Question:
overwhelmed with what to do first

I'm seriously considering surgery. I've done tons of research and feel this is a great choice for me. My ins co is Anthem/BCBS (HMO). I know they cover WLS, I've checked that out. Not sure what to do first. Do I get a referal from my PCP? Schedule a consult with a WLS surgeon in my network? I'm totally ready and absolutely willing. I'm 342 lbs with a BMI of 54.9. I was recently told by my doctor that I have diabetes. I am taking Metformin for it. Dr has also sent me for tests on my thyroid, which I haven't gotten the results back on yet. I've been at this weight for most of my life.....only success that I've had with any weight-loss program was Redux...until that was taken off the market. Now I've gained that back, plus about 80lbs more. Any help with my questions would be greatly appreciated....thanks in advance.....oh, you can also email me [email protected]    — Betsy@goal (posted on November 28, 2003)

November 28, 2003
Does your insurance require a referral? Some do and some don't. Mine didn't so after I had done my research and knew for sure i wanted the surgery, I just called the surgeon of my choice(in network) and they got the ball rolling. Once you tell them you are interested in the surgery, they will usually send you an iformation packet and set you up to attend an informational seminar or support meeting. They will handle it all. my surgeon office even set up all my pre-op appointments.
   — Delores S.

November 28, 2003
Odds are since you have an HMO that your insurance does require a referral to see a surgeon. So now you need to talk to your doctor (your primary care physician - PCP) about pursueing this and see where that leads you. Good luck!
   — [Deactivated Member]

November 28, 2003
Congratulations on making a decision that will change your life!!! It is a scary thing, but you will feel better as you go through the steps of getting to your surgery date. My suggestion would be to decide upon 1 or 2 possible surgeons that you would consider for yourself, and bring those names and your reasons for wanting surgery and research to your PCP's office. If your Dr. sees that you have seriously thought about the surgery and have done your homework, he will most likely be supportive. Be sure you have thoughts about who YOU are interested in seeing as your surgeon, as the WLS surgeons your Dr. may know may not be the ones that you feel comfortable interviewing. Good luck!!
   — Fixnmyself

November 28, 2003
I'd say research, research, research. Research the surgery, the different types of weight loss surgery and the advantages of each, all the after effects, the difficulties as well as the benefits, you need an accurate idea of what to expect. Research your insurance company's requirements - some require physician-assisted diets, some don't, many require sleep studies, and you need to know why it's so important to know whether you have sleep apnea, etc. Research the surgeons your insurance company will pay for, find the most experienced one with the best record, find people on this site who have used that surgeon and email them or look for their comments on their surgeon's bedside manner as well as surgical competence and their staff's attitude and helpfulness. Please don't take the first surgeon you can get an appointment with, just because they're the first. Find someone really good at this procedure. Often those you can get in with easily aren't very busy for a reason. Decide how comfortable you are with being one of the cases a surgeon uses to learn the procedure. For me, I wasn't comfortable with that idea and chose a surgeon who had done in excess of 2,000 RNY surgeries with an excellent record of good results. Check profiles (go ahead, check mine, :o)) and read about people who had great results and people who haven't done so well. Look for what the great results have in common and what the not-so-great results have in common. Basically, learn everything you can, then you know what you want and how to talk about it, and your doctors can see that you know what to expect from the surgery. That makes all the preliminary testing much easier. Hang in there when people tell you you're taking the easy way out, or "you don't really want to do that, do you? It's so permanent" or "all you have to do is eat less and exercise more". We all understand around here why those remarks are so very unhelpful, we've all been there, done that, and it didn't work for us. This site is a great source of information and support. Don't be embarrassed if you spend a lot of time here. My surgeon encouraged me to spend time here, and it's helped me tremendously. Best of luck, and feel free to email me if you like. You're in for an exciting, confusing, rewarding ride! Chyrl Lap RNY 11/13/03 -23 pounds
   — Chyrl W.

November 28, 2003
After I made the decision to do the surgery, I went to an open group meeting at the hospital (St Vincent, Cleveland, Ohio). I learned so much there from the staff that spoke on different topics and the post-ops that also attend the seminar. They are a great wealth of information just like this site. That same night I made my appointment for the consult with the surgeon at the end of the meeting and they hand out the packets of information on what you need before leaving (i.e. 5 year history of weight management, referral from PCP, etc.) They even have monthly meetings for pre-ops to inform them of what to expect and what to do. It's been a wonderful journey (and still is!) I'm 4 1/2 months out and down 100 pounds...it's fantastic!!!!! Good luck with your choice and be sure to do lots of research and be prepared. The best thing I had going in was a positive attitude and that saw me through the scary things. Congratulations on your journey!! :)
   — Dianne M.

November 29, 2003
First, take a deep breathe. Second, the process of having WLS is a long process, so understand from the beginning, that you will have to wait and be patent ALOT. You will have to wait for approval, you will have to wait to see the surgeon, you will have to wait for a surgery date, you will have to wait for your test results. <p>The first step is to do as much research on your own that you can do, inform yourself on Lap RNY, LapBand, VGB, Open RNY, the step you took joining AMOS was fantastic, the support on this site is priceless. <p> You now need to go to your pcp and discuss this surgery with him/her, if your BMI is 40 or more, your co-mobilities, and then your pcp should submit to your insurance company a request for you to go to a surgeon that is in your insurance coverage, for a consult and evauation. I have a copy of my referral on my profile page, if you would like to see it. Then you wait for the insurance company to come back with a approval or denial to see a surgeon. Once you get the approval from your insurance company, you need to call the surgeons office and find out what there procedures are. After you see the surgeon, and he/she agrees to do the WLS, the surgeon's office should submit to your insurance company for the surgery approval. Then you wait again for a approval from your insurance company. Once you have the approval, the surgeon's office will have you do testing, possibly a Psyc evaluation, and other steps, then schedule your surgery date. <p>See, isn't that simple.........lol.......... <p>Good luck, and you are making the best decision on taking control of your life.
   — cindy