knitterme
Journaling my weight loss
Apr 22, 2009
3 mos supervised diet (pre-op) = 22
Month 1 = 15
Month 2 = 15
Month 3 = 10
Month 4 = 6
Month 5 = 7
Month 6 =
Things are going real well. I have my 6 mos appt w/Dr. Lalor in a couple of weeks. Weight loss is starting to slow down. I have Bursitus in my right hip and am getting physical therapy. It seems to be helping. It is impossible to exercise as every time I do the pain gets worse in my hip. My PCP also put my on Vicodin for monthly menstral cramps. I've always had cramps, but not like this!! They seem to be helping. That's all for now.
Dianne
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Month 1 = 15
Month 2 = 15
Month 3 = 10
Month 4 = 6
Month 5 = 7
Month 6 =
Things are going real well. I have my 6 mos appt w/Dr. Lalor in a couple of weeks. Weight loss is starting to slow down. I have Bursitus in my right hip and am getting physical therapy. It seems to be helping. It is impossible to exercise as every time I do the pain gets worse in my hip. My PCP also put my on Vicodin for monthly menstral cramps. I've always had cramps, but not like this!! They seem to be helping. That's all for now.
Dianne
4 Months out - Lost 68 lbs
Mar 10, 2009
March 2009 The 68 lbs is a total from day 1 of summer of 2008. I'm down to 195 lbs and in a loose size 18 /tight size 16. I'm feeling really good except some joints are hurting. I think it's because my center of gravity is off with all of this weight loss. My right hip and my left knee and the insides of my legs hurt pretty often. I have a script to go get physical therapy, I just don't want to go just yet as the pain keeps shifting. I may try to take some Tylenol to see if that helps. Greg tells me how beautiful I look and I'm actually starting to feel it myself. I'm eating all the things I should eat and am recording it on MyPlate.com. I exercise, but not as much/often as I should. My sugar diabetes is pretty much cured. I still take 4 mg of Avandia daily, and my sugars run about 100 in the am. I will continue to take Avandia until I see what my 6 mos visit bloodword reports. Hopefully my A1C will be a good number and they will take me off of it. All in all this has been one of the best things that has ever happened to me! Thank you God!
Dianne
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Dianne
Home from surgery....feeling great! 11/8/2008
Nov 08, 2008
I got home on Friday and I've been doing very well. I've been resting, sipping and just enjoying my family. Last night I slept so well on the sofa. I had weird dreams about the Grinch who stole Christmas. Well, he was stealing at a mall, then he started chasing Santa Clause. weird.
Today was the first day of the liquid diet and all is going down good. It felt wonderful to take a shower. I haven't had any pain meds today. I took some yesterday but only because my back hurt so badly. Those lovely hospital beds you know. At any rate, I'm home and doing well. I praise God everyday for Dr. Lalor and what he has done for me to improve my quality of life. Thank you Dr. Lalor for what you do, you are an angel sent from up above.
Dianne
Today was the first day of the liquid diet and all is going down good. It felt wonderful to take a shower. I haven't had any pain meds today. I took some yesterday but only because my back hurt so badly. Those lovely hospital beds you know. At any rate, I'm home and doing well. I praise God everyday for Dr. Lalor and what he has done for me to improve my quality of life. Thank you Dr. Lalor for what you do, you are an angel sent from up above.
Dianne
I HAVE A DATE
Oct 22, 2008
It's November 4, 2008. yea! I'm happy knowing I'm on my way to a better me. No more diabetes, no more worry that I will end up with 16 surgeries like my dad had. I am truely blessed!
RNY instead of Sleeve.........October 20, 2008
Oct 20, 2008
Well, Aetna has officially denied me for the sleeve gastrectomy. I talked to my surgeon on Friday via phone and his recomendation was to get the RNY. He said with my diabetes and reflux that it would be a better surgery to delete those two things from my system. After researching the surgery and talking with my husband I have to say that I am happy with my choice. I called the surgeon's office today to get the ball rolling. I know Aetna covers the RNY, so it shouldn't take as long to get approval. Now I feel like I'm going through the 'nesting' phase. (you know, like when you're pregnant) I am running around trying to get my house in order. I need to get the kids' summer clothing put away and get their winter stuff out. I need to clean the humidifiers and get them set up. I need to get an old recliner out of our front room and make more room. I have a ton of stuff to haul to the Goodwill. Wish me luck as I also have a baby sweater to knit for Dr. Lalor and his wife.
Dianne
Dianne
Denied .............10/8/2008
Oct 09, 2008
When I called the Care Advocate Team at Atena and asked Matthew why I was denied he said, "I met the criteria, but the procedure is shown to be experimental. The Physician can do a different procedure." I told him that back in July I was told by Liz that the sleeve is covered. And in their booklet it shows the code as a covered surgery. He didn't understand it either. So I got a hold of Heather Ingram (Phone 330-659-8658). She said that the requested procedure is inadequate (????) but they do cover RNY, Lap banding, and DS. I said that if you cover the DS you should cover the sleeve as it is the first of two surgeries. She said that I should have my surgeon talk to the Medical Director at Aetna. I called Lalor's office and talked to the nurse, Deb Dawley. She is going to talk to Dr. Lalor about a peer to peer review, where Lalor and the medical director have a phone meeting. So, I'm waiting to see when that will be scheduled. I'm about sick to my stomach about all of this. Also, a friend of mine was in a car accident Sunday night. Both of her parents were killed in the accident. She is on my mind constantly and I worry about her. Please pray for her. Thanks!
