BigTexasMandy
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Anthem BCBS Insurance Approval / Denial Question
BigTexasMandy posted a topic in Insurance & Financing
If there is a weight gain in one of your appointments during your 6-month diet plan, will you be denied even if overall you lose weight? For example, say I start at 300 lbs, lose 10 lbs in the first two months, gain 5 lbs during the third month, but then I lose 20 lbs over for a final weight loss of 280 lbs, will I be denied? I have Anthem BCBS and I just wondered if they focus on the month to month or overall accomplishments. Gaining weight over the holidays seems to be a logical scenario, but I wondered about anyone else's experiences.- 24 replies
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What's on your bucket list now that you've had surgery? I know this might be a post that's come up a lot, but I wanted to read some fresh responses!
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Sorry this is long.... The first thing I MUST address is the way in which some people talk to on another on WLS forums. Often, I will stumble upon a post because I Google a question looking for an answer in the moment rather than asking something that may have already been asked and waiting. I've noticed a lot of people being extremely critical of the questioner... Here is an example (in a weak moment -MOMENT being the keyword - I might add... I'm on the liquid diet), I found someone asking if in the pure liquid post-surgery diet stage if they could have sugar free soft-serve ice cream. The first response was from someone who decided that rather than answer the question, they would provide an impromptu lecture on slider foods and how they should be dealing with food post-surgery. While I recognize posting on the internet opens you up to opportunities of criticism, I would hope that most people on weight-loss-surgery forums would have enough common sense to understand that most people on here are adults capable of choosing what they want to do. She didn't ask if she SHOULD eat the ice cream, she asked if she COULD eat it. I'm not saying the concern about slider foods wasn't without merit, but it wasn't warranted in this situation. Turns out, the poster just wanted to see if she could indulge in a lick or two in a social setting (a birthday party or something). She wasn't planning to enter a soft-serve eating contest. And even if she was... SO WHAT?! How does that impact the responder in any way? Why waste the time responding? The question wasn't, "What's an exmaple of a slider food and what are the dangers of a slider food?" UGH! This leads me to another thing I'm really, really, really frustrated with. NOT EVERYONE HAS MENTAL ISSUES WITH FOOD THAT IS OVERWEIGHT OR UNDERWEIGHT OR IS INCAPABLE OF CHANGE OR INCAPABLE OF LEARNING WAYS TO COPE WITH FOOD ADDICTION. I am not saying it will be EASY, but it doesn't mean someone can't overcome their addiction. I know people from all ends of the spectrum who have accidentally overeaten at a holiday or party or have made a bad choice (food related or not) and I know many people who OBSESS over the food they put into their bodies and have done some serious emotional and physical damage by being TOO restrictive. Here's the point I am trying to make... WHAT WORKS FOR YOU MAY NOT WORK FOR ANOTHER PERSON. And perhaps this is my unsound opinion, but having HAD WLS does not make you an EXPERT on WLS no matter how long ago you've gone; until you've gone to school and extensively studied psychology, gotten your doctorate, etc. etc. etc., no one wants to hear it unless they specifically ask you hey what SHOULD I do! SHOULD BEING THE KEY WORD! Yes, some people may find it best avoid slider foods at all costs for the rest of their lives. However, other people will be able to indulge in a few bites of ice cream, or whatever and it doesn't undo all of their hard work or everything they've accomplished. I have to say that I'm so disappointed when looking for answers to certain WLS-related questions to see so many people 1 - not answering the question directly, 2 - providing emotional/psychological advice, 3 - just not showing a little more compassion to people regardless of where they are in their journey, 4 - assuming you know anything about the person based on a question they've asked. And hey maybe you can tell they're making a huge mistake, but they may have worded the question incorrectly, they may be having a difficult time with something else in their life and they're searching for empathy from someone else who may have gone through something similar... the point is, a simple question doesn't provide you all the facts so stop assuming things about people because they've had weight loss surgery or are contemplating it!!! On a related note, I'm so disappointed in the frequency in which I read people who start off by replying, "I'm sorry, but..." YOU ARE NOT SORRY! You are about to say something hurtful. If you have to say BUT after sorry, you're just not and you should delete your sentence and go read a book. Unless you're saying, "I'm sorry, but you're totally awesome and I love that you're realizing you're perfectly capable of realizing this is an internet forum and not a conversation with your doctor..." but rarely does it go that way. FINALLY, I am so tired of reading things that are presented as black and white. I bet there are a bunch of people who disagree with what I have said... okay, fine, but does that mean I'm wrong? DISAGREEING WITH SOMEONE DOES NOT MAKE THEM WRONG AND IT DOESN'T MAKE YOU RIGHT. SOMETIMES YOU CAN BOTH BE RIGHT, WRONG, OR IN BETWEEN! 50 Shades of Grey? TRY A BILLION! AHHHH! PS - I really need the pureed food stage to arrive... and fast.
