Larissa P.

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So far, I've learned they are getting bids from Anthem, United Health Care, Aenta and Cigna. They are asking for the bids to include WLS! I also know that we have a Maryland office that is required by law to have WLS coverage!

As a matter of fact, I am getting such a positive reception (I've kept in touch and sent a recent article about the new New Hampshire WLS law that was just passed) they have invited me to the meeting of the benifits focus group!

So, cross your fingers for me!

 Angel Food Ministries

A friend told me about it today...it's a food co-op formed by churches all over the united states...you can get groceries at wholesale cost.

They have certain menus that change each month...you can buy a "unit" for $30, and receive everything on the menu. There is no qualifications, and no limit to the number of units you can purchase. You pay cash and order once a month.

Here is this month's menu from my area. For $30 I would get:

	1.5 lb.	Ribeye Steaks (4 x 6 oz.)
	5 lb.	Chicken Leg Quarters
	28 oz.	Chicken Breast Nuggets
	28 oz.	Salisbury Steak Dinner Entrée
	32 oz.	Breaded Chicken Breast Filets
	16 oz.	Smoked Sausage
	16 oz.	California Blend Frozen Vegetables
	16 oz.	Frozen Carrots

	16 oz.	Frozen Chopped Spinach
	10 ct.	Frozen Waffles
	16 oz.	Bean Soup Mix
	1 lb.	Rice
	9 oz.	Instant Potatoes (14 servings)
	15 oz.	Sliced Peaches
	32 oz.	Borden Shelf Stable Milk
		One Dozen Eggs
		One Dessert Item

Go to the site linked above and see if you have a church in your area participating! I just about died, this will help BIG time in my food budget!

Some people wanted to see the letter I sent to the head of the HR department of my employer about 6 months before "open season." That is typically about the time they start getting bids for any changes in insurance for the next year.

Larissa – Employee – My Story

The majority of my family background is of varying normal sizes. My maternal grandmother however, was the exception. She was a normal sized child, a chubby teen, but after 6 children she ballooned up and over 350 pounds. My grandmother suffered from diabetes, heart disease, high blood pressure, arthritis, skin problems, and numerous other ailments. I remember looking at the number of medications she took in awe as a child and watching her injecting herself with insulin. I never imagined in my wildest dreams that any of this could possibly be in my future.

I, too, started off as a normal weight little girl. In my teens I started to find myself getting chubby; towards my 20s and into having children, I could be classified as overweight. I was dieting on and off again - Slim Fast, Jenny Craig, NutriSystem, Weight Watchers, I tried quite a few. I had my best success with Atkins Low Carb – I lost quite a bit, getting myself down to the upper level of the recommended range for my height. But it was not sustainable. Imagine yourself, on a high wire… but then…slowly…you are losing your center…and you know, you can’t keep it up…and you ARE going to fall.

When I tried to get back on the “wagon” so to speak, I found it harder and harder. Weight didn’t come off like it used to. I found also I had health issues creeping up - like unstable blood sugar, depression, and joint pain. My weight was creeping up and up and I felt powerless to stop it. I tried to find help, but unfortunately, medical obesity treatment of any kind was and continues to be a written exclusion in my employer provided medical insurance.

So where am I now? Truthfully, petrified – without medical help, and soon, this path is leading toward the same fate as my grandmother. Three doctors have told me the same thing: Gastric bypass surgery is their recommendation.

•    I am insulin resistant and pre-diabetic, and my blood pressure is borderline
•    I suffer from gastric reflux
•    I suffer from stress urinary incontinence
•    I fight chronic fatigue and daytime sleepiness
•    I suffer from depression
•    I have arthritis and suffer daily joint pain in hips, back, shoulders and arms
•    I have issues with walking long distances or getting winded easily
•    I come from a family with a history of heart disease and diabetes
•    I’m 38 but feel  much, much older
•    I am a single mother to three beautiful children who need me to be around for a long, long time – they are my daughters Audrey (17) and Madeleine (11), and my son Alistair (15)
•    I’m 5 feet, 2 inches tall and weigh 285 pounds, with a BMI of 52.1 – Super Morbid Obesity


Obesity - A Few Words About This “Self Inflicted” Malady

>>    Although there is no denying that diet and lifestyle lead to obesity and related health issues, a substantial amount of people need medical intervention.

>>    Proven medical causes for obesity have been genetic, thyroid conditions, certain medications, depression, and recent research has pointed to the possibility of some viral causes.

>>    Other “life style” health issues, such as smoking related problems like emphysema and lung cancer treatment, are not denied coverage by insurance companies.

>>    To continue this line of thought to absurd proportions, you could say others who “brought it upon themselves” – alcoholics and drug addicts, perhaps even HIV positive sufferers – are covered for treatment in most insurance plans. But not the obese?

>>    There is a federal law requiring that insurance cover the cost to reconstruct a breast lost to cancer – strictly for the emotional well-being of the woman – but no such law requiring insurance companies to save the life of morbidly obese woman.

>>    Morbid obesity is not just about looking fat – it is about real disease, and the real risk of premature death. It increases the risk of: anemia, asthma, carcinoma (cancer), congestive heart failure, diabetes, depression, dyslipidemia (increased lipids in the blood), gallbladder disease, GERD (acid reflux disease), hyperinsulinemia (insulin resistance), hypertension (high blood pressure), incontinence, infertility, osteoarthritis, and sleep apnea.

