very new

hi there!

My name is Kathy, and I'm a new member as of yesterday. I'm 47, a divorced mother of two kids (ages 18 and 13). I'm in a great place in my life, right now - feeling happy and centered and open. But I'm starting to have health issues related to being very heavy since 2nd grade.

I'm hoping to have surgery some time next year, and at this point am gathering information. I've registered for an informational seminar in Federal Way on the 27th with Dr Oh, and I'm going with tons of questions that I hope I'll find some answers to.

About 19 years ago, I had gastroplasty surgery with S. Ross Fox that was at first pretty successful (with a loss of 130 lbs). As so many do, though, I found a way to eat around that surgery, and now I'm only 15 lbs away from my pre-surgery weight. I have Aetna through Costco, and they've sent me the literature regarding coverage. It looks like I qualify under several categories: arthritis, sleep apnea and a BMI over ... I think the paperwork said 30.

I also found some notes regarding "revisional" surgery being deemed "necessary" for someone who previously had WLS and been successful until their pouch dilated. I wonder if anyone has been qualified under these cir****tances through Aetna. Do they still require the waiting/diet period under that qualifier?

Through all the reading I've done, I think I'd like to pursue RNY (I think that's right), but I'm wondering with my previous surgery, if they'd have to do an open surgery for the revision? Of course, I'm going to ask these questions of the Doctor when I have the opportunity, but I was hoping to gather some thoughts from the vast experience, here, first. They did an open surgery for my gastroplasty, and it was SUCH a difficult recovery - and I was almost 20 years younger, then!

At any rate, I really just wanted to introduce myself and toss a few questions out at the same time.

Thanks!

Kathy

just wanted to welcome you to the family!

Kathy.


Welcome. Im Sunny. Iam having RNY on the 28th. Good luck to you.

Sunny

Welcome,   wish I had some answers for you, I went to Dr. Ohs seminar and it was very informational, He also has a funny sense of humor, He will answer all your ???? and does have people there that work with almost all insurance co.  Good luck and let us know how things work out for you.

Welcome to the Washington Board!!

I also don't have any answers for you either... but I do want to  welcome you the Washington site.

You may get approved since I don't think gastroplasty is  a surgery done much any more. But I could be mistaken.  I would also call Aetna and see what they say what you need do to get approved for a revison from a gastroplasty.

I hope you can get approved!!

Helen

Hi Kathy,

I just wanted to chime in with the welcomes  :-)

I'm 45,  live in Fairwood, and have two daughters - 14 and 17, so we have a few things in common.

I'm into photography and computers, so if you need any help in that direction, let me know.

Good luck with your insurance!

I really don't have any answers to your questions but I too wanted to say welcome aboard!  I have hears wonderful things about Dr. Oh's surgical skill.  I understand he has a very strict program too but his patients are all very sucessful from what I have seen!

Hi Kathy,
Just FYI....when I started my process last February, The insurance rep at the informational seminar I attended said that 3 insurance companies were requiring patients start the process w/ a 6 mo. Dr. supervised diet. I have United Health Care and they were one of the 3, one of the the other was Aetna. :-(

The only reason I mention this is so that you can schedule a Dr. appt in advance to get that started before the seminar.
I am now just 5 days out from having my surgery and I started this process in Feb.

Good luck,
Laurie

Hi Kathy,

I don't have any info regarding the insurance or RNY surgery, but just wanted to say welcome. 

I think the insurance requirements may be different for a revision than someone pursuing surgery for the first time.  Although after all this time it may be the same.  I just don't know.

Anyway, good luck to you.  I also hear Dr. Oh is a very good surgeon.

I am a newbie too... And had my seminar in May, and I should be getting my surgery before thanksgiving. I have aetna.  I am going thru center for weight loss surgery and they have been nothing but fabulous.  I had to do my 3 months for the insurance (well worth it to get me ready and all) I had my last appt on Wed 8th and by Friday the drs office emailed me with an approval.  I'm so excited.  Have some more tests to do for dr Srikanth, & the hospital, and should be on the road to a thinner healthier me really soon.

Good luck,