educationrulz

Wow breekahouse! What a topic! I have cried my way through this entire thread. I too am a single mom and worry about things like this all the time - especially now that I'm planning on this surgery. I don't plan to tell my daughter about the surgery because I'm afraid it will scare her. It may not, since kids tend to handle these things better than we think they will. I guess I just don't want to deal with all the curious little kid questions. I know this is going to really hit me as I get close to my surgery. Hopefully, I will be able to find this thread again when I need it most. Everyone who posted has presented compelling arguments for getting the surgery and some comforting thoughts about putting fear aside. If you haven't already planned it, maybe you can do something really special with your daughter this weekend before your surgery. It will be great bonding time and you probably won't feel up to much of anything after surgery. I hope that you are able to go into surgery fairly calm on Monday. But, if not, don't be ashamed to ask for something to help you calm down while you wait to go in the OR. Those last few minutes before they wheel you in are pure HELL :001_smile: and I think that I am going to ask for something in the old IV before I even get a chance to let a tear drop down my face. Please let us know how you are doing after surgery as soon as you feel up to posting. I'll be thinking about you...and your precious little one.

I actually had a pretty quick turn around time with those initial phone calls. I think I got a person the first time I called. Then, the next person called me back within a couple of days. That second call is when you answer some very basic questions and schedule your intake type call with the case manager. I had to wait about a week and half for this last step because I called around Thanksgiving. Be careful to schedule your call with the case manager at a time you know you can pick up the phone and talk uninterrupted for about 20 to 30 minutes or you will end up playing phone tag. I left my cell as my call back number and kept it in my pocket at the time my call was due. She called to the minute of our appointment time. kkandrod - I think you should definitely call the BRC center before going to any appointments. That's how they want you to do it, so why rock the boat. I too have heard that the approval process is effortless if you follow the steps. I've also heard from a couple of sources that they don't care if you loose an ounce during your six months. Now, your doctor may have some requirements in this area, but not UHC. My doctor only requires that his patients not gain anything once he has seen them for a consult. He doesn't require any loss before surgery. Thank goodness for this bit of sanity in the process! :001_smile:

WOW! Bondage...Now that's an interesting (NOT!) way to lose weight. Glad you got yourself straight about that phone number. :001_smile:

Hey txaggiemom, Do you mind me asking why you're checking in to the hospital at midnight? Just curious...

Congratulations! I'm a year behind you and looking forward to similar victories. I have my eye on some possible career changes that I just don't have the balls to go for at my current weight. But in about a year, IT'S ON!!!! :tongue_smilie:

Hey 2muchfluff! It sounds like you and I are in pretty much the same boat. It also sounds like we have the same insurance plan. March is month 4 of my 6 month supervised plan with UHC and it's going smoothly so far. I can't believe how quickly time is passing and I am so excited about getting this surgery. I can't find anything else out there that I'm interested in. If UHC didn't pay for the sleeve, I'd find a way to finance the surgery myself. I was initially irritated about the 6 month process, but I decided early on to use it to my advantage. I decided on individual counseling instead of support groups because I don't open up well in front of strangers. This forum has been a great support group. In my counseling sessions, I actually process alot of the things I have read about here on the forum and how I might handle similar issues. I've learned a lot of great questions here to ask my surgeon that I would never have come up with on my own. I feel like I will be REALLY well prepared by the time my 6 months is up. I put off my initial consult with my surgeon for a couple of months because of scheduling conflicts, but I'm glad I went sooner rather than later. The main reason is because I had already started requesting medical records to be sent to his office but none of them had arrived at the time of my consult. I went ahead and filled out release of info forms for all of my relavent doctors so that the surgeon's office could assist me with getting all of that documentation collected ahead of time. I don't want any delays when it's time to submit my request to UHC. :crying: If you need to research potential surgeons, check out the patient reviews on the OH (ObesityHelp) website. There's some great info there. Good luck.

Hey Mella. This fellow GA girl is wondering how you're doing. Can you give us an update on your progress?

Wouldn't it be better in this case to forego some of the water and actually eat something? Even though water is extremely important, it doesn't have any nutritional value. At least you could get some more protein and Vitamins in through food. And some food does have some moisture value so that would help with hydration, right?

MlkPas, This is GREAT question and nicely stated. I can't wait to hear the rest of the responses. I definitely agree with MINI-Me that quality of life is an important factor.

Have you tried to see if you have any other comorbidities? Often there are health issues that we've been dealing with for years and just thinking of as a fact of life, when in fact they could help our cause. For instance, do you have knee/joint pain when going up and down stairs? If so, go to your PCP or an ortho and get xrays. They'll probably find some arthritis related to extra weight. Also, get your cholesterol level checked. If it's high, this is considered a comorbidity. Back pain? High BP? Get a comprehensive list of recognized comorbidities from the insurance co. and put your head together with your PCP and I'll bet you can come up with something to win the appeal! You will probably need a strong letter from the PCP along with proof of the comorbidities but I bet you have a chance. Good luck!

