Bad News

Hi everyone, I want to thank everyone who sent me best wishes, words of wisdom, helpful hints, and speedy recoverys. Unfortunatly my surgery was canceled. I was supposed to have it done today but the insurance company denied me yesterday!!! When I got my surgery date from the doctors office I thought I was approved. I started making all the arrangements and then on Friday I got a letter from the ins company stating they needed more information. So I called the Drs office and they said there were on the phone right now with the ins. company. We played phone tag all day which lead to a Monday decision. (Talk about nerve wracking.) I finally got the call Monday mid-morning that I was denied. They said that I needed a 6 month sup. diet. We (myself and the Drs office) asked the ins company several times before if this was needed prior to surgery and they said no and now the day before surgery all of a sudden it is needed. Needless to say I am very upset and depressed by this whole matter. I should be on the losing side by now. I start to cry everytime I think about it. This is going to be a very long and hard 6 months. I will continue to read the boards and post once in a while. Good luck to everyone. Karen

I am so sorry. Hang in there. I believe things happen for a reason and there is a reason for this. Don't let it get you down. Let it give you more determination then ever to succeed at this journey. Eileen 255/169/134

I believe things happen for a reason also but I'm tired of things never going my way. I will try to not let it get me down and fight even harder. Thanks, Karen

I am so sorry Karen. It is very hard, I know, but try and keep your head up high. If you lose a few pounds in 6 monthes, surgery and recovery will be even easier for you. Stay strong and positive, 6 months seems like a long time but it will be over before you know it. Think spring, a beautiful season! Stay strong and stay with us. We are all here for you!

Karen APPEAL. In writing. As swiftly as you can, politely but list the reasons why you feel the decision is wrong. Have the doctor also appeal. Do it and when you mail it, send it REGISTERED, return receipt requested. Its harsh, but much of the insurance company **game** or gambit is denial denial denial. Those that persist dont always win, but most of the time they do. ALSO.. please post often here. Dont be discouraged. I was denied for about 2 years, until I found a surgeon that would take my insurance then by then the insurance company was ready to shoot me with all the letters I wrote. It happens almost always to most of us. Some of us are blessed and approved at first, but I went on a three year journey to find and get the surgery. Its WORTH it. But staying involved with us here will help you.. I didnt discover Obesity Help until AFTER surgery.. it was a long cold three years without much support. We CARE.. and if you stay involved here then you will not regret it I promise. PLUS.. you will learn and gain in wisdom about the dos and donts of POST surgery... really ! ALSO... start your 6mo supervised diet.. IMMEDIATELY. Have you dieted with your doctors knowledge., or other doctors knowledge.. before? Can any doctor you have seen document this? I tried Optifast, Fit for Life, Nutrasystems, and the Atkins diet, along with Cambridge, and about six others (jenny craig, etc). Find a program of **something** (walking, swimming, bicycling, mallwalking, chair exercise) something. Something that you can do that you enjoy, preferably. I swam, at 650 pounds, for about a year three times a week. I couldnt afford the fee to join a health club, so My doctor prescribed physical therapy in a pool for me. Its a fight.. its a journey.. but your not alone. PLEASE dont withdraw,.. and PLEASE dont quit posting and reading. I WAS IN YOUR SHOES.. I lived alone, in Iowa, in a small redneck town that had a pair of overalls in their freaking MUSEUM for a guy they referred to as **FAT CHARLIE.. that weighed over 150 pounds less than I did. It was humiliating .. I put foil on the windows.. and didnt go out except at night.. and at times was soo just willing to quit. So trust me... I been there. Please dont give up? You will realize this dream.. but you MUST believe. Its like.... self fullfilling prophesy. I know SOOO many people who have ultimately triumphed.. and the key is to.. appeal.. write lots of letters.. get involved in a *online* AND a local in person support group... and dont give up. If I or anyone on this board can help you.... please holler and tell us? Hugs.. and hang in there Your Friend in the Journey Timmy Ray

