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KSTUZ

Gastric Sleeve Patients
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Everything posted by KSTUZ

  1. KSTUZ

    First Appeal-DENIED.

    Hi Jess I actually emailed Kelley today and she said she is still waiting on my surgeons office to send them my chart. Sooooo, I'm not really happy about that since it's been a week since they got the money, I called the office earlier and left a message about it. This waiting is for the birds. How are you doing??
  2. KSTUZ

    I was denied!

    I was denied for almost the same reason and cause i don't have a 2013 weight. I hired lindstrom obesity advocacy to help me after my first appeal and was denied again. I feel your pain. Hang in there and keep fighting. I'm trying to take my own advice too
  3. Thank u for sharing your story, I am pre op and struggling after a denial of insurance. Your story is exactly what I needed to read today. Keep on going. You should be so very proud of urself!
  4. KSTUZ

    First Appeal-DENIED.

    Thank you so much. I want this more than anything. I really feel my whole life has stopped because of this. I'm so stressed and just not myself lately. Trying to break out of the funk. Please keep me posted on ur approval!! Sending prayers and good thoughts to you!!
  5. KSTUZ

    First Appeal-DENIED.

    Thank you! It wasn't cheap but like u said, can't put a price on it. I paid for the expedited service, so after they receive all my medical files they have 3 days to submit to Aetna. I didn't know either! Thank god for this website. A few had recommended them. So all I have to do is pray to god that they can get it overturned.
  6. KSTUZ

    First Appeal-DENIED.

    Do they charge for this? I wish you best of luck Yeah they do charge, one flat rate for whichever package u choose. I'm still in the beginning stages of appeals. So they take my second appeal and on. So if it continues to be denied they keep fighting for you until u get approved, still a chance it could be denied, they don't make any promises. They were awesome so far!!Www.wlsappeals.com.Here goes nothin!!!
  7. KSTUZ

    First Appeal-DENIED.

    Hey! Thanks for thinking of me I hired lindstrom appeals, I faxed everything last week. Waiting on hearing back from them. So fingers crossed they will fight this for me!
  8. KSTUZ

    Are there any Philly sleevers?

    I'm right outside philly! Hatboro/Horsham area! Seeing Dr Bonanni at Abington Memorial Hosp!
  9. Sometimes I believe something has to happen for a smoker to really quit quit for good. My husband and I were both smokers. We enjoyed smoking together, even tho I was smoking way more than I normally would. He was a 2 pack a day Marlboro red man. In January as I started my journey and doctors appts I was embarrassed to say I was a smoker. But I did. I was trying to quit, and he made it IMPOSSIBLE for me. We fought all the time. He would say, well u aren't getting the surgery tomorrow so what's the big deal. The big deal was...I was trying to change and save my life. His choice to do what he wanted was exactly that. HIS CHOICE. I was angry that he wouldn't try to quit with me. We both needed to quit. Money was tight. And that alone of at least $500 a month was money we could use. How we quit was very sad and unfortunate. He had a massive heart attack at age 37 this past February 6th. We both quit that morning, but on the ride to the hospital, with him gray and gasping for air and holding his chest, he still tried to smoke a cigg. As I look over with tears in my eyes at the man I only married at that time a year a half ago, gray and both knees bouncing up and down, he took three puffs of the smoke and tossed it out the window. Right there I knew something was very very wrong. Slammed the gas pedal to the floor and we pulled up to the ER. Within 5 min of arriving at the hospital, 17 people flew in the room, screaming yelling and asking me what medications he took this morning etc. I work in a hospital, so I know a lot more than I should but was trying to stay calm and strong for him. And I was, until they threw the heart defibrillators on his chest and they grabbed the crash cart and he sat up with a look on his face of sheer panic. Looking at me and screaming "Katie!! What's happening to me!!" My response in solid fear..."lay down Johnny let them take care of you, your ok. Your ok." Within 15 min of being in the ER I was chasing his stretcher down hallways as they are screaming "move out of the way! Medical emergency!!" And I'm just crying holding all of his clothes. Right before they whisked him into the cardiac cath unit, the nurse saw my face and screamed "stop!!!!" Looks at me and says kiss him goodbye and tell him you love him. They put me in a room and it hit me. I was just sitting on the floor sobbing. And a Chaplin came over sat with me and put her hand on my back and talked me down. I called all of our families, everyone was on the way over. When I finally saw him, worse news. He needed a triple bypass because of three blockages. 3 at age 37. Heartbreaking news. The last 6 months have been a nightmare. His surgery was a disaster. With his family that we barely talk too starting a fight with eachother on his surgery day in the waiting room. So I had to throw them out. Thank god after something like this, he is still smoke free. Scared him straight so to speak. He misses it. But we keep Patches with us just incase we have an urge even 7 months later. I never thought he would ever quit. I thought that him eating better would never happen. We still fight when he wants to order pizza, and he says I could be dead I wanna eat what I want. And I said if it wasn't for me taking u when I did u would have been. Ur way didn't work, now it's my way. Thankfully he doesn't fight me to much anymore. Not that I want ANYONE to go through this. But even before this happened, I was doing me. I don't care what he eats, I don't care if he smokes, 2014 is the year of Kate. And I kept chugging along. U need to take care of you and it's not worth the fight. Ask him to grab a quick shower after he smokes before bed, that u wanna cuddle but the smell of smoke lingers. If u still have love for him, he is worth fighting for. My husband and I now see a psych dr because of his depression afterwards and honestly it has helped us with way more than his heart attack and bypass issues. It has helped us to open up to eachother and talk. To see each persons side without anger or frustration or name calling. We don't EVER name call, but his recovery was very difficult. And so were my inlaws. I had a net gain during my nut visits and I was denied my sleeve. I appealed and was denied again because of the net gain and because I don't have a weight for 2013. But I do have weighs for 2008,2009,2010,2011,2012. But Aetna doesn't care. So I continue to fight. Hang in there. We all go thru ups an downs. My mom always said its easy to get married and hard as HELL to stay married. She just celebrated her 40th anniversary with my dad. It's work everyday. And if you love that person, u work at it every single minute of the day. Best of luck to you and ur husband. Xoxo
  10. KSTUZ

