- Name: Dot T.
- Username: sbtmet72
- Location: Bartlesville, OK, USA
- Member Since: 9/25/2007
- BMI: 35.6
- Post Op
- Surgery Type: RNY (08/13/08)
- Surgeon: Toby Broussard, M.D.
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Labs 08-11 on September 7, 2011 4:55 pm
Here are my labs:
I added the ranges in parenthesis behind my levels. Also added TIBC numbers on here.
Vitamin D level is low - 21 (30-100)
PTH INTACT IRMA (PARATHYROID ANALIZER) HIGH 118 (10 - 63)
RDW- SD stands for Standard Deviation in RDW – 50.3 (normal is 38.7 to 49.6)
RDW-CV stands for Coefficient Variation of RDW – 15.3 (normal is 12.0 to 14.9)
B6 high – 201.4 (20.0 - 125.0)
B12 is 1142 (200 - 1000)
Calcium is 9.3 (8.5 - 10.5)
iron is 53 (35 - 180)
I can't find my ferritin level on here :-( Is there another abbreviation or name it could be called?
TIBC 361 (280 - 380)
iron sat is 15% (15 - 50)
hemoglobin is 12.3 (11.4 - 15.5)
hemacrit is 38.6 (35.0 - 46.1)
RBC is 4.30 (3.94 - 5.13)
folate is 19.8 (1.5 - 24.0)
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weight loss on March 1, 2009 7:42 am
chart posted by diminishing dawn, keeping to make me feel better:
For patients weighing 200 to 250 lbs.
10 lbs. in first 10 days
15 to 25 lbs. in 6 weeks
25 to 35 lbs. in 3 months
35 to 45 lbs. in 6 months
60 lbs. or more in 1 year
70 lbs. or more in 18 months
For patients weighing 250 to 300 lbs.
10 to 12 lbs. in first 10 days
15 to 25 lbs. in 6 weeks
25 to 35 lbs. in 3 months
45 to 60 lbs. in 6 months
80 lbs. or more in 1 year
90 lbs. or more in 18 month
For patients weighing 300 to 400 lbs.
10 to 30 lbs. in first 10 days
25 to 45 lbs. in 6 weeks
35 to 55 lbs. in 3 months
50 to 80 lbs. in 6 months
100 lbs. or more in 1 year
120 lbs. or more in 18 monthsee
For patients weighing 400 to 500 lbs.
10 to 30 lbs. in first 10 days
25 to 45 lbs. in 6 weeks
35 to 60 lbs. in 3 months
50 to 90 lbs. in 6 months
120 lbs. or more in 1 year
150 lbs. or more in 18 months
***********************************************************************
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title on February 23, 2009 4:02 pm
800438
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March 2008 on March 20, 2008 12:59 pm
Nothing Received
March 3, 2008
According to the insurance company, they have not received the fax from Friday :o( They gave me a name of someone who it was supposed to be sent in attention to... I called Amanda to see if she sent it Attn: so-in-so and she said no. She just sent it to "pre-determination department." From what the insurance lady on the phone said, it can take a week for it to get to where it needs to go if you don't specify who it needed to be sent in attention to!! GGRRRRRRR!!!!!!! Wish I had known this BEFORE so I could have told Amanda!! I guess I'll call back in a couple of days.
Insurance Update March 5, 2008
Well, they say they received the fax (finally!) But, it needs to be sent to another department. They should get it tomorrow. She also said they can take up to 30 days to approve it! UGH!! I sure hope it doesn't take that long!
No News is Good News??
March 7, 2008
NO, I'm NOT talking about NO NEWS on the INSURANCE, Silly!! lol I'm talking about my blood work I had done over a week ago! They said that they would have the results of my blood work in a week and if I didn't hear anything, that means everything was clear! Woo hoo! What does that mean? I don't have to be treated for Thyroid or H. Pylori before I can have surgery! And, I guess my liver function is good too. So, in THIS case, NO NEWS is GOOD NEWS!
Called Insurance Co. again March 11, 2008
So, I called the insurance company again to see if there has been a determination made yet... No such luck! They said that Pre-Determination received it on March 5 and that it was a lot of pages and that it can take up to 30 days from the 5th! Well, what I have to say to that is... just because you HAVE 30 days to make a decision doesn't mean you have to TAKE 30 days to make a decision! SO THERE! lol
Surg Assoc Support Group
March 11, 2008
Tonight was another Surgical Associates Support Group. It was basically everyone introducing themselves, telling their story, and Q & A session. There were quite a few new, pre-surgery people there that had a lot of questions. There was a lot of good information given. It's always good when I learn something new :o)
After all of that, they had a taste test of some protein flavors. I didn't stick around for that because most of what I saw was Nectar and I have samples of that from online... It also looked like chaos and I didn't feel like sticking around...