>>    Bariatric surgery, excluded from most insurance policies by name, is the only known cure for type 2 diabetes.

>>    The National Institutes of Health (NIH), Medicaid, and Medicare all recognize bariatric surgery as a valid treatment for morbid obesity and have guidelines set down for coverage.

>>    Several states recently have been debating bills requiring health insurance companies to include coverage for the disease of obesity. Some states already have such laws in place.

>>    The general consensus among those working for change is the reason society has allowed this appalling treatment of the obese by insurance companies is that it is still, to this day, the last acceptable prejudice. To make fun of, and to blame, the obese for their fate.
 

The Case for Including Coverage of the Treatment of Obesity in the Company's Heath Care Plans

Including obesity coverage would send a signal that the company understands the seriousness of the disease. It would remove the stigma from employees who are obese, and allow them to actively pursue treatments for the underlying cause of many other costly and debilitating medical conditions. There will no longer be this invisible line between those whose health problems are inside, and those who are outwardly visible, and clearly whose health problems would be covered, and who were going to have to suffer in silence.

Including obesity coverage will improve not just the health, but the overall quality of life of obese employees and their families. These people face discrimination and hostility from every turn. They face issues you may not even have thought of, such as increased premiums, or denied life insurance due to their health issues. They face issues for things you may take for granted, such as decreased opportunities to participate in family activities due to their physical limitations.

Including obesity coverage will make financial sense in the bigger picture, despite any jumps in premiums at the start. 

If the obese person gets treatment, they will be healthier, and take less time off from work. They will be loyal employees, lowering retention and recruitment expense.  They will more productive because they move quicker, tire less easily, take fewer breaks, are less likely to be afternoon drowsy due to sleep apnea, etc.  If the obesity problem gets addressed, than there will be a reduced – or even eliminated – need to treat diabetes, heart disease, arthritis, (you get the picture) very serious medical conditions that require expensive, ongoing medications, for the rest of the employee’s life. If an employee dies at work due to a heart attack that had nothing to do with the job, the cost of the OSHA inquiry will pay the insurance premium difference for covering bariatric surgery.

My work bought out another company this year, doubling their employees and bargaining power. They are taking new bids for insurance, so I sent the head of HR some info hoping to get WLS surgery included for 2009. Cross your fingers for me!

At the same time, I also found the Duodenal Switch is a superior surgery to RNY Gastric Bypass. And found a new home on the DS Board!

I'm full of hope for the coming year, even as I sit here typing with tree trunks for ankles...

... or something.

Well, I gave up the appointments for the psych eval and the blood tests because why bother? I can't afford it. I tried for a loan on prosper, but Texas restricts the interest rates one can offer, and I didn't get as high of a loan as I needed. I will pay off this one to build "credit" with Prosper and try for a higher one later.

Meanwhile, I got fired from my job, found a new and better one with different insurance. I don't have much hope with Anthem Blue Access out of Ohio because the rep said they had an exclusion, too, for anything to do with obesity.

I'm embarrassed to say that I got very angry at the meeting, told them I felt I was being discriminated, and left the meeting in tears.

Later, I got an email from the HR lady, apologizing for upsetting me, and asking if there was any way she could help. She said it was tough but they can't always accommodate everyone's "desired" options. This was my answer:

Neither you nor the representative from Anthem was at fault, and I apologize for “losing” it like I did. Basically, I’ve been struggling with health problems stemming from my weight for a long time, and each and every employer/health coverage I’ve ever had always specifically said – if you have morbid obesity, tough luck, even if it’s medical, even if you could die any day from diabetes or a heart attack, we don’t cover medically supervised obesity treatments of any kind, period, end of story. I had thought Anthem and this company would be different. I thought I finally was going to get relief. I am on the verge of needing a freaking scooter/wheel chair due to arthritis of the hip and other ailments. I have high blood pressure; there is heart disease and diabetes in my family. All would be cured with one operation – but obesity is the ONE disease that is still ok to blame it on the person for “lifestyle” and not cover it. Imagine wondering if you are going to be around to see your grandchildren. Imagine how I felt the other day when a stranger literally yelled out to me “fat ass!”

This is why I am upset. You’ll cover treatment for the alcoholic. You’ll cover lung cancer for the smoker. But you won’t cover me. Why do I even bother with health insurance? It’s extremely distressing and demoralizing, and I’ve dealt with this prejudice and unfair treatment all my life.

If there was one place you could help, but I don’t have much hope, is to fight to make sure that the plans you purchase for employees are fair and cover all diseases, without discriminating. But most board meetings have people shake their head and say “why should I pay a higher premium because she overeats?” as if it’s that simple.

Larissa

PS – the only “desire” I have is to live pass age 60.

I had my first consultation with Dr. Stewart yesterday. 

It really wasn't much as I had previously filled out all the paperwork at a seminar I attended a couple of weeks ago. 

One thing that did happen, they dashed all hope that I could fight my insurance for coverage. It's excluded, and that's that. Nothing to be done. Give up all hope. I agreed to proceed with self-pay, not really knowing how I was going to achieve that. 

They did a baseline EKG and vitals, gave me a shopping list of tests and evaluations to do (thank heavens that will be covered by my insurance) and gave me an appointment to come back in a month.

As soon as I get the tests done and find financing, I'm good to go. As if it was that easy...