Question about being diagnosed with

bling · 02-12-2008, 06:34 AM

I have a question....

In order to be diagnosed with something, you have to have it, right? What about High Cholesterol? If you have the high numbers, doesn't that mean you have it? Or, does the doctor have to actually make note in your charts that you have it?

My numbers have been high the last few times I have had blood work done, but never been "officially" diagnosed I don't think. Would I have to actually be on medication to be seen as having it?

My BMI is under 40 so I need 2 co-mobidities. I am on BP meds due to high blood pressure, so I need one more. My labs show me to have high cholesterol, but the doc doesn't want me on meds, she wants me to try diet and exercise first (HAHAHAHA)....

Anyway, how does insurance look at these kinds of things? Will the labs that show high levels be enough or do I have to actually be on meds for them to see me with high cholesterol?

shortgal · 02-12-2008, 06:43 AM

I don;t know how your ins company evaluates the co -morbidities, but high cholesterol is anything above normal. so above 199 is high. But there are different levels that Dr's will decide that it's time for meds to control it. Like once it rises over 250. A dr will also evaluate your other numbers like the good and the bad cholesterol and your tricyclerides before deciding if an RX should be prescribed.

But is your number is above normal, then it's high.

This is true of high blood pressure. A small elevated level and the Dr. might not prescribe, but a higher level, they will.

Did you have a sleep apnea test? Being diagnosed with that is a co-morbid.

Jeni 85 · 02-12-2008, 06:54 AM

Just because your not on meds doesn't mean you don't have it talk to your dr. and be honest with them... let him or her to you... but im assuming you do because she wants you to try to get it down through diet and exercise.. dr always want to try this first before RX .

shortgal · 02-12-2008, 07:07 AM

I personally think it's great that a Dr. doesn't want to hand out RX so easily. For some people a little education about waht they have such as high blood pressure or high cholesterol is enough to get them to eat better or reduce salt intake etc.

Of course if the level is too high, especially blood pressure, waiting to start a person on meds is not advisable.

A pill is not an easy fix. They can have side effects and are metabolized by our livers and can effect our kidneys. All we notice is that our cholesterol or blood pressure goes down, we don't see or realize the other effects for years.

Several years ago my cholesterol was 236 and I decided to diet to see if I could get the numbers down. After 6 months my cholesterol went down to 180. A drop of 56 points and put me in the normal range. Not everyone can reduce their numbers by that amount, but now I know I can, at least for now, cholesterol elevates as we get older.

I also saw a reduction in my tricyclerides, although they were in normal range to begin with.

Maybe you could ask your ins. company what comorbids they will accept for surgery.

bling · 02-12-2008, 07:08 AM

I did have the sleep study done and I don't have apnea...

My cholesterol levels are 250 and my triglycerides levels are 221. So, according to my results I have high cholesterol. Guess I will need to see what UHC says...

GayleTX · 02-12-2008, 12:21 PM

Can you ask your doctor to make a notation on your medical records that you do have the high chol. and triglycerides? You don't have to be on meds for it to be a co-morbidity I (had discontinued the meds because of the side effects but it was still on my medical records that I had the bad lab readings). Talk to him and tell him you need his help in getting qualified. It might cost you an office call but it would be worth it if it helps you qualify.

Rainer · 02-12-2008, 12:52 PM

I don't understand...whether you have medication or not, you have high cholesterol. Medication doesn't make the diagnosis any more valid....it just means you are on medication for it.

I was borderline hypertensive and my cholesterol was borderline as well...That was written in my letter from my pcp along with a few other aches and pains due to my weight.

Your dr. will certainly say your cholesterol is high and that you are hypertensive.

Good luck with your approval!

Rain