bella143

When is your surg date? I hear somerset Hosp had a good dr. I dont remember his name my sister lives and works in bridgewater and knows lots of dr cause she works at a dr office

March 19th but I'll be at overlook bc my doctor is in summit.. I'm from your sisters area also. Where r you from?

I am having my sleeve done in flemington' date=' nj. Dr ballem anyone know of him.[/quote']

I've never heard if him.. Will you be in hunterdon med center? I had all 3 of my kids there with dr. Farber, love him. Best if luck to u!!

I'm from jersey-somerset county. Dr. Goyal is doing my surgery.

That's great! Congrats! since your sleeve you've lost 38 lbs?

I'm scheduled in 2 weeks.. I'm sooo nervous. How was your expiernce? how are you feeling now and right after surgery?

Friends-

Today' date=' I Celebrate one of my biggest moments of bravery. I Celebrate agreeing to be wheeled into surgery despite a healthy dose of fear of both complications and the unknown. I had no idea how I'd cope in life without the crutch of food and failure. I wasn't excited about surgery and possibilities. I was simply scared and resolved. Now, I live a life I truly wasn't sure I'd ever get to enjoy. Life is good. So good.

I have been incredibly blessed on this journey. My approval process was relatively painless. It only involved four months of supervised diet. I didn't even have to do a liquid diet leading up to surgery. My only real complication was a very minor infection on one of my incisions. A round of antibiotics and I was fine.

My biggest memories of life following surgery were trying to figure out how to live without food as a focus and exhaustion. I wasn't hungry but still felt a need to eat but couldn't. I worked hard in therapy to be ready for this yet I wasn't. On top of that, I remember being absolutely exhausted until week 5. My other biggest memory is when I lost about 50 lbs. and realized that I no longer hurt. I had been overweight so long that I simply accepted pain as a part of life. To wake up one day and comprehend than general life no longer hurt left me giddy.

Since surgery, I have dropped 112 pounds, 12 inches (literally a foot!) off my waist, and 6 dress sizes (from 24/26 to 12/14). I have found a passion for running that culminated in running a half-marathon in January. I found the confidence to apply for a dream job that came with a crazy raise and got the job! I've found pride in myself and my appearance. I've become more than what I eat and how I look.

I haven't been the most well-behaved sleever. I feel I should share that in the interest of honesty. When I got the crazy, awesome promotion I started making some poor choices. I have yet to gain weight but I am in the world's longest stall due to poor food choices and a lack of focus on diet. I haven't lost a pound since December. I recognize that I haven't lost the last thirty pounds because of my less than ideal food choices but I am okay with this for now. I know that I will soon be ready to lose the last thirty and I will focus and finish what I started. My goal is to be at or under 175 by 18 months. I feel this is very doable. However, I recognize that this is my journey and I will finish it when it is right for me. Right now, I am enjoying the ride and life in general.

I would like to take a moment to thank all of you for your constant support, opinions and advice. I've found this forum and the people it consists of a lifeline on more than one occasion. Bless you all!

Of course, a surgiversary post isn't complete without photos!

PS- I swear I am not a big drinker... it just happens that pics normally occur when I'm drinking. [/quote']

You look beautiful! Congratulations on your weight loss!!

What an inspiration you are and you look amazing! Congratulations on your success and thanks for sharing your story and photos.

yesterday I went to the store and I wear a size 12. I'm down 119 lbs. I was so excited going from 24 to 12. My daughter laughed at me cuz I was so excited. Just thought I would share.:biggrin0:

That's amazing!! Congrats!! I hope I have much success like you.

I have Cigna also. I just finished my 6 month supervised diet with the NUT( through my surgeon's office) had to get a referral from my PCP to finally SEE my surgeon on the 15th. This is the slowest process ever! If Cigna denies me' date=' I will be crushed. But I have a BMI of just barely 40, sleep apnea and asthma. So I hope they will approve me. I can lose weight, but sadly it's the keeping it off for more than a year is where I fail. I just know that the sleeve will help me with this!! Good luck to all my fellow Cigna Sleevers!!

Keep us posted on your approvals!![/quote']

Hi there.. I too have a low 40 but with no other issues and I just got the letter yesterday in the mail that I was approved. I'm sure you will be approved since you have sleep apnea. It took about 3 weeks to get an answer. The longest 3 weeks ever! The 6 months was torture. My friend had bypass 2 years ago and only had to do 3 months so I was thinking the same thing but then when I went the first time and they told me Cigna requires 6 months I was devestated. It's been almost 7 months now. I hope it all works out for you and the looks of it I'm sure it will! Good luck, keep me posted..

