Pre-Op Testing Questions

Hi everyone, I mostly lurk around here, but you are all so supportive and have been through this process so I figured that I would ask. I am hoping to attend one of the pre-op seminars very soon, I just haven't had the courage to talk to my DH about this topic... I don't know how he will react to me wanting WLS and my weight is something that I don't discuss with anyone, so this is very difficult for me to talk about with him. I'm sure that I'm worrying about this for nothing, and hoping that he is nothing short of super supportive, but until then I just need to muster the courage. Anyway, my questions are about pre-op testing. I am hoping to use the doctors at Fairfield County Bariatrics (my mom had Dr. Ehrlich for her lap band last year) do my procedure. Initially I was thinking lap band, but I am leaning towards RNY now. Do these doctors have a set list of pre-op testing requirements for all of their patients, or is it case-by-case? I know that everyone has to do the psych eval, but does everyone have to do a sleep study? I don't have any apnea issues, that I know of at least according to my DH. Also, I have Anthem BCBS of CT and with the CPT codes (I got them from Danielle at the dr. office) according to the person I spoke with, they do cover the procedure as long as it's medically necessary and as long as I meet their requirements. Does anyone know what those requirements are? I'm guessing that they're pretty standard for the company. Do you know if you have to provide them 6 months of a medically supervised diet? I did follow one, but that was about 5 years ago so I don't know if that would qualify. What other types of testing is involved? Sorry for all the questions, but I figured that this would be a great place to ask. Do any of you go to the pre-op meetings that they hold? Thanks again for your help. Lisa

Hi Lisa... You are going to be so happy with your decision to go with FCB. Dr. Ehrlich did my surgery (Lap RNY) this past September and I highly recommend him. He is compassionate, takes the time to listen and is sooooo nice. He will advise you on what he thinks is the best surgery for you. If you go to the preop seminar at Norwalk Hospital, a bunch of us usually speak at the end of the presentation and answer questions...so maybe I'll meet you there!! Going through the sleep study might be beneficial for you because any type of comorbidity that can be submitted to your insurance company will only help you get approved. As for the preop testing, I had to have the psych exam, an upper GI, a lung function test, a chest xray, blood tests, a stress test and a sleep study. If I forgot anything, I'll let you know. I can't stress it enough that this is a great group of doctors. Someone is always there for you 24/7 if you have an emergency. Your followup care is excellent. And the office staff is wonderful. You'll be very pleased. Please email me if I can be of any help or if you have any more questions. Kim K.

Hi Lisa I can't say about the other dr.'s out there but mine gave me a list with the tests I needed circled. I could use the dr.'s he listed or I could use my own as long as the tests he wanted were done. I assume that the list is standard; however, they just check off what they might think you need. If you don't exhibit any apnea issues they might not send you for a sleep study; however, they might do it to be sure. Not to scare you, but this surgery, especially the bypass is serious business, so I would want to be as thoroughly tested as possible. I don't know what the insurance considers "medically necessary"; however, your dr. does. It all depends on how the dr. writes it up, but there are so many good dr.'s out there and they know what to write for most insurances to accept. I would suspect that the more co-morbid issues you have the easier it is. I have just finished all my testing and am waiting for my dr. to get all the results and prepare my file for the insurance co. I also have Anthem and I have been told that they're pretty good. Good Luck and best wishes, Joe ps Hope this info helps you a little.

I am not Dr Ehrlich's patient, but I think it's pretty standard wherever you go. Nutrition evaluations, psych evaluation, cardiac evaluation usually with a stress test, respiratory evaluation usually with a sleep test, and various other tests as necessary. Then once you see the surgeon, they do an upper GI endoscopy to make sure your stomach and duodenum are okay. Obviously lots of education and bloodwork. I have BCBS, and I would call them first before assuming coverage. Your plan may be different than everyone elses. My plan is an excellent one EXCEPT that WLS is a written exclusion and I had to pay for it out of pocket... $20,000 later, I am still glad I had it done, but it's something to look at before hand. BCBS generally does not require the 6 month doctor supervised diet, but again, ask them on the phone. I am sure once you sit down and talk to your hubby, and discuss it, he will be supportive. You are doing this for you, not him. And if he loves you, he will support you, although he may be scared, like mine was and still is! Good luck and feel free to email anytime! Jen

Hi Lisa: Let me throw my 2 cents in here. One of the best things about Dr. Ehrlich et al, is that you get a team of doctors. There is always one of the 3 docs on call, they all know each others patients and they are the most caring compassionate and genuine group of people that you'd ever want to deal with. They have made an ENORMOUS difference in my life. Pre op testing is all individual, based on the patient and what they feel your needs or issues are. Rest assures knowing that you are NOT going to have surgery untill they feel they have dotted all the i's and crossed all the t's. Which ultimately is in YOUR best interest. If you'd like to know about my experiences with this group, feel free to e mail me directly. I'd be more than glad to talk to you via e mail or on the phone. Best of luck to you, All the best, Bob