Frustrated somewhat!

vericks · March 30, 2006

Yee Gads! Now going on a year long process and two doctors later…I have had another set back with paper work. Between the various other reasons and paper work I am trying my best not to give up. I have so waited for this banding. However, due to all the mix ups, tests and delays I am beginning to doubt my decision. I haven't give up, so my persistence I guess is my strength. For the first time during all this process I'm starting to doubt myself. So I guess I need to hear some good news from you other banders. It seems like lately all I've gotten is negative vibes. Help!

vericks

gordonfamily3 · March 31, 2006

Vericks - Don't give up. It is so worth the battle and the fights. Stay on top of it and make sure the dr's have everything. I am seeing first hand if the dr's office the stuff getting insurance approval the first go round is much easier.

Please let us know what we can do to help you out...we are all here for you!!!!

Dragonwillow · March 31, 2006

Don't give up...but I can tell you from my exerpience that I was getting pretty discouraged myself during my "waiting" period. It was just a matter of luck with me...or should say bad luck. First my blood work came back low on viatimans, so I had to get b-12 shots and up my viatimans intake. Then I was found to have the hyplori bacteria...and had to take antibiotics for like 2-3 weeks (like 18 pills a day) Then we had to wait a minumum of 4 weeks to retest after I finished up all anitbiotics. But the first round of anitibiotics caused a major yeast and bladder infection so had to take more for that and had to wait the 4 weeks from that point. Then when I finally thought I was done and had insurance approval I found out my Dr was going through the process of breaking away from the group he was affliated with. I would have to be referred to another doctor as he would be unable to get my surgery in before the break. My luck changed then...because I was able to get a pretty quick appointment with the new doctor. And because I had insurance approval and had already had all the tests done and asked all my questions my first appointment actually turned into my pre surgery appointment and I got a date for a month away that day!

For awhile though as I kept having to "hurry up" and then wait over and over I questioned if it was all some kind of sign that I should be having this surgery. I just had to keep reminding myself that although I have lost weight on my own, I have not been able to keep it off on my own. This surgery was the step that I needed to do that.

It's hard to be patient when waiting, especially when you feel like your life is on hold in the process. My advice...live life now and continue to live it after the surgery. It really doesn't change all that drastically.

vericks · April 1, 2006

Thank you to those that are sending messages of encouragement. I really needed to feel positive and this is helping me to focus on the right things.

ralheit · April 1, 2006

It took me a year of battling to finally get here. I know how frustrated you must be. Just stay positive and keep going.

vericks · April 1, 2006

That guidance I will seek, thank you Jack

skippy01 · April 1, 2006

I am in that same frustrating waiting period. I am fighting with the insurance company even though I have barriatric surgery coverage as part of my policy. It is very frustrating I have no idea how long this is going to take but I understand how hard it is.

jtrek · April 1, 2006

Don't give up fight with the insurance company.

I was unable to ge my insurance to pay, even with a BMI of 49.7 and HBP and depression. Aetna claimed there wasn't enough wrong with me. So in the long run of it, my hubby decided we could self pay. We took a home equity loan. I don't regret it and I am glad I was able to at least do it this way instead of giving up totally.

But fight fight fight and don't give up!

Dody · April 1, 2006

I think when you are dealing with insurance patience perseveres. I have Medicare and finally they began covering the lap banding. I worked months trying to fight them on this surgery and then BAM they decided to cover it. I found a good dr. and was all set, and just a mo. or so they through another clink into the process by stating they would only cover lap banding at a Center Of Excellence. It took me only a short time to realize my dr. didn't operate at one of these. He operated, as many lap banding surgeons do, at a much smaller hospital. I think in one sense Medicare is protecting it's patients, but on the other hand they make things tough. I'm traveling to Vanderbilt in Tennesee and staying with my daughter to be at a Center Of Excellence. If you really want to have it paid for and you are entitled to it then I would dig in my heels and fight them.

gordonfamily3 · April 1, 2006

I just started working in a surgerons office 2 weeks ago and found this out myself...not sure where you are from by Presby in Charlotte is/has applied for the Center of excellence. I know that there is a doctor that takes medicare and works out of presby....but we have SEVERAL people on hold because of the change in the policy. So Doby - good luck on your surgery. When is it?

Dody · April 1, 2006

I was having my surgery in Marysville, Tennessee at a small but very nice hospital (but not a center of excellence). They told me honestly they have supplied the paperwork, but it takes someone from Medicare to do a completel evaluation and walkthough before they will even be considered, and it could take a year or even longer. I've already waited a year, so I shifted gears. I was about ready to give up when my daughter called me and said she had called Vanderbilt in Nashville and gotten me an appt. with a surgeon there. The good part is the surgeon who was originally going to operate will be right there around my daughter and will do the fills and maintenance of the band if there are any problems, and their ER is familiar with lap banding patients. Nashville will be a 3 hour drive and I go to see the surgeon on Apr. 26, and I'm not sure what he will require from me. I've had all my pre-testing done in Idaho where I live....everything you could imagine and more. I have documented weight loss for 2 years; psych eval; upper GI; clearance and letters from my cardiologist and GP; echos, EKG's and anything they can and would require. I hope the appt. goes well and that it won't be long before the surgery is scheduled.

Everyone has applied to be accepted as a Center Of Excellence. Do you know how many smaller hospitals do this procedure? It is going to take a long time to qualify them, and they may not meet the qualifications in the end. I don't want to wait all that time again.......I'm tired of hassleing with insurance.

I hope your hospital gets approved, but I know it is going to take a lot of time. We are talking about every smaller hospital in the U.S. It is hurting the surgeons that operate out of these hospitals too, as it also includes RNY patients. Everyone is on hold and has been for about a mo. and I think it's going to be a lot longer. I'm fortunate to have found a Center Of Excellence and a surgeon that will accept Medicare. Maybe something is finally starting to go right. I'm tired of being on HOLD!!:eek:

gordonfamily3 · April 1, 2006

Hey Doby I know right where Maryville is..I have an aunt that lives there. We get out that way about once or twice a year. :eek: It is very nice there.

No I wasn't saying to wait I was just stating that I knew it had to be frustrating and I am glad you found someplace. We were actually told it would take less then 6 months to the COE so they should actually have it mid-summer is what we have been told. Now let me state for the record..I will believe it when I see it. :eek: I do feel bad for the people in our area waiting on surgery it is so tough...we actually have several that were approved for surgery and then when the rules got changed we had to cancel the surgeries so I know it's frustrating...

Again I am very happy that you are on your way. I am very excited for you.