LearningToLoveMeAgain

On ‎5‎/‎29‎/‎2019 at 12:44 AM, Deedee12 said:

Hello LLane RN, how are you? And how is preop diet going? I bet you are at the edge of your seat!

I just wanted to give you my update. I too got my approoval today and I could not be happier!!

I met surgeon first time 4/24 to have my lap band removed after 7 years od bondage (not all bad, but felt like it). I was disappointed to find that my surgeon would not do the revision simultaneously...but now I am glad she did not as I have had the chance to not go off how I was feeling with the labpband and do some very necessary research both on the site and generally. I did tell the office to go ahead an submit as I did not want a long wait and wanted to know my faith early on in the process.

Request was submitted initially on 4/30 but they had the wrong CPT code and it was resubmitted immediately and we waited 1 week to come find out the new CPT code request was also cancelled same day. So they resubmitted again on 5/13 and they made me wait exactly 2 weeks to hear back today as yesterday was a public holiday that the request was approved.

I met surgeon once, lap band removed on 5/3 and approval today. I am yet to meet the Nutritionist, Psych etc.

I plan to still do all that but it feels good to know the approval is in and I can do all other appointments at my leisure.

Thanks to your encouragement and this site for all the GOLDEN nuggets, it was invaluable.

Good luck to you LLaneRN, I'll be praying that your surgery goes very well and your recovery is speedy!

I had surgery on 5/28. No pain, no hunger, no issues at all. I feel great and am currently 3 weeks post op. I'm getting plenty of exercise and have am in the pureed stage of foods. I hope all goes as planned and smoothly for you. hugs

I have C-PTSD, OCD, major depressive disorder, panic disorder and general anxiety disorder. I got clearance from my regular psych doc and have surgery 5/28. As long as you take your meds and are stable, you should be okay. The problem with Bipolar disorder is that many patients stop taking their meds when they feel better which triggers mania. I’ve been a psych RN for 20 years so I have a lot of experience with this. Also, my sister is bipolar and she had surgery 2 years ago. Our mother is also bipolar.

16 hours ago, Mrs.RNBSN said:

Hey there LLaneRn,

I have UHC advantage plan as well. However, they have told my surgeons office that no prior authorization is required?! They had you go through a prior authorization process? I hope that their not trying to just hang me with an outrageous bill 😩

Medicare doesn't require a prior auth but UHC does, even if they're a medicare advantage plan. Your insurance nurse will likely send in everything anyway to obtain a prior auth because they want to make sure they'll get paid. I would just tell the insurance nurse to send it for a prior auth anyway, even if they said it's not required. At least then you have a leg to stand on if they try to deny the claim post op. Also, if they insist a prior auth is not needed then get it in writing. I called UHC several different times and was told something different by each person I spoke to. My surgeon's insurance nurse told me that everyone requires a prior auth except straight medicare patients, they just have to cross their fingers that it's approved after surgery takes place. Hope that's helpful. Good luck!!

BMI 35, UHC insurance

comorbids: GERD, osteoarthritis, degenerative joint and disc disease, depression

My BP is perfect, cholesterol is great, not diabetic, no sleep apnea

first letter approval

surgery is tomorrow for me, BMI is now 34

I have zero carb Isopure vanilla whey Protein powder. I also bought some powdered Peanut Butter (PBFit). I mix one scoop of Isopure vanilla and 2 tablespoons of the PBFit along with 8 oz of cold Water. Tastes just like a peanut butter shake. 31g protein, 2g carbs, 2g fat for the shake.

May 28 for me. Preop class and diet starts May 14. Not going to MX though. My insurance covers all but $300 program fee and $350 for everything else.

Thank you!! I’m relieved, slept better last night. Good luck!! 🤞🏼🤞🏼

PreOp diet starts 5/14
Surgery is 5/28
Wow!! That 6 mo actually flew by.