Way to balance out the estrogen party in here Bill! :thumbup1: I'm so jealous. Can't wait to post some NSVs. Originally Posted by hope4204 i am 78 pounds down and fit into my friend's bra and dress last night! she took a picture and i hardly recognized myself lol it felt great! i was at a size 44 bra and hers is a 38! not sure what size the dress was... Posts like this are worthless without pictures. LOL. Good job Bill

As crazy as it may sound, I will be thankful for some sleeve discomfort to help me kick my soda addiction. It is truly like CRACK for me!

Great use of your IRA Carrie! :thumbup1: If my insurance hadn't just started covering the sleeve, I would be cashing out any and everything I could to pay for the sleeve.

Thanks guys for your frank input. I guess I just needed to freak out for a minute. This procedure seems too good to be true sometimes, so maybe I'm looking for some down side... I know that there are risks, like everything else, but comparatively it seems like the clear choice. I too prefer a more hourglass, curvier look, so I guess that's what made me get carried away with the underweight thing. I see your points about the importance of adjusting your eating to your body's needs, whether that be weight loss, maintenance, or gaining a few pounds to balance things out. I'm so used to NOT having that kind of will power and control that it's hard for me to imagine being able to so easily adjust my eating habits. I'm used to being in that spiraling out of control phase with eating and I'm projecting that onto the other end of this journey and seeing myself being out of control with not eating. I'll get out of my head now and be glad that I've come across such a great weight loss option at a point in my life when I'm ready to take the plunge. Thanks also to Carolyn for posting this topic. This is yet another thing I had not seriously considered yet need to be prepared for. This forum has been the most helpful tool I have come across in this journey and because of everyone here, I KNOW I"m going to be ready.

Okay, you guys are scaring me now. :scared0: Although I desperately want to lose this weight, I don't want to be anorexic looking at any point. The word skinny really doesn't set well with me either. You guys all look great in your album pics, but what if some people can't stop loosing weight and end up underweight. I would never have thought that I would ever have to worry about that! :001_rolleyes: So how do you stop the weight loss? Is this phenomenom of loosing past past your goal weight related to the size of the sleeve (boughie) you get? This is first day since I learned of this procedure that anything has made me stop for even a second to reconsider getting it done. I've got 3 months left to figure it out so your input would be greatly appreciated.

Stacie, First I want to say that I too am sorry to hear about what you're going through. We're all praying for you to recover soon. I also would like to piggyback on what Tiff said about not taking in any food or fluids while healing from a leak. That seems pretty reasonable to me and I guess the TPN is what makes it possible. Do you have to option to get a second opinion on this? I imagine if you're self pay that may not be possible. I don't mean to suggest that there's something wrong with your doctor, but you do need to start seeing some results soon if for no other reason than your emotional health. I think another important thing is to have someone who can be a strong advocate for you during you doctor visits. The truth of the matter is that when we're sick it's hard to speak up for yourself the way you normally would. I know this from first hand experience. During a bad experience in a hospital once, I had to call my sister and have her make some calls for me (she was out of town) because I was too emotionally fragile to say what needed to be said and to make myself heard. This is SOOO NOT like my normal self. If you don't have someone in your immediate family, you could try getting a friend or trusted co-worker to do some research on this issue, including the info posted by Tiff, and then start interacting directly with your doctor on your behalf. You may already be doing these things but I just wanted to throw it out there. I hope nothing I said was offensive - just hoping to be helpful.

I'm so excited for you. I can't wait to hear how everything goes with the surgery. That is too funny about being able to have a drink and Italian food before surgery. Now that's what I call a pre-op diet plan! :thumbup1: Keep us up to date on your progress.

Thanks for the info SLEEVE. I hope you are able to make contact with someone who actually had the procedure there. There's nothing better than getting it straight from the horse's mouth.

May I ask why India?

Hey Lan, I noticed that you mentioned that all of your meds have been generic. I'm wondering if you might have better success with the brand name version of one or more of the drugs you've already tried. The one that stood out the most to me is Wellbutrin because I know several people who it's been successful for, but I've also seen some stuff on the web about people having bad experiences with the generic vs the brand name version. Don't get me wrong. I'm no generic snob. Most of the meds I take are generic and I'm quite satisfied with them. I have experienced a significant difference between the brand and generic version of a birth control pill. The brand worked perfectly but the generic kept me nauseous most of the day and threw my cycle off. I had similar experiences with a couple of other generic versions. These are just a few of the many meds I've taken in my life, but the fact of the matter is that when you need a drug to work you need it to work right and right now. I say that all to say it might be worth it to try the brand name of any of the medications that you and your MD expected to be successful for you. I would imagine that money is an issue for you like it is for most of us these days so I'm sure that buying brand name is easier said than done. If you choose to check out any brand name drugs, there are prescription assistance programs that can help. All doctor's offices have access to programs that supply free prescriptions but sometimes they don't offer if you don't ask. I've gotten some of my mom's meds this way before her Medicare kicked in. I also got some others for her through online applications for free meds. Some are through the manufacturer and some through 3rd parties. I hope that things continue to get better for you. I'm so excited about the idea of getting the sleeve in a few months that it's hard to imagine feeling depressed afterward. You sharing your story has really helped me keep myself grounded about the seriousness of WLS and how we need to be prepared for any outcome. Because of what you and some others have shared about your experiences after surgery, I have really embraced the counseling process that my insurance company requires before surgery. Every time I come across some major emotional aspect of WLS surgery here on the forum that I hadn't thought of before, I have spent time thinking about how I might handle that issue and I have explored it in my counseling sessions. So, thank you for sharing your experiences. I think that when it's all said and done, the fact that you have shared so much will be as helpful to you as it has been for myself and others. Mary

