Brand New- tons of questions

Hi,

I'm Michelle and had my very first appointment with the bariatric center today. I am 5ft 0 and they weighed me at 190 lbs today. I was a chubby child, through my teenage years, and worked through my late teens and early 20s at maintaining a healthy weight. I come from an obese family and I didn't want to have the issues that they have. My aunt broke down and had the surgery 15 years ago. My mother hates doctors and I watched her weight continue to climb. Last year, she was diagnosed with diabetes. She already has high cholesterol and other issues. She's been told she will have a heart attack if she doesn't make any life changes but she hasn't done anything to improve her situation. I have 6 kids and maintained a healthy weight during and after my pregnancies. After my tubal ligation 5 years ago, nothing I do works. I have continued to gain weight and I have a small frame. I'm at a low point in my life at 190. I'm almost 4 times the pants size I was in high school. I have ZERO energy and that makes me sad for my kids. I'm pre- diabetic, not diabetic. I'm wearing stretchy dresses all the time because shopping for jeans causes true anxiety. My husband is really supportive but he is the type to not say anything about me gaining weight. 

So, after mom called last month and said she is having nerve issues, I made the appointment. They said my BMI is just over 35 and since I'm not diabetic, I don't have any co morbidity. They want me to work with the nutritionist once a month, for 6 months and have ordered what seems like a million tests. Thyroid, an endoscopy even though I had my gallbladder out already, a sleep study, etc. I don't think I have sleep apnea but they wanted to test. It all feels like so much at once, especially if I may not be a candidate for surgery. Was anyone else this overwhelmed when they began the process?

The process can be overwhelming. Lots of steps and hoops to jump through.  But I think in the end its good because it gives us time to get used to the idea and make the necessary behavior changes.  Does your insurance cover WLS?

The doctor said my insurance may cover it if any of the tests come back with a comorbidity. He didn't like that I smoke and said he won't even do the surgery until I have 2 months quit. My heart rate was 124, which he said is high. I've never been told by any other docs that I had any heart issues. The bariatric doc ordered an EKG and echo and said I need to go get those next week. If there is something wrong, I don't now if they'll do it even if insurance will cover it. 

If it turns out you have sleep apnea, that is then a co-morbidity they could use to get the insurance to pay for it. I put the numbers you gave into a BMI calculator and it said 37.1, so if there are co-morbidities then you very well you will qualify... so tests to see if there is anything they can use and many of them you would need for the surgery anyway. Good luck... and yes it is overwhelming...

I also advise you to call your insurance company yourself to verify that bariatric surgery is covered.  Many policies specifically exclude it.  I've seen people write on here that their doctor said it would be covered only to find out later their insurance excluded it.  If you have mild sleep apnea it would actually be helpful to you as the previous poster mentioned.  Just take one step at a time.  You know what they say about how to eat an elephant...just one bite at a time.

Hi Michelle!

Most insurance companies have a LOT of hoops to jump through before having surgery. Everyone's insurance varies, so the first thing to do is to call the customer service number on the back of your insurance card for information on their requirements. Most plans seem to require comorbidities for BMI 35 - 40, and they can usually give you a list of ones that "count" (some plans consider joint pain, others no, etc.).

It's completely possible that you DO have a comorbidity that hasn't been diagnosed yet. My surgeon said over 80% of his patients have sleep apnea, but many of them don't find out about it until they have a sleep study.

Making lists helped me a lot when I was early out in the process. I wrote down what my insurance company wanted, what tests and documentation I still needed, and questions I wanted to ask. I made a spreadsheet on Google Docs and it helped a TON. Maybe a notebook or worksheet would be helpful for you?