Karen APPEAL. In writing. As swiftly as you can, politely but list the reasons why you feel the decision is wrong. Have the doctor also appeal. Do it and when you mail it, send it REGISTERED, return receipt requested. Its harsh, but much of the insurance company **game** or gambit is denial denial denial. Those that persist dont always win, but most of the time they do. ALSO.. please post often here. Dont be discouraged. I was denied for about 2 years, until I found a surgeon that would take my insurance then by then the insurance company was ready to shoot me with all the letters I wrote. It happens almost always to most of us. Some of us are blessed and approved at first, but I went on a three year journey to find and get the surgery. Its WORTH it. But staying involved with us here will help you.. I didnt discover Obesity Help until AFTER surgery.. it was a long cold three years without much support. We CARE.. and if you stay involved here then you will not regret it I promise. PLUS.. you will learn and gain in wisdom about the dos and donts of POST surgery... really ! ALSO... start your 6mo supervised diet.. IMMEDIATELY. Have you dieted with your doctors knowledge., or other doctors knowledge.. before? Can any doctor you have seen document this? I tried Optifast, Fit for Life, Nutrasystems, and the Atkins diet, along with Cambridge, and about six others (jenny craig, etc). Find a program of **something** (walking, swimming, bicycling, mallwalking, chair exercise) something. Something that you can do that you enjoy, preferably. I swam, at 650 pounds, for about a year three times a week. I couldnt afford the fee to join a health club, so My doctor prescribed physical therapy in a pool for me. Its a fight.. its a journey.. but your not alone. PLEASE dont withdraw,.. and PLEASE dont quit posting and reading. I WAS IN YOUR SHOES.. I lived alone, in Iowa, in a small redneck town that had a pair of overalls in their freaking MUSEUM for a guy they referred to as **FAT CHARLIE.. that weighed over 150 pounds less than I did. It was humiliating .. I put foil on the windows.. and didnt go out except at night.. and at times was soo just willing to quit. So trust me... I been there. Please dont give up? You will realize this dream.. but you MUST believe. Its like.... self fullfilling prophesy. I know SOOO many people who have ultimately triumphed.. and the key is to.. appeal.. write lots of letters.. get involved in a *online* AND a local in person support group... and dont give up. If I or anyone on this board can help you.... please holler and tell us? Hugs.. and hang in there Your Friend in the Journey Timmy Ray

Thanks Timmy Ray, Your a man of much wisdom. I will definatly write a letter to the ins. company. I'm still waiting for a call back from a supervisor, it's been three days (don't worry I'm not holding my breath). I'm so glad after three years your finally on the losing side. I won't stop reading or posting, it's kind of addicting. Someone actually said to me yesterday that maybe if I put as much effort into my diet and exercising that I do into this website, researching and doctors appts. that maybe I would lose weight on my own. I don't know how to take that. Do I get mad and hate them forever or do I think their right? It's so hard because I feel like noone understands me. No one I know has gone through this journey so you guys are the only ones I have to learn from. I have been trying to call the doctor's office since I found out I was denied to schedule an appt. for the diet but their phone has been busy for three days. I guess I have to take a drive down there to see whats going on. Nothing is ever easy for me. I hope someday it will. I haven't been on any kind of weight loss program that my doctor knows about so I have to start from square one. 6 months is long but not that long. I just have to keep my head up and think about the holidays. Things always go quick when I plan events. Thanksgiving, Christmas, Vacation, New Years, Daughters Birthday, Easter, Surgery. I'll just take one event at a time and run with it. Well thanks for listening. Take Care. Karen

Karen , I had a similar experience.. did they mention it has to be "medically" supervised.. that means a doctor..... mine needed to be.. just go to your primary 6 times have him counsell you on weight loss and that's it/// if you loose a couple of pounds.. so much the better. Good luck if you need anything ask. Donna

Donna, Yes it has to be medically supervised. I just have to be careful not to lose too much weight because then my BMI will get too low and I won't be able to get the surgery. Even if I lose weight with a doctor the second I stop it will all come back plus some. This is what the insurance companies don't understand. You can't go to a doctor every month for the rest of your life just for a diet. Thanks, Karen

Don't worry. It goes by the weight when you first went to the surgeon. Some of the insurance companies want 6 months of physician supervised diet and exercise program including nutrition counseling. Plus they want you to prove a history of morbid obesity of at least 5 years duration. Even if you don't lose a lb KEEP going to the doctor EVERY month until you're approved. Hang in there! irene