wasted my money
R C
on 5/20/09 9:47 am - IA
on 5/20/09 9:47 am - IA
So I got a call from my surgeons office at the end of April stating that my case went through the review everything was ok except since I had never had a pych eval, I needed to have one for the insurance company. So I went and spent 3 hours on a test and 5 whole minutes with the Dr. Well he told me today that my pain in created! I have a cervical bulging disk and lumbar and extensive arthrititis in my back. He also said that my severe hypoglycemia is psychologic?? What!! How can I make my blood sugars drop to 19? And how can I cause myself to have PCOS? So anyway, the surgeon's nurse called and said they decided I was not fit for the surgery. I have to wait. What a mess, if that was what they were ganna do they shouldn't have made me spend the money.
go and get a secind opinion., i was denied because of my first eval that was done by a LPC and the eval came back with a result that i was not a good candidate. Crazy!!!!! , you mean i paid $200.00 cash money for you to deny me over something that was not true, i was pissed to say the least.But i had a second one done by a phd that was a strong supporter of WLS and was cleared by him that i was a good canidate , and i was approved 3 days later.
Just don't give up. Will the surgeon accept a second opinion?
R C
on 5/21/09 12:48 am, edited 5/21/09 12:48 am - IA
on 5/21/09 12:48 am, edited 5/21/09 12:48 am - IA
I doubt it, the pych dr is in on the review committee. What makes me really mad about it is that the 1st nurse that called me told me they already reviewed my case and I just needed the pych eval for insurance. Now the 2nd nurse said I wasn't even a surgical candidate. Why did they send me off for the evaluation then? I am not very happy with them at all right now.
This is a clear case of conflict of interest! It is in the INTEREST of the insurance company to deny you coverage; it is UNETHICAL that the psych doing your evaluation is on the review board!!! I would make sure they knew a law suit was pending if they did not remedy this situation immediately. Best, Maureen
(deactivated member)
on 5/21/09 2:52 am, edited 5/21/09 2:54 am - Menomonee Falls, WI
on 5/21/09 2:52 am, edited 5/21/09 2:54 am - Menomonee Falls, WI
I am on your side and don't take anything I say as though I am bossy or not behind you. I am actually also in your shoes and frustrated beyond belief.
I am assuming you had some sort of lap band and a revision to a rny and now want stomaphyx? Is that right? I have a non restricting stoma from probably 2 months out but not diagnosed until 8 months out when I insisted on an ugi. I was part of the failed Restor trial. I wouldn't waste any money on stomaphyx or rose or restore. If you need your stoma repaired go for the lap band.
When you take that ridiculous 700 question test answer appropriately.
I also was turned down by my PhD not because of the stupid test. But because I told him I had PCOS and Dr. Prewitt's nurse didn't have any record of it. I took my gyno record to the PhD and he approved me. He wanted to see I had PCOS. Also I took my Weigh****cher lifetime membership, my food diaries and proof that I had lost 110 lbs before surgery. (I could only prove 90 lbs because I never weighed in when I was 276 lbs only 260 lbs.
I think they want to see that you can follow a diet and there is a physical reason you can't lose weight.
Bring in any medical records that you have. Xray reports, gyno records, endocrinologist records, BS meter (if you still have it on your meter).
Personally I would NEVER waste my money on stoma repairs that aren't working for other people. I was soooooo desperate that I jumped on board with the Restore trial. One of the other girls in the trial was a GI nurse. She had seen tons of patients come into her office with popped staples from when they stapled stomachs and they failed. Like she said, "Why did she think those staples would hold the stoma?" .
Make your decision with your brain not because you are desperate. Maybe your surgeon doesn't do lap bands over a stoma. Dr. Chua who is the most experienced surgeon in Milwaukee since the 70's is having great results with them.
Good luck with whatever you do. Hang in there I know it is frustrating. I am doing crappy keeping weight off so I really understand what you are going through. I personally am not psychologically fit for any surgery right now. I have had so many disappointments trust in doctors is running a little thin right now. I am just trying desperately to count calories. I just don't have the will power of those successful ladies doing it.
Daisy
I am assuming you had some sort of lap band and a revision to a rny and now want stomaphyx? Is that right? I have a non restricting stoma from probably 2 months out but not diagnosed until 8 months out when I insisted on an ugi. I was part of the failed Restor trial. I wouldn't waste any money on stomaphyx or rose or restore. If you need your stoma repaired go for the lap band.