Before I left, I went to the bathroom and someone was talking to me about flavors to add to water (like Crystal Light) and some spouse of a WLS patient to-be butted in and said to me "YOU'RE having THIS SURGERY??!!! You're too SKINNY for THIS SURGERY!" OK... So, under most circumstances, that would be a complement... But, today it wasn't! Maybe she should have minded her own business and kept her comments to herself! I told her that my BMI was over 40 and she acted like she didn't even know what a BMI was!! Oh well, I know that my decision is what is best for me and they wouldn't do the surgery if I wasn't a candidate. So there!
Checking Up With Insurance March 17, 2008
I'm trying really hard to not call the insurance company at LEAST once a Day!! I called again today, OK... So, it's been almost a WEEK since I last called!! All I got was the broken record response... "Predetermination received your paperwork on March 5 and they have 30 days from that date to make a decision." Blah, Blah, Blah.....
A Call from Surgical Associates
March 18, 2008
Crystal called today to update me on insurance... She called the insurance co. today. SHE was told that my info was received YESTERDAY and that it takes up to 30 days from THAT date!!!!! GGRRRRR!!!!!!!
I figure at this rate, I might hear something by JULY 4th if I'm LUCKY.
Tulsa Area Support Group March 19, 2008
Because Dan's surgery is next week, we decided to be nice to him and move the support group meeting up a week so he isn't tortured with eating broth while we are having the good stuff!! Aren't we nice??!! lol Anyway, tonight's gathering was larger than the last one. We had Sherrie (from Claremore and her husband), Phyllis, Dan, Lis, Joni (her husband and 1 yr. old son) and myself, my daughter Serena and husband Josh. Talk was good, food was GREAT, and I think we all had a good time (other than the picture taking time for me!) Can't wait until next month!
Another Insurance Update
March 20, 2008
Got another call from Crystal at Surgical Associates. She called the insurance company again today to follow-up on my predetermination. She said that the nurse was going over the paperwork today and that I should hear something by next Tuesday, March 25. (yeah, I've heard that one before!) So, hopefully I'll have some news to pass forward soon! Until Next time.....
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February 2008 on February 6, 2008 10:09 am
Still Waiting………………….
February 1, 2008
I saw Dr. K on 01-23, waited 7 days to call surg assoc to see if they had submitted to insurance yet... No return call.
Called again this morning... still, no one returned my call.
Called again this afternoon... no one returned my call.
Called the insurance co. this afternoon and they said they have not received anything.
I just wish someone from surg assoc will return my call!! I would like to know when they are sending it so I can follow-up with the insurance co and keep them on their toes!
So far, all I've got to do is leave messages on Amanda's voice mail :o(
UGH (twiddling thumbs)
Finally!!!
February 7, 2008
I finally got a call back from Amanda at Surgical Associates!! It took a week and about 4 calls to her to get a return call.
My case has not been submitted. She said she was still waiting on dictation from Dr. K. I had no idea it would take 2 weeks for them to get dictation!! She said she will call me when it is submitted.
So, the wait continues..........
And the Waiting Continues…
February 12, 2008
I called both Amanda and Tracy at Surgical Associates yesterday checking to see if my information has been sent to insurance yet. Tracy returned my call a few minutes ago. I guess Dr. Katsis has been out of the office and that must be the hold-up. Tracy said that he is back in this week and that they are waiting for him to “sign off on the dictation” and that it will be submitted after that. She said it should be “sometime this week” and that they will call me and let me know. From what I understand from literature I have from the insurance company, they should make a decision within 2 weeks. I’ll keep ya posted on when I’m submitted and when I hear from the insurance company! Hopefully it will be Good News, “APPROVED!”
Valentine's Day
February 14, 2008
Hello again... I don't know when I'm going to get surgery. At the moment, I am VERY frustrated!!! I went to the informational seminar November 5 and was given a bunch of tests I had to have done BEFORE I could even consult with the surgeon!
It took me until January 3 to get them all done. Then, they called me to set up my consult. I saw the Nutritionist on Jan 17 and the surgeon on Jan 23.
After the consult, they are supposed to dictate a letter of medical necessity (or predetermination letter) whatever they call it, and submit to insurance for approval.
Well, today makes it a MONTH since my consultation and they have NOT sent it to insurance YET!!! I've been calling them... The last time I talked to them was Tuesday. They made it sound like the doctor had been out of the office and they were waiting for him to "sign off" on the dictation.
