thanks again :)

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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      · 0 replies
      1. This update has no replies.
    • Doughgurl

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      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

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    • Alisa_S

      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. LeighaTR

        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

      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

        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.

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        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

      CaseyP1011

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

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