Tammy McDonald
July 7, 2004
Ihave recieved the 2nd letter from BSBC, they are looking for more information of medically supervised weight loss for the last 12 months which I had already send with my medical records and an excellent letter from my MD. I had been on Meridia for 8 months and after heart palpatations, was taken off and continued seeing my dr continuing with diet and exersice.
I am so frustrated with the "big ins company". I have started on Redux in 1996, did Phen phen, nutri systems on line and Jenny Craig too. How much more do they want. All of these have had some slight success and of course gained it back and more.
Now I have GERD, so bad that sometimes I throw up and High Blood Pressure.
I now need to write a letter to the insurance co to try and state my case.
09-27-04
Received denial letter saying "records submitted do not document the presence of morbid obesity for five years and no documentation of a evaluation from a licenced psychologist to provide evidence that the patient has the ability to understand the risks.
So, I have gathered the 5 yrs paperwork and the lightest I ever was is a 236, so that puts my bmi at 36 with high bp, sleep apnea and gerd. Most of the 5 yrs I was at a bmi of 40 or more.
Hopefully that and having my psych evaluation done, which is tonight, will be the last time I have to go to this pain in the butt insurance company!!!!!! P.S. this was the 5th letter I have received and every time its for a different reason. I have a live person this time and she had said there is nothing else I need to provide.
Pray for me!
10-06-04
Finally! After 5 letters saying no, they have finally approved this procedure for me. I have a 10-20 op date. I need someone to pick me up off the floor. It is just such a weird feeling to have them say yes after all the disappointment.
Now time to get my head together and get on with it.
I am so overwhemled by emotion to start my new life.
****Post Op***** I had a complication due to a large/fatty liver that caused a internal infection and I had to stay for 6 days because I needed IV antibiotics. I had a drain tube for at least 2 weeks and thank God that thing is out.
Pain has been minimal and I really wasn't using the pain meds in the hospital after the first 2-3 days. I am not even using the stuff they sent home with me.
I have lost 26 lbs so far, but that has seemed to slow after the first 2 weeks, I am now 3wks post op
I am getting bored at home, I am walking every day.
The food thing is a pain, trying to figure out what to try. Sometimes I crave some of the old life's food but I am not really hungry, I think that is part of the bordom.
Right now I hope the weight loss continues, its a mind game that I went through all this to loose 26 lbs.
I really want to get back to my old routine with work and getting together with my friends
11-13-04
Not much to report except that I really miss real food. It's hard when my husband is eating fast food at times and things that I miss. And its not like I am hungry. It's all in my head. I feel so not a part of the mainstream! I really wonder if I did the right thing. I am scared sometimes to try things on my list of foods because of the pain it might ensue.
This time now seems to be the hardest, and I thought 6 days in the hospital was going to drive me nuts.
I also want to say to anyone considering this surgery that I felt a little misinformed from all the info I gathered. The surgery is not a cake walk! The people and info kinda poo poo'ed that and just skated to the end result. This is not the easy way out and so far this has been one of the hardest things I have done in my life. With the goal of a healthier future in mind I hope it will be worth it.
12-10-04
Well, 7 weeks out and down 40lbs and drug free, thats right, not one single prescription am I on. I still struggle with eating but it is getting easier. Went to my husbands christmas party and was able to wear a dress I had from 7yrs ago, that was a great feeling. Also getting back to work and into my reg routine is a big help so I am not constantly thinking about diet and what I can and cant do. Dr. Kumar said I am doing fine, a little on the fast side for loosing, but doing ok. I do try some normal foods and find it hard to keep up with the protein.
Also started going to the health club, doing cardio and some weight training, no ab work yet per the Dr. I am proud to report that I wear a 18-20, down from a busting out 24.
Thanksgiving was nice, granted I did all the cooking and none of the eating, but I did'nt seem to miss it.
Until next time....
Tammy 287-259-245
01-12-05
Happy New Year!, and that it is. I feel so much better now that I am off all RX's and have lost 60lbs. I am going to the health club and just got cleared from Dr. Kumar to do abs to addition to the cardio and weight training I have been doing. I am currently 3mos post op.
The first month was the pits and I have to say that it was more mental than physical. I am glad to have gotten thru that part.
Eating out is still a pain, but I eat off of the appitizer menu or have just a side of something.
I feel like I dont eat enough, still doing 3 meals a day and 3 protein a day, but still only about a 1/2 cup per meal.
Going to Mexico on the 29th and I am so exicted to wear clothes that show my new curves that are not fat!, also I wont have to ask for a seat belt extender on the plane. That right there would have made me cry.
Now wearing a 18 and starting to get into 16.
Adios,
Tammy 287-259-245-227
02-09-05 Buenos Dias!
Had a good time in Mexico, I was just loving the idea of not being the fattest woman at the pool, but then again, I have been there and I felt sad for the others. Eating was a challange, but the endless supply of shrimp was a big help on keeping up with the protien. It was wonderful to get into a plane seat and not worry if I would fit or need a belt extender.
What a bummer that I will have to buy all new swimwear for the summer, all the ones I brought were on the verge of being too big.
