PlannerGirl

I was sleeved on Thursday by Dr. Cribbins in Plano, Dr Hamm's partner. I am grateful to have used Dr. Cribbins, as he helped explain everything so thoroughly. There was a small complication at the start of my surgery, and he handled it well with my husband during, and with me after. Also, just an fyi.....Dr Hamm leaves the tube from your nose into your stomach through the first day post op, Dr Cribbins does not. As for pre testing, I went to Pesby Plano, the week before surgery for an upper GI, an EKG, a chest x-ray, and some blood work. No big deal at all. After the tests at the hospital, I went back to their office for a metabolism test that had me breathing into a tube for 15 minutes. My actual surgery was at Baylor Frisco. It's a fairly good distance from our Dallas home, but I think it was worth it, it was a beautiful facility.

CONGRATULATIONS!! Every success story is an inspiration. Thanks for sharing.

I'm sleeved!! I feel so much better than I had worried about. Sugery started later than expected and there was a suprise. When the surgeon made is first incision and felt inside he found a fibroid tumor. Appaerntly I have a fibroid in/on my uterus that extends to my chest and is the size of a football. The surgeon called in a gyno to check if he could still do the sleeve and luckily we were still good to go. So it seems a hysterectomy is next for me. A friend of mine who is a doctor suggest holdig off if I can until I lose the weight so I combine it with a tummy tuck and insurance pay for a lot of it. That makes the news a litter easier to take. In any case, I'm thrilled to become the slender woman I know is inside of me.

I sooooooo love the frankness in these forums!

I am scheduled for surgery on the 18th and I am looking forward to working my sleeve hard. From everything I've read, after surgery one of the keys to losing fast is exercise. I'm looking for a workout accountability buddy. I've got some buddies at my gym, but I'd like to work out with someone who is having similar experiences as me. I go to Larry North Fitness at Preston Royal. Anyone interested?

Hi, I am also in Dallas and I am scheduled to have surgery on Thursday in Frisco. I have more than 100 pounds to lose and I am anxious to start this new phase of my life. I hope you are feeling well and 13 days in getting back to your life. I look forward to reading your posts as you're just ahead of me on this.

Another suggestion is check your policy for it's maximum out of pocket expense. For instance......I have a $250 deductible and 80/20 after that for this procedure and all that goes with it. I also have a maximum out of pocket of $2000. So.....for my surgery I can expect to pay $2250. I am keeping track of what I have paid so far (not the doc co pays for office visits, but the pre op testing at the hospital) Once I hit the $2250, I will tell the hospital to bill insurance, as I have hit my max and I don't want to wait (and perhaps argue) with the insurance company to refund me. I am scheduled for Thursday the 18th, and I am also in Dallas. What hospital are you planning on? Perhaps I can can review it for you.

Perhaps someone could build a little business by creating panty suspenders.

I have found myfooddiary.com to be a good place to track because once you put the food in it, it calculates all the nutritional values. For instance, if you put in 8oz of skim milk, it will put in the Protein, carbs...... You can also build recipes so you don't have to add each item individually, and you can input foods they don't have listed which will most likely include your Protein shakes. Be prepared that you will get a frowny face every day for not taking in enough calories......so be it, the life of a sleever. You can also track your exercise. There are all sorts of charts and graphs you can create which appeals to the numbers geek in me very much. I'm scheduled for November 18th and I'm tracking now with my pre op diet. Good luck to you!

Thank you so much for the link. I have emailed that youtube to all the folks who know about my surgery. What he has accomplished is AMAZING. I think it is something like 175 pounds in 6 months. Now I have a goal to shoot for!

Ericka, Sushi was on our farewell tour. I'm sure it will be part of the post op diet as I love sashimi and you know the rule......protein first. Thanks for the well wishes.

That's amazing, good for you. I hope I can have similar results! (Even without the 13 it's very impressive.)

Julia, May I ask? How much of the 50 pounds have you lost since your surgery 2 months ago? And thanks for the encouragement, it's greatly appreciated.

Today I started my two week pre-op diet. My doc prescribes a no meat, low fat, high Protein low calorie diet so it's egg whites for me! I can't believe surgery is two weeks away. I am a little nervous, but mostly excited. I think my sweet husband is more nervous than I am and it doesn't help that I've been giving him little "just in case" instructions like where our wills are and the key to our safety deposit. (I can't help it......I'm a planner) I had about 10 days between scheduling my surgery and the start of the pre-op diet. I've got to admit, it's been fun. We've been on a favorite restaurant farewell tour. While enjoying some of my favorites, I shut my eyes and tried to make a memory of the taste and texture. I know these foods aren't gone forever, but I am ending our love affair and asking if we can just be friends. This is really going to happen.......I think I'm ready.......how did you experienced sleevers feels two weeks out?

