SOOOOOOO Excited! Aproved! for ERNY

Well I got the call today that CIGNA MEDICARE had overturned their denial for me to see Dr. S for a revision from a rny to an ERny !!!!!! I see him Thursday morning and we go from there! Joyce, how long can I expect it to take till surgery actually happens? xo Nancy S.

Nancy 


 Congratulations !!! awesome news

I bet you get scheduled right away .... or as soon as all your pre-reqs are out of the way..

Wooooooooo HOOOOOOOOOOOO!!!!!  Pack your bag girlfriend cuz knowin Miss Jenn; she'll have you in there after your appt on Thursday!

Do ya need an ANGEL?????!!!!! 

Congrats Nancy!

I'm jealous, as I'm still waiting for my cardio.  I need a stress test and the cardio office messed up their scheduling.  Hopefully, it won't take long for my approval after that.

Keep us posted!

Michele

Michele, don't be jealous.. I just have my FIRST appt with dr. S. today. The reason I know I am approved is because my insurance ( Cigna for seniors or medicareHMO) does not have him in-network and i had to go through a denial and appeal just to see him so they went ahead and approved the surgery at the same time as soon as all the preop stuff is done. They found there is NO other DR in AZ who could or would do my surgery due to so many previous abdominal surgeries and scar tissue. Even though this is a revision of an RNY to an ERNY, I still have all the same co morbidities as I did originally. xo nancy S.

Now I understand, you got one stop shopping from Cigna!

I hope your appointment with Dr. S went well today.  Hope to see you at his next support group.

Michele

Boy it sure has be COMPLICATED, But yes, because he is out of network for me, Cigna first sent me to an in network Dr Fang, who told the insurance that he is not trained in the type of revision I need ( Rny to ERny open and major internal scar revision) So they basicly had to make sure they would approve the surgery before giving me the OK to even has a first visit with Dr. S.  It appears my surgery will be at Downtown St. Lukes  instead of Tempe St Lukes, again because of out of network Hospitals bariactric certification. Both hospitals are the same company so not sure why the big deal, leave it to Cigna to complicate things. My visit with Dr. S. was short and strange, only because he had an emergency at the Hospital right before my appt and needed to get out of the office quick.

He told me i would have a 75-80 cc common channel and that the surgery would be very serious because of my previous extra short limb of my RNY done by the previos surgeon 10 years ago.
he REALLY grilled me on COMPLIANCE with food choices , 1200 cals a day, little fats,  no carbs, 150 grams of protein a day. he even said "Joyce" makes it look easy and it's not,  so don't compare yourself to her.
my pre-op is pretty easy, EKG, Pulmonary function test and the pre-op blood work, and session with the Nutritionist next tuesday, 4 more after surgery.  He wasn't touchy feely but he had someone else's serious health issue on his mind and that's ok with me. xo Nancy S.

ps: I told them I was 5'3" and when I went for the PFT they measured me and I'm 5'2" !!!! Up went the BMI! lol

Nancy,

Sooooo the part where he says that "Joyce makes it look easy and it's not"......needs some clarification!  LOL!  Dr. Schlesinger of ALL people knows that I have had a rough road.  He also knows that together we have worked and worked to find the right balance of EVERYTHING so that it CAN look easy & I CAN live well!  ....  Compliance is absolutely necessary and he just wants to make sure that YOU are not his next emergency when he's in the middle of an office consult!  The ERny definitely requires focus and high maintenance and he would be amiss if he didn't emphasize the uphill road ahead of you.

I am not only as compliant as they come, BUT I go beyond the normal "recipe" for success and take oodles of vites, protein drinks and stay diligent on a low carb, gluten free diet FOREVER!  I'm definitely NOT perfect though or I wouldn't have had WLS in the 1st place.  I make oodles of oopsies and that's when I am soooooo grateful I have a "tool" that can work hard for me! (I just ended 2 weeks of high protein to trim a 5 lb gain....wasn't easy either!  LOL!)

I think that as soon as all patient's embrace the trade-offs and commitment necessary to be successful then they too will make it "look" easy! 

I LOVE Dr. S!  He totally rocks!  ....  Sorry you had an abreviated consultation but you did get to chat at length with him at the support group, right? 

There's never enough time with our good docs.....thats why it's amazing that he actually attends his own support groups!  We get a little more time to pick his brain than those who are in other programs!!

Hang in there!  It's going to work out for you!!!

Joyce, let me explain. I think he got the impression (falsely) that i looked at you now and thought, "She looks great and is maintaining effortlessly" and he just wanted to reinforce that I have long and difficult road ahead of me and am I really committed to the lifestyle change i will HAVE to make to succeed??.
remember this will be my THIRD bariactric surgery in 20+ years, so he has reason to be concerned. I know he had an emergency and i am grateful he could sneak me in.

he asked me if i had any questions and I knew he was pressed for time, so i only asked one ( when i really have many but they can wait)..I asked him "what is his mortality rate for this particular type of revision?" he said "0, so far, but the day will come where that will change"... Honest but scared the bejesus out of me.

I think he scared me straight so to speak. I thought i was taking this very seriously but I realize now I will be risking my life for a new life and I better make the most of it. I am on a lot meds and vits and am very compliant with them so that doesn't worry me. How i am going to be on 1200 cals a day and in that get 150 grams of protein, I'm not sure yet. I look forward to the meeting with the nutritionist, i need the help, he is requiring 5 visits with her.

I was crying in my husband's arms last night in bed, asking him if he believed I could do this and succeed? he said (half joking) that i am a lot more mature than I was 20 years ago and take commitment to the 9th degree so together we would make it work and he would be there to help me at every step. I am a very lucky woman.

"I was crying in my husband's arms last night in bed, asking him if he believed I could do this and succeed? he said (half joking) that i am a lot more mature than I was 20 years ago and take commitment to the 9th degree so together we would make it work and he would be there to help me at every step. I am a very lucky woman."

Hey sweetie pie!  You ARE a very lucky woman to have him AND you've got a new network of support buds that will help you through it as well.  ....  Y'know that i'm a support group junky and run all over the valley getting my "half full cup filled to the brim"!!!  It's a journey with a new lifestyle.....  There's no finish line after the surgery; just lots of twists and turns, a few bumps and hills BUT a great view along the way with lots of FUN!!!  Wooo Hoooo!  SHOPPING!!!

Thinking through the "what ifs" is healthy.  We appreciate the "wow" moments even more!

Have a great weekend!  No worries   You'll do a FABULOUS job!!!