Jen35

I am waiting on approval from my insurance, but really my doctor's office is the biggest hold up. I started this process in September of last year. Had to go through 3 months pre-op appointments for the insurance to approve. My last appointment was 12/6 so I thought I would for sure be getting sleeved in January. NOPE! Dr. office didn't even submit the paperwork to the insurance until 12/28. By 1/8 I had a denial, due to the surgeon being out of network. No problem, the office was going to switch my surgeon to the other in the practice that is in network. I had that conversation with the coordinator on 1/8, but the insurance still has not received the recertification paperwork. WTH???? That was 3 weeks ago! For the last 2 weeks I have been alternately calling the insurance and the cooridinator at the dr. office - getting the run around. Cigna says that they have not received new paperwork - coordinator says that they told her they can make the change over the phone. Each has told me this same info twice. Coordinator told me that they are really busy and she is doing the job of two people. Ok - I understand that, but I have to get a surgery date and approve it with my boss, etc. I need to get this process moving!!!

Update: It's been over a month since I've posted this and still waiting to hear if I'm approved. Turns out that when the practice moved at the end of the year, the new doctor did not have his address updated with Cigna. Sooooo, I had to have the doctor's office submit the address change. I gave it some time and I was very patient (not like me!). I finally called Cigna and the pre-certification nurse (I snagged the direct line of the pre-cert nurse for my case which means I can bug the CRAP out of her!!). After a long conversation to reminder her what is going on, she tells me that , Oh, the address has been changed in the system. I guess if I hadn't followed up, nothing would have moved forward. She told me I just needed the dr. office to fax her something stating we are changing the doctors and she would review. She basically told me over the phone that it looked like I had all the required information submitted. Called the coordinator - she was faxing it that day. That was over a week ago. A couple days ago I called the coordinator and the pre-cert nurse and neither have called me back. I am so close!!! It just is really driving me insane to be this close and nothing is happening! I really want to be wearing a smaller size this summer. At this point, I'm so discouraged.

I just started so really I've only had one session. The research I did prior showed great results for trama and PTSD suffers. It is supposed to work much quicker than just talk therapy and it reorganizes your thoughts, etc. related to the trama. For me, I have a lot of untrue emotions and beliefs about myself (I'm worthless/helpless/alone, etc) related to the abuse that lead to emotional eating. I went in with an open mind and I was pretty amazed at the emotions that came up in just that hour session. Prior to this session we worked on establishing a "safe" place (for me it's the beach) and I used the last week to practice visualizing that as a relaxation technique. During my session, she had me think about the tramatic experience (the emotions I was feeling, the physical sensations, etc.) while she moved her hand from side to side and I tracked her hand with my eyes. Every 20-30 seconds, she had me take a deep breath and update her with my emotional/physical feelings. At one point I actually felt panic and the physical feeling of being unable to run away (very strange). At the end she had me visualize putting all this "stuff" in a box and locking it up and leaving it in her office for next time so I don't dwell on in outside of our sessions. Then I visualized my safe place until I was calm and relaxed. The rest of the day I was kind of down, I think because my mind was still processing things. It's intense, but worth it if it's effective. I'll know more about that as time goes on.

I'm pre-op and started therapy to get a jump start on my emotional eating. I am just starting EMDR and I'm so glad to hear that it helped you. My eating is tied emotions stemming from abuse so I'm hoping this therapy helps me. I have an amazing therapist and she is really helping me so much already. VGS will help with the physical restriction of eating but not why I eat - that is what can lead me right back here even after surgery.

food is my drug. After seeing a counselor and realy analyzing why I eat, I have concluded that I am a food addict. Some people think this is a cop out or not a real thing. But for many, food works on the brain in the same way drugs do. And when you consistently drug yourself with food to cope with pain, anxiety, etc., it's an addiction. I wish I could go to food rehab! Instead, I see my thearpist weekly and I'm working toward getting the sleeve to help facilitate the changes I'm already making. I also can't exercise like I used to because of RA and other health problems. I'm hoping that losing weight will improve those conditions and I can be more active again.

It's not selfish to take care of your health. No one else is going to do this for us - it's up to us to take charge of our lives. That being said, it's important to realize that any changes you make in your life does affect your relationship. Those who have WLS have a higher rate of divorce, for whatever reasons. My counselor recommended that when I get close to goal, that my husband and I do some counseling together. Also, we are trying to work on our relationship along the way - making sure we are staying connected.

