Considering surgery

jwoods31822
jwoods31822 Posts: 12 Member
I have been thinking about having Gastric surgery for a year, but not sure if my insurance will help pay for the procedure. I have done Weight Watchers and lost some weight but gained 80 pounds back over two years. I have done this and I lose for a bit and then gain some weight. I wanted to drop at least 30 pounds or so on my own.

I have heard that you are 200 pounds over the ideal weight for your body height and diabetic then you are suppose to be a candidate but want to make sure definitely before trying to talk to any doctor for this procedure.

Replies

  • Laura8603
    Laura8603 Posts: 590 Member
    Usually it is much less than 200 pounds overweight to qualify. Usually it is a BMI over 40, or 35 with co-morbidities.

    http://nhlbisupport.com/bmi/bminojs.htm

    My highest BMI was 53, It is now 21. Gastric bypass surgery was the right choice for me.
  • jwoods31822
    jwoods31822 Posts: 12 Member
    I have seen your pics and success and that is a big factor for me in this decision.
  • grim_traveller
    grim_traveller Posts: 625 Member
    My insurance was the same, BMI over 40, or 35 with co-morbidities. Some insurance require weight loss, or classes, etc, to varying degrees before surgery, Mine did not, but my surgeon had some requirements of his own.

    Every program and every insurance company is different. The good thing is that a good program has people to handle most of the paperwork and approval process for you. Go to an informational meeting and see if you are still interested. I'm sure glad I did.
  • atakins
    atakins Posts: 32 Member
    My insurance required a BMI of 42, or 37 with co-morbidities. I was at 52, so it was no-questions-asked. They required a 6-month waiting period, where I had to be monitored by the doctor. My surgeon required cardiac, pulmonary and other tests, which were all covered by my insurance. I've lost 80 lbs. so far - over 1 lb. per day - since my surgery on 1/15/13.
  • teresa7926
    teresa7926 Posts: 121 Member
    I spent a lot of time in the contemplating stage. While doing this I went throught the entire process of consultations and tests my surgeon requires. Why not - my insurance pays for it and I would just be that much closer if I decided to go ahead. Yesterday I finally made the decision to move forward with getting the insurance approval. It was actualy my PCP that helped with the final decision. Now I wait for the insurance company. I wish you luck on your decision making process. As my doctor told me, I you know whether or not it is something you will be able to live with for the rest of your life.
  • shirleygirl910
    shirleygirl910 Posts: 503 Member
    I had a very bad experience with the lab band. I am not anti WLS but do know, if you are going to be successful you will have to learn all the habit you have tried before. Eating small amounts and exercise. WLS gives you about a year to get these habits down and then the honeymoon is over.

    You can do it. I like many ony this site have done it and kept the weight off, but I don't want you to go into it thinking it is a cure all. It can be very temporary. But it is very doable.
  • RumpusP
    RumpusP Posts: 163 Member
    A great place for info from folks who have done it is thinnertimesforum.com.

    My insurance had the 40/35 rule listed by others above. The hospital I went through required a couple classes, at least one support group meeting, sleep apnea testing, for some people cardiac tests but this didn't apply to me, a bunch of bloodwork, and a psych eval. I *think* that's everything that was required.

    Post-op, for the rest of my life:

    An average of 60+g protein a day
    80oz of water a day
    2-3 meals a day and no snacking
    no soda
    1hr exercise a day
    no straws, no gum
    no drinking 30 minutes before or after eating
    1500mg calcium citrate a day in chewable form
    200% RDA bariatric vitamins in chewable form
    1-3 sublingual B-12 vitamins a week
    Finish eating a meal before 20 minutes goes by
    checkups and bloodwork every 3 months until 1 year, then yearly checkups

    Hope that gives a feel of requirements to get it and some of what must be done after it (everyone's plan varies some, that's the one for my hospital).
  • annwyatt69
    annwyatt69 Posts: 727 Member
    A great place for info from folks who have done it is thinnertimesforum.com.

    My insurance had the 40/35 rule listed by others above. The hospital I went through required a couple classes, at least one support group meeting, sleep apnea testing, for some people cardiac tests but this didn't apply to me, a bunch of bloodwork, and a psych eval. I *think* that's everything that was required.

