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Shay S.
South Bend, IN, USA
Post Op - BMI: 44.5
Surgery Type: RNY
Member ID: S1047873868
Surgeon: J. Rivera, M.D.

Click here for Shay's surgery support page
Click here for the 07/2003 Reunion Page
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COUNT DOWN UNTIL SURGERY

<Time By Escati

JULY 14, 2003

 



To Shay Smith's Sci-fi

Journey

 

 

 

The Beginning 4/10/03
I am 27 year old female and because of my knee ailments I am now classified as disabled. My Medicare goes into effect on April 1, 2003, which covers gastric bypass surgery. They do not cover the 840.00 in-patient hospital cost and the 20% co-payment. For this reason, I am trying to get my Medicaid to cover the remainder of my medical expenses. As I am in Indiana, my Medicare and Medicaid coverage may vary from others who are not in my state, but any help is always appreciated and warranted. 

 

 

4/26/03 Just a little tid bit of Information for those of you that do not drive or have some difficulty driving. I have located a cab company that will take you ANYWHERE in the state of INDIANA on your MEDICAID, which costs you nothing IF your spend down is met OR if you have regular Medicaid with no spend down. I am only supposed to drive my Truck, but Its down at the present time, so I'll be using this company's services to get to my consultation on May 2, 2003. I could drive my little beat up Plymouth, but I do not want to risk it. Its a car and I am not supposed to drive any cars because of My knee ailment (DLD). I have spoken to this company a few times and they seem very friendly towards obese people. They have cars and vans and I believe some handicapped equipped vans as well. They have told me that they DO NOT leave a client at a physicians office, rather they stay outside in the car until the appointment is over. This saves on gas and waiting for them to get back, no doubt. I also enquired about them taking someone to get a procedure. I was told the cab driver will drop you off, some assistance can be given if needed. The company comes back to get you after your hospital stay. So I'd suggest you have someone call the company ASAP so that they can get the right time frame down to pick you up from the hospital. That company's name is ARS 1(800)422-6196. I will let you know how they treat or provide for the morbidly obese after my consultation. The office hours are M-F 8am -5pm. As soon as You know of appointments call them to schedule a pick up, they will run your Medicaid numbers to check to see which kind of Medicaid you have (spend down or not)and to see if the spend down is met...or WILL be met by the pick up day. I know longer have a spend down since I receive Homemaker/nursing care in my home. That was a blessing from God to be off a Spend down. 

 

 

4/29/03 Just two more days to go until my first consult with Dr. J. Rivera In Michigan City, In. I have received a copy from my PCP's office of the referral letter sent to Rivera On 4/4. When I scheduled the consult, his office told me to bring a referral letter from my PCP with me and to get there 15 minutes prior to appointment time for paperwork. I am not taking any chances, so I asked for a copy of the letter to be forwarded on to me and I will take it to him...Just in case. I also have a copy of the letter I wrote to Medicaid asking for this procedure and describing my many battles with weight, health issues, financial situation, and primary insurance lead in! Just to let them know, They are no longer my primary medical needs carrier. I am hoping not to have many or any bumps in the insurance road. I am praying for a quick approval and a fast surgery date.


 

5/3/03 Okey dokey Smokey, the balls are rolling! I had My first consult Yesterday Friday) With Doctor Rivera. He told me Medicare is not a problem, in fact if all I had was Medicare he could schedule the pre testing for the procedure, because they do NOT require prior Approval. He said Medicaid, on the other hand might take as long as several months to get approval. He gave me a list of things to get so that he could try to get approval. I only had ONE item to get for him because I had done everything Medicaid requires for the procedure. I am scheduled to pick up my 5 year medical history( with documented diets I have tried) from my PCP's office on Wednesday. After I submit that to Dr. Rivera he will try to get Medicaid Approval.

 

 

5/4/03 I forgot to mention my ride down to Michigan City with the cab company, ARS (800) 422-6196. Well, it was just a ride...nothing major in either direction to report. Make sure the time that you give the company are the same time they give your driver. There was some minor miscommunication in that area, but I still got to my appointment...just 15 minutes late! My driver kept saying, "I will get you there in enough time." And he did! I was still seen by Dr. Rivera. I was picked up in an unmarked cab car...It was a rather spacious Grand Marquis and I believe it was Bob's (my driver) personal vehicle. I rode up front and he pin pointed things to give me a route on how to get to get to Dr. Rivera's office by myself, as I did not know how to get there. Bob waited for me in the parking lot, when I was done upstairs the nurse called him on his cellular and he drove around to the front to pick me up. Overall the trip was very pleasant...so much so that I slept (and he even turned the radio off while I was sleeping) all the way home. I recommend this cab company!!

