Guest guest Posted September 1, 2001 Report Share Posted September 1, 2001 I couldn't say if they'll go for it. I think they are going to chalenge you though. A BMI of 45 is not very high, and you don't have any serious co-morbidities. Also, the pain of recovery doesn't get a lot of press here, so I will share my observations. This whole process has been extraordinarily painful and uncomfortable. Even with a BMI of 59 and raging co-morbidities, in the past month I have seriously questioned my decision to do it. It's easy to think of the operation as one neat little BPD/DS package, but actually the partial gastrectomy is quite horrific. The pictures don't do it justice. They cut away 9/10ths of your stomach, leaving a tiny " tube " from esophagus to pylorus. And unlike the intestines, the stomach is nerve-filled and oh-so-sensitive. It takes a long time to heal. I am over a month into it, and my main daily concern is still walking on tender-hooks to avoid agravating my stomach. There is a constant overall nausea which sometimes flares into pain. There are a number of other tough aspects to the adjustments you must make, but I would get cramps writing about them all. And this is if all goes well. One of the things that terrifies me now, is the possibility of a complication that will require another operation. I would have to go through the whole damn thing over again! This would include leaks, herniation, etc. These things are NOT RARE! Aside from a long and uncomfortable recovery, this operation also requires life-long nutritional risk, and potential struggle with insurance over payment for special expensive vitamin compounding, which most don't want to cover. I just had to have mine filled, and it's going to cost over $200 per month. I did not have any idea how tough recovery would be, and I wish I had been better prepared. Since my life was truly at stake, I suppose I would have done it anyway, but if there was a way I could have put this off, I would have, knowing what I know now. If my life was not at staks, there's no way I'd have chosen this torment. And my story is a walk in the park compared to people who have had leaks and other common complications. -Sk xxxxxx wrote: > > Re: Cigna PPO > > > Yes, I have Cigna PPO. You have to persist. Keep applying, appealing, > > calling, etc. (Be nice.) I got the feeling they try to weed out all but > > those who are highly motivated and persistent. Fortunately also, my > > doctor and his staff took the fight to Cigna and kept the pressure up. > > All in all, it took about 3 months for me. > > > > Focus on MEDICAL NECESSITY. Specifically list as many co-morbidities as > > possible on the letter of medical necessity, e.g. diabetes, recently > > diagnosed sleep apnea, hypertension, high BMI (super morbid obesity), > > etc. You have to build a very convincing medical case showing compelling > > medical necessity. > > You're confirming a lot of what I've heard before...I appreciate that, even > though I wish it was better news. > > I worry that my co-morbs aren't enough...my BMI is 45 (while high, it's not > 60), i have high cholesterol, high triglycerides, possible sleep apnea > (sleep study is pending...Cigna is giving the sleep study people a hard time > about preapproval), and borderline high blood pressure. Diabetes and > hypertension are in my family history. Do you think that's enough?? Sigh. > > I promise I'll be persistent!! > -- +--------------------------------------------------------------------- -+ | Abolish the IRS!!! 1-800-FAIR-TAX http://www.fairtax.org | | ENCRYPTION IS NOT A CRIME http://www.pgpi.org/ | +--------------------------------------------------------------------- -+ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 1, 2001 Report Share Posted September 1, 2001 > > I did not have any idea how tough recovery would be, and I wish I had > been better prepared. Since my life was truly at stake, I suppose I > would have done it anyway, but if there was a way I could have put > this off, I would have, knowing what I know now. If my life was not at > staks, there's no way I'd have chosen this torment. And my story is a > walk in the park compared to people who have had leaks and other > common complications. > > -Sk > > , I'm so sorry this has been so tough on you. Hang in there, it does get better. The first month is the toughest, then gradually things improve. I too doubted my decision in the first few weeks.. Be Well, Meli Quote Link to comment Share on other sites More sharing options...
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