Lap_dancer

What do they consider an emergency condition?

FANTASTIC! Let's talk in a year Mommy. Hee hee.

Amandi I envy you. Thanks for your story. It helps people like me have something to look forward to.

The more involved he becomes in his own life, the less he becomes involved in his former life. My father passed in some 10 years ago. Growing up was a strict lesson in a religious and rigorous self denial of anything pleasing to the flesh (but food). Now you would hardly know it was my mother since she remarried. She cusses, drinks and it's a whole other her that I never knew was there. This bothers me to expose my young adult children to this version of their grandmother. The other part is my brother who left his wife for another woman. All hell breaks loose after 40. My own personal values obviously are not that of my mother and brother. What I do to cope with it is draw the line of where I can tolerate and where I cannot. Ask yourself if this was a coworker or longtime friend would you still speak to them? Your husband enjoys his friendship and from that I would take joy that my husband still takes happiness from this friendship. (not my choice or yours but his and independent things seperate from eachother is a good thing). I think you are being a great wife smiling and being pleasant. I would say things like "thank you for keeping us updated on "Marge" it means alot". Have you considered going to visit her? She may not recognize you but the people at the home would know that others do care about her condition and may be more inclined to tend to her in a prudent manner. My two cents.

K Sincerest congrats to you! This is awesome. You are living what most of us dream the experience could be like. Keep us updated.

Thanks Mandy. I have BCBS of FL which has a specific clause in our contract that states it does not cover weightloss surgery. In fact, it went into a full paragraph about not covering any type of nutritional classes which actually made me sick as I read it. Think: So let us get fat, heart attacks, strokes, and diabetes and you still won't pay for educating us or providing surgical rememdy??? That is one of my beefs that they went so indepth as to write exactly what to exclude but not what to include to maintain a healthy lifestyle if you are overweight and nothing is working (as if there aren't us out there in the population). It screamed of discrimination to me, honestly. I sent that appeals letter in today. I sent the pictures yesterday. I also sent a quick email tonight for the name of the state agency we go to next for the third level of appeals from my contact at BCBS. **Mindful thought: These people are only doing their job. They are people just like us and if they have to read the NO word I'm sure it isn't making their day. One individual confided if it was up to her she would approve it as her best friend was over 400 pounds and died waiting for approval for this surgery.**

I long for the day when I have such a problem.

I have panic disorder big time. I take Klonzapam, 1 mg. x 2 a day. I swear by it.

Bitteroldag said: By the way, I study 20th century American war literature and teach a class on it. ..I'd love to take your class!

What was the basis of their denial? Not covered? I am at Level II right now. After this we go to the state level, I'm fine with fighting for this because I believe in change and fighting for change. I just want to leave a nice trail on my way up this mess hoping to CHANGE this system for all the others who accept the "No". What state are you in Mandy?

I was speaking in reference to the hospital I am working with. There are several places that do patients much heavier. This would not apply to those facilities.

Hey you two. I'm over north of Tampa. I didn't know there was someone in little old Dade City! Wow. Cute town. I'm trying to get approved by Blue Cross and Blue Shield for mine with Dr. Dy (Dee) in New Port Richey. He is really strict!

Best of luck to you Tracy. I wish I had someone at my work that was encountering the same situation. Keep an updated post here so I can follow your journey.

What insurance do you have? Congratulations!

The first article talks about a 20 cm incision and dying from complications. That just sounds wrong. I am told four small incisions are used. As for the rest of it, he did not die because of the Lap Band, he died from surgical complications, blood poisoning and other risk factors that can happen with any surgery. I'm sure you all who are banded at the moment have been told to chew your food thoroughly. I wonder how many people have died as a result of obesity? Just curious since the question relates to the Lap-Band.

PS: Anyone else having BCBS issues? I'm curious.

