Guest guest Posted July 17, 2001 Report Share Posted July 17, 2001 .. Do I talk to a PCP first, or contact one of the DS surgeons first? When I contact the surgeon, what do I need to bring to a consultation? Do I need my dieting history then? My medical history? As much as I have researched about the actual surgery, I still seem to be totally clueless on my first few steps. How do I begin? What are the first steps I need to take? I'll appreciate any information on this. I also have a stupid question....lol....I haven't read anything mentioning alcohol and DS. Will I be able to have a glass of wine occassionally? I know I shouldn't even be concerned with this, and in the long run it doesn't really matter, but I'm just curious. Well to get you started....who you contact first depends on your insurance...if you need a referral you will want to have that before you see the DS surgeon. I didn't need a referral so I was able to just make my appts as I wished...not that I was able to get anything paid for...LOL Depending where you are, if you need a referral, make both appts, with the surgeon far enough after your PCP so you can get the referral first. Diet history is again related to insurance and your drs. I would write it all out because more than likely you'll need it. Just on a piece of paper write out what you did, how long, what you lost, why you went off etc. Do the best you can. I made mine up...how could I remember what I did for 37 years...I put down all the ones I'd done and the weight but I had to make up the dates as I had no idea. Your medical history will mostly be pertaining to problems you have relating to your weight or co-morbities. Depending on the surgeon and your insurance you may have to do a psych evaluation, various pre-op tests such as a gall bladder ultra sound, blood work, upper GI, etc...depending on your health issues. Alcohol.....you will be a cheap drunk...my understanding is a few sips is about all you can tolerate due to the small stomach and such. So keep that in mind if you drink. You can also get liver damage easier if my reading was correct on some reports I read. So step one...read your insurance policy or call them and ask what you need to do for a surgical consult. (I wouldnt tell them why yet) Step two...make your dr appts Step three. Get your diet history together and medical history for your dr visits. Hope this helps! Good luck. I remember my first days...you'll do great! ~~* AJ *~~ BMI 59 Surgery date 7/24/01 going self pay - Dr Baltasar Spain Check out the Bellingham Support for WLS WWW.lookin2bthin.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2001 Report Share Posted July 17, 2001 .. Do I talk to a PCP first, or contact one of the DS surgeons first? When I contact the surgeon, what do I need to bring to a consultation? Do I need my dieting history then? My medical history? As much as I have researched about the actual surgery, I still seem to be totally clueless on my first few steps. How do I begin? What are the first steps I need to take? I'll appreciate any information on this. I also have a stupid question....lol....I haven't read anything mentioning alcohol and DS. Will I be able to have a glass of wine occassionally? I know I shouldn't even be concerned with this, and in the long run it doesn't really matter, but I'm just curious. Well to get you started....who you contact first depends on your insurance...if you need a referral you will want to have that before you see the DS surgeon. I didn't need a referral so I was able to just make my appts as I wished...not that I was able to get anything paid for...LOL Depending where you are, if you need a referral, make both appts, with the surgeon far enough after your PCP so you can get the referral first. Diet history is again related to insurance and your drs. I would write it all out because more than likely you'll need it. Just on a piece of paper write out what you did, how long, what you lost, why you went off etc. Do the best you can. I made mine up...how could I remember what I did for 37 years...I put down all the ones I'd done and the weight but I had to make up the dates as I had no idea. Your medical history will mostly be pertaining to problems you have relating to your weight or co-morbities. Depending on the surgeon and your insurance you may have to do a psych evaluation, various pre-op tests such as a gall bladder ultra sound, blood work, upper GI, etc...depending on your health issues. Alcohol.....you will be a cheap drunk...my understanding is a few sips is about all you can tolerate due to the small stomach and such. So keep that in mind if you drink. You can also get liver damage easier if my reading was correct on some reports I read. So step one...read your insurance policy or call them and ask what you need to do for a surgical consult. (I wouldnt tell them why yet) Step two...make your dr appts Step three. Get your diet history together and medical history for your dr visits. Hope this helps! Good luck. I remember my first days...you'll do great! ~~* AJ *~~ BMI 59 Surgery date 7/24/01 going self pay - Dr Baltasar Spain Check out the Bellingham Support for WLS WWW.lookin2bthin.