I'm pre-op, but I know I will feel uncomfortable in these situations after surgery. I started seeing a counselor a couple of months ago. I figured that it couldn't hurt to get a jump start on my emotional eating issues. She has been amazing! We just talked about being "invisible" as an overweight person and what it will mean to be "visible" again after losing the weight. I never thought about it like that before, but being overweight is one of my buffers or protections from everyone else. It's kinda scary to think of losing that. I definitely recommend counseling for bariatric patients because the surgery helps with the physical part of overeating, but doesn't address the mental side of things (why we eat). There are also some great books out there too.

These are all are normal doubts (I'm pre-op and have them too). But going into surgery, you should feel confident in your surgeon. I have met with mine a couple times and I don't even have a surgery date yet. I know he has done hundreds of bariatric surgeries. Is your surgeon a bariatric or general surgeon? I would recommend a bariatric surgeon because that is all they do. Kind of like the difference between going to a regular doctor and a specialist.

I'm using these!!

Love it!! When people know about the surgery, they somehow think that we need their advice (and everyone else's). I have a friend who I told that I am going to get VSG. She started selling HerbalLife and sat me down and went over their diet program that she thought could help me. I didn't go off on her because she was being very sweet and I know where her heart is. But she made a comment about how she was worried about me getting surgery. She knows my brother (who had VSG 2 years ago, was very successful and had NO problems) and she mentioned that he can't eat what he wants, he is limited in how much he can eat. I told her that, yes - that's how he lost weight. But he eats whatever he wants and has kept off 150 lbs for 2 years. I'm thinking "And your diet in which I am replacing 2 of my meals with shakes ISN'T limiting what or how much I would eat?" Many people who don't know about VGS, have a knee jerk reaction that is not even logical. Same thing after surgery, this automatic thinking that we need all the help we can get.

I agree! If we don't stay on top of things, it may not get done. I've been very patient - I haven't called daily, so now I think I'm entitled to be a little pissed off. I was prepared for the insurance taking it's time on approving, but the coordinator messing everything up just has me floored!

My brother went to this program and he referred me (and several others). He gave me the name of the manager who he is still in contact with. I called her and told her the whole situation. She said that my file shows that Cigna has given several different reasons, but the wrong address wasn't one of them. She is going to personally get in contact with Cigna and try to pin down what they need to do and call me tomorrow with an update. Hopefully, she will get the ball rolling a bit faster!

I have been very patient with my coordinator so far, but it's time to talk to her manager. It took almost a month for her to originally submit the paperwork. Then Cigna denied because the surgeon was out of network. That was 1/8. I have called every week and nothing. I called several times last week and was told that she was on the other line and would call me back right away (this was Wed and Fri). Never called me back. Until today. Now she told me that Cigna said the other surgeon is not on my plan. They are working on getting the contract changed but it could take a while. Well, that's a lie. I had already checked that this surgeon was in network. I called the pre-cert contact she had been talking to and she tells me that the surgeon is on my plan (which I knew) but that the office address is wrong. The office moved in December, I tell her. She says that the address has to be updated with Cigna in order to identify him as the surgeon and reconcider the certification. What is the coordinator smoking?? AND why did it take her a month to get that (wrong) information and tell me? Has anyone else had issues like this? I like the surgeon, office etc. up to this point. I don't want to start over with a new 3 month pre-op diet, etc. I'm losing my mind!

I agree. We are here to support each other through good and bad. None of us can verify any of our stories since this is an online forum. I don't really know what someone has to gain by posting a fake experience, other than to try to sway others from having VSG. You have to make up your own mind anyway, not rely on others to do that. I have read those threads too, and they make me wonder if I really want to be on this forum. But there are some great people on here that make up for that. That being said, I would be deeply hurt if I poured my heart out and was accused of lying. And I wouldn't come back.

Thanks for this info - I'm going to try this. My daughter is 10 years old and joining Girls on the Run soon. They train for a 5K and I think the actual 5K is in May. She has to have an adult run with her and I want to be able to. I'm pre-op and was hoping to be sleeved by now, but I can always start training now and restart after. I should have time. I'm 240lbs now but I actually participated in a 10K MS Mud Run a few years ago. I was 210 then, but trained with a personal trainer and was in much better physical shape. I walked most of it but it involved much more than walking/running - every 1/2 mile or so you had an obsicle like walking through a Water filled trench with mud up to your calves or belly crawling through mud, etc. I was so proud of myself for finishing. It was amazing! I want to eventually be able to do it again (only better!)

I guess I could. I haven't had time and I'm really trying to work this out with her first. I'm going to just keep calling everyday, so maybe she will get tired of me enough to get something done. I'm going to tell her to fax the paperwork regardless of what the contact from the insurance told her. Because they obviously don't have that information.

