Today

[Guest guest]

Thanks everyone for the support : )

brooke sheilds wrote:But actually you are a

winner in all reality!

.

wrote:

Sorry this is kinda long....

My sister asked me, why do By-pass surgery? She said that everyone loves me for

who I am not what I look like. I began to explain the first reason was my

health, I wanted to be around to continue to watch my children grow and

hopefully see Grandkids one day.

Then I started to explain my other reasons, such as fitting into chairs, events,

just going to a family function and having to make sure you bring your own seat.

I told her it was embarrassing to not be able to sit down and you don't want to

make a big deal of it so you usually come up with an excuse... Like I've been

sitting all day!! You can't take plane rides because you overlap on the next

person's seat or you have to buy two. I explained to her that I want to live

life instead of watching everyone else. I feel like I'm on the sidelines of a

game watching everyone else play this game of life.

However, after I explained this to my sister she understood and said she would

support me. She said she never knew what I was going through and cried.

I look forward for the day that my insurance calls me and lets me know I'm

approved. Right now my insurance is requesting more documentation: Doctor's

notes 3 years show attempts, I need a Psych Eval & Dietician Eval.

I hear all the positives here and it keeps my hopes up everyday. I look forward

to one day when I can be apart of the losing side myself. There are days those I

want to just cry because I know I may have to wait and do another 26 week

program just to proof I am a failure again….that part stinks!

Dora McCary wrote:

That is the very reason I don't go to the Titans games with my husband. He

always asks and I have to explain I just can't do it. Maybe some day.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

[Guest guest]

Oh my goodness.... I can really tell I was upset when I wrote the below

message. The typos were just terrible I'm so embarrassed. Sorry everyone, I

hope you understood my message. Again I'll try to pay closer attention so that

you won't have to sit there and figure out what I'm trying to say!

wrote:

My insurance carrier is PHCS, (Guardian) - I recieved a letter Saturday with

said: " Determination - Non - Certification " which means services are not

recommended for approval per the PHCS physicaian who is PHCS reviewer. But then

it states PHCS is a medical review company and does not determine benefits,

payment or eligibility. The final determination of benefits and payments rest

with my insurance carrier or plan administrator. PHCS reason for non-cert of the

admissions for Morbid Obesity is : The clinical inforamtion does ot support the

requested level of care.

I'm lost??? My coverage under Guardian statest in my benefit book that as long

as I have a BMI 35 and above and have one of the conditions they stated by-pass

surgery would be covered. How can they state that then turn me down? I have

Sleep Apnea with a BMI of 54. Does anyone have any suggestions on what I do now?

They are giving me 180 days to Appeal.

What do I need to do know.. Any suggestions?

Judith wrote:

It's so much easier herein Al. It took a year, but the insurance was very

quick in answering with a big yes (mayhap because I HAD diabetes.

I feel for you because I have been there, but know it is getting better.

Every day a little bit...... Maybe if you start by eating what we have to

eat - so you get used to it.... Maybe you have a YMCA or a pool you can use

to do some low impact exercise until your surgery so your joints won't hurt

so bad; I know mine do. What is your insurance carrier?

Good luck.

JJ

-- RE: Today

Sorry this is kinda long....

My sister asked me, why do By-pass surgery? She said that everyone loves me

for who I am not what I look like. I began to explain the first reason was

my health, I wanted to be around to continue to watch my children grow and

hopefully see Grandkids one day.

Then I started to explain my other reasons, such as fitting into chairs,

events, just going to a family function and having to make sure you bring

your own seat. I told her it was embarrassing to not be able to sit down

and you don't want to make a big deal of it so you usually come up with an

excuse... Like I've been sitting all day!! You can't take plane rides

because you overlap on the next person's seat or you have to buy two. I

explained to her that I want to live life instead of watching everyone else.

I feel like I'm on the sidelines of a game watching everyone else play this

game of life.

However, after I explained this to my sister she understood and said she

would support me. She said she never knew what I was going through and

cried.

I look forward for the day that my insurance calls me and lets me know I'm

approved. Right now my insurance is requesting more documentation: Doctor's

notes 3 years show attempts, I need a Psych Eval & Dietician Eval.

I hear all the positives here and it keeps my hopes up everyday. I look

forward to one day when I can be apart of the losing side myself. There are

days those I want to just cry because I know I may have to wait and do

another 26 week program just to proof I am a failure again….that part

stinks!

Dora McCary wrote:

That is the very reason I don't go to the Titans games with my husband. He

always asks and I have to explain I just can't do it. Maybe some day.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

[Guest guest]

Hi, : I have PHCS too. I had to prove lots of dieting in the past

-- I joined Lindora for six months last year, plus every other diet known to

man. I had to have the psych review, attend nutrition classes and see my

old doctor. I got a date -- In fact, it is next Tuesday the 7th. Just one

week away.

