|
|
Post by georgiagirl on Jan 1, 2012 13:42:33 GMT -5
OK, so I've looked at my insurance and as near as I or anyone I have called can figure, WLS is covered. I'm still trying to lose weight. I would like to have the surgery in June (I'm a teacher and out of school then), but I'd like to lose some weight before then. I'm running a scooter cannonball race in April and it is easier to buy safety gear if I'm down to a size 16 (which is probably a size 14 in people clothes). I know I can do it, the problem is twofold. I've lost this much weight before. My cholesterol and blood sugar don't respond to weight loss. At all. Numbers are all identical. I don't respond well to cholesterol medication and can only take Zetia, which doesn't seem to be changing my cholesterol at all a year later, and only glucophage for the diabetes. After that my control is all diet. I have to diet hard to get the weight off, and as soon as I stop watching my every bite I bounce back to 220-250 where I stay. Don't gain any higher, I'm really stable there. So my questions - Those of you who were Type II before - how many of you responded well to the DS surgery? The statistics are hard to believe, what was your experience? If I lose enough weight to be comfortably in riding gear, will I place myself out of the DS range? I know and respect how many of you needed to lose far more weight than me, but I'm exploring this more as a way to mediate my health problems (though fitting in nice clothes wouldn't hurt my feelings  ) |
|
|
|
Post by fullhousemom on Jan 1, 2012 13:56:19 GMT -5
Whether you are able to have the DS will depend on your doctor and your insurance. It sounds like you have two comorbids, so if your bmi is above 35, you shouldnt have a problem. However, I would stress that your insurance will dictate those terms. If your insurance is more restrictive, then you may need to pursue the issue with Diana Cox on this site.
Doctors also have their own guidelines and each doctor is different. I read a post from one woman whose doctor only believes in DS if one weighs over 700 pounds! My bmi was around 39 with no comorbids, and my doctor had no problems giving me the DS. I was also self pay and didnt need to stay within insurance guidelines.
A good place to start is to look at your insurance contract and start interviewing DS surgeons.
And best of news! My dad had type 2 diabetes and took the same medication you take. His blood sugar and cholesterol problems were resolved almost immediately. He no longer has sleep apnea. He is 5 years out and at 67 years old, hasnt been this healthy in many many years!
|
|
|
|
Post by hoosiermama on Jan 1, 2012 14:04:05 GMT -5
I left the hospital no longer needing my metformin nor my glyberide. The highest blood sugar reading I have had since about a week or so after surgery has been 115. I'm new so I haven't had a cholesterol test yet but I can't wait  As for insurance, your best bet is to KNOW your policy limitations and exclusions....it's like a conspiracy to keep America fat! |
|
|
|
Post by georgiagirl on Jan 1, 2012 15:02:34 GMT -5
I'm sorry, I wasn't clear - I wasn't asking insurance questions. My husband's company is self-insured and I am wading through that right now. It was more just about how many of you had your diabetes and cholesterol issues resolve, and if I would make myself ineligible if my BMI went below 35.
Thanks to both who replied about blood sugars - that is hopeful.
|
|
|
|
Post by vangy04 on Jan 1, 2012 15:38:47 GMT -5
I'm sorry, I wasn't clear - I wasn't asking insurance questions. My husband's company is self-insured and I am wading through that right now. It was more just about how many of you had your diabetes and cholesterol issues resolve, and if I would make myself ineligible if my BMI went below 35. Thanks to both who replied about blood sugars - that is hopeful. I think their point about the insurance bit is that it will depend on your insurance guidelines whether having a BMI below 35 will disqualify you for a DS. |
|
|
|
Post by fullhousemom on Jan 1, 2012 17:18:28 GMT -5
Exactly. If your BMI is less than 35, then the surgery may not be covered by insurance. Just because "WLS is covered" doesnt mean there arent restrictions on when it is covered or how it is covered. There are approvals, diets, waiting periods, pysch consults which must also be taken into consideration.
