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Steve C. Norwalk, CT, USA Already had Weight Loss Surger - BMI: 24.7 Surgery Type: RNY Member ID: C1044559003 Web Site: http://steverevere.tripod.com Surgeon: Ralph Crum, M.D. |
Click here for Steve's surgery support page Click here for Before & After pictures page Click here for the 10/2002 Reunion Page Click here to print Steve's cards (You can print your own cards, and if you're good at it, you can help print cards for your friends as well!) Click here to view Steve’s friends. |
I was blessed to have had a LAP Roux-en-Y (proixmal) by Dr. Ralph Crum at Norwalk Hospital (CT) on October 9, 2002. Supportive family, friends and neighbors, participation in the area's Bariatric Support Group and follow-up care with Dr. Crum have made weight loss and lifestyle changes a very positive experience. And, the wonderful friendships I've made through our support groups have not only motivated me to stay the healthy-living course but have also enriched my life in ways to numerous to describe.
Having started at over 500 pounds, I lost over 300 pounds in less then two years. But, more than losing pounds and inches, I've gained a sense of control over my life and a freedom from the shame and guilt that plagued me every morning when I awoke knowing that it would be another day of losing to my food demons.
Since about my 15 post-operative month, I have started to try to maintain my weight(as opposed to losing); although this second summer has seen my dropping another 5-10 pounds just from leading a much more active lifestyle. I now wear a size 36-- the same size I was at high school graduation. I am quite comfortable at my present size and still marvel that the NIH BMI charts finally list me as "normal" (if only they knew me)-- of course, a few pounds ago when I was still carrying a BMI of slightly more than 25 (and in that "overweight" category), I still woke up every morning thankful for my health and happy to be the same size I had been in college. Most importantly, I know that I am at a sustainable and healthy weight (particularly given my height).
By my 13th post-operative month, I surpassed the goal that I had originally set for myself and was able to comfortably fit into size 40 pants and am just a plain old XL for shirts; those pants and shirts are now noticeably too big on me. This is quite a change from where I was the day of surgery as I then wore a size 70 pants and a 6x-7x shirt.
It is odd, but my total shape has changed-- although I recognize that it would be difficult to have a wide and protruding buttocks, sagging manboobs and almost distended lower gut while wearing a size 38 pants, I still marvel that I seemed to have flattened out all around. So the challenge now is to maintain my weight, find inexpensive clothes (I haven't been this size since college) and try to resolve the sagging, hanging, chafing "excess" skin issues (along with having some painful vericose veins removed).
I started at about 510 pounds (but I'm 6'3" and I never tucked in a shirt so I'm sure most people only thought I was 490). I dropped 100 pounds in less than 6 weeks, 127 pounds in 3 months, 154 pounds in 4 months, 177 pounds in 5 months, 190 pounds in 6 months and 224 pounds in my first 8 months. By 9 months out, I was finally down to a size 42 for pants (I started at size 70) and an XL for shirts (down from a 6x/7x). At my tenth month, I had lost about 247 pounds and at the start of my eleventh month since surgery I had finally gotten below my original goal weight of 250. Originally, my goal was to get down to wearing a 44 pants and weigh 250 (that's where I was in 1989 when I graduated from law school and was a size at which I was very comfortable).
By the middle of my 12th month out, I had lost 260 pounds (more than half of my originally starting weight). I never imagined that having the RNY would have facilitated such a fast weight loss-- at times I don't recognize myself. And, by staying vigilent, I have been able to avoid the dreaded "bounce" from re-gaining what I've lost. Sure, I still get a little nervous when I start to feel hungry, but I suppose that it certainly beats the alternative where I used to feel anxious after I had satisfied that hunger.
Dr. Crum gave me an opportunity for a long and healthy life.
