Dr Juarez and Mercy Care through AHCCCS

Hello. I am very new to the board. I Only recently started posting and am really looking forward to meeting and getting to know people who understand what I'm going through. First of all, I am 30, 5'5'' and weigh 311 pounds, I think my BMI is 51. I had my first appt with Dr. Juarez today and am feeling......well......anxious, I suppose is the right word. I'm afraid that I will be denied. Which I'm assuming is a very real and valid fear for most everyone who hopes to have WLS. I'm not on any medications and I don't have comorbidities (spelling?). Well I take that back, I do have acid reflux and problems with my period. My period has been off wack for about 5 years now and I have bleeding spells that will last for up to 5 months causing enemia. My OBGYN says that I am insulin resistent and would definitely benefit from the surgery. She also wrote a letter to support that for the insurance company but other than that..........I mean, I do have very severe back pain and need to have that looked at and I also suspect I have arthritis but haven't had these things checked yet so I'll be getting to my PCP for that soon but that's it. After I told Dr. Juarez that I wasn't on any medication and stuff I just felt a huge sinking sensation. I was on cloud 9 this morning on my way to the appt and now I feel like someone knocked me right off that cloud. I asked the Dr. how long before we would find out if the insurance co. will pay for the surgery and he said it could take up to a year!!! A YEAR!?!? OMG, that's just......just......HORRIBLE! So I'm writing this because I really need some emotional support and because I'm hoping to find someone who has both Mercy Care through AHCCCS and Dr. Juarez as their surgeon. Someone that can tell me about their experience and maybe offer suggestions. Should I write the ins. company a letter? What should it say? Should I hurry up and try to find out about my back and possible arthritis so those issues can be submitted? Should I just shut up and stop worrying? Thanks for reading this, Ree

First of all, you're in good hands with Dr. Juarez. He's the best in the country. He now has a partner Dr. Fang who is equally as good. He did my surgery. You have to go through a process or what we call a journey. And you've taken your 2nd step assuming you've been to the information session. So it's just 1 step at a time and in the mean time, do what you have to do to get yourself in the best health possible before your surgery. Good luck Ree and relax

Marie, thank you for your support and input. Yes, I did go to the seminar so I believe that this is my second step Thank you for putting things into perspective for me. I feel much better looking at this as a journey. I realize that there is so much more to this whole thing than just the surgery and there are other things I can do in the meantime. It's very comforting knowing that others have been through this and know what I'm going through. BTW, is your insurance Mercy Care? Would you have any suggestions about what further steps I could take to help the approval along? Thanks Again! Ree

Hi Ree... From what you have posted I would say you have several comorbidities including insulin resistence, menstrual problems, chronic pain, arthritis, acid reflux....I bet you take pain meds, reflux meds, hormones..even OTC counts. Good luck, CJ

Hello CJ! Thanks for your response and for pointing out that I do have more comorbities than I think. I hope the Dr. knows that too! One of the problems though is I HATE TO TAKE PILLS!!! So I don't Which means that I'm not on any medications that are prescribed and that's probably going to hurt my case isn't it? Maybe I should call my doctors and request them to put me back on these meds??? I should be taking birth control to control the bleeding and metformin for the insulin resistence and I should also get a script for the reflux but haven't, instead I drink baking soda and water all day! I also pop asprin, tylenol and IBprofin like candy!! The thing is I'm just so funny about medication, always have been, I even have panic attacks sometimes if I have to take them. But Dr. Juarez doesn't know that yet, and it's not in my paperwork. Maybe I should call the office and talk to someone, an assistant maybe? Let them know these things......what do you think? Ree

Hi Ree, I'm just starting this process my self so I know there are lots of people out there who know more than I do....but I do have a couple of suggestions. 1. take the time to write out your diet and wieght history. List every diet you were ever on starting with the first ..ie..age 9 Atkins 120#'s - 10#s age 10 popcorn diet 140#s -8#. Use any format you like but try to keep it to one page and kep it clear and concise. 2. Also write out all of your health problems and what you are doing for them. include all of the self medication. include everything you can think of reflux, urinary incontinence etc...don't be shy... 3. Write a letter to the doc listing why you want the surgery, referencing the list, the multiple attempts etc. Include that you understand the risks and benefits. 4. Talk to your regular doctor about the health problems and start treatment. 5. check out your insurance policy, talk to the reps. and find out exactly what they need to approve the surgery, ask for it in writing, also ask when tests need to be done and how long are they ggod for. 6. Ask your dr. to put you on a medically supervised diet as a lot of insurance companies are now requiring a 6 month history, you need monthly documentation of weight and exercise. AM I too long winded? 7. Read everything you can on this website about the surgery, check out profiles, look at other sites, a good one is Coastal Center for Obesity, learn eveything you can about the suregery and the diet. 8. Go to the main board and check out Susan Marias post from earlier today...it's an eye opener. The one thing you menioned that you really need to think about is if you have this surgery you will have to take 1 to 2 vitamans a day plus 2 to 3 calcium pills plus B12, whatever your dr reccomends for the rest of our life. You need to deal with the panic attack issue before you have surgery. Well, Ree, as usual I'm long winded.. hope you find some of this helpful. CJ

Ree, I'm glad I'm not alone on the non-comorbidities thing. Not that I want to have high blood pressure, diabetes or a co-morbidity, but it's easier to get approved that way (I'm assuming). So I understand your frustration. Completely! I also have upper-abdominal issues/acid reflux PLUS I have major menstral issues. I don't have one until I take birth control pills or am losing weight. Having this surgery would solve BOTH problems. So I consider those co-morbidities, and I plan to have my PCP's letter and Dr. Juarez to FOCUS on those co-morbidities. I'm going to the seminar (step 1) on 5/21, and my appt with dr. Juarez is June 11th (step 2). My suggestion is NOT to write the insurance company until AFTER their decision because it's not going to sway them either way. And really, it's in God's hands. Worrying isn't going to solve anything. I, myself, want surgery NOW, but my insurance (Aetna HMO) has a long list of things I have to meet to have surgery INCLUDING six months of dr supervised weight loss. Then I wonder, well if I do that AND lose, will they deny my surgery? Doesn't make sense. I don't have ACHHS, but Aetna HMO comes close. LOL So hang in there. We seem to have a few things in common. Write me anytime. Trisha in Glendale

Hi All, I have a friend who is on AHCCCS/Mercy Care and she is having surgery on the 3rd of June. She has no co morbidities other than slightly elevated blood pressure. She is 25 and has been heavy all her life. Mercy Care only asked that she diet while under the care of her PCP and of coarse do all the normal studies like everyone else. She had to see a councelor for months too. It has been about a year or close to it since she started her journey with Dr. Juarez but is having the surgery done by one of his colleauges. It seems that once all the pre tests were done and then the submittal to Mercy Care it was only 2 weeks when she had her approval and a date of only one month from the day she was approved. So Mercy Care is not too tough after all. Good Luck in your journey,