I just got the date today....November 18th. I can't believe it's real.

I am so happy and surprised right now! I just got a call from the surgeon's office to tell me I'm approved. I did not have the the doctor weight history and I didn't think they'd give me the green light. I put together a fairly compelling packet of information and letters for the insurance company and I also sent a copy to the claims advocacy department within my husbands company (I'm insured through him) I would be happy to share what I did to help anyone else get approved.

I had no idea this was a side effect. My husband was already on board with the idea of surgery, but this would have made for a great selling point. I'll have to warn him to rest up!

Your surgery will most likely push you to an amount that's large enough to deduct. Now that you've hit that number, gather up all the receipts for every medical expense you had for the year. Co-pays, deductibles, and I believe you may even be able to include over the counter medication. Talk to your tax person before year end. If you can deduct over the counter, it may make sense to stock up before year end. You also may want to do all of your annual check-ups before year end so you can deduct those co-pays as well.

Tomorrow I go to the doctors office which will complete my pre op requirements and the insurance coordinator will send off my package to Aetna. I've written before in other threads that I am missing the doctor weight records for 2008 and 2009. I have prepared a package to try and compensate for the missing info. The package includes photos with time date stamps from that period of time, photos showing weight issues throughout my life, weigh ins from the gym with a letter from my trainer, a very detailed outline of my diet history over 30 years, and a letter that I hope is compelling enough. If this does work, I will be happy to share my letters and anything I have learned to help others get approval. I have also made a second identical package to send to the claims advocacy department at my husbands employer. Thanks to the suggestions of the kind folks here, I hope that they can direct Aetna, who are simply the plan administrators to make an exception. Please keep your fingers crossed for me. I hope I will not have to appeal, but I am up to the task if necessary. I will be tenacious!!!

Thanks Michelle for the inside information, depressing as it may be. I plan on providing as compelling a case as possible, but I am starting to lose hope. My doctor's office has told me of a lawyer in CA who has a 100% win ratio in getting these things overturned should I be denied. I was thinking about putting in my initial letter something like......"after consultation with an obesity attorney....." Do you think the insurance company will be at all swayed by this. I plan to be tenacious, and I have no problem letting them know that. As I sometimes tell my husband, we can do this the hard way or the easy way, you choose. Thanks again for your insight. PS Michelle, I just noticed you live in McKinney. I'm in Dallas. Have you had your surgery yet? Who did or are you using. Feel free to private message me if you don't want to blast that info to everyone.

I am so sorry to read you got denied. I think it's unconscionable to deny a person with that high of a BMI simply because you don't have the medical records from one of the last two years. Clearly that weight wasn't attained in the last week and a half and Aetna is exercising a loophole hoping you'll give up and go away. Please keep me up to date on your appeal. I'll be sending good thoughts your way.

My insurance is Aetna, through my husband at American Airlines. The doc's insurance submission person told me she had someone else from Aetna declined for lack of history (apparently insurance companies will use anything they can to decline). That person used an obesity attorney who apparently has 100% success and it worked. I hope to avoid that by adding the pictures and older documenation. We'll see.

I am very ashamed to even admit this, but I haven't been to a doctor in the last couple of years before getting involved in the pre-surgery programs. Unfortunately, I don't have the history Aetna requires. My BMI currently is just over 50. Now any reasonable person would know this didn't happen in the last week and a half.....but we are dealing with insurance, so reasonable may be unrealistic. I'm working on some alternatives. I can get a medical record from 2005 and I will send that. I also am putting together a series of pictures where I can hopefully print the time stamp with it. I'm thinking about asking one of the trainers from the gym who has become a close personal friend to write a letter stating that the weight has been an issue for the past two years. Has anyone else had this dilemma, and what worked. I would appreciate the input. Thanks!

Nervous is normal. I think each of us has experienced that. Try to remember you're taking a positive action to improve your life. Most times to get the best life has to offer, we have to work hard, experience discomfort, yet continue to move forward. You will do fabulously, and when you're feeling better and losing weight, you'll be able to share with others how "worth it" it all was.

Hello to you. It sounds like we're on a very similar path as I am also hoping to have surgery in October. Like you, I have Aetna, and I have to see the nutritionist and weight loss doctor for three months prior. In the meantime, I'm trying to lose as much as possible pre-op with the hope of making the surgery and initial recovery easier. I look forward to hearing about your progress and your experiences getting approved through Aetna. Best wishes.