Hi I am new

[CDHilbmann76]

Hi my name is Connie and I am new. I havent been scheduled for anything yet just spoke to my primary doctor today and he put in the referral for me to see about having the vertical sleeve done. I have not been heavy all my life, when I was in high school I weight about 95 lbs however due to PCOS and the loss of a child and two major car accidents that have left me with having Fibromyalgia, I have ballooned to 281. I look forward to meeting new people who have already gone through this journey. I live in Washington state and will be having my surgery done at Sunnyside Kaiser in Portland, Oregon.

 

[DianaCox]

I hope you will also consider the duodenal switch, which as far as I know, Portland Kaiser does not offer - the sleeve will likely not do much for your PCOS, whereas the DS is a metabolic surgery. Kaiser will probably fight you on it, but you may be able to appeal to external medical review, where you will have a better chance to get an objective review.

You also will have to go out of state for your DS, because to my knowledge, there are no qualified DS surgeons in Oregon (or none I've heard of or would allow to touch me). Although the Kaisers are somewhat independent, NorCal Kaiser is contracted with Dr. Rabkin, one of the best of the best, for cases where they have no choice but to pay for a DS.

 

[CDHilbmann76]

I am only qualified for two of them under my insurance, either the sleeve or full bi-pass. I have state insurance, I only have Kaiser because I have Moline under medicaid. So im limited on where I can go. I did just have a full hysterectomy done in November, my GYN said my PCOS should slow down a little bit because I know longer have ovaries. So im hoping.

 

[DianaCox]

What your insurance company tells you they offer, and what the law says they have to offer (any standard of care procedure) are two different things. You are entitled to have the most appropriate surgery for your medical condition. I caution you about accepting the sleeve, because so many insurance companies are including "one-bariatric-surgery-per-lifetime" restrictions - if the sleeve (a restrictive only procedure) fails you - then what? But do NOT consider the gastric bypass, please.

If you learn about the DS on your own (i.e., here) and decide that is likely the best procedure for your medical situation, then we can help you fight your insurance company. The first thing you need is a copy of your Evidence of Coverage document (should be about 100 pages long - NOT the Summary of Benefits), so we can see what your coverage document REALLY says, and what your route of appeal would be.

 

[brooklyngirl]

Hi and welcome! Do lots of reading, as much as you can, before you decide, and then if you do decide on DS, people here can help you fight for it.

 

[GirlFriday]

Hi and welcome! You will find lots of good information and helpful advice here. Best of luck to you.

 

[southernlady]

Welcome @CDHilbmann76

 

[DSRIGGS]

Welcome and please take advantage of what Diana Just offered to you. You will see that we are heavily DS biased on this board and for a reason... It works where as all other procedures have less success.

Diana is an attorney and has a PhD in biology or some other medical related field... I forget... She has helped many people get approved by their insurance company.....and you might not realize it now but that is so incredibly huge.

 

[Munchkin]

Read and learn. PCOS is a metabolic disease. You need a metabolic surgery to fix it. The sleeve is a restrictive surgery so life postop is a diet. Usually around 1000 calories a day. Has that worked for you in the past? And with fibro I would guess extreme exercise is out of the question so you aren't going to be burning a lot of calories that way.

I am not anti sleeve. It seems to be enough for some people who are not extremely heavy.

Do a really good job of analyzing your needs before you jump on the bandwagon, anyone's bandwagon. And just because your surgeon does X is no reason to have X when you really need Y. Think twice, cut once!

 

[hilary1617]

Hello and welcome! I'm wishing you a wonderful and healthy future!!!!

 

[CDHilbmann76]

Thank you everyone SO MUCH for the information, I always though because I had welfare insurance I was kind of stuck. I want what is going to be the best for me. I struggle everyday sometimes just to get out of bed with pain. I have tried every diet imaginable to man. I done the omni diet which restricts you to 500 cal a day and didnt lose weight. Im doing some more research. Diana I would like to add you as a friend as I lose track of names and messages because of Fibro fog, and ill message you after I speak with my doctor next month. thank you everyone.

 

[aaa]

Welcome.

 

[unavidanueva]

Glad you are here, and glad you said hello. Every time someone new posts a bit of their story, I learn something new from all of the comments. Good luck in your journey.

 

[star0210]

Hello.

 

[Will2014]

Welcome Connie!! Best wishes for success in whatever path YOU choose.