Question:
HELP! I'm feeling overwhelmed, depressed, anxious...

In two weeks I have my initial appointment with my PCP, when I will tell him I want WLS. I have been spending hours upon hours reading about and compiling surgery information, my health history, family history, diet history, etc., putting it all in a report folder to present to him. I know he will laugh at me, as I barely squeak by, BMI-wise, and I have a notoriously stingy HMO. I do have a few comorbidities, including very high cholesterol, but I completely expect this to be a very long and stressful battle, as far as getting my insurance to cover it. I know 100% that WLS is what I want, but I feel that it is so out of reach for me. Part of me wonders if I can even deal with this whole insurance aspect and if I shouldn't just go straight to the bank and apply for a loan and pay for this thing myself. I so desperately want to be on the otherside! I need a hug!!    — Samantha S. (posted on March 16, 2002)

March 16, 2002
Hi Samantha. I don't have any great words of wisdom for you, but I definitely identify with what you're going through. Your situation sounds very similar to mine (except my BMI is higher... but a year ago it was lower... I yo-yo terribly). I'm also wavering about whether to fight for my HMO to cover this or to try to get a loan to do it self-pay. If you ever want to talk about it, just email me.
   — Tally

March 16, 2002
No help or answers, but much sympathy here! <P> I'm waiting to see my PCP on March 27th. My big concern isn't getting WLS approved by my HMO, that shouldn't be a problem as long as my PCP agrees. But I'm pretty strongly set on having the BPD/DS which isn't done by any doctors in my state, nevermind my HMO's network!<P> I think at this point a solid yes or no would be easier than this waiting! At least then I could be concentrating on an appeal or something (I wish self-paying were an option if I needed it). Right now, I have a binder, myself, full of info on various surgeries, my views on why I want to have surgery rather than try dieting the weight off (and waiting for it to come back with reinforcements), surgeons, etc. AAAAAARRRRRRRGGGG! There, that felt better. ;)
   — Heather W.

March 16, 2002
I feel you!!! I'm willing to jump through the HMO hoops until I save enough money to self-pay! WHICHEVER COMES FIRST!!! Since I'm aiming for June, it's looking like self-pay. But, for me, I'd rather pay cash this year, than spend the next year hoping, praying, wishing and maybe STILL not having the surgery I want. Good luck!
   — Pamela B.

March 16, 2002
Samantha, I was positive that my pcp would object to referring me for WLS. I was wrong, he was supportive from day one. Then I was sure my HMO would deny me. They approved within four days. My BMI was 47, which I know is higher than yours, but I had no serious comorbidities. Then after I was approved and scheduled, I was sure I would die on the table. Obviously that didn't happen either. Sometimes it is just hard to believe we can and deserve to have things go right for us. Go forward with positive thoughts and good luck to you!
   — Donna L.

December 28, 2002
Samantha! Hi. I am in your same exact shoes. My BMI is 40 if I put quarters in my pockets. I know that my PCP will not approve this surgery b/c a year ago when I asked her help to loose weight, she denied any medications, stating they did not work, that I needed to just eat less and exercise more. I since have called my insurance co. and asked them for the criteria. Having a letter from your PCP was one of them. I told them how I felt about my PCP and she told me, "THEN FIND A PCP THAT WILL SUPPORT YOU!" Even though you have an HMO, you can still switch PCP's until you find one who is empathetic. Educate them about WLS, show them your homework, and don't take "No" for an answer. Also, the day my best friend found me crying over my anxiety, I told her, "My worst fear is that this surgery is too good to happen for ME, and that my insurance co. will laugh in my face, and that will take the only glimmer of hope I have had in a long time regarding WL and being freed from my body" Her wonderful response to me was: "Then pay for it yourself! A new car would cost more than $20k and only last 8-10 years. You are in your 30's and it would last your lifetime." And that my friend put everything in perspective for me. I will be the one to say whether or not this happens for me. Not my PCP, and not my insurance co. If You want this surgery, tell yourself "consider it done." The worst that can happen is you pay for it yourself, and there is no amount of money in the world that can put a price on your happiness and freedom. I am still pre-op and will gladly go through this process with you, encouraging and empowering you all the way. I too need a hug from time to time, today is a good day. [email protected] Michele from Denver
   — Michele B.

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