Unofficial denial :(

[Jess55 97]

I'm so depressed. I called my surgeons office yesterday to see if there was any word on my insurance and the receptionist said she'd gotten a call that they denied me for revising to the sleeve. She was goi g to leave it for the woman in charge of the insurance stuff though. I'm so upset, originally I said I probably wasn't going to get approved since my bmi was under 40 and my only complication was vomiting. Then I got it in my head they were going to say yes and now I'm devastated. I keep gaining weight without any Fluid in my band and I don't want to go back to puking at most times, or being able to eat anything other times. My scrubs barely fit me and I refuse to buy larger ones. My bmi is like 37 right now, it was under a little less at my last surgeons visit. At this point I'm almost thinking if they would approve me if I gain a little bit more, but I really don't want to. I'm probably going to start and try to do a 1-2 week liquid diet n Monday anyways because I need to lose weight bad, I'm miserable.

Maybe the insurance lady at the office will manage to call and talk them into it. Here's crossing my fingers.

[mykdzmom 387]

That is terrible news. I know you must be disappointed, but maybe it is not the final work. I am hopeful that your doctor can help you appeal the decision. Don't give up.

[AvaFern 3,516]

I'm not sure if this will make you feel better or not, but I have the sleeve and I barf almost everyday. Unlike a band, I can't just undo a sleeve, so for the rest of my life I will likely be a puker, which I can only imagine what it will do to the enamel of my teeth, my esophagus, and my electrolytes, given the surgery basically resulted in making me a mild bullimic (minus the finger down the throat part).

Don't get me wrong, I would still get the surgery, but the sleeve may not have cured your vomiting problems and you could have potentially been stuck with that for the rest of your life.

So, reading this, I'm probably not being very helpful, but maybe it gives you a little perspective. I will keep my fingers crossed for you that insurance changes their mind.

[Pinkgirl1234 761]

Ava are you serious?!!!OMG...I am on the fence whether I should get a sleeve or a bypass...I can't stand the vomiting.Thanks for being honest.Are you happy with the sleeve overall?

Jess do you have any health issues like cholesterol,high blood pressure?Have you been checked for a hernia?Ct scanned.There are those lawyers that handle appeals may you should contact them.I think their names is Lindstrom Healthcare Advocacy Inc

wlsappeals.com/

Check them out.

[Jess55 97]

AvaFern, you do? Do you know why? Is there a cause? That sucks.

When I vomit with the band it feels like it's stuck and then most times I just bring it back up. It usually happens within the first few bites, but then after I can eat anything.

So really I vomit but feel like after I have no restriction. So what is the band doing to help me? Nothing. I thought I'd done enough research prior to the band, but apparently not, now I read so much about long term or even short term complications. Slippage, erosion, scarring, ulcers. I don't want to have to worry about that forever so I really wanted it gone. I thought maybe for once I'd be able to be happy in life. I'd lose weight and be happy. I'm going to keep my fingers crossed though and maybe the office will appeal it.

As for the lawyer, I doubt I'd be able to afford one.

[sweettea 300]

@@AvaFern

It took a year for them to approve my gastric sleeve surgery. My BMI was to low. Somehow the doctors staff got it pushed through. Don't give up hope yet.

[Jess55 97]

I got a letter in the mail from the insurance company saying they were denying me because my bmi is only 36. I'm going to talk to the office tomorrow and if they have had people get approved by gaining 10# I may do it. But I don't want to have to stay there. I'm not willing to stay at that weight for an extended period of time though. I mean I'll gain a few pounds and then drink a ton of Water night before going in. But I'll have to see if that would get me approved

[sweettea 300]

Put quarters in your pockets. (me trying to make you smile) My co-morbodities got mine pushed through. Somehow the doctors staff did miracles.

[AvaFern 3,516]

@Pinkgirl1234 Yes, overall I am very happy with the sleeve. I would still do it all over again because the positives far outweight the negatives.

@Jess55 There seems to be no reason why other than that my stomach hates certain foods. It's a little like developing a food allergy to everything that is bad for you (yet also happens to taste great). Some days my stomach is fine, while other days it pukes up almost everything I eat. I've decided to be fine with it. I wanted to be thin and the cost of that is now I never really get to enjoy food again. If my options were enjoy food and be fat or really not care much for it and be thin...I'll take my size 0 jeans everyday.

[Pinkgirl1234 761]

I just want to stop this vicious reflux and vomiting with this lapband.

[rosie227 6]

Wow This is crazy your team needs to help you get approved I had got my band in 2013 and had a low bmi they did everything to push me to get approved to find out what my inc company wants to get approved so a few things where sleep app. and guess what after a test I had sleep app. so I got approved even with a low BMI !!!

Now that I want this band out and a sleeve same deal low BMI but I had a endo and I have a distended pouch and i still have sleep app i think i will get an approved I hope but they wait till they have everything they need to really push for you..

I hope you can maybe ask about some of this

[sweettea 300]

Crossing fingers and toes!

[Jess55 97]

They basically said the only thing I could do is perhaps get the band removed(which they would pay for) and try again down the line. Which there's no guarantee they'll approve me. They said gaining is not really an option that the directors at the insurance have caught on to that and are not approving if you gain. So I guess it's back to the band I go and try with fills again.

[sweettea 300]

Don't give up yet. My doctors staff was wonderful. Then again, I had a lot of physical problems.

[Jess55 97]

Unfortunately besides being overweight I'm very healthy. No problems at all. Which in this case kind of sucks