New lightweight saying hello!

I've been lurking here for a while, finally took the plunge and registered. I'm currently in the process of the planning, doctor visits, labs etc., before shipping off my information to the insurance company for approval - I am so nervous.

I'm 34 5'6 (ish) I swear I'm shrinking, 213 lbs and a BMI hovering around 34.3(ish). My insurance company requires a BMI of 35 with at least 2 co-morbidities. I have those in spades. Uncontrolled type 2 diabetes, high blood pressure, high cholesterol, infertility, more symptoms of PCOS than I can shake a stick at (except the actual polycystic ovaries and missing visits from Auntie Flo - she never fails to visit).

My story is really like most of the ones I've read here. I've yo-yo'd most of my life. I've been dieting since I was 16, tried them all, lost and then gained back + more. I spoke to my insurance rep who was a total angel, seriously this woman was one of the kindest customer service people I've ever spoken to, and she really was on board with what I told her about surgery and my life etc. My insurance is BCBS of Illinois (though I'm in Kentucky) and they no longer require a 6 month medically supervised weight loss program. Just psych evals, the BMI, and a letter of medical necessity.

I went to the WLS seminar at the local hospital, that is a Center of Excellence and the surgeon is super personable and very experienced and has excellent patient outcomes. I'm now waiting for my initial visit to the surgeon's office, which according to the information I've been provided will start at 7am and last about 6 hours. That day all my labs will be knocked out of the way, tons of education classes, 1 on 1's with specialists and finally the physical with the PA to document the BMI and type up/sign the letter of medical necessity.

My nerves and fear comes from my BMI. I normally fluctuate anywhere from a 34-36 BMI. My highest weight I've ever been was 230 and that was back in 2009. I know it may seem like not a lot of weight to some WLS vets, but my co-morbidities are literally killing me. I'm hyperinsulinemic, so my pancreas is burning the candle at both ends and will eventually stop making insulin. I would love to have my surgery done before that happens. I'm tempted to just start smashing ho-ho's and ding dongs/oatmeal cream pies to put on some weight. Even if it's just 5 lbs. My head knows that's not smart, given my health, but I am so afraid I'm going to be knocked out on a technicality of 0.2-0.6 points. Has anyone ever been in my shoes with the BMI thing? If so, what did you do?

I know you all can't give medical advice and I am not asking for any. Just some encouragement. This is literally my life, my chance to become a mother, my chance to not die at a young age, my chance to get my life back, and be healthy enough to finish nursing school and then turn around and give back to people and advocate for them. I just feel like for all this talk of "obesity is a disease" I could eventually be told "no sorry, you're not quite close enough to death to be considered for treatment, come back when you're one foot in the grave!"

Thanks for any words of wisdom, advice, or just general hellos you may feel like sending my way.

Welcome to our LW Board!!!!!   Congrats on your decision to become healthy!! 

Answer to your question lots of posters have worried that there BMI dropped after their initial visit as the prepared for their WLS. It's sounds like you haven't had your initial visit yet so you don't want it to drop below the required BMI.  Do what ever your body can handle!!!  I've even heard of posters who dressed heavy, put weights in their bras, etc.

Keep us posted!!!

This ~~ I read those stories too. "I've even heard of posters who dressed heavy, put weights in their bras, etc."

I just laugh at this when I picture putting weights in my bra. All I did was drink like half a gallon of water that morning because fluid is heavy. Hahaha, weights in my bra. LOLOL  

Good luck and hello there ? I am a lightweight too and just had revision from a sleeve to a gastric bypass. My history and BMI was similar to you without the co morbidity, I ended up,got g private for the sleeve but the public system in my country did the revision due to reflux problems. I have put on a bit since the sleeve so a blessed to get the revision and hopefully will,loose the extra weight too.
I say do what you need to do, to get the surgery. When you do go the bypass not a sleeve. People with our histories need it.
Fingers and toes crossed for you and keep us posted.

I'm still pre-op, so don't take my words as advice - it's just my story.

When I went to the new patient information session at my local weight loss center of excellence they took an initial weight on a tanita scale. A complete body analysis?! I had no idea I would be getting weighed in! My BMI was 35.1 with total body fat percentage of 39%. (Important to note, my insurance company is federal bcbs, so they have a minimum BMI of 35 requirement as well). Well, for whatever reason, anytime I've been overweight I feel like I should be on a diet or I'm taking my life into my own hands and not in a good way. I know the risks of being severely obese, my mom passed away from obesity related comorbidities just a year and a half ago. Ugh. Since I'm always on a diet, I usually have a borderline BMI, just hovering between obesity and severe obesity.