 

 

 

5/8/03 Lets all shout Hooray's to Michelle for my amazing new Sci-fi profile! It rocks the House, Michelle. Nothing yet to report really. I am still waiting to hear from Dr. Rivera's Office wheither or Not my 5 year medical history arrived at his office. I was told I would get a call back later today. My fingers are crossed, as I am ready for him to send out the approval request. Also, My dietician has put a letter in the mail to Dr. Rivera informing him that she placed me on a diet several months back (which I am still on) and that I was already on slim fast from the previous summer. She wrote this letter to make it known that I am on a diet, but that while on her diet she was and IS also aware that I'm using slim fast. I have been on slim fast since last summer (August). For Medicaid approval, they want you to be on at least ONE diet under a doctors supervision for 8 consecutive months. I have been on several, and some weight loss pills, but I opted to get on another diet to make it more recent! 5/9/03 I just found out that the Medical Records lady at my PCP's office NO LONGER works there! That....No, I will not curse her, I will not yell out cruel and unusual obscenities closely followed by rude gestures! I am calm, I am the ocean wave cascading over a waterfall. Is that suppose to really calm anger? I called My PCP's office after I talked to Rivera's Receptionist. She told me NOTHING had arrived and its been over a week since my appointment. So...I called my doctor's office and asked to speak to (I will not name her, but she knows what name I am thinking) the Medical Records department. I almost flipped when they told me "SHE no longer works here and the new girl is just now getting acquainted with the system." I said well, The Old Medical records person said she sent the records via mail and if they had not arrived by Thursday or Friday she would send them by FAX. The Receptionist said..."Shay, she knew WEDNESDAY Was her last day and I show no record of your 5 year medical history being mailed anywhere." Needless to say people...I was quite upset, but I am sure I will just go down there and Pick up my records and hand deliver them to Dr. Rivera. That way I know he gets them! Oy Vey!

 

 

 

 

 

 

 

 

6/4/2003 Well folks I just found out what my actual weight is last week when I had to go and get more x-rays of My knees taken at the hospital. I am crushed to report that I now weigh in at 446 pounds, bringing my BMI up to 72.0. I also have scheduled a consult with a new physician (PCP) because my current one and I have never seen eye to eye on my treatment and care plan. My original physician (Dr. Linda Sanchez Morgan) unfortunately left the area a few years ago and although she referred me to the doctor I will see on Friday, I neglected to go to her then because the distance was just to far. Now that I am familar with ARS, I do not have a reason for not checking out this new doctor. In fact, A few months ago DR. Morgan called me and again stated that I should see Dr. Maria Klahre because she did not think My current physician was compatible with my personality. Boy, was she was ever right. I strongly feel like I stayed with my current PCP because I started the gastric bypass road with him and I felt that if I changed doctor's it might screw up paperwork or other important information from getting to the new doctor. Now that I know exactly how much I weigh and that my knees have gotten worse, I am desperatedly searching for a PCP who is not as uncaring and completely lacking in bedside manner as my current doctor. I wish I had done this 2 years ago, but I can not change the past...I can only focus on my present to ensure a better future. I am advising you all, I am begging you to make sure you have a good PCP and believe me you will know if you do. Does he listen to you? Offer alternate means of care? Is he available when you have an emergency? When you go to the office, do you wait 20--30 minutes in the lobby then an additional 20 minutes for him to come to your room? And when you go to the back, do you hear him talking to the other patients like they are his long lost relatives, spending huge quantities of time with them BUT when he gets to your room, you barely get a "hello" and he says, "whats the problem now?" and spends 5 minutes or less telling you "THERE IS NOTHING ANYONE CAN DO FOR YOU." And then you wonder why your aches and pains are more often, why your weight is up and why you have more problems since you started coming to that doctor. If You are seeing a physician like the one I have described...Quickly, and do not pass go, do not collect your two hundred doolars Start asking others who they see for a general practicioner. Make consult appointments and try to get a feel for a new doctor. Don't wait and waste valubale time that could have been spent getting some kind of alternate help for your co-morbidities. I have no intentions of sitting on my behind and collecting disability for the rest of my life because my knees are shot. 2 years ago I was getting ligament strenghtening injections by a REAL doctor who cared that a then 25 year old woman had the knee problems of a 66 year old. Those injections hurt like hell, BUT at least they were offered to me as a way to build my ligaments up, to give strength to my weakend appendages. I get so tired of hearing from him, "you're too obese for the equipment, you will not fit here or there, or in this machine. That procedure, that physical therapy is a waste of time for you." AND there is a such thing as a portable MRI machine! And obese People do fit in them. I had an MRI of my knees when I weighed 387 pounds! Ok, I'm done. I am getting off my soapbox...for now.  

