I'm new....Please give input!!
Hello Everyone!!! I'm new to the Illinois forum, and wanted to say hello. My name is Laura and I have made the life-altering decision of having WLS. I am scheduled to go to the free seminar at the Kane Center 05/13, where I hope to learn even more. Everyday I come to this site to read and learn from all of you. You guys are all inspirational, and it's so nice to know there's other people out there you can talk to.
I was diagnosed with PCOS and Insulin Resistance in my early twenties ( I am now 30). It makes it almost impossible to lose any substantial weight. I have researched a TON, and my Doctor even told me WLS really helps people with my condition. My BMI is 47.1 at 5'7. I just want to feel good and be healthy. Looking good is an added bonus. I think the RNY is the best for me. Dr. Guske at the Kane Center has come highly recommended from many people on here as well as people I know personally. I am very scared, but also at a strange kind of peace.
Are than any books out there you recommend I read? Anyone familiar with BC/BS of IL PPO? Are they difficult to get approval from? So many things....thanks for listening.
Hope to get to know you guys as I begin my journey.
I was diagnosed with PCOS and Insulin Resistance in my early twenties ( I am now 30). It makes it almost impossible to lose any substantial weight. I have researched a TON, and my Doctor even told me WLS really helps people with my condition. My BMI is 47.1 at 5'7. I just want to feel good and be healthy. Looking good is an added bonus. I think the RNY is the best for me. Dr. Guske at the Kane Center has come highly recommended from many people on here as well as people I know personally. I am very scared, but also at a strange kind of peace.
Are than any books out there you recommend I read? Anyone familiar with BC/BS of IL PPO? Are they difficult to get approval from? So many things....thanks for listening.
Hope to get to know you guys as I begin my journey.
Howdy and Welcome to the IL board...
Best book I can reccommend is Weight Loss Surgery for Dummies. Very plain and simple english. I also suggest You on a Diet, as it gives anatomy lessons in simple english and you will have a better understanding of your organs. On top of that I would also suggest OR Live.com, where you can watch the actual procedures via webcast being done.
Please make sure to join everyone on the daily roll call, and ask as many questions.
Best book I can reccommend is Weight Loss Surgery for Dummies. Very plain and simple english. I also suggest You on a Diet, as it gives anatomy lessons in simple english and you will have a better understanding of your organs. On top of that I would also suggest OR Live.com, where you can watch the actual procedures via webcast being done.
Please make sure to join everyone on the daily roll call, and ask as many questions.
Wendi
Welcome and also an encouragement to stop into the daily roll call.
BCBS of IL PPO is a great insurance. You will more than likely need to do a 6 month doctor supervised diet attempt. Pull out your insurance card and call the number on the back of it. Ask the rep what requirements they have in order for you to qualify for surgery. Follow the instructions to a T and you should be good to go after you fulfill the requirements.
BCBS of IL PPO is a great insurance. You will more than likely need to do a 6 month doctor supervised diet attempt. Pull out your insurance card and call the number on the back of it. Ask the rep what requirements they have in order for you to qualify for surgery. Follow the instructions to a T and you should be good to go after you fulfill the requirements.
Open RNY May 7
260/155/140
Hi Laura and Welcome, welcome, welcome!!!!!
Congratulations on making this life changing decision! We are here to support you every step of the way to surgery and beyond!
I can't help with books, because I have never read one about this surgery, but I can tell you my experience with BCBS PPO.
My first suggestion is to call BCBS and find out what YOUR policy requires---they are all different.
When I first changed to BCBS PPO, one of the the requirements was 12 months of supervised dieting. On first filing, my doctors were sure that I had met all requirements as I had been trying to lose weight for over 3 years with my doctor at the time. I was denied because of the 12 month requirement. They are VERY strict about the "supervised diet" (which is now usually 6 months.....). They want you AND your doctor to document this diet once a month, every month for the stated period of time. It only counts if you see your doctor once a month, within certain time restraints. I made up a little form that I took each month showing a typical day's eating, what my goal for the month was and how I accomplished last month's goal.
In my 9th month, I found out that they had changed to a 6 month requirement and I sent the documentation to the same person that reviewed my file the first time. I did NOT have to re-submit ALL the documentation, only the "missing" diet documents. I was approved within a week and the reviewing person called me personally!
So.....my advise it to find out WHAT they require and give it to them EXACTLY as they require it!
Hope this helps and hope to see more of you around!
Congratulations on making this life changing decision! We are here to support you every step of the way to surgery and beyond!
I can't help with books, because I have never read one about this surgery, but I can tell you my experience with BCBS PPO.
My first suggestion is to call BCBS and find out what YOUR policy requires---they are all different.
When I first changed to BCBS PPO, one of the the requirements was 12 months of supervised dieting. On first filing, my doctors were sure that I had met all requirements as I had been trying to lose weight for over 3 years with my doctor at the time. I was denied because of the 12 month requirement. They are VERY strict about the "supervised diet" (which is now usually 6 months.....). They want you AND your doctor to document this diet once a month, every month for the stated period of time. It only counts if you see your doctor once a month, within certain time restraints. I made up a little form that I took each month showing a typical day's eating, what my goal for the month was and how I accomplished last month's goal.
In my 9th month, I found out that they had changed to a 6 month requirement and I sent the documentation to the same person that reviewed my file the first time. I did NOT have to re-submit ALL the documentation, only the "missing" diet documents. I was approved within a week and the reviewing person called me personally!
