Frustrated and barely started....(Long)
Hi there again! Glad you called BCBS and got some answers. RE: other expenses, did you ask them if you had any out of pocket after the deductible. I'm going to make another suggestion....take your BC insurance card and sign on to bcbsil.com. Then sign up for the Blue Access and, you will have direct access to all of your EOB's (explanation of beneftis) for all of your care with BCBS. Usually, if you've had them for a few years, the EOB's go back 18 -24 months, and when you sign in, the first thing I see is a synopsis of my paraticular insurance program. It shows my deductible, I think co pays and any out of pocket that is required by the plan (not what I have used.) This is a generic listing of the program I am signed up for. I think that will be helpful for you. If you don't see the numbers, then give BCBSIL another call. (Don't woryy about botherig them, this is their job!)
RE: payment arrangements, in this case, I would probably call the finance office at Silver Cross and explain to them what you are doing and what your part of the costs will be and ask them about payment arrangements. I think you may be surprised (I hope anyway!) how flexible they are.
I am going to Private Message you and paste in a copy of my insurance info that I get when I pull up Blue Access on my own ins account so you can see all the info that is listed. Yours, of course, will be different, but should give you a good idea of what all if covered and at what amounts. Hope this will help you.
Again, if I can help, pls let me know.
Georgie
RE: payment arrangements, in this case, I would probably call the finance office at Silver Cross and explain to them what you are doing and what your part of the costs will be and ask them about payment arrangements. I think you may be surprised (I hope anyway!) how flexible they are.
I am going to Private Message you and paste in a copy of my insurance info that I get when I pull up Blue Access on my own ins account so you can see all the info that is listed. Yours, of course, will be different, but should give you a good idea of what all if covered and at what amounts. Hope this will help you.
Again, if I can help, pls let me know.
Georgie
Hey, don't worry about what you sounded like. You were upset and frustrated. We have all been there. If you have any other worries just pop on here and ask. You should join us on our Daily roll call. You can get to know everyone and we talk about anything and everything.
As far as paying the deductible, I didn't get a bill for that until after the surgery. I called the billing department up and set up payments for $100 a month. They were more than happy to accommodate me. They are so used to people not paying their bill. They don't mind helping people that are trying to pay their bill.
See ya later
As far as paying the deductible, I didn't get a bill for that until after the surgery. I called the billing department up and set up payments for $100 a month. They were more than happy to accommodate me. They are so used to people not paying their bill. They don't mind helping people that are trying to pay their bill.
See ya later
Hi Bradley29
Welcome to the Illinois Board and the sometimes VERY confusing process of Weight loss surgery.
First, take a deep breath. Insurance can be a nightmare to navigate but you are off to a good start in calling them. My recommendation is to get something in writing from your insurance company as the rules they go by are those that are in force when you start your program. If they change them and make them more strict or require more information, you would not have to because you started the process now. Also, try to understand exactly the requirements that the insurance company wants. Doctor offices do not make it their importance of making sure you have all the correct information. For example, I did my 6 month supervised diet through my family physcian. My insurance company did not honor a diet conducted with my surgeon or any affiliated programs of that surgeon. My doctor missed one month in recording ALL the information in my chart so I had to do my 6 month diet twice!
Also, I interviewed several surgeons to determine who I wanted to be my surgeon and which office I felt comfortable with. After all, you will be working with that office for many years to come and if you are not comfortable with the surgeon and his or her staff, then I would suggest exploring further choices. Chances are, most of your contact will be with the staff and not the surgeon.
Also, do not rely solely on the surgeon for the type of surgery to have. Please do your research. It sounds like you have a high BMI. I did too. Unfortunately when I was exploring options, the DS was in the experimental stages. I needed to lose about 225 pounds. I have only lost 125 and I have stopped. I am not happy with my outcome and am now considering a revision to a DS. Different surgeries generally yield an average weight loss. There are exceptions with some people doing outstanding jobs and others not succeeding. I am considered a success as far as my surgery goes but I am not happy. I am still 100 lbs overweight. If a surgeon does not do a certain type of surgery, then they are not going to recommend that surgery or will not give a positive highlight of that surgery.