My decision to have WLS is written about by me at http://steverevere.tripod.com
LIFE AFTER THE FIRST YEAR
Late in September of 2003, on a lark, I submitted my resume to a head-hunter, something that I had done without success for years (while heavier); as in the past, I was called in for an interview. However, unlike my past experiences, I was sent out for an interview that day and hired on the spot (I'm an attorney). Now, I guess I could have been upset that I was being judged differently now that I have lost my weight. However, my father helped put the experience in perspective when he asked me if maybe, just maybe, the interviewers were better able to focus on my qualifications because I was not huffing and puffing while being interviewed, I did not have an uncomfortable look on my (as I actually fit in the chair), I wasn't nervous as I didn't fear my suit ripping or my shirt buttons popping and because I was just a lot more confident and comfortable in my own skin (which many people tend to read as honesty). I think my dad was right.
THE GALL BLADDER: Like about 20% of us, I had been experiencing gallbladder pain for several months but believed that it was just some sort of cramping due to the foods I ate. Although I preach to the propsective patients at our new patient support group meetings how they need to listen to their bodes, I kind of ignored the symptoms until I could barely stand and was so overcome with nausea that I couldn't eat (which, oddly enough, hit me while I was leading a new patient support group meeting the first week of November, 2003). After all, in my six years of being a Mr. Mom and fourteen years of being a lawyer, I must have picked up enough medical knowledge to appreciate that I could not be suffering from a gallbladder attack, right? I called my surgeon the next morning (after all, why seek medical help in the hospital where I was leading the meeting the night before when I could prove my refusal to take my own advice). He saw me right away, immediately diagnosed me as having gallbladder disease and sent me that same day to an imaging center to confirm the diagnosis. The next day, I was at Norwalk Hospital having the gallbladder removed. Once again, I was simply astounded by the care my surgeon provided me, the atttentiveness of his staff in making sure that I would be operated on the next day and the high level of care I received at Norwalk Hospital. The moral from this story: recognize that the pain you feel might not always be the "typical" symptoms of the classic problems many of us experience post-op (and don't diagnose yourself).
Now in addition to the attentive care I received at Norwalk Hospital (particularly because I was on the floor where the gastric bypass patients are taken and the nursing staff there is well-educated about our post-operative needs), I was also amazed at how much easier recovery is from surgery when you go in not being morbidly obese. From being able to get out of bed easier, to not being plagued with lots of aches and pains that can mask other symptoms, I was very blessed to have gotten sick with my gallbladder when I was otherwise healthy (oh, you know what I mean).
And once again, Dr. Crum demonstrated that he is not just a skilled surgeon, but an attentive and caring physician.
WANTING TO EXPERIENCE ALL I DISCUSS AS A SUPPORT GROUP FACILITATOR. For months, in talking about the risks and benefits of gastric bypass, I would discuss the slight risk of internal hernias and blockages. I had read about those complications, had talked to Dr. Crum about how they are repaired and had spoken with several peers who had needed surgery to repair their blockages. But, really, can you really speak convincingly about anything without experiencing it firsthand? So, in September of 2004, after feeling a strange tightenning in my midsection that was accompanied by the strongest wave of nauseua and pain, I knew it was time to get myself back to Dr. Crum. I would soon be checked back into my suite at the Norwalk Hospital where the internal hernia was repaired. The tough part was that I had to return to liquids for a few days and then soft food for a few more days after that. It was in those days of transition that I appreciated the hold some of my old food demons held. You see, it was different when I was choosing to control my eating, when I didn't eat by my choice. But, when confronted with a physical impediment to eating, I found myself back to those pre-RNY days when, while dieting, I would long for foods I never really liked. Fortunately, a good counsellor and great advice from friends guided me through this troubling phase. It was a learning experience-- one that made me appreciate that our recoveries are truly life-long and that the journey we are on does not end at our goal weight.