    Oct 25, 2013

    Thank you for sharing, I saw a lot of myself in ur story. I'm having a difficult time right now, still pre op with no date in sight just yet, but ur story is very inspiring. Keep up all the great work
  11. KSTUZ

    First Appeal-DENIED.

    Hi peteyrulz, I just got off the phone with Kelly. She was so nice. May I ask you why she didn't take ur case? Where are you now with everything? Did u get approved??
  12. KSTUZ

    First Appeal-DENIED.

    I have high blood pressure, high cholesterol, depression, at times severe edema in both ankles. So I am being treated for all of the above. I started at 303. Then my husband had a heart attack, between being in the hospital for 18 days including his bypass, i barely ate. After I went back to work and was almost done caring for him. I smell food and gain. But I fluctuate awful. I have been going to 3 more nut visits but I had to cancel August because of my work schedule. I'm calling every morning to see if there are any cancelations. Thank u all for ur support and giving me ur thoughts. I am doing 3 more months, if I have to start over so be it. Like Grammy said, what's another few months for a lifetime of happiness and health!! I'm just so down. Thanks again guys
  13. So I sent my appeal letter certified last week and they received it last Friday. Should I be calling them? Should I be giving it more time? I'm anxious to know if it will be appealed or not. Some people are telling me to call. Just didn't know if anyone out there has had any idea about being denied and appealing. Thanks!
  14. Hi Jess yeah, I have Aetna and they denied me for a net gain. I had lost a lot while my husband was in the hospital. I could barely breathe let alone eat. They took that as my first weigh in. So I was screwed from the start. On to second level appeal!!!!!! Aetna watch out!!
  15. Yeah because of depression meds and I was taking care of my husband after his heart attack and triple heart bypass at age 37. I even gave them all his discharge sheets so they didn't think I was just making up a story (even tho I dunno who would do that but ya know) I have to pick my letter up from my doctor pcp tomorrow and call the surgeons office to see what to do next. 2nd appeal but I'm still going for another 3 months appts. Next week will be my semiconductor month nut visit
  16. Oh man, I'm so sorry. I hope this isn't a setback for you. Can you start the appointments over? Start fresh from 3 months? Yeah I have my 2nd month nut app next week
  17. I just got off the phone, they denied my appeal I'm speechless. And really sad. Thanks for thinking of me
  18. KSTUZ

    Aetna Help!

    I heard back about 8 days later!! Good luck! Let us know how u make out!!
  19. Don't wanna sound lame-can ya sum up the fitbit? I've seen posts but don't know what it does... Thanks and u should be so proud!
  20. Wow. 98 in four months. That is crazy. Congrats!! How soon did u start working out? What kind of exercise? How often? Just figured I could pick ur brain
  21. KSTUZ

    Example patient letter for insurance

    I didn't have to do that, send a letter in with my original paperwork-but I wish I could have!! I will look an see what I can find. Did ur surgeons office ask u to write a letter?? I'm anxious too!! I know just how ya feel!!
  22. KSTUZ

    Example patient letter for insurance

    I didn't have to do that, send a letter in with my original paperwork-but I wish I could have!! I will look an see what I can find. Did ur surgeons office ask u to write a letter?? I'm anxious too!! I know just how ya feel!!
  23. KSTUZ

    Example patient letter for insurance

    Are u looking to send in an appeal letter?? What kind if letter are u sending? If you are looking for examples of appeal letters I did a lot of research before I sent mine. I can email u a copy of my letter if that is what u are looking for.
  24. Omg, I thought it was just me... I feel like everything is in hold, I can think of nothing else, I'm reading on this forum and online alllllll the timeeeeee. I should be finding out on Friday or Saturday if they approve my appeal. I'm like, sick to my stomach. I don't want to go anywhere, I don't want to do anything. I don't think about ANYTHING...but the sleeve. I've been watching my 600lb life. Watching the surgeries and forcing my husband to watch and even pausing the tv to say "look that will be me with all those thingys hanging out of my belly!!" I feel like my life is on hold. I never felt like this before even when dieting and working out previously. A friend I started this journey with had her sleeve this past Monday. I haven't spoken with her yet but I am stalking her husband for updates. I've just been pretty down waiting to hear back!! At least now I know I'm not alone. Thank u for posting!
  25. KSTUZ

    Waiting on surgery date

    Can I ask why you were denied? Yeah, I had a net gain during my 3 month NUT visits. My husband had a heart attack and triple bypass at age 37. So not to make excuses, but I had a lot going on and gained 4 pounds over where I started. Ugh. But I'm appealing in hopes they have a heart and will see I'm more focused and ready for this now more than ever.

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