Good luck and hang in there!
Nancy
Welcome to the Illinois Board and the sometimes VERY confusing process of Weight loss surgery.
First, take a deep breath. Insurance can be a nightmare to navigate but you are off to a good start in calling them. My recommendation is to get something in writing from your insurance company as the rules they go by are those that are in force when you start your program. If they change them and make them more strict or require more information, you would not have to because you started the process now. Also, try to understand exactly the requirements that the insurance company wants. Doctor offices do not make it their importance of making sure you have all the correct information. For example, I did my 6 month supervised diet through my family physcian. My insurance company did not honor a diet conducted with my surgeon or any affiliated programs of that surgeon. My doctor missed one month in recording ALL the information in my chart so I had to do my 6 month diet twice!
Also, I interviewed several surgeons to determine who I wanted to be my surgeon and which office I felt comfortable with. After all, you will be working with that office for many years to come and if you are not comfortable with the surgeon and his or her staff, then I would suggest exploring further choices. Chances are, most of your contact will be with the staff and not the surgeon.
Also, do not rely solely on the surgeon for the type of surgery to have. Please do your research. It sounds like you have a high BMI. I did too. Unfortunately when I was exploring options, the DS was in the experimental stages. I needed to lose about 225 pounds. I have only lost 125 and I have stopped. I am not happy with my outcome and am now considering a revision to a DS. Different surgeries generally yield an average weight loss. There are exceptions with some people doing outstanding jobs and others not succeeding. I am considered a success as far as my surgery goes but I am not happy. I am still 100 lbs overweight. If a surgeon does not do a certain type of surgery, then they are not going to recommend that surgery or will not give a positive highlight of that surgery.
Good luck and hang in there!
Nancy
Cat Lady
(deactivated member)
on 10/27/10 8:37 am - university park, IL
on 10/27/10 8:37 am - university park, IL
Hi Nancy,
Thank you for the welcome and for sharing your story. I am so sorry to hear that you aren't where you hoped to be. All I can say is that should that have happened to me I would have been....crushed. So I can only imagine what it feels like to actually go through all this and still not have the desired success, although losing 100lbs is nothing to sneeze at! Congrats on that much! I am learning from all of you but especially people in the same boat as myself (HIGH BMI) So Thank you, and I truly wish you the best and certainly hope that you are able to get whatever it is you need be it revised surgery or not! Thank you so much again and Best wishes!
Thank you for the welcome and for sharing your story. I am so sorry to hear that you aren't where you hoped to be. All I can say is that should that have happened to me I would have been....crushed. So I can only imagine what it feels like to actually go through all this and still not have the desired success, although losing 100lbs is nothing to sneeze at! Congrats on that much! I am learning from all of you but especially people in the same boat as myself (HIGH BMI) So Thank you, and I truly wish you the best and certainly hope that you are able to get whatever it is you need be it revised surgery or not! Thank you so much again and Best wishes!
Well, if you've been around here before, you probably know my feelings on the DS. Particularly for people with high BMIs, like you and me. Nonetheless, I will get up on my soapbox. Pick and choose what you want to hear.
I also have serious reservations about the VSG for anyone with a high BMI. We see it again and again. The heavier VSG patient loses weight like gangbusters for about 2 years because of the restriction. Then the restriction fades and then the dieting and exercising starts again. (I have the DS, which has a similiar-sized stomach as the VSG--mine was made to hold 2.7 ounces-- and I can tell you that I can pack away the food now. The grehlin may be reduced, but my hunger is definitely back. My stomach has "loosened up." Thank God for the malabsorption of the DS or I would be gaining right now.)
Oh, and PLEASE do NOT believe the crap people say about how "easy" it is to just get the second part of the DS "later." It's NOT. First, your insurance company is not eager to pay for another round of surgery. Chances are, by the time most patients figure out they need more than the VSG to keep the weight off, they no longer qualify for WLS. They have to regain almost all the way up to their original weight to qualify. Insurance companies are now starting to say "one WLS per lifetime," so forget them paying for part 2. And usually a resleeve is needed at that time, too, to get the weight off again. That is a very tricky surgery, one that can have many dire complications.