THE MINOR ANNOYANCES:
Because of my extreme weight, I developed serious varicose veins on both legs. As my life became more active, they became a source of constant discomfort-- burning and tingling, making exercise very uncomfortable-- and a source of some worry (they're large size and the thickness of the clusters along the length of each leg put me at some greater risk for blood clots). I had my right leg done in a nearly 4 hour operation (Dr. Crum had to reconstruct my upper thigh given the large number of clusters that were removed and had to remove an aneurysm that had formed around my ankle) and my left leg will soon follow. Being in the hospital for the varicose vein surgery and living with the discomfort that follows surgery, I have had to relive the anguish that comes from knowing that I had done permanent damage to my body as a result of my food addiction. It has actually been tougher than I thought--- the physical pain is minor compared to the angst of recognizing that I had done this to myself. I guess it was a good wake-up call for me as I had avoided permanent hypertension (although uncontrollable before surgery, my blood pressure has been normal and unmedicated for over a year now) and had avoided having loads of sagging skin despite my rapid weight loss.
And, yes, the longstanding pain in my lower abdomen ultimately required surgical repair, that was done in conjunction with repair of an inguenal hernia. So, once again, it was fall and I was back at Norwalk Hospital having surgery (close to the anniversary of my RNY).
STAYING FOCUSED:
The support groups which my surgeon emphasizes have helped tremendously in maintaining the focus that is necessary for long-term weight loss. Being given the opportunity to help as the facilitator for the new patient meetings makes me re-visit my decision to have gastric bypass surgery every single month-- and serves to reinforce the remarkable changes in my life that the surgery has made possible. Being surrounded by supportive peers makes all the difference in the world-- let's be serious, it's not easy giving up your coping mechanism of choice and completely re-tooling your life, but with great friends and caring peers the road to this new life is the path worth taking.
SUPPORT GROUP LIFE:
Being given the opportunity to facilitate support group meetings has been a blessing-- planning for them keeps me mindful that maintaining health requires constant vigilence and standing before my peers every month helps to keep me honest in my eating.
MAINTAINING:
Passing my second anniversary presented challenges I never quite imagined. First, there is the balance between the thrill of being able to buy inexpensive clothes at stores like Wal-Mart and Old Navy (which are great, don't get me wrong) and the desire to want to wear all those higher-labels items that had been out of reach for so long. Secondly, there remains a constant battle betweeen self-awareness and vanity-- between wanting to stay healthy and wanting (needing) to look my best. And with those challenges, there always comes the ease with which I know I could slip back into my old ways--- disguising my lack of motivation for health (through weight control) with my avowed disdain for vanity. But, I guess the biggest issue has been just trying to find a little balance between making up for lost time and living each day to the fullest without constantly looking over my shoulder to see if the old food demons were catching up on me. Is post-operative life a little more stressful than I had imagined? Yep. But, is it worth being able to avoid the guilt and shame that were my constant companions as I struggled with obesity? Absolutley. So, as I look back on my past 30 months of post-operative life, I must admit without hesitation that it has all been well worth the effort-- after all, in the investment I always wanted to make in my long term health, I finally put in the sweat equity I deserved, and the return has been fabulous.
Having started at over 500 pounds, I lost over 300 pounds in less then two years. But, more than losing pounds and inches, I've gained a sense of control over my life and a freedom from the shame and guilt that plagued me every morning when I awoke knowing that it would be another day of losing to my food demons.
Since about my 15 post-operative month, I have started to try to maintain my weight(as opposed to losing); although this second summer has seen my dropping another 5-10 pounds just from leading a much more active lifestyle. I now wear a size 36-- the same size I was at high school graduation. I am quite comfortable at my present size and still marvel that the NIH BMI charts finally list me as "normal" (if only they knew me)-- of course, a few pounds ago when I was still carrying a BMI of slightly more than 25 (and in that "overweight" category), I still woke up every morning thankful for my health and happy to be the same size I had been in college. Most importantly, I know that I am at a sustainable and healthy weight (particularly given my height).
