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3 months diet and excercise

GCooper

GCooper

Member
I've done all my pre-op testing, blood work, etc etc. only to find out today that my insurance is requiring a 3 month diet and exercise program with my surgeon before they will appove me. I'm so disappointed. I am ready to do this now I have to weight. Late August early septmeber now. :(
If I lose weight will I still get my surgery? Discouraged
 
Hi GCooper
Most bariatric programs incorporate classes with regular meetings usually one or sometimes two per month pre op.These classes serve as the supervised diet and nutrition program that most insurance companies require and are really important to your long term success as a post op bariatric patient-they include regular weigh ins,nutrition classes and tips on activity and expectations for long term success-Check with your Doctors office to make sure you're not missing something here.This surgery is a great benefit but it's also a lifelong committment so you want to be ready for it and smart about the process and what comes after.This probably isn't what you wanted to hear but it's worth the extra few months to get it right for life.Good Luck to You
Ron



Ron
 
Don't feel too bad, my insurance company required me to do it for 6 months. I was very discouraged because I had psyched my self to have the surgery after Labor Day. But once I got the approval, it was only a matter of weeks, and that was because I decided to delay until after a school trip to DC with my son's 8th grade class. I had really wanted to lose a lot of weight before that trip so I could enjoy it more, but C'est la vie. Now that I am almost 2 weeks post op I am glad I waited until after the trip. I would never have made it if I had the surgery in the weeks before the trip. Good Luck!
 
I was told that your weight at your first dr visit is the one that counts even if you have to go a diet to have the surgery. I'm like you..my weight is border line but I also have diabeties, and high blood pressure..

GCooper said:
I've done all my pre-op testing, blood work, etc etc. only to find out today that my insurance is requiring a 3 month diet and exercise program with my surgeon before they will appove me. I'm so disappointed. I am ready to do this now I have to weight. Late August early septmeber now. :(
If I lose weight will I still get my surgery? Discouraged
Click to expand...
 
I too had to do the 3 month exercise diet routine. They weigh me in once a month, told me to modify my diet from breads, rice, pasta and soda. and to exercise 3 days a week to get my heart rate up. My only issue is that I have a disc protrusion and it limits how much exercise I can do. They only look at the starting weight from your first dr visit. I have gained and the lost a the same few pounds since Jan. I have done all my testing, and now am just waiting for my insurance to give the go ahead for the surgery. Which I am
supposed to call my insurance today, but hopefully my dr will call me first to schedule my 2nd consult so we can schedule the surgery.

I wish you luck!;)
 
nana 67/ the waiting is the hardest. If you wnat to go out to eat aftersurgery as an observer oin nthe early days orfer a smoothie and sip on it. No nned to be without your famuly just because of of it. Yes I read sll your posts and am happy to help you in all I can.patti
 
Thanks Patti. I hope to get the call today, though it may be tomorrow. Yes the waiting is the hardest part, and I am a little anxious, but I do know that all will be fine. Friday I am going grocery shopping with my daughter and I'll have my list ready for my liquid diet. How do you get through the pre-op liquid phase without feeling hungry? protein drinks and broth?
 
when I had my procedure done they did not have a diet phas. the smoothies or protein drinks will give you more of a sense of fullness s thean anything else. I'll be thinking of you.keep me posted patti
 
Ok thanks Patti. I do some protein drinks now, but I have to wait to see my surgeon so I can get a letter of medical necessity in order for my FSA to cover the cost of the bariatric protein and supplements. The Body Fortress I currently use has been removed from my approved list according to the nutritionist. She says there is something in the protein that the surgeon doesn't want us to have. Still no word today from the surgeon, so I should hear from them tomorrow. They did say Tues or Wed.
 
Denied

After going through a 6-month nutritional class at the hospital and gradually increasing exercising, I just received a notice today from the insurance company that I am being denied because the entire thing was done with a nutritionist and not the actual doctor. I have been anxiously awaiting a call to see the nurses/physician assistant to see if I needed any other tests before surgery and, instead, heard this depressing news. The hospital told me this is the very first time they have had a patient denied for this reason. :( Has anyone else experienced this?? I've worked really hard to get to this point and it really makes me mad that they've denied it :mad:. I am going to look into other options and plan to see my PCP next week. If nothing else, I'm going to start another 6-month plan with my doctor. Thanks for letting me vent.

