"Normal Grooming. Obese."

[2beskinny 4]

While jumping through all the necesssary hoops for insurance approval, this is what I read in one of my medical records entries, "Normal grooming. Obese." Now offically my "a-ha" moment. Forty-six years of age, thirty of which were spent obsessing about my weight (I dieted myself to 85 pounds of extra weight), my life seemed all boiled down to this note jotted on a doctor's chart.:scared2:. That was the defining moment when I realized LAP-BAND®®® really was for me. Now I sit waiting (not patiently) to hear something back from my insurance company. I am right at 40 BMI and have no co-morbidites (does anyone else hate that term?). If I am denied or they come back with 6 months (more!) of dieting, etc., I will self-pay. I was going to self-pay from the beginning, but the staff at my LAP-BAND®®® doctor's office convinced me to give it a try at first. I have the diet history, and the 40 BMI for the last 2 years (as required). My only worry is that my weight history shows less than 40 BMI however, those visit times coincide with dieting attempts. My diets were usually always somewhat successful, temporarily, then I would gain back the lost pounds plus more. Sound familiar? Most recently, I did a medically supervised diet with diet pills. I thought that would really do the trick for me, but deep down I knew I couldn't live forever on the medication so I lost faith in taking it. Not to mention that twelve years ago I lost ALL my weight with Phen-fen. I think even though I was successful and came out unscathed by side-effects, I knew it wasn't good for me. Too bad...that was truly the easiest thing I've ever done to lose weight. I kept it off for about a year and a half, then life got in the way (corporate moves, three small children, traveling husband, etc.). I will come back and update as there are developments on my journey, and I wish everyone the best of luck on their's! :smile:

[karmaandkismet 0]

Hey there 2beskinny,

What on earth is "normal grooming. obese" supposed to mean? That if you're obese you're not expected to groom? We have some similar stats and history. I have a bmi of 41 and the only times in my life I've been decently successful with weight loss is with prescription diet pills (including the whole phen-fen thing). I got within 15 pounds of an acceptable weight about 6 years ago with the diet pills, but over time they affected my blood pressure (not to mention that I was bouncing off the walls and couldn't sleep) and I couldn't take them now if I wanted to because now I have chronic hypertension. I went to my insurance's website and printed out the requirement page that physicians are supposed to go by for the guideline. It states that the BMI at the time of the application is the one that they consider for approval or disapproval of payment for the procedure. So, basically, even though you have documented lower weights in your history, its your current bmi they will go by. I did a diet last summer with weight watchers. I have my documented weights for every week but I wasn't technically "under a doctor's supervision" at the time so I'm thinking they are not going to count that. Plus I wasn't in a specific exercise regimen since I had just gone through knee surgery and was doing PT for my knee at the time. I'm anticipating that I'll be doing the three month supervised diet thing and I'm ok with that. It gives me more time to build up paid time off for when I have the surgery and it gives my hubby more time to adjust to all this since he was adamantly against it when I first told him. Let me know how your paper chase goes.

[Tkmdhi 0]

Hi 2BeSkinny,

Normal Grooming. Obese... Yes, that would be difficult to see. Sometimes it's those small, unexpected moments that really hit home.

Your tour of diets sounds much like mine. I left out the Fen and just went with the Phen. I also lost 60 pounds on Ephedra before it was banned. It worked great.... until I stopped taking it. I'm glad as well, to have made it through (hopefully) with no side effects.

I do not have any sort of medical WLS coverage in my Kaiser plan. So, I am self paying. Honestly, I didn't think twice about it... just knew I had to make the investment and go for it. I'm planning rather than hoping that this will be the final weight loss frontier.

My surgery date is on May 18th. Needless to say, I'm over the moon. :smile: I hope that your insurance will be approved, but I'm glad to hear that you will move forward with it anyhow. I read posts on here of people that really need this... but absolutely cannot afford it. I'm happy for you that you can.

Keep me posted on your progress... hopefully you can get moving forward soon.

[BetsyB 9]

What on earth is "normal grooming. obese" supposed to mean? That if you're obese you're not expected to groom?

No. It doesn't mean that. Grooming/hygiene are assessed as part of an overall physical assessment; they can give clues to a patient's overall well-being. (Grooming/hygiene can deteriorate as a result of certain physical disabilities as well as due to things such as depression.)

The wording just shows that her doctor isn't a very good writer---like many doctors (and nurses). Physician's and nurse's notes tend to include a lot of rote phrases that do the job of recording an assessment quickly, but not particularly articulately. "Alert and oriented x3; PERLLA; heart rate 80, rhythm regular; lungs clear bilaterally; bowel sounds active; ROM intact to all extremities; skin warm, dry intact; normal grooming; obese."

It's not pretty to read, that's for sure---but all of our charts would contain, I am sure, similar eye-openers.

[Manda87 3]

Last year, at my work, I was reading a chart of a patient I had. It said "Happy obese lady." Why do they have to phrase it like that?

[BetsyB 9]

Well, aren't we all jolly?

[Rsilversea 2]

Ho ho ho? :thumbup:

[2beskinny 4]

Last year, at my work, I was reading a chart of a patient I had. It said "Happy obese lady." Why do they have to phrase it like that?

OK, that IS funny. On a practical level, I knew it was just a mundane note in my chart, but on my soul searching journey of deciding to have wls, it was so eye-opening to be summed up like that. By the way, I am an excellent groomer, HA!

[Manda87 3]

Well, aren't we all jolly?

Hahaha.

No.

[karmaandkismet 0]

I've been told i have nice hair so I guess my grooming is in check. Oh! And here's one for you. I actually still laugh at this one. When I was still married to my ex husband he once told me that my best quality was that I was "non offensive smelling". lol.