By my 13th post-operative month, I surpassed the goal that I had originally set for myself and was able to comfortably fit into size 40 pants and am just a plain old XL for shirts; those pants and shirts are now noticeably too big on me. This is quite a change from where I was the day of surgery as I then wore a size 70 pants and a 6x-7x shirt.
It is odd, but my total shape has changed-- although I recognize that it would be difficult to have a wide and protruding buttocks, sagging manboobs and almost distended lower gut while wearing a size 38 pants, I still marvel that I seemed to have flattened out all around. So the challenge now is to maintain my weight, find inexpensive clothes (I haven't been this size since college) and try to resolve the sagging, hanging, chafing "excess" skin issues (along with having some painful vericose veins removed).
I started at about 510 pounds (but I'm 6'3" and I never tucked in a shirt so I'm sure most people only thought I was 490). I dropped 100 pounds in less than 6 weeks, 127 pounds in 3 months, 154 pounds in 4 months, 177 pounds in 5 months, 190 pounds in 6 months and 224 pounds in my first 8 months. By 9 months out, I was finally down to a size 42 for pants (I started at size 70) and an XL for shirts (down from a 6x/7x). At my tenth month, I had lost about 247 pounds and at the start of my eleventh month since surgery I had finally gotten below my original goal weight of 250. Originally, my goal was to get down to wearing a 44 pants and weigh 250 (that's where I was in 1989 when I graduated from law school and was a size at which I was very comfortable).
By the middle of my 12th month out, I had lost 260 pounds (more than half of my originally starting weight). I never imagined that having the RNY would have facilitated such a fast weight loss-- at times I don't recognize myself. And, by staying vigilent, I have been able to avoid the dreaded "bounce" from re-gaining what I've lost. Sure, I still get a little nervous when I start to feel hungry, but I suppose that it certainly beats the alternative where I used to feel anxious after I had satisfied that hunger.
Dr. Crum gave me an opportunity for a long and healthy life.
My decision to have WLS is written about by me at http://steverevere.tripod.com
LIFE AFTER THE FIRST YEAR
Late in September of 2003, on a lark, I submitted my resume to a head-hunter, something that I had done without success for years (while heavier); as in the past, I was called in for an interview. However, unlike my past experiences, I was sent out for an interview that day and hired on the spot (I'm an attorney). Now, I guess I could have been upset that I was being judged differently now that I have lost my weight. However, my father helped put the experience in perspective when he asked me if maybe, just maybe, the interviewers were better able to focus on my qualifications because I was not huffing and puffing while being interviewed, I did not have an uncomfortable look on my (as I actually fit in the chair), I wasn't nervous as I didn't fear my suit ripping or my shirt buttons popping and because I was just a lot more confident and comfortable in my own skin (which many people tend to read as honesty). I think my dad was right.
THE GALL BLADDER: Like about 20% of us, I had been experiencing gallbladder pain for several months but believed that it was just some sort of cramping due to the foods I ate. Although I preach to the propsective patients at our new patient support group meetings how they need to listen to their bodes, I kind of ignored the symptoms until I could barely stand and was so overcome with nausea that I couldn't eat (which, oddly enough, hit me while I was leading a new patient support group meeting the first week of November, 2003). After all, in my six years of being a Mr. Mom and fourteen years of being a lawyer, I must have picked up enough medical knowledge to appreciate that I could not be suffering from a gallbladder attack, right? I called my surgeon the next morning (after all, why seek medical help in the hospital where I was leading the meeting the night before when I could prove my refusal to take my own advice). He saw me right away, immediately diagnosed me as having gallbladder disease and sent me that same day to an imaging center to confirm the diagnosis. The next day, I was at Norwalk Hospital having the gallbladder removed. Once again, I was simply astounded by the care my surgeon provided me, the atttentiveness of his staff in making sure that I would be operated on the next day and the high level of care I received at Norwalk Hospital. The moral from this story: recognize that the pain you feel might not always be the "typical" symptoms of the classic problems many of us experience post-op (and don't diagnose yourself).
