this just in...

An update on the surgery:It's been over a year since I've seen a cardiologist, so I have to go see one and get a clearance. I go see him on the 30th.The one I saw in the past is on LOA, so I've found another. I hope he says yes!And since I lost some weight, then put it back on, Dr. Green's nurse suggested I have my PCP write a letter to send to Medicare as to why it's almost impossible for me to lose weight and keep it off. I took care of this today, now it's up to her to get it over to the surgeon'soffice. STAT!!! I'd love to grab the Medicare ppl by the whatevers and explain to them how absurd it is to require someone who's lost weight in the past, then regained it plus, plus, to lose weight SO THEY CAN HAVE WEIGHTLOSS SURGERY!!!!!!!!Once again there's our gov't for you!
Is it me or is it normal for the powers that be, to keep finding things you need to do to try our patience?

Yay that you're seeing another cardiologist.  And I know that it seems absurb that the insurance companies want us to lose weight before they will approve us having WLS to lose weight.  I mean are they testing us to see if we can actually lose weight?  Are they trying to get me to prove that I really want this?  Have me get used to eating healthy?  I mean really?  What is it?

Well, my surgeon actually gave me a very clear medical reason as to why we should lose some weight before WLS.  For Gastric Bypass surgery perfomed laproscopically, it greatly reduces the risk factors in the surgery if we lose 10% of our body weight before surgery.  Here's why:  the portion of the stomach on which they perform the surgery is physically underneath the liver.  When we are obese, our liver is greatly enlarged making it more difficult for the surgeon to navigate underneath it laproscopically.  So if we lose 10% of our body weight before surgery, it will shrink the liver enough to greatly reduce the risk of the surgeon having to open us up and do an open surgery.  Open surgeries bring in much great risk of post-op infections.

I hope that helps explain it for you.  It really does help reduce the risk and make for an more seemless surgery and better recovery for us post-op.

Insurance approval seems like a long and convoluted process to most people. Once you understand what they are doing, it becomes clearer why you must go though this. I agree that pre-op weight loss is critical for lapriscopic surgery. Reducing the fat around the liver makes the surgeon's job so much easier. Insurance approval is about looking at your case against the standards your insurer and company's insurance policy has in effect. You should be able to get a copy of the requirements for WLS on your policy. The tests and appointments with cardiologists, psychologists, PCPs and such are all about seeing how you fit into the established criteria. It may seem like a roadblock but it is a safeguard too. They must be sure that your are a suitable person for surgery and healthy enough for the surgery. Good luck! Tom

thank you for the support.
I understand about the liver, and I have lost some weight, but, surprise, surprise, some of it found its way back.
You'd think the liver would be more understanding and say, "Oops, sorry I'm in your way. I'll just wait over here until you're done."
Inconsiderate organs!!!!
So, I went to the cardiologist and had an EKG, and now I have to have a couple of more tests. Ain't getting old fun?
I just hope I don't have to pay a lot out of pocket. Or they'll let me pay with a payment plan.
Other than that, I'm waiting on the insurance to say yes, and then no more waiting.