Sharon1964

If you're familiar with the Minnesota experiments, you'll know that the purpose was to learn more about famine and how to help people in danger of starvation at the end of World War II. You'll also know that the volunteers never went below 1500 calories in a day, and that they also experienced severe depression, emotional distress, hypochondria and hysteria. Further, the physical effects of the experiment on the participants closely resembled the physical effects that happen to people with anorexia or bulimia. And all that with four to five times the calories that you are suggesting. I can't even imagine what will happen to a person who drops to the level you are suggesting. No thanks.

When I called my insurance company to ask about requirements for WLS, they said "no alcohol or substance abuse for 18 months" and "no smoking for last six months." Ask your surgeon what his/her requirements are. It could be anywhere from 30 days to 180 days or more. I tried to give you some links to data regarding smoking and surgery, but those sites were not allowed to be posted here.

Can you be a bit more specific as to what you are having a hard time with? How much to eat? What foods to eat? How often? Are you having a hard time getting food down? If you tell us you're vomiting every time you try to eat, that's a different problem than being uncertain of what to eat.

I know I'm late to the party, but my first reaction was, "I'm about to lose 185 pounds (or whatever your husband weighs) if you don't stop talking about my weight." I always try to channel Miss Manners (Judith Martin), where I first learned that "thank you" is a complete sentence, as is "no", and "thank you but that won't work for me."

I'm not sure how helpful this is... we have a zero tolerance policy for gossip where I work.

I've been working in medical administration for over 15 years. I have NEVER had a secondary insurance that will "just pay" if you bill them (not saying they don't exist, just that I've never seen it)... although I've never worked with Horizon NJ Health. Generally, the secondary follows the decisions of the primary unless you get something different in writing. So if your primary insurance does not cover a procedure, your secondary has two options: follow along with the denial or cover as if they were primary. I would never counsel anyone on my team to perform a procedure without a written authorization/approval from the secondary in your situation. The likelihood that we would get paid for it would be slim.

Wow I'm so jealous! I'm sitting at the hospital right now waiting on my upper gi. Next month is psych eval and colonoscopy. Just starting the six months of medical visits.

I spent some time and read all 107 pages (!!!) of this thread. You all are so inspiring! It is so wonderful to read of all of your victories. Thank you for sharing your stories.

It's not done at the same time. My colonoscopy is scheduled for January; I have four months after that of monthly visits (supervised weight loss) before I can have my vsg.

I have to go back and check my notes, but I'm pretty sure my surgeon's plan says no bread or crackers for six months, as it forms a gummy paste in your stomach, which is very hard to digest.

I would wait to see if you get a denial for that reason. There is a possibility that the medical assistant entered the wrong weight into your records that one time. That is probably what I would base my appeal on. Oh, and as stated above... if you have a medical procedure based on an approval, they cannot come back later and retro-deny that approval. As long as your insurance is current (paid up) at the time of the procedure, and they have not notified you that they have rescinded the approval BEFORE you have the surgery, you're fine.

As with any system, people who abuse it make it harder for those who really need it. I just asked some of these questions yesterday... my sister's ex had WLS right after they broke up. I thought the ex must have paid cash for it, because they were MAYBE 50 pounds overweight and had no comorbidities. My sister said insurance paid for it. How that actually happened baffles me.

Ah, okay. I thought the issue was raising costs for patients. I see what you're saying now. I find it reassuring that my surgeon requires that his patients take care of all of the recommended screening procedures that are appropriate for their age and situation. As part of the life changes that I have to make, I have to take care of all of me. YMMV.

@@samuelsmom Colonoscopy after age 50 is covered at 100% with no out of pocket costs as preventive care.

My surgeon requires you to have all aspects of your health checked out before surgery. That means if you're over 50, you have a colonoscopy. Women must have had a mammogram and a pap within the last two years. Other surgeons don't have those requirements.

I too, have not yet had surgery but a number of years back lost a great deal of weight. This is how a typical conversation would go: Person: Wow, you look great, have you lost weight? Me: thank you Person: (looking confused) how much have you lost? Me: thank you Person: I asked you a question Me: sorry, I didn't hear anything you said after "you look great", because really, is there anything to say after that??

I heard from Ken and all is well. Thanks!

I made an ebook purchase on this site, but when I tried to click the download button, there was no active link (i.e., nothing happened). I used the "contact us" page to try to get it resolved, but haven't had an answer yet. I used to work tech support for a website, so I know how busy it can get... but dangit! I want to read my book! How can I get some help? Sharon

No no no! Don't apologize! We were delighted!

This was my favorite part: "you tell me since the test was friend and when I walked in and I had to go to bathroom to you and for you leave so I was little so says now that was on the way home." Congrats!

Well, we only had the nutritionist as no one from psych showed up to speak at the class!

So i just introduced myself to a tiffany but it turns out out was the wrong tiffany! Tiffany, if you're here, I'm in the black and white dress in the second row on the left!

I vote for hissy fit, but some people might think my version is a bit passive-aggressive. The next comment would get peals of laughter from me until I could finally choke out, "oh gosh! you were serious! I had no idea! I cannot imagine why ANYONE would think it is okay to make those comments!" and then walk away, still laughing. Sharon

I don't know who the speaker will be, will report back after class! Sharon

Hi Tiffany! Come find me on Tuesday! I have super short (like one inch) mostly-gray hair... I'm pretty hard to miss. Sharon