Worrying Too Much!?

I'm pretty new around here and I guess you'd say I'm still in the "research" phase of my journey to lose weight (about 150 lbs.). I've been reading posts here, watching YouTube videos of people who've had WLS and trying to learn as much as I can about all aspects of the process. There's an 18 month waiting list to get an appointment with the surgeon for patients with my type of insurance which is NC Medicaid and I just finished reading their requirements for the surgery. Now I'm worried that once I get an appointment with the surgeon, I won't qualify. My BMI is over 50 and I have several obesity-related illnesses (diabetes, high cholesterol, high blood pressure, sleep apnea, etc). My diabetes and high blood pressure are well controlled with medication (I take 5 insulin shots a day, 2 kinds of medication for the high blood pressure and cholesterol medication). My diabetes lab work has been near perfect recently. I'm terrified that my primary care doctor won't write a letter of medical necessity, although I was referred to the Weight Loss Center by my endocrinologist and not by my PCP. Does the letter need to come from the PCP or the endocrinologist who made the referral? Does anyone know? If my obesity-related illnesses are well controlled will I be turned down for the surgery? What do I need to do in order to qualify for WLS? This is driving me crazy! I've gone from being excited to a nervous wreck! That's why I'm up past midnight and can't sleep! Help!

Step aaawwwwwaaayyyyyy from the ledge!  That's it... now another step. AAAnnnnddd another. Take a deep breath. You are throwing out the baby with the bathwater. 

Why are you worried that your PCP won't write your letter of medical necessity? This person is working for you, not the other way around. I had a doctor years ago try that on me. I don't think he realized that he was dealing with a woman on a mission. 

With all your medications, you are a prime candidate for surgery. But this is going to be a while away. In the meantime, start by slowly cutting out sugar, carbs, etc. One item every 2 weeks and replacing it with a healthy alternative. Learn about proper nutrition. Start walking. 

And I am going to suggest something else... therapy. If you are on Medicaid, you can be referred to some therapy session. This will help teach you how to deal with stress rather than eating your stress. Learning new habits, dealing with the consequences of those new habits, and finding close support around you is the key to long term success. 

One day at a time. One step at a time. 

You'll do fine. I swear. And it will be worth it.

At your BMI and with your comorbidities, you are a poster child for WLS. Any doctor that wouldn't write a letter for you is an idiot.

You may think your issues are controlled with medication, but they aren't. You'll need more meds as time goes on, and they'll never fix you, but surgery could.

The referral depends on your insurance. My cardiologist recommended the surgery to me but insurance still needed the referral to come from my pcp. I just called them and they sent it over. I never had an appointment with her specifically about weightloss but she sent it right in. Like someone said before your pcp wants you to be healthier and less medicated. Just talk with them. 

Thank you all so much. You've given me some very wise, sound advice. I'm trying as I type this to get to talk one on one with my PCP. I plan to talk to her very candidly about why I want the surgery. I think if I present my case from the standpoint that I want to be healthier and not risk having a heart attack, stroke or cancer (I have a lousy gene pool), she'll be on board. I want to not have to be on so many medications--I take 13 kinds and I'm only 43 years old! I want to get out and do some fun things like hiking and bicycling, maybe even jogging. I feel like I've spent half my life watching everybody else live and do the things I've always wanted to do and while I've still got some good years left, I want to be able to get out there and have some fun for a change. Right now even showering and grocery shopping are things that I have to recover and rest from and I don't want to get in worse shape! So I'm going to talk to my PCP as soon as I can!

Dietwise, I have eliminated sugar (except for fruit). I've quit drinking sodas and I eat mostly chicken, salads and fruit. I haven't had fast food in about a month. I am doing a little exercise, but need to do more. My blood sugars have been great. I feel better than I've felt in a long time, but I keep losing and regaining the same 20 lbs. and I'm tired of the yo-yoing that I've been doing the last several years.

I look forward to forming friendships here at OH. This is an excellent resource for support and information! Thank you all again!

When I went to my PCP to start the process for WLS he gave me really hard time.  He told me I don't need to have the surgery I've lost weight before I could do it again, etc.  I told him thanks walked out of his office and found myself a new PCP and he was my PCP for at least 15 years.  If your Dr gives you a hard time maybe you too need to find a new one

         You have made a lot of good starts,  I would cut the fruit eaten, in half.Make sure you get some carbs, you must have carbs to utilize protein.

       You should not have to convince your medical person to assist you. If your present one will not get on board, find another PCP. Your medications alone justify the need for surgery, you should be able to come off most of those within months. That will save the medical system much money, they should work you in to reduce medical expenses....just don't expect them to. 

     Do deep breathing exercises and isometrics at night to help you to build your lung capacity and build muscle mass. This will help you loose weight as well. 

    If you want something sweet I have just found the organic brand of stevia, a natural sweetener that is diabetic safe and zero calorie.. it is pyure brand and tastes very similar to sugar, but you require much less to adequately sweeten. It should be good for making homemade sweets so you can have some treats that are diet safe. It is stable in cooking.I use stevia to make jelly/ syrup with so my blood sugar does not plummet. That way the only sweetener is what is in the fruit.

You are a poster child for "Metabolic Syndrome".  Discuss that with your PCP.  

I can not imagine why your physician would not agree to provide a referral.

Good Luck....get ready for the loser's bench

Thank you! I'm ready to get in the game! 

What is Metabolic Syndrome? I'm not familiar with it.

My PCP had seen many weight loss surgery failures.  People would not follow the food plan, still lose their weight and then gain most of it back.  He still gave me a reference to a surgeon and is happy that I did what I needed to do to make the surgery work for me.