The Process

[JazzyJess20 32]

Hello all! I have made the decision to undergo WLS (sleeve) and will be formally beginning "the process" today, when I meet with my to-be surgeon for the first time.

To my understanding, everyone's process is different, based on their insurance and/or payment schedule.

As of right now, I had to partake in a virtual seminar held by my chosen bariatric doctor. I will be meeting with him in person. Afterwards, nutritionist and psych appointments will be made.

Can anyone and everyone, able and willing to, give me a description of what their process looked like so I have an idea of what to look forward to?

Thank you! (AND I apologize if a thread like this already exists)

[BigSue 1,325]

I had to attend a virtual seminar, and then I had an appointment with the bariatric surgeon. When I went to that appointment, I also met with the patient navigator, who gave me a checklist of everything I had to complete prior to surgery. This was dictated partly by my surgeon and partly by my insurance, and it varies from one patient to the next (they had a long list of requirements and marked off the ones I needed to complete). The items I had to complete included:

• Three months of medically supervised weight loss with my PCP (one appointment per month for three months)
• Preliminary bloodwork (they let me do that with my PCP)
  • My preliminary bloodwork showed thyroid issues, so I also had to go to an endocrinologist and get an ultrasound of my thyroid
• Upper GI (barium swallow test)
• Nutrition consultation with the bariatric nutritionist at my surgeon's practice (this is usually done in person, but I did it over the phone due to COVID)
• Psychological evaluation (one appointment in person, which included some tests and an interview, and a follow-up appointment by videoconference due to COVID)
• Group nutrition class (virtual class due to COVID)
• Group consent class (virtual class due to COVID)
• Pre-surgery appointment with the surgeon a week before surgery
• COVID test
• Pre-surgery testing (EKG and bloodwork), which is normally done prior to surgery day, but due to COVID, it was done on surgery day

[Jaelzion 1,123]

Let's see:

1. Like you, I had to attend a seminar

2. There was a list of tests I had to undergo - EKG, Endoscopy, Colonoscopy, check X-ray, blood work and a bunch of other stuff

3. My insurance had a 6 month "weight loss counseling" requirement, so I had appointments once a month for that.

4. After the 6 months, I had an all day appointment where I met with the surgeon, a psychologist, a nutritionist, a nurse practitioner, insurance specialists and some other folks I can't remember

5. My surgeon's office requested pre-auth from my insurance and got it

6. We scheduled my surgery and it took place on 3/26/2019.

That's about how it went, as I remember. Hope that helps!

[Officially Not Fatty Matty 459]

Welcome and congratulations for making this choice, I’m confident you’re doing the right thing and I hope soon you’ll be saying “I wish I did this sooner I feel great!”
My experience will be vastly different than yours as I did self pay in Mexico. My whole process was three weeks from phone call to surgery, and it would have been just a week if I didn’t have a schedule conflict. My insurance wouldn’t cover the process and to be honest it was so cheap to go to Mexico I probably would have done it anyhow to skip all the drawn out steps insurance typically requires. Some people most definitely benefit from all of that, so don’t assume I’m saying it’s not necessary for most people. The most difficult part for me was the preop diet. It just sucks (depending on what your Dr allows of course). The post op diet, even though it was basically the same as preop didn’t bother me though, the combination of being ready for the journey and stomach discomfort made it easy to not want solids. The surgery itself was pretty easy. I’ve been put under so many times I actually look forward to the experience so no anxiety at all. Recovery was a full day in the hospital they had me up and walking within a few hours. Five hour drive home (I didn’t drive) wasn’t that bad, I had no pain meds so it could have been better but I don’t remember being in much pain but I was very groggy. Day three I had really bad gas pain, particularly in my left shoulder and arm, walked around and it subsided. After that it’s been smooth sailing. I’m four months out, down 85lbs and have more energy than I’ve had in probably 25 years. I wish I did this years ago. Again, welcome and don’t worry about starting new threads for yourself. There are a lot of wonderful people here who are eager to help, it’s a great community.

[The Greater Fool 1,971]

I don't recall the details, it was nearly 18 years ago.

Your Doc will map it all out for you today. Be patient.

Tek

[Cherie04 47]

I am finishing up the process. I have my last appointment with my surgeon tomorrow. My journey has been pretty painless. My insurance had an option for 6 months or 3 months. I started my journey and am hoping to have my surgery before the end of the year, so I chose to go with 3 months.

1. I've had to have 4 appointments with my surgeon (all virtual due to covid)

2. 4 appointments with my nutritionist (I had to show weight loss at each appointment, even if it was only half a pound)

3. Preliminary blood work

4. A history from my PCP showing a history of obesity for the last several years

5. EGD

6. Psychological Evaluation (I was able to use Rolf Gordhamer, PH.D https://bariatricpsychassessment.com/about/ I did an online assessment and a very short 15-minute phone conversation

[BigSue 1,325]

I wanted to add that when I started this process, it seemed like such a long time before I could get my surgery, but the time really flew by. By the time I got to surgery day, I felt like it had snuck up on me and sort of wished I had more time to prepare (but now that I’m on the other side, I’m glad I got it as soon as possible).

[GreenTealael 24,956]

VSG - 3+ yrs ago so slightly different than what maybe happening this year:

I called the local Bariatric Surgery practice to inquire about how to start the process and was told to attend an in person seminar where all of the information would be discussed

After the seminar I called to set up an appointment with the surgeon.

At the appointment my insurance was processed, weight taken then official first meeting with the surgeon where we discussed my health & medical history as well as my options. I chose to move forward with surgery ASAP.

The head nurse/office manager set up my first nutritionist appointment for the same day because the NUT was available right after my consult. I was given info on the diet I needed to begin to follow (I needed to meet just once or twice more with the NUT prior to surgery for more instructions and weigh ins).

At checkout from the initial consult, I was handed a huge packet of info on the next steps/appointments. There were some the office set up and some I needed to do on my own. I needed to meet with my primary for insurance authorization & prior weight loss history. Next was the psychologist, cardiologist, gastroenterologist , sleep study, and my neurologist (case specific) Final steps were endoscopy and barium swallow test then the final required WLS seminar.

Once it was all complete, all materials were submitted and I waited for insurance approval. Once approval arrived I was given options on surgery dates. Prior to surgery I needed to complete pre-op lab/paper work including meeting with the anesthesiologist about 1 week before surgery. No pre-op diet required but I did one for ~ 5 days because I was nervous.

Day of surgery (5 am) was just more paperwork then briefly meeting with the team one more time. Administered light sedation then headed into the OR suite, met the surgerical team, placed on surgerical table, wired with monitors/leads, IV placed and then placed under general anesthesia.

From initial call to surgery day ~4 months.

*Revision to RNY (1+ yr ago):

At one of my regular follow up appointments I told my AMAZING Surgical PA that my GERD symptoms had increased significantly. I was scheduled to see the new Surgeon immediately (original one left the practice).

At the appointment with my new Surgeon it was suggested to conduct an endoscopy immediately. It was scheduled for the same week.

My new Surgeon conducted the endoscopy to have first hand info on my anatomy since they were not the original Surgeon.

A few days later we met again to discuss my options (revision or several months of repeated balloon dilatations) I choose revision and was scheduled for 12 days later. Please note that I was "fast tracked" and I didn't need to repeat any of the initial prerequisites because I was at goal weight and demonstrated significant need for the procedure. No insurance issues either for the same reasons. But this time I had to do the 2 week pre-op diet. The day of revision surgery the same as first surgery.

Good Luck with your journey ❤️

Edited October 19, 2020 by GreenTealael