Taking The Plunge

I just received my paperwork in the mail today and I am already getting nervous.  This packet gave directions on the first steps in the paperwork end of things.  First get a Psych Evaluation, then get 6 months of weigh-ins from my pcp (not looking forward to having to wait 6 months.  I am hoping that we can get around this with my insurance - Definity Health - TN). Then onto the Dietitan appt and nutrition classes.    They did include a few medial tests that they felt I needed to have done:  A sleep study, and an upper GI. I believe the two above tests may get waived as I think they thought I had been diagnosed with Sleep Apnea and Acid Reflux.  On the bottom of the page the secretary wrote that I had Sleep apnea, high blood pressure, diabetes, and Reflux - on prescription.  I did mark the sleep apnea on the initial paperwork, but I wrote (suspected) to the side...I wake up gasping for air on rare occasions.  I have never had diabetes, I am not on prescription for Reflux (and really don't have a problem with it).  I am wondering if she mixed my paperwork up with someone else's.  I did email her back my concerns and hopefully this will clear things up... Anyway, I sure did write a lot for my first post!  If anyone has any insights to Definity Health - TN insurance or anyway of getting around the 6 months of waiting, I would love to know more...  If anyone is in the Memphis Area, who did you use for the Psych Evaluation?

The 6 months is not about waiting. It is about showing the surgeon and the insurance company that you can adhere to an eating plan after surgery. I'm on my 2nd month and am so glad I have this time to prepare for what life will be like after surgery. The 6 months could be a favor to you. Try to see it positively. Karen

Unfortunately, there's no way 'round the 6 month diet. Many insurance companies require it. Hang in there! It'll pass before you know it. Takes this time to really talk to people and get a first hand knowledge of what you are preparing to do.  I'm just over a month out from surgery and not to scare you but the 1 yr and 3 mos i had before surgery wasn't even enough LOL  Kidding, mostly.  Believe me, you will be thankful for the time! God bless!

Hey Tooty! Congrats on the decision to have weight loss surgery.  It is one of the best decisions I have made in a long time!  Anyway, the 6 month diet is a great opportunity to start practicing the strategies and ideas that you will use after surgery.  So, hang in there and take it one day at a time! My wife is the only one I know who never had to do the 6 month diet.  Her insurance required documentation for 5 years of her being overweight.  During a couple of years she never went to the Dr. and insurance let her send in photos taken with a date stamp to show how heavy she was. Bad thing about that was she still ended up waiting approximately 6 months before she had surgery.  so who knows!   Keep us posted! 

I never had to do the 6 month wait either I did however have to show 5 years of being overweight.

I am curious why you are trying to circumvent the system. This is not a race it is a lifestyle change. Take each requirement as a challenge and charge full force but if you try to get out of doing things it will present its self the same way when it comes to exercising or eating. Besides whats 6 months compared to the rest of your life. You will have to take supplements for the rest of your life no way around that either. DO what you have to do and smile cause the end is near. Good Luck to you!

I didn't have to do the 6 month diet either. Neither my insurance nor my surgeon required it. I did have more than 5 years of documented obesity and weight loss attempts on file with my PCP. I also had my Weigh****chers membership book documenting 2 years of weight loss attempt. And, my PCP had put me on Meridia for the 6 months preceding the submission of my paperwork to insurance. So I guess I did have the 6 months of medically supervised weight loss attempt prior to surgery. I just didn't realize I was doing it. But, many things have changed in the 2 1/2 years since my surgery. Now many insurance companies and/or surgeons require the 6 months of documented weight loss attempts. Many surgeons also require all of their patients to undergo the tests you have mentioned. If it is your insurance or your surgeon requiring these tests, there is no way around them. Your surgeon may just want to make sure you don't have any of these conditions so there are no surprises during or after surgery. They may also be looking for co-morbidities that can be used to help obtain insurance approval. Like others have said, use this time to learn more about the lifestyle changes that go with the surgery. The better prepared you are going in, the better you will do post-op. This is not a quick fix. You will have to follow the post-op rules for the rest of your life, you might as well get used to following the rules now as you prepare for surgery. Good luck!!

