Just looking for opinions

I am 5'4" and my weight usually ranges from 205-212.  I have had HTN since I was 17, on meds since I was 19.  Currently on 2 meds, one is a diuretic.  I did a sleep study and the impression on the report states " obstructive sleep apnea syndrome (327.23) moderate overall but severe in REM sleep".  My BMI currently is 36.  My insurance policy states BMI of 35 with 2 co-morbidities.  I was feeling really confident that they would cover VSG but after reading around these forums I am becoming anxious.

Anyone want to offer their thoughts?

Thank you.

Hello,

I don't know what HTN is.  The only advice that I have for you is to fight for the surgery that rings true for you.  Figure out what's right for you and don't take no for an answer until you've exhausted all avenues.  I think it's really important that we get what we want because then we're emotionally lined up with it and can be really happy.  For me being happy is part of healing etc.

I have Kaiser so I can't respond to other insurance companies.  There are several people who had to appeal to get approved for the Sleeve.  Ask NewDirectionHome about her insurance and what she did.

Good luck!

I also don't know what HTN is so am not sure if that will quailfy as one but sleep apnea will.  Does your insurance usually cover sleeves?  Mine didn't and I didn't wait to appeal so I have the RNY and am very pleased with it.

HTN=Hypertenion or high blood pressure!

I can't tell you what the requirements for VSG are as it was not an option with my insurance co.  I know many insurance companies require that you have at least one co-morbidity to quaiify for WLS with a BMI of 35-39.9!  It sounds like you have 2 with HTN & sleep apnea if it requires you to wear CPAP.  Have you met with a bariatric group yet?  Many groups will know what the liklihood of your ins. co covering you with what you are presenting to them.  Your insurance co. should also list what types of WLS they approve in thier coverage criteria as well.  Many ins. co consider the VSG to be "experimental" and will not cover it.  But if you arm yourself with as much information about the surgery and WHY it's the surgery for YOU, you may beable to appeal your way to it.  Good luck with your search for information!

Go to the dr and have your height checked, too... I thought I was taller than I measured....that can help the BMI -- although I don't think you need help.  My insurance company has been very helpful in explaining all of the requirements.. give yours a call and make some friends!

Wishing you lots of luck!
Meg

Good point.   I've been 5'3" all my life but thank goodness I'm 5'2" now and I don't think I could have gotten up to the BMI required for 5'3".  I HAD to have a BMI above 40 for approval because pre-diabetic did not count.  It really sucked having to eat french toast and ice cream and mashed potatoes with gravy just to *maintain* my BMI for my pre-op appt.  Now that I have a date, I can freely lose thank goodness.  I'm sure some day I'll look back at that "maintance period" as a remembering the good old days kind of time.  rofl!

 You are right, I have a little terrier or sometimes "terror". She is smart and loyal to a fault sometimes. I tried to let a friend hold her leash on a walk today, so I could check out a farmer's market (no dogs allowed). I couldn't enjoy, because all of a sudden I could hear her bark. He said she started almost as soon as I got out of sight.

She is my companion and entertainment much of the time. I am so blessed that we found each other.

Good luck with your surgery. I thought I would miss my favorite "pig out" items, but so far so good. There are so many better joys in life.

Hi Wendy!   A friend of mine asked me to watch Little Bear for her while she went on her honeymoon because she didn't want to leave her with her 4 other BIG dogs since she kept picking fights with them.  LOL   She's quiet and has such sweet soulful eyes but boy is she ever the Alpha dog!   She and our Beagle have settled into their appropriate places in the hierarchy.  I think they are truly meant to belong to 1 dog families.   lol   I know what you mean about the barking too!   Little Bear is always by my side and will share my pillow if I let her.  I too am grateful she came into my life... needless to say I would not give her back when my friend returned from her trip!  ;-)

I've uploaded 4 very cute pictures of her different facial expressions if  you want to look at the album.  My other doggie and two kitties are there too.

Thank you for the well wishes and you echo many others who are saying they no longer crave what used to be their favorite foods.  I guess I better start a memorial to my miniature marshmallows.

Thank you for all the replies.  I have spoken with my insurance.  They do cover VSG.  The requirements are BMI of 40 or 35 with 2 co-morbidities.  I know that the HTN (high blood pressure) will qualify, as does sleep apnea.  I just don't know anything about sleep apnea so I didn't know if my findings are severe enough to qualify.  I won't see my do****il the 28th.  The same thing happened to me as one of the PP, I always thought I was 5'5 but the doctor's office measured me as 5'4.  So . . . I should qualify . . . but I have been reading instances on the VSG forum where others are in similar situations and didn't qualify.

Just anxious and have to wait until the 28th.  :(

 Glad you can get the sleeve. You did not mention your age, but how is your cholesterol reading?High cholesterol is a co-morbidity. Do you have normal fasting blood sugar? How are your joints, any arthritis? 

Make sure you pursue what you want. When you deal with your insurance, get a name and location. It can help later, if you get different information.

It's a process, but the waiting period can get you ready. I am happy with surgery, but it is a permanent lifestyle change. I'm glad I had to work for it. No do-overs or take-backs.