Need to know where to start?

I want to do it right the first time, so I need to know where to start. I havent seen a pcp yet since we got this new insurance. So if you ladies and gents can . Please tell me what i should do first.I called the insurance company yesterday and they (BCBS of Il) do cover WLS. She is sending me a paper on everything I need to do on their part i guess. Thanks you guys are all awesome.

Well Melissa i also have BCBSIL and the first thing i needed to do was see my pcp and talk to her about my weight. and then she gave me a referal to the bariatric clinic. after that the clinic just took it from there told me what i needed to do and i did it. They want 6 months of diet and then all the test's that are required by the the dr. like a sleep study and then blood work. ya know all that if you have any other questions just ask. i hope i helped you. Julie Boyd

When are sending in your paperwork?

ummm not sure yet i still have 2 dr visit's left then they will send it in. probably the end of september. i talked to bcbsil and they said that the approval will take up to 14 days.  as long as you have everything that is needed.

I just hope im able to do all this.  I know everyone on here is or has done it already ya know. I just feel like a big chicken, thinking I cant do it and I havent even stared yet. And thinking why am I wasting my time they will turn me down. But all I can do is try.  14 days isnt to long. Ive seen some ppl post that they got approved/ denied the very next day even, after recieving the papers. They need a little smiley t hat has his fingers crossed...lol

well it's will all work out. do you have yahoo instant messanger? if you do add me and we can talk more. [email protected] is my email and name on there.

Hello Melissa, Welcome to the board!  I am going to post, what I think, every newbie looking into WLS should consider.  This should be your FIRST task when looking into WLS.  Once you have done all your research and decide which procedure is best for you, then you can focus on the other stuff. Just a quick note about insurance... if your insurance will pay for WLS, they should pay for ANY procedure you choose whether it is the Lapband, the RNY, the VSG or the DS (my personal favorite.  LOL)  If your insurance says they do not cover one of these procedures and it is truly a procedure you want, don't give up and just take their word for it that they don't cover it.   Good luck and if I can help in any way, please let me know. 1)  Ask yourself have you REALLY done your homework about the path you are going down? 2)  Did you know about all the weight loss surgeries available to you?  Do you understand the differences?  Have you read about how successful they are?  Have you read about the complications?  Have you read about the lifestyle changes each surgery will require?  Do you understand how they are different? 3)  Did you interview more than one surgeon, especially if that surgeon only performs one of the types of surgeries available? 4)  Do you know about the risks?  Did you ask your surgeon how many surgeries he or she has performed?  What about their mortality rate?  What about side effects?  Have you visited a weight loss surgery regret site?  Do you know about the unhappy as well as the happy people?  Did you ask your surgeon how they were trained?  For how long?  Where?  With whom? 5)  Do you truly understand this is a life altering event?  Are you prepared to do whatever you need to stay healthy and lead a productive life? 6)  Is your mind ready for this?  Have you been honest with yourself and your surgeon about how you got to your current weight??  Are you ready to hit your food issues head on? 7) Are you financially prepared to supplement appropriately, with vitamins, protein, etc. for the rest of your life? 8) Have you attended a support group meeting or have you met post ops (from ALL weight loss surgeries) in real life to find out how they live with their choice? If you answer no to any of these questions, I suggest you take a step back and keep researching before you set that date.

