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Tomorrow is the big day for me... last nutritional visit and they submit to insurance. I wrote this letter back when I first started w/the process. Not sure if I should change anything. A letter like this is not required by insurance, but I am including it to put my low BMI in 2007 in perspective. Thanks in advance to anyone who can give me feedback on this. I am so nervous about the stuff being submitted to insurance tomorrow. Yikes!

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To Whom it May Concern:

I am writing today to give you some background w/regards to my personal struggle w/obesity and what I hope to accomplish by having adjustable gastric band surgery.

As with most people who struggle w/obesity, I have been on many diets and exercise program. I have been on so many that I'm sure I'm not even remembering all of them, but here is a sampling of diets I have tried:

  • Weight Watchers (at least 5 times – including the exchange program, flex points, and core programs)
  • Jenny Craig
  • The Zone
  • Dr. Phil's Weight Loss Solution
  • Atkins
  • McDougal
  • Slimfast

In addition, I have also tried many different exercise routines including walking, aerobics, weight training, treadmill, jazzercise, and DVDs.

I have also tried the diet drug Xenical, but have not tried others since most are contraindicated for anyone who has high blood pressure (which has been a problem of mine for many years).

With all of these efforts, I have only had moderate success w/getting my weight down and ultimately have regained all the weight and more each time. My last big attempt at weight loss started in October of 2005 when I joined Weight Watchers for the 'final' time and made the commitment to myself that I would lose this weight once and for all. I stuck to the program, exercised, regularly attended meetings and weighed in for over two years. Over the course of this time, I lost up to 45 pounds, but found that I could not lose weight beyond this point, and ultimately found it impossible to maintain the weight I had lost. I was hungry a great majority of the time and finally lost my will to continue the program last year. Over the course of 2008, I proceeded to gain all the weight back. As you can imagine, this was devastating. It took a lot of time, commitment, and persistence on my part to lose that weight in the first place and it all came back in less than half the time.

Of course, this is just ONE example of my dieting/exercise efforts. I have spent the vast majority of my adult life trying to get my weight down to a healthy level or at least trying to stop gaining weight. Here is my weight history for the last 7 years:

Year

Weight

Height

BMI

Notes

2002

210

65

35

Documented w/Dr. Wilson – includes notes about trying to lose weight before pregnancy

2003

208/230

65

35/38

Pregnancy #1: begin/end weights for pregnancy

2004

213

65

35

Documented w/Dr. Harpenau

2005

207/223

65

34/37

Pregnancy #2: begin/end weights for pregnancy

2006

195

65

32

Documented w/Bierman – on WW & mentioned in doctor's notes

2007

178

65

30

Documented w/Dr. Barlow – on WW & mentioned in doctor's notes

2008

210

65

35

Documented w/Dr. Pozun

2009

226

65

38

Documented w/Dr. Pozun

Prior to each of my pregnancies, I dieted and exercised to try to bring my weight down as I understand that obesity makes pregnancy more risky. Unfortunately, I had very little success w/either attempt and my weight remained severely obese (in the range of 35) prior to each pregnancy. As I mentioned earlier, my last big attempt to lose weight was during 2006-2007 and although I had some success (getting my BMI as low as 30), I remained obese and was not able to maintain the weight loss despite great effort and persistence on my part.

Now, I realize that in the world of weight loss surgery, I may be seen as a 'lightweight' since I am not morbidly obese at this point in my life. I am very seriously concerned about the impact that this obesity is having on my health, though. As early as 1999, I was told that I had high blood pressure so I went off birth control pills to try to bring it down. In 2002, I was put on my first blood pressure medication (Aldomet/Methyldopa). This is one of the few blood pressure medicines that is safe for pregnancy so I remained on this through the birth of my second child although it did not consistently keep my blood pressure under control. In 2006, I changed blood pressure medicine to Atenolol. I had a terrible time on that medication as it made it even more difficult to lose weight and made me very tired all the time. So, I went back on Aldomet. In 2008, I changed to Lisinopril which I remain on today. I am now up to double the dose that my current doctor originally put me on, but my blood pressure is still not well controlled. My last reading (January 2009) was 155/99.

I also found out in November 2008 that I now have high cholesterol. This news may not seem like a big deal to most people, but it really hit me hard as I feel like I am going down the same path as my mother did w/all of the health problems she has had her entire life due to obesity. I am very afraid that I will end up developing Type 2 Diabetes just as she did along w/all of the other obesity related problems she has endured. As I have tried so hard to lose weight myself, I have seen her try just as hard, but ultimately fail each and every time. It has been heartbreaking to see what she has gone through and even more heartbreaking to know that my husband and children may have to go through the same heartbreak w/me.

The one thing that has given me hope recently, though, is seeing what my mother has been able to accomplish (in regards to turning her health around) in the last year since she had lapband surgery. She has lost 95 pounds and is off almost all of her medications (for high bp, cholesterol, and type 2 diabetes). At one point, she couldn't even walk one block and now she walks several blocks to and from work every day. I know from her that even w/this surgery, it still takes a lot of work to lose weight and keep it off. But, I know that this is the tool that can finally help me to help myself actually get to a healthy weight and, most importantly, keep it off.

Sincerely,

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Its too long... I have put you all to sleep. LOL OK, this thing is getting submitted to insurance today along w/all the rest of my stuff (my file must be an inch thick by now). Wish me luck!!!

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Keeping my fingers crossed for you. This leeter shows how determined you are, congrats!

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I hope nothing but the best for you. Good luck, Jennifer

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Long long overdue update. I was denied in July because my BMI in 2007 was too low. I thought I'd wait until January to re-apply because then my 2007 weight wouldn't matter anymore. But, after my last doctor visit, I found out I have prediabetes and had to go on medication for high cholesterol too. That prompted me to write an appeal. I was denied again. I did a second level appeal. This one did the trick! Just found out today...

I am approved!!!

So for those of you out there struggling w/the insurance part, hang in there. Its a frustrating process, but persistence pays off. :biggrin:

Edited by adagray

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