That said, I am more disturbed that you are letting your insurance company dictate which surgery would be best for you. I KNOW which surgery your surgeon's office will "recommend" to you--the only ones they do, naturally. They will badmouth the ones they do not. (BTW, since Sept of 2009 BCBS of IL has covered the DS. Your plan may very well cover it if it covers WLS. The DS has been around for over 20 years now and has been covered by Medicare for over 3 years.)
I would not waste one second on crapola.This is your life. Think twice, cut once. You do not want to need a revision down the line.
I would contact your insurance company and ask them WHICH surgeries your policy covers (get procedure codes from them, too). They WILL know this info--they are a business. If they tell you they will only cover X Y or Z surgeons' offices, then you appeal their decision. Make them refer you to an actual DS surgeon, since they cover it (presuming they do). There is a list of qualified DS surgeons at www.dsfacts.com.
Do your research. Get the surgery YOU want, not what the surgeon the insurance company has over a barrel can do.
Best of luck to you, no matter what you decide.
Nicolle
I also have serious reservations about the VSG for anyone with a high BMI. We see it again and again. The heavier VSG patient loses weight like gangbusters for about 2 years because of the restriction. Then the restriction fades and then the dieting and exercising starts again. (I have the DS, which has a similiar-sized stomach as the VSG--mine was made to hold 2.7 ounces-- and I can tell you that I can pack away the food now. The grehlin may be reduced, but my hunger is definitely back. My stomach has "loosened up." Thank God for the malabsorption of the DS or I would be gaining right now.)
Oh, and PLEASE do NOT believe the crap people say about how "easy" it is to just get the second part of the DS "later." It's NOT. First, your insurance company is not eager to pay for another round of surgery. Chances are, by the time most patients figure out they need more than the VSG to keep the weight off, they no longer qualify for WLS. They have to regain almost all the way up to their original weight to qualify. Insurance companies are now starting to say "one WLS per lifetime," so forget them paying for part 2. And usually a resleeve is needed at that time, too, to get the weight off again. That is a very tricky surgery, one that can have many dire complications.
That said, I am more disturbed that you are letting your insurance company dictate which surgery would be best for you. I KNOW which surgery your surgeon's office will "recommend" to you--the only ones they do, naturally. They will badmouth the ones they do not. (BTW, since Sept of 2009 BCBS of IL has covered the DS. Your plan may very well cover it if it covers WLS. The DS has been around for over 20 years now and has been covered by Medicare for over 3 years.)
I would not waste one second on crapola.This is your life. Think twice, cut once. You do not want to need a revision down the line.
I would contact your insurance company and ask them WHICH surgeries your policy covers (get procedure codes from them, too). They WILL know this info--they are a business. If they tell you they will only cover X Y or Z surgeons' offices, then you appeal their decision. Make them refer you to an actual DS surgeon, since they cover it (presuming they do). There is a list of qualified DS surgeons at www.dsfacts.com.
Do your research. Get the surgery YOU want, not what the surgeon the insurance company has over a barrel can do.
Best of luck to you, no matter what you decide.
Nicolle
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
(deactivated member)
on 10/27/10 8:31 am - university park, IL
on 10/27/10 8:31 am - university park, IL
Oh Nicole Nicole!!!
You have now made me turn the corner and head towards DS. I REALLY thought I wanted the VSG, but I can honestly admit my ignorance about the long term care required for the WLSI am not talking about short term liquid diets and wound care, I am speaking of the ways in which I would need to eat. I would read the boards here, get so envious of people that had the surgery and were losing and then I would go back and feverishly read more about insurance and denials of coverage. Most of what I knew about this surgery was from talk shows and the like. All I knew was that you ended up with a smaller stomach which they basically implied automatically meant weight loss. I had no idea that there was a certain way to eat and etc. That said I was going to lean towards the VSG simply because I have a consult scheduled with a surgeon who flat out stated he does not do DS. So I decided well....Im already headed down this road plus it may actually work.