Well, if you wake up gasping for air that is a sign that something is not right. Many people have sleep apnea. I was diagnosed with sleep apnea almost 5 years ago. Sleep apnea is a co-morbidity and if you have it you definitely need to be treated. Usually that means a cpap machine that blows air to keep your airway open. Sometimes the cause is anatomical or weight related or as in my case a combination of both.  I am 8 months post op and have had another sleep study a few weeks ago and am free of my cpap machine now. Hallelujah! If you think they have your records mixed up it doesn't hurt to check and see. That's just common sense. But don't be disappointed if you do have to do the 6 month wait.  Most insurances require this. As far as the medical test go, most surgeons require those tests if you have not already had them recently.  I didn't have to have a sleep study because I was already diagnosed.  They examined my air way prior to the surgery and put me on my cpap machine as soon as I was back from recovery. The tests are for a good reason, to see if you have anything wrong--they don't want any surprises during the surgery. You want the best outcome possible. Have you been for a consult with your surgeon? He or She should be able to answer a lot of your questions. The time will pass faster than you realize and you can use this time to help prepare you for the coming lifestyle changes you will have to make.

Congrats on starting the process for surgery. I hope you have get a speedy approval. I had to do the 6-month "diet" too. Uggghh. Bad thing for me is that I didn't know up front I had to do it for my insurance. So, I went through all the other requirements and tests - which took 6 months - only to find out I would have to do the 6 month diet. So, I had a huge delay. It is good you know up front. The truth is, it will take about 6 months to get through all of the tests and requirements and paperwork anyways so the 6 months will go by really fast. Just make your first appointment with your PCP really quickly to get the first weigh in done.  I would not count on getting out of the Sleep test or Upper GI. I had to do both as well. I didn't know I had sleep apena but I knew I was exhausted all the time and it turned out, that is what I had. So, it is just a "normal" test that some surgeons test for before approving surgery. As with the GI. You don't have to have "symptoms" sometimes and they will still do it. It only helps them in making sure they know what they are working with before they do the surgery.  So, hang in there. Get all of your tests, appointments, and evaluations scheduled and get started. Hopefully about the time you are through, your 6 months will be about up. At least for me (here in Nashville), it took a bout 5-6 months to get all of the tests scheduled and done. There was a wait for the sleep test and the psch eval.  Good luck and keep us updated.

Hey, Tooty! Congrats on getting your paperwork filed and starting on this journey! If I may enter my 2cents worth... I had never had a sleep study done, I had not been diagnosed with a sleep disorder, and didn't suspect that I had one. However, it was explained to me this way... MANY obese people have sleep disorders (sleep apnea being a big one). If you have sleep apnea, it means that you are not getting the deep, restorative, repair-ative sleep that you need. God designed our bodies in such a way that during our sleep cycle, our body is made to repair itself from the little bumps and bruises we went through that day. Surgery is a major BUMP!!! If you have sleep apnea and are not being treated for it, your recovery will be much, much harder! On the other hand, and this is verbatim what I was told, "If you are tested and diagnosed w/ sleep apnea, and can have it treated for at least 2 weeks before surgery, it will make all the difference in your recovery." I was tested and diagnosed w/ sleep apnea, started using a CPAP machine approx. 5.5 - 6 weeks before my RNY surgery and my recovery was a breeze!!!  You and your doctor have good reason to believe you may have sleep apnea. Having it diagnosed will not only help you get the approval from insurance, having it treated will help you more than you know when it comes to your surgery! (BTW - I no longer have to use my cpap machine either!) As far as the upper GI goes, it was explained to me that they do this test to know ahead of time the condition of your gall bladder. The surgeon wants to know if there is cause for concern w/ this when he goes in. If so, they can remove it at the time of surgery. The test is no big deal - the stuff that you drink tastes nasty, but, OH WELL! Follow your doctor's instructions --- they're for your own good. It's time to make healthier decisions all the way around. Take a deep breath and realize that instant gratification is what got us here to begin with. Steadfastness and patience and persistence are the new items on the menu! The good thing is - they're all SUGAR FREE!   :) ~ Tara

Hi Ms. Tooty, Welcome to the forum.  Your participation is greatly acknowledged and appreciated. 

I did not have to do a six month diet...  However I did have to complete a 10 % body weight loss.  This was truly hell and somehow I am able to look back over the past 18 months and thank God for those who were knowledgeable before me.  I have Blue Cross.  I could not have done it without the encourging souls here.  So please hang on sweetie....  This too shall pass.. 

I have lost 161 pounds and I weigh 116 pounds.  I am 5 foot 3 inches. I have been unable to have plastic surgery however I am working on that and my friend Shiela keeps me inspired to do so... She is my hero no matter how medicated she is.....LOL...LOL...... 

If you do not mind me asking , who did you receive the paperwork from?  Knowing that may help those that have traveled that road before you, give you some insight.  Or a curve ball if you will..