Keep pushing it. Don't let the reviewer dampen your spirits. One thing

that I think kind of helped too -- when they were dragging their feet (In my

opinion), I told them that it would be a shame if I had a stroke or relapse

of cancer that I could trace back to their hesitancy. I told them that I

would have no " hesitancy " sueing the pants off of them for lack of care.

After all, I would have to pay for care after such a catastrophic disease.

I couldn't and wouldn't expect myself or my kids to pay for care for

something they caused. They seemed to work harder on my behalf then or

maybe it was just time.

Keep hanging in there.

Maggie

RE: Today

Sorry this is kinda long....

My sister asked me, why do By-pass surgery? She said that everyone loves me

for who I am not what I look like. I began to explain the first reason was

my health, I wanted to be around to continue to watch my children grow and

hopefully see Grandkids one day.

Then I started to explain my other reasons, such as fitting into chairs,

events, just going to a family function and having to make sure you bring

your own seat. I told her it was embarrassing to not be able to sit down

and you don't want to make a big deal of it so you usually come up with an

excuse... Like I've been sitting all day!! You can't take plane rides

because you overlap on the next person's seat or you have to buy two. I

explained to her that I want to live life instead of watching everyone else.

I feel like I'm on the sidelines of a game watching everyone else play this

game of life.

However, after I explained this to my sister she understood and said she

would support me. She said she never knew what I was going through and

cried.

I look forward for the day that my insurance calls me and lets me know I'm

approved. Right now my insurance is requesting more documentation: Doctor's

notes 3 years show attempts, I need a Psych Eval & Dietician Eval.

I hear all the positives here and it keeps my hopes up everyday. I look

forward to one day when I can be apart of the losing side myself. There are

days those I want to just cry because I know I may have to wait and do

another 26 week program just to proof I am a failure again..that part

stinks!

Dora McCary wrote:

That is the very reason I don't go to the Titans games with my husband. He

always asks and I have to explain I just can't do it. Maybe some day.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

[Guest guest]

Maggie,

Thank your for the advise ~ 've printed it off and will surely use it. Thanks

again

Maggie Cline wrote:

Hi, : I have PHCS too. I had to prove lots of dieting in the past

-- I joined Lindora for six months last year, plus every other diet known to

man. I had to have the psych review, attend nutrition classes and see my

old doctor. I got a date -- In fact, it is next Tuesday the 7th. Just one

week away.

Keep pushing it. Don't let the reviewer dampen your spirits. One thing

that I think kind of helped too -- when they were dragging their feet (In my

opinion), I told them that it would be a shame if I had a stroke or relapse

of cancer that I could trace back to their hesitancy. I told them that I

would have no " hesitancy " sueing the pants off of them for lack of care.

After all, I would have to pay for care after such a catastrophic disease.

I couldn't and wouldn't expect myself or my kids to pay for care for

something they caused. They seemed to work harder on my behalf then or

maybe it was just time.

Keep hanging in there.

Maggie

RE: Today

Sorry this is kinda long....

My sister asked me, why do By-pass surgery? She said that everyone loves me

for who I am not what I look like. I began to explain the first reason was

my health, I wanted to be around to continue to watch my children grow and

hopefully see Grandkids one day.

Then I started to explain my other reasons, such as fitting into chairs,

events, just going to a family function and having to make sure you bring

your own seat. I told her it was embarrassing to not be able to sit down

and you don't want to make a big deal of it so you usually come up with an

excuse... Like I've been sitting all day!! You can't take plane rides

because you overlap on the next person's seat or you have to buy two. I

explained to her that I want to live life instead of watching everyone else.

I feel like I'm on the sidelines of a game watching everyone else play this

game of life.

However, after I explained this to my sister she understood and said she

would support me. She said she never knew what I was going through and

cried.

I look forward for the day that my insurance calls me and lets me know I'm

approved. Right now my insurance is requesting more documentation: Doctor's

notes 3 years show attempts, I need a Psych Eval & Dietician Eval.

I hear all the positives here and it keeps my hopes up everyday. I look

forward to one day when I can be apart of the losing side myself. There are

days those I want to just cry because I know I may have to wait and do

another 26 week program just to proof I am a failure again..that part

stinks!

Dora McCary wrote:

That is the very reason I don't go to the Titans games with my husband. He

always asks and I have to explain I just can't do it. Maybe some day.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

[Guest guest]

Maggie ~

How selfish of me

I forgot to wish you the best next Tuesday. I wish you a speedy recovery.

~

Maggie Cline wrote:

Hi, : I have PHCS too. I had to prove lots of dieting in the past

-- I joined Lindora for six months last year, plus every other diet known to

man. I had to have the psych review, attend nutrition classes and see my

old doctor. I got a date -- In fact, it is next Tuesday the 7th. Just one

week away.

Keep pushing it. Don't let the reviewer dampen your spirits. One thing

that I think kind of helped too -- when they were dragging their feet (In my

opinion), I told them that it would be a shame if I had a stroke or relapse

of cancer that I could trace back to their hesitancy. I told them that I

would have no " hesitancy " sueing the pants off of them for lack of care.

