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2 weeks into process, crazy insurance rules and confused!



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Hi, I just started with a Bariatric Center with the goal of gastric sleeve, and I'm confused enough it's frustrating. Had my first visit with surgeon, he told me that for my insurance, I should lose 10 lbs (no more without endangering my insurance).. Seems like it's five months until surgery, possibly six. I then attended a (no lies, pretty bad) online group nutritional presentation, that really skimmed over things like no caffeine and no carbonated bees, and was also informed that I had responsibilities to make ALL my pre op appointments myself, but I haven't been given any list of labs/tests to do so. I have no diet assigned... ? No instructions were specific about what I should be eating right now, but am trying to go for a LOT more Protein and a LOT less carbs. Am I supposed to be starting with Protein Shakes? They mentioned, but no real clear direction. No followup appointments with the bariatric center have been scheduled as yet, no one has returned my call of last week, basically begging for my pre op appointment list.

I try to be patient but am definitely a type A person who likes to plan. I am worried about losing too much weight and very confused about what specifically my diet IS. Already down about 2.5 pounds. I don't do well with uncertainty I guess. Also, the changes over the past two weeks, eating less, the ever=present journalling of food, the appointments I have been called for (apparently, not everything was my responsibility), the trying to lessen the caffeine, and my beloved sodastream plain seltzers, is difficult.

I'm definitely planning to call the center with more specific questions this week, and in hopes I receive a call back, but can anyone give me a feel for what the first couple weeks in a program are like, and should I relax about what feels like chaos?

Edited by LisaCee
clarification about nutritional group online meeting

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Sounds like mine tho my insurance wont cover it and i am paying cash. Tho i thought by paying cash it would be quicker. My 1st appointment was last month wtih the surgeon. Was not even 5 minutes. I had to go pick up a binder at another office with all the information. I had to do that Nutrition class which was completely pointless and useless. It was 40 minutes on zoom with some other people telling me the same things i already knew thru youtube videos (there went $400) As for labs and such they sent me that a few weeks later thru the mail but warned me not to do them yet because apparently the labs and other stuff like xrays and EKG were only good for say 30 days. If i did it too early i would have to redo them. But yea i got no diet to follow either. They said that would be a part of the 2nd surgeon appointment. Next up i have a psychological evaluation in March. After that if everything is good then i can make my 2nd surgeon appointment where they will look over everything and let me know if we can schedule surgery or not.

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7 minutes ago, seadoo2021 said:

Sounds like mine tho my insurance wont cover it and i am paying cash. Tho i thought by paying cash it would be quicker. My 1st appointment was last month wtih the surgeon. Was not even 5 minutes. I had to go pick up a binder at another office with all the information. I had to do that Nutrition class which was completely pointless and useless. It was 40 minutes on zoom with some other people telling me the same things i already knew thru youtube videos (there went $400) As for labs and such they sent me that a few weeks later thru the mail but warned me not to do them yet because apparently the labs and other stuff like xrays and EKG were only good for say 30 days. If i did it too early i would have to redo them. But yea i got no diet to follow either. They said that would be a part of the 2nd surgeon appointment. Next up i have a psychological evaluation in March. After that if everything is good then i can make my 2nd surgeon appointment where they will look over everything and let me know if we can schedule surgery or not.

Gee, that sounds very similar, although they told me (on this WEIRD group chat) that I could set everything for ASAP. Won't it be fun if that isn't correct? I have endoscopy, sleep study, cardiac clearance, upper GI, some other lung study (X-ray?) to do. I have a sneaking suspicion I'm going to have to carbo-load near the end of this stress, just to ensure that I don't lose too much weight. The whole 'lose but not too much!' thing is likely to drive me batty! Plus it seems extremely unproductive and antithetical to learning new habits. Trying to stay positive, but like I say, I'd prefer to type-A it, making specific goals of weight per week, IF they tell me the 'by when' date for losing.

