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The Truth. Here It Is.

CherylA

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Here I am sitting at 308 lbs, well that is what they weighed me in at the doctor's office on May 9th 2012. I went for my first consult. The dr says he does not think showing a medical need will be any problem. It is just a wait and see game to know what hoops the insurance(Aetna) is going to make me jump through. The office said it will take about 2 weeks to hear back from the insurance company. Come on 2 weeks. I am ready to start a life that has me playing the lead as a smaller ME!

 

I have been fat my entire life and it has caused me such mental pain and now it is causing me physical pain as well. This is the largest I have EVER been in my entire life. When you hit rock bottom I guess there is only one way to go and that is up. My weight got out of hand after being pregnant 5 times. I have had two miscarriages and 3 live births. I was on bed rest with the last two for a good half of the pregnancy. Since that time I can not make the scale move in the opposite direction. It just keeps moving up.

 

I want to be able to chase my girls and play without being afraid of hurting one of them. It is funny the larger I get the more I just want to hide and the more impossible being able to hide gets.

 

Does anyone have Aetna? If so what kind of experience did you have?



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I had my first consultation with my surgeon, and after that I was told I would have to be on a 6 month supervised diet, per Aetna. I weighed 298 at my highest, I am a female, I am 5’6, and my BMI was 47? I went every month for weigh in's, talked about my food intake, and sometimes had blood tests. I had to go to a nutritional class, a one on one nutritionist appointment, and a psychologist. I didn't lose any weight at all during my 6 month check in sessions. After my last 6 month doctors appointment my paperwork was sent to Aetna. There was a snafoo as to who wasn’t sending over paperwork (my doctor’s office not sending or Aetna not receiving it). However once I stayed on the phone it was easily taken care of and I was approved immediately after my case was reviewed. My experience was a lot better than some of the horror stories that I read and Aetna really wasn’t that bad to work with once the ball started rolling. I had a friend who had the surgery done and she went thru Aetna and she had to do a 3 month, instead of a 6 month, but her requirements were more strict and she had to show more documentation than I. She also had to work one on one with a nutritionist for those 3 months. Im not sure which route your health insurance will take you down but remember the months of waiting are a good thing. It gives you time to change your unhealthy habits to start adapting to a healthier lifestyle.

You can, and will do this, if you are meant to. Stay strong and my wishes for best health. <3

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Good luck to you and don't be discouraged if you have to do the 6 month supervised diet. Many doctors in the United States are now instituting the six month supervised diets, nutritional classes, psychological testings, seminar's, etc. whether or not insurance companies require it. Their reputation is on the line and they want the best outcome. I have gone through it and the time goes by quick. I've been fat a long time and six more months isn't going to kill me and I lost 60 pounds in that time!

If you have to do the six months supervised diet, why not put 100% into it! Go low carb 40-75 - high protein, learn to not drink with your meals, learn to chew your food slowly and thoroughly. It's what this time is for. Surgery is a lot easier on you and more successful if you can start working on behavior modifications in advance.

I suggest signing up for http://myfitnesspal.com and logging in once a day to keep track of your water intake (try to get up to 64 ounces) track your food and calories and exercise. Can't exercise? Neither could I. I stood in place and walked for 5 minutes at a time and tracked it. I finally was able to fit on the Gazelle and could do 5 minutes, now I can do an hour and walk a mile and I haven't had the surgery yet.

The first time I went to a surgeon for WLS, I was became depressed learning about the six month diet. I ended up quitting. Second time I went to another doctor, and I couldn't write it all down, and I ended up getting pneumonia, and kept drinking orange juice and eating pretzels and even lied about what I was eating and quit.

By this time I gained about 60 more pounds for my third stint. This is a lifestyle change, not a diet or an easy-way-out, this is hard work, so I figured I would try working on changing behaviors now.

I wish you the best of luck.

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I had Aetna. They wanted 3 months documentation of a weight program (dr assisted)and a BMI over 40 with either High blood pressure, Sleep Apnea or Diabetic. It started seeing my doctor in april or may of 2011... Turned in paperwork just to be denied in August/september...BECAUSE I had yoyo dieted and within the last 5 years my BMI had gone down. Ended up going to a different physician and had sleep study and high blood pressure and got it approved, but since it had been so long Aetna would only approve it to be done before Feb 22 2012..I think thats the date. Anyway, I had mine done on Feb 17, 2012.

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My BMI is 51.3 and I have have had left knee surgery. Both of my knees are messed up. My chloestrol is just now starting to go up.I am pretty much in good health. I most likely have sleep apnea judging by the way I snore. If need be we can do the test. I really hope I don't have to do the 6 month ordeal, but if I do I will make the best of it. Thanks for all the info.

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