tnwalkersu

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I have been so busy caring for my mother that I haven't had the time to write.  My insurance turned down my surgery and I have to start my appeal.  But taking care of her came first.  Last Tuesday we admitted her to the ER with shortness of breath and while there she had a heart attack.  They placed in the hospice unit since we knew she couldn't go back home and the end was coming soon.  She passed away on Sunday morning.

Starting next week I will start on my appeal to get my surgery.  I was told that no one had ever gotten the surgery after the insurance denied on exclusion of policy.  But I will try anyway. 

The holidays were hard.  My mother has lung cancer and was put in the hospital for two weeks and we had to take turns taking care of her.  Then my SIL had a heart attack and had bypass surgery so it seemed like I was living at the hospital.  I decided to wait till after the holidays to make my consultation with Dr. Olsen.  I now have my appointment for this month.  All of my paperwork is done so after talking with him it will be a wait and see thing. I'm waiting to see if the insurance will approve me.  They have already said no but I will keep on trying.

Today I had an Upper GI for my revision.  I wanted also to see what was going on since I was hurting a lot when I ate.  The radiologist asked me if I had a band in now and I said yes.  She the remarked, This doesn't look good!  Ouch!!  When I looked at the screen I could see what she meant.  You couldn't see the band at all which probably means erosion.  I'll have to wait to see what the report says when the doctor calls me.

Today I heard from Dr. Olsen's office and they have my medical records.  I have to get an upper GI and send it to them and then I will get my consult.  One step closer to my surgery.  My company could change insurance at the change of the year.  Then I will have to start over.  I don't think there is anyway to get all of this done before the end of the year and have surgery.

Yesterday was not a good day.  I have been having problems eating.  It is just like when I had a fill.  Tight, reflux and vomiting.  I don't have anything in my band so I'm thinking I have a slippage.  I hope not.  I don't want to have to go through two surgeries.  One to remove the band and the other to get the DS.  Mailed my papers to the Dr's office.  They will get them Monday then it is a wait and see game.

I have know gotten all of my medical records together and am sending one copy to Dr. Olsen's office and one copy to my insurance company.  I have also sent a cover letter to my insurance company again stating my desire for
WLS and that I will not stop calling until I get my approval.  Even if I have to get an attorney involved.

I received my notices today in the mail that showed the insurance got my appeals letter.  I also talked to the doctor's office and they called my insurance and they said I need to get the last 3 years of medical records together from my doctor and the records from Dr. Byars about my band with a statement about the floro fill showing the failure.  This is a break.  The insurance company didn't say I couldn't have the surgery.  I just have to get them the paperwork.  I'm going to drive down to Dr. Byars and pick it up so I don't have to wait on the mail.  I'm so excited!  My first real step.

I got the address for my insurance's appeal dept. and talked with them.  I mail it in today, they don't have a fax.  I think I'm going to send it registered so I know that they got it and they can't say they never received it.  My rep was really helpful.  She said that the way I worded it, I should be able to get them to do it.  Off to the post office.

I talked with my company's insurance rep today.  She is going to check to see what all they require in filing my appeal.  She's also going to check to see if she can help me get approved or what paperwork I need.  She was really helpful.  I told her my story and she was surprised that the band had the problems it did.  She hadn't heard of these things either.  She has a friend that has a band and she is going to tell her about some of the things that they don't tell you.  When I told her that my band could cause stomach erosion and that it was only meant to stay in for 5 years she was shocked.  She agreed that I needed to get it out.  So she is on my side.  I talked to Lori at Dr. Husted's office to let her know I was going ahead with fighting the insurance company and that I would keep her informed.  She is so nice.  I can't wait to get switched!

The economy stinks.  Unless there is a big turn around there will be no surgery.  I can not afford to pay for the surgery because the money needs to stay in the bank in case things get worse.  The only way to get the surgery now is to have the insurance pay for it.  Even if it takes a couple of years I won't stop trying.  My husband says he doesn't want me to have it.  He says I lost weight on my own in the past and I can do it again.  He also thinks I am fine the way I am.  It's just so hard to not want to be thin again.