Well, another lady I know from support groups (and the OK board here) said that she saw the doc last Tuesday and that she didn't think he had been out of the office... So, I'm mad if they are lying to me and I want to know what the hold-up is with them submitting to insurance!!!!!
I also don't know if my insurance is going to be a pain in the butt or if they will approve me because I meet the criteria. I don't know anyone personally with my insurance to ask how their process with insurance went.
Anyway, they told me on Tuesday that it should be submitted THIS WEEK and that they will call me when they submit. I'm still waiting IMpatiently for the phone to ring.....
Sorry I just needed to vent!
Rescheduled Appointment
February 18, 2008
Due to the icy weather, I called Surgical Associates to reschedule my appointment that I have for this Thursday, 21st for next Wednesday, February 27. :o(
Weight Check, Blood Work, Support Group, OH MY!!
February 27, 2008
So, I went to Surgical Associates today to have my weight check done. I'm DOWN 9.5 lbs! Good for me! I had my blood work done (thyroid, liver panel, and h. pylori) Results will be in 1 week. I asked about the status of my case being sent to insurance... They said they were working on it TODAY and that Amanda was on the phone with the insurance co. at that moment. I plan to call the insurance co. tomorrow to see if they have received everything. I sure hope so! My goal now is to have a surgery date the first week of April so I'm 4 months out when we go to San Diego this summer (1st week of August) so I can eat somewhat normally!
Tulsa Area Support Group Meeting
February 27, 2008
Since I had my appointment in Tulsa this morning and the support group meeting at MiMi's Cafe tonight, I spent the day hanging out with Michelle. I had a good time getting to know her better. That evening, Michelle, her daughter Abi, and myself met up with Dan and Amybeth. Too bad more couldn't have made it, but that's what happens when it is flu season :o( Even though the attendance was low, we had a good time.
We tossed around some locations for next month... I think it's going to be Abuelo's Mexican restaurant.
The next date is Wednesday, March 26!! The night before Okie's surgery!! We all have to take a bite for him (chew REALLY well) and he has to BYOB (bring your own broth, Okie!)
Hope everyone is healthy by next month and we can all get together and have a great time!
11:28 a.m. February 29, 2008
February 29, 2008
Submitted to Insurance!! I received the call from Amanda today that my case has been submitted to insurance!! I will call the insurance company MONDAY to make sure they received everything they need!
She said I should know something within a couple of weeks! WOO HOO!
I'll keep ya all posted :O)
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My Story My Journey at a glance:
2007 9-21 Found out New insurance covers WLS 9-25 Made appointments for informational Seminars 10-01 New Insurance goes into effect 10-2 Talked to PCP about WLS 10-16 Info Seminar (Dr. Out of Network) 11-4 Info Seminar (This is the Surgeon I'm using) 11-9 Cardiologist (EKG) 11-9 Sleep Study 11-13 Support Group Meeting 11-15 Cardiologist (Echo & Adenosine Stress Test) 12-4 Sleep Study W/ CPAP 12-20 Psych Eval MMPI 2 12-27 Psych Results of MMPI 2 2008 1-3 Pulmo - Chest X-ray, Lung function 1-8 Consultation Scheduled 1-8 Support Group Meeting 1-17 Dietitian Appointment 1-23 Surgeon Consultation 2-12 Support Group Meeting
2-27 Weight Check w/ Dr. K's Nurse (down 9.5 lbs)
2-27 lab work (h. pylori, thyroid, liver function) 2-29 Submitted to Insurance
3-11 Support Group Meeting
MY STORY
Hi, I'm Dot, stay at home mom of two girls ages 14 and 9. I'm married to Josh and we live in Oklahoma. I have not been overweight my whole life, but my weight has been climbing since 1993. I'm just starting my WLS journey!!
I have not been overweight my whole life. Really just since having my first daughter 14 years ago at the age of 21. Other than the yo-yoing up and down over the past 14 years, my weight has only been going upward. Especially, it seems, since having a hysterectomy last year 
My sister had roux-en-y 4 1/2 years ago which has been very successful for her. We are shaped different though. I guess she takes more after our dad's side of the family. I would call her apple shaped. I take more after my mom and am pear shaped. My sister had a slightly higher bmi at the time of her surgery than I do and we have different co-mobidities. She had PCOS and was wanting to lose weight to get pregnant and I'm DONE having babies! 
Enough about her...
