I am New Here...

Hello, my name is Dee. I am new to OH and have been considering WLS for over 5-years. I have recently recieved my packet in the mail for surgery with Dr. Gagliardi as the surgeon. I finally decided to take the step forward to surgery, simply because I want my life back. I want to gain back my mobility, so that I can finish my college degree and be a participant in my marriage. I've just spent the last few hours trying to fill out some of my packet, hoping not to miss any detail for insurance purposes, so my mind is a little fried. Mostly, I want to take this time out to say hello and see who I can learn from and what friends I may make. It's late and I just wanted to start my introductions before I turn in. ~sigh~ I don't even know where to begin, it's all overwhelming. Thank you for reading and hello. Dee

Hello Dee, I am also new to this board. I am starting my journey on finding a Surgeon and where to start. I have been researching this for over 5 years and been back and forth. Now it is time and I want a new lease on life. I will be getting a packet myself either today or tomorrow from St. Joe Bariatric Center and the doctors and the center got the Excellance Award from the Bariatric Groups so I go to my first group meeting on June 19. I own my own company and am searching for insurances that offer this selection so if you have any insight on anything let me know. Thank you and take care...Angela

Hello Angela, I know first hand the frustrations of insurance companies. I am sorry that you are having a difficult time of it and I hope that you will find something that works out for you. I started off this journey with a packet from Dr. Gagliardi's office, but after having a few questions about the packet itself, and having difficulties trying to get ahold of someone in his office to explain my concerns, I've decided to look into a different Dr. I have now contacted the Center for Weight Loss Surgery in hopes that I can give myself better options when having this surgery. I am wanting to make sure that when I have this operation, if I am need, I can quickly get ahold of a staff with any problems that might come about; not being able to get ahold of any staff to answer packet questions, doesn't instill confidence in the surgeon for me. :chair: I just got off the phone with a Rhianne (I think I got the name right) at the CFWLS and she has already set me up an appointment for a seminar on 6/12/06. I am excited about it and having already been given an appointment for something has made me feel as though there is action being taken, rather than potential possibilities. When I finally did get ahold of someone at Dr. Gagliardi's office, Miss Tanya proceeded to tell me that she is the only one working his cases right now and due to personal cir****tances, she was having a hard time staying on top of everything. She also told me that it can take up to two-weeks just to hear back from my packet being mailed to the clinic. I don't know if that is a normal time frame, but I was a little annoyed with a packet taking two-weeks to even be looked at and responded to; hence my looking at the CFWLS. My husband and I have Humana through his employer, for what it's worth. I don't know how well Humana handles this type of surgery, but as I go through this process, I will keep you updated on the events as they unfold. I did switch to Humana, because I was informed that they do tend to handle this surgery better than others; we shall see. Take care and good luck, DeAnne :fairy:

Hi, Dee. I also have Humana insurance and am a pre-op patient at Georgetown. They are wonderful at guiding you through the insurance approval process. When you go for your first appointment, one of the things you'll learn is exactly what Humana will require you to do. Here's what they told me: I had to have 6 months of documented, supervised weight loss attempt. For me, that has meant that I see my PCP once a month and have her complete a form (which Georgetown gave me). I saw her to start the 6 month diet in January, so I'll finish in July. Humana requires that your BMI still be above 40.1 at the end of the 6-month period. They also asked me to complete a sleep study, a stress test, and an echocardiogram during the 6-month period and to have my PCP write a letter of support. I'll have all of that documentation along with my 6 months of forms for Georgetown to submit to Humana in July. Hopefully, I'll be approved and will then get to see the surgeon, complete any additional tests, and set a date for surgery! I hope the process continues to go well for both of us! Kathy

