FreeTheSkinny66

That's terrific! I have Anthem BCBS (in CT) and my surgeon's office told me that my almost 8 months of doctor supervised dieting (which required me to meet with a coach and get weighted and have my fat and hydration %s checked weekly) was not good enough for insurance because it was in 2014. Even though Anthem's guidelines state within the last 2 yrs. So I have to go through 6 months at the doctor's office. Doesn't that just sound silly??

Of course everyone has varying degrees of tolerance for procedures but I had one done when I was a teenager and it really is no big deal, you will be fine.

Anyone have a trans-nasal endoscopy? I'm scheduled for mine in a few weeks and I'm a bit freaked about it. No sedation - they just numb up the throat and pass the tube up the nose and down the throat. I am way squeamish about things up my nose - I can't even use saline spray! I'd rather be put out and have it done the normal way, but this is what he is doing so....

Anyone do this?? I need reassurance that it doesn't completely and totally suck.

I'm not really broadcasting that I'm having the sleeve done. What did you tell people during your recovery process? Like a few weeks after surgery i will be class mother at my sons kindergarten field trip to the local zoo. It will only be 2 weeks post op. Am I going to be able to do this? Walk the zoo? My surgeon says yes. They encourage you to be back to your routine. I have some family functions that I figured out how I can play off the esting portion of the function (see my other post on Italian family functions post op lol) but what about the normal stuff I may respond no to following? I mean I'll be recovering from surgery but that excuse will
Lead to questions and I just don't want the judgement eyes on me. I just want to do my thing and after I've reached my goal if I decide to scream it from the roof top that's on me but until the I want to just do it and not tell anyone until it's a success. Of course my husband and parents will know but I mean extended family and friends.
So anyone keep their journey a secret even though they have big Italian nosey friends and family hahahaha (whom I love dearly may I add but I need to be the only one in my head right now letting them in will force me to think of them instead of me and right now it needs to be about me...) Wooohoooo
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I was told by my surgeon's office that when they submit, they simply say "Obstructive sleep Apnea" ...they do not qualify as mild, moderate or severe. I asked specifically because I have Anthem BCBS (in CT) and for it to qualify as a co-morbidity, sleep apnea must be severe...and mine was mild. Also, the ICD-10 code is the same regardless of if it is mild or severe, so there's that.

Good luck. It is nerve-racking.

When will you be submitted? I am curious to see how you make out!

I know how you feel! I personally HATE photos of myself....and I get tired of people saying "OH you look GREAT!" which is bee ess...because what I see in the photo has to be real. I also have issues with the mirror..I always think I look a lot smaller in the mirror than I do on photos or video.
I finally told myself that I had it and it was time to change for good.
On another view, obesity is not always a choice. A close cousin is 125lbs....however her diet is slightly worse in that she ALWAYS eats out (burgers, fries, pizza, fried foods etc) while I'm home eating homemade salads, chicken breasts, green juices and veggies) Yet, she stays at 125lbs and I gain 15 (Surprise, Im up to 225lbs!!). Something's not right about that and while I don't know all of the scientific stand behind this, I just see it as a problem and sometimes a curse but regardless of the reason I am at the weight I am, I've gotta get rid of it! It just doesn't seem fair that my body does not work like others (who are at normal weight) works....

@@VSGAnn2014
This:
"For those of you who haven't lost all your weight yet or who haven't thrown away all your fat clothes, please save one outfit to remind you of how far you have come and of the respect you owe to the person you once were for having the fortitude to survive the burdens of morbid obesity. One day, you will appreciate more than you can imagine right now that fat person's courage.
Wow. Very powerful. For those of us living in this moment of disgust, being able to step outside of ourselves and appreciate that we are summoning up the courage and fortitude to do this...to take drastic action to fix this....that is important to recognize. Thanks for that.

@@VSGAnn2014
This:
"For those of you who haven't lost all your weight yet or who haven't thrown away all your fat clothes, please save one outfit to remind you of how far you have come and of the respect you owe to the person you once were for having the fortitude to survive the burdens of morbid obesity. One day, you will appreciate more than you can imagine right now that fat person's courage.
Wow. Very powerful. For those of us living in this moment of disgust, being able to step outside of ourselves and appreciate that we are summoning up the courage and fortitude to do this...to take drastic action to fix this....that is important to recognize. Thanks for that.

