DONT GO TO FALLON!

I cant stop crying. Ive been crying for hours. Im so mad right now. Ive been in a bariatric program for TWO YEARS now and still no surgery. The team met this week and did not approve me (not insurance approval) for a consult with the surgeon because of my AGE!! The team requires you to be over 18 and I am almost 20!!! If they are so worried about age then they should change their minimun age to like 25. They said that I may regret surgery in 20 years just like if I got plastic surgery when Im young. That made me flip!! How could I regret a happier and healthier life? How could I regret not having hypertension, sleep apnea, insulin resistance, infertility, joint pain, and hormone problems? And if I wanted plastic surgery Im old enough- I dont need a 2 year program in order to get it- but even so HOW DARE THEY compare WLS to breast implants!!! Im so angry. They built me up and then tore be down because every department told me I was ready. Ive been in it for TWO YEARS and jumped through hoops doing everything they asked of me and it was all for nothing. They suggested that I lose the weight on my own. THATS NOT GOING TO HAPPEN- thats why I started the program in the first place!! Im just so done with them. Im miserable and hopeless. Go figure, this is the story of my life. I guess Im destined to be fat for the rest of my life and at the rate Im going I will be over 600lbs in the next 5 years. I dont think its fair how 6 people have the right to make a decision over my life. Im the one who knows if Im ready or not. Not them. It should be MY decision. I have to live in this body and experience this pain every single day...but its just a game for them. They gave me a list of more things to do for a reconsideration for approval but I just have nothing left inside of me. Im finding a new program but getting a referral from my PCP will be hard because this program works for the same company as my doctor so they dont like to refer people to other programs. I promised myself I wouldnt be fat next summer but...I just may be. THIS BLOWS!!!

I am sorry you have been yanked around. Why don't you call another hospital. I know at Brigham & Women's in Boston they can take some of the other hospital's testings. Go to the website..pick a doc and give a call. Get yourself on the track you want to be on. Joan

Thank you. I realized this and I did look into another program. Its still frustrating but nothing worthwhile is ever easy right? Thats what I keep telling myself.

Hi Angela, I'm sorry you had to go through all that for what seems like nothing, but as the previous post said I'd look into another program. I'm having RNY at New England Medical Center on 11/14. I met a girl there who was having surgery this summer 3 days after her 18th birthday......so age may not be such a factor there. The surgeons there are the same ones that are featured in the video presentaiton with surgeons that you can access from this site. It's a good program.....worth a look I'd say..... Hang in there! Melinda

Hi Angela, I have a solution for you. You should talk to your doctor and explain your just not happy with umass. Tell her you want to go see another doctor. I started my process on 6/26 and that was just my first new patient meeting. On 7/26 was my first appt and 10/3 was surgery. I know they are booking appts for January, with the practice I went through. I also know they take all types of insurance. I went through Newton Wellesley. Yes its a longer drive but you will not jump through hoops with them like this program that umass has. Dont wait to make the appt, call make the appt and then call your pcp for the referal, If they wont give you a referal my surgeons office has a list of doctors that accept your insurance and are accepting new patients. They are great at what they do, I wish you the best. If I can be any more help just let me know Jess

Anglea, I'm confused...is your problem with the program/hospital/doctors or YOUR INSURANCE CARRIER?? If it's Fallon as your post suggested, then you need to take on the Insurance Commissioner of the Commonwealth. I have a friend who worked in insurance and said she'd help me write an appeal letter for an upgraded insulin pump, but luckily for me, I don't have Fallon. (I had them in the past and it was the first and last time I ever used them. They rarely approved anything. When they finally approved the new pump I needed, the kept refusing the quarterly supplies I needed to stay alive! The pump is useless without the catheters!) I'ts not your age, and not in your head. If it's your medical team, NEMC is great, BMC is too (my doc is Dr. Donald A. Hess). I'm sure you'll find a doc and a program that won't make you wait longer than you already have! Good luck! Marie

No it wasn't the insurance company- I haven't even began to ask them for approval but Im not worried about that part. Its the medical TEAM at Fallon Clinic. They wont even approve me for a consult with the surgeon. I have to work with behavior and nutrition and lose a bunch of weight and then when THEY think Im ready, I can meet with the surgeon. They told me if I stay in the program then they will reconsider me for approval in the spring. So Id be getting surgery in the summer- ALMOST 3 YEARS AFTER STARTING THE PROGRAM!! Thats ridiculous. But I did call NWH and I have a consult with the surgeon, psych, and nutrition on November 15th. Just have to get a PCP referal. I give up with Fallon Clinic. I just hope that since I have Fallon insurance its no issue. But I do have Select which allows out of network doctors as long as I obtain a referal. Thanks for everyone's information!

Go to Umass hospital make an appointment in worcester

How about trying the Umass program. I have Fallon Select and I was going through thier program and did not like it at all. So, I switched over to the Umass program, which I think is great. They only expect you to loose a couple pounds and stay under your starting weight if only by 2 pounds. I am almost at the end, just need to meet with the surgeon and then wait for surgery date. I have had no problems with the insurance since it is Select. Amy

You wrote: " Its the medical TEAM at Fallon Clinic. They wont even approve me for a consult with the surgeon. I have to work with behavior and nutrition and lose a bunch of weight and then when THEY think Im ready, I can meet with the surgeon. " That is the process with most programs, including mine, Angela. I couldn't get an appointment with my surgeon before I lost 5% of my pre-op weight. I have the appointment scheduled, but if I don't hit the target weight, I get kicked out of the queue. That's not your surgical team being mean to you, that is simply them trying to maximize your chances of success. you mention that you haven't met with the behaviour and nutrition folks yet. Why not? I'm sympathetic to your pain, Angela, but you'll probably increase your success pre and post surgery, by following the rules that the hospital/surgical program sets down. We laypeople may not automatically understand why the guidelines are there, but they are present fora reason. Is it just the pre-op weight loss you are struggling with, or is there something else? I understand how hard it is, -- I'm struggling to get/keep my 5% off so that I don't have my surgery cancelled. Hang in there. Donna B.