Question:
overwhelmed with what to do first
I'm seriously considering surgery. I've done tons of research and feel this is a great choice for me. My ins co is Anthem/BCBS (HMO). I know they cover WLS, I've checked that out. Not sure what to do first. Do I get a referal from my PCP? Schedule a consult with a WLS surgeon in my network? I'm totally ready and absolutely willing. I'm 342 lbs with a BMI of 54.9. I was recently told by my doctor that I have diabetes. I am taking Metformin for it. Dr has also sent me for tests on my thyroid, which I haven't gotten the results back on yet. I've been at this weight for most of my life.....only success that I've had with any weight-loss program was Redux...until that was taken off the market. Now I've gained that back, plus about 80lbs more. Any help with my questions would be greatly appreciated....thanks in advance.....oh, you can also email me [email protected] — Betsy@goal (posted on November 28, 2003)
November 28, 2003
Does your insurance require a referral? Some do and some don't. Mine
didn't so after I had done my research and knew for sure i wanted the
surgery, I just called the surgeon of my choice(in network) and they got
the ball rolling. Once you tell them you are interested in the surgery,
they will usually send you an iformation packet and set you up to attend an
informational seminar or support meeting. They will handle it all. my
surgeon office even set up all my pre-op appointments.
— Delores S.
November 28, 2003
Odds are since you have an HMO that your insurance does require a referral
to see a surgeon. So now you need to talk to your doctor (your primary
care physician - PCP) about pursueing this and see where that leads you.
Good luck!
— [Deactivated Member]
November 28, 2003
Congratulations on making a decision that will change your life!!! It is a
scary thing, but you will feel better as you go through the steps of
getting to your surgery date. My suggestion would be to decide upon 1 or 2
possible surgeons that you would consider for yourself, and bring those
names and your reasons for wanting surgery and research to your PCP's
office. If your Dr. sees that you have seriously thought about the surgery
and have done your homework, he will most likely be supportive. Be sure
you have thoughts about who YOU are interested in seeing as your surgeon,
as the WLS surgeons your Dr. may know may not be the ones that you feel
comfortable interviewing. Good luck!!
— Fixnmyself
November 28, 2003
I'd say research, research, research. Research the surgery, the different
types of weight loss surgery and the advantages of each, all the after
effects, the difficulties as well as the benefits, you need an accurate
idea of what to expect. Research your insurance company's requirements -
some require physician-assisted diets, some don't, many require sleep
studies, and you need to know why it's so important to know whether you
have sleep apnea, etc. Research the surgeons your insurance company will
pay for, find the most experienced one with the best record, find people on
this site who have used that surgeon and email them or look for their
comments on their surgeon's bedside manner as well as surgical competence
and their staff's attitude and helpfulness. Please don't take the first
surgeon you can get an appointment with, just because they're the first.
Find someone really good at this procedure. Often those you can get in with
easily aren't very busy for a reason. Decide how comfortable you are with
being one of the cases a surgeon uses to learn the procedure. For me, I
wasn't comfortable with that idea and chose a surgeon who had done in
excess of 2,000 RNY surgeries with an excellent record of good results.
Check profiles (go ahead, check mine, :o)) and read about people who had
great results and people who haven't done so well. Look for what the great
results have in common and what the not-so-great results have in common.
Basically, learn everything you can, then you know what you want and how to
talk about it, and your doctors can see that you know what to expect from
the surgery. That makes all the preliminary testing much easier. Hang in
there when people tell you you're taking the easy way out, or "you
don't really want to do that, do you? It's so permanent" or "all
you have to do is eat less and exercise more". We all understand
around here why those remarks are so very unhelpful, we've all been there,
done that, and it didn't work for us. This site is a great source of
information and support. Don't be embarrassed if you spend a lot of time
here. My surgeon encouraged me to spend time here, and it's helped me
tremendously. Best of luck, and feel free to email me if you like. You're
in for an exciting, confusing, rewarding ride! Chyrl Lap RNY 11/13/03 -23
pounds
— Chyrl W.
November 28, 2003
After I made the decision to do the surgery, I went to an open group
meeting at the hospital (St Vincent, Cleveland, Ohio). I learned so much
there from the staff that spoke on different topics and the post-ops that
also attend the seminar. They are a great wealth of information just like
this site. That same night I made my appointment for the consult with the
surgeon at the end of the meeting and they hand out the packets of
information on what you need before leaving (i.e. 5 year history of weight
management, referral from PCP, etc.) They even have monthly meetings for
pre-ops to inform them of what to expect and what to do. It's been a
wonderful journey (and still is!) I'm 4 1/2 months out and down 100
pounds...it's fantastic!!!!! Good luck with your choice and be sure to do
lots of research and be prepared. The best thing I had going in was a
positive attitude and that saw me through the scary things. Congratulations
on your journey!! :)
— Dianne M.
November 29, 2003
First, take a deep breathe. Second, the process of having WLS is a long
process, so understand from the beginning, that you will have to wait and
be patent ALOT. You will have to wait for approval, you will have to wait
to see the surgeon, you will have to wait for a surgery date, you will have
to wait for your test results.
<p>The first step is to do as much research on your own that you can
do, inform yourself on Lap RNY, LapBand, VGB, Open RNY, the step you took
joining AMOS was fantastic, the support on this site is priceless.
<p> You now need to go to your pcp and discuss this surgery with
him/her, if your BMI is 40 or more, your co-mobilities, and then your pcp
should submit to your insurance company a request for you to go to a
surgeon that is in your insurance coverage, for a consult and evauation. I
have a copy of my referral on my profile page, if you would like to see it.
Then you wait for the insurance company to come back with a approval or
denial to see a surgeon. Once you get the approval from your insurance
company, you need to call the surgeons office and find out what there
procedures are. After you see the surgeon, and he/she agrees to do the
WLS, the surgeon's office should submit to your insurance company for the
surgery approval. Then you wait again for a approval from your insurance
company. Once you have the approval, the surgeon's office will have you do
testing, possibly a Psyc evaluation, and other steps, then schedule your
surgery date.
<p>See, isn't that simple.........lol..........
<p>Good luck, and you are making the best decision on taking control
of your life.
— cindy
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