So Sick and Tired of This Battle

[j_war06 0]

I am so sick and tired of saying, "Well I'm getting a Lap-Band soon." It is getting so old. If I wanted it to look cute it would be different, I just want to walk and go to school and make friends. I only have one friend left because of my handicaps. I just want a life, I am tired of living the way I do, I want to go out and do stuff, but I can't, and its getting old quick. I feel like every evil force is working against me. Everyday I get on here and someone else is getting approved, why can't I post that?? What am I gonna do? I cant get the surgery till after school starts, I am such a loser.

[princess_n_thep 2]

Jodie,

I think your frustrations are very common among all of us as we went through the process of either gathering our money for self pay or waiting for insurance approval. All things come in time. I know it is hard to wait but try and use this time wisely. You can really try to spend this time supporting others in their journey, self reflections and some healing, becoming mentally prepared for the life change, etc etc.

Your approval letter is coming, I can feel it. You are NOT a loser. And let me tell you one more thing.... ONE good friend is worth a MILLION superficial ones.

We are all here for you hun! We will be here doing a happy dance with you when that letter finally arrives!!!

[j_war06 0]

Im glad u all can dance, I can't even do that. Why is it that when I NEED something it just doesnt happen?? I feel worse everyday like my knees are going to just bust

[j_war06 0]

Im just ready to get out of this HOUSE!! and be able to enjoy it, if the insurance does come back with something, anything (yes or no, preferably a yes) I am going to turn into an agoraphobic, I havent seen a crowd and not cried because they were stepping on my and pushing me in 6 or 7 years. I cant wait until I can push them back, rude SOBS. I just dont understand, dont they know I need an education, I am not even in school right now

[DeLarla 22]

Jodie, sometimes I come here just to bitch and rant and rave. Any good therapist will tell you to grab a pen and paper and write, write, write. Keep writing, girl. Get all your feelings out, and don't worry about feeling bad. We all felt bad enough to get banded. Your life sounds like mine, with huge road blocks around every corner, so I don't want to tell you to cheer up (not yet, anyway.) Just keep getting your feelings out and soon your head will clear and you'll be ready for this crazy journey.

[MerryHearted 20]

(( hugs ))

I think we all empathaize that high school can be a real b*tch when it comes to people being mean about how you look, particularly weight.

Hang in there! And if approval doesn't come, know this: you are a valuable person regardless of your weight and any disabilities that come along with it.

[Alexandra 55]

Jodie, where do things stand with your insurer at this point? Are you certain they have all the information they need to make a decision? There is NOTHING worse than waiting and waiting only to be told after a month that one document was missing. Stay on top of them to make SURE they are not missing any pieces. Once the file is complete they really can't take more than 30 days to make their determination.

[porclndoll 0]

Jodie...

I am so sorry that you are sooo fustrated! I know what its like to be overweight and in high school, I think most of us here know what thats like. I am 32 years old and I still hear the taunts and teases. I just recently ran into a guy who use to tease me something terriable! He was as nice as pie to me! I didn't know what to think. I on the other hand was a bit standoffish. Some people here have been thru h*ll to get their approvals and it doesnt always come right through...sooo like Alex suggested keep on top of your insurance company. Is your mom or dad or a family memeber helping you with this whole process? Maybe they can help you contact the insurance company?

As far as your limited ablities. (I have no idea what they are so please dont take offense to this suggestion) I know this is gonna sound corney and you may not be ready for something like this, but it will certainly help you out a little bit...May help you start to lose weight or improve moblity....but there are video tapes out there that are geared for people in wheelchairs, or for people who just can't stand up to exercise for 30-40 minutes. Its pretty amazing to think you can exercise from a CHAIR but it really works. I had to buy one for my mother, she has limited moblity and she needs to lose weight. Richard Simmons also tells people SOME movement is better than NO movement. Sooo maybe while you are waiting for your approval, you can use your fustrations to motovate you into moving a little bit. Check out this link, I found it online for you

http://www.activevideos.com/instructors/richardsimmons.htm?gtse=GOTO&gtkw=richard%20simmons

Its called Richard Simmons Sit Tight Video. It costs 14.95. If you want here is the 800 number to order....1-800-342-4320............

I KNOW its hard to commit to an exercise routine. God knows I dont do enough of it as it is.....I should do more. But you have the time right now while you wait for your insurance to come thru. Your doctor may require you to lose weight before your surgery anyway....sooooooo maybe this will help. I hope it does.

Talk to you soon!