After reading more and more on this board (a couple hours a day at least) , I was back to being torn between the DS and the VSG (so much for my "decision" to have the VSG!) Lol. As for insurance or the doc determining the type of surgery I 100% agree with you. I called the University of Chicago today and although getting started is a bit more rigamarole than the place I recently started with, they do the DS and I wanted that OPTION no matter what. Wheras the place I have a consult scheduled with doesn't offer the DS option. I truly appreciate your advice and would like to ask where you had your DS done?
My concern is exactly what you described. That after a few years I would be able to shovel the food right on down. Make no mistake I am gonna do the nutrition classes, and try my best to eat better, but... Anyways, thank you so much for your input.
You have now made me turn the corner and head towards DS. I REALLY thought I wanted the VSG, but I can honestly admit my ignorance about the long term care required for the WLSI am not talking about short term liquid diets and wound care, I am speaking of the ways in which I would need to eat. I would read the boards here, get so envious of people that had the surgery and were losing and then I would go back and feverishly read more about insurance and denials of coverage. Most of what I knew about this surgery was from talk shows and the like. All I knew was that you ended up with a smaller stomach which they basically implied automatically meant weight loss. I had no idea that there was a certain way to eat and etc. That said I was going to lean towards the VSG simply because I have a consult scheduled with a surgeon who flat out stated he does not do DS. So I decided well....Im already headed down this road plus it may actually work.
After reading more and more on this board (a couple hours a day at least) , I was back to being torn between the DS and the VSG (so much for my "decision" to have the VSG!) Lol. As for insurance or the doc determining the type of surgery I 100% agree with you. I called the University of Chicago today and although getting started is a bit more rigamarole than the place I recently started with, they do the DS and I wanted that OPTION no matter what. Wheras the place I have a consult scheduled with doesn't offer the DS option. I truly appreciate your advice and would like to ask where you had your DS done?
My concern is exactly what you described. That after a few years I would be able to shovel the food right on down. Make no mistake I am gonna do the nutrition classes, and try my best to eat better, but... Anyways, thank you so much for your input.
Hi, Bradley!
I had my DS with Dr. Rabkin in San Francisco. He comes to Chicago for almost all of our monthly support group meetings (3rd Monday of each month). There are several dozen of us in the Chicago area who have had their DSes with him. Traveling is really no big deal to get the best. He's awesome and one of the most experienced out there with the DS. Here's his web site: www.paclap.com.
Be sure and check out the page with his practice's 10-year data: www.paclap.com/pacific-laparoscopy/our-results.cfm
On paper, the VSG seems like a great choice. Hell, I even wavered on it the day before my surgery because I was scared! No malabsorption, you lose weight and you take less vitamins. But the reality, by watching the VSG board and reading scientific studies, shows a different reality, in my opinion. VSGers take plenty of vitamins--a few, including MacMadame take more than I take (I take 12-14 pills on any given day and 8 of those are calcium). Regain after 3 years is happening with the VSG because they have no malabsorption to support the extra food they are able (and wanting to eat) once the restriction loosens and hunger returns.
I was NEVER good at dieting, so I am certain I would be on the way back to 344 pounds if I had changed my mind at the last minute and had the VSG.
I think the VSG can work well for people who have very little weight to lose and have not had their metabolism shot by years of dieting/starvation. It's good for people who love/feel virtuous by counting calories and doing lots of exercise. Then again, those people may be successful without any surgery, too.
And by "work well," I use the standard set by the bariatric surgeons themselves--50% of EWL. For me, that would have been only losing 100 pounds OR regaining 100 pounds. That would not be good enough for me.
The DS has the BEST success rate of any of today's weight loss surgeries, including the LapBand and RNY. On average, DS patients lose the most weight and more keep it off 7-10 years out, which is what we all should shoot for, right? See page 10 of this guideline document of the American Society of Metabolic and Bariatric Surgery. It lays out the stats nicely.
http://www.aace.com/pub/pdf/guidelines/Bariatric.pdf
The DS has a excess weight loss rate, 7-10 years post-op, of 60-80%. Pretty damn impressive.