Hey, I'm no insurance expert but this definitely sounds like it's being driven by the hospital. Since the doctor is going to get his money from you for the second procedure regardless of what the hospital charges, they are the ones who stand to lose. They only get a contracted amount for the insurance covered procedure, so they will make their money from the revision that is not covered by the insurance. I think they are trying to squeeze some money out of you :biggrin2: since the use of the OR for the revision should be included in the procedure to remove the lapband. Maybe you could try calling some other hospitals to see how they would bill for this situation. I've heard of situations where you would only be charged the doctor's fees for the second procedure, so maybe you can find somewhere else to get it done. Good luck!

Hey ChiTown, I thought I'd reply to your post since I didn't get any replies to my post about UHC requirements - that has been kind of frustrating. Maybe us UHCers are not a common group here. Anyway, I have the UHC HRA plan which covers WLS as any other procedure. The main thing I had to do was initiate the process through the Bariatric Resources Center before I scheduled any appointments. If you haven't already done so, you could try calling them to see if they can help you. This is from the benefits site: Bariatric Resource Services is a program administered by UnitedHealthcare and its affiliates. For obesity surgery services to be considered Covered Health Services under the BRS program, you must contact Bariatric Resource Services and speak with a nurse consultant prior to receiving services. The member can access the BRS Service Centers of Excellence Programs at 1-888-936-7246. I would think that you could simply call the regular customer service number on your card to find out if your plan covers a specific procedure. I have never given any codes to anyone so I'm not sure why you would need to do that. I just told them that I wanted the sleeve and they verified that it was a covered procedure. I guess it depends on who you're talking to sometimes, so you might need to call the main customer service number a couple of times until you get someone who is really interested in helping you verify covered procedures. Good luck with getting everything paid for. I'm not sure what I would have done if I hadn't come to this decision and "discovered" the sleeve around the same time it became a covered procedure. I suspect I would be even deeper in debt trying to pay for it.

HI everyone! This is my very first post on the forum. :thumbup: I've been reading posts for several weeks since I made the decision to get this surgery. I decided that instead of doing my usual routine of observing and reading forever (lurking), I'll just jump in and get as much preop support as I can from the great people on this site. VSG has just been added to our WLS coverage options and I'm so excited. This is the only WLS that I've researched that hasn't scared the wits out of me. :biggrin0: I've started the ball rolling with my preop requirements by getting a psych assessment, scheduling my counseling sessions (I'm not the support group type), and getting my PCP on board with the requirement for 6 months of weight loss/nutritional documentation. My question is, does anyone here have some insight on the documentation requirements for insurance coverage? I'm particularly interested in those with UHC policies, but would love to hear from those with other coverage as well. My main concern is being sure that I have the proper documentation for the nutritional/exercise components. My nurse coordinator explained to me that I could do something like weight watchers or go to my PCP and have them document my weight, diet, and exercise once a month for 6 months. I didn't see any point in paying for weight watchers when the PCP visits would be the same cost or cheaper. When I talked to my doctor about it, he readily agreed to complete the documenation for me, but was kind of vague about it. He gave me a handout with a diet plan, so I guess that's what he'll document as my diet. They weigh me everytime anyway, so that's not a concern. But, I wasn't clear on how they'll document the exercise part. When I pushed the issue with the doc and asked how we would document the exercise, he just said something about me needing to do 30 minutes of exercise a day. I guess that's what he wrote in my chart. We all know how dismissive docs can be. I'm no shrinking violet, but I was sick when we we talked about this and was actually focused on my other health issues so I didn't push things as much as I could have. After all this babbling, my point is that I want to know if anyone had any difficulty with this part of their documentation for WLS. Did the insurance company question this aspect of the info sent in? Did you have to go back and provide additional documentation? Or, was it pretty much the formality that it seems to be and that my PCP made it out to be? I plan to contact my nurse coordinator again to revisit this issue but I would love some insight from anyone here who has experience with this. My biggest fear right now is to go 6 months thinking I've done everything right and then get turned down over something so minor. (By the way, I still may add the weight watchers piece just to cover my bases.) Happy to be here, Mary