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Topic: RE: PCOS & Tri-Care Insurance Approval
Hi i was just wondering how things went for you cause i just had my pcp give me a referral to Portsmouth naval hospital to see someone . I have to wait till Wednesday or Thursday to call to set an appt . Do you have anything to tell me about your wait did you end up waiting six months ? I have seven months till my husband retires ..
Topic: RE: Hope for those with fertility issues...and a suggestion...
Thank you for this, it has given me a better insight and questions to ask my doctor!
Topic: RE: PCOS after pregnancy?
Please read my post Hope for those with fertility issues...and a suggestion...
You are describing much of what I initially dealt with after the birth of my daughter. She was born in 2002. My OB/GYN said my PCOS was "irritated" by the gestational process.
I didn't have a Mirena placed until after my son was born in October 2009. I did have some abdominal pain with it at first, but it was more a cramping feeling and was not severe. I did lose about half the hair on my head in the first 3 months after placing the Mirena, but I was warned there were possible side effects due to the body's need to acclimate to the new hormonal levels. I guess for me that was how it manifested. I have also noticed an increase in acne but, again, mine was not severe. I had my Mirena placed in December 2009 and as of today most of the issues have resolved themselves.
If you are experiencing anything you can call severe you may want to see your doctor ASAP if you already haven't.
You are describing much of what I initially dealt with after the birth of my daughter. She was born in 2002. My OB/GYN said my PCOS was "irritated" by the gestational process.
I didn't have a Mirena placed until after my son was born in October 2009. I did have some abdominal pain with it at first, but it was more a cramping feeling and was not severe. I did lose about half the hair on my head in the first 3 months after placing the Mirena, but I was warned there were possible side effects due to the body's need to acclimate to the new hormonal levels. I guess for me that was how it manifested. I have also noticed an increase in acne but, again, mine was not severe. I had my Mirena placed in December 2009 and as of today most of the issues have resolved themselves.
If you are experiencing anything you can call severe you may want to see your doctor ASAP if you already haven't.
Topic: Hope for those with fertility issues...and a suggestion...
I was dx with PCOS when I was about 20 (after I had my first child and had tons of complications) and was told I would probably never have another child. I was devastated to say the least. My doc put me on Metformin and told to me lose weight (easier said than done). I'm sure you have all heard some variation of this from your own healthcare provider.
In addition to the PCOS dx, I was tested for testosterone levels because I started having unusual hair growth on my face (cheeks and chin and neck). Ack! The test came back stating I had higher than normal levels of testosterone and was told there was really no treatment at that time for that particular issue. Hmmmm... This got me thinking. I wasn't sure why but I felt like there may have been more going on than just the PCOS issue since I couldn't find any data to support PCOS as being the cause of the T level increase. I decided to get another opinion and was basically told the same thing by another OB/Gyn. I decided to let it go.
It wasn't until years later when I was being referred to an Internal Medicine Specialist for infertility and repeat miscarriage related issues that I received a FULL blood panel workup. Wouldn't you know it, when the tests came back there appeared to be more endocrine levels off than just my T level and blood sugars. It wasn't long after that I was sent to an endocrinologist and dx with Hypothyroidism and Insulin Resistance (the precurser to full blown diabetes).
After stabilizing my thyroid levels and changing my medication from Metformin to ActoplusMet (Actos + Metformin) I felt much better, conceived and KEPT a second child (who is now 7 months old & healthy) and was able to really understand my battle with weight loss was more than just me not trying hard enough or not exercising enough or whatever. According to both my Internist and Endocrinologist, there are several endocrine issues that can look like PCOS but aren't or exist in conjunction with PCOS.
So what is my point here?
First, know your own and your family's medical history well. Had my OB/Gyn looked into mine he would have seen my grandfather has Hypothyroidism and could have done a simple blood test to check it sooner.
Second, if you really want a child never submit to the idea of never having a child before you have exhausted all options.
Third, insist on having a FULL blood workup once a year to check for issues that sometimes are misdiagnosed as something else. Also, this can catch things like pre-diabetes which are often missed until it's too late.
