Need to qualify!
Can anyone advise on the order of the steps I should take to get approval for RNY?
I have a current BMI of 37 with no comorbidiies. I am not a candidate for lap band because of esophageal problems. I actually have Barrett's Esophagus, which is life threatening and considered to be precancerous, but the surgeons I saw previously didn't seem to think that would be a comorbidity.
In May and June of this year, I talked to my PCP and consulted with one group of surgeons, and then we were traveling for the summer. In the spring, I had a sleep apnea test, which was normal, bloodwork, which was mostly normal, just borderline cholesterol.
My insurance (Carefirst in VA) actually has some weight charts from MetLife that show a range of weights and the policy online states if more than 100 lbs above weight range. So the medium build range has a high weight of 147, meaning that if I were 247 I would qualify, right? No one has ever declared me small, medium, or large, but whatever. 247 is a bmi of like 38. So then I'm there?
Anyhow, I don't know if I should pursue this at current weight, or just forget about this for now and revisit if I develop comorbids or gain 20 lbs? I have an appt with PCP next wed to begin medically supervised diet just in case, but again, I don't really qualify (I *think*) at this weight. If a surgeon would fight for me, it might happen, but I wanted to get the ball rolling on this.
I would consult with another surgeon, and don't think I could get an appt until October. In the meantime, I don't know what I should do about my weight/eating. When I'm restrained, I hang out in the 230s. If I don't give a darn, I can easily go up to the 240s and hit the 247 I'm seeing in my insurance info (although I have NEVER read anyone being approved from a chart and not BMI).
Sorry for the rambling, but I guess my question is this: What would you do at this point?
-Proceed at current BMI and do supervised diet?
-Forget this all for awhile and do what I need to do to get up to a higher weight before I begin supervised diet?
-See surgeon first at current weight before beginning diet?
-See surgeon at higher weight before beginning diet?
If my PCP documents a higher weight and I am able to lose some on supervised diet, hence knocking me out of qualifying range, is this a problem? Do I need SURGEON to document highest weight or PCP to do so?
I have a current BMI of 37 with no comorbidiies. I am not a candidate for lap band because of esophageal problems. I actually have Barrett's Esophagus, which is life threatening and considered to be precancerous, but the surgeons I saw previously didn't seem to think that would be a comorbidity.
In May and June of this year, I talked to my PCP and consulted with one group of surgeons, and then we were traveling for the summer. In the spring, I had a sleep apnea test, which was normal, bloodwork, which was mostly normal, just borderline cholesterol.
My insurance (Carefirst in VA) actually has some weight charts from MetLife that show a range of weights and the policy online states if more than 100 lbs above weight range. So the medium build range has a high weight of 147, meaning that if I were 247 I would qualify, right? No one has ever declared me small, medium, or large, but whatever. 247 is a bmi of like 38. So then I'm there?
Anyhow, I don't know if I should pursue this at current weight, or just forget about this for now and revisit if I develop comorbids or gain 20 lbs? I have an appt with PCP next wed to begin medically supervised diet just in case, but again, I don't really qualify (I *think*) at this weight. If a surgeon would fight for me, it might happen, but I wanted to get the ball rolling on this.
I would consult with another surgeon, and don't think I could get an appt until October. In the meantime, I don't know what I should do about my weight/eating. When I'm restrained, I hang out in the 230s. If I don't give a darn, I can easily go up to the 240s and hit the 247 I'm seeing in my insurance info (although I have NEVER read anyone being approved from a chart and not BMI).
Sorry for the rambling, but I guess my question is this: What would you do at this point?
-Proceed at current BMI and do supervised diet?
-Forget this all for awhile and do what I need to do to get up to a higher weight before I begin supervised diet?
-See surgeon first at current weight before beginning diet?
-See surgeon at higher weight before beginning diet?
If my PCP documents a higher weight and I am able to lose some on supervised diet, hence knocking me out of qualifying range, is this a problem? Do I need SURGEON to document highest weight or PCP to do so?
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