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Thread: Denied

  1. #106
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
    Name
    Christie
    Surgery date
    11/03/2016
    Surgeon
    Dr. Wright
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    Nov 2016
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    09-12-2019 04:13 PM
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    Default Re: Denied

    I am so sorry to hear that Kristi. I swear sometimes the decisions insurance companies make doesn't make any sense. Big hugs.



  2. Gastric Sleeve Surgery With Weight Loss Agents
  3. #107
    Gastric Sleeve Member Kristi7928's Avatar
    I have had a gastric sleeve.
    Name
    Kristi
    Surgery date
    09/27/2018
    Surgeon
    Dr. Bradley Thaemert
    Join Date
    Sep 2017
    Last Activity
    04-17-2022 02:53 PM
    Location
    Sioux Falls
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    Default Re: Denied

    Today was a Monday for sure. I'm glad it came today. Still wet from the down pour earlier and spilled my big water cup all over the floor. Water was not my friend today. A girl from across the hall loaned me her umbrella which latched onto my chair so not such a bad ending. She shared an umbrella with a coworker. My hair is still wet from the down pour this morning.

    Emailed my primary doc and my surgeon's nurse to see what needs to be done, what she needs, etc.

    My crappy edema may be to my advantage. It is a cormoribity so going to get the nurses and doc to document that thoroughly. He better document it - it's his bright idea that caused this. My physiatrist thinks I need lympodema massage to get it pushed towards my heart. My boss was very sweet and said if I need to take off to get my legs up to do it. I'm not at that point, but close. I only have like 60 hours of vacation was hoping to save a lot of it for surgery. I used to wear a kids size 6 and now I can't even get into a WW shoe.

    Thinks have to get better. They just have to. I'm close to a breaking point. Haven't broke down yet, but a girl can only take so much. Talking it out helps. Thanks for listening.
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  5. #108
    Gastric Sleeve Member
    I have not had a gastric sleeve.
    Surgeon
    Dr. Felix
    Join Date
    Apr 2018
    Last Activity
    06-20-2023 02:04 PM
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    Pittsburgh, PA
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    Default Re: Denied

    Quote Originally Posted by Kristi7928 View Post
    I did get the Zolfran filled, but did not go back on antibiotics. I see ID tomorrow along with podiatarty, but not my normal ID doc. We shall see what he says. Feeling a lot better. Stomach is still a little off, but getting better. I had a little bit of Diet Ginger Ale, but Diet Sprite seemed to work better.

    Refilled my normal muscle relaxer Amrix and insurance denied it and the pharmacy is trying to figure it out. I'm not too happy about it. I know why - because I got put on Baclofen (cheaper) they are probably going to make me try 3 more muscle relaxers just to get back to Amrix. Hoping pharmacy can convince them that it interacted with the Zyvox and it wasn't by choice I had to switch.

    I'm going to give it another week. I'm alone at work again and swamped and still need to tackle some other insurance issues with work and Cigna. Ugh.

    How are you Donna? Any news on your journey? How about your friend? After seeing myself on the news - good lord, that surgery can't come soon enough. Holy fat!! Ugh!
    I am so sorry you are having such a fight for this! That sucks. You've got so much going on all at the same time. Maybe you need a sappy movie night? Whenever I can feel myself getting close to a breaking point, sometimes I will kind of "induce" it by watching tv shows or movies that I know will make me cry. Usually once I get a good start, I just keep going, and when I have a really good cry it's like I get it out of my system, and can move on. It doesn't 'fix' anything, but it lets me feel more like I can process and move forward, I guess.

    As for myself, I met with my surgeon. I really really like him and his team. They are very organized, and I LOVE it. I got this huge binder full of great information. They gave me prescriptions for all the tests I may need before this is all through. They also gave me a checklist of all the things I need to get done in order for my insurance to agree. I have been drinking protein shakes every day, or at least every day at work. It's nice seeing the number on the scale drop- I am under 300 for the first time in a very long time. That is very motivating. I told my surgeon my plan is to have the surgery in late December/very early January and he said that sounds totally reasonable to him.

    My friend is doing well. She just had a house built and is enjoying the gardening- that girl has SO MANY flowers and plants in her yard, I am amazed. I planted a couple of flowers and I am feeling like little miss Suzy Homemaker.

    I don't think I would want anything to do with seeing myself on the news right now. You are a brave soul.


  6. #109
    Gastric Sleeve Member Ann2's Avatar
    I have had a gastric sleeve.
    Name
    Ann2
    Surgery date
    08/18/2014
    Surgeon
    n.a.
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    Oct 2013
    Location
    Missouri
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    6,630
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    Default Re: Denied

    I'm really sorry, Kristi.

    It's strange for me to say this, but somehow I know this is going to work out for you. I have no idea what the ultimate path will be, but it's there. As someone (who's very active in Al-Anon) told me recently, "Just do the next right thing." I'd never heard that before, and it seemed like an excellent mantra.

    BTW, I do know it must get old being told "You're so strong!" It's exhausting being and staying strong. I just wanted to say that.



