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BGrundee

Gastric Sleeve Patients
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Everything posted by BGrundee

  1. BGrundee

    Time off from work

    Do you have an HR person? You can file for FMLA or Family/Medical leave...By law your company cannot fire you during that time and your job position has to remain for you by the time you return. My neighbor had her surgery and she took 4 weeks. You never know how you will feel. Sometime going back to soon is not always the best. I haven't had my surgery but Im going to ask for 3-4 weeks. I dont want to go back to work and find out a week back in that I need to take more time off cause its im in pain or suffering from nausea, migraines, soreness, etc...If im 110% ready, strong physically/mentally before 3-4 weeks, ill go back in early....
  2. BGrundee

    April/May 2018 Sleevers!!?

    I have Aetna and my IPA group is Health Care Partners. I did my 90 day regimen per Aetna requirement and doctor submitted paperwork last Thursday. Ive been calling HCP for status everyday. As of today It is still "pending". This is driving me nuts...On Monday the rep said to call back on Tuesday because it only takes 3-4 days for approval. Today I called and told it will take 7-10 days. These guys are really pulling a number. Anyone else had a long time before their insurance provider group gave them an answer?
  3. BGrundee

    Submitted to Insurance, now I wait...

    For nausea try boiling ginger root or brewing alot of ginger tea bags to make a big quart of full strength ginger tea. Put it in the fridge to save and add a table spoon of into your water bottle. It will take away the nausea fast. I usually take ginger caps when I experience nausea, or motion sickness but I imagine with a tiny stomache, you can only sip water here and there....You got this!!
  4. BGrundee

    April/May 2018 Sleevers!!?

    Yes, its very realistic. Get into the habit of doing some cardio to help you meet that goal.
  5. BGrundee

    Could Aetna deny me?

    I have Aetna and just finished my 90 day regimen. It was more like 94 days because I had a 4th visit to do as well. My paperwork/report was completed today and sent in. My bariatric weightloss center will not schedule anyone until there is a confirmed approval from Aetna. Once approved for surgery and recieve a date, thats when I will have to schedule EKG, X-RAY, LABS and make sure its all done before the surgery date. I think your pretty set. If you do not get approved its because your plan does NOT cover it. If you've come this far, why would they stop you now. It just doesnt make sense.
  6. BGrundee

    Submitted to Insurance, now I wait...

    Congratulations!!! You actually had a very fast surgery date. I would love to have a surgery date in April but my weight loss cordinator said most likely in May now. I starting the 2 week liquid diet to help boost an earlier surgery date. Crossing my fingers I get approved just as fast. How does it feel? Your a full week out from surgery, im so happy for you!
  7. BGrundee

    Submitted to Insurance, now I wait...

    Hi did you get approved? I have Aetna and my paperwork was either submitted on Thurday (if my weightloss coordinator got to it) or will be submitted on Tuesday. If you did get approved. How long did it take them?
  8. BGrundee

    April/May 2018 Sleevers!!?

    Congrats! How long did it take for insurance to approve?
  9. BGrundee

    April/May 2018 Sleevers!!?

    Hey guys, I havent posted in this thread for a while because Ive been freaking out about my last weight in with my weight loss cordinator (I had to do the 90 day multidisciplinary regimen required by Aetna). I am completely done, and paperwork was either sent yesterday or will be sent next Tuesday...Now, I have to wait for approval for surgery and get a date. Im going to push and call Aetna every day for a response. Cross your fingers for me that Aetna gives me a fast approval so I can get a date locked in!
  10. BGrundee

    April/May 2018 Sleevers!!?

    You can totally do this! I read, if you get hungry is just to wash your hands. Washing your hands will reset your mind. =)
  11. BGrundee

    April/May 2018 Sleevers!!?

    Congratulations!!! Quick question. Is insurance requiring the 30 days liquid diet for you? Its usually 2 weeks here...30 days is long time
  12. BGrundee

    April/May 2018 Sleevers!!?

    Woooo hoo! You did make the right choice. Your going to not just live life but truly live life and enjoy things that obesity hindered you from. Congratulations!!
  13. BGrundee

    April/May 2018 Sleevers!!?

    I totally agree. I have about 30 days until my final weight in and submit for approval to get a solid surgery date (im slated for an April date) but Im not going to go into old habits again. Some things I've ready on the forum board blows my mind. I don't want to judge, but. If your doctor says dont do certain thing until x amount of days later, dont do it! Theres a reason why they're saying now to do certain things. This surgery is only a tool. I have a friend that had surgery and gained it back after a couple of years and he points it back to not following directions and taking advantage of it. Im sooooo happy for you!!!! Yay!!
  14. BGrundee

    April/May 2018 Sleevers!!?

    Congratulations! I considered and researched Mexico for a awhile as the first 5 months, Aetna was giving me a hardtime with approval. Fortunately DMHC overturned the denials and now im back on track with a local surgeon. Don't worry You will be good hands =). Is a trusted friend going with you or are you taking the trip alone? I suggest taking a friend to help calm the nerves.
  15. BGrundee

    April/May 2018 Sleevers!!?

    Yay!!! We can check up on each other! Im excited about the liquid diet and dreading it at the same time. Its going to be struggle but mind over matter, right? =)
  16. BGrundee

    April/May 2018 Sleevers!!?

    So lucky!!! Im crossing my fingers for a date in April!!
  17. BGrundee

    April/May 2018 Sleevers!!?

