Mattie
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Everything posted by Mattie
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Hi Everyone... For two years I tried to convince myself that I didn't need this procedure, talk about being in a state of denial! I'm 200 pounds overweight. 200 pounds. When I say it out loud, I just want to crawl up into a fetal position (if only I could) and just cry. But, due to the fact that the lap band surgery can be done as a laparascopic procedure, meaning the risk of death is immensely less, and that my secondary insurance now covers it (Tricare for Life; I have Medicare as primary because I've been disabled for 10 years now), and the fact that I am probably only a couple of months of being in a wheelchair, I HAVE to do this. I am going to the seminar on April 10th. I'm hoping that once I do all the other appointments, maybe I could have the surgery by the end of May. Maybe sooner. Especially since I know insurance won't be a problem. I'm still scared. Mainly because I have bad fibromyalgia. I'm unable to move around much at all. I can not stand more than a couple of minutes. I push myself by gardening (it's quite a sight seeing me roll around in my garden, but it's the only way I can do it), ironing (I can only do a hour at a time - I used to do it for 2-3 hours at a time), and some crafts. But for the most part, I end up paying the price with increased levels of pain for a day or two, or more afterwards. That being said, how am I going to do the exercise part? It's going to be a while before I'm able to do any type of exercise, other than my chair exercises and chair yoga exercises. What if I go through this procedure but my fibromyalgia holds me back from doing any significant exercise and I just don't lose the weight? I am so depressed. I am going to do this, but I don't know how to incorporate the exercise without increasing the pain I already have 24/7. :confused2:
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Cindi: Thanks for the warm wishes. I know that I will be working as hard as I can. I guess I really shouldn't worry about what anyone else thinks because I know that I'll be giving it my very best effort. Congratulations on your weight loss! How terrific!
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If my insurance says I have to be 100% over what should be my normal weight, PLUS comorbidities, BUT if I'm 200% over what should be my normal weight I don't have to go through the comorbidities workup, how do I know which catagory I fit in? I just don't want to waste a couple of extra months having to go through another sleep apnea test (which I have), diabetes (I have Type II and take medication for it but it's under control and has been for 10 months), more painful fibromyalgia testing (have been on permanent disability for it for 10 years), more CT scans for my degenerative arthritis in my spine, etc. I mean really, I need this. I'm going to die if I don't have this. Why make me suffer needlessly just to prove what is already medically documented and quite obvious even if they only open their eyes partially and look at me! I'm 5 ft tall and weigh 350 pounds (gulp). I'm ready. I go to my pre-op seminar on April 10th. I have Medicare as my primary and Tricare for Life as my secondary. I shouldn't have too much of a problem getting approved, right?
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Determining overweight percentage for insurance.
Mattie replied to Mattie's topic in Insurance & Financing
I'm not even sure I have to get approval in advance from Tricare. I have Medicare as my primary and for everything I do, the bill goes to Medicare first and they automatically forward the remainder (20%) to Tricare for Life. Which is a whole different procedure than when we had Tricare Prime. When I was declared permanently disabled, and became eligible for Medicare, Tricare changed me from Prime to Tricare for Life. But I am going to call them and ask. I already know that Medicare will pay for the LB. But since I never have to get preauthorizations for anything else, I doubt that I'll have to do it for this. I'm totally devastated by what Wheetsin said. That I'm TOO big for a lap banding. There's no way I'm going to let them reconstruct my organs and I really feel that it's just so much more dangerous to do a bypass. I'm just at a total loss now. -
The physiotherapist will be at the seminar on April 10th. I'm going to bring this topic up because I'm worried about it. There are days when all I really want to do is take pain medication and lie in bed all day - but I definitely don't. In fact, I really push myself on those days because I realize that I need to keep moving no matter what. But, I don't know what they'll expect from me right off the bat. And it's not like I'm not willing or making excuses, far from the truth. There's only so much pain I can tolerate before I have to take meds to dull it and I HATE doing that. Thanks for the warm wishes.
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I have fibromyalgia and I'm really worried about the exercise routine after I have the surgery. What if I am unable to do any exercise (like now) because of the pain levels I experience 24/7? If you were to ask me how bad the pain is from the Fibromyalgia, daily, I would have to say 8 out of 10 on a good day. (10 being the worst):teeth_smile: How do I deal with that?
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Taz, thanks for the response post! I live in a very small town. I did go to the pain management clinic. My doctor gave me the referral. Bottom line of what they told me was that they could not help me until I lost the weight. Period. I take hydrocodone as well. But only at night. I wouldn't be able to function if I took it during the day. And I'm very careful how often as well. The other medication I take is Skelaxin. It's a muscle relaxer. I'm supposed to take it every 6 hours, but again I only take it at night. I don't like feeling sleepy or "drugged" all the time so I only take these things at night when it's almost impossible to sleep because of the pain. I am going to do the best I can with the exercise. I just hope the physiotherapist at the hospital understands fibromyalgia and the impact it has on my body. If not, I'll be more than happy to educate him.
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Right now I am at the point where I walk, barely, with two canes. I can not go for more than maybe 20 feet then back. I KNOW I will be able to do more when I lose the weight, but I'm worried that the lap banding will take too long to lose the weight and that maybe I should have the other one, Gastric Bypass. But I don't want to have that because it's too dangerous. I'm not afraid to exercise. 10 years ago, I used to walk 2.6 miles a day (in the mornings), I used to weight lift, I used to walk during my lunch break at work instead of eating. I've lost all that AND my job. It's been pretty much downhill since 1998. And now my doctor tells me I am probably 3 months outside of being put in a wheelchair. I can't handle that. I'm afraid that will break me. So, I DO want to exercise. And I will. I'm just afraid everything won't happen fast enough to prevent the wheelchair thing. Thanks for the response.
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Christasha: Thank you for the post. I think that my biggest fear is that the pre-op eval will not go well because I will be unable to do what the physiotherapist requires. I am unable to use a heated pool due to another problem that involves wound care and being exposed to the heated pool. Too complicated to get into here; but the pool is out too. Do you think the physiotherapist will understand that it might take a couple of months or so before I'm really able to exercise regularly? Have a great weekend!
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Thanks for the response. I'm Hoping for the best outcome.
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Millersville area.
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It has taken me two years to make the decision to have the lap band surgery. Until recently, I did not have medical coverage, there wasn't a hospital nearby, and laparoscopy surgery wasn't available. Well, the stars have aligned in my favor, I'm not nearly as frightened as I was prior to learning about the laparoscopy procedure. The only thing that frightens me more right now is that if I don't do this, my weight and my fibromyalgia will do me in and I'll either be in a wheelchair or dead before I hit 60. This will not happen.
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Congratulations!
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I searched the forum and could not find anyone who used Medicare as the Primary insurance and Tricare for Life as the secondary insurance. If you have, how did it go? And, Medicare DOES REQUIRE an overnight stay, correct? Thanks in advance. :smile: