Lisa S.
It is really happening!!
Jun 06, 2012
Oh my gosh!! I was able to move up my surgery date: 07/20/2012. That is just 6 weeks away!!! I am so excited. I will be buying my airplane ticket this evening and paying the deposit and getting the cashiers check for the rest. It is surreal. My in-laws blessed us. I had the choice...motorcycle or healthy me. It was a really hard decision. LOL. I chose me..my health. It sucks a little bit. My husband got a new/used motorcycle. I still have my 50cc pink scooter. I can't ride with him now. But when I get to goal, I can ride behind him and not feel uncomfortable.
So...I think the fear and anxiety is kicking in a little bit. Am I gonna have complications?? Will I get stuck in Mexico w/o support? My dad lives in San Diego but he suffers from dementia. Will my plane be delayed and I miss my chance?? Will I not be able to resist carbs???
Any words of wisdom???
2 comments
So...I think the fear and anxiety is kicking in a little bit. Am I gonna have complications?? Will I get stuck in Mexico w/o support? My dad lives in San Diego but he suffers from dementia. Will my plane be delayed and I miss my chance?? Will I not be able to resist carbs???
Any words of wisdom???
I am in shock!!!
May 31, 2012
My in-laws have blessed us. They are going to pay for my surgery - as a gift!!! I am so blessed!!! I was getting discouraged, especially after an emergency room visit 2 days ago for severe back pain. The doc basically said, "lose weight and then strengthen your back". I was feeling sorry for myself. Then they called this morning. It is surreal still. Until I am lying on the operating table I won't believe it. Yikes. I so appreciate all the good info I have received on this site. I pray that soon I will be able to give tips/advice based on experience too.
So...August 10 is the big day. I would have scheduled it asap. But I don't have my passport. I just sent off for it yesterday...just in case I was able to come up with the funds for the surgery. Also...I want to go on missions trip with my church. See...its funny how things work out.
I have been planning on RNY since last October. I was preparing for the vitamins, diet, etc. now I have to change my research to the sleeve. Oh...and Alison..if you read this...I want to do a triatholon or tough mudder in so-cal next year. (I am originally from SF bay area. My dad is in Oceanside, my in-laws are in Hemet). Yeah baby!!!
Again..thanks all for sharing the good, bad and ugly. You have been a blessing to me. I am sure I will have more and more questions as the date gets closers.
3 comments
So...August 10 is the big day. I would have scheduled it asap. But I don't have my passport. I just sent off for it yesterday...just in case I was able to come up with the funds for the surgery. Also...I want to go on missions trip with my church. See...its funny how things work out.
I have been planning on RNY since last October. I was preparing for the vitamins, diet, etc. now I have to change my research to the sleeve. Oh...and Alison..if you read this...I want to do a triatholon or tough mudder in so-cal next year. (I am originally from SF bay area. My dad is in Oceanside, my in-laws are in Hemet). Yeah baby!!!
Again..thanks all for sharing the good, bad and ugly. You have been a blessing to me. I am sure I will have more and more questions as the date gets closers.
A little sad...
May 24, 2012
I have been feeling sorry for myself ALOT lately. Yes...my insurance has finally cancelled. Therefore no surgery for me. I have a tentative date for the sleeve in Mexico. But we can't afford it. I am praying that by some miracle the funds appear. I have thought about fundraising, robbing a bank (j/k), begging, and borrowing. I just have to leave it in God's hands. Its funny - If I had cancer and needed treatment I am sure family and friends would help. Its totally different being obese. Its like we did it ourselves so we have to suffer the consequences. Its true to a point. But what about the severe joint pain that has now become unbearable?? Or the liver disease?? Or the high blood pressure?? Every single day has become a challenge for me. I can't remember the last time I had a pain free day. I keep on though. I have a family to take care of. I have a church family that I love to be involved with - Awana's and Sunday School. I am looking forward to the day that I can wake up in the morning and not feel the familiar ache in the back and knees.
For all of you who have already had the surgery, I hope you each truly realize what a gift you have been given. I know every day is a struggle for y'all as well - food choices, exercise, demands of work & family. Just know that I feel each of you has been blessed. You all did something so brave and positive. I support each one of you whole hearted. Don't be discouraged if the scales don't move, or move in the "wrong" direction, or if you eat something that is a no-no, or you didn't get in your exercise. Tomorrow is another day. Keep looking forward as well. And just know you have a cheerleader rooting for you...ME!!!
