how about if you haven't been to a doctor in....decades...

I'm about to begin my search for a PCP. I haven't had a physical check-up since I was a kid in 1984 and there's only one reason for that: Scale Phobia. Even then I had my mom ask the doctor not to put me on a scale.  I tried to get thin BEFORE seeing the doctor (or doing almost anything else in life). I was watching that PBS documentary about FAT, and there was a segment about how women got breast cancer because they did not want to go to the doctor and get weighed and be scolded. For me, being scolded and being told you should do almost EXACTLY what you have spent your life doing is far more infuriating and frustrating than any hateful remark, dirty look, or smartass hint shoved in your face. I wasn't on a scale once between November 1981 and September 1997. And since 1997 I've only had three or four periods where I got on the scale for a couple of weeks and was in sheer misery and just immobile, not wanting to exercise or do anything and for two weeks I'd eat three times what I normally eat - after all, dieting never helped. Then I'd put those cheap Little Debbies away, get back on my Stairmaster, shove the scale aside for years and tried to forget I saw those numbers. I can't live or work or be active, period, when I accept them. But I'm much older now and not as easily hurt, I don't think. I've gotten on the scale again for the first time in three years, have cried my buckets of tears, done the self-flagellation bit, pulled myself out of my 2-week 'post weigh-in eating binge' and got my butt back on the treadmill this morning for an hour and 15 minutes. I'm accepting the bloody numbers and therefore accepting outside help, and I'm ready to see a PCP,and I'm willing to do this ridiculous 6 month medically supervised plan that is a big waste of time and money. But there again is the problem of years of documentation. What I HAVE instead of years of medically supervised diets (unless childhood counts), are exercise equipment receipts and manuals and family photos and home movies. I found my 1998 stairmaster receipt the other day. I still have my treadmill receipt from a month ago as well as the tread itself. I had 1-800-got-junk haul off my stairmaster a couple of months ago - it conked out for good in March - but I kept the console and the optional cushioned pads you put on the foot pedals. I never cleaned the pads. Wonder if the dirt and grime in between the grooves of the pads from years of labor, 6-7 days a week, 45 minutes a day (with the exception of four 2-3 week periods when I was out of town)  - would be sufficient proof with the insurance company? I also found old bike and exercise bike manuals. I wish I had my Jane Fonda's workout tape I used in high school. I have photos of me on the basketball team as a kid and home movies of me playing basketball. I have proof of some of my exercise efforts at least. I don't have much diet proof - I never did Nutrisystem or Jenny Craig - I did Weigh****chers as a kid. I was in the school of eating fruits and vegetables and under 1500 calories a day and also fasting and throwing up. Maybe I can find my childhood doctor's records as well; he had me on all sorts of diets that failed when I was little. My dad died recently, and I've been feeling sentimental, I put together a family photo album and dug up hundreds of photos of me as a spoiled fat little girl and also had transferred to dvd some old Super 8 movies my dad made. 99% of those movies are unfortunately of me. In them I am having fun at around 2 through 8 years old, fat as a pig but happy because I do not know any better, and then the older I get, the more self conscious and unhappy I get, and the last film was of me about 11 and in McDonalds and upset because of the latest person who called me fat. My dad thought it was cute - that's why he filmed it. But it was the beginning of decades of pure pain for me. So my question is,  does anybody think that those exercise equipment receipts/manuals, family photos/home movies , as well as photos of scars from my breast reduction surgery I had when I was 16 years old (one of many radical attempts I made to be thin) meet the "years of documentation" requirement when I am seeking insurance approval? That's in ADDITION to the 6 month plan. I know every insurance company is different - I have Blue Cross Blue Shield of Tennessee. But if somebody who had not been to a doctor in years can tell me what happened to them, that would be great. Oh, and one more question, should those of us who do not already have a PCP find a PCP first or the bariatric surgeon first and let the BS recommend a PCP. Thanks!