    I have Aetna and it was actually even hard for me to get approved for my initial consultation with my bariatric surgeon. I got denied twice, and took it up with the state (requested an external review). The external review overturned the decision of my insurance plan! Im doing the 90 day multi-disciplinary regimen which requires the below. Luckily, im not required to go to my PCP's office every time to get a montly weigh in. Its nerve wrecking around this period because supposedly you cant gain weight or lose too much. Psych eval 3 x Nutrition visits (Once a month) 1 Support group meeting Once approved for surgery, you have to scramble to get the below done in a timely manner: EKG Chest X-Ray Pre-op Blood Work I've heard of Aetna denying people for random stuff before surgery so im getting ready to take it up with the state again. I don't even mess around with insurance. I learned if Insurance is giving me a hardtime, to just file a complaint with a DMHC. Insurance is in the business of denying people to keep their money.
  18. BGrundee

    April/May 2018 Sleevers!!?

    Hey Becky, I have my last nutrition visit in April too and we have the same name!! Wooo hoo. April 2nd is my last nutrit. and paperwork submital date. My weightloss coordinator suggest on 4/02 I start the 2 week pre-op liquid, so by the time I get approved for surgery I would already be on the liquid diet and could schedule surgery date as soon as early as possible. Im excited to be on this journey and can't wait!!
  19. Please don't feel upset with all these different answers/responses. At the end of the day, everyone means well and wants you to succeed in permanent long term weight loss. I have not had my surgery yet and I would say to stay away from it as long as you can. My weightloss coordinator recommended to not have a drink atleast 1 year after as alcohol is not tolerated well in your stomache. The first 6 months are the months you will lose the most weight, why throw a rock in your own path? No joke, my good friend had gastric surgery and 2 years later he gained it all back because he loved to drink. Theres a ton of people struggling on here to keep the weight off even after surgery due to over eatting and drinking. We all need to learn from their mistakes. We have to remember that we are a complete different breed of people (due to different genes) and have to always work harder/exercise more than normal skinny people who never has to consider weight loss surgery because they can eat all they want, not exercise, and never gain weight (This is my sister). Girl, I feel you 100% but weight loss surgery is only a tool. You and I are the same and have to train our minds to eat/drink better, exercise more than the average person to maintain a healthy weight at all times so we can live life well and live longer...Heck, in two months after my surgery,m I might be on here asking the same question but Im gonna look to you to tell me to NOT do it. If we were good friends out and about, I would slap the alcohol drink out of your hand and give you cool water with cucumber/lemon wedge because I want you to do well. =) You got this under control! It's all a mind game.
  20. Hi, My guy friend had weight loss surgery in Germany. He lost alot of weight and he gained all of it back 2 years later. He's not as big as he was but he's pretty fluffy and admits he kept drinking beer and alchohol. The beer and alcohol did it to him...On your profile picture it shows you enjoying or holding a mixed drink...I would highly keep beer and alcohol to a minimum.
  21. This happened to me on a smaller scale. I was at an "in network" facility to get my blood work done. Unfortunately, the person who took my blood, sent my blood to an out of network lab. I was billed a little over $700 dollars and insurance would not cover this what so ever. I had to make calls and challenge the office management on how this could happen. No one wanted to own up to it and kept pointing fingers to another person. At the end of the day, I didn't care whose fault it was because ignorance or lack of knowledge is not an excuse for negligence to ignore doctor orders. In my case negligence to send to the wrong laboratory, and your case schedule out of network people. Under Doctor's orders you were to be scheduled and should have been seen by the right the In network people. For me, the out of network laboratory made my balance a zero because it turned out the girl who took my blood was an actual employee of the laboratory and outsourced to draw blood in my "in network" facility, however she must always follow doctors orders and rules of insurance. On the day she took my blood, she didn't read my insurance card and sent it to her home corporate laboratory. I would talk to the coordinator that compiled your team together and demand why it was over looked or not shared before hand of use of out of network staff. Tell them you will not pay it as its negligence and file a billing complaint with the Department of Managed Health Care in your state. You should not pay for someone elses rookie mistake.
  22. BGrundee

    Low BMI Insurance approval??

    I have Aetna and got denied twice. I have a 39.51 BMI which right on the fence and still got denied as I wasn't at 40 BMI, even with hypertension. I took a sleep study test, which showed I had obstructive sleep apnea. Once I had been diagnosed with OSA, I got an approval. I suggest asking your PCP for a sleep study test to see if you have OSA. If you have it, your BMI can be at 35
  23. Hi Everyone I have Aetna insurance with HealthCare Partners and having issues getting a an approved referral just to go to a bariatric surgeon. My PCP said I wouldn't have a problem but unfortunately I am. I am 4'11/193 lbs with a BMI of 38.7 with health problems such as joint pain especially in ankles, stress incontinency, etc. My whole livihood is going down the drain, and believe me I work out 4 times a week just to make sure I do not gain anymore weight as I'm pushing into 200 lbs and it's scary. Thanks Sent from my SM-N910T using BariatricPal mobile app
  24. Hey everyone, just a friendly update...I had an IMR and got approved as of 12/14. DMHC overturned Aetna decision! It was a long process. If insurance is being difficult, take it up with the state. The state reviewed all my records and in matter of days after accepting my case, the decision was deemed medically necessary.
  25. Congratulations!!! You look amazing and enjoy not just living life, but truly living life to the fullest!! Sent from my SM-N910T using BariatricPal mobile app

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