Be blessed!!
1 comment
For all of you who have already had the surgery, I hope you each truly realize what a gift you have been given. I know every day is a struggle for y'all as well - food choices, exercise, demands of work & family. Just know that I feel each of you has been blessed. You all did something so brave and positive. I support each one of you whole hearted. Don't be discouraged if the scales don't move, or move in the "wrong" direction, or if you eat something that is a no-no, or you didn't get in your exercise. Tomorrow is another day. Keep looking forward as well. And just know you have a cheerleader rooting for you...ME!!!
Be blessed!!
Denied...surprise surprise.
May 03, 2012
My requesty for pre auth was denied on 04/24/12. Therefore my surgery date has been cancelled. I wasn't surprised. I am just really disappointed. My cardiologist said I need to fight it. It seems this whole process has been a battle. But I am in tears everytime I hear someone tell their story about getting a date so quickly after starting their journey - tears of jealousy, tears of joy for them and tears of frustration. I feel so stuck between a rock and a hard spot. I CAN NOT afford to self-pay. But I am afraid I can not afford to put it off too much longer either. I don't remember the last time I had a day without pain in my knees or back. I realize that WLS can not reverse the damage already done. However losing the excess weight will certainly make a difference. I have a tentative date for sleeve surgery in Mexico in September. But only a miracle can make that happen. Its $4500. I had my psych suggest HCG and a friend at church recommend "ideal protein" diet. I am just kinda numb right now - trying to figure out my way in all this. Please keep me and this situation in your prayers. And thanks for letting me have my pity party.
2 comments
My approval is pending.....
Apr 18, 2012
Ugh...I feel like these last 7 months have been more like 7 years. My surgeon has submitted a request for authorization with a surgery date of 05/30/2012. Woo Hoo!!! I feel scared, nervous, frustrated, excited and scared some more. LOL. I am afraid that I won't be approved. This past month, physically, has been the hardest to deal with. My back pain is so bad! I know the surgery won't heal it. But it sure will help. I just need to stay positive and know that my God will work it all out to glorify Him... not just to make me happy. Be blessed y'all!!!
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Re-submitting
Apr 17, 2012
Okay...so my insurance is in effect again. Not sure for how long though. Ugh!!! I called my surgeon's office this morning and asked her to resubmit. The positive person she is responded, "They are going to deny." Nice huh. So much for being positive and encouraging. That's okay. I anticipate that. I am getting my appeal ready. Please keep me and this situation in prayer. Have a great day and be blessed!!
0 comments
Can I get any more frustrated???
Apr 10, 2012
Okay...so my insurance DID cancel me effective April 1. They were suppposed to keep me active during this whole hearing process. But they didn't. I talked to about 4 different people today to try and make some sense out of it. That is the problem...it just doesn't make sense. Anyhoos...they are re instating me. And this is where it gets good (I hope). I was told I would be added to straight medicaid. Well if that does happen then I am good to go. I have met ALL the requirements. If they add me back to the group I had before, then its a battle again. They require the 3 years medically supervised weight loss. I will have to appeal that one. So..my prayer...they add me to straight medicaid and my surgeon submits asap. We will see how that goes. I see my surgeon again in 2 weeks. He wanted an April surgery date. Its too bad he wouldn't just schedule me anyways and work out then insurance mess later. 
I know alot of you have had your own struggles as well. I am complaining. But I appreciate all the hard work each one of you had done to get where you are. If this whole insurance thing does not work out then I am going to go to Mexico to have VSG. Its not in my budget- AT ALL. But I am afraid that my health won't wait too much longer. Thanks all in advance for your prayers. I will keep y'all updated. Be blessed!
0 comments
I know alot of you have had your own struggles as well. I am complaining. But I appreciate all the hard work each one of you had done to get where you are. If this whole insurance thing does not work out then I am going to go to Mexico to have VSG. Its not in my budget- AT ALL. But I am afraid that my health won't wait too much longer. Thanks all in advance for your prayers. I will keep y'all updated. Be blessed!
Keep on Keeping on...
