My surgeons office just called me. I was denied. She said she has never experienced this before with my insurance plan. They gave two baloney reasons

First that my blood pressure needs to be higher even though I'm on medication??? WTH does that even mean?? They want to see a constant of 140 over (I don't remember the number) while trying to be controlled

Second. I have not lost enough weight. I'm down to 199 if I get any lower I will now qualify.

I started loosing weight on my own at 245 lbs. I originally went to the bariatric center to get help with medication weight loss. That was when I found out I had high blood pressure and the dr said definitely no she would not give me medication to aid in my weight loss. They took that weight 215 and compared it with the next weight they had 9 months later ( once I decided to go for surgery) I had gained 9 pounds...over the period of 9 months.

Sorry if I'm all over the place with this I'm just so upset. My dr has had to up my high blood pressure medication once because it was not working. I have a appointment with her this afternoon to see if she can fax that to my surgeon. The bariatric center has 14 days to fight it. If they don't win it's a definite denial. My surgeon is going to do an eye to eye?? With the insurance.

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@@jazzyjay wow, less than a month!!! So exciting! Have you been to a neurologist for your headaches? I know you have high BP issues too, but if meds can't get the headaches controlled, maybe it's something to consider.

I'm heading in to see my Orthopedic surgeon right now. My knees are bad ???? & he's a Godsend & great to look at!!! Lol Catch ya later!!!

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Yes I'm so excited!! I never considered a neurologist. Thank you. My dr keeps chalking it up to my stress levels and high blood pressure. Which could be it but I think I'm going to look into that.

My mother in law had surgery on her knees. Pretty swift recovery now a days with the new technology. And it doesn't hurt that he's a pretty boy!!

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My Orthopedic Dr said my knee problems are from arthritis & a condition called Chondromalasia (sp?) on my kneecaps. It's basically a wearing down of the back side of the kneecaps, causing all the issues. There's not much to be done except various medication injections & dealing with it until I can't anymore.

I hope you are able to find a good neurologist that can help you. No one should have to live with these headaches like this. How is your blood pressure doing?

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Oh man that sucks. Sounds painful. I hope you can get some relief. I guess the only exercise you will be able to do is swimming without pain. Poor thing. I couldn't do injections in my knees. You are very brave!

My blood pressure has stayed the same pretty much. Today it was 171/98 I've had a headache for two days with little relief. I have a doc appt this week. She will probably change my medication.

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Holy cow! 171/98 is crazy high. No wonder you feel like shit. Mine was consistently 145 over something & I was having migraines constantly. If your Dr isn't taking better care of you maybe it's just the Dr. not doing the proper due diligence for you. Just my opinion. I hate Dr's that don't do their jobs.

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I know...Good point..The last two times she has said it's cuz the stress I'm under. I'm just hoping once I have this surgery it will go down.

I generally don't like or "do" doctors. I lost my grandma and father too early because the doctors that were caring for them didn't really care. So I have little faith in Drs. I guess that's a bad thing to say since I'm awaiting surgery lol.

How did your appointment go?

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I have little patience for lazy doctors. I'm stuck in a rural area with few options for primary care Dr to choose from, so I'm stuck with the idiot I have right now until after surgery. But after that, I'm looking for a new one.

My appointment went well. He took X-rays of my knees & looked at my surgical history & remembered that I have a defect in my kneecaps causing them to deteriorate, I have arthritis, & no meniscus in either knee. Plus I had ACL replacement when I was 16 yrs old. Dr told me I have choice of steroid shots, lubricant shots or taking anti-inflammatories when needed. The problem is when I get started on any of them, I either get stuck on them forever or there are side effects. So I decided that I can deal with how they are now, I'll start exercising to keep them loose & break up some of the inflammation in there & see where that leads me. He agreed that was a good plan of attack. I just got stuck with really bad genes. ????‍♀️

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My Orthopedic Dr said my knee problems are from arthritis & a condition called Chondromalasia (sp?) on my kneecaps. It's basically a wearing down of the back side of the kneecaps, causing all the issues. There's not much to be done except various medication injections & dealing with it until I can't anymore.

I hope you are able to find a good neurologist that can help you. No one should have to live with these headaches like this. How is your blood pressure doing?

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I have chondromalacia patella and osteoarthritis in both of my knees. I take pain meds and have had injections in both knees. The injections aren't bad and they can really help you be more active. I know I will have to have a total knee replacement on my right knee soon, as two out of the three joints are severe. The most important thing is to be proactive about it.

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Awesome news! Yay

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@@GBLady41 I'm very lucky that I'm not in pain, my knees just make a lot of "noise", they creak, crackle, & pop a lot, especially when I do any kind of squatting motion. My Dr isn't too concerned about replacement yet, there is still a fair amount of space between the femur & tibia on X-rays. I'm not on any pain meds & I've had steroid injections in both knees, but it's been almost 2 years since the last ones. I think having WLS will help the longevity of my knees, but my bad genes will not help in the end.

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I believe the surgery will definitely help. I mean, I'm hoping to not have to have total knee replacement for at least 6 months or so.

Someone told me to do this if insurance ever denied a procedure. Apparently the boards that make these decisions aren't doctors.

1. Who made the decision?

2. Are they Hippa certified? (Very imp ????)

3. Can I see their certifications?

Insurance resubmitted the paperwork and they were approved. I don't think it was regarding bariatric surgery, but I wrote them down just in case.

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