    Consult: 235 lbs
    My and doc's preop diet: 216 -19 lbs
    M1 postop 205 -30
    M2 193 -42
    M3 184 -51
    M4 174 -61
    M5 167 -68
    M6 162 -73
    M7 156 -79
    M8 151 -84
    M9 148 -87
    M10 146 -89
    M11 144 -91
    M12 143 -92
    M13 142 -93
    M14 140 -95
    M15 139 -96
    M16 137 -98
    M17 135 -100

    First Surgiversary post

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  7. #110
    Gastric Sleeve Member Kristi7928's Avatar
    I have had a gastric sleeve.
    Name
    Kristi
    Surgery date
    09/27/2018
    Surgeon
    Dr. Bradley Thaemert
    Join Date
    Sep 2017
    Last Activity
    04-17-2022 02:53 PM
    Location
    Sioux Falls
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    Default Re: Denied

    I got admitted to the hospital today right after my appointment. Doc admitted those dressings weren’t for me. Because I’m feeling crappy and having small fever and chills he thought I should be admitted. ID agreed and I was like you agreed to that way too fast. I got a room within like 5 minutes. By the time they got me in my bed the swelling was already down.

    The wounds look worse. Way worse. And have two new huge red spots that I’m hoping do not turn into sores. It’s just skin and bone there. Front where foot goes into 90 degrees. I think it’s just a few days. I hope. Just got done being cold. Now getting hot.
    .
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  9. Gastric Sleeve Surgery With Weight Loss Agents
  10. #111
    Gastric Sleeve Member AnnieG's Avatar
    I have had a gastric sleeve.
    Name
    Annie
    Surgery date
    10/05/2017
    Surgeon
    Dr. Ryan Heider
    Join Date
    Oct 2017
    Last Activity
    11-29-2020 11:18 AM
    Location
    NC
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    1,572
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    Default Re: Denied

    Quote Originally Posted by Kristi7928 View Post
    I got admitted to the hospital today right after my appointment. Doc admitted those dressings weren’t for me. Because I’m feeling crappy and having small fever and chills he thought I should be admitted. ID agreed and I was like you agreed to that way too fast. I got a room within like 5 minutes. By the time they got me in my bed the swelling was already down.

    The wounds look worse. Way worse. And have two new huge red spots that I’m hoping do not turn into sores. It’s just skin and bone there. Front where foot goes into 90 degrees. I think it’s just a few days. I hope. Just got done being cold. Now getting hot.
    .
    Hey cookie lots of prayers. I know you're struggling with lots of health things now. Just know you are not alone. Please keep us updated.
    [I]HW: 240 lbs SW: 199 lbs GW: 140 lbs

    1 MO = 167.0 2 MO = 156.4 3 MO = 148.4 4 MO = 140.6
    5 M) = 136.0 6 MO = 130.0
    1 YR = 122.0 2 YR = 140.00 2.5 YR = 139
    Happy with my weight; happy with my size; over-the-moon with my health!

  11. #112
    Gastric Sleeve Member Kristi7928's Avatar
    I have had a gastric sleeve.
    Name
    Kristi
    Surgery date
    09/27/2018
    Surgeon
    Dr. Bradley Thaemert
    Join Date
    Sep 2017
    Last Activity
    04-17-2022 02:53 PM
    Location
    Sioux Falls
    Posts
    173
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    Was Thanked 134 Times in 78 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Denied

    The swelling has gone down a lot. Doc thinks because I was in bed. I was like no I had them up all weekend and they didn’t go down. I know - I measured them. He agreed no more profore and will talk to the nurses about proper wrapping. The new marks are from them not being wrapped right. Grr! I wish sometimes docs andnurses listened to patients more.

    Probably switching my antibiotics to vanco as this new one is effecting my CR and might have been the reason why I felt crappy. Here til at least tomorrow.

    I’m so bored!
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  13. #113
    Gastric Sleeve Member Kristi7928's Avatar
    I have had a gastric sleeve.
    Name
    Kristi
    Surgery date
    09/27/2018
    Surgeon
    Dr. Bradley Thaemert
    Join Date
    Sep 2017
    Last Activity
    04-17-2022 02:53 PM
    Location
    Sioux Falls
    Posts
    173
    Said "Thanks" 72 Times
    Was Thanked 134 Times in 78 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: Denied

    I'm home!

    I didn't have to wait til my CK levels came down because they knew it was caused by the daptomycin and now it is on my allergy list. I'm not really allergic to it, but only should be used for life saving measures if nothing else works.

    Doc feels really bad about the new wounds caused by his wound team - he will have a sit down with the two nurses that caused this and I hope it doesn't happen to anyone else. He talked about amputation again, but really said he wants to save my feet. Possibly going to try wound vacs Tuesday at my appointment. Not too excited about it, but apparently they are pretty small and can be hidden with a bag. If it helps I guess that's all that matters. The right foot is the worst now.

    Did get the process started with primary and my surgeon's office about resubmitted to Medicaid. We shall see how that goes. These feet are probably setting me back at least another month or so if not more. However, I just want to get approval. We can set a later date if need be once it is approved.

    Glad to be out. Apparently I am a stellar patient. I never really felt awful - just sluggish. So I was mostly bored and didn't bug the nurses unless I needed something.

    On top of this - my truck is out of commission. Hoping it is just a fuse, but right now can't get the doors open. Be getting rides for the time being.

    Looking forward to a day with friends tomorrow.
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  15. #114
    Gastric Sleeve Member
    I have not had a gastric sleeve.
    Surgeon
    Dr. Felix
    Join Date
    Apr 2018
    Last Activity
    06-20-2023 02:04 PM
    Location
    Pittsburgh, PA
    Posts
    59
    Said "Thanks" 80 Times
    Was Thanked 25 Times in 21 Posts
    Said "Welcome to Gastric Sleeve" 6 Times
    Blog Entries
    2

    Default Re: Denied

    Hi, Kristi

    It's been a while since you've updated so I wanted to check in and see how you are doing.

    Did you get your truck fixed?

    Have you gotten any more news? How are your feet?


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