Aimee J.
Been away for awhile...
Mar 04, 2009
Wow! I've been away for quite awhile now! I gave up on having the surgery because my financing fell through. I ended up moving to Texas in November of 2007 and lost 40 pounds over 3.5 months doing Weight Watchers and a daily gym routine. I stalled and found out I was expecting my first baby! After a rough delivery (including pre-eclampsia and borderline gestational diabetes), I delivered Keaton Paul on November 17th, 2008. Now, approximately 4 months later, I am pursuing WLS again.This must be the right time for me. I say this because I just found out my insurance does cover WLS (it didn't before I moved back home to Michigan). I called the Barix Clinic, where I initially met with Dr. Schram in 2007, and they advised me to see my PCP for a letter and get my psych eval taken care of.
Today I saw my PCP and had the sample letter (fit to my criteria) typed for my doctor. I know my doctor because I work in the ICU and she occasionally admits patients and rounds on them. She took one look at the letter and is waiving the supervised diet. She considers WW a structured program so she claimed that met criteria for her! On a sad note, I was officially diagnosed with hypertension today. My blood pressure was 156/96. She believes it has a bit to do with my pre-eclampsia and the fact that my OB/GYN allowed my BPs to get as high as 200s/100s and never put me on medications. She said it may take 6-12 months to subside, but this will increase my chances for approval. I am now on Lisinopril for my blood pressure.
BCBS PPO requires these for WLS to be "medically necessary":
BMI >35 with comorbidities or >40 without. My BMI is roughly 43 and I have several comorbidities.
Structured or medically supervised diet for 6 consecutive months: DONE!
Psych eval
Knowledge of bariatric surgery and noted/verbalized understanding of requirements.
I have my psych evaluation next Thursday and I see Dr. Schram on 3/19. Cindi from his office said they will submit my paperwork and I may have an approval the same day! Please keep me in your prayers!
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About Me
Greenville, MI
Location
26.9
BMI
Surgery
05/04/2009
Surgery Date
Aug 26, 2004
Member Since