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2001 Report Share Posted July 17, 2001 Hi- I became a member of this list over a month ago and tend to read posts rather then write them, but I would like to know a few things. I have researched WLS for almost a year and have finally (after many tears and scarey thoughts) become confident and possitive about having this procedure. I'm still scared of course, but excited about the future. Now that I have finally decided to this, I really need some information on how to begin. Do I talk to a PCP first, or contact one of the DS surgeons first? When I contact the surgeon, what do I need to bring to a consultation? Do I need my dieting history then? My medical history? As much as I have researched about the actual surgery, I still seem to be totally clueless on my first few steps. How do I begin? What are the first steps I need to take? I'll appreciate any information on this. I also have a stupid question....lol....I haven't read anything mentioning alcohol and DS. Will I be able to have a glass of wine occassionally? I know I shouldn't even be concerned with this, and in the long run it doesn't really matter, but I'm just curious. Thank you all, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2001 Report Share Posted July 17, 2001 Hi- I became a member of this list over a month ago and tend to read posts rather then write them, but I would like to know a few things. I have researched WLS for almost a year and have finally (after many tears and scarey thoughts) become confident and possitive about having this procedure. I'm still scared of course, but excited about the future. Now that I have finally decided to this, I really need some information on how to begin. Do I talk to a PCP first, or contact one of the DS surgeons first? When I contact the surgeon, what do I need to bring to a consultation? Do I need my dieting history then? My medical history? As much as I have researched about the actual surgery, I still seem to be totally clueless on my first few steps. How do I begin? What are the first steps I need to take? I'll appreciate any information on this. I also have a stupid question....lol....I haven't read anything mentioning alcohol and DS. Will I be able to have a glass of wine occassionally? I know I shouldn't even be concerned with this, and in the long run it doesn't really matter, but I'm just curious. Thank you all, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2001 Report Share Posted July 18, 2001 > I have researched WLS for almost a year and have finally (after > many tears and scarey thoughts) become confident and possitive > about having this procedure. I'm still scared of course, but > excited about the future. It is an emotional time when you come around the deciding to have this done! ::hugs:: > Do I talk to a PCP first, or contact one of the DS surgeons first? I chose a surgeon first and then let his office handle the hoop- jumping. I had a PPO plan though, so I was able to self-refer. If you have an HMO, you might call the surgeon's office and ask them to refer you to a DS-friendly network PCP, and then you can go to that doc to ask for your referral. > When I contact the surgeon, what do I need to bring to a > consultation? Do I need my dieting history then? My medical > history? As much as I have researched about the actual surgery, > I still seem to be totally clueless on my first few steps. > How do I begin? What are the first steps I need to take? When I called for my initial consultation, Dr. Rabkin's office mailed me a long questionairre that I filled out and took with me to the appointment. This included a detailed health history and diet history and lots of other things. (You can find it in the " For Patients " section of Rabkin's website http://www.pacificsurgery.com.) I think that a lot of the docs do something similar. They will tell you what they need -- just follow their lead. > I also have a stupid question....lol....I haven't read anything > mentioning alcohol and DS. Will I be able to have a glass of wine > occassionally? I know I shouldn't even be concerned with this, and > in the long run it doesn't really matter, but I'm just curious. Dr. Rabkin is emphatic enough about NO ALCOHOL during the first year post-op that he requires his patients to sign a paper stating that they will abstain. I did