**Had to edit here ~ I just saw your ticker thingy...Girl you lost 14 pounds all ready! HOLY CRAP thats awesome! Congratulations!!! 14 pounds is like 56 STICKS of butter!! 14 pounds is 2 1/2 BAGS OF SUGAR! 14 pounds is like 2 BAGS OF POTATOES.....That is amazing work right there! KEEP IT UP!!

[dylansmom 27]

Mega hugs to you. I went through my whole school years timid and ashamed of who I was. I was laughed at, made fun of, and was sometimes even treated like I was non existent. Just depended on the day.

Although I have since forgiven those individuals who saw fit to torture me, I have no desire to go to any of my class reunions because of it. Why would I want to see them again? Sure people change with time, but why bring back the old memories?

I can assure you that it does get better with time. I am now a strong and confident young woman (using the term "young" loosely at age 30) who is happily married for 9 wonderful years, and has a beautiful 2 year old too.

Sending mega hugs your way, and just give a holler if you need me. While I don't post here as often as I once did (just very busy this summer) I still try to pop on to lurk at least every other day.

Praying for you acceptance letter! ~Kelly

[j_war06 0]

I am not worried about the teasing, I have dealt with it from the same people all my life, and it never changes, its the fact I cant get around school, I cant sit in the desks for very long or I get stiff, if I stand or walk to long then my knees get too wobbly. I cant write very much with a pen or pencil (about a paragraph) because my hands hurt too bad. I cant do a lot that has to do with school. I cant do any exercises because my whole body is like my knees, too small and limber for the amount of weight on them. I have lost 14lbs because I take prescribed amphetemines because if I gain ANY weight over 240 there is a 10% increase every 5lbs or so that my knees WILL collapse. I just want to be able to go shopping, and actually be able to walk into the store instead of having to sit and rest ALL the TIME. I want to be able to go to college confident that I can do whatever the other kids are doing. I am tired of staying home every night! I just am physically unable to do much of anything.

The insurance has everything they need I assure you, and then some. I am a pre-law student and wrote a 3-page letter entailing details of my conditions and doctors referrals and visits

[Alexandra 55]

Jodie, do you have a medical condition other than being overweight? Is it being treated?

The insurance has everything they need I assure you, and then some. I am a pre-law student and wrote a 3-page letter entailing details of my conditions and doctors referrals and visits

How long have they had the application at this point? YOU may think they have everything they need, but until they confirm that you just don't really know. Do give them a call and make sure. I know from experience that one tiny piece of missing information can screw up the whole thing if someone at the carrier decides it's required before they can proceed. Your 3-page letter is only ONE element of the whole file. Make sure they have whatever it is they want so they can get to making their decision.

[jqpublic 1]

Jodie it all take s time just hang in there There is an old saying God only gives you what you can handle....you will get there but it will take time! I was going to an apointment the other day thinking how bad I felt about my knee, when this little old lady that could hardly walk told me she had broke her neck blown out disk in her back like six months ago. as she got up to leave she said after all this I have cancer?

and I thought I was having abad day! well good luck take care hope things work out sooner for you..

[j_war06 0]

I know, I am a firm believer in everything happens for a reason. And my impatiance goes against this, but I feel like I am dying, I really do. Everyday my body hurts more, my knees are stiffer, my hands are more cramped, and I am SOOOO tired all the time. I just know that everyone that was in that office with me today has gotten their bands, and it seems like everyone but me is getting it (those who want it). I just dont understand why I have all the bad luck and stupid luck.

[porclndoll 0]

Jodie...This is a really personal question, but what other health issues are you facing other than being overweight? Im sorry if thats asking too much, but I can't help but wonder with all the pain your in.....Are you on meds? How long has the insurance company had your paperwork? Have you given any thought to that Richard Simmons work out video that I suggested?? Just curious and wondering about ya!

TTYL

[j_war06 0]

Well I have several conditions other than being obese, that is why I am having the surgery. Mom calls the insurance company like every other day, and they keep saying they need more time. I have 3 doctors referrels with the letter and a list of references that they can contact to validate information. Acid reflux disease, temperomandibular jaw disorder (TMJ), chronic pain, sleep apnea, panic disorder, chronic fatigue syndrome, kydney conditions, hyperextension, patella alta, patella tendonitis and depression. Below is a copy of my Appeal letter:

Dear UnitedHealtthcare Appeals,

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This letter is in regards to your recent denial to provide coverage concerning my request for morbid obesity surgery in the form of gastric banding.