Now in addition to the attentive care I received at Norwalk Hospital (particularly because I was on the floor where the gastric bypass patients are taken and the nursing staff there is well-educated about our post-operative needs), I was also amazed at how much easier recovery is from surgery when you go in not being morbidly obese. From being able to get out of bed easier, to not being plagued with lots of aches and pains that can mask other symptoms, I was very blessed to have gotten sick with my gallbladder when I was otherwise healthy (oh, you know what I mean).
And once again, Dr. Crum demonstrated that he is not just a skilled surgeon, but an attentive and caring physician.
WANTING TO EXPERIENCE ALL I DISCUSS AS A SUPPORT GROUP FACILITATOR. For months, in talking about the risks and benefits of gastric bypass, I would discuss the slight risk of internal hernias and blockages. I had read about those complications, had talked to Dr. Crum about how they are repaired and had spoken with several peers who had needed surgery to repair their blockages. But, really, can you really speak convincingly about anything without experiencing it firsthand? So, in September of 2004, after feeling a strange tightenning in my midsection that was accompanied by the strongest wave of nauseua and pain, I knew it was time to get myself back to Dr. Crum. I would soon be checked back into my suite at the Norwalk Hospital where the internal hernia was repaired. The tough part was that I had to return to liquids for a few days and then soft food for a few more days after that. It was in those days of transition that I appreciated the hold some of my old food demons held. You see, it was different when I was choosing to control my eating, when I didn't eat by my choice. But, when confronted with a physical impediment to eating, I found myself back to those pre-RNY days when, while dieting, I would long for foods I never really liked. Fortunately, a good counsellor and great advice from friends guided me through this troubling phase. It was a learning experience-- one that made me appreciate that our recoveries are truly life-long and that the journey we are on does not end at our goal weight.
THE MINOR ANNOYANCES:
Because of my extreme weight, I developed serious varicose veins on both legs. As my life became more active, they became a source of constant discomfort-- burning and tingling, making exercise very uncomfortable-- and a source of some worry (they're large size and the thickness of the clusters along the length of each leg put me at some greater risk for blood clots). I had my right leg done in a nearly 4 hour operation (Dr. Crum had to reconstruct my upper thigh given the large number of clusters that were removed and had to remove an aneurysm that had formed around my ankle) and my left leg will soon follow. Being in the hospital for the varicose vein surgery and living with the discomfort that follows surgery, I have had to relive the anguish that comes from knowing that I had done permanent damage to my body as a result of my food addiction. It has actually been tougher than I thought--- the physical pain is minor compared to the angst of recognizing that I had done this to myself. I guess it was a good wake-up call for me as I had avoided permanent hypertension (although uncontrollable before surgery, my blood pressure has been normal and unmedicated for over a year now) and had avoided having loads of sagging skin despite my rapid weight loss.
And, yes, the longstanding pain in my lower abdomen ultimately required surgical repair, that was done in conjunction with repair of an inguenal hernia. So, once again, it was fall and I was back at Norwalk Hospital having surgery (close to the anniversary of my RNY).
STAYING FOCUSED:
The support groups which my surgeon emphasizes have helped tremendously in maintaining the focus that is necessary for long-term weight loss. Being given the opportunity to help as the facilitator for the new patient meetings makes me re-visit my decision to have gastric bypass surgery every single month-- and serves to reinforce the remarkable changes in my life that the surgery has made possible. Being surrounded by supportive peers makes all the difference in the world-- let's be serious, it's not easy giving up your coping mechanism of choice and completely re-tooling your life, but with great friends and caring peers the road to this new life is the path worth taking.
SUPPORT GROUP LIFE:
Being given the opportunity to facilitate support group meetings has been a blessing-- planning for them keeps me mindful that maintaining health requires constant vigilence and standing before my peers every month helps to keep me honest in my eating.
