SFOTraveler

I am having surgery Dec 15. I was hoping for the 13th but the OR was booked up already : ( Hoping I am ok by Christmas to at least be fucntional and able to enjoy the company, not the food! haha. Anyone else starting to have fear/anxiety? I was so gung ho prior to booking surgery and now I am really really scared about the recovery period.

Hi Everyone! I am so excited to have found this community online. May name is Alexis, I am 27 and am a stay at home mom to 2 young children. I recently submitted a claim to UHC for the sleeve surgery and it was denied. I am trying to figure out how to appeal so that it gets approved. The one major issue is that i haven't been at my current BMI of 40 for 5 years. In fact I have only been at it for a year. I have no major comorbidities either. Does anyone have any suggestions on how to appeal this and win??? Thanks so much for your help and I look forward to getting to know everyone.

Congrats on finding a surgeon you like. Just FYI about the calcium citrate.... Citracal is Water soluble so if you take a pill and dissolve it in water, you can just drink it that way. There was a doctor at my last surgeon support group who specialized in osteoporosis and he told us that. Apparently it tastes like lemonade when dissolved and the nutritional value remains the same. Just an idea ; )

I just wanted to say that I have yet to even have surgery but all of these stories are so incredibly inspiring! I can relate to so many of the "fat" experiences that now define my life. Ugh... can't wait for insurance to hurry and decide about my appeal. If they don't approve I am strongly considering going to see Dr. Aceves but I am super scared about surgery in Mexico..... someone make me feel better!!!

Just wanted to thank you all for your kind words and advice. I wanted to post my appeal letter... I think it came out well. My goal was to appeal to their sensitivty... we'll see if that works : P Dear Sir or Madam; I recently received a denial of benefits for the proposed Laparascopy, a longitudinal gastrectomy (i.e. sleeve gastrectomy) based on the fact that I have not been at a BMI of 40 or higher for 5 consecutive years. I am appealing this decision and hope that based on the facts that I present in the following letter, that the decision will be overturned and I can be approved for surgery as soon as possible. I have attached a copy of the denial to this letter for your records. I understand that the policy states that I must be at the current BMI or higher for a minimum of 5 years, however I firmly believe that in 5 years, not only will I be much heavier, but I will also have a long list of comorbidities to add to my current morbid obesity. In 2005 I weighed 193 lbs. In 2010 I now weigh over 230 lbs. At the rate at which I am gaining weight I will easily weigh 280 lbs by 2015, which far exceeds the title of morbid obesity. It is this hypothesis that has led me to the option of bariatric surgery, which for someone like me, will literally save a life. I come from a long line of obese individuals. Not one person in my immediate family is not classified as obese, and many of my extended family member s are morbidly obese. I have a cousin who died of morbid obesity in 2005 at a weight of 650 lbs. She was living life in a wheelchair because she had lost mobility and eventually had a heart attack and died at the age of 35. Diabetes also runs rampant on both sides of my family; my father, sister, uncles, aunt, grandmother, and grandfather all have been diagnosed with type 2 diabetes. I tested borderline for gestational diabetes for both of my pregnancies and one of my biggest fears is being diagnosed with type 2 diabetes. In addition, hypertension and high cholesterol also permeate my family?s medical history. My mother, father, sister, aunts, uncles, and cousins ALL have hypertension so severe that they are on medication. My grandmother, mother, and father all have high cholesterol, also severe enough for medication. I see myself as next in line. Currently, I have chronic heartburn which I fear will transition into GERD in no time. And I have begun snoring, which has the potential to turn to sleep apnea as time passes and my weight increases. You see, I simply do not have 5 years to wait and see how sick I become. I am attempting to be proactive and save my life. If not for myself, for my 2 young children. My daughter is 2 and a half, and my son is 9 months old. My prayer is that I can have this surgery not only to lose weight, but to bestow upon them proper eating habits and nutrition as well as the love of exercise. As it stands right now, my mobility is affected by my weight and it breaks my heart that I can?t be the mom I want to be simply because of how heavy I am. I am essentially dragging around at least 100 extra pounds with me every single day, which makes it difficult to do simple things like walk up the stairs in my home. I don?t want to write a research paper about the benefits of the sleeve gastrectomy because I do trust that you are an informed medical professional. But I want to explain why I am choosing this surgery over all of the other options out there. The reason why I am not simply accepting gastric bypass (e.g. Roux-n-Y) or gastric banding (Lap-Band? or Realize?) is because both have very high rates of long term failure. And the reason why I have chosen not to apply for the Biliopancreatic Diversion with Duodenal Switch is because I feel as though the surgery is A) extreme for someone with my BMI and also leads to nutritional deficiencies and high rates of osteoporosis as the malabsorptive properties of the surgery are almost ?too effective? and can lead to malnutrition. I do believe that the vertical sleeve portion of the DS surgery (sleeve gastrectomy) is the best option for me because it is a highly successful restrictive procedure and I can still absorb the essential nutrients that my body requires without extreme amounts of Vitamin supplementation. Supporting Literature A systematic review of the literature covering LSG through January 2009[1] was published in June last year. Conclusion: From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis, and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reduction that exceeds, or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been acceptably low. Long-term data are limited, but the 3- and 5-year follow-up data have demonstrated the durability of the SG procedure. A handful of additional work has been published since that literature review concluded, with additional long term durability data and adding considerable support to the efficacy of LSG in resolving diabetes.[2],[3],[4],[5],[6],[7],[8] Two International Consensus Summits for Sleeve Gastrectomy have been held, the first[9] 10/25-27/2007 and the second[10] 3/19-21/2009. At the second conference, during the consensus part, the audience responded that there was enough evidence published to support the use of SG as a primary procedure to treat morbid obesity and indicated that it is on par with adjustable gastric banding and Roux-en-Y gastric bypass, with a yes vote at 77%. In conclusion, I ask that you please approve the Sleeve Gastrectomy surgery for me based on the medical information that I have provided as well as personal consideration and kindess. I truly need this surgery to save my life, and I pray every day that it can happen. I appreciate your time and sincerely hope that you can assist me in changing my life and my children?s lives. Kind Regards, Alexis