Advice From my Fellow Michiganians?

Hey everyone, it's been MONTHS since I posted here.

Here's what's up...

Name:Eric
Gender: Male
Age: 19
Starting BMI: 50.2 (370)
Current BMI: 49.9 (368)
Insurance: McLaren Medicaid

I have been going to my family doctor (PCP) once a month since December 28th.

December: Discussed dieting/exercise (Weight: 370)
January: Discussed dieting/exercise (Weight: 372)
February: Discussed dieting/exercise (Weight: 368)
March: Tomorrow.  He has me scheduled to get blood drawn, and I'm sure he'll take my weight and talk to me.

Any advice for what I should be doing four months into my Med. Supervised Diet?  How do I get talking to a surgeon?  Do I schedule myself up for their monthly session thing?  Any advice would be greatly appreciated.

I am also kinda concerned that I went up two pounds the 2nd month from the 1st month.  Granted it's only 2 pounds, but it was a weight gain during my medically supervised diet.  Very nervous about that.

Any advice is greatly appreciated ahead of time.  I am getting nervous that insurance will try denying me, but I already know that if they do, I am going to appeal it, with them knowing I'm not going to be giving up, whatever it takes.

Thanks in advance.

Hi Eric - do you have a copy of your insurance requirements so you know what you need to do to qualify for WLS?  If you started on December 28th then your 6 months would be up on June 28th so you could submit for insurance approval after that.

Just make sure your doctor is documenting everything in your chart such as following a reduced calorie diet, exercising x number of days a week, making  behavior modifications (such as giving up pop, not drinking with meals, getting in 64 oz of fluids a day, etc).  Also in the notes should list the reason for the visit as Weight Loss and include your weight & height and BMI at each visit.  If you haven't already done so, I would definitely attend a seminar and set up a consultation with a surgeon.  

As far as gaining 2 lbs, I wouldn't sweat it.  I gained 6lbs from start to finish of my physician supervised diet.  Unless your surgeon requires to lose x amount before surgery or it is one of the requirements listed in your insurance then it shouldn't be a problem.

Good luck to you!

  

I would make sure your are following all the insurance requirements. And doing your homework on surgeons in your area. Make appointments to meet with different ones and find who is best for you.

Try and fit in an appointment with a nutritionist that your primary care doctor refers you to.  The whole multi disciplinary/medically supervised diet should also include at least a visit with one..just to cover your bases.  Also,  if you've joined a gym or bought any fitness equipment, save the reciepts.

Eric,
You can contact a Bariatric Surgeon and get started with his/her office.
You can be pro-active and call your insurance and ask what is required of you.

I did what you are doing, seeing my internist every month for a weigh in to be documented.
I also at the same 6 month time I did the following:
Exercised
Followed a low cal diet of 1200 a day and journal my eating and my feelings.
Went to a Bariatric seminar
Went to bariatric support group
Seen a therapist recommended by the Bariatric Surgeon
Had my sleep study done (ordered by the bariatric surgeon)
Had labs done
Had cardiac study done

After my 6 months were up I was scheduled for surgery 3 weeks later because I had all the work done ahead of time.

 

Hi Eric -

These nexts few months are going to be hectic, so you need a plan.  Make sure you have a hard copy list of requirements from your insurance company .... you need to know EXACTLY what criteria you must meet for approval.  If you don't already have that - get it TODAY.  This will serve as your checklist.  It'll also assure you that you're doing everything right along the way.

You don't want to get to the end of your 6 month diet thing and find out you've been doing it wrong all this time.  Insurance companys have very specific and strict requirements for what that diet must include - it's not always just a weigh-in and a discussion.  It might also include nutrition counseling, psych counsleing, drug therapy, etc - so make sure you know exactly what they want.

Find a surgeon.  You should be compile a list of surgeon in your area (or however far your'e willing to travel for your surgery) and start researching them.  And be sure to do your research on their clinics too -- aftercare programs are JUST as important as the surgeon, so look at what they are offering you besides a safe surgery.  You'll also need to find out which surgeons take your insurance - that'll be a big deciding factor as well.  Then start attending info seminars.  They're free and you are not committed to go with that clinic unless you decide to.  Going to several will give you more information in general, but also give you a chance to check out what they're about.

Once you settle on a surgeon, then set an appointment.  And be prepared for a "process" -- this is not a quick deal.  Often a surgeon's office will have additional requirements besides what the insurance does.  So make sure you know that ahead of time and start working on what they want from you. 

You'll likely have to have a psych eval.  Sometimes it takes a while to get that appoinment, so if you can get it scheduled now and be ready to do the appointment around June-i****'s best to get on the calendar. 

In the meantime.  Just be reading as much as you possibly can about the surgery.  Learn what post-op life is going to be like and how your body functions afterward.  Here's a post on my blog that might help get you started with some research.

One last thing.  Find a support group locally and start attending.  Learning from other patients is the best education.  I attended a support group for a full year before my surgery and it's one of the best things I did to prepare myself.  Ask lots of questions and be open to what they say -- sometimes patients might not say the same thing that surgeon's say, but we've lived through it and know what life is like on the other side, surgeons and nutritionist only read about it.  So tap into the vast amounts of knowledge a good support group can give you.

Good luck
Pam

you are gonna have to show them more weight loss though to qualify they told me 3-5 pounds a month would be a good minimum but they require you to meet that goal of SOME weight loss for 6 consecutive months of "dr. supervised dieting"   I am SUPPOSED to have McLaren medicaid I wish I knew what happened to that! I have called them 5 times and they say I just have to wait for my letter fo come... been waiting since before Christmas.  AnYWAY, I am in my 6th month technically....so if I ever DO get that damned letter I could try for approval...*hmmph*   I am supposed to be eligible for blue cross in less then 3 months though so it looks like I'll just continue to extend my journey...

I think you have the right attitude in spirit....as to never giving up... I also think doing this at your young age and making a commitment to your health , well thats AMAZING if onyl we'd all done this at 19! lol   I wouldnt have qualified for WLS at 19 but if Id commited to not GAINING at the very least...eh? lol

good Luck!!!  :)