_{Bedhead' date=' well yes and no,. Because there was a portion of her stomach that was left in (as it is when you have gastric bypass) and she evidently was an acid maker, she developed an ulcer (probably more than one) She did not go back to her surgeon. We had been wondering about why the boys said she was sleeping so much during the day, it was because she was anemic because the ulcer was bleeding. All of her pain symtoms were mimicing gall bladder disease. So, after several trips to the ER they took it out. Long story short, she came home on a Thursday after surgery and died that Saturday when the ulcer perforated. It is my opinion that this was a needless death. She should have gone back to her surgeon who should have recognized the symptoms, she should have listened to her body about how sick she was (but she hated sickness and tried to ignore it) We saw a change in her appearance, hair, skin tone, etc but could not get her to go. The physician who did the gall bladder surgery also does bariatric surgery so he should have recognized the possibility instead of just doing the surgery without any additional workup. That is one reason that my husband and I (who have both had sleeve surgery, no stomach left in) went to a surgeon who does nothing but bariatric surgery. Anyway, bad things happen all of the time for all sorts of reasons to all types of people. As for her boys, it has been almost four years and they are doing really well. The youngest does have some issues, but did before she died (he is a little bit on the spectrum and a little ocd) They have the most amazing step mother who lost her Mother the year before our daughter died so she understands that type of loss. We feel very blessed that our son in law had the wisdom to marry such a wonderful person. [/sub']}

_{I am so deeply sadden and sorry to read your story!}

Sometimes when you read that someone is going to be sleeved really soon' date=' you wait for them to write there first post. Sometimes that takes a little while, while they are trying to figure out what they can and can not eat or drink. This is my first full day home. I came home yesterday afternoon. We had planned for my hospital stay to be 23 hours, but things didn't go as planned.

On Thursday at 9:30am I had my surgery. I was in a great mood. Needed the waiting to be over. An hour and a half after surgery, my surgeon went to the waiting room to tell my husband and two good friends that I was fine. They heading up to the recovery floor to wait for me, two hours later the surgeon called my husband to tell him something had gone wrong and they were taking me back to the ER for a Trama Emergency. I did not have a leaky stomach, but somewhere I had lots of interal bleeding. My blood pressure was falling fast and I could hear everything in a room suddenly filled with 20 or more people talking, working, hurrying. No time for anything to be done laparoscopic, they just needed to open me up, give me blood transfusions and stop the bleeding. When I finally remember waking up in the ICU, I was tied down and incubed. I never had such fear in my life.

The good news is, I was in a good hospital with a good trama team and they moved quickly. It was very hard on my husband, who suddenly was scared he might lose me. In the ICU they took very good care of me. I wanted so much to have ice chips or Water, but they couldn't allow it until after my sip test. My priest came up to see me, but there were too many people in the room to actually say anything. Plus, I was on a lot of pain meds. They moved me from the ICU on Saturday and allowed me to come home last evening. I have a lot to learn, i.e. three sips is too much.

The stairs going up feel okay, when I get to the top I feel like I just ran around the block. Car rides feel like being out at sea during a storm.

Other good things:

It was good that I decided to drive up to church and receive a blessing from my pastor, the evening before surgery.

Micro waving a heating pad/towel.

Having the cat sit with me.

Relaxing but moving often so not to get stiff and taking very short walks out side.

Something hard: not having told many friends. Cause suddenly I needed a whole lot of prayers and some extra love.

Looking forward to healing and embracing my new sleeve and the health it will bring to me.

I am thankful to be home and feeling good.

Thanks for your support and prayers.

...thinking about changing my name from Very Soon to Blessed! ;0)[/quote']

Oh my im so sorry, but so glad to read you are doing better! Do you know what caused the complications?

Cigna gave me a pre-approval with my 6mo requirements and then 3 weeks before surgery they denied. I appealed and they were quick to deny again! I went ahead and got a medical loan and paid the (gulp)20k!! Mexico wasn't an option for me on a personal level but a LOT of people go there and have great success for less than half of what I paid. So check into that. Good luck

Hey there.. Did Cigna say why they denied you both times?

I have Cigna too.. I've completed all requirement too and am waiting for an answer. Im so nervous bc I hear Cigna is pretty tough!

Why were denied did they say?

Best of luck to you both!!

Thanks so much! Fingers crossed.

Thank u so much!

This might help:

Thanks so much! Fingers crossed.

To clarify (I may have misstated something) CIGNA approved me the first time to have my band removed' date=' but DID NOT approve me the first time to have my sleeve. I had to appeal.