I am so impatient. I just called UHC and asked about my prior auth and she said I was approved as of 4/30. I called Anita, my insurance nurse, and left her a message. I'm so excited and hoping now some of my anxiety and stress will diminish.

For stats if anyone is wondering, this was my process:

*6 mo physician supervised diet/exercise

*5 years of BMI (didn't have to be over 35)

*my co-morbids are osteoarthritis, GERD, borderline DM, borderline hypertension, borderline high cholesterol

*my submitted BMI was 37 (I maintained my weight for 6 months, didn't try to lose weight)

*cardiac clearance

*psych clearance

**didn't need sleep clearance because I don't have apnea

Started process in November 2018

Final clearance was 4/16

Submitted to UHC on 4/19

Approved by UHC on 4/30 with no denials

The wait is torture. Anita says I’ll be fine and she knows best so I’m listening to her advice and trying not to get to anxious.

Just now, LinaInbaasuu said:

Thank you!

No problem.

60-80g Protein, low fat, low carb. 64oz minimum of Water a day. Try to cut out caffeine (soda, coffee, etc.) now because you don't want to go cold turkey off of it with surgery. If you smoke, stop now. I had to maintain my weight for 6 months to keep my BMI over 35. Another thing...they're probably going to want your A1C down before surgery so try your hardest to eat a low carb diet. Healthy veggies are okay but stay away from processed foods and always eat your protein first. Take your time with your meals, 30 minutes to complete one and pay attention to hunger cues. If you feel satisfied, stop eating. Some docs will refuse to do surgery unless your A1C is under a certain level. I'm not sure what that level is because I'm thankfully not diabetic, yet. My last A1C was 5.1. Since you have DMII then you should be able to go below a BMI of 40 as long as you stay above 35. A low carb diet is the best way to get DMII under control and lose weight. Good Luck! You got this!

I'm relieved! My insurance nurse called me yesterday to say that they still hadn't received my EGD op report or my Cardiac Clearance report even though they had requested them a few times. I called the providers for both of those tests and requested to have the reports faxed directly to my insurance nurse. This all happened around 4pm yesterday, so just when everyone is fixin to close up shop and head home. Anita called me this morning to tell me that my phone calls worked because she arrived to work to both reports sitting on her desk! woohoo! There's something to be said for being an RN and knowing how to deal with doctors to get what you want from them. She said she submitted me for approval and UHC is taking an average of 10 days to respond. Super excited now, it's feeling real. I asked her specifically about falling below BMI of 35 preop and she said they have had a few patients who have walked into surgery at a BMI of 32 but had managed to stay above the 35 until they were submitted for approval. She said they do not submit any other weights after they submit for approval which was a big fear of mine. I fall in that boat. So, now I'm working to lose so I can be as healthy as possible come surgery day. The day is getting closer. I'm shooting for sometime in May. Also, I've averaged 23k steps on my Fitbit this week. I've been participating in challenges and meeting a lot of folks who are trying to get fit. There are several losers on the site (trolls who are there seeking some sort of relationship 🙄) but most of the people I've "met" have been friendly and fun. I have actually danced my way to 20k steps already today, LOL. Have to make it fun! Have a great Easter weekend, ya'll!

On 04/18/2019 at 18:18, hamby said:

Well the insurance company wanted a letter from my doctor supporting the surgery. My family doctor was right on it and I got the approval today. May 9th is the day.

On 04/18/2019 at 17:41, BulletWithButterflyWings said:

Lexapro would have been a better choice. Celexa does nothing for anxiety. Sorry, been a psych nurse almost 20 years.

Oh I'm glad you said something because, dont get me wrong I love my PCP, but he acts like he has no idea what will work. I was on Klonopin for a while but my panic attacks got so bad they weren't helping anymore. He has been chasing his tail to find something that works but it's mainly been antidepressants that make it worse. I had Adivan(spelling?) A few years ago and it was as needed and really helped. A months supply lasted me 3 months a lot of the time but that was a different dr lol