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Blsmbry

LAP-BAND Patients
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Posts posted by Blsmbry


  1. Hi that's so funny! I'm 13 weeks out and my stomach growles like crazy. Im not sure what calms it down but this has been happening every since I came home from the hospital. I assuming it can be gas bubbles or something. I'm sorry I can't be of much help, just know you're not alone. Good luck!


  2. I'm 33 days post-op with a 30lbs loss. I just have this fear that I wont lose as much as I will like to. I also purchased some HCG before my surgery and did not use it. I was just thinking about incorporating it into my sleeve at this time. Am I to nervous or should i just chill out a bit and give myself some time before I do HCG? Just your thoughts!


  3. Hello Ladies,

    Words can not express how I'm feeling right now. From the moment the ins. rep told me that I was approved for wls, my life started to change at that very moment. I am so blessed and grateful that "it's my turn now"! Faithfulness is a powerful force and I'm just so happy to share it with others!

    Pre-op 2/24

    Surgery schedule 3/1

    1st day liquid diet 2/16

    Thanx!


  4. Tomrrow is the do or deny day for wls! I'll keep you posted as soon as I know something. In the mean time, I would like to thank all of you for your support and prayers and though I may not continuing posting if I'm denied but I surely will return when I get on the ban wagon to have wls! Tthanx! I love you guys!!! :P


  5. Awesome! I am 32 yoa and have been researching wls every since 2005. I am employed with a company that covers wls. However, I have been denied twice. They say the 3rd tyme is a charm right? Well we'll just have to see about that. My consistency will pay off at the end. My ins company has everything that they need from me, physc eval, 5 yr weight history and some clinicals. my surgeon submitted the paper work on Jan 25 so I'm still waiting on the verdict. LoL :P Thank you for this thread I'll visit more often.

    Blsmbry


  6. I am currently waiting to be approved for VSG. Like you, I too want to have kids. My thing is just like the others have said. I'm going to be successfuk in weight loss and go through my pregnanices and after I've had two then I'm going to get myself fixed up. So, if I were you I would wait until after you have kids like I would. Good Luck!!! Tootles!!!!!!


  7. Hello,

    First of all I hope everything works out well for you. This insurance process can put you on a roll-a-coaster ride that will try to throw you if you're not strong enough. Hold on and don't give up. I was denied intial and was denied again because my 5 year history was not included. A couple of days ago my insurance re-submitted with my 5 year history for pre- determination so hopefully I'll be approve this time. Also I wrote my own appeal letter and I will like to share it with you. You can edit or add what pertains to you. Good Luck. Keep us updated!

    <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>I am writing this letter to appeal United Healthcare decision to deny coverage for laparoscopy, surgical, gastric restrictive procedure that was denied. Based on the letter of denial dated December 22, 2010, this procedure was denied because “ the minimum of five year weight history was not met. Therefore, this service is not a covered benefit under plan. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>I was referred for this surgery by my PCP, who is very concerned about my health because of severe morbid obesity. I am a 32 year old morbidly obese female who is 5’4 iches tall and weigh 298 lbs., giving me a body mass index of 49. The body mass index is calculated by dividing a person's weight in kilograms by their height in meters squared. When a man's BMI is over 27.8, or woman's exceeds 27.3, that person is considered obese. The degree of obesity associated with a particular BMI ranges from mild obesity at a BMI near 27, moderate obesity at a BMI between 27–30, severe obesity at 30–35, to very severe obesity for patients with a BMI of 40 or greater. Therefore, I may be classified as being very severely obese. The annual number of deaths in America attributable to obesity has been estimated to be 300,000 deaths per year With my abnormally high BMI, I am at an estimated 190 percent increased risk of death at my present weight. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>After you reviewed my additional clinical information I know you have found to fact, that I have co morbidities of Obstructive sleep Apnea, Polyarthralgias, and Gerd. I have made many, many attempts to lose weight and this has gone on all my life. My previous over the counter weight loss aids, such as Slim Fast, South Beach Diet, Atkins, Hoodia pills, Alli, Slim Quick, and LA Weight loss was only a 5-10% success. I would lose some weight then gain it all back, and more. As you can see, I have spent all my adult life trying to lose weight. I am now at the point where everything is an effort. I have functional impairment in the activities of daily living. This dysfunction impacts sleep, recreation, work and social interactions. I am having significant adverse symptoms from my obesity. I have difficulty standing. I have difficulty performing my daily activities, and in participating with my family in recreational activities. I suffer from sleep apnea and acid reflux. I have arthritis and pain of my weight-bearing joints. An increase in body weight adds trauma to weight bearing joints and excess body weight is a major predictor of osteoarthritis of the knees. This is a mechanical problem and not a metabolic one. Weight loss will markedly decrease the chance of developing osteoarthritis. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoBodyText>Both my PCP and I believe that laparoscopy, surgical, gastric restrictive procedure is medically necessary and will significantly benefit my health. I believe that laparoscopy; surgical, gastric restrictive procedure will increase my overall health physical, mentally, emotionally, and even finically. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>However, I have included additional clinicals that will show a history of morbid obesity over a five-year history. I have also included some pictures that will show a life long history of obesity starting from childhood. My prayer is that you will take into consideration to accept these pictures as a documented five-year plus weight history and reverse your denial to an approval for laparoscopy; surgical, gastric restrictive procedure. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326v2> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>Economic costs of Obesity:

