MandyLou

I was told this morning that I was denied because the co-morbidity I have isn't "severe enough". My BMI is 37, and I have sleep apnea. I also have Rheumatoid Arthritis and Fibromyalgia (Which I know they don't consider). I have been not been able to lose more than 20 pounds in over 20 years. I need to lose roughly 80lbs. There is a "peer review" today with my doctor and the insurance company. Has anyone had it overturned by this action? I'm devastated.

Mine did not. I am putting in my first appeal.

I have BCBS and the peer to peer didnt work and I am on my first appeal.

Someone told me they suck on sugar free lollipops too and that helps with munchies!

If my surgery goes through (still waiting for insurance crap to be handled), which is Monday, I was told to wait 2 weeks prior and 2 weeks after. I use MM but first off, it can mess with anesthesia, and second it can interfere with your healing (something to do with the blood vessels contracting.) It has been hard for me too, since I also use no pharma as well. Work is stressful for me so its been hard to not grab it when I need it.

Oh thank you!

I cannot get the thing to change to lbs. I dont know why it says kgs!

I am set for 9/20 pending insurance approval. Also there are a lot of covid patients in our hospital, so I am hoping it doesn't get cancelled. I just ordered all of my vitamins, and I am going shopping this weekend for my pre-op shakes. I am also making bone broth to sip. I am only scheduled for a 5 day pre-op diet. I am nervous things will fall apart last minute after everything they put you through to get you to this point. Here is hoping.

Hello! I am also scheduled for 9/20. I am still awaiting approval though, which is super frustrating, but I am hoping this all works out. I am not getting bypass, but sleeve. Yes, it's been a long process, but I feel blessed for the opportunity and excited for the changes to come!

I don’t have a BMI over 40 and I am “only” 215lbs. That’s a lot of weight for me. Ive had Rheumatoid arthritis since I was 17 (I’m 43 now) and all these medications and up and down depressing anxiety fits made me put on 80lbs. I had tried everything to lose the weight to no avail. Exercise is getting hard for me and last summer I barely could hike up a mountain. I couldn’t breathe and my knees almost gave out. There are so many things I want to do and I never thought WLS was an option because I was told I wasn’t “heavy enough”. But between the RA and my family’s history with obesity I went on a journey that started with helping my anemia first. I got a hysterectomy in March and now I am period free. Next I went to a clinic that does both surgery and medical weight loss. He explained he would do everything he could to help me and ordered tests. He told me that my quality of life and my joints would benefit greatly from WLS. I knew this but still thought I was not eligible as autoimmune disease do not count towards your approval. He ordered a sleep test and it turns out I have sleep apnea which has me getting an excellent shot at approval. I feel humbled and blessed to have this option. So my tipping point was last year and it’s been a slow crawl but I’m here waiting for a surgery date. For the first time in a long time, I am hopeful.

I did a long time ago. I should maybe try again. This is so frustrating.

What about getting approved? I am at 36 and change. I am 5'4 and have no co-morbidities. I have 2 autoimmune diseases and have had 0 success with diets, "lifestyle changes" and so on. I even took weight loss meds that had me injecting myself. Obesity runs in my family and at this point, 8 family members, including my sister and niece have gotten the surgery. My grandmother's cause of death was obesity. I went to an information session and they looked at me like I had 3 heads. Losing 80lbs at my age (43) and shotty joints is nearly impossible and I am having a hard time enjoying my life. I see the GI doc soon, as I have bouts with Gallbladder issues and I am hoping this is the deciding factor. What did you all have to do to be approved for this surgery? Any information would be helpful! Thank you.