What should I ask my PCP?

Hi everyone I live in Illinois , I hope its ok if I ask a question over here, I cant seem to get anyone to answer my post on the Illinois side...lol....thank you in advance. IM going to my first vist to a new dr,we just moved here( Illinois) from Kansas a few months ago. Im looking to try and get approval for WLS. I have never been on a dr supervised diet. I was diagnosed with pcos 2 yrs ago and have had trouble with high blood pressure and high sugars. But its been a good 5 yrs since I have had any test run. Can anyone tell me what I should ask the pcp on my future vists to get the ball rolling so to speak. Im totally lost on this...any help is apprecaited . Thank you. Melissa

Melissa, Hi & welcome. I would start off by telling your dr you need a complete physical with blood work. That will give you & the dr's a baseline to start with to know what issues you have that need addressed. Second, if your insurance covers Gastric Bypass, I would just schedule a consult at St. Vincents in Indianapolis. From Danville that would be a straight shot on 74 to Indy. It would take you about an hour & a half. But well worth it. The Bariatric Surgeons, like Dr. Inman that I had, can tell you what tests you need. Or what exams you'll need before they'd approve you for surgery. I know you said you have PCOS, do you have a dr here for that? If not, I highly recommend Dr. John Jarrett. He has an office in Champaign, IL (about 30 min from Danville). And also one in Inianapolis. Thanks to him, I was able to treat my PCOS and get pregnant twice with him. If you're looking for a local support group. We are forming a new weight loss support group in Terre Haute, IN (about 45 min S of Danville). We will have our first meeting on Monday January 29th from 6:30-8:30 pm. It will be held at: St. Patrick Rectory > 1807 Poplar Street (building just west of the > church) > Terre Haute, IN 47803 If you have any other questions, feel free to contact me. I live in Dana, IN which is about 30 min S of Danville. Goodluck.

Thank you so much Laura, I really had no idea where to start. Ill keep the support group in mind and will try to make it. Our insurance says the will cover the surgery if medically needed. I should be able to get it approved since who knows what the dr will find and having pcos. And im 5'3 and somewhere between 330-345 lbs..Thanks. Melissa

Is this group for people that have already had the surgery or people that are going to have the surgery? I work in Newport, IN so Terre Haute would be great for me to go to. Let me know b/c I would be happy to meet some new people!! Becky

Becky, This group is open to anyone who has had/or are just thinking of having the surgery. I hope the group will become a lifeline for people who have had the surgery. And encouragment for those waiting for surgery. Or even those that decide against weight loss surgery but still need help & encouragment in loseing weight. Where do you work at in Newport? My mom's whole family is from Newport. Look forward to hearing from you & hope to see you at our meeting. Laura

Melissa, I would call your insurance company even before your doctor appointment. Ask them for specific details on what is required for them to approve wls. For example mine wanted it documented that I had tried weight loss with the doctor for 6 months prior to approving surgery. They wanted to see in the doctor's notes that we had discussed both diet and exercise. That way I knew what to tell the doctor had to be in the notes, so I could get approved. When you get the specifics from them, you will also have a better idea how to proceed. BTW, always get the name of the person you talk to, so you can reference them later if you need to, and ask for the requirements in writing if they will do that for you. Linda Vicory

Melissa, I agree that your first call should be to your insurance. Ask them if they have an approval packet that they can send you (some do, such as Anthem). Ask them if you also have to have dietician visits (MPlan requires them). Ask them if you have to go to support group meetings, and if so, how many and what kind of documentation would they accept. Some only accept support groups which are directly affiliated with a hospital. Also, ask which bariatric surgeons are included in their network and which hospitals. I love St. Vincents & I love Dr. Gupta but with you being in Illinois, I would be surprised if your insurance would cover an out of state medical facility at the same percentage. Your pcp will need to keep meticulous notes whi*****lude diet & exercise discussions, weight and BP must also be measured at each visit. Ask the insurance how often the visits are to be. Oh...some insurance also require that the diet and exercise be the ONLY purpose for that visit so if you have a boo-boo, that has to be handled at a different visit. I would start keeping a journal of your foods & exercise. Some insurance require that...and it can make approval that much quicker. Along with finding a local pcp and GYN, I would also find a local pulmonary doctor. It would hurt to have a sleep apnea test ran. Many of us had sleep apnea pre-op. To find a bariatric surgeon close to you, I would look on the reviews here on OH. Also check out the reviews of the local hospitals. I know it sounds like alot of hoops to jump through, but it really is worth it. You are welcome to come on our board whenever you'd like. We have get togethers and such that you are also welcome to join us for if you're up to the drive...although, you're closer in distance than many of our Hoosier Loosers. Best of luck, Sherri

you ladies are so nice..I posted a couple of times in the Il message room, and never got a response...lol. I just got off the phone with our insurance, and they said that i have to have a 12 month supervised diet and exercise program. Plus a bunch of other stuff. He is going to send me a packet tho so I can read it for myself. Its hard to remember what all he said after you hang up the phone. Thanks i'll keep you informed on whats going on. Melissa

Hey I just noticed your from Danville. I used to go up to Cayuga for work. That's not too far from there, is it? I dont' think so, because I know alot of the kids I would work with wanted to go to DACC. Linda Vicory

Melissa, Indiana use to be where the insurance could require up to 18 months...which most did. Recently (June or July of 2006), the state law was changed to make it 6 months maximum. I think you'll find that the 12 months will go by quickly. I'm sorry that you didn't find your homestate board to be very responsive. Ours is pretty active and sometimes outspoken...I'm probably one of the worse gabbies we have..lol. We do really care for each other though and try to cheer each other on. Please do keep in touch! Sherri