 

 

6/5/2003 God answers all prayers....even when you can't get on your knees anymore. I have been approved by Medicaid after the 1st letter for the procedure! It took exactly one month from the date that I drove the 5 year medical history to my gastric surgeon. In case I forget to make updates periodically, my angel Is PAM PATE and she has done a terrifc job. She has sat and answered many numerous questions, she has shared her personal experiences and has become not only a AMOS family member but also a friend. She was the 1st person I called to tell my approval had come through and she was second, only to God for always believing in me and never once being in doubt or having anything negative to say. Thank you God for answering prayers...even when you can't get on your knees.

 

 

 

 

6/17/2003 I HAVE A SURGERY DATE!! I am scheduled for a Rouen Y (gastric bypass) open distal GI, on July, 14, 2003. That's just 5 days after my 28th birthday! I have one more thing to complete prior to the blood work the week before surgery. I am scheduled to stay at the sleep clinic Tomorrow night (6/18/2003) to monitor my sleeping habits and to better determine what level of sleep apnea I have. I have also managed to lose 12 pounds since my last posting; I am down to 434 pounds. I have a wonderful new PCP and things are looking up. "All things are possible through Christ who strengthens me."

 

 

 

6/25/2003 I am trying to remain strong and put all my faith and trust in God that the news I heard today can be rectified and I will not have to postpone my surgery. I got a call this evening from Ted at the Sleep clinic where I went for a study on 6/18. Ted told me that the level of sleep apnea I have is quite severe and that no aniesthiologist could put me under with the results from my sleep test. He said He would try his best to get me in before July 14 for all follow up testing, but to be prepared that Dr. Rivera may not be able to perform surgery on the set date for my procedure. I was crushed....I was heart broken, and then I got mad. I have yet again come upon a stumbling block. Except this one is now preventing me from proceeding with surgery. Folks, I went to my past PCP on a few ocassions, complaining about my lack of sleep, and the fact that I suspect I had sleep apnea, I complained about my snoring being so loud it would wake me up from sleep. My then PCP told me, "' Loud Snoring, is not a symtom of sleep apnea...not breathing while sleeping is." He dismissed my concerns and said, "we should try to get surgery WITHOUT obtaining a sleep apnea test; They cost too much money and Medicaid might just approve me without one. But if they deny you....we have the sleep apnea test to fall back on to get approval. They should approve you without it...we are, afterall saving them money by NOT giving you the test." This man had total disregard for my health and my quality of life. I should have sought out a better health care practicioner a long time ago. Had I bipassed him and went to another doctor, I would have already known the severity of my sleep apnea and something could have been done already to better prepare me and the doctors for my surgery. I'm so close to the "losing side" of my battle...so close and still so far away. I am hoping and praying that the next step of my study, which is scheduled for June 30, is successful in determining that I can have my surgery as planned. Apparently in this second step, I will have to wear some type of mask, an air ventilation system of some sort. Ted, at the Sleep clinic has instructed me that it would be wise at this stage to get copies of my sleep report, making sure I get the interpretation of the report as well as the actual documentation. He suggested that a copy be sent to my PCP and that I have one for my own records because whomever my anesthiologist is will need one before I go into surgery. I have alot of calls and planning to do before the 30th. Praying never stops...that is a constant in this house. God give me strength to make it pass one more hurdle in the road. On a good note, I was told by my PCP that since my insurance will not cover staffing at home, but instead will pay for services as in patient in a hospital or EFC facility, that she will do her best to ensure I am either discharged after surgery to a Nursing home, or I will stay at the Hospital where surgery is performed. The words "nursing home" sound gloom to me, but she was very positive about it saying many people who have a need for round the clock care, and do not have the help needed at home, benefit from a short stay at a Care facility. She said a good week or possibly two could make the world of difference in my speedy recovering, the proper cleaning of my wound site and making sure I am eating and drinking as the doctor orders. The Nursing home is my only option now because My bariatric bed has yet to arrive and I now have a small Hernia from the strain of getting out of my bed. My PCP thinks, and I agree, that it would do more harm to postpone my surgery for the bed and staffing problems alone and thus I will be a Young nursing home client. It should make for some interesting conversations though! I will be sure to contact her about my sleep apnea problem and see what road she wants us to travel on now. Considering the way I was told about it, I am thinking the Nursing home sounds better and better. I will remain positive that God has a plan in store...and I am right where he wants me to be. If anyone has any second sleep study insight, please don't hesitate to share. I was told I stopped breathing 40 times in a 4 and half hour period, which was all the sleep I got. Ted informed me the longest period without air was 33 seconds, and the shortest interval was 18 seconds. My oxygen level dropped from the 100% its supposed to be to 75% while I slept. He also said I slept 60% of the time on my back, which is the worse position for me to sleep in, and 20% on my sides. My headaches, my sleepiness throughout the day, my insomnia...are all directly linked to my sleep apnea. Now that I know what the problem is, I am ready to deal with it and try to find some solutions so that I can get my surgery as scheduled.