Melissa, Welcome to ObesityHelp & to the IN board. Congrats on making the first step..the decision to improve your health! That is a biggie step right there.  The first step would definitely be to talk with your PCP. With your old insurance, did you regularly see your PCP? Most insurance will require that you have had 6 months of PCP supervised dieting. For some (mine), seeing the PCP regularly while on his plan is enough. For others, they want you to go to a regular weight loss center. You may also be required to go see a dietician. Some require proof of long-term obesity (+5 yrs) (my old PCP lost my records so I submitted a statement from where I work for my annual physicals/weights there). Some like to see a journal of some sort of your own efforts (I submitted one on my food and exercise which I had done in Excel). Each insurance has their own little tweaks of what they want. And the tweaks are often governed by the employer they are contracted with. I also have BCBS but their contract with my employer may differ than the one they have with yours. After you have all of your stuff together, then it's time to think of who, where, and what. All three of these are often tied in together. The most common WLS is probably RNY. Distal Switch is fairly new but terrific for those who are super morbidly obese. And then there's lap band...which can be a very effective tool, but you have to be strict with yourself...whereas with RNY & DS, your pouch is strict with you. The best way to decide is researching all three procedures. Yes, there's a 4th (VGB) but so many people have had problems with it that I'm not giving it the time of day...k? All surgeons don't do all procedures. For instance, Dr. Inman is the only one I know who does the DS. Most do the RNY and some still do the lap band. Also consider the hospital you'll be staying at post-op. How to decide???? There is a ton of information on here about each procedure. Read up on each. Check members profiles and those who are POST-OP, write them and ask them all the ?? you have. I say post-op because the pre-ops just have an idea of how it SHOULD be, not how it was. JoMac would be an excellent lap-band resource person. Several of us would be good for RNY. Be sure to ask about complications as well. They DO happen. We all like to think that they won't happen to 'ME'. But they do. Read my profile. But...I would do it again in a heartbeat. Once you decide what procedure you want, then start checking out the surgeons & hospitals. The reviews on here can be a great place to start. If you see where someone has had a certain surgeon, contact them and ask them their opinion about the surgery, complications, hospital, was their laparoscopic or did it end up being open, etc. On the board, just about everyone will say 'my surgeon is the best'...so if you want to improve the chances of getting straightforward talk, send them a note through 'contact'. I would contact more than one person for each surgeon. Some people have negative attitudes about everything and I'd hate to see you get a slanted opinion because you happen to have wrote one of them. Also, try to ask one who isn't too far post-op (~6 months) and one who is quite abit out (+2 yrs). It's good to get the short term and long term opinions. Once you decide on who, go have a consult with them. Be sure they are one you can talk easily & open with. If not, consider a 2nd consult with someone else. Their office should help guide you through the insurance approval process. Once you are approved (2 days to 4 weeks), they will set you up for the surgery, pre-op testing, etc. The pre-op testing to be sure you're healthy enough for surgery and that there won't be any surprises. You'll probably also have a dietician class in which they'll give you your post-op instructions for a healthier lifestyle. Then, it's wait for the surgery date. Post-op, you will absolutely hate the first 4-6 weeks. Period. You are learning how to drink water all over again. Sip, Sip, Sip. I think of it like pouring water in a funnel. Once you master what speed you can pour the water in without it wanting to come back out at you, you're all set with getting in your liquids. You're also trying to find a protein drink that your taste buds will approve of. Don't try to do this pre-op as your taste buds change. And then there's meals. 1-2 oz seems like so little when you're pre-op, but post-op? It's all you can do to convince yourself to pick up that spoon some days. It doesn't help that the food choices are very limited. They have to be. You have the size of a pouch of a newborn and it has just had major surgery on it. You have to feed it gently. As you get further out, you will be able to enjoy food again...just not in the quantities you did pre-op...and hopefully, prepared in a healthier manner. In between all of this, you are also learning to take your vitamins. These are a MUST. Your body can no longer break down the food to give you all the nutrients you need so you must get them from supplements. If you aren't willing to do this, do NOT even have the surgery.  When you are about 2 hours post-op, the nurses will (should anyway) get you out of bed to walk. That is starting you on a healthy beginning.  There are three main components of losing weight: PEW. Protein, Exercise, Water. Be sure you get in plenty of all three and you will have a successful weight loss journey. What can you do in the meantime???? It never hurts to start a healthy lifestyle. I would recommend you joining SparkPeople.com. Complete your profile & goals on there. Make your goals reasonable!! No more than 2 lbs a week pre-op is reasonable. Let it help guide you. One thing I cannot stress enough, drink at least eight 8oz glasses of water a day, every day. Water flushes out the fats. It also keeps you from being dehydrated. Once a person gets dehydrates, liquids can make them queezy (and lightheaded and a host of other problems). The more queezy, the more dehydrated. It's a vicious cycle. Don't let it start.  Stop smoking (if you do). A smoker heals slower and has more complications than a non-smoker. Once you quit, stay off of them...you never know when you may have to have additional surgeries (again, see my profile).  Stop the coffee. Caffeine stimulates your appetite as well as dehydrates you. You don't need either thing going on. For each ounce of caffeinated drink a person has, they need to drink 2 oz of water (in addition to the 64 oz) to make up for it. So...a 12 oz can of soda? Even if it is sugar-free but not decaf? You have to drink 24 oz of water in addition to the 64 for a total of a minimum of 88 oz of water that day. Do yourself a favor and drink sugar-free decaf or water. Post-op, you'll be instructed not to drink pop for 6-12 months post-op. The carbonation can cause problems for your pouch. I'm 3 yrs post-op and carbonation still doesn't set right in my tummy.. I think that about covers everything. Most of all though, have a good support system in place. You made the right first step...you sought advise on here. It's a great bunch of people here and they don't mind helping in any manner. We often have get togethers, etc. You are welcome to join in. Or if you are going to be somewhere on a certain day/time (say...TGIF at ___ this Friday at 6 pm), post on here and chances are great that you'll get a few people who are able to meet you there. We are definitely NOT an online only board! Again, Welcome! Sherri ps..I'm going to add this to my profile for any future pre-ops...

Wow thanks so much for the awesome replies.  I'll know in a couple days what my insurance requires.  Have a great holiday everyone, be safe.

Hi Sherri, Great post!  But just a couple of things: 1.  The DS stands for Duodenal Switch, not distal switch.  And it isn't really new.  It's been around for about 20 years and is a proven procedure which Medicare now approves as well.  Research shows the DS has the greatest percentage of weight loss and the greater percentage of keeping weight off of all WLS. 2.  I think you mean the VBG (vertical banded gastroplasty), not VGB.   Hope that wasn't too nit-picky. Take care, and again, great post!