Sharon1964

Got it!

I know there is a facebook group, but I'm not much of a facebook-er. Here is everyone that has chimed in so far: 1 ************ 2 ************ 3 - Tazwella, lohcinlaehcar, sbg224, BrownEyedTxGirl 4 - soonsleeved, becca2015, swim and climb 5 - ladyfrann, KF2007, smallbmi 6 - calee, kblbe98, Nickkibear24, Madtownsunshine17 7 - Frequently_Fantastic, MiamiBlue13 8 - Sharon1964 (yes, Saturday) 9 ************ 10 - jking612, bekah81015, sshellssea, purplegirl20073 11 - mmb2003, jelmomof4 12 - rebornnae, PDX_LDN, KimH_888 13 - BethC (conversion) 14 - LaLaLucy, bonniegold, Sleeved8.14 15 ************ 16 ************ 17 - ylluz, Anumarie, theother_onefoot 18 - GrannyRose, Clementine Sky 19 - Pillar2butterfly, tubabuddha, Imm300missouri 20 - camsmom08, Geron Girls, volgirl 21 - Latina_Diva 22 ************ 23 ************ 24 - haleyk, Fluffypal, dkrause, Shakti 25 - byebyedarkpassenger, Soodoo, Luraine, Less Cushion More Pushin 26 27 - tera1982, gabisha 28 29 ************ 30 ************ 31 - JAMuffin45, Litzy, Tya806, dustyateit, khinote, ttdish, PamInWA

Here is info from someone in San Joaquin County (which, as you know, is one county west of Fresno County): http://www.bariatricpal.com/topic/221572-anthem-blue-cross-medi-cal/ I would do one or both of the following; 1. Call the member services number on her insurance card and ask what the coverage is, and the requirements are, for bariatric surgery. 2. Call ALSA (Advanced Laparoscopic Surgery Associates), the office of Dr. Kelvin Higa. Dr. Higa has a reputation as the best in Fresno and is the only surgeon my own primary care doctor would let me see. Ask them if they are still on the Blue Cross Medi-Cal plan (he is currently listed as being on the plan). And then lastly, she should make an appointment with her assigned primary care doctor and ask for a referral for a bariatric consultation.

I truly don't understand why there are so many differences. My preop diet is one day. Full liquids, doesn't have to be clear. I'm having more trouble with the fact that I've had to stop my daily anti-inflammatory since my surgery is in one week. My knees and feet are hurting me in a way they never have before.

I love your style!

I tried very, very hard to resist. I did, really. Sigh. I lost the battle. Dude, you're smoking it right now, aren't you???

Okay, stick with me here, there's going to be some math. According to the nutrition guide from my surgeon: 1. at my height my Protein goal is 64-70 grams per day. 2. you can only eat three meals per day. 3. most protein sources that they list as "good" contain 7 to 10 grams of protein per serving (except tofu, which is 20). 4. most of the serving sizes are 1/2 cup. 5. at six months, they expect you will be eating 1/2 cup of food at each meal. 6. protein supplements are discouraged. 7. they don't expect you to hit your protein goal until you are out of the liquid stage. So, with all that, 7 to 10 grams of protein per serving times three meals per day is 21 to 30 grams of protein, not 70. What am I missing? My pre-op is on Tuesday, so I will be bringing this up then. I figured I would ask here first in case there was something glaringly obvious.

This. Totally.

He needs to get a copy of their policy regarding weight loss surgery. If it doesn't say he must stay the same or lose weight during the nutrition portion, then he should be able to successfully appeal. In that case, it would be the insurance company's doctor's OPINION to deny, and he is not following the written policy.

When I was pregnant, I got tired of intrusive people. When someone (particularly a stranger) asked when I was due, I would say, a little loudly, "I'M NOT PREGNANT, I'M FAT!" Yah, I can be a pain sometimes.

I had a hard time reading this, with sentences that are clearly missing words. It appears that you meant either "over a 100 pound weight loss" or "over a major weight loss period". I think you will put forth a better image if you spent some more time editing. And as someone else mentioned, the pronouns need help. And lastly, over $30,000? Most people I know cannot relate to that (including me). I'm guessing that was over one or two years, so either around $2500 per month or $1250 per month. That's more than my rent.