At 2.5 years out I honestly am shocked at what I can, volume and enjoyment-wise because of my DS. I do not miss food because I am eating things I love all day long. Today was an out-and-about day:
3-egg omelette with sausage, 1 cup of cheese, potatoes, peppers
Diet Coke
mocha cappuccino
4 mini candy bars (can you say "Halloween?")
2 cookies
milk
1 double cheeseburger (White Castle)
3 cheese sticks (White Castle)
Diet Coke
1 hot dog wrapped with a crescent roll
Diet Coke
And I am not done yet. I will probably have a bunch of cheese and Triscuit crackers and then finish off my day with an ice cream cone or Oreos and milk.
As long as I get my protein and vites in, I eat what I want. Now, some people after WLS are lactose- or gluten-intolerant, etc. Not me, thank goodness, but some are. Everyone is different.
Can I eat this way forever without gaining weight? Probably not. For now, it works and has been working for almost 3 years. I do try to keep an eye on my carbs. Not too many, not too few. My labs are good and I feel awesome.
Anyway, feel free to ask me anything!
Nicolle
I had my DS with Dr. Rabkin in San Francisco. He comes to Chicago for almost all of our monthly support group meetings (3rd Monday of each month). There are several dozen of us in the Chicago area who have had their DSes with him. Traveling is really no big deal to get the best. He's awesome and one of the most experienced out there with the DS. Here's his web site: www.paclap.com.
Be sure and check out the page with his practice's 10-year data: www.paclap.com/pacific-laparoscopy/our-results.cfm
On paper, the VSG seems like a great choice. Hell, I even wavered on it the day before my surgery because I was scared! No malabsorption, you lose weight and you take less vitamins. But the reality, by watching the VSG board and reading scientific studies, shows a different reality, in my opinion. VSGers take plenty of vitamins--a few, including MacMadame take more than I take (I take 12-14 pills on any given day and 8 of those are calcium). Regain after 3 years is happening with the VSG because they have no malabsorption to support the extra food they are able (and wanting to eat) once the restriction loosens and hunger returns.
I was NEVER good at dieting, so I am certain I would be on the way back to 344 pounds if I had changed my mind at the last minute and had the VSG.
I think the VSG can work well for people who have very little weight to lose and have not had their metabolism shot by years of dieting/starvation. It's good for people who love/feel virtuous by counting calories and doing lots of exercise. Then again, those people may be successful without any surgery, too.
And by "work well," I use the standard set by the bariatric surgeons themselves--50% of EWL. For me, that would have been only losing 100 pounds OR regaining 100 pounds. That would not be good enough for me.
The DS has the BEST success rate of any of today's weight loss surgeries, including the LapBand and RNY. On average, DS patients lose the most weight and more keep it off 7-10 years out, which is what we all should shoot for, right? See page 10 of this guideline document of the American Society of Metabolic and Bariatric Surgery. It lays out the stats nicely.
http://www.aace.com/pub/pdf/guidelines/Bariatric.pdf
The DS has a excess weight loss rate, 7-10 years post-op, of 60-80%. Pretty damn impressive.
At 2.5 years out I honestly am shocked at what I can, volume and enjoyment-wise because of my DS. I do not miss food because I am eating things I love all day long. Today was an out-and-about day:
3-egg omelette with sausage, 1 cup of cheese, potatoes, peppers
Diet Coke
mocha cappuccino
4 mini candy bars (can you say "Halloween?")
2 cookies
milk
1 double cheeseburger (White Castle)
3 cheese sticks (White Castle)
Diet Coke
1 hot dog wrapped with a crescent roll
Diet Coke
And I am not done yet. I will probably have a bunch of cheese and Triscuit crackers and then finish off my day with an ice cream cone or Oreos and milk.
As long as I get my protein and vites in, I eat what I want. Now, some people after WLS are lactose- or gluten-intolerant, etc. Not me, thank goodness, but some are. Everyone is different.
Can I eat this way forever without gaining weight? Probably not. For now, it works and has been working for almost 3 years. I do try to keep an eye on my carbs. Not too many, not too few. My labs are good and I feel awesome.
