Where do I start?

[Dgunstone]

Hello everyone,
I am finally in a position to pay for surgery. I have done a quick phone call chat with weight loss consultant, and have information for surgery with Dr. almonza. What else should I be looking at? Where can I get honest reviews of patients experiences in TJ? I know that, at 270lbs, 5'4 , I qualify. I know that it's around 4k, plus travel to San Diego. That's it. How do I decide which doctor is a good 'fit' for me?
Anything else I should be prepared for?
With gratitude, Dara

[The North Sleeve]

Well I sure wish I could help you out with info about Doctors in Mexico. I have no experience with that and I don't want to give you bad information so I will let others who know more give you your answers. I would like to welcome you to the forum and wish you the best of luck with your journey. You will be very happy with yourself when it's all over and you begin your journey. Keep us posted!!

[tonewbeginnings]

Hi, I am right in the middle of listening to the latest podcast (Weightloss surgery podcast hosted by Reeger Cortell). This months podcast is about a first hand account of a patient getting her sleeve in TJ. She talks about her experience from clinic selection to after surgery. It might be interesting and informative to listen to. Other than that I don't know anybody that has had their sleeve done there. Good luck to you

[Dutchie]

Just wondering: you BMI is around 47, if my calculations are correct.
In Europe you get approval from the insurance companies when the BMI is higher than 40, or between 35 and 40 with co-morbidities.

I don't think I understand the requirements in the US, if this BMI is not good enough.
What are those requirements exactly?
Or does that vary from one company to another?

Best of luck to you!
I don't know anything about this surgeon, but I would never go to the cheapest one, but that's me...

[AnnieG]

Just wondering: you BMI is around 47, if my calculations are correct.
In Europe you get approval from the insurance companies when the BMI is higher than 40, or between 35 and 40 with co-morbidities.

I don't think I understand the requirements in the US, if this BMI is not good enough.
What are those requirements exactly?
Or does that vary from one company to another?

Best of luck to you!
I don't know anything about this surgeon, but I would never go to the cheapest one, but that's me...

US requirements are different depending on your insurance, which is (in my thinking) a bit arbitrary. I had been as high as 240, but was not in a position with my health to have any more surgeries. I managed to get my weight down to 204, but it dropped me out of the BMI parameter for our insurance. I did have 5 co-morbidities, but even though docs know they are reduced/improved by VGS, insurance looks at cost recoupment, profit or break even. So then they set a very high bar - for me it would have been 1 year of dietary appointments and following diet, exercise, and counseling. So we went self pay because my comorbidites were so bad that they were a larger concern than the money.

I wish I knew more about TJ. There are lots of folks who have done that, so I'm sure you'll get lots of information. Best to you!

[KiwiGal]

Hi. Sorry I can't help with any of your questions. Way different system here in NZ.
I'm sure someone will be along shortly who will have the answers to your questions.
Good luck and keep us posted on how you get on please.

[Christie13]

Congrats on your decision and ability to get surgery. Reach out to Tamera2. She used Dr. Almanza and will be able to give you lots of good advice and information.

[Dgunstone]

Hi guys! Thanks for the responses. I've been pre-approved with Dr. Almanza, for the sleeve. Thank you for the podcast referral, I'm enjoying it as we speak. I haven't set a date yet, pending receiving the money. Dreading this diet, just anxious. I know I can do it. Wish I had thought of it sooner. I'm still not set in stone about Tijuana. If I could find a surgeon, reputable, in US, for around 8k, I would jump on it. I suppose I should start looking...family thinks I'm crazy for going to Tijuana for surgery...

[Dutchie]

US requirements are different depending on your insurance, which is (in my thinking) a bit arbitrary. I had been as high as 240, but was not in a position with my health to have any more surgeries. I managed to get my weight down to 204, but it dropped me out of the BMI parameter for our insurance. I did have 5 co-morbidities, but even though docs know they are reduced/improved by VGS, insurance looks at cost recoupment, profit or break even. So then they set a very high bar - for me it would have been 1 year of dietary appointments and following diet, exercise, and counseling. So we went self pay because my comorbidites were so bad that they were a larger concern than the money.