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3 minutes ago, LisaCee said:

Gee, that sounds very similar, although they told me (on this WEIRD group chat) that I could set everything for ASAP. Won't it be fun if that isn't correct? I have endoscopy, sleep study, cardiac clearance, upper GI, some other lung study (X-ray?) to do. I have a sneaking suspicion I'm going to have to carbo-load near the end of this stress, just to ensure that I don't lose too much weight. The whole 'lose but not too much!' thing is likely to drive me batty! Plus it seems extremely unproductive and antithetical to learning new habits. Trying to stay positive, but like I say, I'd prefer to type-A it, making specific goals of weight per week, IF they tell me the 'by when' date for losing.

Lots of people on insurance have so many requirements that take months. Luckily i had a Endoscopy earlier this year so i dont need to do it again. as well as the stress test. The stress test tho was only 15 minutes on a treadmill with a bunch of wires connected to me. typically you also have a Chest Xray and a EKG. sleep study is no big deal. I did that earlier this year and got diagnosed with sleep apnea. and personally i love the cpap machine lol. Most hate it. but yea i tried to speed everything up and could not. Only thing holding me back is that stupid Psyc Evaluation that is probably gonna cost me around 800 bucks or so.

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3 minutes ago, seadoo2021 said:

Lots of people on insurance have so many requirements that take months. Luckily i had a Endoscopy earlier this year so i dont need to do it again. as well as the stress test. The stress test tho was only 15 minutes on a treadmill with a bunch of wires connected to me. typically you also have a Chest Xray and a EKG. sleep study is no big deal. I did that earlier this year and got diagnosed with sleep apnea. and personally i love the cpap machine lol. Most hate it. but yea i tried to speed everything up and could not. Only thing holding me back is that stupid Psyc Evaluation that is probably gonna cost me around 800 bucks or so.

I know as a retiree that I couldn't afford this if insurance doesn't cover it, heck just the copays will be costly. Yeah, psych eval is part of this too, although they haven't called me for it, nor have I seen it in the document I'm raking for possible appointments to make (since they seem very slow to get me the information, after insisting I don't wait to make them!)

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22 minutes ago, LisaCee said:

I know as a retiree that I couldn't afford this if insurance doesn't cover it, heck just the copays will be costly. Yeah, psych eval is part of this too, although they haven't called me for it, nor have I seen it in the document I'm raking for possible appointments to make (since they seem very slow to get me the information, after insisting I don't wait to make them!)

Yea mine is costing about $19K. Which kinda pisses me off because i swear with insurance insurance negociates prices with the hospitals but apparently i cant... Like i had a colonoscopy, Endoscopy earlier last year and they billed my insurance like $15K but my insurance only paid them around $3K. But anyways My binder i got with all my info said i needed to call to make these appointments for everything. The hospital would not do it. I also have to call like 6 different companies to make payments for the surgery once i am approved from the surgeons office, anesthesiologist, hospital fee, Pathology, Some complication insurance coverage they require and so on. lol

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my insurance also required six months of a professionally-supervised diet (that is, by a PCP or a registered dietitian). They didn't specify the TYPE of diet, though - as long as it was professionally supervised. I worked with a dietitian. She had me eat c. 2300 calories a day, gradually increase my Protein intake, and gradually decrease my carb intake. I also had to wean myself off caffeine and carbonated beverages. I had to add in fruits, vegetables, and whole grains. Just basic healthy eating.

it kind of prepped me for what eating would be like after surgery.

Edited by catwoman7

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17 hours ago, catwoman7 said:

my insurance also required six months of a professionally-supervised diet (that is, by a PCP or a registered dietitian). They didn't specify the TYPE of diet, though - as long as it was professionally supervised. I worked with a dietitian. She had me eat c. 2300 calories a day, gradually increase my Protein intake, and gradually decrease my carb intake. I also had to wean myself off caffeine and carbonated beverages. I had to add in fruits, vegetables, and whole grains. Just basic healthy eating.

it kind of prepped me for what eating would be like after surgery.

Thanks! That's helpful, I guess this is what they mean. I'm doing the same, trying to lower my caffeine, and slowly weaning off the seltzer, the amount of Water they suggested is mad crazy though. I'm now 3.5 lbs down out of 10. I lose weight easily initially, just seems like they could have spelled this out in simple terms! The insurance requirements are rough for me, as I have little margin for loss, but really need this for my health!

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