Becky
 
I am so sorry to hear that Becky. It is very difficult to go through thewhole prosses just to be denied, you would think the insurance company would have layed out all the requirements for a pre authorization. It is to bad you can't appeal their denial. Keep trying, now that you know the ground rules maybe this time they will approve it. Tom
 
Still Hopeful

Thanks Tom for the words of encouragement. The doctor/org. I am going through got pre-authorization requirements directly from the insurance company. However, they said they have never had someone denied because it was a nutritionist/dietician and not a doctor as a doctor is overseeing the entire program. This is a Bariatric Gold Center of Excellence that performs 100s of surgeries a week so I think they were shocked by the denial as well. I spoke to a representative at the hospital yesterday and they want me to hold off on appealing the denial. They are having the doctor do a medical review with the medical director of my case with the insurance company and seeing if they can get the decision overturned. So as of today I'm still hopeful. You're always so supportive and I appreciate that! Hope you have a good day!
 
That had to be a big disapointment for you. In my opinion the nutritional program you attended at the hospital had an obligation to make sure their program qualified. In any event, try to stay positive and focused on getting through a qualified program. Time will pass quickly and before you know it you will be having your surgery.
 
Thanks Pat for your words of encouragement and support. I do believe they have some responsibility in their classes not meeting prequalification requirements but also take responsibility as well. The program said they would call my insurance company and I never went and checked for myself ~ my mistake. And, moving forward, I'm going to go to my primary next week and start with her. Very very disappointed but not defeated! In the meantime I'm going to keep walking, biking and doing strength training.

Becky
 
OH MY GOODNESS!!! The hospital sent in an appeal which was denied for a 2nd time and I pretty much figured I was going to have to start the 6-month process all over again. Lo and behold . .. I got a call yesterday afternoon from the bariatric center that a 3rd appeal was submitted with additional information and it was approved!!!! Woo hoo! I have an appointment on Tuesday to meet about any additional testing I might need but, other than a sleep study, I've tried to get other things done such as a cardiology clearance, etc. Just had to share the good news! One other question though . . . . I was told that most people return to work 2 weeks after having a RNY with the condition that no more than 10 lbs. is lifted. Does that sound reasonable assuming everything goes well?
 
Congratulations on getting the approval! I know how you feel about the long drag out process!

I was expecting to go back to work 3 weeks after the RNY, but my primary care physician would not even consider releasing me to go back until 6 weeks, and then went part time for 2 weeks. I have a desk job, no lifting involved. I was very disappointed about the delay, but I have to admit she was right, there is no way I was ready to go back any sooner. I am told that abdominal surgery takes a while to recover from, and I think that is right.

Good luck!
 
Scooter-There is no way you will be able to return to work 2 weeks after surgery. I'm thinking at least 2 months is more realistic. You are going to be completely wiped out for at least 6-8 weeks after surgery because your body is healing and you are adjusting to living on very few calories PLUS a large weight loss. Add all of this up and you get exhaustion. You are going to need to sleep at least 8 hours a day plus naps. You should be able to take care of yourself but adding work to that will be next to impossible. During your third month your energy will start coming back and in your fourth month you will probably have energy to spare :) :) :)
 
I'm so glad I asked that question. The nutritionist said, "Oh, almost all our patients go back to work after 2 weeks" which seemed early to me but I thought she must know what she's talking about. Since I work in the educational system with young children, I probably would need the time as you have both suggested. Thanks ladies!
 
Hi Scooter, I was out for a month and then returned to work on light duty for two m ore weeks, so I would have to say two weeks is a pipe dream. I would plan on at least 4 weeks and then have your employer plan accordingly and to fleable in case of any complications. :cool: Tom
 
This website is just wonderful as everyone is so supportive. I really appreciate your insight Tom, and am glad that "those who have gone before" are willing to stay around and support those of us who are at the beginning of the journey. My "gut" told me that 2 weeks was optimistic so I appreciate the input. I can provide my supervisor with a more realistic idea of the time this may take.

Becky :eek:
 
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