It is your right to know what is going on in your body and if you have been dx as a PCOS patient I strongly urge you to talk to your doctor about any additional concerns you have, whether it's a hair growth issue or a skin change issue or anything else you feel could be a sign there is a bigger endocrine issue at work. Best of luck to you all.
In addition to the PCOS dx, I was tested for testosterone levels because I started having unusual hair growth on my face (cheeks and chin and neck). Ack! The test came back stating I had higher than normal levels of testosterone and was told there was really no treatment at that time for that particular issue. Hmmmm... This got me thinking. I wasn't sure why but I felt like there may have been more going on than just the PCOS issue since I couldn't find any data to support PCOS as being the cause of the T level increase. I decided to get another opinion and was basically told the same thing by another OB/Gyn. I decided to let it go.
It wasn't until years later when I was being referred to an Internal Medicine Specialist for infertility and repeat miscarriage related issues that I received a FULL blood panel workup. Wouldn't you know it, when the tests came back there appeared to be more endocrine levels off than just my T level and blood sugars. It wasn't long after that I was sent to an endocrinologist and dx with Hypothyroidism and Insulin Resistance (the precurser to full blown diabetes).
After stabilizing my thyroid levels and changing my medication from Metformin to ActoplusMet (Actos + Metformin) I felt much better, conceived and KEPT a second child (who is now 7 months old & healthy) and was able to really understand my battle with weight loss was more than just me not trying hard enough or not exercising enough or whatever. According to both my Internist and Endocrinologist, there are several endocrine issues that can look like PCOS but aren't or exist in conjunction with PCOS.
So what is my point here?
First, know your own and your family's medical history well. Had my OB/Gyn looked into mine he would have seen my grandfather has Hypothyroidism and could have done a simple blood test to check it sooner.
Second, if you really want a child never submit to the idea of never having a child before you have exhausted all options.
Third, insist on having a FULL blood workup once a year to check for issues that sometimes are misdiagnosed as something else. Also, this can catch things like pre-diabetes which are often missed until it's too late.
It is your right to know what is going on in your body and if you have been dx as a PCOS patient I strongly urge you to talk to your doctor about any additional concerns you have, whether it's a hair growth issue or a skin change issue or anything else you feel could be a sign there is a bigger endocrine issue at work. Best of luck to you all.
Topic: RE: a little frustrated, and confused - suggestions?
If your insurance has a clause in it's coverage stating they cover any form of weight loss surgery at all you have a fighting chance for approval. Here is what you may want to try. I pulled this information from the internet back when I was helping my mother seek approval from her insurance company. It was not an easy process and was frustrating at times but it did end in her insurance covering the procedure.
Instructions (from http://www.ehow.com/how_2039640_insurance-gastric-bypass.htm l)
Step 1 - Discuss with your surgeon the financial aspects of gastric bypass surgery and the amount needed post-operation. This would depend on the complexity level of the surgery.
Step 2 - Assess your financial requirements. The key point is the amount you can claim from the insurance company and the money that you will have to shell from your pocket before, during and after the operation.
Step 3 - Go online and shop for the best quotes. Several insurance agents can help you buy the right kind of insurance. Take advice from reliable insurance companies or agents.
Step 4 - Compare ratings of the company. Insurance companies are rated by several agencies such as S&P and Moody's. Choose a company with higher rating and the ones which offer better service on claim processing.
Step 5 - Ask the insurance agent or read the clauses carefully in the policy. Find out whether the coverage of gastric bypass surgery is as per your requirements.
Step 6 - Provide a referral letter from your primary physician and the surgeon when necessary
Step 7 - Maintain accurate health records and receipts before and after the surgery. They may be needed for payment the insurance claim.
Step 8 - Ensure that your surgeon has all the required documents ready for the insurance company in your case.
Step 9 - Contact the insurance company periodically before and after the surgery to know about the progress of your claim.
Step 10 - Find out the payment mode of insurance claim. Ask your insurance agent when and how the payment would be made to settle the surgeon's bill.
Or you can try going the route of the appeals process which I have heard is also frustrating but very worth it in many cases. You have the right to appeal to your insurance company with the help of your primary care physician or surgeon. You will need to look up the appeals process for your insurance carrier and make sure you follow it to the letter. You can probably get your doctor's office to assist, especially if you are dealing with a bariatric surgeon. They are sometimes more versed in the proper way to appeal to insurance companies (those they accept payment from) and garner a positive outcome for you as their patient.