 

 

 

 

 

6/27/2003 More news...this time, not so bad. My surgeon called and said the risk of infection is too great and he can not in good conscience release me to a nursing home after my surgery. SO, I am glad he was truthful and was not thinking about getting paid but was more concerned with my life ater he completes the procedure. He said we need to come up with a better solution for after I am to be released from the Hospital and this when I had a brainstorm with Tasha, a friend who is also a member of the site. Why not just STAY in the hospital or at least get sent to one in my town upon his official release after surgery. Since the risk of infection is obviously less in a Hosptial, and I can get the specific care I will require in a hospital...I suggested this to his Nurse this morning, no word yet though on what he says. My PCP was left a message last night advising her that he will not go along with a Nursing home, and that another option needs to be thought out. I will call her and also suggest just staying in a hospital for an additonal week or two. The problem is making sure my Insurances pay for it. I am still scheduled for Surgery on the 14th, pending the results of my second sleep study, My surgeon and the anestheiologist are aware I am going in for the CPAP test on the 30th. We are all confident that the CPAP will pinpoint my exact levels and we can proceed with the surgery. Thank you to all who wrote and prayed and offered support and your own stories of encouragement. This site is a Godsend for support and offers a vast amount of information either already printed, or just waiting on someone to ask the question. AMOS family, continue to keep me in your thoughts and prayers.

 

 


7/12/2003 Hello My AMOS family. Just a few butterflies, more from the anticipation now because all those kind emails just keep coming and my nervousness has passed. THANK YOU ALL! It helps so much to receive personal stories or just a few "keep your chin up" notes. It lets me know that I am not alone in this struggle. :o) OK here's an update for you: I slept with my C-PAP, with oxygen filtration, for the first time last night. I did not wake up until 5 am this morning! thats a record for me! Although the C-PAP was proven to greatly lessen the quantity of my apnea episodes, it did not help me with oxygen levels and thus I have to hook an extra tube into my C-PAP machine which gives me the 02 my body is lacking when I sleep. All is well is Shayville! I am focused...I am confident, and I am thnakful to have been pointed in the direction of this site. Lets all give a big AMOS well done to those Angels who really step up to the plate and give their time, energy, effort and unwavering support. Here's to mine...PAM PATE for always making time to answer my questions online and on the phone! I can be a nuisance! Big Hugs Pam...Thank you! I will meet you at the "losing side" and It begins Monday!

 

 

 

7/21/2003 Hello ALL!! I want to give praise to God for getting me through my surgery, for helping endure the pain, for easing the pain with medications, and for Helping me deal with the pain! :o) There is ALOT of pain involved with the cutting of your stomach muscles with this surgery. I knew It would not be easy though....I just want to maintain my composure and keep a level head. Thank you all so very much for all the kind words while I was in the hospital. It makes it easier to sit here reading all the "get wells" and God Blesses" knowing I am not alone in my decision to follow through with this operation. I Was In the Hosptial a week, and I get my staples on Next Monday, the 28th. Keep praying and sending that positive energy this way.

