Newbie!

heplayswithtrains · 04-21-2006, 07:37 PM

Hi all! I am so happy to have found this site and board! My name is Julie (33) and I thank all you for sharing your lives. I have just recently started reading about this surgery. First, I would like to say that I admire all of you, no matter what stage you are in. I think it is wonderful to have people out there helping people. I feel I have gained alot of insight so far into this surgery. I am very, very interested in meeting with a surgeon in my area. Obviously I have lots of questions. Of course, one main question is will Blue Cross cover me? But the next one is a biggie as well. I dont know if I will qualify because I am not quite at the 40 BMI...I am 5' 4" and weigh approx 220 lbs....but I would need to check to see what the doctors scale says : ) Three years ago my sugar and cholesterol were borderline high so I dont know if that makes a difference. They may be higher now, but I have been avoiding my health problems instead of facing them. Anyway, I imagine I have many things in common with most of you. I have struggled with weight my whole life and have been on the looney roller coaster of weight loss and gain. Of course, after each weight loss, the gain is more. I have tried just about everything....except this!!

I look forward to learning more and meeting you all!

Have a fabulous evening!

Julie

fr1endly2 · 04-22-2006, 04:56 AM

HI JULIE!
Welcome to the boards!
I look forward to getting to know you more thru
your posts.
ITS an exciting journey! AND i wish you
all the best. YOUR BMI is right on the guideline
for my surgeon. USUALLY if you have commorbities...
with that BMI you might be able to have the surgery!
GOOD LUCK!
and loo forward to getting to know you and dont
forget to stop by chat

freebird · 04-22-2006, 06:32 AM

hi julie
i'm glad you found this site, there's lots of good caring people here, as for the insurance i live in canada so it's a bit different here. sweetie, even if you decide to try and do something other than this surgery, don't avoid the health problems, they'll just get worse, and you will feel better if you deal with them,
for myself when i found out i had high blood sugar levels, just making some small adjustments in the foods i ate made a big difference in how i felt, energy and wellness, and proud that i was at least doing that much for my health.
i would love to get to know you here through these boards and through chat, hope to se e you there soon

christyblue · 04-22-2006, 06:57 AM

hi julie. so glad you could join us and thank you for sharing the start of your wonderful journey with us.you will find a ton of support here and any questions or anything you need just ask.welcome
huggs
christy

DocSanae · 04-22-2006, 11:19 AM

Welcome to the board, Julie!
Thank you for joining us, I hope you'll enjoy posting here, and meeting people in chat.

About your qualifiying, the NIH criteria for obesity sugery is BMI 40 or over with no co-morbs, BMI 35 or over with co-morbs, or 100lb or more than your ideal weight (that is the weight that will put you at BMI 22). The insurance should be going along with that criteria, and the surgeons should, too, though there are surgeons who will not do the surgery unless your BMI is over 40, co-morbs or no co-morbs.

Since you say your last blood lab 3 years ago showed borderline high cholesterol and blood sugar levels, it is quite likely that they will be at the level to be considered co-morbs when you have them now. Also, how about your blood pressure, and do you have any joint pains or arthritis that is caused by your excess weight? These also are co-morbs that qualify you for the surgery.

Armed with this info, discuss the matter with your PCP as well as researching surgeons of our choice.
As for insurance, I'm not expert, so I can't say much, but Craig who hosts this site, and his wife Leslie did extensive research on insurance issues, and have an ebook out, so that may be one of the things you'd want to look into.

heplayswithtrains · 04-22-2006, 02:50 PM

Thank you all so much for the warm welcome and the great advice and info you have already given me! I appreciate so much your sweet thoughts, good advice, and knowledgable information. Here is just a little more background on me....I am 33 and have had asthma since I was about 7 years old. My asthma has worsened over the years and I believe the weight is not helping in that regard. At one point in my life (when I had an awful doctor and didnt know any better) I was put on steroids for nearly a year. The main reason for this was because everytime I weaned myself off of them, I ended up back in the hospital with an asthma attack and they started me on them again. I found out on my own, that nobody wants to be on steroids permanently unless they absolutely have to do so. I switched doctors and eventually was able to get off the steroids. I do have to have a short dose about once a year or so now. Anyway, I have alot of aching in my hips and have recently noticed pain in my right knee. I do not know if these problems are deterioration related to the steroids or if they are caused by my....or both. I plan on calling on Monday to find out some information about doctors in my area. By any chance can anyone reccommend someone from Central Illinois??? Thought it was worth a shot!