Dianne
Dianne
Received a call from Aetna........... October 6, 2008
Oct 06, 2008
3:30 pm. Reveiced a call from Heather at Aetna. Dr Lalor is IN THE SYSTEM !!!!!!!!! She said he was 'in the system' effective 8-1-08. 
Lalor's office needs to call 1-888-632-3862 and follow the promps for pre-certification. I said that all my paperwork is already there! She put me on hold for quite a while to go and check. She came back and said that all my clinicals ARE in and they will review them tomorrow. She said I should get a response back this week. Hopefully by Wednesday. They will be calling Dr. Lalor's office to let them know the outcome. Then, Dr. Lalor's office will call me and let me know what was decided.
Dianne
Lalor's office needs to call 1-888-632-3862 and follow the promps for pre-certification. I said that all my paperwork is already there! She put me on hold for quite a while to go and check. She came back and said that all my clinicals ARE in and they will review them tomorrow. She said I should get a response back this week. Hopefully by Wednesday. They will be calling Dr. Lalor's office to let them know the outcome. Then, Dr. Lalor's office will call me and let me know what was decided. Dianne
Not there yet! September 18, 2008
Sep 18, 2008
I just looked at Aetna's doctor's listing and Lalor's name still ins't there. Still waiting..........
Dianne
Dianne
THE WAITING IS THE HARDEST PART Sept 5, 2008
Sep 05, 2008
It's taken me a full day to recover from the news I received from Aetna. Apparently Dr Lalor isn't 'fully credentialed'. Heather from Aenta talked to Kris from Lalor's office and they sent out the paperwork a half hour after the initial phone call telling Lalor's office that he isn't 'fully credentialed'. I"m not sure what exactly that means but Lalors office was afraid they would get penalized for not being 'fully credentialed'. Sooooo, I was told that this process would take another 30 days. 
It seems I haven't waited long enough. So, after Lalor has been 'fully credentialed' and he's 'in the system' they can go ahead with reviewing and hopefully approving my sleeve. Tune in in 30 days. I'm really sad 
right now.
Dianne
It seems I haven't waited long enough. So, after Lalor has been 'fully credentialed' and he's 'in the system' they can go ahead with reviewing and hopefully approving my sleeve. Tune in in 30 days. I'm really sad right now.Dianne
INSURANCE COMPANIES !!! Sept. 3, 2008
Sep 03, 2008
ok. so I'm a little tee-ed off right now. 
I called Aetna and talked to Tara/Cara whatever, and she said they did receive the fax but it was routed to the wrong dept. It should've come Attn: Ruth. She also said they didn't receive the clinicals. Wha? 
Then! she went on to say that Dr. Lalor IS NOT in the network. He is not a participate in the Plan. I thought that had to be hogwash!!!!! So I called Dr. Lalor's office and talked to Kris. She said she will call Heather first thing tomorrow morning. I said it's really more with Aetna now than with Heather as Heather DID send out the fax. Kris at Dr. Lalor's office also said that they ARE in Aetna's network. I thought so!!! This is so rediculous. I am about ready to cry. I have been waiting and waiting and have been compliant with all that I'm supposed to be doing. Then comes along these idiots. 
Hello!!! Does ANY INSURANCE COMPANY KNOW WHAT THEY ARE DOING ???????? DO THEY PURPOSELY TORMENT PEOPLE ?????? IS THAT A PART OF THEIR JOB DESCRIPTION????? I hope Kris will come through for me tomorrow. Tune in then for an update!
Dianne
I called Aetna and talked to Tara/Cara whatever, and she said they did receive the fax but it was routed to the wrong dept. It should've come Attn: Ruth. She also said they didn't receive the clinicals. Wha? Then! she went on to say that Dr. Lalor IS NOT in the network. He is not a participate in the Plan. I thought that had to be hogwash!!!!! So I called Dr. Lalor's office and talked to Kris. She said she will call Heather first thing tomorrow morning. I said it's really more with Aetna now than with Heather as Heather DID send out the fax. Kris at Dr. Lalor's office also said that they ARE in Aetna's network. I thought so!!! This is so rediculous. I am about ready to cry. I have been waiting and waiting and have been compliant with all that I'm supposed to be doing. Then comes along these idiots. Hello!!! Does ANY INSURANCE COMPANY KNOW WHAT THEY ARE DOING ???????? DO THEY PURPOSELY TORMENT PEOPLE ?????? IS THAT A PART OF THEIR JOB DESCRIPTION????? I hope Kris will come through for me tomorrow. Tune in then for an update! Dianne
About Me
Bowling Green, OH
Location
29.9
BMI
Surgery
11/04/2008
Surgery Date
Surgeon
Jun 03, 2008
Member Since