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On March 22, 2005 I visited the office of Dr. Ronald Lindsey in the matter of chronic severe knee and body pain. His diagnosis was that I had very small bones and joints for my weight (235 lbs) and that the cause for the smaller bones and joints was that I have a disposition of hyper-extension within my joints. According to Taber’s Medical Encyclopedia hyper-extension is the extreme ability to stretch out and/or abnormal extension. The significant amount of weight on these already flexible joints can be compared to placing a brick on top of a toothpick, the excessive amount of weight on my limbs (as ruled by Dr. Lindsey) will take its course someday. Dr. Lindsey’s prognosis was that unless I lost a great amount of weight in a short amount of time, that my knees would suffer substantial permanent damage. In lou of his prognosis he suggested bariatric banding surgery in order to lose the weight.

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In response to Dr. Lindsey’s suggestion, I called and made an appointment with Dr. Felix Spiegel, a bariatric surgeon within the <?xml:namespace prefix = st1 /><st1:City w:st="on">Beaumont</st1:City> area of <ST1:place w:st="on"><st1:State w:st="on">Texas</st1:State></ST1:place>. Dr. Spiegel determined, based upon his professional experience and training, that weight loss via his surgery would indeed help my knees, since my BMI is 41 (normal is about 24, as determined by the World Health Organization), and will also significantly decrease my chances of developing other comorbid conditions, and would rid me of the ones that are already present such as acid reflux disease, temperomandibular jaw disorder (TMJ), chronic pain, sleep apnea, panic disorder, chronic fatigue syndrome, and depression. It has also come to my attention that although you stated in your denial letter that the GTECH Corporation’s benefit plan does not cover surgical and non-surgical treatment of obesity, your company (UnitedHealthcare) covered the costs associated with Dr. Spiegel’s consultation ($250), with me only paying a copay of $40. This discovery is contradictory to the policy exclusion, why would one choose to spend the money on a consultation of a patient by a doctor who specializes in a program that is not covered under the company policy? Why spend the extra money?

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From the year 2002 to the present (Summer 2005), GTECH Corporation’s benefit plan through Cigna and UnitedHealthcare has spent approximately $9,716.89 on my medical costs alone. Every year my medical costs almost double due to knee pain which has been determined by medical professionals to be a direct cause for the chronic pain and inflammation that constantly plague my knees. Now that we have finally come to our last resort, surgery, the same pain is becoming more prevalent throughout all my joints, including my hands, elbows, wrists, feet, and lower back. With the pain spreading, it is projected that my medical costs will possibly triple by January 2006. A breakdown in costs reveals that my policy spent atleast $242.58 on orthopedic consultation and physical therapy in 2002. From 2003-2004 UHC has spent an estimated $4,931.79 on medical costs associated with obesity comorbidities. Just this year, 2005, UHC has spent an estimated total of $2,238.18 as of May 2005, that is not even half of the year and UHC has spent about half of the previous year’s expenses. If you were to add it all together, by the time I would no longer be carried by GTECH’s policy UHC will have spent over $35,000 or more in health care costs for me (Jodie Warner) only. Hypothetically, if UHC was to pay for the complete costs of the surgery, UHC would only total about $27,000. These figures do not even include the very real possibility of knee surgery resulting from damage to my knees caused by morbid obesity.

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Morbid obesity as a disease, not as outward appearance, has truly taken over my life. I can neither stand nor sit for too long of periods, walk very far, or even drive my car most of the time. Morbid obesity is controlling my life, and simple diet and exercise can not fix the problem because it is impossible to exercise because of the crippling pain in my knees (and now throughout my body). Also, because of the pain I have had to unenroll from public school and am forced into a homebound program. In this program I have had to be placed within my school district as special education, although I am extremely intelligent and am in no way mentally retarded or paralyzed. My knee pain, as a result of morbid obesity has caused me to miss an estimated 50 school days per year, which takes a dramatic toll on my grades. Before I had knee pain I was an “A” student and in the top 10% of my class, now I make grades all over the chart and have stepped down into the first quartile of my class. Obesity will only worsen my condition, and could very possibly send me to an early death. Under Supreme Court ruling concerning morbid obesity, it has been determined that obesity and especially morbid obesity is a disease and a disability under the American Disability Act. As an obese, female teenager, I feel as though I am being discriminated against by GTECH’s policy because I am obese and I am experiencing unmentionable pain (like elephants standing on my knees all day). This surgery, gastric banding, is not for cosmetic purposes, if I want to look pretty I put on make-up, it is to save my future ability to walk. I believe people are beautiful no matter what their pant size is, but when the pants are not the right size, then they cause problems. This is what is happening to me, my weight is causing my body to be in severe and damaging pain. I have an extremely small frame that refuses to bear the burden of my weight any longer. If this issue is not addressed in a very timely and serious manner, my knees may collapse and cause serious and permanent injuries.

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*If you would like to validate any of this information, I have provided the contact information on the following page*

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Sincerely

Jodie Warner

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