Recent Posts
Topic: If you need an ANGEL ...
If you are nearing your surgery date or have recently had surgery and need a SSA...
We have started a Surgery Support Angel group on my OH blog.
Click on my name ~ Under Tall or Web Medic ~ (right near to the cow) and it will take you to my blog.
Go into the SAA group and pick someone you would like to be your angel. Every person on here are just wonderful people and would love to be your angel.
If you want to join the group as a SSA, please do. We need you on our team!!
Topic: RE: new member
I had my Pre-admission testing today at CAMC Women's and Childrens, My Lap RNY is scheduled for 12-28-06, Dr. Shin., same hospital. I'll let you know how it goes.
Topic: RE: Need help with WVA local support groups
I also live in Martinsburg and I am in the process of getting approved for surgery. I travel 2 hours to Baltimore for support group meetings ( at the hospital I am going through) what a haul! Perhaps there are more us us in the area hiding out? I hear that Winchester, VA has a group ( not that far) but I don't have the details.
Topic: RE: new member
Hi. I had mine 9-19 at CAMC. I couldn't have been treated any better. Everyone at CAMC was super. Dr. Stickler performed my surgery and I am extremely pleased with him and his staff.
I believe Dr. Stickler has had several patients from down your way. I live in Parkersburg.
Feel free to contact me and ask anything. If you prefer email, I am at [email protected]
Peg Miller
Topic: new member
hey everyone I was wondering if there was anyone who have had their surgery at CAMC in Charleston, WV. How about contacting me if so and letting me know how it went and so on and so on. [email protected] Anyone from princeton area?
Topic: SURGERY SUPPORT ANGELS NEEDED
Hello to Everyone,
I have started a list on my OH blog for persons interested in becoming a SURGERY SUPPORT ANGEL. If you are interested in being a support person please put an entry into the comment spot, just click on my name to go there.
Please sign-up for a SURGERY SUPPORT ANGEL, there are so many people that would like someone to give update reports, call them and keep tabs on their well-being after surgery.
A lot of patients go without because they don't know how to find someone.
Topic: Home! Long Post
Hi guys, I thought I would drop in here and post an update. I had my surgery thursday. I was in my room by 11:30 or 12:00. At about 2:30 the pain meds had taken the edge off and I told my wife to help me to get my fat ass up an lets go for a walk. The nurse had told me that I would have to get up in four hours after getting in my room so I thought I would get it over with. I walked for about eight or nine minutes and lengthed that till I was up to twenty. Trust me I was not moving very fast but I was moving. Saw my surgeon in the hall as I was walking. He is not the most personable guy you ever want to meet, but he said some thing about your going to do alright, from him that is really excited. Don't get me wrong he his not rude or anything it is just his way, any way I ended up walking about five times thursday and it really does help. One thing that amazed me is that I saw my surgeon in the hallway three of the five times I was walking. The morphine helps to. Don't be afraid to use it. It took a little while to get on top of the pain but once I did it made it easier to function. In recovery I woke up and felt like I had been run over by a truck, but it did get better.
Friday I had my upper GI, drink the nasty stuff and got xrayed. The contrastng agent, the nasty stuff wasn't that bad when it happened, it was the after taste that got worse as I waited to get the results. All was well. They took off the morphine pump, started to give me liquid loritab and allowed to start sipping. I never new a sip of cold water or lemonade could taste so good. Walked five or six times saturday, twenty minutes ea. time. Doc told me I would probably go home Saturday.
Saturday woke up ready to go home. Sipped breakfest and watched tv. The Doc had told me to sit up all that I could, when I sipped liquid, my ass was hurting so told my wife I was going for a walk, of course she went with me. Walked down the hall and some guy I had seen in the hall's the last couple of days said I was moving alot faster and looked better than thursday, I thanked him and told him I was going home today and I felt great. Walked down the hall past another nurses station and one told me I was going to walk a hole in the carpet, told her the same thing. While going for my second walk the Doc said he would be in my room in a few minutes. Went there and waited about thirty. He sat down and told me I doing great and we went over my after care and he answered our questions. Go to his office this friday and get my staples out.
One thing I will say is his Phys. Asst. told me that my sticking to the pre-op diet really made their job easier. It only took them 55 minutes. He said my liver had shrunk and the fat over my intestines had thinned out and it really helped. The last time I was in his office the PA asked me if I was sticking to the diet and I was, but I told him even though I was eating the low fat foods I was eatng lager portions of salads and veggies than was on the diet, he said it was OK as long as I was choosing the right foods.