Predetermination is an estimate of benefits (what's payable, what you will pay, etc.). Does not guarantee payment.

Preauthorization determines whether or not the procedure are a covered benefit. Often it guarantees payment as long as the treatment given is the same as the treatment submitted, and that it occurs within some time frame from when the preauthorization is given, usually about 60 days. But some places will still state that it does not guarantee payment (legal red tape).

You might also hear "precertification," which determines medical necessaity and what and duration (e.g. is it a medically necessary procedure and how long are you allowed to stay in the hospital).

IIRC. You can get specific definitions here.

Wow thanks for the info!! So what r the chances of getting an approval for predetermination? Does it mean that the actual prosedure (sleeve) is covered and they need to determin the hospital covered costs now?

BABE I hope it works out for u too.. I feel like I'm In the same boat as you. the waiting is torture! I think I may call Cigna myself today n see what's going on. I called last week and the girl started out being klnice then the. Went into being firm and a little nasty and just trying to get me off the phone. She said there's nothing they can do to speed up the process m it can take 45 business days. Ugh!

I had no co-morbities. I believe I was approved within 5 days (including the weekend). I honestly think that the insurance person for my Doc is extremely good at her job' date=' and made sure every piece of info that was needed was included. I called the day after submission and got the auth number, I then continued to call back everyday until I received a response.

To be completely honest I work for them, not in utilization review, but I know what it's like trying to do my job and having to pend my work until the provider submits additional info. Try not to get too frustrated, but when you call ask if they have all documentation needed, or are they waiting on something. Almost bet that if it's taking a really long time they (Cigna) are waiting for some more info.[/quote']

It's been 16 business days since my papers were submitted into Cigna.. I'm getting worried now. My insurance nav told me yesterday we are waiting for a predetermination approval number for the hospital..? What ever that means. He told me with my plan i didn't need approval just the predetermination auth number for the hospital. I have no Clue what that means. Someone said the longer Cigna takes the worse it may be and most likely it will be a denial. I'm so stressed and upset. I was thinking of Fallon Cigna today myself.

That's great! Does anyone know what's the difference between getting an authorization or pre determination?

Oh yes' date=' they approve on the first time too. Believe it or not.

My case was a little different. I'm a revision: previously had a band (under UHC), had the band removed (under Cigna, first time approval) and then submitted for a sleeve (denied by Cigna first time, approved on appeal).

They denied me because I didn't prove mechanical failure, and I didn't prove compliance with the post-op diet. Well -- my band had a "profound" slip. It was considered uncorrectable, and my choices were pretty much removal, or live with it slipped. Slip is a nice term for the stomach prolapsing through the band, btw, so we aren't really talking about comfortable living conditions. It was clearly visible in the xray and I had an EGD as well, and 2 years of GERD and aother slip symtoms which can cause their own complications (I had aspiration pneumonia from the GERD twice, basically inhaled vomit and it gave me pneumonia... not to mention it is gross, and hurts like a mutha). So how they figure I didn't prove that it was a mechanical failure, I have no idea.

As for required diet - there isn't one with the band, so how do you prove that? Gah. That one took some work. I was only with Cigna for about 2 years, but I absolutely hated them.[/quote']

Oh Cigna approved you the first time?? I'm still freaking out.

Thanks for the info! I am freaking out lol. Aside from the over 6 month waiting period being torture waiting for an answer is beyond torture!

Do you know anyone who was approved by cigna the first time?

Cigna's official policy on preauthorizations or predeterminations (per Cigna) is a minimum of 20 business days' date=' but no more than 30 business days. Their trend seems to be the longer it takes, the less you're going to like the response.

They took 29 days to respond with my denial.

When I appealed the denial, it took 29 days again to get the approval.

By that time it was December and my insurance was changing Jan 1, so there wasn't enough time to schedule me in anyway.[/quote']

Oh my gosh are you serious!? When I called they said upto 45 business days. They said try recieved it on feb 7. How do you know the longer they take the most likely they will deny?

I was originally told 30 days also but when I called Cigna my self they told me 30-45 business days.

I had my response within days. I called everyday on it though' date=' so they might have been trying to get me to stop pestering them! What part of north Texas are you in? If you don't mind me asking?[/quote']

Hi.. When u called Cigna what did you say? I called once n they were so rude.

I have Cigna' date=' I believe it was less than three weeks.[/quote']

Hi there..

It's been over 3 weeks for me to gt an answer from Cigna. I'm going crazy. Where r you located? Do you have any other health condition besides the obesity? If you don't. Ind me askig. In just getting worried i won't be approved.