Well it is a new year and 2009 has to be better than 2008. Between almost losing my dad, my brother and sister in law going through a sepearation, the gaining of 80 lbs to my body just shutting down and being tired all the time to the insurance denials for my VSG. But I have a good feeling about 2009.
I started low carb dieting today, making changes. I know if I get this surgery approved, I have to drop some weight prior to surgery for my liver's sake and I should have done this a long time ago. That is where the procrastination comes in. Same with smoking! I just got flustered with each denial and gave up in a sense. Same as I always do..self sabotage. Went back to eating all the wrong foods and smoking like a freight chain. I had my "last suppers" this weekend. All the fast food, sweet tea, carbs, chocolate and junk I wanted. I got water today instead of my diet coke and it has taken me all day to get through 16 oz when by this time I have had 2 diet cokes or a 32 oz sweet tea. Ugh! I hate water! But I will learn to love it!! LOL I have 5 packs of cigarettes left so I will start my zyban again tonight and try to slowly ween myself off again by not smoking in the car or the house so maybe when I put them down again this time, it won't be so hard. Caffeine will be the next to go. I am changing my coffee over to half and half..same with my beloved hazelnut creamer..I will be converting to sugar free by doing half full creamer and half sugar free until I can tolerate the sugar free. I have to change my mindset that I am not giving up all my comfort foods but instead making a change for a healthier lifestyle. I am a true food addict and chain smoker so this is not going to be easy. Then again I guess if it was I would not need a tool like the VSG to help me. I would have already done it on my own.
My hope comes from the meeting with the 2nd level appeal board on Dec 30th. I was told before the meeting that BCBS and myself would each state our case to a general surgeon. He or She was the deciding factor. They would hear us out and decide whether or not BCBS had to pay for my surgery. I asked ahead of time would it be a bariatric surgeon and the ins. lady said they could not guarantee the general surgeons specialty, it could be brain surgery for all she knows; that they just go down a list. So when we met, the general surgeon introduced himself as Dr. B, general surgeon, specializing in bariatric surgery for 12 years. In my head I was saying cha ching! Yes.. Yes! Thank you God Yes! So we go through the ordeal and to make a long story short, the ins. folks kept referencing gastroplasty and banding and being unsuccessful and this is the reason for denial and it being not medically necessary. Dr. B said you do realize gastroplasty and gastrectomy are TWO different procedures. There were crickets in the room, then some shuffling of some paper and stumbling over some words. I stated my case, Dr. B asked me about my sleep apnea and then I was dismissed. I was told I would receive a letter within 7 calendar days. I have great hope that this time it will be approved. How could it not?
Monday, January 5, 2009
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3 comments:
I am hoping for great things for you too! I can't wait to hear what the result is. Keep positive. You may be right, 2009 may be your year!
Good luck!
Thank you, I appreciate that!
I just saw on OH that you were approved!!! Can't wait to hear about it!!
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