Fancee

Send Message

Block

Add Friend

Ok I called the insurance company today to find out my status.  I should have known when I called twice and both times was put on hold. Both reps took my number and said if we get disconnected they woudl call me back. Both times i got disconnected.  I was calling from my cell phone so i know it was me that dropped the call but anyway.... neither rep called me back.  So, i was preparing my self.  So, on the third call i got the rep that i talked to the second time.  She told me that i had been denied. She told me that she could not tell me exactly why i had been denied but they faxed a letter to the surgeon with the reasons and mailed me a copy.  She said that she thought it might be because i did not have 5 years of medical records showing obesity.  Well, my WLS faxed the info over without my 2007 records. Now, they faxed my 2004, 2005, 2006, 2008 and 2009 records.  To me it is common since if my butt is fat in 2004, 2005, 2006 and in 2008 and 2009 then it stands to reason that i was fat in 2007! I guess that makes too much since! The thing that makes me so mad is that i have been trying to get my 2007 reocrds from my PCP for the past month.  Believe you me it is on and poppin' come Monday morning at my PCP's office!  so, i am asking my friends now not to spend too much money this weekend because i may need some bail money come monday!  

Seriously though, I am very frustrated by this and shed some tears ( although, honestly i think i am a emotional too due to death of my first love- Michael Jackson RIP).  My boyfriend is being very supportive and loving and is telling me that it is not the end of the world.  I love him for it.  It is just so frustrating.  Honestly, I was very discouraged by this news. I almost wanted to quit.  Just say forget it i will just be fat for the rest of my life. Then i said the Devil is a Liar! This is just a small setback.  A test, to see how bad i really want this surgery.  So, i am just going to take this as a small road block and keep on pushing.  


I am claiming my approval! All things are possible through those who love the Lord and work according to his plan!

I called the insurance company this morning just to make sure that they had actually received my paperwork and to see what to expect regarding the approval process.  The lady told me that they had received the paperwork that morning and that a decision will be made within the next 48 hours.  So, I will no something by Friday at the latest.  But, i know me. I will call them tomorrow morning to see what is  up! LOL.  I am so nervous that I won't be approved.  I am trying to stay positive and claim it as already done.  I am also trying to tell myself, if i am denied it is not the end of the world and to not give up.  I am sure most people go through this when they are at this stage.  It is so nerve racking.  I guess it is just the not knowing.

okay, well today i received an email from Centennial.  They submitted my paperwork to the insurance company today!  I am so excited and nervous.  I guess i will be hearing something pretty soon.  Just when i was starting to have fleeting thoughts of giving up. I did say fleeting.  I know that I not only want this surgery, but i need this surgery.  I am praying that the insurance company approves me.  I know that the documentation from my Dr. is not the greatest. I am also missing my 2007 medical records.  My doctor's office has been slow in sending them, so they just submitted with out it.  I pray that everything goes well.  I have my fingers crossed.

Hurry up and wait! That is what I feel like. I am trying so hard to get all of my information in to Centennial. I keep running into road blocks.  Granted they are small compared to some people's blocks, but they are aggravating all the same.  Let's see so far my 6 month program, medical records from 2004, and my PCP letter is in. All i need is my psych eval, which is scheduled for tomorrow, and my medical records for 2005-2007.  Well, here  are my problems so far.  My pcp's office has not yet sent my 2006 and 2007 records.  I asked for them and they said they were large and i would have to pay for it if i wanted the whole record.  I called back and told them that i did not need the whole record.  Just partial, enough to show my weight during those years.  I have called three times. But i still have not gotten the records sent!  In 2005 i was between PCP's. I remember going to TN Urgent Care.  I called them to have them fax my 2005 record over. The lady i spoke with was very sweet and said that she would do it immediately after she got the release.  I contact Centennial and gave them the information.  I was told that they were faxing the release right then.  Done, right? wrong.  Now, no one is answering at TN Urgent Care. I don't want to whine and complain.  Like i said other people have had a harder time than me so far, but geesh. I am getting tired and frustrated.  On top of that i guess i am really anxious about starting nursing school at the begining of July.  I am afraid that the surgery will inerrupt school.  I would much rather have this surgery right now.  The problem is i have demoted from work and changed shifts just to be able to go to this program starting in July.  I would not be able to enroll in the program again until December 2011.  If there was a program that started before that I would be all over it, but such is not the case.  What should i do?  I definitely do not and cannot postpone this surgery for any longer.  I begin thinking about having it done about 5 years ago.  I seriously began thinking about it and starting the process back in 2007.  This has been a 2  year process.  Wow!  I told my boyfriend how i was feeling.  He thought it was really deep.  He too has made some adjustments for me to go to school in July.  He said that he needed to process what i told him.  I know that i cannot tell my mom about this. She is not totally against me having the surgery, but she is not happy about it.  I know that she would tell me to wait on having the surgery until i was finished school.  Truth is I will probably not finish school if i don't have this surgery.  I won't have the energy.  UGH!  I am praying about this everyday.  Lord, please help me and give me guidance.  Sometimes i feel like i am all alone in this struggle. But i know that HE is with me and my strength is in the Lord.  



Praise Report:  I just got off the phone with TN Urgent Care and i was there in 2006 and 2007.  Their printer/fax machine was down yesterday.  She is faxing it as we speak.  She pulled the records up with me on the phone! I am so happy. Lord please continue to be with me during this process! 