I have elevated cholesterol, elevated blood pressure (neither of which are being treated), plantar facitis, shortness of breath upon exertion, low self esteem, gall stones, heart burn, lower back pain, family history of heart disease, family history of diabetes, possible sleep apnea, depression, and I'm post-menopausal due to hysterectomy. In addition to all of that, I feel like my weight is having an effect on my marriage and that sucks! 
As far as dieting over the years, I've done the starvation diet (lol), slimfast, weight watchers, nutri-system, e-diets, scarsdale, OTC weight loss meds, and doctor supervised (phentermine) from a local weight loss clinic. I have bought so many books to try to help me with various diets that I could fill a small library! Not to mention (again) having that money for self-pay! 
As far as my exercise... It comes and goes. I'll get on a roll and do good for awhile and then fall off the wagon and stop. I've tried going on daily walks, I've purchased a treadmill (I ended up using it as an anex to my closet), so many exercise videos and pieces of equipment that if I still had all of that money, I could self-pay for my surgery, and I was a member of curves at one time. 
I have had some success with all of these methods of weight loss and exercise, but not lasting results. I'm looking for something that will keep the weight off long term. 
I have thought about wls several times over the years, but #1) didn't have a high enough BMI #2) couldn't afford it #3)had insurance that did not cover it under any circumstances . As for #1, since having my hysterectomy that has not been a problem. I can't seem to take off weight no matter how hard I try, but it sure doesn't have any problem sticking to me! As for #2 & #3 recently hubby got a different job that *does* cover "surgical treatment of morbid obesity withhealth problems that are aggravated by or related to the morbid obesity, including gastric by-pass, etc."
Now, I just have to go to a seminar, choose a doctor, have my consult, *probably* have some tests to prove it is necessary, and then get approved! (I know, probably easier said than done) 
Well, enough of my story for now. I need to get some things done. I'll update soon!
INSURANCE STUFF:
The following is directly from our "Employee Benefits Plan" book regarding WLS:
SURGICAL TREATMENT OF MORBID OBESITY
Covered expenses shall include charges for surgical treatment of morbid obesity for covered persons with health problems that are aggravated by or related to the morbid obesity, including, but not limited to gastric by-pass, gastric stapling, or gastric balloon.
DEFINITIONS
Covered Expenses -- Medically necessary services, supplies, or treatments that are recommended or provided by a physician, professional provider, or covered facility for the treatment of an illness or injury and that are not specifically excluded from coverage herein. Covered expenses shall include specified preventative care services.
Morbid Obesity -- A diagnosed condition in which the body weight is one hundred (100) pounds or more over the medically recommended weight in the most recent Metropolitan LIfe Insurance Company tables for a person of the same height, age, and mobility as the covered person, or having a BMI (body massindex) of forty (40) or higher, or having a BMI of thirty-five (35) in conjunction with any of the following co-morbidities: coronary artery disease, type II diabetes, clinically significant obstructive sleep apnea or medically refractory hypertension (blood pressure > 140 mmHg systolic and/or 90 mmHg diastolic despite optimal medical management).
Medically necessary -- Service, supply, or treatment which is determined by the claims processor, named fiduciary for post-service claim appeals, named fiduciary for pre-service claim appeals, employer/plan administrator, or their designee to be:
1. Appropriate and consistent with the symptoms and provided for the diagnosis or treatment of the covered person's illness or injury and which could not have been omitted without adversely affecting the covered person's condition or the quality of the care rendered; and
2. Supplied or performed in accordance with current standards of medical practice within the United States; and
3. Not primarily for the convenience of the covered person or the covered person's family or professional provider; and
4. In an appropriate supply or level of service that safely can be provided; and
5. Is recommended or approved by the attending professional provider.
The fact that a professional provider may prescribe, order, recommend, perform, or approve a service, supply, or treatment does not, in and of itself, make the service, supply, or treatment medically necessary and the claims processor, named fiduciary for post-service claim appeals, named fiduciary for pre-service claim appeals, employer/plan administrator or its designee shall be final and binding.
Illness -- A bodily disorder, disease, physical sickness, or pregnancy of a covered person.
Claims Processor -- CoreSource Inc.
Named Fiduciary -- CoreSource Inc.
Employer/Plan Administrator -- Atlas America Inc.
MEDICAL EXCLUSIONS
** Charges for services, supplies, or treatment primarily for weight reduction or treatment of obesity including, but not limited to: exercise programs or use of exercise equipment; special diets or diet supplements; appetite suppressants; Nutri/System, Weight Watchers, or similar programs; and hospital confinements for weight reduction programs.
** Charges for surgical weight reduction procedures and all related charges, unless resulting from morbid obesity.
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