Even though you have not been keeping logs of every attempt you have made to lose weight your weight loss efforts may be documented well enough in your doctor's office visit notes over the years that you may not need to have the added frustration and expense of a costly diet program. The key is talking to your past caregivers to see if they will write letters of recommendation for you based on your medical history (so long as they documented any weight loss related conversations you had in your visits). The more the merrier in this case. I would recommend obtaining a copy of your medical records from your doctors so you can review them yourself and read through the doctor's office visit notes. This can save you time in the long run. You won't be left waiting weeks for the doctor to get around to reviewing your chart and then waiting some more while the office staff drafts something he is willing to sign.
I hope this helps you. I know it's a lot of information and I know insurance companies can be a pain, but hang in there and give it your all and you have a good chance of being approved for surgery. Best of luck to you.
Instructions (from http://www.ehow.com/how_2039640_insurance-gastric-bypass.htm l)
Step 1 - Discuss with your surgeon the financial aspects of gastric bypass surgery and the amount needed post-operation. This would depend on the complexity level of the surgery.
Step 2 - Assess your financial requirements. The key point is the amount you can claim from the insurance company and the money that you will have to shell from your pocket before, during and after the operation.
Step 3 - Go online and shop for the best quotes. Several insurance agents can help you buy the right kind of insurance. Take advice from reliable insurance companies or agents.
Step 4 - Compare ratings of the company. Insurance companies are rated by several agencies such as S&P and Moody's. Choose a company with higher rating and the ones which offer better service on claim processing.
Step 5 - Ask the insurance agent or read the clauses carefully in the policy. Find out whether the coverage of gastric bypass surgery is as per your requirements.
Step 6 - Provide a referral letter from your primary physician and the surgeon when necessary
Step 7 - Maintain accurate health records and receipts before and after the surgery. They may be needed for payment the insurance claim.
Step 8 - Ensure that your surgeon has all the required documents ready for the insurance company in your case.
Step 9 - Contact the insurance company periodically before and after the surgery to know about the progress of your claim.
Step 10 - Find out the payment mode of insurance claim. Ask your insurance agent when and how the payment would be made to settle the surgeon's bill.
Or you can try going the route of the appeals process which I have heard is also frustrating but very worth it in many cases. You have the right to appeal to your insurance company with the help of your primary care physician or surgeon. You will need to look up the appeals process for your insurance carrier and make sure you follow it to the letter. You can probably get your doctor's office to assist, especially if you are dealing with a bariatric surgeon. They are sometimes more versed in the proper way to appeal to insurance companies (those they accept payment from) and garner a positive outcome for you as their patient.
Even though you have not been keeping logs of every attempt you have made to lose weight your weight loss efforts may be documented well enough in your doctor's office visit notes over the years that you may not need to have the added frustration and expense of a costly diet program. The key is talking to your past caregivers to see if they will write letters of recommendation for you based on your medical history (so long as they documented any weight loss related conversations you had in your visits). The more the merrier in this case. I would recommend obtaining a copy of your medical records from your doctors so you can review them yourself and read through the doctor's office visit notes. This can save you time in the long run. You won't be left waiting weeks for the doctor to get around to reviewing your chart and then waiting some more while the office staff drafts something he is willing to sign.
I hope this helps you. I know it's a lot of information and I know insurance companies can be a pain, but hang in there and give it your all and you have a good chance of being approved for surgery. Best of luck to you.
Topic: RE: First period after RNY!!!
My period came the day of surgery (on its own, which is rare enough) which was 3/25. I got it AGAIN on 4/24 and AGAIN on 5/22. I was thrilled, too, so I can relate. 
I can't tell you the last time I had two periods in a row, let alone 3!!! I am starting to think things are getting back to "normal." I have had PCOS and messed up cycles since I was 13. Now at 35 (36 tomorrow) I am feeling like I might be on the track to regular!
Congratulations on your cycle!!