When you take that ridiculous 700 question test answer appropriately.
I also was turned down by my PhD not because of the stupid test. But because I told him I had PCOS and Dr. Prewitt's nurse didn't have any record of it. I took my gyno record to the PhD and he approved me. He wanted to see I had PCOS. Also I took my Weigh****cher lifetime membership, my food diaries and proof that I had lost 110 lbs before surgery. (I could only prove 90 lbs because I never weighed in when I was 276 lbs only 260 lbs.
I think they want to see that you can follow a diet and there is a physical reason you can't lose weight.
Bring in any medical records that you have. Xray reports, gyno records, endocrinologist records, BS meter (if you still have it on your meter).
Personally I would NEVER waste my money on stoma repairs that aren't working for other people. I was soooooo desperate that I jumped on board with the Restore trial. One of the other girls in the trial was a GI nurse. She had seen tons of patients come into her office with popped staples from when they stapled stomachs and they failed. Like she said, "Why did she think those staples would hold the stoma?" .
Make your decision with your brain not because you are desperate. Maybe your surgeon doesn't do lap bands over a stoma. Dr. Chua who is the most experienced surgeon in Milwaukee since the 70's is having great results with them.
Good luck with whatever you do. Hang in there I know it is frustrating. I am doing crappy keeping weight off so I really understand what you are going through. I personally am not psychologically fit for any surgery right now. I have had so many disappointments trust in doctors is running a little thin right now. I am just trying desperately to count calories. I just don't have the will power of those successful ladies doing it.
Daisy
Daisy... "Make your decision with your brain not because you are desperate." These are the wisest words I've ever seen posted to this Board! When we begin to see weight re-gain after all that we've been through to lose the weight, desperation sets in like a bitter cold winter on the heart. It's all we feel and so we strive to latch onto anything that holds a remote promise for reversing the trend of gaining the weight back. The endoscopic stoma/pouch procedures DO NOT, DO NOT, DO NOT WORK!!! What does work??? Hard, hard effort to exercise every day and to make really good, healthy food choices and not give in to crap-food-eating - every day. For the rest of our lives. This is what works. Thanks for this post. Best, Maureen
R C
on 5/21/09 12:33 pm - IA
on 5/21/09 12:33 pm - IA
Thanks Daisy,
It's nice to know someone understand the frustration. I lost about #!40, but I also was able to get to my goal and maintain if through a very strict exercise program. I ran 3-4 miles twice a day for usually 6-7 days and also did some sort of aerobics. I now have 2 bulging disk in my back and moderate arthritis and cannot do that at them weight I am. I took my xrays and diagnosis from my OB-Gyn that my surgeon wanted. I scheduled an appointment to speak directly to him because the 2 nurses I spoke with gave me 2 completely different answers. I have a hard time with my BS to. They just shake their heads and look at me like I sit around and eat bon bons all day. Well I wish I could! I have a 3 year old to keep up with and who is in so many activities we are constantly on the run. Thank you again for listening and for understanding. It't not that I want another surgery, I have absolutely no restriction since I had my stoma dilated April 2005 for excessive vomiting.
Kourt
It's nice to know someone understand the frustration. I lost about #!40, but I also was able to get to my goal and maintain if through a very strict exercise program. I ran 3-4 miles twice a day for usually 6-7 days and also did some sort of aerobics. I now have 2 bulging disk in my back and moderate arthritis and cannot do that at them weight I am. I took my xrays and diagnosis from my OB-Gyn that my surgeon wanted. I scheduled an appointment to speak directly to him because the 2 nurses I spoke with gave me 2 completely different answers. I have a hard time with my BS to. They just shake their heads and look at me like I sit around and eat bon bons all day. Well I wish I could! I have a 3 year old to keep up with and who is in so many activities we are constantly on the run. Thank you again for listening and for understanding. It't not that I want another surgery, I have absolutely no restriction since I had my stoma dilated April 2005 for excessive vomiting.
Kourt
Insurance companies will look for a way out of paying for anything if they can get away with it. You MUST get confirmation from your PCP that your bloodsugar is REAL. Hypoglycemia is one of the most prevelant and severe consequences of WLS, starting at around 3 years out. People are blacking out from it. Get a bonafide diagnosis from your regular doctor, FAX it to your insurance company and demand a re-evaluation of your case - threaten a law suit if you have to. Do not take this!!! Do not accept this!!! Keep us posted. Maureen
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