After all, I would have to pay for care after such a catastrophic disease.

I couldn't and wouldn't expect myself or my kids to pay for care for

something they caused. They seemed to work harder on my behalf then or

maybe it was just time.

Keep hanging in there.

Maggie

RE: Today

Sorry this is kinda long....

My sister asked me, why do By-pass surgery? She said that everyone loves me

for who I am not what I look like. I began to explain the first reason was

my health, I wanted to be around to continue to watch my children grow and

hopefully see Grandkids one day.

Then I started to explain my other reasons, such as fitting into chairs,

events, just going to a family function and having to make sure you bring

your own seat. I told her it was embarrassing to not be able to sit down

and you don't want to make a big deal of it so you usually come up with an

excuse... Like I've been sitting all day!! You can't take plane rides

because you overlap on the next person's seat or you have to buy two. I

explained to her that I want to live life instead of watching everyone else.

I feel like I'm on the sidelines of a game watching everyone else play this

game of life.

However, after I explained this to my sister she understood and said she

would support me. She said she never knew what I was going through and

cried.

I look forward for the day that my insurance calls me and lets me know I'm

approved. Right now my insurance is requesting more documentation: Doctor's

notes 3 years show attempts, I need a Psych Eval & Dietician Eval.

I hear all the positives here and it keeps my hopes up everyday. I look

forward to one day when I can be apart of the losing side myself. There are

days those I want to just cry because I know I may have to wait and do

another 26 week program just to proof I am a failure again..that part

stinks!

Dora McCary wrote:

That is the very reason I don't go to the Titans games with my husband. He

always asks and I have to explain I just can't do it. Maybe some day.

Dora in Tennessee

Lap/Open RNY 9/20/2004

Vanderbilt Hospital

[Guest guest]

I am a little excited i have my appointment with my md to get all my

referrals for my . Pulmonologist and Cardiologist and the

Psychiatrist and to just spend sometime speaking to her. She has

been my Dr for 9 yrs so i just love her i can talk to her about

anything. And i can't pull anything over on her and she doesn't hold

anything back with me which is why i like her so much.But i know she

thinks this is the best thing for me so we shall see what happens

for some reason all of a sudden i feel this is becoming a long

process. Fornately i don't have to wait for approvals but still

things take time. And i am starting to get antsy and want to get

this going sitting around listening to everyones story can get a

little freigtening so i just want to get it done and start my new

life.I know many new changes will have to be made and many new ones

have been made already.Thanks for listening and teaching!

in NJ.

[Guest guest]

,

CONGRATULATIONS!!!!!!!!!! I'm so happy for you. Keep up the good work,

positive attitude and you'll do great.

Laurette

4/23/04 open rny

309/290/234/150

St. Charity

Cleveland, Ohio

[Guest guest]

good luck!

julia in delaware

lap rny 3/10/04

261/166/120

[Guest guest]

> I am a little excited i have my appointment with my md to get all

my

> referrals for my . Pulmonologist and Cardiologist and the

> Psychiatrist and to just spend sometime speaking to her. She has

> been my Dr for 9 yrs so i just love her i can talk to her about

> anything. And i can't pull anything over on her and she doesn't

hold

> anything back with me which is why i like her so much.But i know

she

> thinks this is the best thing for me so we shall see what happens

> for some reason all of a sudden i feel this is becoming a long

> process. Fornately i don't have to wait for approvals but still

> things take time. And i am starting to get antsy and want to get

> this going sitting around listening to everyones story can get a

> little freigtening so i just want to get it done and start my new

> life.I know many new changes will have to be made and many new

ones

> have been made already.Thanks for listening and teaching!

>

> in NJ.

Omg everyone i am so excited i got all my referrals today from my Dr

I am so exstatic i can barely stand my ownself. And this biggest

thrill i got today was when i stepped on the scale and it said i

lost 5 and half lbs i was so freakin surprised i almost jumped on

the nurse. Specially because well it is the dreaded time of the

month.But i have been working to change my ways so i guess it did

pay off some. and my little dog bless her heart i think she has been

pushing me to as well. My Dr is so good to me she said i am

motivated and says i will be good for this surgery and she is happy

for me and wants to see me 4 weeks before i have it done which is

required by my surgeon anyway (giggles). I am so freakin happy just

hope someone don't try to pop my bubble. I am not guna let em anyhow

even if they try. Thanks to you folks i told my Dr you all been

teaching much more then the surgeon ever could she was very happy to

hear that and sgreed as did the nurse. And i was even more surprised

to find out one of the medical secretries in the office just had the

surgery as well i don't know which one but she has not returned to

work yet. The nurse who took me in said she was out for 4 weeks. Ok

i will shut up now...lol.Thank you all you doll babies!

In care always,

in NJ.

[Guest guest]

Good for you ! Keep us updated!

in Delaware

Lap RNY 3/10/04

261/166/120