06/01/07

Jun 02, 2007

Well today I went to see my PCP to tell her what is going on and see what she thinks she can do to help my situation.   Since the reason I am being told I am denied is because not enough information in my diet reports.   
My PCP said that she will get a letter out (should have it done by tuesday) that states everything, so we will see.

We started my 6 month diet over... arrgghhh today also since I might have to do that too.  My PCP made sure to write all kinds of stuff in my file, so their will be nothing about not having enough information.  She still thinks it is a crock of crap to do the diet... LOL.. but she understands the reasoning.

I am still not confident that my PCP writting the letter or anything else will help, so I am not getting my hopes up.  My life seems to go like that, I have to fight for everything I want.  Ho Hum, poor me... LOL

That is all for now.
ME

05/31/07

May 31, 2007

Well today started out as a good day.  I weighed in at 387.0 (down 8 pounds)...whooohooo

I called the insurance company just to see if they got my paperwork and yes they did... whooohooo 

BUT... 

This afternoon I get a call from the surgeons office stating that I am DENIED!!!!!   How can they deny me... I am fat, I have jumped thru their hoops, everything was sent in.  Well Valerie from Dr Avara's office couldnt get any information from them, so I told her that I would call.

So I call the Insurance (BC/BS of IL) and ask them what is up, why was I denied... well I get a real bitch of a customer service girl... she said you didnt do a 6 month supervised weightloss program... Well yes I did and it was turned in... so she puts me on hold to find it... of course it is there.   Then she said we need alot more information than this... we need to know what you ate everyday and when you excercised and what you did and how many calories did you burn.. etc..etc
I let he know that I have that information on my computer I can print it out and send it to her, but each month is 45 pages long (ProTrack Software), so that would be over 250 pages... 
Then she starts back tracking telling me she needs everything and why didnt my doctor adjust my diet if it wasnt working during that 6 months.  blah blah blah... I only lost 7 pounds in 6 months... alot of the months I stayed the same weight.

So then I hang up on her and call Valerie back and let her know what is going on and she just cant believe it.. She said my forms were perfect, they even took my information out and gave it to other patients who needed things to bring to their doctors.   (thanks to whoever gave me the form to start with).   So Valerie said to call my PCP (who did my diet) and see if I can get more information from her.

I called to talk to my PCP today and they make you get an appointment you cant talk to her, and her nurse has the sympathy of an ant.  SO I am being squeezed in tomorrow at 11:45.
So I started working on another form that will have all the information on it, without being 45 pages long... well I work on it for 1.5 hours till I get a bug up my butt and want to talk to the insurance people again.

So I call the insurance company again, hoping to get another person... which I do.  This lady is actually nice, even gave me her extension and all to get back with her again (we will see if it is a real number next time I call... LOL)
This lady says that they dont need or want all my food, but want more information about my diet and why my doctor didnt notate anything about changing it all up when it wasnt working.  arrgghhh   But she also told me that my surgeons office has requested a Peer to Peer Review.  So she wants me to wait and not do anything till we see what comes from that.  She was also hinting that if it is still denied that I will probably have to do the 6 month diet again!!!!!  That way my doctor can make changes to my diet if it isnt working... OMG
SO if that does happen I will be dieting till end of November, then everything goes to insurance, then if they do approve it that would be end of December or early January..  My insurance changes (open enrollment, insurance changes every year) on January 1st... so no time for surgery.   and I bet the company decides to take WLS off the policy.

So I waited till 10PM to eat dinner (bad move) because if I went in the kitchen I would have cleaned out the cabinets.  The only real reason I ate was because hubby was yelling at me to eat dinner.  I went to taco bell and got two cheese quesadilla's  they sounded better than they were, and gosh too many calories... almost 1000 in those two.  Even though I am still at 1200 something calories for today, I still feel like a big fat failure.

I hope your day went much better than mine.  :-)

05/29/07

May 29, 2007

Well I weighed in today and I am at 390.0, so 5 pounds down in a week... not too shabby.  Only 15+ pounds to loose before surgery... LOL

I lost my voice today which made working (since I talk on the phone all day) very hard... had to get rid of most of my hours.

Daniel and I have been very very lazy today... we really need to get atleast one thing accomplished today... LOL  I think our entire week will be like this... LOL

The battery in my car died last night... (fun fun) so we are stuck at home... which is probably a good thing since gas is hugely expensive and it is raining today.

I am kinda getting worried that I wont loose the required amount of weight before surgery and Dr Avara will tell me NO.  I know that there will be a liquid diet right before surgery and I know I will loose weight withat , but you never know.  

I think that is about it for today...  :-)

05/28/07

May 27, 2007

Well I am down some more... 

This morning when I weighed in I was at 389.0... down 6 pounds since my consult... Tomorrow will be my official weigh in, since my consult was on a tuesday.

Everything is going pretty good... I am going to call insurance on Friday, to make sure they have everything... I was going to call on Wednesday... but since there was a holiday in there I figured I will give them an extra day or two... LOL (nice of me huh).