Anyway, feel free to ask me anything!
Nicolle
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
(deactivated member)
on 10/27/10 11:01 am - university park, IL
on 10/27/10 11:01 am - university park, IL
Well you are a woman after my own heart! I love love love Diet Coke. yea yea yea, I know it's probably awful for you and nothing in excess qualities is good for you...But man o man, I love my Diet Coke. Anyways, Thanks for providing your info. Why did you choose to go so far? Strictly the surgeons rep? I would travel but my youngest is only 10 months old and my husband acts like a blithering idiot when it comes to the day to day care of our son. I plan on having my mom come help since my husband is virtually useless when it comes to our kids.
However if I did choose to go a long distance, be it to CA or even just a few hours drive away, how to they do all your pre op testing? Do you do them at a local hospital and have the results sent or?? Also what is the timeline, insurance aside? I imagine yours was pretty accelerated since you had to travelbut...Take for instance the Joliet Clinic, they have me scheduled for an initial consult and then who knows. Where as the University of Chicago has your initial consult, psych eval, and nutritionist meeting all in one day. I realize there would still be testing needed beyond that, but it seems like they have you hit the ground running as opposed to an appointment here and an appointment there (3 weeks later.) What constitutes a physician supervised weight loss plan? I know that weigh****chers and jenny craig fit the bill, but what else? I ask because I would prefer to get this done prior to Jan 1 when our 3K deductible resets and according to insurance I need a 12 week physician supervised weight attempt prior to approval. Sorry to ask so many probably redundant questions. Im sure all of what I asked is posted around here somewhere...Thanks for your help!
However if I did choose to go a long distance, be it to CA or even just a few hours drive away, how to they do all your pre op testing? Do you do them at a local hospital and have the results sent or?? Also what is the timeline, insurance aside? I imagine yours was pretty accelerated since you had to travelbut...Take for instance the Joliet Clinic, they have me scheduled for an initial consult and then who knows. Where as the University of Chicago has your initial consult, psych eval, and nutritionist meeting all in one day. I realize there would still be testing needed beyond that, but it seems like they have you hit the ground running as opposed to an appointment here and an appointment there (3 weeks later.) What constitutes a physician supervised weight loss plan? I know that weigh****chers and jenny craig fit the bill, but what else? I ask because I would prefer to get this done prior to Jan 1 when our 3K deductible resets and according to insurance I need a 12 week physician supervised weight attempt prior to approval. Sorry to ask so many probably redundant questions. Im sure all of what I asked is posted around here somewhere...Thanks for your help!
Yeah, sadly, they're going to have to pry a can of Diet Coke out of my dead hand.
I brought my blithering idiot husband with me to San Fran. I kid...he was awesome with me.Kept me company, was my helper. My family watched our kids while we were gone. We got to sightsee and visit family while we were gone. Without the sutures, it would have been like a second honeymoon!
I went about WLS the only way I know how to do anything: by research and introspection. I am not a caution-to-the-wind type of person on big decisions.
First, I researched all of my options. Learned as much as I could about the main 4 surgical choices and their success rates, lifestyles and potential side effects. Read scientific data via pubmed. Joined OH for anecdotal info/stories. Interviewed a few Chicago-area surgeons. (Naturally, they pushed me to get the RNY, which they offered.)
Second, I thought about who I am and how I wanted to live the rest of my life. I know me, and diets and counting calories are not my thing. I also like to exercise, but not crazily so. Just moving and feeling good a couple of times a week plus being active daily. I thought about the type of food I wanted to be able to eat afterwards, the type of social situations I am in, the fact that I am a mom of young kids (at the time of my DS, my kids were 22 months old and 5 years old) and how I want them to see me eat (no off-limit stuff, just commonsense based on my own body).
I decided on the DS. Yet our insurance did not cover the DS, so my hubby changed jobs to one that would cover the DS. (Yes, the DS is THAT good.) Fortunately, he loves his job.
THEN, I went surgeon-shopping. I knew I wanted the DS and I knew I wanted the best I could find. That kept leading me to Dr. Rabkin's practice. With more than 1500 DSes, he was the man for me. I didn't care about distance, just quality. Then I met him and it sealed the deal for me. Nice man, good surgeon.
