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I had the weight loss team at my clinic submit a request for me to have bariatric surgery even though they put in the request that I didn't have a documented BMI of 35 or more for two years.  I knew I'd get turned down (unless someone was just being sloppy in reading the request) and I found out today they faxed the clinic with a denial.  I am appealing.  I can documented weights that put me at 34.56 BMI one year ago - and if you plug in the right height - it would be 35.2.  Then, there is only one weight a year before that.   I have gained and lost so much weight that having been at a BMI in 2007 over 35 was probable even if not noted by a doctor's office visit.
So, I'm writing the appeal letter.  Using these "facts" and adding some sincerity, resolve, commitment.  I know Health Partners isn't a person who cares but maybe somehow I can get the approval I need to get healthier now rather than having to wait another year.
Fingers crossed.
a.

I wonder where I'll be in 18 months?  I wonder if I'll still need this procedure?  That is how long my insurance company wants me to wait because I don't have documented BMI over 35 for 2 years.  In the mean time, I can't let myself just sit at my current weight - or will I?  I liked to be 10,20,30,....60 pounds lighter before that!

Oct. 28th, 2009
 So, I failed.  I can't be approved without a 2 year documented history of BMI that is too high.. though I meet all the other criteria and my BMI is now at least 40.  I can't get approved for another year and a half because of that rule.  Am I disappointed and sad; quite.  I can't be this heavy for that long.  I will have to try again to fight my appetite as I have done over and over and over in the past for the hope of losing a little weight.  Maybe this time I'll do everything so much better....really hard to get up from this depression right now.

I had gotten to the point where approval for surgery appeared certain.  Did the EGD (even the other end, oh boy), the dietitian visit at the clinic and over the phone with Health Partners (4 visits between the two), met the surgeon, took the MMPI, met with the psychologist and everyone said I should be approved.  I even spoke with the RN case manager for the bariatric department who is the "guru" for the health insurance process.  Somehow, no one noticed or noted to check one last thing: did I have a documented BMI of 35 or more for 2 years - the last 2 years - and I don't.  I don't even have a documented weight for 2007.  Weeks of working and I never even should have started the process....  Sad doesn't even begin to cover it.

I'm gradually getting my support system in place by telling people who care about me my hopes for this surgery.  I need to see "how they react" and then wait to see if I get their support.  Isn't it strange that this support is questionable?  I imagine there are other people like me who are afraid to tell some friends because they think that friend will object.  I have one who is a holistict physician and she is VERY tiny - seriously probably weights about 115 lbs, and would think I'm sure that my considering this surgery is too drastic.  I wonder if I will have the courage to say anything to her before hand or not.

Having read more I know I would like to have the gastric sleeve procedure.  I have talked with people but also found this web site most helpful.  My difficulty now is the waiting; waiting to see if my insurance will approve coverage.  My knees hurt, I can't move as well as I remember I used to be able to, my ability to down stairs is worse (the knees), I am embarassed to look at current pictures of myself.  I don't feel that heavy when I am focusing on other things but then I'm reminded when I walk by a mirror or have to pick out clothes.  I hope my case will be submitted soon.  I went through the self baring process of the MMPI today.  Although I knew I was mentally ready, it was nice that the psychololgist agreed and didn't tell me I wasn't "proper material" from the mental health standpoint.  How frustrating to have to be so investigated, have your privacy taken away, and yet not really know yet if you will even get the "tool" you need to feel better physically.  I'm working to stay positive.

I'm learning about the procedures, have started the process of getting insurance approval, meeting with a dietician and surgeon etc  I think that the newer "sleeve" procedure is the choice I willmake.  Sometimes though I wonder if the more traditional bypass procedure is more effective.  Looking forward to reading about other people's experiences.