No catheter. When I got to my room it hit me it didn't feel like there was a tube down mr happy's throat and also no j tude drain. He told me in his office that only about 20 percent really need one. So far this has not been near as bad I as I thought it would be. Your mileage may vary. Had to include that disclaimer.
So here I sit, at home, getting excited about all the things I might be able to do in the future. I am on vacation next week, and can't drive till after I have my staples out on friday, but I am ready to get living right now.
pan head
Topic: Finally got approved..a.k.a. Its been a long time - Tips for PEIA/Newcomers
Hello Fellow Members, 
I haven't posted recently since I have been struggling with my insurance company. My rants were annoying, even me. In any case, its been 20 LONG months but I finally got approved.
My surgical date is scheduled for January 8th 2007. Dr. Robert Shin (CAMC) will do the honors.
In case anyone has forgotten me... my issues:
I, like many others, have been told by my PCP's to lose weight, exercise more, bla bla bla. They set me up on diet plans, exercise, ect... which I assumed ( and you know what they say when one assumes...) was being documented on my medical record.
Well, they weren't documenting. At least MY PCP's weren't.
So, when I went to Dr. Shin's seminar in April 2004, I thought, this could be a literal "piece of cake", since my last 10 yrs with my former PCP has been one weight related issue after another.
Not so.
When I finally got copies of my medical records ( which my former PCP charged me for... with fees for the person to print them out ) my records did NOT show documentation of diet related material. Even the meds prescribed for me were missing. Odd? I thought so. But I applied anyway.
And, I was turned down by my insurance company, Acordia PEIA. They specify 12 months of detailed documentation. They also want it worded a certain way.
Since they ( insurance ) couldn't use my previous records, and by then, I had asked my former PCP about their thoughts on Gastric Bypass Surgery ( which they refused to support me ) I needed to make a decision regarding my PCP. I needed a provider that was willing to work with me before, during and especially after.
After asking other members of this board, a new PCP was recommended.
After interviewing and accepting this new PCP, I prepared to get documentation. But even with a great PCP, I still had one issue to deal with... and my insurance company nit-picked it constantly.
See, my new PCP wanted me to journal and come in for bi-monthly weigh in's. I am not much of a blogger, diary or journal. Never have been. And, I simply didn't have the time to wait in the PCP's office to have them get my chart, find a nurse and document.
I didn't see this as being a problem since this isn't specifically noted in Acordia's
terms. Well, I was so wrong! Evidently, if the PCP says part of your plan is to journal, then you MUST journal. If they say jump, you MUST jump. Acordia is really specific with their terms.
Of course, I didn't realize this until I applied and got denied AGAIN.
So, in early spring of 2006, I began journaling like a son-of-a-gun. I did exactly what they were looking for. My last denial letter said I could re-apply "at the end of the year" which I translated as Mid-November.
So, the first of November 2006, I re-applied.
And wouldn't you know...my PCP didn't submit my weigh in! Could this get any worse?
By now, I filed an appeal, which ended up at the Capital. They had their medical directors evaluate my application and they agreed that I had cooperated BUT they still needed more documentation.
I immediately contacted my PCP and they had medical records fax a copy of my weigh ins to the Medical directors. With the holidays in November and the fact that the Medical Director is only in on certain Tuesdays... I was definitely not a happy person.
But it finally happened. All the stars aligned up for me and I got the phone call. Within a few days, I got the letter.
I was finally approved.
Hallelujah!
So, I got my Christmas wish early. I decided ( now that this is back in my control ) that I would wait until after the Holidays to begin my new journey.
If anyone needs specifics, please feel free to contact me. If you're a newcomer and/or are fighting with Acordia, I can give you names, numbers and suggestions.
If there is one thing that I can say, now that I am on "this side" of the situation, be patient. Follow the rules, tell your PCPs what they need to document. Some will be apprehensive because they don't like being told what to document. But let them know its nothing personal, its insurance related. Find a good surgeon, who's office staff will assist you completely ( for me, Dr. Shin's Office, in particular ) and don't be afraid to ask others who have experienced the similar issues.
And one final thought...... I deeply believe that things happen for a reason. As much as I went through the frustration and aggravation of dealing with denial after denial, I believe that things happen when the timing is right. For whatever reason, the timing wasn't right for me. Yes, I can say that NOW but it was the only thing that kept me going these last 20 months. It was the ONLY thing.