drink about 1 ounce of champagne on Y2K Eve (when I was only 2 months post-op), and that 1-ounce made me woozy! The new instestinal configuration makes you a cheap drunk. lol. But the reason its important to abstain, especially during the time when the weight loss is rapid, is that the weight loss stresses our liver all by itself, and adding any further stress (such as drinking alcohol) is just not wise. I'm 21-months post-op now, and I do occasionally have a cocktail. Maybe twice a month or so, I'll have a margarita with a dinner out, or a rum punch, or somethng like that. I usually never have more than one drink, and that is usually enough to do me! M. --- in Valrico, FL, age 38 Starting weight 299, now 156 Starting BMI 49.7, now 26.0 Lap DGB/DS by Dr. Rabkin 10-19-99 http://www.duodenalswitch.com Direct replies: mailto:melanie@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2001 Report Share Posted July 18, 2001 > I have researched WLS for almost a year and have finally (after > many tears and scarey thoughts) become confident and possitive > about having this procedure. I'm still scared of course, but > excited about the future. It is an emotional time when you come around the deciding to have this done! ::hugs:: > Do I talk to a PCP first, or contact one of the DS surgeons first? I chose a surgeon first and then let his office handle the hoop- jumping. I had a PPO plan though, so I was able to self-refer. If you have an HMO, you might call the surgeon's office and ask them to refer you to a DS-friendly network PCP, and then you can go to that doc to ask for your referral. > When I contact the surgeon, what do I need to bring to a > consultation? Do I need my dieting history then? My medical > history? As much as I have researched about the actual surgery, > I still seem to be totally clueless on my first few steps. > How do I begin? What are the first steps I need to take? When I called for my initial consultation, Dr. Rabkin's office mailed me a long questionairre that I filled out and took with me to the appointment. This included a detailed health history and diet history and lots of other things. (You can find it in the " For Patients " section of Rabkin's website http://www.pacificsurgery.com.) I think that a lot of the docs do something similar. They will tell you what they need -- just follow their lead. > I also have a stupid question....lol....I haven't read anything > mentioning alcohol and DS. Will I be able to have a glass of wine > occassionally? I know I shouldn't even be concerned with this, and > in the long run it doesn't really matter, but I'm just curious. Dr. Rabkin is emphatic enough about NO ALCOHOL during the first year post-op that he requires his patients to sign a paper stating that they will abstain. I did drink about 1 ounce of champagne on Y2K Eve (when I was only 2 months post-op), and that 1-ounce made me woozy! The new instestinal configuration makes you a cheap drunk. lol. But the reason its important to abstain, especially during the time when the weight loss is rapid, is that the weight loss stresses our liver all by itself, and adding any further stress (such as drinking alcohol) is just not wise. I'm 21-months post-op now, and I do occasionally have a cocktail. Maybe twice a month or so, I'll have a margarita with a dinner out, or a rum punch, or somethng like that. I usually never have more than one drink, and that is usually enough to do me! M. --- in Valrico, FL, age 38 Starting weight 299, now 156 Starting BMI 49.7, now 26.0 Lap DGB/DS by Dr. Rabkin 10-19-99 http://www.duodenalswitch.com Direct replies: mailto:melanie@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2001 Report Share Posted July 18, 2001 It really depends upon the type of Insurance you have. I knew I wanted this surgery so when my company decided to swtich insurance plans so I selected a Blue Cross Blue Shield PPO plan which allows you to see doctors out of network and allow you to see specialists without a referral from your PCP. However I felt that it was important to have supportive PCP because my former PCP was an insensitive jerk. I asked people at the AMOS site to reccommend a PCP who was supportive and I found one and and developed a supportive relationship with him. I then made my appointment with DR Gagner in NYC. Everything just started rolling after that. If you have a tradional insurance plan you need a referral from your PCP. So your first step is to make an appointment with your PCP if you have traditional insurance and get a letter of referral and insure that he will write a letter of support. You also have to have a lot of pre-op test done which are expensive so you need to have your PCP order them for you if you are seeing a surgeon out of state or of your insurance