MAINTAINING:
Passing my second anniversary presented challenges I never quite imagined. First, there is the balance between the thrill of being able to buy inexpensive clothes at stores like Wal-Mart and Old Navy (which are great, don't get me wrong) and the desire to want to wear all those higher-labels items that had been out of reach for so long. Secondly, there remains a constant battle betweeen self-awareness and vanity-- between wanting to stay healthy and wanting (needing) to look my best. And with those challenges, there always comes the ease with which I know I could slip back into my old ways--- disguising my lack of motivation for health (through weight control) with my avowed disdain for vanity. But, I guess the biggest issue has been just trying to find a little balance between making up for lost time and living each day to the fullest without constantly looking over my shoulder to see if the old food demons were catching up on me. Is post-operative life a little more stressful than I had imagined? Yep. But, is it worth being able to avoid the guilt and shame that were my constant companions as I struggled with obesity? Absolutley. So, as I look back on my past 30 months of post-operative life, I must admit without hesitation that it has all been well worth the effort-- after all, in the investment I always wanted to make in my long term health, I finally put in the sweat equity I deserved, and the return has been fabulous.
Photos
 500 60 days before RNY and at my heaviest |
 |
 203 After 21 months, my body decided to start losing again-- here I am after dropping my 300th pound. |
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Surgeon Info:
Surgeon: Ralph Crum, M.D.
Whether evaluating his skill as a surgeon, his zealous post-surgical follow-up or his organizing a team of specialists for pre-op evaluation and in-hospital care, Dr. Crum would clearly be among the top surgeons with whom I have ever dealt. He seems to take a very no-nonsense approach to the need for gastric bypass surgery-- he quickly pointed out during our very first visit that the surgery is merely a tool and that a lifetime of hard work would need to follow for permanent weightloss. You just have to appreciate that kind of honesty. Although some might consider him a tad too blunt, I have always found him to be, well, charming-- he is as attentive to the issues that have arisen post-operatively as he was during our first meetings when I explained to him the scheduling concerns I had. And, he honored his promise to move up my surgery date (he gave me a week's notice when another patient had cancelled at the last minute). Particularly impressive for me was his determination to perform his Rous-en-Y's laproscopically-- he has undoubtedly honed his craft for the benefit of his patients (which was particularly difficult given that I started with a BMI of over 60 and a weight of nearly 500 pounds). He was reassuring in the operating room, engaging during his visits with me in the hospital and encouraging during all of my follow-up visits. Perhaps the greatest measure, I think, of Dr. Crum (to my mind at least) has been the kindness he has always shown my daughters (who were 4 and 5 when I first started seeing Dr. Crum) during my office visits. He has surrounded himself with a wonderful staff who share his same commitment to patient care. When my wife had questions in the first few days after surgery, Dr. Crum's staff (in particular Jeanette) quickly returned phone calls and helped us out. When I have called with questions about over-the-counter medications or with concerns about pains, the office staff provides quick, but thorough, answers and refers everything to Dr. Crum for possible follow-up. When some very minor problems arose about 4 weeks after surgery (I caught a stomach virus that wreaked havoc with my new pouch), Dr. Crum brought me in immediately to help. At about 6 months, when it seemed that the incredible pain I was enduring was a stricture, Dr. Crum met me at the emergency room (fortunately, no surgery was needed). At 13 months, when I had (what would later be a gallbladder attack), Dr. Crum had me in the office as soon as I called in and operated on me (and my diseased gallbladder) the next day. At 17 months out, Dr. Crum was once again standing over my unconcious partially clothed body repairing the varicose that had been causing me lots of pain and burning and repairing the skin around the huge clusters that were being removed. The repair work was incredible-- I have been satisfied to be free from the pain that the varicose veins had caused and over-joyed to have had removed the disfiguring skin that hung around my knees. Dr. Crum's reconstruction of my thighs is particularly impressive given the size of the clusters that were removed from above each knee. In September of 2004, I suffered an internal hernia that Dr. Crum skillfully diagnosed and corrected surgically. Of course, the true mark of his care came