@@VSGAnn2014
This:
"For those of you who haven't lost all your weight yet or who haven't thrown away all your fat clothes, please save one outfit to remind you of how far you have come and of the respect you owe to the person you once were for having the fortitude to survive the burdens of morbid obesity. One day, you will appreciate more than you can imagine right now that fat person's courage.
Wow. Very powerful. For those of us living in this moment of disgust, being able to step outside of ourselves and appreciate that we are summoning up the courage and fortitude to do this...to take drastic action to fix this....that is important to recognize. Thanks for that.

This morning I did another closet cleansing -- moving out more clothes that no longer fit and no longer look good on me.
At the back of the closet I found the literal fat suit -- a navy, boxy Pendleton wool suit, the outfit I'm saving forever to remember, really remember, how fat I used to be.
I put it on. It was huge. The jacket wrapped around me twice. The pants are so enormous I had to hold them up with my hands. Feeling that garment against my 135-pound body brought back the terrible heaviness, physical pain and grief that were with me constantly and the awesome toughness I summoned to survive every day when I weighed 100 pounds more than I do now.
For those of you who haven't lost all your weight yet or who haven't thrown away all your fat clothes, please save one outfit to remind you of how far you have come and of the respect you owe to the person you once were for having the fortitude to survive the burdens of morbid obesity.
One day, you will appreciate more than you can imagine right now that fat person's courage.

we are a nutty bunch here, your BP family, and we don't always agree and we argue at times but we do truly 'relate' to each other -
jane

Go to your husband's employer!! Contact the Benefits Coordinator for his employer and request a copy of the Plan Document. As an insured, you are entitled to this document, as it lays out what is covered what is not, etc. I just had a similar situation with United Healthcare - I asked multiple times for thePlan Document and they just kept telling me to go to the employer. I did and got it within 15 minutes.

Good luck. This can all be SO frustrating!

Do you have a copy of your approval letter? did they approve the specific procedure or just WLS in general? Your doctor should be preparing an appeal....Contact them (surgeon) and ask if in their request for approval they specified which procedure they were doing.....ask them if they are submitting an appeal......Try to not stress, I work in the insurance business and I think you'll be okay....The most important thing is did they request approval for the specific procedure, and I can't imagine getting an approval if they didn't do that....The only problem would be if they got an approval for one procedure but they performed something different.....Your insurance didn't have any changes after your approval did it? You can also call your insurance company and ask why it was denied after being pre-approved, but your surgeon will probably have better luck because the appeal will require all the medical records and such.... Best of luck!.....

Also, I noticed your profile say's you're in CA....but you mention BCBS of TX. If you're coverage is with the TX plan but your surgery was done in CA, the claim will be processed by the CA plan but using the Texas guidelines....through a program referred to as "BlueCard" It's possible the wires got crossed between the two plans.....call your plan and ask for a supervisor......an upset member calling sometimes is all it takes.......but upset, verses mad will work much better.

@@izzy13 Just curious - who is your insurance through? I'm in a similar situation - < 40 BMI, and my sleep apnea is only mild (severe is required) and I do not have high blood pressure or diabetes....and I am very worried about getting approved (not there yet).

I'll be watching the responses you get. And will keep my fingers crossed for you. I've read sometimes an appeal goes to a "peer to peer" review with your doctor and one from the ins co. That personal "touch" might make a difference.... |??

@@Rainy Days Did the one you have automatically shut off (light was off in the a.m.) or did you have to turn it off manually? If it turned off on its own, I think you got what was required!

My results said I have mild sleep apnea - which will be corrected with surgery. The question is....will the insurance company consider "mild" bad enough to have it stand as a comorbidity?! Ugh

Me, me, me!
My BMI was 39 -- 235 pounds and 5'5".
My three comorbidities were arthritis (knees - severe), lower back pain, and stress incontinence.
FYI, I lost 100 pounds, now weigh 135 pounds, and have canceled my knee replacement surgery. Feel great.
No lower back pain, and I haven't bought "pee pads" in 12 months.