DENIED...AND IT IS BS!!!

I wasn't going to put my 2 cents worth in but I see that the poster had been a member here since 8-2005 so she should have picked up information regarding pre op diets and requirements for surgery. It is a shame that some doctor's practices are so worthless that people have to go online to get advice. On the other hand a lot of time is spent trying to help someone only to find out later that they haven't given us all the facts, and I'm not accusing this person but it happens all the time. It is just my opinion and anyone can pooh pooh it if you want to:
1. A 1 or 2 week pre op diet is not sufficient. If you are obese enough that you qualify for WLS then you need a longer period of proper dieting to reduce the fat in your liver for a safer and easier operation.
2. It gives you a longer time to prepare yourself and adjust to less food intake.
3. It allows time for making a commitment to future requirements.
4. It gives you a head start into exercising and getting ready for surgery.

If the first doctor that you see doesn't have the nutritional support and full disclosure on what you're getting into then find another doctor. In all honesty, I didn't grasp this initially either but I know now. There are no shortcuts here.

 That is why I deleted the post so I would stop getting
Responses. But since you did,  - I know that lots of surgeons require a plan but mine did not. So I, personally, made the mistake of not focusing on the scale. I have said
I have done many things to prep. I was reweighed yesterday and
Lost 6 pounds and am within thei guidelines. It was a bad time to weigh. The nutritionist APOLOGIZED to me that we were more focused on slowing down meals, eating and not drinking and fluids rather than maintenance. 

 Sherrie is there an appeal process?  Or can you start over with the insurance's approval/pre-op process?  I hope that you find a way to get through this.  In the meantime, know that there are perfect strangers (like me), rooting for you!


Be encouraged!


Deb

Thanks Deb - and yes, my Doc is doing a peer-to-peer review this morning to get the decision overturned. My original post had that in there. I was trying to vent out all the nonsense and then got some responses that upset me.  Trying not to get in a flame war with people I don't even know - I deleted post.

I fully admit that it was my fault that I gained weight.  I admit that I was not focusing on the scale, but other behaviors.  My doctor/nutritionist did NOT give me a diet plan to follow, which is why it made me so mad the stupid insurance denied me for non-compliance.

YES YES YES I have read and I do understand that weight loss before surgery is a good thing, I never denied that.  I had 2 summer vacations right before my pre-op, one a cruise .. and forgive me for enjoying something I paid thousands of dollars for.  YES .. I realize that is why I am fat.  I realize I have to change my eating habits.  I get all that and had someone looked at me and said, "this is YOUR diet and YOU have to lose weight before you pre-op" I would have done it.  NO WHERE in the BCBS guidelines for my surgery did it say "comply with pre-op eating plan."  So that is why I called BS on it.  I know this surgery is a tool.  The Lapband was a tool.  I ate on point with it and threw up all the time, had horrid reflux and it was the worst 4 years of my life (the time it was filled).

Thanks for your encouragement!!

1 - the member date doesn't have to mean anything.  mine says i have been a member forever.  i signed up YEARS ago to ask one question and didn't come back for years.

2 - i call BS on the liver shrinking thing.  not every doctor requires it - mine doesn't, LOTS don't.  so dont assume it's standard procedure or that it's necessary.  i had a fatty liver - almost all obese people do.  some surgeons can work around it without an issue.


Dude - why can't people just let her vent. 

I'm sorry you got denied. I know this won't make you feel any better but the surgery is just one tool.  One year ago I started my "diet" to comply with the program's requirements.  Just changing what I ate I lost 10lbs in one month. I ate what they told me.  That is as much as I lost per month since my surgery.  I had lost 32lbs in 3 months prior to the surgery and only 68 since the surgery.  What I have realized is the only real things this surgery did for me was 1) make my stomach a bit smaller and 2) the malabsorbion.  Those two things alone won't get me or keep me thin. 

The rest of it is up to me.  I have a steel drum stomach. I can eat EVERYTHING and not suffer adverse effects. I don't dump. I can eat pretty much everything I could before. Meats, breads, sweets...you name it I can eat it.  Although I have not yet tried soda and vow to never again.  So since my stomach can handle all food its up to me to manage my weight myself.  I struggle with this every day. Today I was really good but not perfect. But I'm not going to give up. 

Try the mindset that you have had the surgery. Then petition the insurance company to reconsider you.  Good Luck and I'm sorry it didn't get approved.

Not in reference to the opening post, however, there are many situations where the following happens:

1. Perhaps, the required information isn't shared.
2. Perhaps, the person being given the information isn't focused (not listening, distracted).
3. Perhaps, there is a lot of information being given and only part of it is recalled.
4. Perhaps, there are reading materials to be reviewed and they aren't.

Again, I don't know what happened in this situation. This same thing can occur with side effects or complications. While it may be reviewed, you don't expect to happen and it is shocking if it does.

It may be that you may have another opportunity. Best Wishes for your success, in whatever form it takes.

I just wanted to say, I didn't have a pre-op plan either. My Dr. didn't require a 3 month,2 month or even a 2 week diet. Many people in my group had last hurrahs before surgery and I'm sure we all gained a few pounds(not saying you did, as I can't see the original post but that's how it was in my group)

I'm sorry you're going thru all this and hope you get approved.