Okay, so I went to the information session in December and I knew I wouldn't be seen until at least a week into January, so I felt like I had a "cushion" during the holidays? I could get through Christmas and New Years without feeling guilty. I mean, I took the first step, right?

So, January comes and I get to meet with the surgeon one on one. At this point, my BMI is 36.3, and my fat percentage is 44%?! Good Lord, Christmas was not kind to me. LOL (Please note, I did NOT intentionally gain weight, I just stopped making good choices and nature took its course). I mean, almost half of my body was made of fat at this point. After sitting down with Dr. M, I knew i was making the right decision. He told me all about me before I even spoke a word. He understood my life and my struggle. For the first time in my life, someone understood!!! This time when I asked for help, I got it. (A little insight here, the first time I went to a doc about my weight getting out of control, he said to me, and I quote, welcome to 40. I was 37 years old and had gained 40+ pounds in a single year, I needed help). You all know how small we lightweights are, so you get that 40 pounds is a big deal on someone 4'11" with a small frame. I'm petite in every sense of the word, except my weight. But enough about me.

I guess, if I had one piece of advice it would be, don't reach for the oatmeal creme pies. They won't help you. If you really want to gain 4 pounds to hit 35 BMI, eat some healthy fats and protein and gain a little muscle. You're doing this for the right reason, don't go making yourself sicker. If you make that commitment to your health now, I know you will be successful on this journey. 

Just know that I completely understand your apprehension and the need to get healthy. I really do.

I'm so happy that you've made the decision to take control of your health and your future! Good luck on your journey.

Welcome.

Thank you for sharing your story. I'm so sorry about your mom :( Losing a parent is hard. My dad died when I was in my early 20s from a massive heart attack, gone in the blink of an eye. Heart disease and diabetes run all throughout my family and many have died and lost toes and feet too. I, like you, wanted to make a change early enough in my life so that I can hopefully extend my days.

I've never really been a petite lady, mostly just average height, but I have always carried all my weight right around my midsection and more than once have been asked "When are you due?" it's a nightmare. My PCP is behind me all the way, we talked at length about surgery and like any good doctor we talked about other options, because surgery is so invasive, and comes inherently with it's own risks. After she saw how desperate I felt because of my past failures she hopped on board. I'm blessed to have a really good PCP who listens to me. I actually did ask her how many hoho's and dingdongs I'd have to eat to get to 35, she just laughed and responded with "I don't know any type 2 diabetic that doesn't know how to gain weight, I don't think your BMI will be an issue when the time comes."

I always felt like you, the need to be on a diet. I guess because I've always been on one, always analyzing what I eat and journaling my food, I don't really know what it feels like to not be on a diet. I'm glad your surgeon was really nice and supportive of you. The surgeon that I plan to use, Dr. John Oldham, seems to have a very personable attitude and has been reported to have good bedside manner. We shall see.

Thanks again for your story and encouragement!

My PCP had to turn in my monthly visits to my Surgeon. The first weight I had taken there was actually the one the Surgeon used to turn in my paperwork.

Thanks everyone for your kind words. Upping my protein and healthy fats to gain some muscle is a great idea, why didn't I think of that?! That will be the route I'll go and if all else fails I guess I can stick some rolled up quarters into my bra! After speaking with my insurance rep I feel pretty confident that I won't be denied as long as my BMI is 35, because of all the co-morbidities that I have. It's just nerve wracking.

So this is going to sound silly but can you get shorter??  I was/am in the same position as you.  A bucket full of co-morbidities and about 6 lbs shy of the required 35 BMI at my first weigh in appointment.  I found that if I tipped my pelvis forward when I was measured that I was about 3/4 of an inch shorter.  That was all I needed to get to 35 and I have added the additional lbs since then so the weigh-ins are no longer as stressful.  

I would be careful about coins in your bra.  At my appointment they did a 'quickie' physical exam.  Heart, lungs, reflexes, swallowing, pelvic palpation.  I'd be afraid to lay on the table with coins in my bra that end up rolling up and out the top.  Not a good look for me.

The more difficult part has been maintaining the weight while covering all the pre-op steps.  It seems a little backward that I started this to lose weight but I need to maintain until the surgeon submits the packet to the insurance company. 

Please check in with how it goes for you!

 

My nutritionist worked very closely with me to not lose too much weight. I have lost less than 10 pounds in three months, but my bmi at my last check in was 35.1 - just barely above the guideline. They have assured me that the weight they submit is the first one from my initial visit, so I have nothing to worry about. I was just extra careful because during my first appointment with the surgeon he cautioned me not to get down into the low 30s. That's only about 22 lbs for me, and I know I can lose 22 pounds in 3 months. I'm an expert-level dieter! LOL

If you can, stand short. :)