Re: I'm ok

[Guest guest]

glad you made it through the presentation. sorry things weren't as you had

been told. i know 2 people that just had gastric bypass. one has lost 50 lbs

in about 6 weeks. she has tried to eat and been real sick. she told me during

her hospital stay that she would have never chosen to do this again. it was

very painful. i think she is in early 30's and healthier than all of us. for

me i've just try to make healthier choices each time i put something in. i'm

gonna try to do sit and be fit after my son returns to school again. i need

to keep moving. rest my friend. you had a very stressful week. kathy in il

[Guest guest]

So sorry to hear that you weren't offered even a consult, Tess. It's

hard for me to understand why they would put you through all of this

given their reasoning for the denial.

I'm glad you saw a glimmer of the old you shine through though. That's a

huge positive!

Rest well,

[ ] I'm ok

> Hi All...well, at least it's over. There is no way they will approve

a

> consult, let alone surgery. There were NINE people, and me. They had

> folks from the business end of things to a nurse and a doctor. They

> were very nice, not at all condescending.

>

> They say their statistics show a much higher rate of complications and

> for a much longer time than what are posted at the weight loss surgery

> sites. They also said the mortality rate is 4 of 100, not 1 of a 100

as

> the weight loss surgery sites state. There are no long term (minimum

5

> year) studies of the surgeries that are used now.

>

> Their rules state that they can only consider weight loss surgery in

the

> event that the patient is in imminent threat of death, and then it

> depends on what illnesses you have and if there is a reasonable chance

> of survival.

>

> So..................for now, I am just going to try to keep improving

my

> habits...eating better and moving more. I will need to think about

> whether I am better served fighting for the surgery, or putting that

> energy into other ways of dealing with this.

>

> One thing I saw...there was a SPARK of the me who is good at public

> speaking, performing, sharing. I thought it might be gone forever,

but

> it's not. Maybe there will be a book tour.

>

> I'm pooped.

>

> Love....

>

> Tess

[Guest guest]

Tess,

I¹m glad you¹re ok. After reading all of the adhesion problems that Debs

and Lynn are going through, this may be a blessing. I hope you use your

energy to devise a plan of attack and can loose the weight safely. Maybe

they will pay for a dietician???

I hope you don¹t loose that spark! There are many things you can do to put

it to good use.

Hugs,

a

[Guest guest]

Hi a...I had an " exploded " appendix when I was 13 and have had

surgery for the adhesions years ago. If I can avoid surgery, I will. I

am a spunky, tenacious little thing under all the moodiess - both sad &

silly. I won't quit trying to have better health & a better life.

Love & Hope...

Tess

[Guest guest]

So sorry that they turned you down -

Kathe in CA

__________________________________________________

[Guest guest]

Thank you, Kathe. I really am ok. I think I am so grateful that stress

is over, and I didn't believe there was much of a chance. But I did

need to try.

Love...

Tess

[Guest guest]

AH Tess...I am so sorry.....I was so hoping it would

go your way as you seemed so excited about it.....I

wish I could offer you the one my husband turned down

......hugs to you dear Tess.....Kathi in OK

--- Tess_St_Pierre@... wrote:

> Hi All...well, at least it's over. There is no way

> they will approve a

> consult, let alone surgery. There were NINE people,

> and me. They had

> folks from the business end of things to a nurse and

> a doctor. They

> were very nice, not at all condescending.

>

> They say their statistics show a much higher rate of

> complications and

> for a much longer time than what are posted at the

> weight loss surgery

> sites. They also said the mortality rate is 4 of

> 100, not 1 of a 100 as

> the weight loss surgery sites state. There are no

> long term (minimum 5

> year) studies of the surgeries that are used now.

>

> Their rules state that they can only consider weight

> loss surgery in the

> event that the patient is in imminent threat of

> death, and then it

> depends on what illnesses you have and if there is a

> reasonable chance

> of survival.

>

> So..................for now, I am just going to try

> to keep improving my

> habits...eating better and moving more. I will need

> to think about

> whether I am better served fighting for the surgery,

> or putting that

> energy into other ways of dealing with this.

>

> One thing I saw...there was a SPARK of the me who is

> good at public

> speaking, performing, sharing. I thought it might

> be gone forever, but

> it's not. Maybe there will be a book tour.

>

> I'm pooped.

>

> Love....

>

> Tess

>

>

__________________________________________________

[Guest guest]

Hey Kathi...pick myself up...dust myself off...start all over again! I

really am ok...I had a few hard moments and may have a few more.

Have you ever seen " Shawshank Redemption? " There's a particularly

intense & wonderful scene where Tim Robbins (sheesh - I hope thats

right!) character knows he has to either choose to live, or curl up and

die. He chooses to live. So do I.

Love You, My Okie Buddy...

Tess

[Guest guest]

You go girl....besides WE need you...love to you

Tess....Kathi in OK

--- Tess_St_Pierre@... wrote:

> Hey Kathi...pick myself up...dust myself off...start

> all over again! I

> really am ok...I had a few hard moments and may have

> a few more.

>

> Have you ever seen " Shawshank Redemption? " There's

> a particularly

> intense & wonderful scene where Tim Robbins (sheesh

> - I hope thats

> right!) character knows he has to either choose to

> live, or curl up and

> die. He chooses to live. So do I.

>

> Love You, My Okie Buddy...

>

> Tess

>

>

__________________________________________________

[Guest guest]

Oh Tess, I'm SO sorry that things didn't work out the way you had hoped.

Sometimes our prayers aren't answered exactly the way we wish, but maybe

that's because the surgery wouldn't have been good for you. A one in 25

chance of death is incredibly risky.

I'm so glad you were aware of that spark yesterday. Keep nurturing it and

it will again be a flame, my friend. We're looking forward to seeing you on

the book tour!

Love and hugs,

Carol

[ ] I'm ok

Hi All...well, at least it's over. There is no way they will approve a

consult, let alone surgery. There were NINE people, and me. They had

folks from the business end of things to a nurse and a doctor. They

were very nice, not at all condescending.

They say their statistics show a much higher rate of complications and

for a much longer time than what are posted at the weight loss surgery

sites. They also said the mortality rate is 4 of 100, not 1 of a 100 as

the weight loss surgery sites state. There are no long term (minimum 5

year) studies of the surgeries that are used now.

Their rules state that they can only consider weight loss surgery in the

event that the patient is in imminent threat of death, and then it

depends on what illnesses you have and if there is a reasonable chance

of survival.

So..................for now, I am just going to try to keep improving my

habits...eating better and moving more. I will need to think about

whether I am better served fighting for the surgery, or putting that

energy into other ways of dealing with this.

One thing I saw...there was a SPARK of the me who is good at public

speaking, performing, sharing. I thought it might be gone forever, but

it's not. Maybe there will be a book tour.

I'm pooped.

Love....

Tess

[Guest guest]

Tess,

I am so sorry to hear that they will not offer a consult but believe

there are good things in store for you. I will continue to have you

in my thoughts and prayers.

My best to you.

Al in IL

[Guest guest]

Dear Al...thank you...you are a sweetie. I am going to do what I can to

get healthier...there is so much I want to do that I can't right now.

But I will keep hoping.

Hugs & Love...

Tess

[Guest guest]

Dear Carol...Thank you for being there through the ups & downs. I

suppose I might be on a bit of a rollercoaster ride for a few days, but

truly, I want so much to get healhier. I do believe God wants the best

for all of us...including me. So I will keep walking forward, and trust

that He will direct my path.

Hoping...