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VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
@PatientEleventyBillion you're really invested in proving me wrong and bringing me down... why is that? what's so wrong in your life that you can't just f**k off? there, how's that for being direct and honest? -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
I didn't say every weight loss surgery patient, I said not everyone and I sincerely believe people are capable of change. If you don't, why are you on here and why did you get surgery? Why don't you just eat all you can and die? It's not black and white as I stated. -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
I feel you like people just don't get it. -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
Ultimately, I posted this because I was frustrated with the way in which some people responded to the people on the forums. I feel that many overweight people are stereotyped and have likely had little compassion for their situation. In my opinion, compassion and patience do not equal coddling per say. Tough love doesn't mean being rude; it represents honesty and a genuine willingness to help someone. Perhaps I was a bit unhinged and didn't completely express myself as I would have liked in the initial post. I do not disagree with being honest by any means, but as some have mentioned, there's a difference between being honest and being rude. Bluntness can be necessary, and I agree there are many posts in which people are seeking justification for bad choices. Additionally, I should say that when you post something on the internet asking for advice, you should show the same respect towards the people who are genuinely looking out for you and ignore those who are taking the time to be hurtful and mean. My post is mostly to say that I wish people wouldn't assume something about a situation, stereotype weight loss surgery patients (especially those who are WLS-patient's themselves), and to in general show kindness to one another. Outside of this community is already flush with judgment and it would be nice if we could just be nice. I appreciate everyone who contributed their thoughts, and I apologize if I didn't accurately express my feelings. I did not intend come across as we should live in a world with rainbows, unicorns, and sunshine all the time. I simply mean to say, that you should think about what the person is asking, consider if what you're writing truly expresses what you mean to say, and if it's worth saying what you have to say. -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
I am a new user and did not realize there was a place to rant. I posted under this topic because it's where I am at in my process... Is there a way to move a post? -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
Haha, you're absolutely right! People are weird. I hope you're enjoying farm life! -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
And your reply won't change how people are either... did it feel productive what you said? Do you feel as if you changed me and my whininess? I believe this post stated this was a vent/rant... I wonder how calling my whiny will change my opinion or improve your life... -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
I can definitely agree with what you're saying and perhaps I went a little off the deep end in my opinions. My post ultimately was to address that sometimes someone asks a question and instead of getting a straightforward answer, they get someone who's going on and on with the tough love thing (which fine, I can't stop anyone from doing that) but doesn't even answer the questions directly. It's like people are on a campaign to bring people down when they don't know the motivation behind the question. It wasn't as if the person said, "Yes/No, ice cream is okay at stage ABC. However, don't forget that ice cream can be a slider food." They didn't address the question at all and determined that because someone had a question about ice cream, they had issues with ice cream. -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
I definitely agree. And perhaps my hunger-laden post did not express that. I don't disagree that in some instance people need a firm hand or some straightforward talking to, but the way in which people speak to one another is very disappointing. I just wonder if some people would actually say certain the things they say to someone's face. I mean to a stranger's face they just met. Maybe they would... -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
Ha, thank you. (that's supposed to be a popsicle) -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
My point is that who are we to decide who needs coddling and who doesn't? You read a few words in a forum or blog and you know what they need emotionally? Additionally, how does a yes or no question warrant a lecture? I agree there are posts in which people are asking for an opinion and get what they ask for, but I think people give their opinions when no one asked them. I realize that's the way of the internet, but I just think that a lot of people don't know what someone is going through and it couldn't hurt to show a little human decency. Human decency does not necessarily equal coddling... in fact, perhaps I did not convey this particularly well, but my point was that sometimes questions warrant no emotion whatsoever. In my opinion, people who favor the tough love approach with strangers probably have some issues facing things themselves. Not everyone is a piece of crap and sometimes tough love makes people feel that way. Additionally, there's a difference between tough love and being outright rude. -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
Unfortunately, it can. I do know that you can't prevent anyone from having an opinion, but sometimes I just don't understand the why and when someone chooses to share that opinion. People don't understand how their words can affect some people. That's more the point I was hoping to make. And yes, this liquid diet has made me rather adversarial! -
VENTING - can vs should
BigTexasMandy replied to BigTexasMandy's topic in POST-Operation Weight Loss Surgery Q&A
I definitely agree with you in that we are all different and handle things differently. And sometimes debate and conversation is warranted. I think what I'm trying to say is that people really jump to providing criticism or opinions in situations where it isn't warranted. -
I'm feeling this way too. I'm not even a week out, but I really miss the ability to just eat a tasty piece of pizza. Or have a migas taco. The cravings and desire were not cut out with the surgery. It makes me sad to think I'll forever have to do things in a different way. Or that I'll be the difficult one when it comes to choosing where to go out to eat. Or yeah, just not being able to have a sandwich... it's heartbreaking. I hope it gets easier when the weight drops, but IDK.
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Outpatient surgery?
