- HEALTH TRACKER
Newton Falls, OH, USA
Post Op - BMI: 54.6
Surgery Type: RNY
Member ID: P1121492421
Surgeon: Aviv Ben-Meir, M.D.
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Im not much of a diet person, I have tried many times but just cant seem to stick with it or lose anything for that matter, or when i do lose, i just gain it back and then some. all i need is a step in the right direction and surgery just might be the way .. i have been diagnosed with RA, hypertension, borderline diabetic, hypothyroid, infertility problems which include absent and irregular periods w/ symptoms of PCOS, sleep apnea, along with other health complications. I also cant walk without feeling like my feet are going to break. I would like to be able to play with my kids like i use to or tend to them like a mother should and be able to keep up with my household chores without having to stop or slack off due to exhaustion.
next tues march 11, i have a seminar to attend and we'll see what all buckeye needs for me to get approved ...
I have gained 15+ lbs since 2006 and this is my heaviest ive ever been ..
The journey into my new me starts today
I went to my Dr today to discuss weight loss and brought up the surgery, she said that she has sent people for it and she thinks its a good idea especially in my case, she believes that the insurance will approve me based on the fact that i have diabetes, high blood pressure, RA, IR, and a few other things.. she's getting some of my old records and will be sending a referral letter to get approved, i know that this is just the first step in a long journey, i also found out that i dont weigh 220 like i thought, i weigh 207 (which still puts me at a 48 BMI )
So to a healthier and happier me .. !!!
I called Medical Mutual yesterday and asked about if they cover the surgery and what i needed to do, the CSR was great, said that as long as Im 100lbs overweight, have a 5 yr weight history, psych test, and dr's notes, and medically necessary, they'll approve me ~ however they dont have a list of bariatric providers so I have to do all the research myself ..
I have decided to go to St. Vincents Mercy Hospital, it wasnt my first pick but since Akron City (Dr Z) cut all ties with MM and Dr Chlysta (Akron General) wont take MM anymore, my hands are pretty much tied as to where I could go, but since Cleveland is an hr away, its alot closer than the Bariatric Clinic in Groveport ... Anyway, I have signed up for the seminar for Sept 7.
I had my seminar last nite and it went pretty good, i really didnt find out any new stuff, basically everything they covered is everything i already knew, i got my packet and of course started on it right away, called MM to inquiry about the benefit cap and found out there wasnt any, so that was a huge weight lifted of my husbands shoulder, called to schedule my psych test (which is next week), went to the drs and got my 5 yr weight history, but im glad im did b/c THEY CALLED, can you believe it, not even 24hrs has gone by since the seminar and they called .. im excited and nervous all at the same time ...
Had my consultation appt yesterday, found out that my intake worker is LaTonya and she gave me a list of what i needed to get for MM, I had a list of dates and weights for the past 5 yrs but they want progress notes as well, so i have to get a hold of my dr for that, and get my supervised diet papers too, (hopefully what my dr and i did will be ok, b/c if not, then ill looking at 3-4 months of a supervised diet thru a dietician (im really hoping to get everything taken care of this yr b/c come the first of the yr, my deductibles start all over again and we really dont wanna have to pay out more than we have to, especially since we are already living on a tight budget) I have my first psych appt tomorrow, and ill be getting all the info from the drs office
Thought Id update alittle, I had my first appt for my psych test last week, just sat and talked, nothing big, will finish it up tomorrow and i have my sleep study tomorrow nite as well, so im hoping that this time next week all my paper will be in and that LaTonya can send it over for the approval process .. keeping my XXfingersXX that everything goes smooth and that MM doesnt jerk me around and want more and more info
I had my last psych eval appt and sleep study yesterday, the eval went good, she said that she doesnt see a problem so WOOHOO in that corner, and as far as the sleep study, i have absolutely no clue, i honestly didnt feel like i slept a wink there, i know i tossed and turned alot, but when i asked her if i snored she said yes .. lol
so who knows ~ she said ill have the results in 7-10 days, boy do i hope it doesnt take that long, im so hoping to get all my info sent to MM by the end of next week
I had just gotten my sleep apnea results and they arent good, as a matter of fact, my drs office called me yesterday to inform me that someone was gonna be calling me to get fitted for the machine, apparently it was severe enough to warrant one, so in the back of my mind, im thinking, ok how bad could it be, well apparently it was pretty bad, but my dr said that b/c it is a serious health problem that it will help me get approved.. i asked her about the letter of recomendation and she said it was done but that she wanted to add the sleep apnea to it to help plead my case, so it should be ready early next week and all im really wanting on now is the psych eval, which ive called 2 days in a row now with no response .
by now they are starting to schedule for nov already, im so hoping to get a nov-dec date ..
