Newbie here!! (long)

Hi everyone..i'm so glad I found this place. I guess I should share my story and why i'm here I'm 25 years old and have been obese for all of my life. I have done diets/exercise almost all of my life (I was in weigh****chers at 11!!) and i'll lose some weight, but I always gain it back and then some. Surgery is definately the last resort and am hoping to have surgery. I know it is not a quick fix and is a life changing procedure so I'm definately not entering into this lightly. I qualify for surgery based on my BMI alone (currently it is 46.7) and thankfully as of yet I have no co-morbidities that require medication. I do have some serious hip/knee pain and shortness of breath from climbing stairs. I went to a seminar that Dr. Madan hosted this past tuesday. I am interested in the laprascopic (sp?) RNY procedure. I want this surgery because I want to live..there is no telling how long I will live and I don't want to develop diabetes and everything else that is associated with this disease. I know that surgery is not a quick fix and that it is just a tool to help you to lose weight and i am ready to seize this opportunity. I want to be able to do so many things. It is my dream to one day be able to run a marathon and to be able to rock-climb. Plus I want to be around for my three year old son and to be able to play outside with him and not get worn out. These are supposed to be the best years of my life, but to be honset I feel like I'm an old woman. :( I am going to go see my PCP tomorrow and discuss with her that I want this surgery. Does anyone have any recommendations on what I should bring, what I should ask, and I need help on how to deal with tenncare as I'm afraid that it is going to be a battle with them. Any help would be so appreciated. Thank you so much for you help. Sorry for the long post. Jess

Jess, and welcome to our wonderful board. You will need a letter of referral from your PCP that states that it is "medically necessary" that you have this surgery. Start collecting all your medical records, and if you see of Dr.'s also ask for a letter of referral that it is medically necessary. Then when you see your surgeon, you will have everything ready. Find out from the surgeon what tests he requires before you have surgery, your PCP can arrange to get them scheduled. Call the number on the back of your TNCare card and ask for a case manager. This person will help you in more ways then one. Also call TnCare and ask what their requirements are in order to be approved. Basically that's it. Best of luck and know we are here from you. Kathy

Hi Jess. Welcome to the board. And I totally agree with what Kathy has already stated just collect as many referral letters and medical records that you can find. When I first started looking into this surgery 2 years ago I had TnCare and the only surgeons they would approve the surgery for were Dr.Woodman in Memphis, some Dr. in swee****er Tn and a surgeon that is no longer even practicing in Tennessee anymore. I don't know if they have changed their policy but the surgeon had to be in the TnCare network and be willing to take the small payment that TnCare pays. But hopefully they have changed their policies and you can choose your own surgeon. But if not just ask for an out of network referral and if they deny you just keep appealing and appealing eventually they will give in. My current insurance always loses the first paperwork and denies the 2nd request and you have to always do a 3rd but they eventually know you are serious and wont give up. I wish you the best of luck. And remember keep fighting this is your life we are talking about there is nothing important that ones health to be there for their family. Larry.

Thanks for the warm welcome everyone. I went to my PCP today. It went well. She was very encouraging about the surgery and everything. She gave me a referral to see Dr. Madan, now I just have to wait for the paperwork to come in and make an appointment with him. I don't care how long this takes I'm definately not going to give up.

Hello Jessica, My name is Sara. I am post-op. My surgery was May 2nd. I have BlueCare/Medicade. I had NO trouble whatsoever. I was approved in a matter of day's. I used Dr. Michael Hodge in Johnson City.I am a heavyweight & had no trouble at all. This is a good surgery & you seem to have a well researched attitude. I wish you the best of luck. Oh yes, & by the way, welcome to our family. Love, Sara.