    Post-op, for the rest of my life:

    An average of 60+g protein a day
    80oz of water a day
    2-3 meals a day and no snacking
    no soda
    1hr exercise a day
    no straws, no gum
    no drinking 30 minutes before or after eating
    1500mg calcium citrate a day in chewable form
    200% RDA bariatric vitamins in chewable form
    1-3 sublingual B-12 vitamins a week
    Finish eating a meal before 20 minutes goes by
    checkups and bloodwork every 3 months until 1 year, then yearly checkups

    Hope that gives a feel of requirements to get it and some of what must be done after it (everyone's plan varies some, that's the one for my hospital).
    Things were a bit different here--64 oz. of water a day, 30 minutes of exercise, 3 meals and 2 snacks allowed. Keep in mind that meals are, at most, 1/2 cup of food at a time and snacks are small. Always eat the protein first, then the veggies. All the other things were the same. Had almost a year of practice before my surgery--was denied by my insurance 3 times and had to appeal because the surgeon's office made errors with the paperwork and there was no doctor close by in my network. I had to travel 140 miles to have it done. Good luck and congratulations on a life changing decision!
  • Laura8603
    Laura8603 Posts: 590 Member
    I don't follow all of these.

    An average of 60+g protein a day- I average around 100 grams a day. During the losing phase I ate even more.
    80oz of water a day- this one I pretty much do follow
    2-3 meals a day and no snacking- I eat 6-7 times a day. 2-3 is insane. no way to get everything in.
    no soda- I do follow this. Too many post-ops i know in real life who have gained or never got to goal drink diet soda. I see the correlation.
    1hr exercise a day- i exercise 3 times a week
    no straws, no gum- I do both with no problems. I think this one is silly.
    no drinking 30 minutes before or after eating- I drink up until I eat and then wait an hour afterwards to drink again.
    1500mg calcium citrate a day in chewable form- yes
    200% RDA bariatric vitamins in chewable form- yes
    1-3 sublingual B-12 vitamins a week-yes
    Finish eating a meal before 20 minutes goes by- Nope. Depends on the setting.
    checkups and bloodwork every 3 months until 1 year, then yearly checkups- I do get extensive bloodwork and mine is perfect.

    There is a lot of difference between doctors viewpoints.They all can't be "right". I do a combination of what my doctor recommends and what I have learned through my own research (the ASMBS has a lot of information online). I am fanatic about taking my vitamins. I am 4.5 years out from my RNY. I have managed to lose and keep off 200 pounds so I have found what works for me. We all need to find our own path.
  • annwyatt69
    annwyatt69 Posts: 727 Member
    I don't follow all of these.

    An average of 60+g protein a day- I average around 100 grams a day. During the losing phase I ate even more.
    80oz of water a day- this one I pretty much do follow
    2-3 meals a day and no snacking- I eat 6-7 times a day. 2-3 is insane. no way to get everything in.
    no soda- I do follow this. Too many post-ops i know in real life who have gained or never got to goal drink diet soda. I see the correlation.
    1hr exercise a day- i exercise 3 times a week
    no straws, no gum- I do both with no problems. I think this one is silly.
    no drinking 30 minutes before or after eating- I drink up until I eat and then wait an hour afterwards to drink again.
    1500mg calcium citrate a day in chewable form- yes
    200% RDA bariatric vitamins in chewable form- yes
    1-3 sublingual B-12 vitamins a week-yes
    Finish eating a meal before 20 minutes goes by- Nope. Depends on the setting.
    checkups and bloodwork every 3 months until 1 year, then yearly checkups- I do get extensive bloodwork and mine is perfect.

    There is a lot of difference between doctors viewpoints.They all can't be "right". I do a combination of what my doctor recommends and what I have learned through my own research (the ASMBS has a lot of information online). I am fanatic about taking my vitamins. I am 4.5 years out from my RNY. I have managed to lose and keep off 200 pounds so I have found what works for me. We all need to find our own path.

    Your progress and maintenance is absolutely amazing!!! Very inspirational--and I pray that I will be as successful. I am only 6 months out and 20-25 pounds away from goal and things are going so slow right now.
  • I am like you I tried every diet, diet pills, shakes and whatever I lost I gained back and then some.

    I had thought about surgery for about 2 years. weighing the pros and cons and doing a lot of research and asking questions. my primary care giver was no help at all and when I weighed almost 350 lbs she never said a word about surgery but told me to watch what I ate and exercise. that was it!

    when I finally got my nerve up to see a surgeon I found that my insurance would cover everything but a co pay of $300. I was so happy I cried when they told me that.

    my starting weight was 347 lbs with a BMI of 55. I am now 237 lbs and 35 BMI and my 1 year anniversary date is 5-9-13 and I have never regretted it at all. I just miss the extra fat to stay warm, LOL.
  • atakins
    atakins Posts: 32 Member
    That last sentence made me laugh so hard! It's so true. I've lost 85 lbs. of a goal of 200, and I feel like I'm always cold now! I joke with my coworkers that by the time I hit goal, I'll be a skinny ice cube.. :)
  • lol it is true.

    when I had surgery I was warned that I would get cold sooner because I was loosing so much fat. so I have went from 4XL mens sweats down to 3XL and now 2 mens XL.

    even the 2 XL are getting baggy for me but until I hit the 120 lbs gone I am staying in 2XL but I will start buying 1XL sweats