* I use to be a secretary *

Congrats to all of you who are with the band. I envy you and hope to be there soon. Right now I am so flustered with BCBS of Florida. I went to my seminar in Sept. Had LOADS of tests done which include: X-ray and ultrasound of stomach, medically induced stress test for my heart, colonoscopy and the other one down the throat plus test for the bacteria in the stomach, full blood work, sleep study for apnea (positive). BCBS of Florida denied because it is a specific exclusion from my policy. My doctor is 100% behind me. he has drafted letters and together I am appealing. Level One appeal was a joke. I asked to be in on the conference call where four individuals asked me nothing other than did I want to add anything regarding my file. I did request an immediately answer via phone call if they would be so kind. I'm a big girl and promised not to yell at them. I got the call, denied. Level Two appeals happening January 9th. I took pictures of myself NUDE. That's right. I flipped the fat, flashed the flesh and JPEG'd it to the nurse in charge of my case. 10 big old shots of me baring it all. I put some nipple in there just to be shameless. ( you have to have humor or you cry ) Meanwhile to answer questions for folks who are researching. There are states, North Carolina specifically, that uses "Centers of Excellence" for bariatrics, I think 12 doctors. They did so because many doctors not necessarily trained were doing GBP and other WLSurgery. The latest study shows a great reduction in post-operative hospital stays as a result. Of course BCBS is bragging about this. Google "BCBS Center Excellence" and follow those hits. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> I add a personal letter to each level of Appeal. Here is my latest: Dear Review Panel: Presented to you for review is my case for a gastric procedure known as a laproscopic banding procedure or "Lap-Band". In a lower review, BCBSFL did not dispute that I meet the criteria for the Lap-Band procedure. There is no dispute that I would benefit from weight loss surgery and there is no dispute that losing weight would be beneficial to my health. At issue is the coverage of this surgery and the exception I am requesting for this exclusion. Ironically, I received a phone call a few weeks ago from BCBSFL's new Diagnostics Program that offers support to wellness. Through this program, I gained beneficial information in the form of a booklet, catalog and DVD on the very weight loss surgery I am requesting. There is evidence in my medical records that I have tried for years multiple weight loss regimens and used pharmacotherapy for obesity under the supervision of my physician, Dr. ILOVEYOUSOMUCH. For my mental state, it is documented by my therapist, IMA CRACKEDPOT, that I have a full understanding of what this procedure entails and that it will be a lifetime commitment on my part. There is no indication that I am unstable, misinformed with perceptions of unrealistic expectations; Rather so, that I have pursued this avenue under the direction of my primary care physician and other medical personnel, with cooperation, information and education; That I am laying the course for my surgical event and post surgical life by the compass of these individuals and their combined medical expertise demonstrates I am an individual who very much wishes to be healed. Unquestionably, I am ill and feel I am fighting for my life. As a result of my severe morbid obesity, I suffer from sleep apnea, diabetes, depression, back problems, joint pain, hypertension, migraines, Pictures will show my condition and the severity of my obesity. It is true that my life is endangered. This procedure will prevent the worsening of my condition, alleviate present harmful medical conditions and perhaps cure them. It is the conclusion of my physican(s) and myself that I am in need of this operation. Please authorize my surgery. Additional: As providers of health care coverage, Blue Cross and Blue Shield has historically authorized weight loss surgery. Currently, Blue Cross and Blue Shield of North Carolina cut in half hospital re-admissions "by the twelve surgeons in North Carolina that are designated as centers of excellence for bariatric (obesity) surgery." Additionally, BCBSNC was one of the first insurers in the nation to officially recognize centers of excellence for bariatric surgery. Illinois also follows this model as well as South Dakota, Iowa, Michigan and several other states. In recent publications in the Tampa Bay area, BCBSFL appears to be using bariatric surgery denials as a financial decision rather than one in the best interest of patient care. I must express my concern that with sufficient evidence from their medical providers and informed decisions with which they move forward, it is very troubling that patient/physician decisions of health necessity are disrupted, ignored and denied, superceded by a focus on cost. It is hoped that Florida will soon follow the successful excellence practice as established by Blue Cross and Blue Shield in other states.

John the only thing I can tell you is that my surgeon would like me near 315, I'm at 360 right now. It could be a thing with the surgeon or with the particular center you are going with. Sounds right to me. My surgeon won't touch anyone at 375. The table won't hold anyone that heavy.

I'm dealing with BCBS of FL right now. OMG...urgh.

We have a secret code name for my Lap Band procedure in my house and it is called The Dance or Lap Dance. That is why I chose LAP DANCER for a name. I have my appt. with my surgeon on Monday. We will set a date at that time. I have completed all the required things and am simply waiting to have it done. Nice to be here and I look forward to getting to know you all.

You know I am quickly learning that mysherrijo! What great people on here. And I love love love the international "flava" it has!

At 46, I've come to the conclusion I have a little bit of everything in me! And that's Okay!!!...but for the detoxing! :faint:

Thanks Jo Ann. WHEW! I was getting a tad bit concerned. I start my day with lemon juice (the real stuff) and Water and from there it is cleanse every green leaf and no gucka in the body. Well I think my body got a clue! (all exits, everybody OUT ) By the end of the day:faint: I appreciate the support.

I'm on a detoxification diet at the moment, second day in. Frankly, I have the trots. :crutch: Is this to be expected????