requires that your PCP order all diagnostic tests. Read your policy carefully to find out what the requirements are. Good Luck!! > > > I have researched WLS for almost a year and have finally (after > > many tears and scarey thoughts) become confident and possitive > > about having this procedure. I'm still scared of course, but > > excited about the future. > > It is an emotional time when you come around the deciding to have > this done! ::hugs:: > > > Do I talk to a PCP first, or contact one of the DS surgeons first? > > I chose a surgeon first and then let his office handle the hoop- > jumping. I had a PPO plan though, so I was able to self-refer. If you > have an HMO, you might call the surgeon's office and ask them to > refer you to a DS-friendly network PCP, and then you can go to that > doc to ask for your referral. > > > When I contact the surgeon, what do I need to bring to a > > consultation? Do I need my dieting history then? My medical > > history? As much as I have researched about the actual surgery, > > I still seem to be totally clueless on my first few steps. > > How do I begin? What are the first steps I need to take? > > When I called for my initial consultation, Dr. Rabkin's office mailed > me a long questionairre that I filled out and took with me to the > appointment. This included a detailed health history and diet history > and lots of other things. (You can find it in the " For Patients " > section of Rabkin's website http://www.pacificsurgery.com.) I think > that a lot of the docs do something similar. They will tell you what > they need -- just follow their lead. > > > I also have a stupid question....lol....I haven't read anything > > mentioning alcohol and DS. Will I be able to have a glass of wine > > occassionally? I know I shouldn't even be concerned with this, and > > in the long run it doesn't really matter, but I'm just curious. > > Dr. Rabkin is emphatic enough about NO ALCOHOL during the first year > post-op that he requires his patients to sign a paper stating that > they will abstain. I did drink about 1 ounce of champagne on Y2K Eve > (when I was only 2 months post-op), and that 1-ounce made me woozy! > The new instestinal configuration makes you a cheap drunk. lol. But > the reason its important to abstain, especially during the time when > the weight loss is rapid, is that the weight loss stresses our liver > all by itself, and adding any further stress (such as drinking > alcohol) is just not wise. > > I'm 21-months post-op now, and I do occasionally have a cocktail. > Maybe twice a month or so, I'll have a margarita with a dinner out, > or a rum punch, or somethng like that. I usually never have more than > one drink, and that is usually enough to do me! > > M. > > --- > in Valrico, FL, age 38 > Starting weight 299, now 156 > Starting BMI 49.7, now 26.0 > Lap DGB/DS by Dr. Rabkin 10-19-99 > http://www.duodenalswitch.com > > Direct replies: mailto:melanie@t... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2001 Report Share Posted July 18, 2001 It really depends upon the type of Insurance you have. I knew I wanted this surgery so when my company decided to swtich insurance plans so I selected a Blue Cross Blue Shield PPO plan which allows you to see doctors out of network and allow you to see specialists without a referral from your PCP. However I felt that it was important to have supportive PCP because my former PCP was an insensitive jerk. I asked people at the AMOS site to reccommend a PCP who was supportive and I found one and and developed a supportive relationship with him. I then made my appointment with DR Gagner in NYC. Everything just started rolling after that. If you have a tradional insurance plan you need a referral from your PCP. So your first step is to make an appointment with your PCP if you have traditional insurance and get a letter of referral and insure that he will write a letter of support. You also have to have a lot of pre-op test done which are expensive so you need to have your PCP order them for you if you are seeing a surgeon out of state or of your insurance requires that your PCP order all diagnostic tests. Read your policy carefully to find out what the requirements are. Good Luck!! > > > I have researched WLS for almost a year and have finally (after > > many tears and scarey thoughts) become confident and possitive > > about having this procedure. I'm still scared of course, but > > excited about the future. > > It is an emotional time when you come around the deciding to have > this done! ::hugs:: > > > Do I talk to a PCP first, or contact one of the DS surgeons first? > > I chose a surgeon first and then let his office handle the hoop- > jumping. I had a PPO plan though, so I was able to self-refer. If you > have