Congrats to all who were approved:) I'm hoping for all of you in limbo like me. I'm still waiting, very impatiently. I was denied 1/8 and all the insurance coordinator had to do was change the surgeon on my paperwork and fax it back to the insurance. It's been 3 weeks and the insurance still doesn't have it. She is trying to tell me that her contact at Cigna made the changes over the phone. But Cigna has told me 3 times times now that they have to refax the papers with the change - there is nothing on my file stating it is being reconsidered. Has she done it? NO! I left her another message today, but she didn't return my calls, so I won't here from her until I call again.

I have Cigna and I had to do a 3 month supervised diet too. I personally saw the surgeon and their nutritionist every month. My coordinator was leary of me even doing the 3 months with my regular MD since they don't always gather the required information. I'm not sure if they will take weight watchers. I would call your insurance and ask specifically what is required so you don't waste your time. The other thing I learned is that they go by calendar months and I had to see both the doctor and the nutritionist in the same calendar month. So one of my appointments was 2 weeks apart because one was at the end of the month and the next at the beginning of the following month.

That is so frustrating! Especially when you did everything you were supposed to do. You checked with the coordinator that the Nutritionist was okay. It might be worth the 80 mile drive to go to their office for the appointments just to be sure. Don't give up. You are so close! I'm going back and forth with the coordinator and the insurance right now and I'm going crazy. The office was so wonderful up to the point of submitting to the insurance. Now they are dragging their feet, not getting back to me, etc.

I really can't wait to feel more comfortable in shorts and summer clothes. We usually go to Floriday on vacation in September. So I hope to be wearing some cute stuff by then!!!

Congrats! I thought I was going to be a January sleever, but it looks more like February. I'm hoping to hear any day now to schedule the date.

I'm so glad that you posted this - I know it wasn't easy to open up about what is going on. I am pre-op so I don't have a lot of advice about the post-op part except to agree that this is a very strict post-op diet. I don't think I could follow those restrictions. Definitely talk to the nutritionist to see what you can do to make it work for you. That being said, you already know what not to do . It's just really hard - I know. However, I can completely relate to the thoughts going on in your head. I have issues with self-esteem, hating myself, not feeling good enough, etc. That's one of the reasons I eat. I'm seeing a therapist and working on these issues. It's really hard but worth it. One thing she told me: If I don't love myself now, how will losing weight change that? I need to accept myself now, love me NOW. If I don't, I won't treat myself well. She had me list all the things I like about myself physically (that was hard!) and personality - those things won't change when I'm thinner. I read that list everyday and I am starting to accept those parts of myself. The other thing that I learned: There is a reason I sabotoge myself when I'm trying to lose weight. This goes back to abuse in my childhood/teens. My "fat suit" is my protection from the world. It keeps me at a distance from others and safe (at least in my mind). As much as I want to lose weight, I'm scared. It's scary to change after being this way for so long. That's where counseling is already helping me. You are not alone. You are not perfect - so don't expect perfection. Do your best each day, and if you mess up, don't hate yourself or give up. Start over with the next choice you make. You are worth the effort to be healthy and you CAN DO THIS! I know you can!

My surgeon did tell me that my reflux could get worse after being sleeved and the sleeve is not the first surgery they recommend for those with severe reflux. However, I am not a candidate for bypass due to an autoimmune disease. But if he thought is should not be done at all, he wouldn't do it. You have to make an informed decision - weighing the benefits vs. the risks (as in all surgeries). My weight also contributes to my reflux so in that respect it could get somewhat better. I also may have a hernia that can be repaired. As with any surgery, it is best to discuss all the risks of surgery and come up with the best decision based on your specific needs and health issues.

I had to go through a 3 month supervised diet program which included seeing the surgeon and the nutritionist each month for 3 months. You can also go through your regular doctor, but the surgeon's office knows exactly what is required for the insurance, so if you can do that, it's easier. There are a lot of requirements - like you have to see the nutritionist and the doctor in the same calendar month for it to count. So it just made more sense to me to go to the surgeon and their program. I know it seems like a long time, but it goes by fast. During that time, I focused on healthy behaviors and I started seeing a counselor to get a jump start on my emotional eating. You may want to get started on the 6 month program while still trying to sort things out with WW. Hang in there

The insurance coordinator at the surgeons office just called. She talked to Cigna and they are finally getting the surgeons switched on the paperwork. I should know something tomorrow. Yay! She talked like this is the only issue to approving.