Thank you Annie!
Sounds to me like they have an awful lot of power...
Not good, in my opinion.
But there is this tendency here in Europe to follow the US guidelines, that worries me.
We pay a lot to have those insurances, but they not always have our best interest and well being at heart, it seems.

Sorry for the off topic.

[AnnieG]

Thank you Annie!
Sounds to me like they have an awful lot of power...
Not good, in my opinion.
But there is this tendency here in Europe to follow the US guidelines, that worries me.
We pay a lot to have those insurances, but they not always have our best interest and well being at heart, it seems.

Sorry for the off topic.

Not off topic at all! I spent my life working as MH clinician, and one of the issues the US companies (not health professionals) are pushing is payment based on outcome. (You know, like if your car isn't right after the mechanic documents he did his best to repair it). And the lobbyists for insurance companies and especially pharmaceuticals. It's very corrupt, very controlled and very linked to politician pockets. (My apologies if any one here is in those professions -- you are probably the exception).

I had a "scope" yesterday related to my cancer life. It was clear, hooray. But my gastro hepatologist remarked on the weight loss and the amazing improvement in all my labs. Same with cardiologist, oncologist, neurologist, primary care doctor, and neurosurgeon. ALL have said it is known to them that VGS is an enormous tool towards better health for most patients, but that insurance doesn't cover it in part because most Americans only stay with a company 1 year. Often because your employer goes with someone else who gets them a less costly policy for the group (not better, just less $).

That said, insurance does not break even on weight loss surgeries, nor come near recoupment of costs. It's a badly broken system in so many ways.

Those of us who are retired pay a monthly premium for our Medicare insurance, plus whatever we have to pay for the "Part D" coverage. Ours this year is through UHC/AARP.

For me, the insurance company would have been savvy to pay for the VGS about 10 years ago; I might have spared them 7 heart stent surgeries, an open heart surgery, 2 rounds of cardiac rehab, and cardiac EECP treatment (roughly over $200,000 insurance costs). And the quality of my life would have been better.

Until there is some uniformity/consensus and political clout behind weight loss surgery, I do not anticipate it getting better. It is not necessarily meant as a discouraging thought, but we all need to be aware that perhaps our success can be an impetus to action to change things for other people.

[Dgunstone]

And sadly, I am out of the game. My financial source is no longer there. My grandfather will is now contested, which take years. Sigh.

[Luann]

I'm so sorry. Maybe another avenue will open up for you. As for insurance, many employer based insurance plans in the US do not cover bariatric surgery at all. The employer must select coverage as an option.

[Quarry]

And sadly, I am out of the game. My financial source is no longer there. My grandfather will is now contested, which take years. Sigh.

Hi, Dgunstone. Three years ago I joined this forum to explore the sleeve. If it were not so costly, I might have taken that route. I still read posts here from time to time to continue my understanding of this method of weight loss and to follow the storylines of people here with whom I've become familiar.

As it happens, I fell in with the low-carb/high-fat or keto way of eating. No one is more surprised than I to report I've lost 70 pounds without having to wrestle with myself over hunger. Until your financial prospects change, you could explore LCHF. There's tons of both information and mis-information online, but the dietdoctor website is a good entry point from which to get a basic grasp. There are three notions I'll reinforce: (1) Let go of your preconceptions about what fat does to/for us; (2) Mind the electrolyte advice (increase magnesium, potassium, sodium); (3) Give yourself several weeks for your body and mind to adapt. Google "keto" and your favorite foods, and you'll find recipes for virtually anything.

Wishing you well. We're all working to become our best selves using those tools that are within our grasp.

[SapphireLevaou]

Hello everyone,
I am finally in a position to pay for surgery. I have done a quick phone call chat with weight loss consultant, and have information for surgery with Dr. almonza. What else should I be looking at? Where can I get honest reviews of patients experiences in TJ? I know that, at 270lbs, 5'4 , I qualify. I know that it's around 4k, plus travel to San Diego. That's it. How do I decide which doctor is a good 'fit' for me?
Anything else I should be prepared for?
With gratitude, Dara

hey so if you go to my page i have a list of surgeons and their pricing, please check it out!!