KinkySlinky

The only thing I can suggest is to send in an appeal... Something else you might try is contacting your HR department.. or whoever is in charge of selecting the medical insurance plan and try pleading your case... The thing about insurance companies is that they do not set the rules... It's the EMPLOYER... so I'd appeal your insurance, if that doesn't work, start with HR.. It's going to take a lot of time and dedication, but if you're persistent, you might have a chance? Let the benefit decision maker know that you were in the process of doing the required monitoring prior to the insurance plan being changed and you want it to be covered.. I will tell you that my insurance has a max of $10,000 per procedure.. Well, the hospital itself has a contracted rate of $17,000, that doesn't include the surgeon, the anesthesiologist, etc... But with a few days of thinking, I have been able to find a way around this... But it took some time, a lot of phone calls, and some bargaining... Good luck!!

It really depends on how bad of a bush you got going on LOL.. If it's so bad that it's going to take like two nurses just to put in a cath, one to hold back the hair and one to open the labia (i am exaggerating a lil bit here)... then trim it up LOL... If it's just a lil stubbly and a lil hair but not afro-like, then no big deal.. no one cares.. it's only when it's CLEARLY never been taken care of that some nurses might have a thought or two to the effect of "you could have at least shaved your tw*t ok" LOL.. Most of the time, we don't care.. Caths take like 2 seconds to do so we aren't down there long enough to really notice or care... When I had my c-section in 2010, I shaved my stuff completely but it's just personal choice... if u aren't wanting to shave (and it isn't a bush that sticks out of ur panties), then dont lol.. Oh, and I also had a pedicure before my c-section lol.. Just my choice =)

I've always thought that when people aren't happy that a friend or relative is losing weight, it's probably because they are losing the person that plays the fat role. They want to keep YOU down so that it will make themselves feel better... The thin never want the heavy to lose weight (some times... at least among women).. Just because they are no longer "the hot chick and her fat friend," it's now the "two hot chicks." Or, in your case, the two hot men lol... Which makes them an equal to you... and a lot of people can't handle that.. Some relationships are based on one person being "better" than the other... and those are toxic relationships that really need to be severed if the foundation is not changed... I have no intentions of telling anyone about the surgery because I feel it is a private issue... But if there are people that can't handle it, then they need to go.. I have a feeling I have a few friends that won't be able to handle it as well... We will see.. Good luck to you!!!

I completely agree. Our system is not the best, that's for sure... It's a shame really... We provide unnecessary tests and diagnostic imaging just for liability sake... My background is ER, and I cannot tell you how many CTs we do on people... No one really considers the amount of radiation because they believe their risk of liability is > than the risk of cancer from multiple CTs... It's horrible.. Man, don't even get me started on EMTALA! LOL.. THAT is something that needs to be fixed, right along with malpractice!!! I really believe that if are able to start refusing patients in an ER setting, healthcare costs will go down.. not necessarily malpractice costs LOL.. but healthcare cost will go down... Not enough facilities practice the "medical evaluation" portion of EMTALA... Why not?? Liability... In fact.. my husband is a paramedic... he has received a call where someone gave a bogus complaint like back pain, and instead.. he just wanted the paramedics to bring him a pepsi from the fridge.............. Yes, patients call 911 to have the paramedics help them with household chores or even making them dinner!!! I'm sorry, but if you cry wolf too much....................... that's how I feel... probably just the jaded ER nurse coming out LOL!!

I am sorry I am late on this... I'm glad it seems like you have everything situated at this time.. But I totally agree with not letting your b**** a** in laws see your children.. I know I wouldn't want my children to see someone disrespecting me.. Plus, it's hurtful for your children to hear those snide remarks from their grandparents about their MOTHER... and I'd also tell my husband to get the titty out of his mouth and be a man for once in his life This post makes me angry FOR you!! LOL Hope I'm not offensive.. Don't mean to be!! It is my TOM.................... lol

Wow, thanks for the info!!!

Well said

I completely agree... Our hospital stays here are ridiculous!! We send home patients that should not be sent home just yet... I do hear the hospital stay in Mexico is longer, which is better... Gives you more time to acquire the diet (since you are being fed hospital food lol), pain is better managed, etc... Did you ever find insurance post-op?

Well, just because a surgeon is an "assembly line" surgeon, doesn't mean he doesn't take his time with you... For example, my surgeon spent a lil over an hour with me answering my two pages of questions lol.. Thankfully my surgeon is both approachable AND skilled... But if I had to choose between the two, I'd most definitely go with skilled. My whole point is that even if your surgeon is called "assembly line," that it isn't necessarily a bad thing... I don't know anything about the Mexican surgeons but I have heard the assembly line jargon before... So, essentially, I am defending the fact that the most important thing, regardless of the 'assembly line' feel, is surgical skill.

Right... but a surgeon is just that.. A surgeon... His main goal is to perform the surgery, and do it well... A surgeon is not there to cuddle you after your done with the surgery.. My surgeon has several other staff members that help out post op.. We get the work email address of the nutritionist, which I *really* like because I am sure I will have a ton of questions afterwards... But as far as for this surgery, as an RN, I am perfectly content with an assembly line approach, which is also why I see a surgeon as a surgeon and nothing more... I like the lower risk of complications... Each person is different in their preference, but this is my take on the 'assembly line' approach

I was actually told that if I go to the surgeon I have now that it is like an assembly line.. FINE WITH ME!!! The most important thing is surgical skill... Not bedside manner lol.. Assembly line-ish is actually kinda good when it comes to these types of procedures... Most experience, everything is in order, less likely for complications..

