Losing hope -just venting

[Brenda Sherwood 64]

So I started this journey in december when I went to my surgeons seminar. Finished up all the pre op tests and 3 mo diet last month and dropped 25lbs. I worked hard to get that weight off. Had hoped to get my surgery the first week of May and had everything set up, including family in town to help and time off from work. Well, insurance denied me when I was in day 5 of my liquid preop diet. We have sent in appeals but its not going anywhere. I'm soooo bummed out. Continued on with my diet for a few days but now I'm at the point where I said Eff it and ate a ton of crap today and yesterday. Now I feel even crappier for eating junk when Ive worked so hard for months. At this point I dont think I'm getting approved and its really destroying me. I was so mentally prepared for all of this and looking forward to my new life. Sorry, just needed to vent.

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[KindaFamiliar 3,867]

Vent away @@Brenda Sherwood

Especially if it's gonna help...

Don't forget tho - this site doesn't disappear just because you have a setback or two...

We still remain your support network..

There's still a wealth of knowledge and caring here...

As far as your couple of crappy eating days, it's done now...

Acknowledge it and move on...

Be ready for your approval to come thru, no matter how unlikely it is...

Better to be ready and have it not come thru than to have it come thru and have to put it off..

Stick with the good things that you're doing...

The good eating/diet habits you're learning now will be invaluable to you in he future..

Good luck to you...

Keep your chin up...

Take care...

[LRHillian 5]

Did they tell you why you were denied?

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[KristenLe 5,979]

Don't give up!

[jane13 2,256]

@@Brenda Sherwood - try to get back on track with atleast eating better and find out why you were denied.

We are here.

Vent.

[IrishGermanRN 151]

Find out why and if the appeal doesn't happen, I would look at cash pay. I went to OCC in Mexico and had a great experience.

[Brenda Sherwood 64]

Find out why and if the appeal doesn't happen, I would look at cash pay. I went to OCC in Mexico and had a great experience.

I was denied due to "no proof of disabling condition" which seems like they are asking for a comorabity even though its not supposed to be required with my bmi (46). I am considering Mexico as a backup. Just emailed OCC actually. Called insurance and Dr office today and still have no answers as to whats going on

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[izzy13 117]

I am working with the lindstrom advocacy group for my appeal, their website is wlsappeals.com and they have been incredibly helpful. It cost a little but it's a lot cheaper then trying to get to Mexico for myself. I'm in my 2nd denial now and I've been so anxious and depressed but I'm keeping my fingers crossed!!!!

[jea(n__n)ette 98]

You might need a letter from your doctor stating that without the surgery your risk for developing comorbidities is very high. It's not a guarantee, as it sounds like your insurance company has blinders on and doesn't want to pay for the surgery. But imagine how much they would save if you developed uncontrolled diabetes and renal failure, and they have to pay for multiple hospitalizations for non healing wounds, diabetic ketoacidosis, amputations, & hemodialysis (sorry if it sounds morbid, but that's very common at my hospital where the community has 25% population with diabetes).

[Brenda Sherwood 64]

Thank you for your responses. I have a NUT appointment at my Drs Wednesday and am hoping to get some answers then. I wont give up, just a bit bummed at the moment. Off track with diet because if that and that my inlaws are with us and eat horrible. They will be back in NY soon so that will help. Feel like I need a reset mentally

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Edited May 9, 2016 by Brenda Sherwood

[Clementine Sky 707]

I would be crushed and frustrated, too. You had everything nicely organized and were mentally and physically revving up for the surgery. I'm sorry you've hit this roadblock. I knew from the start that insurance wouldn't cover my surgery because my BMI was under 35, but I've read so many posts here about people successfully fighting for coverage after being denied. There's another thread on here today where a woman has posted the letter she wrote to her insurance company, using some of the suggestions another poster had given to her. There are a lot of knowledgeable and kind people here.

I had a really positive experience having surgery in Tijuana, and have had mostly smooth sailing post-op as well. I didn't have to jump through many hoops to arrange it either. The costs were also really reasonable.

As for eating more in frustration, I think that's a pretty natural response, especially considering that you'd been on a liquid pre-op diet. Don't beat yourself up over it. Just move forward. Best wishes to you.

[Cape Crooner 589]

Brenda, you should connect with @marcian. She was denied for health reasons and almost gave up. She stuck to her diet and eventually got approved. She was down a ton of weight by surgery and this is getting to goal very quickly.

Also, you can lose the weight on your own (people do it), but the WLS is really needed to keep it off, so just keep losing and fighting!

[Brenda Sherwood 64]

Brenda, you should connect with @marcian. She was denied for health reasons and almost gave up. She stuck to her diet and eventually got approved. She was down a ton of weight by surgery and this is getting to goal very quickly.

Also, you can lose the weight on your own (people do it), but the WLS is really needed to keep it off, so just keep losing and fighting!

I can lose on my own...about 30lbs, then 40 comes back...year later lose 30, gain 40, repeat. Been doing that about 20 years. I'm getting back on track now. Gained back 6lbs just in 3 days not eating good and its not like I went crazy. I cant get surgery until mid July now regardless because work is crazy from May 26 til July 15 so have time to fight with insurance. If we cant get through, Im on my way to Mexico!

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[Cape Crooner 589]

@ Brenda Sherwood - I know about losing and gaining more back, I did it for 50 years, but this time will be different because you have such a bright light at the end of the tunnel.

I remember waiting and wondering if I'd get approved and I ended up going to a hypnotist. He helped me stick to the pre op diet and all the anxiety of the big unknowns!