an HMO, you might call the surgeon's office and ask them to > refer you to a DS-friendly network PCP, and then you can go to that > doc to ask for your referral. > > > When I contact the surgeon, what do I need to bring to a > > consultation? Do I need my dieting history then? My medical > > history? As much as I have researched about the actual surgery, > > I still seem to be totally clueless on my first few steps. > > How do I begin? What are the first steps I need to take? > > When I called for my initial consultation, Dr. Rabkin's office mailed > me a long questionairre that I filled out and took with me to the > appointment. This included a detailed health history and diet history > and lots of other things. (You can find it in the " For Patients " > section of Rabkin's website http://www.pacificsurgery.com.) I think > that a lot of the docs do something similar. They will tell you what > they need -- just follow their lead. > > > I also have a stupid question....lol....I haven't read anything > > mentioning alcohol and DS. Will I be able to have a glass of wine > > occassionally? I know I shouldn't even be concerned with this, and > > in the long run it doesn't really matter, but I'm just curious. > > Dr. Rabkin is emphatic enough about NO ALCOHOL during the first year > post-op that he requires his patients to sign a paper stating that > they will abstain. I did drink about 1 ounce of champagne on Y2K Eve > (when I was only 2 months post-op), and that 1-ounce made me woozy! > The new instestinal configuration makes you a cheap drunk. lol. But > the reason its important to abstain, especially during the time when > the weight loss is rapid, is that the weight loss stresses our liver > all by itself, and adding any further stress (such as drinking > alcohol) is just not wise. > > I'm 21-months post-op now, and I do occasionally have a cocktail. > Maybe twice a month or so, I'll have a margarita with a dinner out, > or a rum punch, or somethng like that. I usually never have more than > one drink, and that is usually enough to do me! > > M. > > --- > in Valrico, FL, age 38 > Starting weight 299, now 156 > Starting BMI 49.7, now 26.0 > Lap DGB/DS by Dr. Rabkin 10-19-99 > http://www.duodenalswitch.com > > Direct replies: mailto:melanie@t... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2001 Report Share Posted July 18, 2001 AJ- Thank you so much for the great info and for taking the time to give me so many details. I have briefly glanced at my Insurance coverage (HMO Blue Choice Select). This is what is states at my local BC BS website: " Special Help for Members with Morbid Obesity or Chronic Pain Our bio/behavioral health case management program is a unique service that helps coordinate and facilitate care for members whose medical illness has a significant behavioral component. Examples include morbid obesity and chronic pain. Morbid Obesity As part of this program, our case managers have followed all members approved for gastric bypass surgery (weight reduction) since January 1998. Members are contacted before surgery to make sure they are ready for surgery and the post-surgical lifestyle changes needed to succeed. We continue to follow these members for one year to guide their nutritional and exercise changes, and triage symptoms when necessary. In March of 1999 we launched a weight management pilot in cooperation with the University of Rochester's CORE program. This 46-week program includes medical, behavioral, nutritional, and exercise components. The program offers a comprehensive approach to weight management that can be tailored to meet individual needs. " I think this sounds positive....what do you think? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2001 Report Share Posted July 18, 2001 Thank you and everyone who responded to my questions. I can't tell you how much I appreciate everyone for helping me. I am curious though...does anyone else have any experience with Blue Choice Select? It is an HMO in my area of Western New York. Another question (lord, I have an attack of endless questions..lol)...I live in a very rural area and the doctors are...ummm...how do I say this nicely? Oh forget nice, I'll stick with honest...they are not very good and from what I have been able to see, they have no idea how to care for a patient who has had DS surgery. (I'm not even sure they would know what DS surgery is) How would I find a PCP in my area who is knowledgable about after care for this surgery? I have read many posts which suggest not giving Blue Cross any early indication that a person is looking to have DS Surgery. This being the case, I can't really call Blue Cross and say I am looking for a PCP who can help after DS surgery. Any suggestions on how I would find a doctor in