Ok what has happened since the last entry. Let's see.... I decided to go back to the informational session at Centennial because it had been about a year since i had gone through it.  I started this process about a year ago, and, well, life happened, so i stopped. So, I thought it was a good idea to go back to the session and hear what they had to say again to refresh my memory.  Boy was I glad!  I found out that my insurance company requires 6 months doctor's supervision, but it does not require it to be consecutive.  And according to my calculations... I have 6 months! So, I leave the informational inspired. This may happen sooner than i expected!  The funny thing was at this time i had lost about 13 pounds in the past 2 1/2-3 months.  I though i was doing pretty good. My insurance company says that if u lose 10% of your body weight you are NOT elligible for the surgery. How crazy is that. Some insurance companies won't do it unless you lose 10% and mine says they won't cover it if you do! Anyway,,,,I was rolling high! By my calculations i could possibly have my surgery before the end of the summer.  "Lord willin' and the creek  don't rise" (as my grandmother used to say). So, I have been on my game to make sure that I have everything in order.  Now it is time to make sure that i jumped through my hoops correctly.  I have my fingers crossed and  a prayer on my lips that everything is done right.  Or at least good enough for approval.

My Diet was submitted to the surgeon's office.  I received an email yesterday that they had received it as well as the past two years medical records.  They need the past 5 years and some of my doctor's notes were pretty shotty. Well, I knew this already. My current PCP had already advised me that the first couple of notes that were in my file from the previous PCP were bad. I am going to have them  submit them anyway with the hopes that they will fly because he sent me to a nutritionist at the time and her notes are in the file around the same time.  Hopefully they will suffice.  The other problem with my record is that i started at my current doctor's office in 2006. I was at my previous Dr.'s office in 2004. So, in 2005 I did not have a PCP. I am hoping that this is not held against me.  My Insurance company wants documentation that I was obese for the past 5 years. Well, if you ask me if i was obese in 2004 and obese in 2006, chances are i was obese in 2005! Wouldn't ya think. But that is logical. And although insurance companies sometimes seem to be from another planet -Vulcan is not it!. LOL.  Hopefully, I will have everything in by the end of the week so I guess i will know something pretty soon.

My bestfriend, just had her lapband surgery almost two weeks ago. She said it is slow going.  But she is doing well. I am so excited for her.  It is funny that she had it done because last year when i was talking to her about it, she said no way was she gonna do it.  Then she beat me to it!  We are both so excited and looking forward to a new begining........

I decided to write more frequently here. I think it will be neat to have a log of what i was feeling and to document this whole process. So let's see....where am i in this process??  Sometimes i feel like i don't know whether i am coming or going. So let's see.  I am not sure if i want to have RNY or Lapband.  I have been researching both and feel there are pros and cons to both procedures.  I like that the lapband is less invasive.  I have never had any type of surgery so this really appeals to me becaues i am scared of surgery.  The RNY seems like it is more successful. However, the dumping and possible complications of the RNY are scary to me too.  I liked the Sleeve, but my insurance does not cover that procedure.  So that is out! I have not even decided which hospital to have the surgery in.  The one i thought  i wanted to go through had a $250.00 program fee.  I am not willing to pay that. If I HAD to that would be one thing, but there are plenty of people who perform this surgery here that I don't have to do this.  So, I will go to another seminar next week to check out another program. 

I have started the 6 months supervised diet that my insurance (Cigna) requires.  I have completed about a month and a half.   So far i have lost 6 pounds.  I am attending a lifestyle changes place that helps with diet and exercise, started taking anappetite suppressant and working out.  Overall, things have been going pretty good. But i have my days and my moments already when  I feel hungry.  And want to binge. But i am trying to stay focused and keep my eye on the prize......a thinner, healthier me!

I have not always been overweight.  As a child and a teenager, I was active and I had a nice shape. In college a gained a few pounds.  Okay, more than a few, more like 40.  Although, i was thick, I still had a pretty good shape. It was really after college that the pounds started pouring on.  I got married in 1997 to my college sweetheart and things went down hill from there.  I gained more weight.  We separated and then divorced. I gained more weight. I moved from Philadelphia to Nashville, and gained more weight. One day, I woke up and did not even know the woman staring back at me in the mirror.  I was depressed. Who would want me know? And you know what i did...EAT of course!  I have tried time and time again to lose the weight.  Everytime, I fail.  One slip up turns into two, then three... You know the story!  Well, when i tipped the scale over 300 pounds (I am 5'7). I said this is it! I can't take it anymore.  It is time to do something about it!  So, I began my journey to WLS.  I actually went to an informational session and started the 6 month deal for the insurance company about a year ago.  But i quit. Life got in the way.  But now I am back on board and starting again.  Priorities in order. I am tired of being fat.  I try to fool myself into thinking that i am okay the way i am.  That i love myself and that i am beautiful.  Don't get me wrong.  I am okay with who i am and think that I am a wonderful person.  But, there is this constant nagging in my head that says  yeah.. but your fat.I am tired of my knees hurting and getting out of breath just walking.  The steps in my home are kinda steep for steps inside a house.  I am out of breath everytime i go upstairs.  I hate to go up them.  I dread it! If i had a shower downstairs i don't think i would ever try to tackle those steps.  I have to take them one at a time because my knees hurt!  You know, I can't even walk up the stairs correctly?! I crawl!  I actually crawl! I am 36 years old and CRAWL up the steps! So anyway, I can't take it anymore! I am gonna do it this time! I have started over!  This is my second week of trying to lose weight.  My starting weight was 308 and i am now 304.  Will update that on a weekly basis!

Please feel free to add me as a friend or to post comments. This is my first time blogging or doing anything like this so i really would appreciate the support! THANKS!