Rebecca
I can't tell you the last time I had two periods in a row, let alone 3!!! I am starting to think things are getting back to "normal." I have had PCOS and messed up cycles since I was 13. Now at 35 (36 tomorrow) I am feeling like I might be on the track to regular!
Congratulations on your cycle!!
Rebecca
We are perfect examples of imperfection. So we ARE perfect!!
Topic: RE: a little frustrated, and confused - suggestions?
Hi,
I had to go through 6 monthly weigh ins and keep and activity and food log with my primary doctor before I could do my education day with my WL surgeon and my Psych eval. The whole process took about a year and a half but even though it was frustrating at times, it was so worth it in the end and I would do it all again if I had to. Hope this helps you decide if it's for you. Just remember that this surgery is not an easy fix for weight loss. It is just a tool and you will need to work at it the rest of your life to maintain the weight loss.
I had to go through 6 monthly weigh ins and keep and activity and food log with my primary doctor before I could do my education day with my WL surgeon and my Psych eval. The whole process took about a year and a half but even though it was frustrating at times, it was so worth it in the end and I would do it all again if I had to. Hope this helps you decide if it's for you. Just remember that this surgery is not an easy fix for weight loss. It is just a tool and you will need to work at it the rest of your life to maintain the weight loss.
Topic: RE: Hi everyone (newbie here)
Hi Tanya, I see your surgery date is tomorrow - good luck! This is my first time on the PCOS forum, I've been on the main forum and the RNY forum quite a bit. Just remember, they recommend you wait for awhile (one year?) after having surgery before you try to get pregnant so you'll want to use some sort of birth control for awhile. Anyway, best of luck and let us know how you made out when you're able to.
Meg
Meg
Topic: a little frustrated, and confused - suggestions?
hello. I was told quite a while ago that I have PCOS.
I am really overweight. I have been overweight for quite some time (and am tired of it), I think since I was in my early 20's. My doctor told me that I am about 80lbs overweight now. I am fairly active for an overweight person, and probably like everyone else, I have tried every diet known on earth and despite not cheating, I have had no positive results. My obgyn(who did tests and diagnosed me with pcos) has told me that I need to have wls or I will get diabetes (he did sugar tests).
To make a long story short, there are 2 woman at work that have had great success with wls (i don't know if they had pcos) and they have been telling me all the positive aspects of wls. After considering a lot of this, and listening to them, I finally decided I want to do it.
Here's where the frustration kicks in.. my insurance. I have finally psyched myself up to get started with this process, then my insurance tells me that they wont pay for me to have the surgery unless I do a Dr. monitored weight loss program for 6-9 months to prove I cant lose weight. Why am I frustrated? Well, my obgyn already told me that I cannot lose weight, nor will I without surgery. I am on a budget, and the insurance wants me to pay to be on a an expensive diet that will do nothing for me. Did you all have to do the same thing? Is it just my stupid insurance? (its a very costly PPO program btw) I was psyched to do this, and was shot down. I am not trying to get pregnant or anything.. I just want to lose weight.
any comments are appreciated.
I am really overweight. I have been overweight for quite some time (and am tired of it), I think since I was in my early 20's. My doctor told me that I am about 80lbs overweight now. I am fairly active for an overweight person, and probably like everyone else, I have tried every diet known on earth and despite not cheating, I have had no positive results. My obgyn(who did tests and diagnosed me with pcos) has told me that I need to have wls or I will get diabetes (he did sugar tests).
To make a long story short, there are 2 woman at work that have had great success with wls (i don't know if they had pcos) and they have been telling me all the positive aspects of wls. After considering a lot of this, and listening to them, I finally decided I want to do it.
Here's where the frustration kicks in.. my insurance. I have finally psyched myself up to get started with this process, then my insurance tells me that they wont pay for me to have the surgery unless I do a Dr. monitored weight loss program for 6-9 months to prove I cant lose weight. Why am I frustrated? Well, my obgyn already told me that I cannot lose weight, nor will I without surgery. I am on a budget, and the insurance wants me to pay to be on a an expensive diet that will do nothing for me. Did you all have to do the same thing? Is it just my stupid insurance? (its a very costly PPO program btw) I was psyched to do this, and was shot down. I am not trying to get pregnant or anything.. I just want to lose weight.
any comments are appreciated.
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