Tess

[Guest guest]

Tess,

I am so very, very sorry. After you wrote about the gastric bypass surgery,

I read up online and am very interested. I am ~ 100 lbs overweight. I sent

an email to the surgeon who did my last plastic surgery hernia repair to see

if it is even a possibility. I can easily get referrals from my

rheumetologist, pulmonary doctor, internist and probably the surgeon but

never thought I'd have to fight the insurance company.

I had a malignant tumor removed from my kidney last summer by CT guided

radio frequency ablation and the insurance company wouldn't pay because the

said it was experimental. Well they would rather wait a few years to pay

$10,00 to have my kidney removed or worse than pay $1,00 now to get rid of

the tumor while small!

So sorry!

Temple

3 Fox Haven Way

Chelmsford, MA 01824

dat2352@...

[Guest guest]

Thanks Tess. So are you. Take care.

Much love,

Al in IL

> Dear Al...thank you...you are a sweetie. I am going to do what I

can to

> get healthier...there is so much I want to do that I can't right

now.

> But I will keep hoping.

>

> Hugs & Love...

>

> Tess

[Guest guest]

Dear ...thank you for your kindness. I'm so sorry you have gone

through so much.

My insurance is for low-income disabled folks, so it is more restrictive

than some private insurances. You might not have trouble at all getting

approval. Just be sure you study well the types of gastric

bypass...Duodenal Switch, Roux-N-Y, and Lap Band (these are the three

types used the most today - the Lap Band being the one with the least

complications, but a slower loss and the newest, so some surgeons are

just learning it.). It is always best if a person can get the weight

down without surgery, but for some folks the surgery is a life-saver.

Underneath my moody-self, is a spunky person. I will continue to strive

for a healthier life. You all make that easier.

Much Love...

Tess

[Guest guest]

Hi Kathy...you are making some good, healthy decisions...eating better

and moving more. " Sit and Be Fit " is a great program.

Thank you for your kindness & friendship. You are a sweetie.

Much Love...

Tess

[Guest guest]

Hi June...I need to look at it that way...most of the time I do, just

have a few bumps in the road. Thanks for your love & support.

Hugs...

Tess

[Guest guest]

Tess,

I wish things had gone better for you. Maybe there is a reason, why all

this has happened. They say things happen for reasons. I know that is hard to

understand, I can't understand all that has happened to me. I can tell you that

my surgery, taking out most of my stomach is similar to the surgery you wanted.

The after effects are terrible. You can't eat when you want too, you have to

watch everything you eat and still you will get sick. My surgery certainly was

not the same but the part about the smaller stomach is and it is terrible to

deal with. You only hear stories of people who have had it done and all the

weight they have lost. They don't tell you all the side effects. Maybe the

insurance company was just honest about it all. You will figure something out

and it will probably help you.

Lynn (MeMom)

Carol wrote:

> Oh Tess, I'm SO sorry that things didn't work out the way you had hoped.

> Sometimes our prayers aren't answered exactly the way we wish, but maybe

> that's because the surgery wouldn't have been good for you. A one in 25

> chance of death is incredibly risky.

>

> I'm so glad you were aware of that spark yesterday. Keep nurturing it and

> it will again be a flame, my friend. We're looking forward to seeing you on

> the book tour!

>

> Love and hugs,

> Carol

>

> [ ] I'm ok

>

> Hi All...well, at least it's over. There is no way they will approve a

> consult, let alone surgery. There were NINE people, and me. They had

> folks from the business end of things to a nurse and a doctor. They

> were very nice, not at all condescending.

>

> They say their statistics show a much higher rate of complications and

> for a much longer time than what are posted at the weight loss surgery

> sites. They also said the mortality rate is 4 of 100, not 1 of a 100 as

> the weight loss surgery sites state. There are no long term (minimum 5

> year) studies of the surgeries that are used now.

>

> Their rules state that they can only consider weight loss surgery in the

> event that the patient is in imminent threat of death, and then it

> depends on what illnesses you have and if there is a reasonable chance

> of survival.