 

 

 

July 28, 2003. Hello All. Just wanted to let you all know how I am doing two weeks after surgery. I AM TIRED. I have no energy what so ever, I am exhausted all the time. I got the staples out and got weighed, I have lost 32 pounds, down to 408 from my surgery weight of 440. I am eating alot better, I have heartburn alot if I eat too much to soon, or if I over eat. I have gotten sick one time...and that was enough for me! I drank too much water! Can you belive it, too much water, not over eating....I was over drinking! I swear I feel like I am going through menopause or something, I stay hot all the time....I can not get cool enough! Which is why I drank too much water. I must be flashing! :o) If anyone has any advice, or can tell me if they went through the same thing...please contact me! Until the next update...I will see you all on the "losing side."

 

 

 

 

 

8-19-2003 Hello to all my AMOS friends. Just a little note to let you all know what I have been going through the last couple of weeks. Yesterday (8,18, 2003) I had an Upper GI and a Barium and a cookie Barium. The cookie one is where they make you eat small portions of food to see how it goes down, checking for acid reflux or any swallowing problems. The good news is my micro pouch is holding up fine and so is the bypassed sections of my intestine and my regular stomach. The bad news...My micro pouch isn't so micro. Mine is 4 ounces, not the 2.5--3 ounces I was told it would be. This upset me to some level yesterday, but I have been on a calorie and protein intake regimen for about a week and I was assured that my weight loss will be slower, but more gradual and it will come off following the "diet" and exercise. My goal of being 200 pounds is still a foreseeable goal. My surgeon tells me in a year and half I could very well be 200 pounds. My PCP has already started my water aeorobics/aquatic therapy sessions at a local facility here to expedite the weight loss. More good news...Today and yesterday were the first days A regular sized adult blood pressure cuff have ever been used on me! And I went to the cheap movie seats here in town...and I was actually able to just sit down, no squiming, no uncomfortable side ways sitting...just sat right down! Its these little things that make all the difference. My weight loss, drum roll please...Down to 402 pounds, I have lost 38 pounds in 5 weeks! I am a firm believer that with the exercise regimine I will start next week and continuing to eat right ( I have NO intolerences to food, except too much fat!) I can and will difinately make my goal weight, I want to lose 100 pounds in 6 months...I could still possibly do it. Keep your fingers crossed and keep me in those prayers.

 

 

9/28/2003 Hello AMOS family and friends. I must say I have been really busy trying to attend as many of my exercise therapy classes as possible. I will admit I over did it on Doing some Richard Simmons Routines...It was the Disco tape. I just felt so good being able to actually DO The ENTIRE tape that I forgot all about the bending and turning until the next day when I was flat on my back in pain! AGH! So My PCP has told me what I already know...NO RICHARD SIMMONS, unless its the sedintary tapes. The Good News, I had lost another 10 pounds in two weeks. That brings my weight down to 392 pounds and a total loss of 48 pounds in exactly 2 months! This update is late because I was weighed on Sept. 14, again...Sorry AMOS. I am still trying to maintain an optimistic outlook on the 4 ounce stomach pouch and the inevitable facts that I will have to stay positive and work harder to keep losing weight as the months pass into years. I still believe I can reach my goal of losing 100 pounds in 6 months. This is my primary goal and the one I feel is most important to reach to keep me focused and staying on the positive road.
I have had a few hurdles to jump over already and truth be told I am ready for things to just go smoothly for a while. Well family until next time, I wish you all good Health and heart warming smiles.

 

 

 

 

