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babettes_feast
on 4/13/19 1:22 pm
Topic: RE: Insurance Issues VSG, DS 8 years later

When I saw my surgeon about this a year ago, the insurance denied me. I didn't appeal at the time, life was too crazy and I hadn't faced the orthopedic crisis I'm now facing.

When I saw her last week, she could see very clearly that I am having severe joint problems: I had a total knee replacement in July 2018 w/ a very difficult recovery, and will have to have to have the other knee down. I also have unrelenting lower back pain/herniated discs. Finally, there are studies linking MS (which I also have) and obesity. So, best case, my surgeon can advocate and we'll be fine. Otherwise, I think my ortho doc and neurologist will get on board.

Also, I asked my insurance company online if I qualified/am eligible for WLS at this time and got a yes, in writing.

PattyL
on 4/13/19 9:45 am
Topic: ThinSlim ZERO Carb Bread!

You have to order it but it's good. Worth eating! They also make bagels, pasta, and hot dog/hamburger buns.

Sunshine16
on 4/13/19 12:49 am
Topic: RE: Weight Loss, How after 5 to 10+ Years

Hi Liz, that is very encouraging...tencouraging...the 32 pounds. Do you know how she lost her weight?

SW / CW / GW 292 / 188 / 174 - Height 5'7, Size 10

dover421
on 4/12/19 1:15 pm
Topic: RE: Revision from VSG to DS

Thank you very much for the information and your kind words. Much appreciated!

larra
on 4/12/19 10:06 am - bay area, CA
Topic: RE: Revision from VSG to DS

Good decision! We are seeing more people with failed VSG all the time, and the logical revision is to the DS, as you already have the sleeve part of the DS now. And I hope you understand that it's the operation that failed you, not the other way around. Once the sleeve stretches out, which seems to be inevitable, you are left with no tool to help you lose weight or prevent regain.

I've sent you a pm with more information.

Liz J.
on 4/12/19 7:13 am
DS on 11/29/16
Topic: RE: Weight Loss, How after 5 to 10+ Years

I'm only about 2.5 years out but I hit my lowest, which was 30lbs lower than my doctor set for my goal, and I only stayed at it a day before I gained back 3lbs... I know it's only 3lbs BUT that's where I felt the best! Both of my doctors say I'm fine, I want back at that weight...

Do what makes you feel good. Your tool will still work no matter how far out you are from surgery. There is a lady that come to one of the support groups I go to. She is 11 years out from the DS and just lost all her regain in a few months, 32lbs!

HW: 398.8 SW:356 GW: 175 CW:147

Sunshine16
on 4/12/19 6:16 am, edited 4/11/19 11:16 pm
Topic: RE: Weight Loss, How after 5 to 10+ Years

Yes getting your common channel to 75 wis helpful. But I am not sure how my body would hand the deficiency. If I do not take my Vitamin K for 2 days I bruise fast, when I do not take my calcium my teeth goes bad, and etc. I am definitely on Vitamins and Suplements for the rest of my life. However, it must be nice....mnice....my weight seems to go up now almost every year. I'm trying right now to find out what works best for me to lose weight. And dont mention my Iron....my energy is always low, unless I take them...but that runs in my family with the women who has cycles.

SW / CW / GW 292 / 188 / 174 - Height 5'7, Size 10

Sunshine16
on 4/12/19 5:58 am
Topic: RE: She's BAAAAaaaack!!!

Wow, you have done fabulous! What nutrition crisis have you gone under, and do you think?

SW / CW / GW 292 / 188 / 174 - Height 5'7, Size 10

Noodle65
on 4/11/19 7:30 pm
DS on 10/18/12
Topic: RE: Insurance Issues VSG, DS 8 years later

Hi there

I have tricare prime and they paid for my crapband which of course failed miserably. When I started pursuing the DS I was denied and told only one WLS. I considered adding additional insurance but during that time, 2012 the DS was not covered by many.

Ultimately, my surgeon agreed to give me a smoking deal as self pay to remove the band, repair a hiatal hernia and a DS for $12K as he was trying to get more DS procedures on his resume.

Absolutely no regrets, love love love my DS. I'm very fortunate in that I pretty much eat whatever I want and hold around 150 to 155. If I watched my carbs I'm sure I could get down but at 5'8" I'm pleased.

I do think having your med to the calling is smart. Tons depends on BMI and co morbidities

Blessings

Julie

babettes_feast
on 4/11/19 11:56 am
Topic: Insurance Issues VSG, DS 8 years later

Hi everyone,

I was also very active on these boards 8-10 years ago. I won't share the long story, but the short version is that I need a DS and my surgeon agrees, robustly! My concern is about my insurance. I have BC/BS of Florida (even though I live in MA, dh's company is in Florida). Has anyone had a problem approaching insurance for a second WLS? What kinds of issues did you face and how did you get an approval? My hunch is that my calling will do nothing, but my surgeon and insurance department at her practice will get results.

Thoughts?

Thanks!

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