Very Frustrating Doctors Appt .

[coltonwade 27]

I am revising to a sleeve. Since I could not afford self pay and cant get insurance I managed to scrape up enough money to get the PCIP insurance ... They will cover revisions..

They did an upper gi and the lady asked me how in the world I was eating ? I told her not very well .My band has so much damage, scar tissue that liquids barely go through my band .. Doc told me there are ppl with band issues and then there is me ! Mine are bad basically . He told me to come back next week for and egd, they stick a tube down my throat to see if my ban

d has erroded through my stomach , he suspected it has . Sounds all bad huh ? It is problem no one is in a hurry to get it fixed ! The insurance corrdinator is an idiot ! She was basically telling me my insurance most likely won't pay for anything when I know they very well will .. she really made me mad . She had never dealt with my insurance yet was telling me she didnt even know that PCIP was not through an employer I guess cause its not what I wanted to hear .. anyway I had a sleep study done to see if I have sleep apnea . So hopefully will know more in the next dayor so ?? he also told me if i dont revise to a sleeve because of my PCOS that with in 2 months of band removal i will gain back the rest of my weight and will contiune to regain about 30% more weight . HE also said due to the PCOS with out a sleeve i will get diebetes with in 5 yrs ! LOVELY ! All in all i was discouraged, Mainly because the insurance lady didntknow what she was talking about and it pissed me off.

Im just not sure if this is par for the course or not ? Im not sure why i feel the way i do ?

[Eat That Frog 53]

I don't know the answer to any of your questions but would like to give you a hug and wish you luck.

[Angelmom 30]

Sounds like you are kind of doing the appeal battle that a lot of us have to do....basically the same thing...feeling run around...no hurry, etc.

I sure hope you are ok. The big reason I did not want the lapband was because of what's happened to you...that and I didn't want a foreign object in me, or to have to have needles to get fills....not for me.

I can't believe you'll gain the weight back. I think you should hunker cown and get your food logs going and restrict yourself to Protein shakes and 1500 calories...I highly doubt you'll gain all that weight if you try and fight it...at least until you get your revision. I dont have PCOS...but who knows...isn't there a way we all can battle the buldge?

[coltonwade 27]

Its not an appeal . i got the insurance i have because they cover the revision . The insurance coordinator did not knwo what she's talking about which is what pissed me off.

PCOS is a nasty thing. i WILL gain back the weight with out another surgery .

since i cant eat anything right now its difficult to main tain any calorie count.

[coltonwade 27]

This explains my situation a little better. http://tryingtostayskinnyintexas.blogspot.com/2012/07/day-in-my-life-how-lap-band-affects-me.html

[Angelmom 30]

I know it's not an appeal...just sounds like a lot of the rigamoro of appeals others of us have gone through...just as frustrating and annoying.

I meant in the future you could try and combat the weight gain by keeping food logs...always helps me. Got to try somehow.

[coltonwade 27]

oh ok I think the biggest issue was the coordinator was not listening to me for some reason and thought she knew what she was talking about and she didnt ! I just emailed them and told them i wanted to know what was happening and when they were going to find out what my insurance would pay for ? Basically what the steps are. For some reason PCOS does not respond well with regular diet and exersise and he evern said that. I just hope i can get my band out and sleeved SOON !

[mysunflower621 69]

I completely understand what you are saying and where you are coming from with the PCOS and yes friends, she will regain it that fast. I have PCOS too and decided against the band too for the reasons you are describing as well as I didn't think it would ultimately help maintain the weight with the PCOS, my doctor agreed and we are doing the sleeve in November. I'm scared to death, but I have to do something to get the PCOS under control. I had lost 50 lbs on Medifast 2 years ago, the diet stopped working after 6 months (this is something elose that happens to those us with PCOS, our bodies also adjust to any diet!) and I stayed on it for a year, paying for it in hopes to just maintain what I lost.... well, thanks to PCOS, guess what? Yup, I gained it all back adn then some in less than 6 months!!! Hence, the need for the sleeve.. I'm tired of this roller coaster ride. I do fear though, that eventually the sleeve will stop working and I'll be right back here 2 yrs down the road...

Good luck, hopefully you will get this all straightened out and will get that band out safely ASAP.

[coltonwade 27]

thanks sunflower ! I am glad you understand. I lost 125 pounds with my band ,went from 250 to 125 . So i know how to work the WLS I have gained as much as 15 pounds in one month . the doc told me ( I am up to 218 again ) with in 2 months of band removal with out a sleeve the rest of my weight will be back on ! My mom was with me at my appt and i was glad she heard that. I was glad she heard that its not me eating. I can barely get liquids down my throat most days but can gain 15-20 pounds in a month ! WTH ?? Good luck with your surgery !