It was hard to stay hydrated and I got bored with the limited options for fluids, no soda or high sugar juices really narrowed it down.
I just checked my bmi and now I am "obese" vs morbid.
Total since surgery is 70lbs!
Happy Valentine's Day,
Tammy 287-259-245-227-217.
**03-08-05**
Not too much to report but I like to update everytime I have a follow up visit at the DR. I am at a total of 73 lb loss and am doing well.
I need to stop cheating with the carbs, some things I can tolerate and taste sooo good. My focus needs to be on keeping hydrated and getting in my protien.
My surgeon is going to check my blood to make sure my vitamin levels are good especially after my kidney stone episode 2 weeks ago. I thought I saw God!!! That's where the hydration is comming in.
Most foods are going well and keeping away from the sugar is ok for me. I have tried a little salad with raw vegies and that seems to go well.
I went shopping for a bridesmaid's dress I need for November and was able to almost zip up a 16! And those bridal dresses are always sized so small anyway so I was thrilled! I will be in a 14 I am sure by November.
3 mos till my next follow up, so until then or my 199lb mark....
Take Care,
Tammy 287-259-245-227-217-214
09-22-05
It's been quite awhile since my last update because I have been so busy with golf and work and just being able to do so much more! I have since been able to get into that bridesmaid dress without any alterations talk about happy! I don't think it will be taken in because of my belly and chest. I have been naughty about working out because in the summer I would rather be outside doing yard work, golfing or walking my dogs so the "workout" is lacking. My total weight loss is 95 lbs and I feel great. The last 3 mos I really have stalled out and that is because of the carb thing. I could do better but I have trouble since I travel for work and eating out can be tough. Dr Kumar looked at my blood work and my vitamin levels are "perfect" so no B12 injections for me.
I wear a 16 now, in between a L or XL in Misses depending on the cut or manufacturer.
I do think about a tummy tuck and really a breast reduction and lift. I have always been big chested and the 38DD really get in the way. That would be a year or so off.
That's it for now, and yes I am enjoying my new life in onederland!!!
Tammy 287-259-245-227-217-214-192
02-27-06
Long time, no update. Still at 192-190. I am not too worried about it because I am not gaining. I got a new job that makes me wonder from the plan sometimes because it is hard to find things like snacks on the road.
My new years resolution was to gather info on a breast reduction. I made an appointment with Dr. Michelle Bonness on Jan 8th and she submitted for insurance coverage. She had said I was also ready for a tummy tuck but I am not. Both financially and physically. I don't have the time to heal from that with my very physical job which will get very busy this summer. The reduction is not as long of a recovery.
I got approved 1st time for the reduction, she will remove at least 5lbs. My surgery is 03-30-06. I am nervous about the pain. The gastric bypass was really not much at all, but I think I am in for a wake up call with this one.
Going to pliates 2x a week and stepping up the cardio but still no weight loss.
My other resoultion was to drink 2qts of water a day. I think it is helping.
Till next time,
Tammy 287-259-245-227-217-214-192-190
Hospital Reviews
Member Interests:
Click here to see interests of other ObesityHelp members.
Surgeon Info:
Surgeon: Parmod Kumar, M.D.
Insurer Info:
Blue Cross Blue Shield of IL, PPO
1st letter was a denial, not enough information and no medical history of treatment, even though they had paid for Meridia, but after a couple of months I had to stop because of heart palpatations. Have had my MD write a letter and send all my history of monitored weight loss efforts for the last 8 years. Waiting for response from insurance company, they recieved paperwork on 6-14-04, still reviewing as of 07-02-04. As of 07-08-04, even though they have all my medical paperwork and a letter from my Family practice MD, for the last 24 mos, now they are requesting records for any dietary or behavioral modification. My surgeon is going to call to appeal, but they really havent denied me yet. This has been a real frustrating experience and I really have my doubts if I will get approved. They will pay for it one way or another, either with by pass or other surguries to correct troubles caused by weight. 08-03-04, I have written a letter of my history and current health problems and my surgeon is writing another letter to BCBS to try and get me approved one last time. It appears the hang up is that I was on the Meridia for only 8 months not 12, even though I continue to see my DR and follow his diet and exercise recommendations. I really have lost hope and dealing with BCBS is really a joke. 08-31-04, Recieved the reply of my letter and appeal. Continued to be denied. Now they claim that they have no paperwork that I have been morbidly obese for 5 yrs and that there is no psch evaluation. This might be a good thing because I can provide them with both, but it seems that every time that I give them what they want they need something else. Absoulutly a pain in the butt, this has been the most dishearting process I have ever been through. 11-19-04 POST OP I just got one of my EOB's from surgery and they didn't pay for the surgeons work to the tune of 7,300 dollars. I called them and talked to a clown answering the phone and they said I was not approved for this. What a bunch of yo-yos! I told them I am looking at a letter reversing the denial from there offices and they said there is no one there with that name. Duh, its from your medical appeal group and my surgeon called for pre approval to admit me for day of surgery. They will forward this to a technician. She said they will call me. I said when, she said when they have reviewed it. THIS COMPANY IS A REAL PAIN!!! They were fine for the everyday stuff, but after that, it's been a joke.