>

> So..................for now, I am just going to try to keep improving my

> habits...eating better and moving more. I will need to think about

> whether I am better served fighting for the surgery, or putting that

> energy into other ways of dealing with this.

>

> One thing I saw...there was a SPARK of the me who is good at public

> speaking, performing, sharing. I thought it might be gone forever, but

> it's not. Maybe there will be a book tour.

>

> I'm pooped.

>

> Love....

>

> Tess

>

>

[Guest guest]

/Tess,

What kind of insurance companies do you have your medical insurance with?

My employer is self-insured, using BC/BS as a TPA (third party

administrator). We have a PPO arrangement, fortunately have never gone the

HMO route. Several of our insureds have had the bypass surgery with

virtually no hassle from BC/BS.

, how could an insurance company deny coverage of a procedure to

remove a malignancy? Does your insurance company provide the option to

request a medical review to receive benefits outside the contract? Imagine

the expense if the malignancy had been allowed to grow.

Tess,

I'm so sorry you were turned down. I really don't understand the reason.

Is there an appeals review process beyond this group?

My coworker's husband had the bypass surgery a few years ago. He was close

to 500 pounds and in very uncertain health, constantly being admitted to the

hospital for health issues complicated by his obesity. He was truly in

danger of dying from this condition. While I don't remember if he had any

complications from his surgery, he lost a ton of weight after the surgery.

(Maybe 150 pounds?) And his health did a complete turnaround. Then, this

year, he was in a very bad car accident. Another vehicle pulled into his

path and caused his truck to roll over several times. Unfortunately, because

of his size, he didn't like wearing his seat belt and didn't have it on. He

was thrown through the windshield and suffered a number of very serious

injuries. One of the weird side effects he suffered was from the bypass

surgery. He couldn't stop losing weight. For a period of time he was losing

a pound a day. My coworker was quite alarmed. He seems to have finally

stabilized, but I think he may have lost another 50 to 75 pounds as a

result. I haven't seen him yet, but I'll bet he looks vastly different with

that additional weight loss. I know we were all worried for a while that

the surgery was causing some kind of irreversible weight loss complication.

(All I could think of at the time was the King novel " Thinner " .)

As it has been said before, this is a serious surgery one doesn't take on

lightly as the effects last a life time.

Suzanne

Re: [ ] I'm ok

> Tess,

> I am so very, very sorry. After you wrote about the gastric bypass

surgery,

> I read up online and am very interested. I am ~ 100 lbs overweight. I

sent

> an email to the surgeon who did my last plastic surgery hernia repair to

see

> if it is even a possibility. I can easily get referrals from my

> rheumetologist, pulmonary doctor, internist and probably the surgeon but

> never thought I'd have to fight the insurance company.

> I had a malignant tumor removed from my kidney last summer by CT guided

> radio frequency ablation and the insurance company wouldn't pay because

the

> said it was experimental. Well they would rather wait a few years to pay

> $10,00 to have my kidney removed or worse than pay $1,00 now to get rid of

> the tumor while small!

> So sorry!

> Temple

> 3 Fox Haven Way

> Chelmsford, MA 01824

>

> dat2352@...

[Guest guest]

Suzanne,

I know it was crazy but it was not the malignancy removal under question but

the procedure. It was done by CT guided High Frequency Radio Ablation.

Only done in a few hospitals throughout the country, Mass General being one.

My insurance is Blue Cross/ Blue Shield - Blue Choice - a point of Service

policy. Raytheon is also self insured-sounds similar. I had all the

appropriate referrals in place and never imagined this could happen. They

said it was experimental and therefore not covered. It did go through all

the review processes. Mass General ultimately ate the cost. Same thing

happened when my orthopedic surgeon insisted on me donating 2 pints of blood

to be used after surgery. BC will not pay for blood storage and Mass

General said that they absorbed that too.

Temple

3 Fox Haven Way

Chelmsford, MA 01824

dat2352@...