stacy71

I'm walking, just no dancing yet! I'm just really praying every day gets easier!! Slept on the couch last night because I'm up 3-4x a night peeing! Hope THAT goes away soon!

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Up on your feet and walk, the journey of a thousand miles starts with a single step. You're gonna dance in the sunlight of good health my friend. Greater is He that is within each of us as believers than riches the world can accord. Be praying for you Now and in the Future.
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If you have severe acid reflux (Gerd) it is best to go through RNY gastric bypass because the sleeve can make that condition worst. Other than that, you could go either way.

I had lapband in 2011. Got pregnant almost right away, finally years later had 2 fills. I have vomited almost daily now for years as well. After many life changes (divorce, new career, etc) I'm ready for me. I saw my surgeon today and had the 5cc's in my band taken out and I noticed the moment it was out. That pressure was gone but for me, it was normal. So I start my 6 month process of hoops now for the insurance. I'll be paying plenty out of pocket along with it but I'm torn. I was totally ready for Sleeve but now I'm wondering. Go big or go home? Enough screwing around and just do the gastric. My surgeon (same who did my band) agrees wholeheartedly on a revision but she herself said there is no winner. She thinks both would be fine since I'm not a heavy or sweet eater. I'm just scared and I have time but..... Any help? BTW, Back at the heaviest I have ever been, just not sure how to update my profile on here.

I also have UHC and I’m in Texas!! My paperwork was sent off this morning for prior authorization! I’m in Houston and having surgery with TLC surgeons!! I’m so glad I found your post! It says they can take 15 days to approve or deny!! I’m hoping I will hear something next week sometime!!

Oh my gosh this is good news I also have uhc my criteria is 6mo diet,psych evaluation and 40+ BMI my consult is today any other pointers would be great

I’ve lost 100 pounds and my boobs look like tennis balls in tube socks. I definitely need new bras but I can’t figure out how to measure my saggy boobies. God knows I’m not letting someone else lift these things to measure them. I’d be mortified.

Me also, do you think I could get a prescription written for 2 seat belt retractors? That way,I could roll them up and stuff them in my bra.

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The only crack going on here is my butt crack when I’m swimming laps because my swimsuit don’t fit anymore. No deaths so far but I’ll let you know of the first casualty when crack kills!

Amen my brothah! (Now put down the crack pipe and do something constructive for God's sake! Not that there's anything wrong with that!)
BTW? I love you guys too and look forward to your posts.

I have my days of seriousness and days of fun, but overall, I do love me some Doctor @FluffyChix too!

Hey some topics are very serious. I get it! But I try to add humor to my responses I have no intention of offending anyone. If you don’t have a sense of humor then good luck healing. So I guess if your one of those “serious people” then you might consider skipping my posts & responses. After all laughter is the best medicine. Happy healing! Thanks for laughing with me FluffyChix!

It's best to talk with your surgeon in regards to that. If you lose too much, many insurance companies may think you can do it on your own and if you don't lose enough, they may deny it and think you are not trying hard enough.
It also depends on what your BMI is. For example, someone I know was over 5'5 and almost 385 lbs. She lost 50 lbs during her 6 month wait period and was still approved because her BMI was too high and the surgeon justified it by saying that the fat around her organs needed to decrease to do the surgery successfully.
It is really up to your surgeon and his team and how he feels comfortable too with doing the surgery. As a reminder, they are the ones that can word it in a way in which can convince the insurance company to cover it.

Hi all.
Just want to give my experience with the UHC process. I made the decision to go this route in may of 2017. I made the call to UHC who set me up with Optum Health which is part of the bariatric sub division. I was simply required to complete 6 months of guided weight loss which I did through the Center of Excellence facility that I chose as everything was on site there. I completed this process in December. The facility tried to submit my info to optum only to find out my case had been closed. Finding this odd I called them, got scheduled to a call with a case worker on February 8th. Had the call and at that point the case was ready for review with optum for the "letter of medical necessity" However, I found out today that I have to do another call with a place called CBA which will take place on Feb. 15th. It is nice to see however that it seems like once it finally gets to UHC for approval they seem to have a pretty quick turnaround. Once that approval is given, surgery will be 2 weeks from that day!

Good luck !

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Great info for a current 2018 UHC pre-op. After talking to my UHC Bariatric nurse I already had my appointment set with the Center for Excellence Dr as required. I have slightly different requirements but still the 6 month monitored diet, endoscopy and psychological testing. Everything else is held at the Bariatric Center. It’s really a great place that the doctors work together to have the dietitian, workshops ... whatever is needed right there! I’m hoping I do correctly for the monitored diet plan and progress enough to get approved but not enough to get denied!!

I'm in a similar situation. BMI is 40.6 I have co morbidities but my previous doctor didn't like officially diagnosing me. She said I had asthma when I was 12. Depression at 13. GERD at 15. Gastritis at 17. Ulcer at 19. Diabetes at 21. Now I'm 22 switching doctors and according to my health records. I was never diagnosed with anything other than mental health thanks to my therapist.
The only co morbiditirs my insurances allows with BMI under 40 are diabetes and hypertension (or life threatening cardio problems)
So I have to say "I hope I have diabetes" otherwise I'm screwed on surgery.

Depends on your insurance. I have Regence BCBS Oregon and their policy is "bmi above 40 at the START of medically supervised blah blah blah"...BUT it's best Togo thru your pre-op process in the minds of insurance claims administrators. Unfortunately, their goal is to make money-not give it away. So their main objective when determining medical necessity is finding ANY REASON to deny you. Sure, they have the policy and you can check every box, but they may or may not deny based on that one weigh in that dips below 40 bmi. This is where you'll want appeal...most insurance companies bank on denials over small details like that hoping you won't appeal but if you do you'll most likely get it. Hope this helps!