Getting Approved

Sep 05, 2012

 After the roller coaster ride and an emotional civil war with myself, I went back to the surgeon in January of 2012. My BMI was 38 or 39, I'd had a sleep study which showed sleep apnea, but I never followed through and got a CPAP and my blood pressure was high, but not high enough to warrant medication - only watching.

We (a surgeon from the NJ Bariatrics practice and I) discussed the lap-band. I know it works for some people, but I can tell you, I'm not one of them. It's reversible - something that reminded me of every weight loss I ever had. I had mentioned the sleeve a year earlier but the practice was a little hesitant because they hadn't seen a 5-yr track record, my insurance didn't recognize the procedure as a viable alternative, etc, etc.. Anyway, I asked about the VSG again and then he turned me over to the nurse who is the business administrator for the practice.

Our conversation was the most important one I ever had until that time. We got into detail about the requirements for a VSG, how to get the approvals through the insurance company and what I would need to do on my side. 

First and foremost, I'd need to get to a 40 BMI or 38 with two proven comorbidities. Then, I'd need a 90-day supervised diet with regular visits to one of their nutritionists, I'd need to have a psych eval and consent from my GP. I needed to NOT GAIN WEIGHT once the ball was started so I had a decision to make. No matter how much better it seemed, I couldn't permit myself to intentionally gain weight so that I could qualify for a surgery, So, I put on all of the clothes I had, my jacket and stuffed the pockets with change from my car, my cell phone and a couple magazines from the waiting room - 300lbs. It wasn't 40, but it was close enough that I'd just have to work with the sleep center to get the results confirming my apnea and the BP thing, well, I could handle that. So I was off to the races, my 90-day clock started ticking right then.

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