2-3-2004 Hello My AMOS family and how the heck are you!? It has been a wonderful 6 months post op. First I want to say I have been off my C-PAP with Oxygen for over 4 months! I stopped snoring completely and no longer require O2 or the C-PAP at all. I did not make my 6 month goal of 100 pounds lost in 6 months, however I did lose 85 pounds by Janu. 14, 2004 (my 6 month anniversary). I currently weigh in at 350 pounds, so as of Yesterday ( I had a Doctor's Appointment) I am down 90 pounds! I also got the results of my 6 month blood work up and panels. I am borderline anemic, no wonder I stay Cold now! So I plan to make myself take my iron supplements daily. I have not really had any real medical problems...other than the ones previously posted. So that is good news. My hair has been shedding or making itself scare from my scalp for the past two months. My PCP tells me this is natural because the extra estrogen I had when I was heavier is now gone and my body will start to level out eventually. I was given a prescription for a cream to try twice a week on my scalp where the breakage is more severe. I will let you know how this cream helps with the hair loss. I am more active than I have been in YEARS, I feel good and I am thankful for life. Even though I am no longer suffering with the Apnea, I still do not sleep for any real length of time. I guess my body is just use to getting two or three hours here and there, not an entire 8 hours at a stretch. I can live with that! My next goal is to get a mountain bike by the beginning of spring so that I can peddal the pounds away during the summer. Staying busy has helped to get me exercising and keeping the pounds coming off. As I have been told by my Angel, Pam Pate on several occasions, my social life has difinately improved with the weight loss. I am currently involved and things are all looking up in what is a promising relationship. If (when) we pass the 6 month goal I will let you know. It helps to have a postive male support in my life and it is beneficial to me not sitting around having just my TV and the fridge to turn too! I must end this update, but I will make it a habit to try and come back more often. Until then...I wish you all well and I am joining those ahead of me on the "losing side." There is room here for us all, so come and join us! PS, A very special thanks to my angel, Pam Pate, Whose new figure has allowed for me to get some great clothes for the winter and the spring ahead. Thank You PAM. :o)
6-6-05 I have not written in over a year. I could not. Too Much has transpired in all that time. I am down to 276. I am about to start an assistant management position at a local company part time. Hopefully my knees will hold up. I am dating. And hopefully the guy who fits the bill of serious potential of what I am seeking will come along sooner or later, BUT until then...I am just having fun going out. I am still the same ole me...just in a much smaller package. I bought a mountain bike this spring, just like I said I would so long ago. I ride it about twice a week. ....And I still miss Pam...so I know the more things change the more things still remain the same. Somewhere in these pages I talked about hitting a goal of 250, its not so far out of my reach Pam, But then...even When I was saying I couldn't, you were saying...I could. UPDATE

 

 

 

 

 

 


 

 

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    Surgeon Info:
    Surgeon: J. Rivera, M.D.
    5/3/03 Went to see Dr. Rivera on Friday, May 2, 2003, and let me just say he is not the most cordial man I have ever met! He was very focused on the procedure and the things needed to begin the process. He knew I was serious when I unzipped my backpack and whipped out my pad and pen to take notes and ask the pre written questions. Then I preceeded to give him my referral letter, my psychological Evaluation AND my own 3 page, typed letter to Medicaid! He was astonished by my initiative in that I had done everything needed for Medicaid approval and I had my questions already written out. He was very professional and impersonal...which is fine with me. If he is that dedicated to his medical practice, I am sure he must be a fantastic surgeon. All his energy is centered on it, none is spent on bedside manner! I am not looking for a friend, I am looking for a competent surgeon...one who knows his stuff! And for that...I suggest Dr. Rivera. Of course, these are just my thoughts and your impression may be totally different from my own. 4/24/03 I have a first consultation scheduled now. I have chosen Doctor J. Rivera, In Michigan City, IN. I have read all about him from postings at the site and I have spoken To Pam Pate(who had her procedure performed by him) several times. I am ecstatic! I am so happy things are finally moving forward.
    Insurer Info:
    Medicaid-disability(IN) and Medicare(A&B)
    4/24/03 Took over a month to get a consultation scheduled because ONLY the Bariatric Surgeon can request a prior approval for a procedure. I'm telling everybody, you must take some things into your own hands...I would never have known this if I would not have made a nusiance of myself calling the Medicaid EDS line. They (Medicaid) will not release the actual phone number to prior approval to you, BUT they will tell you to give the EDS number to your PCP's office and have them call. Alot of confusion and run around could have been avoided if Medicaid would just have told me that my Surgeon needs to submit the request for the Bariatric procedure, not my PCP. Oh well...Live and learn! Nothing to report on Medicare yet because all my information says they only provide a Gastric Bypass surgery for Morbid Obesity, it just has to be medically necessary. So I am hoping there will not be a problem on that end. 6/18/2003 I had no problems getting approved for my surgery. Medicare did not and does not have a prior approval process. The only requirement is that the surgery must be medically neccesary and the ONLY form of weight loss surgery they cover is gastric bypass. Medicaid approved me after exactly 1 month, just 4 weeks after my paperwork was sent in. It took only one attempt to get the approval from Medicaid. I suggest that if you want to expedite things, do your homework on the surgery and what your insurance company stand is on it. Do all the prior approval things in advance. I know that doing all my Medicaid hoop jumping months ahead of time, saved me from having to wait on this procedure.