So, I begin the newest chapter of my life history. Although I feel the worst has been overcome, the best will be the real test. And I am ready.
Merry Christmas and Happy Hanukkah everyone. And may you all have a spectacular new year where all your wishes come true.
Jen
I haven't posted recently since I have been struggling with my insurance company. My rants were annoying, even me. In any case, its been 20 LONG months but I finally got approved.
My surgical date is scheduled for January 8th 2007. Dr. Robert Shin (CAMC) will do the honors.
In case anyone has forgotten me... my issues:
I, like many others, have been told by my PCP's to lose weight, exercise more, bla bla bla. They set me up on diet plans, exercise, ect... which I assumed ( and you know what they say when one assumes...) was being documented on my medical record.
Well, they weren't documenting. At least MY PCP's weren't.
So, when I went to Dr. Shin's seminar in April 2004, I thought, this could be a literal "piece of cake", since my last 10 yrs with my former PCP has been one weight related issue after another.
Not so.
When I finally got copies of my medical records ( which my former PCP charged me for... with fees for the person to print them out ) my records did NOT show documentation of diet related material. Even the meds prescribed for me were missing. Odd? I thought so. But I applied anyway.
And, I was turned down by my insurance company, Acordia PEIA. They specify 12 months of detailed documentation. They also want it worded a certain way.
Since they ( insurance ) couldn't use my previous records, and by then, I had asked my former PCP about their thoughts on Gastric Bypass Surgery ( which they refused to support me ) I needed to make a decision regarding my PCP. I needed a provider that was willing to work with me before, during and especially after.
After asking other members of this board, a new PCP was recommended.
After interviewing and accepting this new PCP, I prepared to get documentation. But even with a great PCP, I still had one issue to deal with... and my insurance company nit-picked it constantly.
See, my new PCP wanted me to journal and come in for bi-monthly weigh in's. I am not much of a blogger, diary or journal. Never have been. And, I simply didn't have the time to wait in the PCP's office to have them get my chart, find a nurse and document.
I didn't see this as being a problem since this isn't specifically noted in Acordia's
terms. Well, I was so wrong! Evidently, if the PCP says part of your plan is to journal, then you MUST journal. If they say jump, you MUST jump. Acordia is really specific with their terms.
Of course, I didn't realize this until I applied and got denied AGAIN.
So, in early spring of 2006, I began journaling like a son-of-a-gun. I did exactly what they were looking for. My last denial letter said I could re-apply "at the end of the year" which I translated as Mid-November.
So, the first of November 2006, I re-applied.
And wouldn't you know...my PCP didn't submit my weigh in! Could this get any worse?
By now, I filed an appeal, which ended up at the Capital. They had their medical directors evaluate my application and they agreed that I had cooperated BUT they still needed more documentation.
I immediately contacted my PCP and they had medical records fax a copy of my weigh ins to the Medical directors. With the holidays in November and the fact that the Medical Director is only in on certain Tuesdays... I was definitely not a happy person.
But it finally happened. All the stars aligned up for me and I got the phone call. Within a few days, I got the letter.
I was finally approved.
Hallelujah!
So, I got my Christmas wish early. I decided ( now that this is back in my control ) that I would wait until after the Holidays to begin my new journey.
If anyone needs specifics, please feel free to contact me. If you're a newcomer and/or are fighting with Acordia, I can give you names, numbers and suggestions.
If there is one thing that I can say, now that I am on "this side" of the situation, be patient. Follow the rules, tell your PCPs what they need to document. Some will be apprehensive because they don't like being told what to document. But let them know its nothing personal, its insurance related. Find a good surgeon, who's office staff will assist you completely ( for me, Dr. Shin's Office, in particular ) and don't be afraid to ask others who have experienced the similar issues.
And one final thought...... I deeply believe that things happen for a reason. As much as I went through the frustration and aggravation of dealing with denial after denial, I believe that things happen when the timing is right. For whatever reason, the timing wasn't right for me. Yes, I can say that NOW but it was the only thing that kept me going these last 20 months. It was the ONLY thing.
So, I begin the newest chapter of my life history. Although I feel the worst has been overcome, the best will be the real test. And I am ready.
Merry Christmas and Happy Hanukkah everyone. And may you all have a spectacular new year where all your wishes come true.
Jen 
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