SqueakyWheel&Ethyl

I did that. Then I said, has anything else worked for the past 30 years? No. Have you done adequate research on this subject? Yes. Do your physicians support this decision? Yes. Then, trust yourself. The person who brought you this far obviously has done her homework. Trust her. I made peace that way and now I want to hug her for bringing me to this. I have a new birthday. April 17th! Thanks, PBCN

Not trying to argue this.... I totally agree, if they absolutely do NOT cover under any circumstances then its done. My advice is based on the insurance companies that do cover SOME cases, but don't want their customers to know it. Which is pretty common from what I've learned from my own research and my surgeon's insurance specialist. I think it's unethical to say "no" when asked, when they are aware that SOME cases would be approved under THEIR guidelines.

Quote from the movie, 'A League of Their Own': "It's supposed to be hard. If it wasn't hard, everyone would do it. The hard is what makes it great." Day 6 Post-Surgery for me. It's worth it.

I hate nausea and throwing up. If you do, too, you'll take tiny nibbles and gradually take little bit bigger bites until your body says, EH. Your body will tell you. I don't think the pouch can stretch that much, unless maybe if you deliberately try to force the issue, but I've never heard of anyone doing that.

I'm not saying they ALL have to approve you. On the first call I made, mine said they don't cover it. Case closed. But when I pressed further, it turns out they DO cover it if: 1. 100+ lbs. overweight, OR 2. Less than 100 lbs. overweight, but have at least two medical conditions that will be improved or eliminated (in my case, Diabetes and PBC/NASH). If they had said it doesn't matter how sick you are or how heavy you are, we NEVER cover it, then, I would completely agree with you. Once they admit they DO cover it under certain circumstances, and the patient meets the criteria, AND the patient fulfills all the terms according to don't you - in your profession - believe they SHOULD honor the terms THEY set?

that sounds good!

NEVER NEVER NEVER let anyone with your insurance company sense that you think denial is even an option to consider. If they DONT APPROVE, you call the insurance company and ask for the Medical Director in charge of your procedure approval. You'll probably get a nurse who works with the MD. Ask them what is needed to get this through. Present it like, "I understand your rules for approval are 1. xxxx. I did that. 2. xxx. I did that too. ..." Confirm they see the docs to support each line item. Find out EXACTLY what is missing and tell them you'll make sure it is in their hands by xxxx date. When you are playing by THEIR RULES and you meet each task as required, they HAVE to approve. Keep that in mind with every contact you make with them. And, try to keep it in a business tone, non-emotional. If they sense that you already KNOW you are going to get the approval, they know you aren't messing around, you'll be surprised how quickly you'll get your approval just to get you off their backs.

My ins co said, "where's your food journal for the last six months?" I worked all night and turned it in the next day. Got approved 24 hours later. DON'T GIVE UP!

Let go of that fear. You will lose. I don't know ANYONE who has failed.

Centrum Chewables are bright colored round balls with a thin candy shell that tastes fruity and good!

My surgery was the 17th, too. Thanks for asking this question. I LOVE hummus and can't wait to get some! Looking forward to the minced white fish, too. That's in the Purée stage just around the corner!!!

Oh, I agree with cbd that you get more with honey than with vinegar (my grandma used to say), however, I have also experienced being LIED to by the insurance company repeatedly in the beginning of this quest. When I got them to FINALLY admit that - under certain circumstances they will cover it, I asked for a printed out list of guidelines to follow. For example, 100+ lbs overweight 80+ lbs overweight with 2 or more qualifying medical conditions that will improve or be eliminated through this surgery And then the rules I must follow to get it all approved, such as, 6 months Nutritional Counseling Maintain a food journal Psych Evaluation by a Psychiatrist, etc ..... They refused to give me anything in writing to use as a checklist to make sure I did everything ACCORDING TO THEIR RULES. It's at this point that being nice, saying ma'am, and thank you are NOT enough. They have been trained to NOT be cooperative with the 'nice' people. They figure if they resist enough, the nice ones will give up and stop calling. I documented every call, email, etc. After 2 months, I called again, and was told they had no record I had ever contacted them on this subject - EVER. When I sent my DETAILED documentation of every contact made, including their name, date, and time of contact, they FINALLY started cooperating with me. If you can get there with kindness, GREAT! But, make it clear that they shouldn't confuse a kindness with weakness. Good luck!

Thinking about you today!

I'm excited for you! Good luck!

