Weight gain, insurance, no support, I just need to VENT!

[TinaM8 9]

I really just need to vent.

I have all but talked myself out of this surgery and that in itself frustrates me beyond belief. First off I have no choice but to be approved through insurance because I cannot afford another self-pay surgery (I had the lap band in 2006). Even if I am approved I have a deductible of $6000. That is STEEP to say the least. In order to try and get approved I have to gain weight before I can be considered for insurance coverage because I don't have any "check list" health problems and my BMI is under 40. I was told I would have to gain 25lbs. Seriously!! That goes against everything I am trying to do! It goes against everything I have been trying to achieve for the last 34 years of my life.

I also, have no support with this surgery. It feels like everyone closest to me just wants to talk me out of it. They keep saying "Oh I know you can do it with diet and exercise". OH REALLY? Well let's do the math. I am 34 years old and have been obese my entire young adult/adult life. I was also heavy when I was young. I literally spent 2 years of my adult life not being obese. It was between the ages of 19 and 21. I had no relationship, no husband, no job, no kids, no job, virtually NO STRESS AND I was exercising 4 HOURS A DAY !!! Of course I was able to do it. It took me a year to lose 80lbs which was all I needed to lose at the time and I kept it off a year. That in NO WAY is a success. I gained it back plus 30+lbs so OBVIOUSLY I need help. I know that the opinions o2 weight loss surgery are vastly different. Some people are for it and some people think it is the worst thing you can do. I have found there very rarely is any middle ground. I know it doesn't help that I already had the lap band and "failed at it" but the more I learn and the more the lap band is around I see that the band is just not going to work with everyone. I try not to be hard on myself but BELIEVE ME I am and I feel bad that I wasn't able to succeed with the band. It is a huge disappointment. Not to mention embarrassing. Everyone knows that you had it so it is obvious you aren't succeeding with it.

I know that there are so many worse things in life that I could be dealing with but right now this is my hell. I have these waves of excitement thinking that I could possibly get a handle on this once and for all. Then it switches to nervousness thinking about having a part of my body removed. Then I just get waves of complete "I am just going to throw my hands up and quit and I will just have to deal with being fat until I die." It helps to have somewhere to vent especially since nobody gets it until they have been there.

[Raquel313 0]

Are you me??? I am in the same boat. I am self pay again (banded in 2009), but am pretty sure I will have a lifetime of obesity, or yo-yo dieting w/o the surgery. I'm weighing the pros/cons every millisecond of the day, but deeeeeep down know I should go forward w/ my surgery. I am not afraid of the surgery at all (nothing could be worse than 2 C-sections), but just the difficulty that I know lies ahead and the repeat disappointment if it doesn't work. TOUGH CHOICE!!!!

[TinaM8 9]

I am SO you !! I have had 2 c-sections too!! I know that I NEED this surgery. I am so unbelievably unhappy with myself just on a day to day basis. That probably sounds so dramatic but it is just really how I feel. I don't know why it is so hard for me to explain that to people that I NEED this surgery. Why they can't understand. I know it is a big deal BELIEVE ME I know it is a huge step but I do need it. I hate to say that the thought of another surgery does scare me. Really just from a nonsense point of view. I let myself think of all of the most ridiculous scary things that could happen and convince myself it is going to happen to me. How selfish I would be to leave two kids behind just on the Quest to lose weight. Anyway, those are the things I always think of.

I am also just STUCK. Do I gain the 25lbs just in order to see if I can get approved and then risk possibly not being approved and now I am even more miserable than before. Or gain the 25lbs and get approved and then find out that I will have to pay the full $6000 deductible which is still too steep for me. I just don't know what to do at this point!!

[annabelle 76]

im so with you on I need this surgery, Ive no one here to share my feelings with and at times I feel as if im drowning, im beating myself up for the last few days with head hunger, when will you hear from your insurance company maybe they can threw some light on it for you

[RebecaSparkles 247]

Gonna get sooo flammed for this but :

Ankle weights? Gain 15 + weights for the rest?

Eat tons of salty food& take psuedophed right before your blood pressure test? Manipulate the test. Think of ur babies getting hit by a car, or other stressful situations during test?

Eat sugary foods after midnight on the days of your glucose test.

Hey- insurance wants to play- fight fire with fire!

Not advocatibg this but, iit an option ifyou can still sleep at night knowing you gamed the system.

[Cyant 29]

@rebeca ROTFL

[leeann71 539]

Tina, I really dont know what to tell you lol. What I can say is my dr. cut my deductable in half so I could get my surgery. There are a lot of doctors in Texas that will do that. Have you had any slippage or problems with the band? What about high cholesterol, sleep apnea, asthma? There are alot of health problems from being overweight. Bladder problems, varicose veins? Just to name a few. Good luck! I would if I were you fight fire with fire lol.

[Katie713 423]

Have you thought of having the surgery in Mexico for a cheaper price than your deductible? My understanding is that since it is self pay - you don't have to go through the rigorous pre-op qualifications.

Go to the forum on this site - there are plenty of great recommedations for surgery outside the U.S. Check with OTR sleever...he has nothing but great things to say about his surgeon.

Good luck!!

[RebecaSparkles 247]

Ok real idea this time:

Wlsappeals.com

They're lawyers that help you get it approved. Even if your plan doesn't have bariactric coverage they can argue that it's discrimination to not offer coverage for specific diagnosis.

They can also appeal for if you don't meet the numbers for eligibility.

Not sure if you can do it on your own but an advocate is always a good idea.

At least call & get a free consult or their data on your insurance & your odds for over turn

[SpaceDust 585]

Gonna get sooo flammed for this but :

Ankle weights? Gain 15 + weights for the rest?

Eat tons of salty food& take psuedophed right before your blood pressure test? Manipulate the test. Think of ur babies getting hit by a car, or other stressful situations during test?

Eat sugary foods after midnight on the days of your glucose test.

Hey- insurance wants to play- fight fire with fire!

Not advocatibg this but, iit an option ifyou can still sleep at night knowing you gamed the system.

Just a note that cheating the glucose test probably won't help - if they don't already check your A1c as part of the blood test, they would certainly do another panel and check it if you came back with wacky high glucose, and since the A1c is essentially a look at your average glucose levels over the last 3 months (more or less - I'm simplifying) it would be pretty obvious that you deliberately blew the test. Not that anyone was seriously considering doing this, but still...