I didn't know that Humana had to have documentation of a 6 month diet, how very interesting. I've been dieting for six-months, by a Dr.'s suggestion, but unfortunately not being followed. I wonder if I can get my doc to maybe say she has been following me with this diet. I don't know, it sure can be frustrating. None the less though, I will do what they ask, because I really want to be approved and I suppose a 6 month, supervised diet, isn't going to hurt me. I hope that you get your approval soon and a schedule date. I am looking into Georgetown bariatrics, but wonder if my UK PPO High will be in network or out of network. I will give them a call tomorrow to ask some questions; I didn't get their link till just recently and it's too late to call them right now. How have you been doing on your 6month diet? Do you mind if I ask you which diet you are doing specifically? I am doing the slim-fast one myself at this time, but I have lost little, if any, weight. Take care-- DeAnne :fairy:

Dee, I've gone up and down during my 4+ months of dieting. My plan was to eat lowfat and to reduce my portion sizes. I've also stopped drinking carbonated and caffeinated drinks. I've been successful with all of that, but I haven't lost weight consistently. I also was supposed to increase my exercise by walking and doing some aerobics. I've not been real successful with either. I injured my knee in a fall in December, and I broke a rib in March during a bronchitis coughing bout. I'm currently dealing with a muscle spasm in my back. Exercise hasn't come easily for me! My goal is for my weight at the end of the 6 months to be lower than my starting point in January. I have sleep apnea, high cholesterol, asthma, and chronic back pain. I hope those co-morbidities combined with my 40+ BMI and my 6 months of jumping through hoops will satisfy the insurance gods! If you have been seeing your doctor regularly over the past 6 months, you might be able to get a letter from him/her saying so and explaining your weight loss efforts. I've talked to several people who have been able to use previous efforts for their documentation. It would be great if you didn't have to start from scratch with another 6 months, but I agree--it's worth doing it if it gets your insurance approval. I look forward to hearing how things go for you. Kathy

It is overwhelming. It took me over a year to get all my insurance paerwork in & approved. Be persistent & make copies of everything. Georgetown has a great insurance coordinator that was there for me all the way. She either called me back or emailed me & I had a LOT of ?'s. I had a bypass done @ Georgetown 2 months ago & I've lost 60 lbs & down 2 sizes. I also had a strickure within the 1st month but I'd do it all over again. I met a lady from Bowling Green that had surgery the same time I did & we call each other every week to check on each other & see whats working & what's not. Food doesn't control my life & all my thoughts anymore. I get up & move now & I look forward to weighing myself. I went to www.baraticeating.com & ordered a sample package, about $30, so I'd know what drinks I'd like & I used this site a lot to get insights & feedback. Hang in there Dee............it's all worth it!!!

Thank you for your words of encouragement Ginny; I appreciate it very much. I have UK PPO High and I am hoping that I already meet the requirements for this surgery. I have been reading the insurance pages of this site and it appears that I do and shouldn't be a problem. However, I don't want to get my hopes high, just have them smashed by a red disapproval marking. If anything, I know that I can appeal, appeal and appeal. I have an appointment for a seminar on June 12, 2006. I'm really looking forward to going and finding out the right steps to take as they're supposed to be taken. ~sigh~ I keep having to remind myself that I need to slow down and take deep breaths. I've been fat all my life and waiting a few months, or several which ever the case may be, won't be a spit in the ocean comparitively. :deal: It would be nice to meet people in the same starting stage as I am and have a RL support group to cheer me on and go through the experiences together. :gossip: I noticed that the boards here are a little slower than what I'd expected, are there busier places on the message boards I'm not familiar with? Thank you and I will keep fighting, for my health, for my life-- DeAnne :fairy:

Hi DeAnne, sometimes the KY board can be a bit slow...don't leave us, keep posting but also check out places like the main board. go to the lapband and the RNY boards..you can get alot of information there. read all you can about the surgeons by going to the left side of this page..click on surgeons then read what information you can about them.. good luck in your search and at your seminar June 12th.. Please post and let us know about your search and what decisions you end up making...go with your heart and you will do just fine!! Brenda