Well things are finally moving along but still at a snails pace..I had my 2nd sleep study to be fitted for my machine on monday (10-10)
they said i should have a machine within 2wks, I had called LaTonya today to find out what the next move was after they got my psych results, she said that they would schedule me for my consult with Dr Ben-Meir and then send all the paperwork in to the insurance company, but that since all we were waiting on was the results that she would just go ahead and schedule me, so i have my consult appt tomorrow at 11:30 ~~ now all i have to do is get those dang eval results and ill be on my way to the approval process
Gosh, I hadnt realized that its been awhile since i last updated, a few things have happened since then, I had my consult with Dr Ben-Meir on the 14th, great dr, i would advise anyone who lives in the cleveland-akron area to see him ... he knows what he's doing, and informs the patient of everything ..
i had gotten my bipap machine, its alot of getting use to ~ apparently i need oxygen as well (didnt know it was that bad)
i had finally gotten my eval results that tues after i saw the dr, had my dr send it over to LaTonya and had called her to confirm if she had received it .. so now on to today ~~ called LaTonya to confirm that she had indeed sent everything over to MM for approval .. so now im in the waiting period
there really anything new to report except that i had called MM to make sure they had gotten my info and they did .. so now im in the waiting period
I had gotten a surprising call today from LaTonya, I was APPROVED, i couldnt believe that it didnt take that long at all
i need to get an echocardiogram since i was on redux and phen fen and she said that someone would be calling me within the week to schedule everything WOOOHOOOOOOOOOOO
well the new me starts Dec 27th.. yep, my surgery got scheduled today and my preadmission testing is Dec 2nd, the bad part is my dh works nites, and doesnt get home til like 3am and the testing is from 7:15-1:30 and that doesnt leave him much time to sleep
well its march 7 2008
and unfortunately i wasnt able to get the surgery done back in 2005 due to finding out i was pg a day before my preop so im back once again at the start line, but thats ok ... a new beginning for me
i now have buckeye health (medicaid) and hoping that things go alittle smoother than when i was on Medical Mutual.
april 9, 2008
I had my consultation with Ben-Meir again, not much has changed since before, he does want me off my prednisone for 2 months before surgery (great, now what do i do about my RA flare ups, thats the only thing thats helped) LaTonya is going to use all my old info to send over and all i need to do is update my psych eval (which im in the process of doing) and get a EKG test (which i already did) and when everything is done, it'll be sent for approval.
May 2, 2008
Well I had sent over my psych eval and EKG results to LaTonya on weds and i called today to find out if she did get them and she did and said that she had already sent everything over to Buckeye to get approved so now im just at the dreadful waiting period, wonder how long this time around is gonna take ... ???????
May 29, 2008
LaTonya called and said I was approved, apparently Buckeye gave them a hard time and denied me at first, something about wanting more info, so LaTonya had a peer to peer conference and found out that all the info they wanted was stuff they already had in front of them.
June 5, 2008
I finally have a surgery date, a new me starts on July 24th
my preop is June 26th .. im so nervous and excited, ive been getting books off amazon and ebay. Guess that means no fair food this yr, oh well, going to cedar point on the 13th with my mom. i know i wont be able to ride much but at least the kids will have fun
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Surgeon: Aviv Ben-Meir, M.D.
My first impression of Dr Ben-Meir was that he was (is) very confident but thats a good thing, he is a very skilled surgeon who takes pride in his work and record. He went over his stats compared to the national stats, which is very impressive and explained that since he does take pride in his work he has very little complications if at all. He explains everything so that you can understand what the surgery entails before, during and after and also the risks involved both minor and major ones. I feel that I made the best choice when I decided to go to CCBS, even though I didnt get to choose my surgeon, im very confident in the choice that was given to me ..
Buckeye Community Health
They gave my insurance intake worker the run around for 2-3 wks, claiming they never received the first packet, so she resent it and within 2 days later i was denied, so my intake worker did a peer to peer and found out that they denied me over info that they had infront of them but didnt bother to look, so i was immediately approved keep copies of everything you submit that way you have proof, make sure you do everything they want or else they will deny you