So.....my advise it to find out WHAT they require and give it to them EXACTLY as they require it!
Hope this helps and hope to see more of you around!
Tell someone that you love them!
Dawn
253/223/167/127
HW/SW/CW/GW
Hi Laura
Welcome!
I think you will enjoy the amazing ride that this surgery offers. The best book that I found I got at Amazon.com. It is called "Weight Loss Surgery: A Lighter Look at a Heavy Subject." It is written by a weight loss surgeon and became my "bible" through my journey. It was very positive but very good at explaining all the proceedures and the possibilities of side effects that could happen. I referred to it often. It is easy reading.
Join us for the daily roll call and let us get to know you!
Welcome!
I think you will enjoy the amazing ride that this surgery offers. The best book that I found I got at Amazon.com. It is called "Weight Loss Surgery: A Lighter Look at a Heavy Subject." It is written by a weight loss surgeon and became my "bible" through my journey. It was very positive but very good at explaining all the proceedures and the possibilities of side effects that could happen. I referred to it often. It is easy reading.
Join us for the daily roll call and let us get to know you!
Cat Lady
I just wanted to stop by and say welcome to the Illinois forum. I am glad you have decided to make this change in your life, a healthy lifestyle change.
I have BC BS/Iowa, I think I slipped through the cracks because all I had to do was get the BMI under 50. I started in Nov,2006 with a BMI of 52.4. I went on a spinach, green beans and cottage cheese diet for 2 weeks. When I got the scales down right to 49.9 I went to my PCP and had then weigh me and we faxed things off to the Dr and I was approved 2 days later. Now if I had want RNY I was approved right away. So I had a surgery date for DEC 06 but had to have the gallbladder out first. Then had to heal and had to find a new doc, but was re-approved right away and had it all done March 2007. I feel wonderful.
So call your insurance get their requirements and if you can have them fax, email or mail you so you have them documented. Keep copies of all your test for your records. Seems like paper work gets lost from time to time. Or like for me since I had to change Dr's I needed a new copy of my phyc elval. It could not be forwarded because of the privacy thingy. So I have copies of everything in a special folder.
Good luck on your journey and sending prayers your way.
Karen
I have BC BS/Iowa, I think I slipped through the cracks because all I had to do was get the BMI under 50. I started in Nov,2006 with a BMI of 52.4. I went on a spinach, green beans and cottage cheese diet for 2 weeks. When I got the scales down right to 49.9 I went to my PCP and had then weigh me and we faxed things off to the Dr and I was approved 2 days later. Now if I had want RNY I was approved right away. So I had a surgery date for DEC 06 but had to have the gallbladder out first. Then had to heal and had to find a new doc, but was re-approved right away and had it all done March 2007. I feel wonderful.
So call your insurance get their requirements and if you can have them fax, email or mail you so you have them documented. Keep copies of all your test for your records. Seems like paper work gets lost from time to time. Or like for me since I had to change Dr's I needed a new copy of my phyc elval. It could not be forwarded because of the privacy thingy. So I have copies of everything in a special folder.
Good luck on your journey and sending prayers your way.
Karen
Hi Laura,
Dr Guske is great. The Kane Center, like others, it gets bogged down at times, and stuff sometimes gets misplaced, or calls don't get answered, but, I am really glad that was my place of choice.
I have BCBS Ohio, and like you have already been told, get the information you need from your own provider. They will send you a packet with all the things you need to do and have. My really best advice I can give you is whatever you send or take to the Dr, make sure you keep a copy of it. Even phone calls, make sure you know who you talked to on which day, and what the call was about.
Good luck on your journey, and join us in our daily roll call. We will love to hear from you.
Hugs,
Lisa
Dr Guske is great. The Kane Center, like others, it gets bogged down at times, and stuff sometimes gets misplaced, or calls don't get answered, but, I am really glad that was my place of choice.
I have BCBS Ohio, and like you have already been told, get the information you need from your own provider. They will send you a packet with all the things you need to do and have. My really best advice I can give you is whatever you send or take to the Dr, make sure you keep a copy of it. Even phone calls, make sure you know who you talked to on which day, and what the call was about.
Good luck on your journey, and join us in our daily roll call. We will love to hear from you.
Hugs,
Lisa
Hi Laura and Welcome!
I just had my surgery with Dr. James Kane from The Kane Center on the 28th and he was fantastic! You will LOVE him, their program, staff, etc. I drove three hours because of their reputation.
Since I am a newbie, too, I do not have the knowledge our co-members have here, but anything about The Kane Center, I would be glad to help!
Good Luck!
Georgianna
I just had my surgery with Dr. James Kane from The Kane Center on the 28th and he was fantastic! You will LOVE him, their program, staff, etc. I drove three hours because of their reputation.
Since I am a newbie, too, I do not have the knowledge our co-members have here, but anything about The Kane Center, I would be glad to help!
Good Luck!
Georgianna
Hi, welcome to the board. I have Bc/BS of IL and they required me to do the 6month of diet supervised diet by my physician. I got approved march 24th on the first try. It took about 1 1/2 weeks.
Teresa
Teresa
Teresa 
I now have a new & healthy life!
I now have a new & healthy life!HW 245/ PO 242.8 /SW 234.1/ GW 145 / CW 132 (Total Loss -110.8 lbs)
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