Christabel

Dance away! But be sure to save some boogie room for me in December. :001_tt1: Congratulations!!!

Still can't believe it's real, but I've got a couple of months yet to get my head around it. December 27th is New Me Day. It's my choice to wait that long due to work obligations. I wanted to do it this year since it would go toward this year's deductible, and I wanted it to be after the holidays so I didn't have to worry about shopping, family dinners, etc. I can just take 2 weeks and recouperate. I did tell my boss, and he's fully supportive. I'm hoping it will stay that way. I also asked him not to tell anyone else. He's the only one at work that knows. He did mention that once all the weight comes off people will ask, but I'll deal with that as it comes. I just keep thinking, "Please God, don't let me fail again!" because this is IT. I know that's the wrong attitude to have, but I also know most of you can relate. Am I scared? You betcha! Is it gonna be life-changing? Dang tootin'! You think that's gonna stop me??? NO WAY. I'm in it for the long haul, and I can't wait for 12/27 to get here! :thumbup: :thumbup: :thumbup: :thumbup: :thumbup: :thumbup: :thumbup: :thumbup: :thumbup: :thumbup:

My surgeon required a recent sleep study to qualify for surgery. Luckily I had one recently due to the sleep apnea I have. What threw me was just when I thought I had jumped through every hoop Aetna had, they required a test to see if I had peptic ulcer disease. Thankfully it was just a blood test and it was taken care of in a matter of days! You might be sure to ask if that's needed as well.

YES!!!! I know exactly how you feel! WHOOOPEEEEE!!!!

I think we all suffer from the same doubts and fears, Tracy. For me, it's that I've become too comfortable hiding behind this layer of fat. No one can see the real me, and frankly, I'm afraid to let her out. What if no one likes her? What if she doesn't look the way I want her to? What if I don't lose ENOUGH? What if it's too hard to do? In the end, all the "what ifs" are just another excuse for me to hide. And frankly, I'm tired of hiding. I want to be the person I was meant to be, no matter what it takes. I'm sick and tired of failing at every diet under the sun! This surgery is my last ditch effort to shine and to be healthy and to be proud of who I am and what I look like. With the support of the people on this board, my surgeon and staff, family and selected friends, I believe I can do this. And I believe you can, too!

After months and months of insurance hoops, fully expecting to be denied the first time through, imagine my shock when I found out today that I was APPROVED in two days after turning in the final test results required!!!:biggrin2: I almost fainted dead away in the office. Seriously.:w00t: And now, due to conflicts with work schedules, I need to wait to get my date until late December or early January. But hey, NO COMPLAINTS HERE. :biggrin0: Know why? I'M APPROVED!!! :thumbup::laugh0::thumbup1:

My final, 7th appointment with the nutritionist and exercise physiologist was this week! I have officially jumped through the last hoop set before me so far in order to get the insurance to pay for the VSG. However... I found out that Aetna is only the administrator of the policy, and that my insurance doesn't cover VSG without special review by a staff of physicians. Because of this, I fully expect to be turned down flat. The only surgeries they cover are the band and RNY. Since I won't have either of those, I'd like to get started on the appeal process now. Any ideas and/or help would be appreciated!

Two weeks ago I called my new insurance company to make sure VSG was covered - before I ever went to the informational meeting about any type of bariatric surgery, before I got my hopes up, before ANYTHING. I went to the meeting, got excited, got down and got funky with the idea of VSG. I filled out the forms, I made the appointment for my first visit with the surgeon. My first visit was today. I got weighed in, measured, and then the assistant asked what type of surgery I was interested in. I told her VSG. *crickets* "Oh honey," she said. "Aetna doesn't cover VSG." But they DO, I argued. They SAID SO when I CALLED THEM. They wouldn't lie to ME, would they? "Way-ul, we'll just play like they're gonna cover it for today. You give 'em another call again tomorrow and let me know, and we'll see what happens." Fur will FLY, Ladies and Gentlemen, if I have been lied to. FUR WILL FLY.

MoreThan, I think I love you. Seriously. :tongue_smilie: I'll be calling my insurance on Monday to check in again. Hopefully my employer will have also updated their policies. Cross your fingers!

I would be very leery of anything told to you by someone over the phone unless it was a case manager. I have to speak with a special pre-approval number (I learned this the hard way) in order to get the true information I need. As of today Aetna has still not updated the policy bulletin, and I found there are other policy bulletins that have not been updated that date back to the first of January so I'm not holding my breath. In addition, I found out today that even if Aetna approves VSG, it still has to go through an approval process with my employer before it will be covered. In the meantime, I am doing everything I can to just hang in and follow the regimen. Had the first of 7 nut and exercise meetings, and went through not one but two psych evals. The psych evals were required by the employer and could not be finished in one sitting due to length. Three different tests, one 384 questions long. And so I plod along....:svengo:

I have over six months to wait to get my sleeve according to current insurance and employer standards. Six months of "dieting" to prove to them that I can be successful in following a "program" that I will need to follow the rest of my life once I have the sleeve. But if my BMI drops below 35 once during this period, I am denied the surgery. To top it all off, at this point it has to go to a physician review board to see if I'm even bad enough off to qualify for the surgery after the six month time period is up since my insurance doesn't recognize the sleeve as anything other than experimental. If the review board OKs it I'm good. If not, more hoops. It's as if they and my employer are trying to see how many road blocks they can put up to see just exactly how far I'm willing to go to get this particular surgery. If the insurance requires a three-month diet, the employer tacks on another three months for good measure. If there's a psych eval required, the employer tacks on another 400 question eval to fill out and return. Well I'm here to tell you folks, I am one stubborn individual. I can take all they can throw at me, because it means that much to me to be at a healthy weight without all the problems I have now. And if I have to jump through hoops from now until surgery, I guess I'll be the most proficient hoop-jumper there ever was. But I'll need support. Can I count on you? If I need to vent about another hoop or rule or reg or eval or whatever, do I have your permission to do that here? Because honey, it's gonna be a LONG six months...

As of 2/12/10 there has been no change in the policy, however the case manager told me it still read "Next review date, 2/11/10" so I'm sure it just hasn't been updated yet. :lol0: Has anyone heard anything either negative or positive through the grapevine?

Haven't had the surgery yet, but I asked my surgeon about this one. He said about 30% of his patients are pukers, no matter what he does. He said the liquid diet two weeks prior helps the average rather than hurting it.

I know that I was convinced I was going for the band until I got on the Internet and did extensive research. That's when I found out there was such a thing as VSG. I think as more people take time to delve into the problems that could and do occur with whatever they choose as a solution, VSG will become more widely known. As for right now, surgeons are offering it as a choice, so that's a plus.

When I told my family what I was going for, I prefaced it by saying I would not listen to any naysayers. I did all of the research, I knew all of the risks (very few), and they had not lived this part of my life so they had no say or room to talk. I told them if they couldn't be supportive not to say anything at all, because I was going ahead with it come hell or high Water. I think you need to take the same approach with your friends. Good luck tomorrow, and we'll all be pulling for you!

So happy for you! Wishing you all the best...

UPDATE Shot down like skeet. While the case manager nurse was very sympathetic and almost SURE it was covered at first, upon further review she found it wasn't. I almost cried. I was so dejected. I thanked her for her time and got ready to hang up the phone. She said,"You mean you're just going to GIVE UP??" I asked her what choice I had. I'm not going to have the band and told her why. I'm not going to do RNY and told her why. I told her the only option I was interested in was the sleeve and why. I told her about the arthritis in my knees and feet that make it hard to walk. I told her about the sleep apnea and the CPAP machine. I told her about the depression, the cyclical joint pain and fatigue that knocks me flat, and my family history with obesity. She asked me again if I was just going to give up. I asked her what other alternative I had. She suggested going through all the hoops necessary to be approved for bariatric surgery, no matter what kind, that my insurance requires. Currently it's a six-month diet, psych eval, behavior modification, etc. She told me the insurance is constantly under review and hopefully by the time I was done with all the pre-op work it would have changed. So I stopped feeling sorry for myself. I'm being proactive. I'm taking her advice. I'll do what I have to do, and I'll hope things change between now and then. And if they don't, THEN I'll sit in the corner and suck my thumb and eat hot fudge sundaes until I pop. That's logical and sane, right?

Newbie talk here....what is NSV?

My first post - a day which will go down in history, I'm sure! I decided several months ago to pursue the Lap Band, but after looking into it more convinced myself it wasn't for me. Instead, I found VSG - a procedure which seems to suit both me and my family much better. I am the type of person who researches everything out the wazoo. Before I purchase a new toothbrush I have to go online to see what type of bristles are best for my teeth, what angles suit my gums, how hard the bristles should be, the advantages of sonic vs hand-held, etc. - so you know I've done my homework on this. Here's the thing...so far I have yet to find anyone who regrets having it done. Now maybe I'm not looking in the right places, but I think I've done a pretty thorough job here. Even with the complications I've seen some people experience at first, it seems not one of them would have wished they hadn't gone through with the surgery. That says a lot to me. What also says a lot to me is the fact that my surgeon would choose this surgery over any other WLS if he had to personally have WLS for himself. I asked him that very question when I went to the informational meeting. Of course, he also said he would trust himself to do the surgery in a heartbeat as well, meaning he's a bit cocky. Not so impressive. :001_tongue: He's young. I forgive him. At any rate, I have my first appointment with him tomorrow to begin my own personal journey. Aetna is my insurance, and I've been told they will cover the surgery if it's medically necessary. With a BMI of almost 40, sleep apnea, arthritis, asthma, and what my PCP says he'd call fibromyalgia except that I'm not depressed enough, I'd say it was. We'll see what they say. Any advice, hints, criticism or words of wisdom are more than welcome. Thanks for letting me join you! Christabel

Thanks everyone, for making me feel welcome! And Cajun? It's Sonicare, hands down. :smile: The appointment is at 3 today Central time, so I'll report after that. That is, if I don't have to go home and change my pants first. I'm really excited.