BigTexasMandy replied to RHmama's topic in POST-Operation Weight Loss Surgery Q&A
I was outpatient! Sleeved Monday, 5/22. At first, I was concerned, but I was anxious to get out of there. I am not sure why honestly. Maybe I was just bored? Ultimately, they will not let you go unless you're absolutely ready to do so. They said that if there were any concerns, they would keep me until it was time. I peed almost immediately after surgery, had no problems taking in fluids, and was walking around fairly easily right away. In fact, I had a good amount of energy. A few days later, the pain is lingering (though tolerable) and I'm sleeping more and not AS motivated to be active. I'm taking long walks as best I can. If you're concerned, hold in your pee! They said I couldn't leave until I peed! -
Putting Myself Out There - Pre-Surgery, Female, 29 years old
BigTexasMandy posted a topic in Tell Your Weight Loss Surgery Story
Hi everyone, I'm sure I'm not unique in sharing all of this. I'm 29 years old and I live in the Austin, Texas area. I've recently started the process to get bariatric surgery. I have chosen the gastric sleeve as my surgery choice and I have my first appointments to begin my required 6-month pre-surgery stuff. I grew up thin and have only struggled with my weight in the past 7 years (give or take). I gained 120 lbs in that time and there seems to be no going back. After marrying my husband, I tried to gain control and even participated in my first half-marathon, but things were not getting better no matter what I tried. I'm married with no children (just a crazy and wild dog). My mom had gastric bypass surgery and it changed her life. I was looking for answers to help me with my journey, but I didn't find exactly what I was looking for so I decided to start a blog. I'm hoping to help people like me and find support along the way. If you're interested, the website is www.bigtexasgirl.com. I have only shared this with one other person. I hope you'll come connect with me. Mandy -
Anthem BCBS Insurance Approval / Denial Question
BigTexasMandy replied to BigTexasMandy's topic in Insurance & Financing
I wish I lived in Dallas. My husband's company (although we are in Austin) allows BCBS of Texas if we live in Dallas but not Austin. He has to go with Aetna. Sigh. Stupid insurance. -
Anthem BCBS Insurance Approval / Denial Question
BigTexasMandy replied to BigTexasMandy's topic in Insurance & Financing
I live in Texas but my employer is based out of Georgia. I am not sure if where I live makes a difference. Technically, I'm considered corporate but we have "local" or "regional" employees who's insurance coverage can vary. For example, employees in California can get (or have to get - not sure) Kaiser Permanente insurance. I personally am in my six-month diet phase just worried about the potential for rejection. I am not sure why I thought it would be a good idea to schedule my next appointment the Monday after a food holiday. The following appointment will be the Tuesday after Christmas. It's amazing how much weight can fluctuate. I'm also battling bad depression so I'm hoping she takes mercy on me and that Anthem BCBS does as well. Hopefully, as long as I lose enough to show a net loss it will be okay. This month has certainly scared me so I will be making better choices and hopefully not stress. I hope to do what @@Djmohr suggests which is take it one obstacle at a time. In the end, it will work out the way it is meant to... I just wish it were easier to seek approval and that there was more support. In the end, isn't it more affordable for insurance if I weigh less and don't end up with weight-related health issues? -
Anthem BCBS Insurance Approval / Denial Question
BigTexasMandy replied to BigTexasMandy's topic in Insurance & Financing
I've just been feeling depressed in general and I'm starting to really worry. I've got an appt on Monday and I'm going to talk to her about managing my depression. I know I'm capable of the necessary changes but I just can't pick myself up to move forward. It's not just tied to wanting this surgery, but of course, this is part of it. I wish I could see the light at the end of the tunnel. I know it will work out as it's meant to, but it's just really hard right now. Thank you for your kind post and for taking the time to provide reassurance and kind words. -
Anthem BCBS Insurance Approval / Denial Question
BigTexasMandy replied to BigTexasMandy's topic in Insurance & Financing
Well, I hope that turns out to be the case for me. I'm just so stressed and depressed worrying about everything. :-( -
Anthem BCBS Insurance Approval / Denial Question
BigTexasMandy replied to BigTexasMandy's topic in Insurance & Financing
Gosh, I am so sorry that you had to go through all of that to get approved. Everything went so well with my mom when she did gastric bypass 5 years ago. I'm so stressed about everything and depressed. I hope your husband is approved soon. -
Putting Myself Out There - Pre-Surgery, Female, 29 years old
BigTexasMandy posted a topic in The Lounge
Hi everyone, I'm sure I'm not unique in sharing all of this. I'm 29 years old and I live in the Austin, Texas area. I've recently started the process to get bariatric surgery. I have chosen the gastric sleeve as my surgery choice and I have my first appointments to begin my required 6-month pre-surgery stuff. I grew up thin and have only struggled with my weight in the past 7 years (give or take). I gained 120 lbs in that time and there seems to be no going back. After marrying my husband, I tried to gain control and even participated in my first half-marathon, but things were not getting better no matter what I tried. I'm married with no children (just a crazy and wild dog). My mom had gastric bypass surgery and it changed her life. I was looking for answers to help me with my journey, but I didn't find exactly what I was looking for so I decided to start a blog. I'm hoping to help people like me and find support along the way. If you're interested, the website is www.bigtexasgirl.com. I have only shared this with one other person. I hope you'll come connect with me. Mandy