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Newbie Wannabe Loser



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Hi everyone! I have been lurking for a couple of weeks now and just joined a couple of days ago. I am 5'6" and 265 pounds. I'm tired of being fat! I used to be "merely" overweight, by about 3 pounds, and thought that was the worst ever. Boy, was I wrong! I was a teenager and constantly picked on by a step-father who enjoyed making cruel comments and pig noises at me. Now, I am 34 years old with two children and zero energy. I look at pictures of myself as a teen and wish I still looked that cute. For a long time I used to view every bite I took as an "Eff you" to the ex-step-father. I have made peace with my past and realize it was his issue, not mine. (FYI his comments to his sister, and apparently also his current wife, have made them both anorexic. That really helped me realize he is a small man, and I am worth so much more than him.) Unfortunately, now I am terribly obese, and cannot lose the weight. For years, I considered weight loss surgery but did not want to be re-routed. I also did not like the thought of a band stuck in me. I recently discovered the sleeve and I know this is the best option for me.

I lost my job two years ago, which meant losing my insurance, too. I just qualified for Medicaid and view this as an opportunity to finally get the surgery I know will help me. I am pre-diabetic, have PCOS, high cholesterol and heart disease runs in my family. I am not living the life I deserve. My children are not getting the mom they deserve because I have no energy.

Medicaid is a new thing for me! I have contacted the bariatric center I will be using and the *** (I had to choose an *** through Medicaid, so I chose Coventry Cares because they have an excellent dental plan). Can you believe Coventry has no actual criteria? They view each case separately which is scary! My first appointment with my PCP is October 2 and I am hoping I can convince him to make my case look like I badly, badly need this surgery. I suspect I will still have to do the 6 month medically supervised diet. I was hoping I could get that cut down to 3 months since my sincere wish is to be back on my feet financially and off Medicaid by the time the 6 months are up. I guess my health is worth waiting a few extra months!

Has anyone else had any experience with Coventry Medicaid in Pennsylvania? Or any of the Medicaid HMOs in PA? The bariatric surgeon I will be seeing is Dr. Neale in Wilkes-Barre, so any advice to this newbie would be so very welcome.

I apologize for the novel!

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Interesting. I never would have thought that the acronym for Health Maintenance Organization would be asterisked out.

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I don't have any answers for you. Best of luck on your journey! I had hoops to jump through for my insurance but I got approved and will be sleeved next Wednesday.

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Congratulations on your approval!

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Welcome to the party! It's a bumpy ride, but the people on this forum are wicked uber nice and supportive. You've come to the right place.

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    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
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    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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