|
|
|
|
Post by Joanne on Jan 1, 2012 17:19:55 GMT -5
Have you been to www.dsfacts.com?There are links to peer reviewed studies there that show the statistics on the DS curing diabetes. I would judge by the statistics (which are excellent) rather than personal stories. However, if you're looking for some real life examples, I can name at least a dozen right off the top of my head (including my brother), and there have to be many, many more. Only you can determine just how important this April race is to you. IMHO why risk your insurance coverage over it? If you meet the weight qualifications now, go for your approval now. You can always schedule your surgery for the end of the school year but is this race worth risking your surgery and the solution to your health problems over? |
|
|
|
Post by sherbearmama on Jan 1, 2012 17:31:45 GMT -5
I just had my DS 4 weeks ago and so far my blood sugar readings in the morning are still in the diabetic range. I've lost about 25 pounds so far so I'm surprised that the numbers aren't reflecting that. However, I've been told that once I lose another 10-20 pounds it should make a difference. I stopped taking my Metformin before going into surgery and can't take it now because I'll upset my stomach. But I'm confident that the DS will have some impact on it within the next year.
As for losing weight pre-surgery, it was the best thing I did. I lost 25 pounds pre surgery, started a walking regimen and got in really good shape. I still had a BMI of 37 or so but I believe my recovery was so much better because of how healthy I got before surgery. NOW, advice for you--maybe this isn't good advice, but I used it for me since my insurance was strict about BMI requirements: I wouldn't do much weight loss until you're approved for surgery. You can always delay the surgery by however long, so that you can drop a few pounds and get into good cardiovascular shape. But I'd be worried that if you lose too much, you could be denied your surgery because you don't make the BMI requirement.
I wish you luck. I'm sure some of the other diabetics on the forum will chime in with how well they've done. Most of the people I asked about it said that they went home from the hospital without their meds and did great.
Good luck!
Sheri
|
|
|
|
Post by teachmid on Jan 1, 2012 19:13:36 GMT -5
I took my last dose of Metformin the day before surgery and my last insulin 2 days after surgery. My blood sugars are normal and my A1C is in the non-diabetic range. I was initially diagnosed with DM in 1985; got a 6year reprieve after my RNY; then my DM and the weight came back with a vengeance. My #1 goal with my DS was to improve my DM.....I'm ecstatic that its gone.
|
|
|
|
Post by shann_ds on Jan 1, 2012 19:43:53 GMT -5
Like Gail, I took my last dose of Metformin the day before surgery. My blood sugars and A1C are normal. I had gestational diabetes with both my kids in 2001 & 2004. I developed full blown diabetes in 2008 and used 2 oral meds for it until my surgery in 2010. I kept careful count for a while, but I now just check it randomly. Every time I check it's completely normal.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Jan 2, 2012 10:36:33 GMT -5
Yes, you will make yourself ineligible if your BMI drops below 35.
Regarding type II diabetes: I'd been on insulin since 1992 and oral meds since 1993. I was off insulin within a month, off Actos in a few more months. I am CURED, as in I have had the equivalent of a negative glucose tolerance test.
It's not the weight loss that does it, it's the intestinal changes. These only happen in the DS.
|
|
|
|
Post by sherbearmama on Jan 2, 2012 11:19:35 GMT -5
Yes, you will make yourself ineligible if your BMI drops below 35. Regarding type II diabetes: I'd been on insulin since 1992 and oral meds since 1993. I was off insulin within a month, off Actos in a few more months. I am CURED, as in I have had the equivalent of a negative glucose tolerance test. It's not the weight loss that does it, it's the intestinal changes. These only happen in the DS. EN, I'm 4 weeks out and my blood sugar levels are still in the diabetic range. I'm worried that the DS isn't going to have much affect on my diabetes--which would really suck because this is exactly why I had the surgery. That's why I just figured I'd take a "wait and see" sort of attitude. So have you heard of this happening before? Sheri |
|
|
|
Post by hoosiermama on Jan 2, 2012 11:39:28 GMT -5
Sherbear,
Have the numbers changed? What were you fasting numbers before and after?