    Obesity has been shown to directly increase health care costs. In an article in the March 9, 1998 issue of the Archives of Internal Medicine 17, 118 members of the Kaiser Permanente Medical Care Program were studied to determine the association between body fatness and health care costs. The results showed that patients with BMIs greater than 30 had a 2.4 times greater risk for increased inpatient and outpatient costs than patients with BMIs under 30. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>Indirect costs:

    Americans spend an additional $33 billion dollars annually on weight-reduction products and services, including diet foods, products, and programs. Most of these expenditures, as is evidenced in this case, are not effective. Rather it can expected that they will continue to gain weight and the costs of co-morbid conditions, including the ones they already have and ones they surely will acquire as time goes on, will far outweigh the costs of gastric bypass surgery that we are asking you to please approve for me. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>As you can see I have exhausted all the traditional ways to lose weight. The gastric sleeve procedure (also known as laparoscopic vertical gastrectomy or laparoscopic sleeve gastrectomy) is an approved and proven means to permanently lose weight. Please approve this surgery for me by reversing your denial to an approval. I would like to thank you in advance for your time and effort in making this happen for me. Thank you very much. <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal> <P style="MARGIN: 0in 0in 0pt" class=yiv318147326MsoNormal>


  8. I live in Florida and I have UHC ins. wls is covered but I have been denied 2 x. I'm in the process of re-submitting my 2nd appeal by the end of this month. Hopefully persistence will pay off!!1 I'll keep you updates. Good Luck

    Hello!!

    I have been doing some reasearch and was wondering if anyone had any luck with United Healthcare Insurance. I also would like some information on how to go about seeing if I am a covered candidate for VSG.

    Thanks,

    Margoboo


  9. Wasn't aware. Very imformative. Thanx for the info! :o

    2 Case reports of birth defect associated with deficiency in bariatric surgery patients

    The January 2010 issue of SOARD reports on 2 cases of birth defect that appear to have resulted from severe maternal Vitamin deficiency after malabsorptive bariatric surgery. The first case was of a baby born at 33 weeks to a 27 year old mother 16 months post-op from a biliopancreatic diversion (BPD). The mother was deficient in Vitamin A, D, K, Protein, selenium and zinc. The infant was delivered prematurely with multiple defects including bone malformation, cleft palate, facial hypoplasia, and respiratory insufficiency. The baby died at 3 months of age. The second case was of a full-term infant born to a 26 year old mother 11 months post-op from a roux-en-y gastric bypass. The infant was born with multiple defects of bone and cartilage as well as hearing loss which were attributed primarily to maternal vitamin K deficiency. While most of the recent reports of pregnancy after weight loss surgery have been positive in terms of both fetal and maternal health, these cases should remind us that nutritional deficiency in pregnancy can lead to grave results. Both of these patients had been counseled about waiting 18 months to 2 years before becoming pregnant, one even having signed a consent form prior to bariatric surgery. Because of the significant impact that massive weight loss can have on fertility, it is likely that more young, obese women will opt for bariatric surgery to not only improve their overall health, but also to assist with pregnancy. Clinicians and patients alike need to be made aware of the problems that can arise when women who are not adequately nourished become pregnant.

    Reference: Kang L , Marty D, Pauli RM, Mendelsohn NJ, Prachand V, Waggoner D. Chondrodysplasia punctata associated with malabsorption from bariatric procedures. Surg Obes Relat Dis. 2010 Jan-Feb;6(1):99-101. Epub 2009 May 23.

    Abstract: Click Here


  10. I need to be on the pay roll lol! I actually found out that my appeal papers wasn't sent in, when they clamied they did. My paper did not have all of my clinicals and that's why I was denied intialy. On top of that I found out through my ins that the appeal papers was sent in on 12/7. I called back to Dr. Jawad office as calmy as possible and confirmed with them tthat they did fax the appeal to the ins. I have been so furious so upon finding out this info. My first try ever I get denied because the Dr ofc dropped the ball isn't that something? Sorry I'm so long!!!!!!!!!! Im waiting.

    Blsmbry

    Just checking in to see how things are. Have you heard anything back from Dr. Jawad's office or UHC? ( I too have Dr. Jawad) I have to do the six month diet and exercise and the labs and the eval. Still have two more months with pcp. I know that my pcp has faxed things to Dr. Jawad. But she is waiting to send UHC their paperwork until my six months is up. She wants to make sure that all of the six months are together. I hope things work out for you and get a date soon. Let us know how it goes.


  11. I have UHC EPO and I live in Fla. I was denied last week for wls. The reason was because they didn't have my BMI nor my 5 year history. I notified Dr. Jawad's office about this and they assured me that they sent everything over. For the last week I have been going back and forth.

    I spoke with the Dr. office and they again assured me that they have faxed over the appeals paper work, but when I called the ins. company top verify they said they haven't received anything. I don't know what to do.

    I have no co-morbidites, other than sleep apena, infertility, gerd, I have my 5 year history showing my BMI have been over 40 for the last 5+ years.

    In my plan I dont have to have the 6 mos supervision which is great but, I don't know where to turn. I need your help? Should I seek out another Doctor and If so will I have to have them to submit an appeal since I've already been denied? Any help is welcom and appreciated.

    Thanx!!

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