So disappointed..39.84 BMI

ladygodiva1228
on 3/28/17 5:38 am - Putnam, CT
Revision on 02/04/15

You wouldn't be laughing if Medicare found out what you did and turned around and billed you for 100% of the surgery. That would suck having a 50K or more in medical bill.

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

H.A.L.A B.
on 3/28/17 12:17 pm
On March 28, 2017 at 12:24 PM Pacific Time, VSGAnn2014 wrote:

And now for a different perspective ....

During my first appointment with my surgeon, I qualified for WLS in terms of my BMI. I had 3 qualifying co-morbidities and a BMI of 39 and change. (I was insured by Medicare / Medicare supplemental, which requires a BMI of 40 with no comorbidities or 35 with 3 qualifying comorbitidies.)

However, I could not wait to get my own weight loss show on the road prior to my WLS, even before the surgery was scheduled. So I started losing weight slowly on a 1400 calorie/day diet of my own design, modeled after what I was learning about eating post-op.

But I was very concerned that my pre-op weight losses might endanger my eligibility for surgery.

So ... I bought a couple of ten-pound weight belt, the kind that have half-pound weights that fit into little slots on the belt. And at subsequent pre-op surgery appointments I tucked those weights into my bra, pockets, underwear, etc.

BTW, I lost 11 pounds on my own prior to losing another 8 pounds on my doc's own pre-op liver-shrinking diet.

Today, two years and eight months post-op, I've lost 100 pounds and have maintained that weight loss for the last 15 months.

Yeah, I'm just ridden with insurance fraud guilt!

if the 2 10 lbs weight allowed you to have the surgery - that is an insurance fraud. I am not sure wt you posting that in an open forum?

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

VSGAnn2014
on 3/28/17 2:46 pm, edited 3/28/17 7:47 am
VSG on 08/14/14

FTR, I lost 11 pounds on my own diet pre-op, putting me at a BMI of 37.1 before my surgeon-required liver-shrinking diet. That was well within the Medicare / MC supplemental requirement of a BMI of 35 + 3 qualifying co-morbidities.

ANN 5'5", AGE 74, HW 235.6 (BMI 39.2), SW 216, GW 150, CW 132, BMI 22

POUNDS LOST: Pre-op -20, M1 -10, M2 -11, M3 -10, M4 -10, M5 -7, M6 -5, M7 -6, M8 -4, M9 -4,
NEXT 10 MOS. -12, TOTAL -100 LBS.

CerealKiller Kat71
on 3/28/17 5:26 am
RNY on 12/31/13

I am anti-insurance fraud, too -- but seriously, you are literally a large glass of water away from the needed BMI. Additionally, if you have sleep apnea, you will have a serious co-morbidity. I do not think all is lost.

"What you eat in private, you wear in public." --- Kat

PCBR
on 3/28/17 2:46 pm

Lol, I know! I'm like, if i wore a sweater and a chunky necklace and drank a cup of water in the lobby, I would not have this headache. C'est la vie!!

Gwen M.
on 3/28/17 5:27 pm
VSG on 03/13/14

Or hadn't pooped prior to the appointment. It seems like your doc should have just rounded up. Ugh!

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

HonestOmnivore
on 3/28/17 5:53 am
RNY on 03/29/17

Welcome to the boards!

I'm an auditor who works with (not for) Medicare and Medicaid compliance for the hospital system where I'm having my surgery. I knew I was skating the 35bmi with my comorbidities of high blood pressure and sleep apnea. This past summer I gained some weight without intending too, just crept up to the magical number for me (206lbs) so I decided it was a sign from the sugar gods that I make my appt with the barbaric center and find out if I qualify.

My health insurance is also "home turf" or employer funded. I was told that if I dropped below the 205 range prior to the end of the physician supervised diet it might mean I wouldn't be approved. I complied to the diet by documenting every bite, sip, nibble of food I ate for three months, while getting the other testing and meeting taken care of. At the final per-insurance weigh in I was 206. To help ensure I might make the weight, I did not use the restroom prior to the weigh in and I wore an outfit that was a little heavier. I know people who just kept their winter coat on, or forgot to remove a bottle of water from their coat pocket.

My diet physician told me to enjoy the Christmas holiday (final weigh in was mid January) but to make smart choices. Bottom line, I met the standards and I'm having my WLS tomorrow. I didn't gain weight to meet the requirements, nature simply took it's course for an almost 50 year old female, I just leveraged it to make a long term change.

5'4" 49yrs at surgery date

SW - 206 CW - 128
M1 - 20lb M2 - 9 lb M3 - 7 lb M4 - 7 lb M5 - 7 lb M6 - 6 lb M7 - 4 lb M8 - 1 lb M9 - 2 lb M10 - 4 lb M11 - 0lb M12 - 3lb M13 - 0 lb M14 - 2 lb M15 - 0 lb M16 - 3 lb

VSGAnn2014
on 3/28/17 8:26 am
VSG on 08/14/14

Congrats and good luck tomorrow! It's a great, great tool.

ANN 5'5", AGE 74, HW 235.6 (BMI 39.2), SW 216, GW 150, CW 132, BMI 22

POUNDS LOST: Pre-op -20, M1 -10, M2 -11, M3 -10, M4 -10, M5 -7, M6 -5, M7 -6, M8 -4, M9 -4,
NEXT 10 MOS. -12, TOTAL -100 LBS.

PCBR
on 3/28/17 4:28 pm

Thank you and best of luck!

Highfunctioningfatman
on 3/28/17 9:34 am
VSG on 08/29/16

A agree on not doing fraud. Like mentioned you are jus****er weight away. That and a bowel movement could make the difference. Heck even if you had something salty you would be retaining water. I'm not suggesting that you do these but I am pointing out that on another weigh in you might be there.

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