BCBS of TN

Hi Sharon,   Yes, we talked a couple months ago. I was going to Dr. Madan. He has just left & gone to FL. He is a excellent surgeon but they do not help you get approved. I told you I was thinking of going to Dr. Weaver. Several on here love her. Is the in. commissioner in Nashville for BCBS or all insurance? Thanks Ellen

Bonnie (Or ANYONE that has knowledge that will help me know what to do and give my hope that I can get the Gastric Bypass),

I know your post was many years ago, but I am hoping you will still receive this message! I am 37 years old and I had major spine surgery 4 years ago at the age of 33 years old. I had 8 ruptured discs in my neck and back. I had a spinal fusion in c/6 and c/7 and then a spinal fusion in T2-L2 with 23 screws and 23 rods, 8 discectomies, and laminectomy of the spinal covering. I have always had problems with my weight and yo-yo dieting. I weighed around 180 pounds when I had my spinal fusion surgery. That surgery was traumatizing to my body and my mind.... It was the most horrific surgery I have ever been through! I have Fibromyalgia so when they cut through all of those muscles in my back it devastated my body!! I have never recovered from that surgery. As I laid on the couch for months and months which turned into years along with taking high doses of Lyrica caused a significant weight gain! I gained 100 pounds so I now weigh 280 pounds and I am 5'8 making my BMI a 43! All of this extra weight on top of my spinal fusion has given me chronic pain that I have to manage with narcotic pain medicine. The pain medicine causes my acid reflux to be much worse as well as shortness of breath and wheezing and constipation. I have Osteoarthritis throughout my body, I tore the meniscus in my right knee and had to have it repaired in 2007, I have degenerative disc and joint disease, I was hospitalized the day after Christmas in 2012 for Strep Throat that was so severe and my health is so bad that I couldn't fight it off and get rid of it!! I am trying to heal now from a Tibial Stress Fracture in my right leg caused by all of this excess weight weighing down on my knees, I had a stress fracture in my left foot/ankle from the stress of the excess weight as well. My vitamin D level has been scary low many times over the last few years. One lab test showed that my vitamin D level was a 4! I am currently taking a prescription of 50,000 IU Vitamin D for a year to keep it at a healthy level. As you can see I have many comorbidities and my BMI is 43. I want to get off of the narcotic pain medicine as well because it scares me to be on something that will eat my organs up long term including my heart! :( Heart disease runs significantly in my family as well as lung disease. I already have heart palpitations, chest pain, severe shortness of breath and a constant wheezing/whistling sound, excessive sweating and high blood pressure (not on medication for this, but it's high at a stage 1 hypertension level).... Oh and my back does not bend anymore because with the fusion my spine is just one long bone now. With it not bending and all of the weight I carry on the front of my upper body I feel like I am trapped in a straight jacket unable to move!! I struggle to get up from sitting down or get up from bed. I have to roll over to the side to get up! All of this is constantly making me strain my back muscles and my Sciatica. It's just awful!! I really feel that I might actually be able to be less disabled if I can get this surgery and get the weight off. As far as insurance since I am on permanent disability I am on Medicare. I have a supplement insurance which is Blue Cross Blue Shield of TN- Blue Advantage (Garnet) Do you know any of the requirements for this insurance? I know that my plan does cover the Gastric Bypass surgery. Do you know if I have to wait the 6 months and all of that? Any information that you can give to help me would be more than appreciated!!! Thank you so much.... :) April 

 

First, have you met with the surgeon's office? They will call your insurer and get it in writing what needs to be done. If you are on disability and Medicare is your primary, then yes, you doo need to do a 6 month medically supervised diet. Medically supervised. Your surgeon will set you up with this. Go to the doc and gather all the information. Six months is over before you know it. It's been 9 years for me this year! Still so glad I went for it! Good luck!

Bonnie,

I have my paperwork from the Doctors Diet Program that documented my Weight and BMI each visit and shows that even with that diet and the Phentermine I couldn't lose the weight. I did that for more than 6 months. Would that take the place of having to do another 6 months of a medically supervised diet?

I noticed how old this post is but was wondering , do you know the bcbs of Tennessee requirements for a revision from band to sleeve ? And if your still working for a bariatric surgeon in tn 

I wok for a surgeon in Knoxville, not Memphis. BCBS FED is different than the rest.  You should not have had to do a 6 month diet at all. Our BCBS FED pateints in the Knoxville office get approved without doing the MSD, you should have too.  Someone at your docs office isn't doing their homework, BCBS FED is one of the easiest for approvals. You could have had surgery 6 months sooner! I should know, I do this everyday. Bonnie