Almost THERE

Alright...as many of you know over the past few weeks i have begun to update again on my progress. Well today I got some really hopeful news. Today my insurance coord @ my bariatic center notified me she may have something up her sleave to get things going a little quicker. Instead of sending everything freshly into humana again, they are now requiring me to use a cpap machine unsucessfully to be approved for surgery, which wouldn't be very difficult to do but time consuming to say the least when the sleep dr. doesn't want me to get back in until end of sept for my trial run on cpap. So back in jan of this year, they sent me for approval i guess to see what humana was requiring for surgery, they denied me for lack of evidence of a supervised 6 month diet...which i did have at the time. Meanwhile I had been struggling with the decision of completing the wls after getting the run around @ SJE last summer, i had become burnt out with trying and became very frustrated with the psyc. evaluation and person administring it there, he wouldn't give me clearence. I have never been one to really get second opinions but nonethless this was something meaning the wls i was commited to. I decided to go to gch and do a psych evaul there to see what he thought of me. First and foremost I was very honest w/that psych. I didn't lie or alter my answers, I went in and out of that eval w/a clear mindset of what I wanted. He did give me clearence and now I had my 6 month supervised diet history in hand from SJE. Back to the hopeful news. The Ins coordinator has sent me up for approval w/Humana today by doing an appeal based on their claims from last time. She added the information from the sleep study showing that I do have sleep apnea which I scored an 11.5, insurance requires a patient to score at least an 8. So there it is the good hopeful news. It is weird for me even @ the moment to fanthom the idea of being able to complete this part of my journey. I'm scared, anxious..worried...and about every emotion today to say the least. I am now truly and deeply mentally and physically ready to leave this life behind and start my new journey, my new life of course asap, however I will deal with it if it is sooner rather than later...it doesn't matter. I feel as if I have been given a new opportunity for life. The tools to make my life change around for the better. I am ready now to give it 100 effort and commitment. Ross

Sending up prayers that u get an approval and get started on your weight loss journey. Its truly an amazing road to travel! Hugs and keep me posted on how its going. Hugs Angela

Angela, I keep somewhat updated with your profile and kudos to you and your journey. You are like my wls idol, hehehehe..at least one of them. Your journey is amazing. I'm praying and wishing and hoping...Cause ultimatly this is my decision to embark on. I mean I have support with family and friends and people on here. However people outside of bariatric land always seem to point out the dangers of this surgery and I have to keep myself up in spirits. I think..is it worth to keep this weight and suffer problems later on in life when I am older? Or by chance...go ahead and take this risk, have the surgery, have some problems and go ahead and get through them? I mean if I stay in this body the way I am now, I know I will be dead sooner than later...it's just hard explaing everything to the people that "love" you. Oh well, I might be rambling on as more thoughts run through my head as I seem to be getting closer and closer to making this dream of mine fulfilled. But anyways, maybe you can make sense of it..hehehheh

Good luck Ross! I have troubles with HUmana also. So in Novemeber I am switching Insurances over to UHC. I should be good to go then. IF not, I don't know what I'll do then.

Awww u r making me blush! But, seriously, thank u! I am sure u will be here on the losing side before ya know it jus****ching the pounds just melt off. For me, it was totally my decision to have the open rny gastric bypass. My husband loved me as I was, he supported my decision to do this and he loves me now. He sees that I am so much happier with myself and in some ways, well most ways it has helped us grow closer. My parents on the other hand were scared to pieces of me doing this, especially the open. I could have had Lap but I chose Open and felt safer. I did opt to have the vena cava filter put in as a precaution and it made me feel so much better about having the surgery. U might want to consider that if the thought of the risks worry u or your family. Blood clots were my biggest fear and the filter helped me not be as scared. I say WHEN u get your approval, go for it! Don't hesitate at all. This has been the most amazing journey of my life. I only ever dreamed of being thin, never imagined what it would be like and now I know, its GREAT! I may not ever be the skinnest person around but I have lost a total of 167 pounds in 16 months and I am pretty dang proud of that and so thankful. If u ever want to chat about surgery, the risk, whatever heres my email and my messenger [email protected] or [email protected] for chatting. If u IM me on yahoo and I don't answer its either because I am not in the room or Adam my hubby is on Ebay drooling over the motorcycles and he never answers IM's when he's on, not even for his family. I tell him it makes me look rude when he ignores his mom, but hes a terd...Have a great night and u r not rambling, your excited and nervous, impatient! I know I was. Heck, I am impatient now. My insurance has till next Thurs to let me know about my tummy tuck and I am on pins and needles. Have a great night! Angela

Good for you Ross, don't ever give up!!

Good luck, Ross. Humana approved me 2 weeks ago. I meet with the surgeon Tuesday, so I'll have a surgery date sometime in August! I hope things so smoothly for you. Kathy

So I got to looking at this post that I did on here. It could be that I was incoherent the day that I wrote this b/c it doesn't make sense really to anyone but me after having 5 or 6 days of looking @ it. Referring to the Insurance Coord. @ my hospital that i'm working up I referred to her using "up her sleave." I actually meant this as she was working hard for me. I went to Eku and majored in creative writing so I often think of things in a "creative" or abstract way. What we are doing is actually appealing a deniel notice that I had received from my insurance company earlier this year. My hopes are not too High on getting it done. But to me the situation arose and my "creative" mind put a spin on how I explained it to you all. I hope this clarifys things up for you all. Also the deal with the CPAP machine and the requirment of using it. This is where I went a little crazy on trying to explain about it. I did have sleep apnea and a different docotors office (where I took the sleep study test) gave me the approval to use a CPAP machine. My insurance approved me for 2 months of use on the basis of me having a titration (sp) study and copperation with it. After that 2 months the insurance will then again lease me the CPAP machine for another 8 months and if I continue to use it and able to tolerate it then they will actually purchase the machine for me. I hope this clears everything up for you all. See what happens when you try typing, playing yahtzee (online) and taking a dose of nyquil @ the same time...

Ross, Thanks for making the clarifications for everyone. Your second post makes your thoughts much more understandable. We appreciate the fact that you're sharing your story online. We hope to see you soon for surgery. Catherine Birdwhistell Insurance Coordinator The Bariatric Center @ GCH