Sad and Disappointed

Caidkin
on 4/1/11 9:20 am - Canandaigua, NY
RNY on 07/02/12
I went to my second seminar yesterday.  I loved the doctor and the hospital.  But I won't qualify.  I'm right on the border.  Right now I am 40 BMI.  If I loose the 5% weight it will take me below 40%.  I specifically asked if they consider my before weight or after weight for the surgery.  She clearly stated if I went below the BMI after loosing I would not qualify.

It makes me wonder.  The first seminar I went to (didn't like the doctor, different hospital) I asked the same question and they stated that they record your initial weight as your qualifing weight.

What annoys me more is my insurance doesn't require that I loose the 5% for a bypass.  WTF???   I don't want the bypass, I want the band.

I'm just so bummed.  I have done soooo much research.  I really wrapped my brain around this.  I was READY... ready to start tomorrow.  FULL FORCE. 
Just had my RNY on 7.2.12!!!!  WOOHOO!!!!!         
1106ng
on 4/1/11 9:27 am - Greenville, MI
I had the same issue. Mine said they used the initial wt so there wouldn't be a problem, and there wasn't.
Lin_2
on 4/1/11 9:34 am
Frustrating!!!  I wish you the best. I don't really have any suggestions except that maybe try a third place? maybe you would like the doc and maybe they use inital weight as qualifying weight? or can you try to reach someone higher up in your insurance to see if they could work with you on it (sometimes you can find helpful people in insurance, sometimes not)
Good luck!
        
MARY ANN M.
on 4/1/11 9:35 am - Las Vegas, NV
DON'T GIVE UP!!
The person at that office is wrong.  Go find another Dr. if you can.  You shouldn't have any problem qualifying at that BMI.  Check with your insurance and see if they can recommend another surgeon.  The lap band has been such a blessing to me.  You can do this. Just keep moving forward!

Mary Ann

                
Caidkin
on 4/1/11 10:10 am - Canandaigua, NY
RNY on 07/02/12
Thanx for the comments, just want I needed.  I was so down today!  I will keep going then! 
Just had my RNY on 7.2.12!!!!  WOOHOO!!!!!         
Lisa O.
on 4/1/11 11:09 am - Snoqualmie, WA
Is your surgeon saying that you must lose 5% before he will do surgery?  Or, are they suggesting that you lose weight prior to surgery in order to shrink your liver ?  My Dr. suggested that I lose, but I didn't.  My BMI was higher though. 

Do you have other co-morbidities?  That counts too and you should be tested for sleep apnea as well. 

Work with the surgeon.  They may have an insurance specialist that works for them that can help you navigate the insurance.

First, find out if the 5% is a mandatory requirement or just a recommendation.

Best wishes!
Lisa O.

Lap Band surgery Nov. 2008, SW 335. Lost 116 lbs.  LB removal May 2013 gained 53 lbs. Revisied to RNY October 14, 2013, new SW 275.

    

    

RobinJoy13601
on 4/1/11 11:47 am
I was questioning this  a little while ago since I was on a losing streak.  I was afraid I'd lose too much and not qualify for surgery since I have no co-morbidities.  Upon talking with the Nurse she stated to hold back and not get below the 40 BMI which I am just  slightly above.  The worry I had was I didn't want to stop what I was doing to lose it cause I am in the zone still!!  Needless to say my surgery date is April 18th and I can't imagine Im going to lose much more than a couple of pounds.  But Im thinking I should be good since Im approved and all.  For yourself is there a way you could gain lets say 15lbs?  I mean I really wouldn't have a problem gaining that I'd just go back to my old habits!!  Just a thought anyways. 
Surgery Date=      April 18th 2011        

                
Caidkin
on 4/1/11 11:37 pm - Canandaigua, NY
RNY on 07/02/12
Yeah... I hear ya.  I've gone down 4 pounds in the last 2 weeks. LOL, I haven't lost a POUND in like 5 years, all I've done is gain.  Now that I'm actually going forward with this my body is not behaving. 

I'm wondering if I should go with the surgeon that I didn't get a warm and fuzzy feeling from because it seems that they record my before weight for insurance approval. 

The other thing, if I was an INCH shorter this wouldn't even be an issue.  UGH.  I'm so on that line, ya know? 

I'm just going to call both docs on monday and speak individually with someone about their rules and go from there.
Just had my RNY on 7.2.12!!!!  WOOHOO!!!!!         
Lin_2
on 4/4/11 10:59 pm
So frustrating! Word of caution though: pick a surgeon you trust. Surgeons often aren't the warm and fuzzy type, but you want them to be competent. I worked in hospitals for over 8 years, so TRUST me when I say: make sure you pick a surgeon you believe to be competent. Don't settle! Look for another before you settle for someone that you think might not be too good. You aren't specifically saying that you don't trust the other guy, but I've known many people who say that "I had a feeling he wasn't quite right." I'm not trying to read into what you're saying, just wanted to say if the doc makes you uncomfortable, is that because you have a sixth sense about them. Good luck!!
        
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