United Healthcare Point Of Service-Need Guidance & Opinions PLS!

christy217
on 9/15/11 2:20 pm - Mechanicsville, MD
I posted a post like this back in March of this year, gosh, reading and typing that I cannot believe it's almost the end of September and I am still having trouble with my weight! Here goes my post: 

Hi there everyone! My name is Christy. I just turned 34. I am 5'2 ( I swear I think I have shrunk an inch this past year) and 193lbs. roughly, now I am about 200lbs).

I am very interested in getting some type of weight loss surgery. I say some type because, I know I am not eligible for the roux-en-Y or regular gastric bypass surgery with the re-routing of intestine surgery, because I had colon cancer at 28, and I have no large intestine, they performed a procedure called a total colectomy on me, so basically my small intestine is connected to about 2 inches of my rectum.

Long story short, initially when I posted on here I had BCBS and they specifically stated theeir requirements etc., Now I have UHC POS and they cover it 100% with a covered provider and facility but they don't stipulate any other information, for example, when my providers at Dr. Denis Halmi's office in Woodbridge VA contacted them at the beginning of Sept-when my now UHC POS became effective they replied back to them and told the provide they want something that displays a 5 year history. I called UHC and they didn't tell me much either.  Having had cancer I have seen numberous docs in the last five years. My game plan is to go to those docs like my onocologist, pain management, neurosurgeons, fertility doc, etc., and ask them to write a letter on my account stating they advise the procedure to be done for overall health improvement.

I have always had issues with food addiction, I am the largest person in my immediate family, and have always been. I was always told I was "big boned" but personally, I've never seen a fat skeleton!

I am interested in having the sleeve gastrectomy done, and I've been to three separate doctors that suggest that as well, stating I could have complications with a lap band and end up with a colostomy bag and I would starve to death with the way the normal procedure is carried out. The docs all agree o the sleeve, with 80% stomach removal. This I feel for me would be a double benefit-my colon cancer gene prediposes me to an increase in stomach cancer by about 13%-which isn't a lot but every bit helps! :)

I have the following other medical issues that will accomodate my reasoning for my surgery:
-high blood pressure-2.5-3 years
-GERD-10
-infertility-5
-sleep apnea-I don't use a CPAP though-1 I have upper airway restructive syndrome
-Disc disease-along with 3 slipped discs, an impinged nerve and annualar tear in my lumbar spine.
-I've already had my gallbladder removed-but I had issues with this
the increased weight bothers my knees and my carpal tunnel as well.
-Depression
-Fibromyalgia

I have now found my surgeon, Dr. Denis Halmi, we have discussesd that the gastric sleeve would be the best option for me and my current situation, however, given that my inusrance company-UHC POS-is new to me, they want a 5 year history on me which pertains mainly to my weight IMO. 2 years ago I was this weight, but not 5, I've fluctuated from 200 down to 150 up to 165, 175, stayed back up to 180 then to 200. I am wondering at this point if it would be worth me trying to see if this wil get approved after all, has anyone else experienced this? 

Christy from MD
Stats:
Height-5"2
Highest Weight-Feb. 2011-205 lbs.-sought out WLS
Total colectomy patient from genetic Colon Cancer in 2006-I have only 2/3 of my rectum and no large intestine and no colostomy pouch. Only physically able for VSG.
July-2011-down to 195-lbs
Oct-2011 Approved finally from changing ins. twice, for VSG.
Nov. 9, 2011-started liquid diet/Opti-fast
Nov. 15, 2011-VSG, hernia repaired and scar tissue @ Potomac Sentara Hospital
Nov. 16, 2011-Had Upper GI in hosp, started clear liquids
Nov. 17, 2011-Started full liquid diet
Nov. 17, 2011-Released to home on full liquid diet for 14 days.


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