Any Teachers? Did BC/BSAL Cover your WLS?

Hey y'all!

I'm working hard to get this done, since I've had a couple of scares recently.

I've had a little time to get my application packet and choose a doc and a WLS (Dr. Dennis Smith, and BPD/DS, I hope, pending insurance).

A couple of weeks back, I had the WEIRDEST thing...my right leg below the knee blew up like a balloon to about twice the size of the other one.  The calf was discolored, a dark reddish brown, and was painful for a couple of days.  It was getting better, but about a week later, I wore shorts in front of the wife and kids (19, 17, and 13) and they freaked and insisted I go to the ER.  Never found anything, did ultrasounds, but no DVT or obvious blockage.  They gave me antibiotics and told me to keep it elevated.
I did a little symptom sleuthing on tha intarwebz and the only thing that matched this and the weird lingering cough I've had for a month is PPH.  Boner on the Men's Forum said it might be Diabetes-related edema.  In either case, Holy guacamole, Pancho! :eek:

It doesn't help that since mentally deciding 'yep, I guess I'm having WLS', I've eaten like a PIG and gained about 40 pounds in the last 2-3 months...(please call me dumba$$ as needed).

Which leads me to my next 'stream of consciousness' stupid question...is there any advantage to being at my heaviest possible when I first consult for this? I'm 6'0" and usually bounce between 335-350.  I'm 375 right now, and have NEVER felt so short of breath, tired, and old.  I've been borderline diabetic for a couple of years, well controlled with lowered carbs...but I'm really feeling the glucose/insulin ups and downs pretty heavily at this point...
I'm thinking it might be in my vested interest to get some weight off NOW!!! duh...

And finally, (feel free to PM if the urge strikes) any advice for me in trying to push DS through my BCBS of AL insurance?  I know there are so many different stories here on OH, that surely someone may have been through approval with DS and/or Blue Cross/Blue Shield
(LeaAnn and I are already talking and strategizing)...

Thanks,
Dan

I had BC/BS AL through UA.  All I can tell you is that it took 18 months and first I had to enter a regular weight loss program.  Unfortunately my PCP made some mistakes and I had to start over twice.  Now, you must weigh in with the PCP each month and have him take blood pressure, height, weight, etc.  I would recommend that you consult with a dietitian and get a food plan and counseling from her that you can document in your medical record.  That you must do a weight loss program for 6 months...which really translates about 8 months in something like Weigh****chers.  And your PCP has to document that he saw you and discussed your progress and diet at each meeting...and saw you once a month....it has to actually be spaced out one month a part, too, for the whole 8 months basically.....in other words you start on a date, the end of that month counts as 1 and then you do 6 more visits and then a final visit before he recommends you to BC/BS.  Then most likely they will deny you and you will have to appeal before you get the ok.   But they paid for all my surgery, but I had to pay for the copay on the dr. visits, the dietitian, the Weigh****chers meetings, the psychological, and the copays on all the screenings.  I would say that it cost about $2000 out of pocket totally...but it was a little at a time.

Thanks, Skydancer!

Long story short, I should settle in for the Long Haul in order to jump through all the hoops and 'check the boxes', huh?

That's fine.  I can make it.  One small step at a time. 

Hi Dan,
Welcome to the Bama Board!! Congrats on making the decision to get healthy.. this will be the best thing you have ever done for yourself!! Jump through them hoops my friend...it is so worth it!! Hope to see you posting more!! Have a Wonderful BLESSED Day!!
MicheleLuv

Thanks Michele!
 
I am determined to make this happen, one way or another.  I really appreciate your support!
Hoping some more teachers will 'weigh in' for me about their experience with WLS and BC/BS of AL!

Dan