new to tennessee board...info on tenncare would be great

hello all, my name is joyce... i am new to tenn and just wanted to stop in and say hi.  i am a 36 yr old mom of 4 and have been researching gastric bypass for about 5 yrs now.  i was living in nc for awhile and was 1 appt from getting my surgury and i dropped 30 lbs in a month and the doc told me that i could do it on my own.  little did he know though that i had a swollen lymphnode that had some sort of a "fungus" (i know YUCK) in it which is what was causing me to lose the weight.  anyhow here i am back to being big bulky and feeling completely unattractive and unlovable.  my kids and my husband tell me that i am pretty and such but i feel so BLAH all the time.  so here i am trying to find out who i can go to in the greater chattanooga/cleveland area for gastric bypass and who will take the local medicaid (tenncare?)... i dont have it yet but am hoping to be able to get it soon. and what is the criteria, the requirements here for someone with that insurance? any excessive amount of charting your weight or going through a family doc with pills and weight loss programs before they will start talking to you?  if anyone can give me a heads up on what i will be getting myself into it would be greatly appreciated.

Thanks
Joyce Harrod
Cleveland, TN 

I have no answers for you about Tenncare but wanted to say hello and welcome to the board. I'm a former Memphian, so feel qualified. LOL I had the DS in Nashville with Dr. Hugh Houston on 4/6/10 and LOVE it, love Dr. H and his staff!

Are you looking into RnY bypass or Duodenal Switch? Please research both intensively before choosing one. I was unaware of the DS until I read about it on the main board.

Welcome again and good luck in your research.

i have done quite a bit of research and was gonna do the RnY....but maybe i will have to check into the Duodenal Switch.... what is the differance?

thanks for the reply and if it is ok...can i add you to my friend list?

Lots of differences b/w RnY & DS.  *I* chose DS over RnY because:
1) DS has the best long term outcome - greater EWL, highest rate of resolution of co-morbids, lower regain rate, especially for those with BMI >50
2) Fully functional stomach with intact pyloric valve (no dumping)
3) Lower risk of ulcers, vomiting, etc.
4) Less dietary restriction - I eat high protein, moderately high fat & low carb

This is all described in great detail over on dsfacts.com

I am about 90 minutes from Chattanooga.  I live in Knoxville and I am currently going through the process with TennCare.  I had Bluecare and I found that not many surgeons would take my insurance due to the low approval rates.  I did find Dr. Greg Mancini @ UT Medical Center and his staff is wonderful.  I have been told that they are no longer accepting new patients with BlueCare, but they are taking new patients with Americhoice.  You are allowed to switch your insurance once a year, but make sure you have a reason.  Dr. Greg Mancini has the weightloss program with his brother, Dr. Matthew Mancini (who does not accept BlueCare).  I have had previous surgeries for other non related issues by Dr. Matthew Mancini and have had a great experience every single time.  Both are great, take time to listen, and they have an incredible PA, Lynn.  About a month ago, I called TennCare and asked to switch insurances from BlueCare to Americhoice so that I can have Dr. Matthew Mancini perform the surgery.  Why mess with a clean record of no problems and switch doctors (even if they are brothers working together). 

Tenncare requires certain BMI levels with comorbidities to qualify.  You have to go through a psych evaluation, blood work, monthly weigh-ins, have tried other forms of weightloss, all of the basics that are required by most.  You do not however have to lose a certain amount of weight before surgery.  Dr. Mancini's office requires additional things such as group session, you can not gain any weight from the time of your first weigh in or you have to start the process over again.  You have to have a 2 week all liquids diet before the surgery.  Then there is also a day long class that you have to attend.  There are aproximately $600 worth of program fees not paid for by Tenncare that you have to be prepared for.  

Every program is different, but if you are able to travel, definitely check it out!

Good Luck!   

 thank you for the info i will definately keep it all in mind... how long do you have to have monthly weight ins? i guess i will have to start over and get a pcp before i can even think about the other stuff.  thanks again

I have to do weigh in for 6 months, which is depressing.  You have this motivation at first that hey I'm ready and it's time to get healthy and then you have to go through six months of weigh ins, which if I were able to lose weight on my own I wouldn't be having surgery.  You have to turn in a food journal of everything that you have eaten in the past month.  It's kind of crazy what you have to go through, but now that I am getting closer to the end, I'm glad that I had to go through the baby steps.  There is no way I was actually prepared for all liquids or no longer eating out.  They say to go and eat your last meal, but really I've had lots of last meals; seafood, thai, japanese, chinese, mexican, McDonalds, KFC, Taco Bell, Italian food, ect.  I've had to say good bye one by one because I just couldn't end them all at once.  I still have to work on not ordering lunch with everyone at work.  Subway is my next habit to kill.  They say healthy lunches, but really when you think about it they're not that healthy.  My stomach is about to become not much bigger than a single meat ball.  Sorry I ramble, a lot.  Hope this helps. 

 thank you that helps alot.  i was all set about 5-6 yrs ago to get the surgury, had all of my appts done, the psych eval, dietition, ect... and then i lost 30 lbs in a month or two and instead of trying to find out WHY the doc just told me that i didnt need the surgury after all and said i could lose it on my own.  and i went from 313 on May 30 2004 to 222 on Jan 22  2007.  then i had a swollen lymphnode removed and the weight loss stopped.  i have since had my 4th child and am back up to about 280.  i still have a bmi of 43 and have issues with shortness of breath and asthma.  i dont have and havent had a pcp in years and so i dont know if i have any other co-morbids. my mother and grandmother was diabetic and obese so it is in the genes, i just havent gotten there yet.  there is high blood pressure in my family and heart disease...but at the moment i am healthy as a horse, only problem is that i am as big as one too (a horse...lol)

thanks so much for your input and hopefully i can get my insurance soon, and be able to get the ball rolling.  i am determined that i am gonna have quite a bit of weight loss within the year.