[mysunflower621 69]

I do hope you can get the revision done soon, I do know what it feels like to really work hard at losing it only to regain it so rapidly because of the PCOS. It's so frustrating, that is where I am at now! I can look at someone else eat something and gain 10 lbs just from smelling it! Thats how bad it is for me. Then I just give up and though I'm not a horrible eater, I'm not the best either. So frustrating!

Hang in there! Ping me anytime you want to vent, I do understand the PCOS hell!

[coltonwade 27]

So here is an update w/ my situation I decided to go to a doctor here in Austin , the doc in Dallas I just could not do . I could not handle the coordinator.. Forgive me i'll post updates from my Facebook page .. but this is what has happened over the last couple weeks...

Just got home from my doctors appt. Really loved the doc, he was very nice and very caring . He sat down and went over everything with me . Told me that he would submit the removal AND Revision for approval for insurance ASAP that the revision is just as important as the removal to him .. He told me to Be prepared I MAY wake up with out a sleeve( the weight loss surgery part ) IF My stomach is in too bad of shape or is not healthy enough to tolerate both procedures .. He said do not worry if that happens in 3-6 months he WILL do the revision ! He said he was very sorry no one found this important enough to them to fight for it and he would fight " tooth and nail" to get this approved no matter what ! Once approved i have to see a nutritionist he told me to prepare to take Vitamins for the rest of my life .. mainly because i have been mal nourished ( Yes its possible to be malnurished and fat LOL ) for the past several years because of not being able to eat anything . I also have to do an EKG and Blood work , but that's it. He was going to request a rush approval .. SO HOPEFULLY I can get this done before the end of the year still !

So here is my update on my band/ revision surgery . earlier this week I got an email from my doctor saying they had all they needed to submit for insurance EXCEPT my latest Upper GI .. I asked them if this was from the band doc in Dallas ( the doc I saw once Or my original band doc ) Before I got an answer from her I called my original band doc and asked her If my records were ever sent to the new doc . Her response ( the receptionists i should say ) was " I requested them from storage yes " I said " that was nearly 3 WEEKS AGO have you gotten them to the new doc yet " her response " I Have requested them from storage that is all i can do " I then said " why dont you go a step further and CALL STORAGE and ask them where the hell my records are after 3 weeks of not getting them . " She obv

iously had no intnetion of going the extra mile, I told her " I spent nearly $20,000 there PLUS refered over a dozen patients who actually HAD Surgery you and this is how you treat me " She said ' what do you want me to do " I was FURIOUS . SO then i find out they just needed the Upper GI report from the last doc visit in Dallas, I call them and ask them if they can send it over .. The office manager said , well i think it was sent over let me look , it was sent over and it says your band was NORMAL " WHAT THE HELL ARE YOU TALKING ABOUT its NORMAL she said ' they band placement is normal " I told her " there is NO WAY you can put the band is " normal " On that report I cant freaking eat ... " So i call the new doc she said " We cant submit this report to insurance , they will deny it " So they decided to submit it with out the Upper GI and IF they ask for one I'll go in and do one in their office and he will state band placement is normal but function is NOT . I have NEVER been so angry in my life So FYI Make SURE your upper GI's do NOT say normal ..... the paper work was submitted Thursday I believe I should hear something , most likely , we need an upper GI next week . and OH BTW I can no longer eat solids or mushy foods in any form .. Only liquids, my meds wont go down either. GRRR

I should hear something from the insurance this week .... I fully expect them to tell me I need an Upper GI which I am ok with but I secretly hope they just approve me ! Thanks for listening !

[mysunflower621 69]

What a roller coaster ride you have been on!! It does sound like this new doctor is wonderful and exactly what you need to help you fight for this! If you have to do another Gi, that is ok, at least it will state what you need to be able to have the revision!!

Hang in there, you are well on your way with this new doctor!

[lakobe00 63]

Hi Mindy.....would you please share the info on the insurance you purchased that covers revision?

[coltonwade 27]

Thanks y'all. I am really ready for this roller coaster rid eto be over !!! SOON !! The new doc is awesome ! I love him .

Lakobe... the insurance i got is PCIP insuarance through the govt.. It is covering my revision, or it should i should say .

Message me if you want more info , there are certain criteria you have to meet in order to get the PCIP . one of them being with out insurnace for 6 months.

MIndy

[kparadisek 115]

Hi Mindy please share the PCIP insurance info. Thanks!