Nothing else exciting going on.. just working.


5/24/07

May 23, 2007

Well I think my diet is working... LOL
This morning when I weighed in I was 392.5  WHOOOHOOOO

I will write my diet down later today....

5/23/07

May 23, 2007

Well folks, I need to be accountable to someone for my eating, so I make sure to loose the 20-25 pounds that Dr Avara is requesting.   So at the end of the day I will write down my food for you all… J  You don’t have to read if you don’t want to… LOL

5/23/07 - Weight 395
Breakfast:
1 slice toast, peanut butter, yogurt, apple juice
Lunch:
2 slice toast, tuna salad, diet ocean spray drink
Snack:
Cottage cheese, peaches
Dinner:
4 oz salmon, broccoli w/cheese
Snack:
S
ugar Free Jell-O

So today my totals looked like this… 
Calories = 1050
Fat = 28
Carbs = 131
Protein = 70
Fiber = 11
Sugar = 76

The bread I am using for toast (until I run out) is Bunny Bread, so that isn’t the best choice.  The yogurt I have is the Activia yogurt so that can be better too… LOL  But this  girl has to use up all the groceries so I can buy more… LOL

 


5/22/07

May 22, 2007

Hi everyone,  
I had a great consult today with Dr Avara and his staff… the only crappy part is that he is asking me to loose 20-25 pounds before surgery…arrgghhh  

I have my last PCP appt on Friday so I will run that last piece of paperwork over to Dr Avara’s office and they will submit my stuff to insurance on Friday… they told me to call on Monday to make sure it was received… OMG can you believe it is this close already….   They said I could hear back from the insurance company in 2 weeks (they are diligent) or the insurance company could take up to 60 days (being a butt head)… so I told hubby, who is stressing about my surgery since it is getting closer and he has lots of work to do at work that they said it could take up to 60 days… so in his head it is 60 days… LOL   I know that I can get Michele to help with Daniel so that will be handled… Chuck might have to take a couple days off work or just work from home… so I don’t see the big deal… but Chuck is a worrier.  
I guess I need to start dieting now, so I will work on that today (figuring out what to eat and when), think I will do a modified liquid diet… LOL… since they don’t want you to do full liquids yet since I don’t have my surgery scheduled yet… I don’t want to gain weight.

Dr Avara said that they sent their first patient home on Friday without having surgery.  This guy gained like 15 pounds before surgery and they tried to do the surgery and they couldn’t move his liver enough to do the surgery.  The fat in his liver made it like cement, so he told me to loose my weight so they wont have to send me home.  The nurses there said that he is getting more serious about the weight loss before hand.  

I weighed in at 395 (did I say that out loud..arrgghh) and a BMI of 56.7 (arrgghh) which is what my scaled weighed me at this morning, so that is good to know.  My PCP scale is atleast 4-5 pounds heavier each time.   I asked Dr Avara what was a reasonable goal for me to aspire to, then he asked me what weight I wanted to get to (he was pushing for 200 pounds… LOL) I said how about 190lbs.. he said that was a good goal and it will take some hard work but I should be able to get there.  WHOOOHOOOO… I will eventually be in wONEderland… LOL  

Well I am going to go research vitamins and protein and my diet..  I hope everyone had a great day.  

Susan 


5/9/07

May 09, 2007

Not much exciting going on here.. just impatiently waiting for time to pass... LOL

I have everything ready for my appt with the Dr Avara, copies of everything.  

I have been wondering if Dr Avara has you do a liquid diet, and if he is type specific (Optifast etc).  I know I will find out on the 25th at my appt but I just like to be prepared and shop around for great prices.

That is about it... gotta get back to work.

4/26/06

Apr 26, 2007

Well today was my PCP visit for my diet.
I have one more left and my medically supervised weightloss will be over...whooohooo

My last PCP appt is May 25th @ 9:15am 

I have my consult with Dr Avara for May 22nd @ 8:00am, they say it lasts for 3.5 hours... WOW

I am excited to finally get the ball rolling.. everyone pray that it is all smooth sailing with insurance and all.

Oh Yeah... my twin sister (michelemcd) is having her surgery on Monday (4/30/07)

Have a great day.
Susan

3/27/07

Mar 27, 2007

WOW it has been a long time since I have posted.... sorry :-(

Not much exciting going on here... 

I did have my Psych Evaluation and that went pretty well, before I took the billion question test, she stated that I was a good candidate for surgery.  Also, if my test and our discussion differed she would call me in to talk about everything.  So far no call, so I guess it went well.

Tomorrow (3/28) I have and appt with my PCP for my 6 month diet... havent lost any weight to speak of.

That is about it for now... happy day
Susan

About Me
DIberville, MS
Location
34.9
BMI
RNY
Surgery
07/31/2007
Surgery Date
Nov 24, 2003
Member Since

Friends 28

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