Take care all and good luck! Hope to chat with you soon!

Julie

DocSanae · 04-24-2006, 12:58 AM

One more co-morb I forgot to mention is sleep apnea. This has to be proven with a sleep study, but do any members of your family tell you that you snore very loudly, or that your breathing stops many times during the night? If so, there's a possibility you do have sleep apnea.

Steroids are very effective and useful medication, but they are also tricky to use because of the side effects, but with those who have severe attacks, there is no choice. However, if you are on maintenance and still need steroids, there now are excellent steroid inhalers, which do not affect your entire body the way oral or injected medication does. In any case, steroids are among the drugs that induce weight increase and diabetes also, among other things, so you need to be closely monitored while taking them.

As well as looking for a surgeon, I suggest you talk about the surgery with your PCP. If your PCP is not supportive of your having the surgery, talk it out with your dr why, and if you feel the reasons your dr gives you is prejudiced, you might want to look for a PCP who is more understanding and well informed. I also would suggest that you ask your dr for some blood work and physical exam to see where you stand in regards to co-morbs, so you will have material on hand to go on with the process.
Also, most insurance now require documented proof of unsuccessful weight control, so if you have dieted under your PCP or any other dr's supervision, have that documentaion ready, too.

Even if your insurance covers WLS, you will find that you are going to have one hoop after another to jump through, so while you are researching surgeons and clinics, you should see your PCP and find what co-morbs you have, and start having them treated. If you have proof of your sincerity in wanting better health through controling your weight, the better your chances are for getting approval.

Good luck, may your journey go well!

fr1endly2 · 04-24-2006, 05:30 AM

HEY JULIE just want to say it was great meeting you
in the chatroom on saturday night!
ITS a great place for tons of support!
I look forward to getting to know you
more and more thru chat and message
board posts

freebird · 04-24-2006, 05:59 AM

hey there heplayswithtrains! It was great to meet you in the chat room the other night, hope to see you there again soon. the Doc always gives great advice, and i would definitly look into craig's e-book. it is full of information that's fairly easy to understand and he included a wls insurance record thingy and a wls journal, (both of which i am using even though the insurance is a little different here). I got this e-book just before i went to the psychiatrist appointment that is one of those hoops the Doc was telling you about and read it on my way to rochester ny (6hour drive, didn't take that long to read it), and before i read it i was nervous about the appointment but this section in the e-book really gave me the confidence i needed to go into the appointment calm cool and relaxed. so you should really look into this book, i think it would be of value to you, i know it is to me.
anyway hope to see you soon in chat
freebird

Heidi · 04-24-2006, 04:01 PM

Hi Julie, and welcome to this wonderful site. I know you'll find it really supportive and informative just like I have. I look forward to hearing more from you.
Heidi

04-21-2006, 07:37 PM	#1 (permalink)
heplayswithtrains Newbie Join Date: Apr 2006 Location: Central Illinois Posts: 2 Please Enter Height:	Newbie! Hi all! I am so happy to have found this site and board! My name is Julie (33) and I thank all you for sharing your lives. I have just recently started reading about this surgery. First, I would like to say that I admire all of you, no matter what stage you are in. I think it is wonderful to have people out there helping people. I feel I have gained alot of insight so far into this surgery. I am very, very interested in meeting with a surgeon in my area. Obviously I have lots of questions. Of course, one main question is will Blue Cross cover me? But the next one is a biggie as well. I dont know if I will qualify because I am not quite at the 40 BMI...I am 5' 4" and weigh approx 220 lbs....but I would need to check to see what the doctors scale says : ) Three years ago my sugar and cholesterol were borderline high so I dont know if that makes a difference. They may be higher now, but I have been avoiding my health problems instead of facing them. Anyway, I imagine I have many things in common with most of you. I have struggled with weight my whole life and have been on the looney roller coaster of weight loss and gain. Of course, after each weight loss, the gain is more. I have tried just about everything....except this!! I look forward to learning more and meeting you all! Have a fabulous evening! Julie