Apr 01, 2012
I haven't posted in awhile. I figure I should. So here is what has been happening in the last 2 months. My insurance is going to drop me because our family is over income. I am asking for a hearing for 2 reasons: 1) they do not count the kids as dependents because they are mine, not my husband's. 2) to delay the inevitable. I am scared and frustrated. I only found out recently. In the meantime I have called my insurance 6 times to get benefits. And EACH time they tell me there is no criteria other than BMI >40 and pre auth. One of the reps actually told me there was no criteria. Can you believe that!!!?? I was counting on my insurance denying me because they tell my surgeon I need to have 2 years supervised medical weight loss. I was going to appeal it based on the mulitple quotes I have received from THEIR reps. Now I am afraid I won't even get the opportunity. Darn it!!!! I see the cardiologist next week to finish up the pre-op. (My surgeon is wanting an April surgery date). I have never ever wanted something so bad. I have a hard time walking now due to osteoarthritis in my kness and degenerative disk disease. I just keep on praying though. At this point, it is in God's hands. If this surgery doesn't happen now, I don't know what I will do. I know...keep on keeping on right?! Please please please keep me in your prayers. I need peace and encouragement. I keep telling myself, "Lord, it is in your hands now. You tell me when to stop." Be blessed y'all!
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Pulling myself up by the bootstraps!!!
Jan 26, 2012
Okay...so I had a meltdown the other day. Who wouldn't!! I was just so frustrated. I contacted my insurance company to get the criteria for RNY and it was like pulling teeth. The rep was clueless. I was on the phone with her for over 1/2 hour. And then she stated that they could not provide me with ANYTHING in writing about the criteria for the surgery. I am thinking it would be so easy to get a mis quote. Anyhoos...my surgeon's office said they would not request approval unless I met ALL the criteria. The only thing I am missing: 2 years medical supervised weight loss. I didn't have insurance until recently. However, I still tried numerous weight loss attempts. But like a dummy, I did not document anything. I never thought I would actively pursue surgery. I have a very long list of co morbidity's. And I live everyday in tremendous back pain due to DDD (degenerative disc disease). My pcp says I need to do something NOW for my fatty liver disease. I don't know if I can go another 2 years without putting myself at further risk or even putting up with the pain. Spinal surgery is ALLOT more expensive than RNY. You would think the insurance company would consider, from a financial position, that the RNY is much cheaper. I am just going to keep moving forward, I am taking my nutrition class today. I see the surgeon again on February 16. I will talk more with him then. I just have to trust that it will all work out according to God's plan..not my own. It is so hard to feel you are not in control. I am frustrated. I had my hopes up...high...maybe too high. LOL.
Please, all, keep me in prayers. I notice everyone on here goes thru different trials. I pray for you as well: healing, strength, support, etc. I welcome and appreciate any advice, suggestions, comments you give. Have a blessed day!!
2 comments
Please, all, keep me in prayers. I notice everyone on here goes thru different trials. I pray for you as well: healing, strength, support, etc. I welcome and appreciate any advice, suggestions, comments you give. Have a blessed day!!
Heart Breaking News!!
Jan 24, 2012
I can't believe this. I called my doc's office today to ask about the nutrition class I needed. They informed me that the criteria for my surgery is 2-3 years medically supervised weight loss!!! When I started this process in September it was only 6 months. And here is why: I have Nevada Medicaid. When you first sign up and are approved, you have "straight medicaid HMO" until you are assigned a group. Straight Medicaid HMO requires 6 months medically supervised weight loss. So for 1 month, that was the coverage. Once you are assigned a group the criteria changes to: "Documentation supporting the reasonableness and necessity of the surgery must be in the medical record, and should include a 3 year documentation of medically supervised weight loss and weight loss therapy including recipient efforts at dietary therapy, physical activity, behavior therapy, pharmacotherapy, combined therapy, or any other medically supervised therapy."
I am anal. (LOL). But they are using the word "should". I take that as meaning it is a good idea. But not a deal breaker. This is a contract. The word "must" is not open to interpretation. Why didn't the criteria say must??? I want to fight it. But my doc won't send for prior authorization based on the criteria.
I am thinking that maybe I should find another surgeon who will fight for me, or even a lawyer. I live in Las Vegas. My surgeon is Dr. Umbach. What do you all think????
4 comments
I am anal. (LOL). But they are using the word "should". I take that as meaning it is a good idea. But not a deal breaker. This is a contract. The word "must" is not open to interpretation. Why didn't the criteria say must??? I want to fight it. But my doc won't send for prior authorization based on the criteria.
I am thinking that maybe I should find another surgeon who will fight for me, or even a lawyer. I live in Las Vegas. My surgeon is Dr. Umbach. What do you all think????
About Me
NV
Location
30.5
BMI
Surgery
07/09/2012
Surgery Date
Nov 30, 2011
Member Since