It is my understanding that BC/BS will NOT accept anything less then the 6-month physician supervised diet (that mind you is based on the recommendation of a nutritionist).  We have BC/BS PA (for UPRR employees) and they require, the 6 month diet plan, dietician consult, psych eval, and letter of referral to surgeon (eventhough our plan does NOT require PCP referral to any specialist).  So, my advice to you is to find a WLS friendly PCP as soon as possible and get the ball rolling.   I will complete my 6-month BS on Monday and then on Friday I have my initial (yes, the very first) visit wtih Dr. Anthone.  When I started thsi process after I hung up from making my initial PCP appointment, I then called BC/BS and asked then to mail me the portion of the policy that related to WLS coverage as well as asked them to read it to me over the phone (I am on the impatient side of life).  That being done, I got on here and began my quest for knowledge and the "perfect" surgery for myself.  Paul from Dallas has been an INCREDIBLE help and was willing to share his wealth of knowledge.  I have assisted my PCP by summerizing my monthly appointments (which end up being 7 trips to docs office) and also having all of his dictations sent to me upon completion in case there are any discrepancies that need to be addressed.  It seems that as long as you have your "ducks in a  row" that BC/BS is less stringent than some of the other insurance companies. I do not know which surgery you are considering, but my PCP had little information about the DS which is what I have chosen to go with.  He has since gone to the physician's seminar and then met with Dr. Anthone so he is more informed than his patient.  The surgeons in this area (midwest) that perform the DS do require all new patients attend the informational seminar prior to making an appointment with them.  For myself, I failed to see why I should go to the surgeon for a surgery consult until I had everything completed to pacify BC/BS so that the surgeons office could submit my pre-approval packet with everything intact.  I did not want to give them a "freebie" for a denial due to the lack of completion of the 6-month physician supervised diet (and I cannot stress that you cannot miss a month, the BC/BS rep flat out stated that if you failed to make it to an appointment one month that it would void out previous months as being part of that 6-month diet and you started over at square one). As I said I have not been to the surgeon nor have I received an approval from BC/BS, but from everything I have read and have had confirmed by BC/BS it seems to be very valid information.  Good luck on your journey and hang tough with those weigh ins....they are crucial for insurance approval. 

Hi Michelle, Thanks for your help. I think the course you've taken is the right course to take. The 6-month plan doesn't worry me - I'm not happy about it but I can do it. My chief concern is the YEARS of documentation; in fact I'm worried now more than ever and can't believe how stupid I was. I sat down last night and went through all pages of the insurance forum and read all the posts that discussed the 5-year-history. If that is a requirement I don't have a chance! So stupid of me to think my exercise equipment receipts and family photos count as good documentation. And stupid of me to think I could play the childhood obesity card although I truly believe that if you are born fat and fat every year of your childhood you're basically screwed metabolically speaking for the rest of your life. Well, I'm sure of one thing. Like you said, I need to get to the PCP and get the ball rolling and get on this 6 month plan regardless. I'm not even sure what I weigh, to tell you the truth. My scale was a Taylor dial scale and an old one and it teeters between 240 and 260 - it's probably broken from years of kicking it. Then I got a superbright red digital scale from Walgreens - also a Taylor - and it said 230-237. And I got on a cheap Healthometer floor scale at Walmart and it said 215! Then I splurged and got a Pelouze scale with the remote display so I don't bend over and mess the numbers up, and it goes back and forth all day between 241 and 243. That sounds about right. So I don't qualify unless I have comorbidities or unless I'm shorter than I think I am. I always thought I was 5'8" but lately I get 5'6". And what if I have muscle - all those years of working out I must have something to show for it, especially if my calves are hard as rocks - so I need a PCP just to get my stats straight!!! I wish I could just afford to go away by myself and not work and stay on a beach for a year. I'd get it all off then! (but would I maintain it?) Roxie PS: Yes, I was reading Paul's posts, too, and he seems like a very smart, thoughtful man. And, like you, the duodenal switch is what appeals to me the most - from what little I've read so far. I wish I could find a book SOLELY about it. But I think I'd take anything I can get. :-) I'll cross that bridge if and when I get to it. Thanks again for your help.

Just one more thought,,,, our policy does NOT require the 5 year documentation just the 6 month BS, so maybe yours does not either (I don't know if you have that info yet or not), I also worried about that, pretty much the only time they weighed me was when I was prego.  And truely, the 6 months fly by, it seems like yesterday that I truely investigated this and got the ball rolling.  Good luck.

I have BCBS of AL and had a similiar problem.  I was missing weights for 2 of the 3 required years.  I took camera dated pictures to my PCP and had her write a letter of authenticity.  That is what BCBS of AL requires.  I'm not sure about in your state.  They told me I had to have dated pictures with a letter from my PCP.  They wouldn't even accept my weights from ER records from that year.  They thought it was a stated weight rather than an actual weight. Check with them before starting and you'll know what you need.  That's the best way!   Good luck on your journey, Vicky

Whew, that's a good sign,  I'll find out when I talk to my insurance. Thanks, Michelle, And thanks, Vicky, for that suggestion about the letter of authenticity. That's a very good idea. It will be hard to find photos from recent years because I think I deleted them from my PC, but I'm sure I can dig something up - if nothing else, I have Sams Club and drivers license photos. Obviously I'll have to have a chit chat with my insurance. But first step is finding a PCP. Thanks again for all your help

My BCBS of Alabama required that the dates be camera stamped on the photo.  Then had to take the pics to my PCP and have her write a letter saying these pics were a respresentation of my weight for that year.  I'd check with the insurance company and ask them what they will accept in place of missing medical records showing your weight.  That's the safest way so you don't get disappointed.  Been there, done that.  Not fun.  Good luck to  you!