04-22-2006, 04:56 AM	#2 (permalink)
fr1endly2 Seasoned Veteran Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY Posts: 6,756 Weight Statistics June 1, 2005 Start Date: Please Enter Height: 310 lb Start Weight: 167 lb Current Weight: 159 lb Goal Weight: 143 lb Weight Loss: 8 lb Lb Left to Lose: 46.1290322581 % % Lost: Body Mass Index 51 BMI Start: 27 BMI Current: Weight Loss Method Roux en Y Gastric Bypass	HI JULIE! Welcome to the boards! I look forward to getting to know you more thru your posts. ITS an exciting journey! AND i wish you all the best. YOUR BMI is right on the guideline for my surgeon. USUALLY if you have commorbities... with that BMI you might be able to have the surgery! GOOD LUCK! and loo forward to getting to know you and dont forget to stop by chat __________________ LISA http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass

04-22-2006, 06:32 AM	#3 (permalink)
freebird WLS Mentor Join Date: Feb 2006 Location: outside of Ottawa Ontario Posts: 1,187 Please Enter Height:	hi julie i'm glad you found this site, there's lots of good caring people here, as for the insurance i live in canada so it's a bit different here. sweetie, even if you decide to try and do something other than this surgery, don't avoid the health problems, they'll just get worse, and you will feel better if you deal with them, for myself when i found out i had high blood sugar levels, just making some small adjustments in the foods i ate made a big difference in how i felt, energy and wellness, and proud that i was at least doing that much for my health. i would love to get to know you here through these boards and through chat, hope to se e you there soon __________________ Don't let todays sorrows cloud tomorrows dreams (Surgery date? = still waiting)

04-22-2006, 06:57 AM	#4 (permalink)
christyblue Super Moderator Join Date: Oct 2005 Location: illinois Posts: 510 Weight Statistics 9/12/05 Start Date: 9/12/05 Surgery Date: Please Enter Height: 317 lb Start Weight: 184 lb Current Weight: 150 lb Goal Weight: 133 lb Weight Loss: 34 lb Lb Left to Lose: 41.9558359621 % % Lost: 09/12/07 Goal Date: Body Mass Index 51 BMI Start: 29 BMI Current: 24 BMI Goal: Weight Loss Method Roux en Y Gastric Bypass	hi julie. so glad you could join us and thank you for sharing the start of your wonderful journey with us.you will find a ton of support here and any questions or anything you need just ask.welcome huggs christy __________________ ChristyBlue surgery 9/12/05 open RNY BMI 51/29 315/185/150 130 pounds lost

04-22-2006, 11:19 AM	#5 (permalink)
DocSanae Super Moderator Join Date: Nov 2005 Location: Tokyo, Japan Posts: 9,475 Blog Entries: 2 5' 5" Height:	Welcome to the board, Julie! Thank you for joining us, I hope you'll enjoy posting here, and meeting people in chat. About your qualifiying, the NIH criteria for obesity sugery is BMI 40 or over with no co-morbs, BMI 35 or over with co-morbs, or 100lb or more than your ideal weight (that is the weight that will put you at BMI 22). The insurance should be going along with that criteria, and the surgeons should, too, though there are surgeons who will not do the surgery unless your BMI is over 40, co-morbs or no co-morbs. Since you say your last blood lab 3 years ago showed borderline high cholesterol and blood sugar levels, it is quite likely that they will be at the level to be considered co-morbs when you have them now. Also, how about your blood pressure, and do you have any joint pains or arthritis that is caused by your excess weight? These also are co-morbs that qualify you for the surgery. Armed with this info, discuss the matter with your PCP as well as researching surgeons of our choice. As for insurance, I'm not expert, so I can't say much, but Craig who hosts this site, and his wife Leslie did extensive research on insurance issues, and have an ebook out, so that may be one of the things you'd want to look into. __________________ "In every job that must be done, there is an element of fun." Just a li'l bit 'bout myself Last edited by DocSanae : 04-22-2006 at 11:24 AM.



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	Weight Loss Surgery Insurance
	Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.