I got plugged in to his local support group here and met plenty of people who traveled there and it seemed very do-able.
Pre-op testing is no biggie, one doc sends it to another. My PCP handled it all. You just have to leave time enough for things to get where they're supposed to go. I DID do a phone interview with the practice's psych and nutritionist. No worries there. The day before my surgery, I went to the San Fran hospital to get final clearance, but that was easy.
My timeline? The insurance approved the surgery in late December and I was on the table in late February. I could have had it in early January, but I wanted to wait for the holiday stuff to fade, line up help at home and get mentally ready.
My opinion...the U of C does not seem to have its crap together lately. People I know from the DS forum seem to get the run-around there lately on the paperwork side and there have been whispers of a few bad outcomes, ranging from leaks to a rhabdo case (Leslie--she posts on the DS forum). At the time of my DS decision, the U of C had terrible infectious disease stats and they had just lost a patient, so I was happy to look elsewhere. This is all MY opinion. Take it or leave it.
As to the physician-supervised stuff, do NOT assume JC or WW is fine, as there is NO doctor involved. Your insurance company can tell you what is acceptable. And take down the date, time and name of who tells you stuff at your insurance company--you may need it later.
Usually, the physician-supervised stuff is monthly visits to your doctor where he/she records your weight and vitals, talks to you about losing weight and you MAY have to go to a dietician/nutritionist monthly, too. This usually is either 3 or 6 months. You MUST get very specific with your insurance company as to what they will accept or they can deny you or make you start the process all over again.
If, as you say, your insurance requires a 3-month physician-supervised plan, you may be screwed if you have not seen your doc in October. They usually count the months as:1) October, 2) November and even if you do it December 1, 3) December counts. If you can get the U of C to take you on in late December, I would be happily surprised. they seem to drag their feet some.
This is a game and the insurance company sets the rules. Follow them to the letter and you should be okay.
Now, head on over to the DS forum and ask some questions there, if you have not already. Be specific in your topic line and people will probably be able to help you with their direct experience of the U of C, insurance, etc.
Nicolle
I brought my blithering idiot husband with me to San Fran. I kid...he was awesome with me.Kept me company, was my helper. My family watched our kids while we were gone. We got to sightsee and visit family while we were gone. Without the sutures, it would have been like a second honeymoon!
I went about WLS the only way I know how to do anything: by research and introspection. I am not a caution-to-the-wind type of person on big decisions.
First, I researched all of my options. Learned as much as I could about the main 4 surgical choices and their success rates, lifestyles and potential side effects. Read scientific data via pubmed. Joined OH for anecdotal info/stories. Interviewed a few Chicago-area surgeons. (Naturally, they pushed me to get the RNY, which they offered.)
Second, I thought about who I am and how I wanted to live the rest of my life. I know me, and diets and counting calories are not my thing. I also like to exercise, but not crazily so. Just moving and feeling good a couple of times a week plus being active daily. I thought about the type of food I wanted to be able to eat afterwards, the type of social situations I am in, the fact that I am a mom of young kids (at the time of my DS, my kids were 22 months old and 5 years old) and how I want them to see me eat (no off-limit stuff, just commonsense based on my own body).
I decided on the DS. Yet our insurance did not cover the DS, so my hubby changed jobs to one that would cover the DS. (Yes, the DS is THAT good.) Fortunately, he loves his job.
THEN, I went surgeon-shopping. I knew I wanted the DS and I knew I wanted the best I could find. That kept leading me to Dr. Rabkin's practice. With more than 1500 DSes, he was the man for me. I didn't care about distance, just quality. Then I met him and it sealed the deal for me. Nice man, good surgeon.
I got plugged in to his local support group here and met plenty of people who traveled there and it seemed very do-able.
Pre-op testing is no biggie, one doc sends it to another. My PCP handled it all. You just have to leave time enough for things to get where they're supposed to go. I DID do a phone interview with the practice's psych and nutritionist. No worries there. The day before my surgery, I went to the San Fran hospital to get final clearance, but that was easy.