Congrats!!!! I am very happy for you!!!!!!!! and you are absolutely right about these fad diets that only work temporarily... Good luck on Tuesday!!!!!!!

This is my take on it... A lot of requirements here that are done by the surgeon is really because of, aside from complications, LIABILITY.. Now, I'm no lawyer or anything but... You can try suing a Mexican surgeon, but I'm really not sure how far you will get with that, you know? Now, I'm not saying he's a bad surgeon or anything of the sort... but quite a few of the hoops we have to do here in the U.S. is because people are just too sue-happy... Medical malpractice is a joke... If they make you do everything in their power to prevent any complication, it makes it harder to win a malpractice suit... As far as the insurance hoops... Those are set in place by the employer.. Not the insurance company.. I agree it's ridiculous... But unfortunately, a lotta times it's necessary protection for the surgeon....In fact my surgeon is 1 week liquids pre-op, and THREE weeks of liquids post op... He's also done just under 1000 sleeves since 12/06 (or so he says).. he averages a lil over 900 procedures per year.. There are good doctors everywhere, you just gotta find them... and you're right about how surgeons will do what they've been taught... Most patients have a larger incision on the left (from what I've read), but my surgeon prefers to have the larger incision on the right side.. Different technique... Good luck to you!!!!!!!!

LOL Yeah... I've never had an upper GI or a colonscopy.. I've just watched it happen to others... Thankfully we are put to sleep... Mmmm versed

I can't believe you are looking forward to a colonscopy either!!! Although, it is better than an upper GI in my opinion.. Congrats!!

This is correct.

Check with UHC and see if you can provide 7 years of weight logs because you did not seek treatment for two years... Unless you had UHC during those two years, then they will be able to tell..

I am not a nutritionist nor have I had the surgery yet... But my advice would be to really try to get in your water.. If you don't drink enough water, your body will start to retain what little water you DO take in.. So drink lotsa water so you won't have any water weight gain

A hernia is when abdominal tissue of sorts protrudes through a weakened abdominal wall (which could be from incisions)... Usually you develop a hernia with heavy lifting, horrible coughing spells, straining, etc.... Hernias are usually OK as long as it doesn't interfere with the normal workings of your abdominal organs.. Hernias become concerning when they're extremely painful with nausea/vomiting, tenderness... The concern there is a strangulated hernia. which means the tissue has had the blood supply cut off and is going to die... that's an emergency and requires immediate surgery to release the tissue so blood flow can be resumed... Another problem with hernias is when a piece of bowel is herniated... That can cause a bowel obstruction which may also require surgery... Signs and symptoms of a bowel obstruction include abdominal pain, abdominal swelling/tenderness, nausea/vomiting, constipation.. I asked my surgeon how often he sees hernias post op and he said rarely.. Doesn't mean it can't happen... But nothing to really stress yourself out about unless you have one with severe pain... Hope this helps!!

Hahaha.. I like the celery stick with a candle in it!!! Great idea

Hello! You will find there are SEVERAL nurses on this board who have had or are going to have the sleeve. I am an ER nurse turned case manager and am in the process of getting approval from my insurance. I decided about a month ago to begin looking in to the surgery after several failed attempts at weight loss and only getting bigger by the minute (literally lol)... I've done a TON of research over the last few weeks... Medical research, listening to patient stories, reading up on physicians, etc... I am pretty certain in my decision to have the surgery but also have a ton of fears because of the complications... In fact, last night in bed I was talking to my husband about it and how scared I am... We are just going to make sure everything is in legal order prior to having surgery just as a precaution... Being in the profession really SUCKS when you need something, you know? lol.. I am always thinking worst case scenario... Just do as much research as possible, ask any question you can possibly think of and make the best decision for you. We are all here to help answer your questions if you need it!!

That's exactly what I am doing... I have no intentions of telling anyone other than my husband... If family asks why I am losing weight, I will let them know that I am tired of being ginormous and it is time for serious diet and exercise... and leave it at that.. They don't need to know you had surgery at all!! Just don't plan anything with them for a week or two.. Go "on a vacation" if you need to

Good idea!!! But just so you know, high protein diets can actually cause kidney stones... So you might want to just rearrange your excuse a little bit.. like tell them you had your gallbladder taken out and because of that, you feel you should be on a healthier diet.. Just thought I'd let you know in case you do use this excuse so you won't get caught

What is the purpose of a review committee? A review committee at your surgeon's office?? Sounds to me like that they are just trying to rack up insurance claims if everything else checked out on your psych exam... Maybe they aren't happy with the amount that the insurance pays... I'd let them know that I would be finding another surgeon and ask for all of your medical records so maybe you won't have to go through the same stuff at another surgeon's office?

It all depends on the requirements set by your insurance... If you meet all of the criteria, then there shouldn't be any issues... Each plan is different based on what the EMPLOYER has chosen... So in most cases, a plan will not be the same from person to person unless it's the same employer or a specific type of insurance plan that most companies do not have except mom and pop businesses... Sounds like you already have everything in order... Good luck!!