04-22-2006, 02:50 PM	#6 (permalink)
heplayswithtrains Newbie Join Date: Apr 2006 Location: Central Illinois Posts: 2 Please Enter Height:	Wow! Thanks! Thank you all so much for the warm welcome and the great advice and info you have already given me! I appreciate so much your sweet thoughts, good advice, and knowledgable information. Here is just a little more background on me....I am 33 and have had asthma since I was about 7 years old. My asthma has worsened over the years and I believe the weight is not helping in that regard. At one point in my life (when I had an awful doctor and didnt know any better) I was put on steroids for nearly a year. The main reason for this was because everytime I weaned myself off of them, I ended up back in the hospital with an asthma attack and they started me on them again. I found out on my own, that nobody wants to be on steroids permanently unless they absolutely have to do so. I switched doctors and eventually was able to get off the steroids. I do have to have a short dose about once a year or so now. Anyway, I have alot of aching in my hips and have recently noticed pain in my right knee. I do not know if these problems are deterioration related to the steroids or if they are caused by my....or both. I plan on calling on Monday to find out some information about doctors in my area. By any chance can anyone reccommend someone from Central Illinois??? Thought it was worth a shot! Take care all and good luck! Hope to chat with you soon! Julie

04-24-2006, 12:58 AM	#7 (permalink)
DocSanae Super Moderator Join Date: Nov 2005 Location: Tokyo, Japan Posts: 9,475 Blog Entries: 2 5' 5" Height:	One more co-morb I forgot to mention is sleep apnea. This has to be proven with a sleep study, but do any members of your family tell you that you snore very loudly, or that your breathing stops many times during the night? If so, there's a possibility you do have sleep apnea. Steroids are very effective and useful medication, but they are also tricky to use because of the side effects, but with those who have severe attacks, there is no choice. However, if you are on maintenance and still need steroids, there now are excellent steroid inhalers, which do not affect your entire body the way oral or injected medication does. In any case, steroids are among the drugs that induce weight increase and diabetes also, among other things, so you need to be closely monitored while taking them. As well as looking for a surgeon, I suggest you talk about the surgery with your PCP. If your PCP is not supportive of your having the surgery, talk it out with your dr why, and if you feel the reasons your dr gives you is prejudiced, you might want to look for a PCP who is more understanding and well informed. I also would suggest that you ask your dr for some blood work and physical exam to see where you stand in regards to co-morbs, so you will have material on hand to go on with the process. Also, most insurance now require documented proof of unsuccessful weight control, so if you have dieted under your PCP or any other dr's supervision, have that documentaion ready, too. Even if your insurance covers WLS, you will find that you are going to have one hoop after another to jump through, so while you are researching surgeons and clinics, you should see your PCP and find what co-morbs you have, and start having them treated. If you have proof of your sincerity in wanting better health through controling your weight, the better your chances are for getting approval. Good luck, may your journey go well! __________________ "In every job that must be done, there is an element of fun." Just a li'l bit 'bout myself

04-24-2006, 05:30 AM	#8 (permalink)
fr1endly2 Seasoned Veteran Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY Posts: 6,756 Weight Statistics June 1, 2005 Start Date: Please Enter Height: 310 lb Start Weight: 167 lb Current Weight: 159 lb Goal Weight: 143 lb Weight Loss: 8 lb Lb Left to Lose: 46.1290322581 % % Lost: Body Mass Index 51 BMI Start: 27 BMI Current: Weight Loss Method Roux en Y Gastric Bypass	HEY JULIE just want to say it was great meeting you in the chatroom on saturday night! ITS a great place for tons of support! I look forward to getting to know you more and more thru chat and message board posts __________________ LISA http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass

04-24-2006, 05:59 AM	#9 (permalink)
freebird WLS Mentor Join Date: Feb 2006 Location: outside of Ottawa Ontario Posts: 1,187 Please Enter Height:	hey there heplayswithtrains! It was great to meet you in the chat room the other night, hope to see you there again soon. the Doc always gives great advice, and i would definitly look into craig's e-book. it is full of information that's fairly easy to understand and he included a wls insurance record thingy and a wls journal, (both of which i am using even though the insurance is a little different here). I got this e-book just before i went to the psychiatrist appointment that is one of those hoops the Doc was telling you about and read it on my way to rochester ny (6hour drive, didn't take that long to read it), and before i read it i was nervous about the appointment but this section in the e-book really gave me the confidence i needed to go into the appointment calm cool and relaxed. so you should really look into this book, i think it would be of value to you, i know it is to me. anyway hope to see you soon in chat freebird __________________ Don't let todays sorrows cloud tomorrows dreams (Surgery date? = still waiting)

04-24-2006, 04:01 PM	#10 (permalink)
Heidi Cub Reporter Join Date: Mar 2006 Location: Taihape, New Zealand Posts: 85 Please Enter Height:	Hi Julie, and welcome to this wonderful site. I know you'll find it really supportive and informative just like I have. I look forward to hearing more from you. Heidi

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