I was surprised that stress incontinence was on the questionnaire at my surgeon's office. We talked about it specifically, and he said the majority of his patients with it report significant relief after surgery. I take a diuretic now, so combined with stress incontinence, it's a disaster waiting to happen. It's one of the improvements I'm looking forward to after surgery.

At the nutrition class I went to (run by a nutritionist who works for my surgeon), we were told that the surgeon isn't really big on shakes, and prefers "real food". I asked how we were supposed to get in our Protein before we were back on solid food, and the answer was that they don't expect us to get protein the first two weeks. So since they "prefer" real food, but don't forbid shakes, I will probably use them to supplement.

Commit these phrases to memory: "I'll give that all the consideration it deserves" "I'll let you know when it's okay to discuss me behind my back" "I'll let you know when my choices are open for discussion" and when someone says, "we've been discussing your wanting surgery...", you interrupt with, "well that is certainly odd. You must have been really bored lately" and then find a reason to walk away or have a topic to immediately change to.

I wouldn't assume that. I would call the member services number on my insurance card and ask them directly.

I called my surgeon's office to ask about stopping metformin after the surgery. The nurse I spoke to said we wouldn't know until we did a blood sugar level in the hospital. I don't take metformin for high blood sugar (my numbers have always been normal). I take metformin because my A1C is too high. So blood sugar levels aren't going to tell us anything. Is there anyone else in this situation?

My coworkers are very supportive (or they're too afraid of me to say anything else!), it's the people who drop in - attorneys, vendors, etc.

I think some people are confusing FMLA leave with disability insurance. FMLA gives you the right to take off work and have certain protections. Disability insurance may or may not pay for that time off. There is no "FMLA provider".

@@ShrinkingPeach Now don't you go ruining my rant, Missy!!!

I think there is a difference between asking and not asking a question. In my case, I did not ask a question or ask for opinions (I mean, in my office, not in posting this here). If I post in rants, I expect people to respond. If I ask a question, I expect (hope!) people will respond. If I make a statement face-to-face with someone, I don't expect them to launch into a speech to try to educate me.

At my office on my door, I have a countdown calendar for my surgery date (3 weeks from today, YAY!). People visiting my office who see the calendar ask me if I'm going on vacation as they are assuming that's what it's for. I always say, "I'm having bariatric surgery." Without fail, every single person then launches into "here's what you have to do", and then proceed to tell me how to be successful (whether it's Water or exercise or whatever). It's always about a friend or a relative or a friend of a friend. I've taken to holding up my hand to stop them and tell them that I've done all my research and I'm good to go. If it didn't torment my boss so much, I would take down the calendar. My boss is in a panic over me having surgery; he thinks I'm going to be out for a month (I told him a week). I told him I've taken longer vacations than I'm going to be out for surgery. /end rant

Most people report they sleep the rest of the day after surgery. Since it doesn't sound like you'll have time for visitors (unless you stay more than one night), I wouldn't want to expose people to hospital germs.

He's attempting to have you do this as if he was out of network, which makes me wonder if he really IS out of network. If he is not out of network, he would be violating his contract with what he is telling you. If he is out of network, then he can ask for full payment up front, give you the claim forms and the op report, and have you file your own claim with the insurance company. It would be subject to the terms of out of network procedures, which can be really bad, depending on your plan. If they deny the reimbursement, it would be up to you to fight it. It sounds to me like he wants to avoid the trouble of complying with your insurance and getting an authorization. For non-emergency surgery, you would probably still have to jump through the hoops or risk having everything denied. I would find another doctor.

Pictures. This thread needs pictures!

If you don't want to tell anyone, then channel Miss Manners (aka, Judith Martin). She recommends "polite evasion" and/or "shocked astonishment." In your situation, I would go with "shocked astonishment." When you are confronted with a question so horribly impolite you will find yourself at a temporary loss for words. You would say, "pardon me?" in an astonished tone, because the question is inappropriate. If they don't "get it" and repeat the question, you would continue to look shocked and say, "Well goodness, THAT is certainly a personal question" then turn and walk away.