when I spoke with him after the surgery about the concerns I was having over re-incorporating food into my diet (after intestinal surgery, you need to return to liquids and soft foods for a while). Now, I realize that, as I continue to recount my surgeries the typical reader is probably wondering if I truly harbor a desire to appear unconscious and on my back wearing nothing but a hospital johnnie, or if I have just had a little bit of bad luck. The answer probably lies somewhere between the two. You see, I have had to come to terms that my years of super morbid obesity caused damage to my body-- although, I take comfort in knowing that my vital organs were spared permanent damage. And, there is a certai empowerment in knowing that I can avail myself to surgery to fix what ails me without the fear that confronted during my many knee surgeries when I had been obese. In all my surgeries with Dr. Crum, I never cease to be amazed by his level of personal attention and by his tremendous skill. The fact that Dr. Crum is so dedicated to helping his patients maintain their health (and their weight loss) is evident by his attending two support group meetings a month where he answers questions and provides lots of encouragement. Certainly I am biased because he did give me the opportunity to live a long and healthy life; he guided me to a 154 pounds loss through my first four months and a 300+ pound loss during my first 24 months. But, having had significant other operations at leading hospitals, I can objectively evaluate Dr. Crum as among the best surgeons and physicians I have ever had the pleasure to know.
Insurer Info:
CIGNA, EPO
CIGNA has finally (after being caught in their pattern of lies, distortions and papershuffling) paid my surgeon, hospital and anesthesiology costs. Of course, it too my wife's employer month's of fighting with CIGNA as they pre-approved me, then denied coverage after surgery, next approved the surgery at the start of April and then in May sent me a letter from their review contractors claiming that the surgery has been denied and allegeing that they needed information that had already been provided them. CIGNA pre-approved me after the initial contact by my surgeon. Of course, after I had the surgery, they began sending me a series of letters indicating that they needed more information from my surgeon in order to evaluate the claim (which they had already pre-approved). After several months of frustration in dealing with CIGNA, I then received a notice that they were denying my claim as they alleged that weight-loss surgery was expressly excluded from my policy (which is an outright fabrication as weightloss surgery is evaluated on a case-by-case basis). So, I hired an insurance consultant and an attorney and had them call and write nasty letters to CIGNA. CIGNA then approved the claim. But, and here is the but, they then denied claims for post-surgical follow-up as they again alleged that it was coded by my surgeon's office as being for "weight loss" and the policy does not cover "weight loss". Needless to say, after threatening to sue them (they had, after all, issued a denial of benefits), they told me that they would pay for the office visits if my surgeon resubmitted them with a different code. Then, CIGNA's claims review contractors alleged that CIGNA would not approve the claim as they were never provided a weight loss history, evidence of past medical efforts to treat my co-morbidities and weight-related health problems and evidence of long-term involvement in weight-loss programs (which is a new demand that was never set forth in my insurance booklets or in any of my prior communications with this awful company). As my wife's employer becamse very involved in the process, it dawned on all of us that CIGNA was sending demands to my surgeon for more information (claiming that they didn't receive evidence of medical necessity despite it being sent to them at least three times), notices to me that the surgery claims were duplicates and that the delay in sorting through them was holding up payment of the claims and then promises and assurances to my wife's employer that everything was being taken care of. My doctor's office told me not to worry about anything as they have the CIGNA approvals; my wife's employer told me that they would fight with CIGNA for me; yet, I can't help but feel completely cheated by CIGNA. At first I just assumed that they were, perhaps, a little disorganized and that explained the contradictory statements that I received. Now, I have come to the conclusion that they would prefer to engage in unfair and deceptive practices to force surgeons and hospitals to settle for smaller amounts and to try to discourage insureds from getting much-needed and life-saving WLS. Although my claims have finally been paid, it was not without a lot of aggravation for all involved. And, in the end, CIGNA held on to its money for more than a year after being billed for my surgery.