me
|
|
|
|
Post by sherbearmama on Jan 2, 2012 11:56:42 GMT -5
Sherbear, Have the numbers changed? What were you fasting numbers before and after? me The fasting numbers are exactly the same as they were pre surgery. I was on Metformin though so i'm sure they're better now since I'm not taking Metformin anymore--it always made me sick to my stomach so I figured it would be worse now. But WITHOUT the Metformin, I'm still diabetic. I never really found that with the drugs that my blood sugar was high after eating a normal meal though so I doubt that's an issue since I'm eating almost all protein now. I'm bummed though that my fasting is still above 130. |
|
|
|
Post by dlappin413 on Jan 2, 2012 12:01:24 GMT -5
I am 9 weeks out this coming Wed (two days from now). I took my last doses of metformin and actos the day before surgery and haven't had any since. My readings are usually in the 100-115 range without meds now but it does spike up to about 150 every once in awhile. I also had high blood pressure and cholesterol issues pre-surgery and have totally stopped meds for those. My last cholesterol readings were well within normal range with the exception of HDL which was slightly low. My BP readings are consistently good in the 105/70 to 120/80 range, usually on the lower end. So, for me, DS has taken care of those three co-morbidities to this point. I have my 3-month labs at the end of January and we'll see what happens then.
|
|
|
|
Post by shellyac on Jan 2, 2012 12:40:57 GMT -5
It is highly likely that the DS will help to improve your diabetes. The sleeve alone was shown to result in "remission rates of type 2 diabetes...between 60% and 80% depending on the patient population and length of
follow-up. A systematic review of diabetes remission rates after SG included 27 studies and 673 patients.33 At a mean follow-up of 13 months, diabetes had resolved in 66% of patients and improved in 27%. There was a mean decrease in blood glucose of -88mg/dL and a mean decrease in HbA1c of -1.7%." The above was taken from the ASMBS position statement on the sleeve. By going with the DS I would think that those figures would only increase. As you can tell from some of the other posters, you might not have immediate improvement but it will improve in time.
As for making yourself ineligible that may depend on your insurance and when you begin fulfilling their requirements, it could be that if you start your program meeting their requirements it doesn't matter if you are under their BMI requirement at the time of surgery, also if you have a qualifying BMI within a specified past time period that would be good enough.
Finally although your insurance does cover WLS you confirm what they cover and when, for example my insurance will only cover the band and the bypass for BMIs between 35-50 and will also cover the sleeve for BMIs over 50. I'm not sure what the requirement is for DS specifically but I assume that it starts with a BMI of 50. It's important to know what obstacles you may face from the beginning instead of finding out when you a finally ready to schedule the big day
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Jan 2, 2012 13:02:42 GMT -5
Finally although your insurance does cover WLS you confirm what they cover and when, for example my insurance will only cover the band and the bypass for BMIs between 35-50 and will also cover the sleeve for BMIs over 50. I'm not sure what the requirement is for DS specifically but I assume that it starts with a BMI of 50. It's important to know what obstacles you may face from the beginning instead of finding out when you a finally ready to schedule the big day It more depends on who is providing your insurance...cause the Medicare standard includes the DS with NO BMI limit. With that said... I have been diabetic since 1997 and on insulin since 2002. I petitioned and got on an insulin pump even tho I am a type II. I was also on metformin. My surgery was Jan 24th...glad I ignored the PA who told me to take off my pump...the surgeon saw it and said it was fine as I was on a very low dose. Came out of surgery still needing it. On Feb 1, I stopped using the pump and on the 11th of Feb took my last insulin. A week later, we cut my metformin from 2000 a day to 500. By April, I was off that as well. Last Oct, 2010, my a1c was 8.2. Three months after surgery it was a 6.3. This Oct 2011, it was a 6...and I should be lower than that next set of labs due in a few weeks. It doesn't ALWAYS happen overnight but it usually does happen. Exception to that rule are type 1's or 1.5's. forecast.diabetes.org/magazine/features/other-diabetes-lada-or-type-15Liz |
|
|
|
Post by curiouscat7 on Jan 2, 2012 14:21:21 GMT -5
Hi... Unfortunately the State of GA has decided not to cover WLS in 2012...it has been a topic on OH Ga board for a while.....  I would check your new insurance for 2012...and yes some GA teachers qualified for the DS but that was when WLS was covered. CC |
|
)