My primary insurance resisted for a LONG time. Honey, do what I did. Take that bull by the balls. Call the Insurance Company and ask for either the Medical Director or their Nurse. These are the actual people who rubber stamp the approval. Don't hang up til you get them. If you hit a brick wall, tell them you expect a call back by 5 pm today or you will be contacting both your Congressman and the local news media outlet. When you get the MD or their Nurse on the phone, tell them what you need done. Tell them, "i believe i have been patient enough waiting for your company to do your job on my surgical request. my secondary approved it long ago. In a perfect world, I would be able to schedule surgery as soon as I hang up this phone. But I know this isn't a perfect world. So, YOU tell ME when the authorization will be approved. I NEED this surgery no later than May XX." Pick the date that works best for you. Don't say 'approved or denied.'. In your brain, denial IS NOT an option. Lay it out. Remind them of what THEIR rules are for approval. Go over each rule step-by-step confirming you have completed each task. Then, hold their feet to the fire on getting the approval in the next 24 hours. It's quite simple. Its THEIR game. And, if YOU have played it by THEIR RULES, you WILL WIN because they HAVE to play by their rules, too. Everyone where I work told me our insurance doesn't cover it. I got approval (cuz I can be a bit of a b***h... With documentation to support my bitchiness.) and had my surgery last Wednesday. Don't be discouraged if you find you have to do Nutritional Counseling for 6 months or a year. Even if your husband is not there to help with the kids, YOU can line up the support you need. I am the caregiver to my severely disabled sister who is at home with me on life-support. If I can line up people to take care of her for a couple of weeks, ANYONE can. You just have to find the burning desire in your heart to demand doing something FOR YOU. In the long run, it's for them too. And, I believe your husband can still play a big role in the support you need even from halfway around the world. ((HUGS)) to you. Please stay in touch. I am here to help you find the words you need.

How can I get the little weight scale tracking bar that I see here so frequently?

Had mine last Wednesday, April 17th and I'm already down 13 lbs. I'm thrilled!

I was frustrated with the 6 month wait, too, but so glad I did it. I gave me the time that I didn't realize I needed to psychologically accept the permanent and drastic life change in front of me. And, in answer to the other question posted here, I was told by my surgeon's office they have NEVER seen an insurance company deny the procedure because you didn't lose weight.

I had mine on April 17th. Already down 12 lbs! I love this website!

My Dr would not let me go on a liquid diet before surgery. He recommended a low-fat or no-fat diet only. No bowel prep was needed either. 2 nights before surgery, I had my last Outback Steakhouse Prime Rib dinner. The next morning I took a gentle laxative. I'm Day 4 Post Surgery. I mixed a little Cream of chicken with Herbs Soup with a little cream of mushroom with garlic soup and mixed in my double-milk. Heated it up and poured it into a mug to sip. Mmmm! It tricked my brain into thinking I had a meal that I had chewed up! Double milk is 1 cup skim milk mixed with 1/3 cup of powdered low-fat milk. It tastes rich and doubles the Protein content. Mix up a pitcher and use it in your puddings and Protein Drink mixes, too.

I had mine April 17th. I'm SOOO glad I did! Day 4 and I'm down 10 lbs already!

Hi. I'm new to this site. It took me six months of diligence, but I finally got approval from my insurance company for my sleeve surgery. I had it on April 17th. I'm feeling remarkably well on Day 3 post surgery, much better than I had mentally prepared myself for (from past experience with C-section, tubal ligation, hysterectomy and two knee surgeries). At 7 am today (65 hours after surgery) I walked my dog around the block and had no set-backs from it. Later, I took a car ride (first real outing) to shop and came home very weary, but still ok!and, 3 days post surgery, I've already lost 10 lbs. That's what really impressed me! My motivation to have this procedure stems from my decimal history. Like most obese people, I am becoming diabetic, my joints hurt, and the GERDS is only getting worse. But, unlike most other obese people, my thyroid tanked about 27 years ago, which has made weight loss an even greater challenge. Add to that, I found out 5years ago that I have - not one, but TWO rare auto-immune diseases. Primary Biliary Cirrhosis ("PBC") and Nonalcoholic Steatohepatitis (NASH). Another name for NASH is Fatty Liver Disease. My weight continued a gradual climb over the years, despite my efforts to change my eating patterns and selections. I felt cornered. This surgery was my only hope to delay - and maybe even eliminate the need for a liver transplant someday. And, if a by-product of this decision is that my sweet husband gains 'arm-candy,' then great! I selected the sleeve over the other procedures because the full bypass surgery makes it impossible to receive a transplanted liver in the future (nix that one), and the Lap-Band is too easy to reverse. I wanted this decision to be permanent and never look back. I work with three people who had the Lap-Band, and only one of them has been successful at it. The other two have gained back all their weight and more. I know several others who have been successful at Lap-Band, but I wanted a permanent life-change. I'm so glad I did it. Pain and nausea? You bet! Unbearable? Maybe once or twice for five minutes, but I kept telling myself, 'this is normal. This, too, shall pass. The outcome of all of this is that YOU get to live to see your 3 year old granddaughter grow up.' There is so much stigma with gastric weight loss surgery, that I've chosen to not share it with more than my husband and two very close friends. It's no ones business why I chose to do this. I see people who have been skinny all their lives say, "Oh, I see.... No wonder you've lost weight," implying the fat person failed and had to "cheat." My coworkers, siblings, and others were told I'm having a procedure done to 'prop-up' my liver, give it some relief, and hopefully delay a transplant - all of which is 100% true. Maybe someday, I'll feel better about sharing the whole story with everyone. I am into Day 4 post-surgery. I've lost 10 lbs. I'm on the right track.