My timeline? The insurance approved the surgery in late December and I was on the table in late February. I could have had it in early January, but I wanted to wait for the holiday stuff to fade, line up help at home and get mentally ready.
My opinion...the U of C does not seem to have its crap together lately. People I know from the DS forum seem to get the run-around there lately on the paperwork side and there have been whispers of a few bad outcomes, ranging from leaks to a rhabdo case (Leslie--she posts on the DS forum). At the time of my DS decision, the U of C had terrible infectious disease stats and they had just lost a patient, so I was happy to look elsewhere. This is all MY opinion. Take it or leave it.
As to the physician-supervised stuff, do NOT assume JC or WW is fine, as there is NO doctor involved. Your insurance company can tell you what is acceptable. And take down the date, time and name of who tells you stuff at your insurance company--you may need it later.
Usually, the physician-supervised stuff is monthly visits to your doctor where he/she records your weight and vitals, talks to you about losing weight and you MAY have to go to a dietician/nutritionist monthly, too. This usually is either 3 or 6 months. You MUST get very specific with your insurance company as to what they will accept or they can deny you or make you start the process all over again.
If, as you say, your insurance requires a 3-month physician-supervised plan, you may be screwed if you have not seen your doc in October. They usually count the months as:1) October, 2) November and even if you do it December 1, 3) December counts. If you can get the U of C to take you on in late December, I would be happily surprised. they seem to drag their feet some.
This is a game and the insurance company sets the rules. Follow them to the letter and you should be okay.
Now, head on over to the DS forum and ask some questions there, if you have not already. Be specific in your topic line and people will probably be able to help you with their direct experience of the U of C, insurance, etc.
Nicolle
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
(deactivated member)
on 10/28/10 12:56 pm - university park, IL
on 10/28/10 12:56 pm - university park, IL
Thank you Nicole so much for taking your time to post all that. Especially about the U of C information, I was reading more on the boards earlier and I saw a post from you somewhere else about their leaks and etc. I was on my phone and RAN to my computer to read more about it. I get the gist that they don't have their crap together as well. the website says to CALL first to schedule an evaluation THEN attend an informational session. I tried to call and the woman who answered the phone transfered me to a voicemail box. I called right back and managed to get the same woman who very curtly told me that "Sheila" is the one who schedules the appointments and with no further conversation she transferred me to that same voicemail. Not understanding how one woman does the scheduling for an entire department. I left my information and fired off an email. "Sheila" called me back (within the hour) and stated that the website was wrong and that I must attend the informational session first. Why on earth is the website of a so called world renowned hospital displaying incorrect information. Fair enough though, these things happen I guess.... While talking to Sheila I happened to be in my email and noticed that they had immediately emailed me back with a short questionaire. I asked Sheila about it and she said she didn't know why they continue to do that because the email would have never reached her. It was one of those auto reply emails that would have been sent back to an unmonitored email address. Again why... She gave me her email address and said she would be getting back to me today....yea right. That so didn't happen. I'm rather disappointed because traveling seems so out of the question right now.
My husband is not exactly supportive, (tells me to eat better, work out etc, it's just a matter of wanting it etc.) This is from a man who eats constantly, smokes close to a pack a day, and is probably underweight. he would never stand in my way, but when it comes to convincing him to do stuff, he is just dreadful to deal with. My mom is more than willing to pitch in, but she can only either help me while Im away or be here with the kids. My husband doesn't even know where my oldest catches the bus. Anyways, I digress. Again, Thanks for your information. I am truly using it to make my next move. Thanks again!
My husband is not exactly supportive, (tells me to eat better, work out etc, it's just a matter of wanting it etc.) This is from a man who eats constantly, smokes close to a pack a day, and is probably underweight. he would never stand in my way, but when it comes to convincing him to do stuff, he is just dreadful to deal with. My mom is more than willing to pitch in, but she can only either help me while Im away or be here with the kids. My husband doesn't even know where my oldest catches the bus. Anyways, I digress. Again, Thanks for your information. I am truly using it to make my next move. Thanks again!
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