my area? Thank you again. Take care, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2001 Report Share Posted July 19, 2001 >... I have briefly glanced at my Insurance >coverage (HMO Blue Choice Select). This is what is states at my >local BC BS website: > > " Special Help for Members with Morbid Obesity or Chronic Pain >Our bio/behavioral health case management program is a unique service >that helps coordinate and facilitate care for members whose medical >illness has a significant behavioral component. ... > >I think this sounds positive....what do you think? > Sounds like a way to put you off for at least 46 more weeks before they have to ante up and pay for WLS. This comes close to " bait and switch " in my mind. --Steve -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2001 Report Share Posted July 19, 2001 - > would I find a PCP in my area who is knowledgable about after care > for this surgery? I have read many posts which suggest not giving > Blue Cross any early indication that a person is looking to have DS > Surgery. This being the case, I can't really call Blue Cross and say > I am looking for a PCP who can help after DS surgery. Any > suggestions on how I would find a doctor in my area? Thank you again. I guess there are a couple things you can do in a situation like this. It kind of depends on how far you are from your surgeon. I live about 45 minutes away when traffic is good, so I chose a PCP that is right in the same building as my surgeon and who has had other patients go to this surgeon, etc.. I think it is so important to make sure you get good care afterwards! I have talked to all kinds of people who have had this surgery and some people have complications and some people have long term difficulties with nutritional status(usu. because they don't take their vitamins). But, you want to have a PCP who is going to help identify any problems and work with you to get them fixed up. So ideally, if you can find a PCP that knows about the surgery maybe you can find one that is fairly open-minded and is willing to let you and your surgeon educate him/her. I mean, that is the other thing, you can enlist your surgeon by having him talk with your PCP to make sure your PCP has all the details to give you good care. And then of course it always helps if you bring your PCP literature to read. For some reason, maybe it is all the journals they have to read in med school or something, docs seem to be more impressed with papers than patients sometimes. Anyhow, good luck! Amy Y. Fremont, CA DS July 6, 2001 Rabkin/Jossart Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 19, 2001 Report Share Posted July 19, 2001 , You have a couple of options. Right now though you need to concentrate on geetting through the red tape and getting you surgery. But here is how you can handle post op care: Very early on you might want to make the trip to your surgeons office for a couple of post-op visits. After than have you surgeon send the list of test for you PCP to order. Then have the results faxed back to the surgeon. Ask your suregon to review the results (as well as the PCP) for any abnormality. If there is a serious problem then get your PCP to write another refereal right away. Try to get an understanding with your PCP that you need quick action if their are nutritional issues. You don't need to worry about this now, you can deal with it later. You HMO will usually let you follow up with the surgeon at least a couple of times before asking you to use your PCP. Wait until after the surgery to resolve these issues. Hull > Thank you and everyone who responded to my questions. I > can't tell you how much I appreciate everyone for helping me. I am > curious though...does anyone else have any experience with Blue > Choice Select? It is an HMO in my area of Western New York. > > Another question (lord, I have an attack of endless > questions..lol)...I live in a very rural area and the doctors > are...ummm...how do I say this nicely? Oh forget nice, I'll stick > with honest...they are not very good and from what I have been able > to see, they have no idea how to care for a patient who has had DS > surgery. (I'm not even sure they would know what DS surgery is) How > would I find a PCP in my area who is knowledgable about after care > for this surgery? I have read many posts which suggest not giving > Blue Cross any early indication that a person is looking to have DS > Surgery. This being the case, I can't really call Blue Cross and say > I am looking for a PCP who can help after DS surgery. Any > suggestions on how I would find a doctor in my area? Thank you again. > > Take care, > > Quote Link to comment Share on other sites More sharing options...
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