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Thread: Denied

  1. #76
    Gastric Sleeve Member Kristi7928's Avatar
    I have had a gastric sleeve.
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    Kristi
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    09/27/2018
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    Dr. Bradley Thaemert
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    Default Re: Denied

    A retired service officer was in the office today so I asked him for some advice. This guy has been at hearing in front of judges in Washington D.C. Let him know the lawyer called and what he said and he said - the lawyer should not be predicting what the judge's verdict is going to be and it was intimidation. He should not have been talking to me before the hearing and to start with that information. He also told me to record the conversation and let them know I am recording it just in case this has to go to DC. Thanks to my Titan truck guys was able to find an app already on my phone that will record and I don't have to do too much.

    Starting to get nervous and hope it goes by fast. The service officer thinks the judge should rule in my favor after what the lawyer said, if only it could be that easy!

    I'd appreciate any prayers and well wishes you may have for this. I appreciate all the support so much!!
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  3. Gastric Sleeve Surgery With Weight Loss Agents
  4. #77
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
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    Christie
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    11/03/2016
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    Dr. Wright
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    Default Re: Denied

    It seems like people keep falling into your path to help you along the way and give you good advice. I will keep praying for you hon. I know how bad you want and need this and hopefully the judge will see that too. Big virtual hugs.



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  6. #78
    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

    Phew. Glad that is over with. I think it went well.

    High points
    • Asked the doc in my most serious voice - as a T1 paraplegic do you think my arms are weight bearing joints and she said YES! FINALLY!
    • Called lawyer out on calling and he back peddled and said well, I'm not one to make medical decisions. Then why call? I let the judge know it was intimidating.
    • Lawyer did not want documents from NIH and CDC, etc. submitted as record and judge, but was OK with medical evidence. She put them in.
    • Lawyer was gone for a week so my evidence I submitted (on time) he didn't have a chance to look at.
    • Made the point that just because PT released me doesn't mean I am not in pain.
    • Let judge know this is a chronic issue with or without PT and going to ask for more Monday. They think it's acute and I'm magically cured when PT is done. Also, let judge know they ONLY want records from the last year. Heck, if we went back 5 years - it would show this is chronic.
    • Stated if I get that last appointment and get more PT I have met all the pre-qualifications and she said YES. Hopefully, the judge is understanding that I am ALMOST there and have gone through hoops to get there.
    • Let judge know that I have been trying to get a peer to peer review, but have been constantly denied. And Dr. Schulz is ready to talk to anyone - they just need to call his office.

    Low points
    • On my side - none that I can think of. I was honest and sincere and chocked up a little bit when I said they were considering bilateral amputation if we cannot get my feet healed.

    We closed the case and now waiting for the judge.

    The lawyer said if it doesn't go in my favor that I could start over and could expedite a new request. Basically have it all resubmitted with that 4th visit and notes from PT that my shoulders are chronic and not acute.
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  8. #79
    Gastric Sleeve Member Ann2's Avatar
    I have had a gastric sleeve.
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    Ann2
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    08/18/2014
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    n.a.
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    Default Re: Denied

    Kristi, I hadn't been following your thread until recently and have now caught up a bit.

    I think you're one of the best advocates for yourself I've EVER seen on this board. And your report above of the latest hearing is just AWESOME.

    You keep advocating for yourself and keep taking on The Man! You will succeed!

    P.S. And a pox on that stupid lawyer for trying to intimidate you. I know lawyers. He will be lucky if the judge doesn't cite him for that. Not cool.



    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

    Second Surgiversary post

    Third Surgiversary post

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  10. #80
    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
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    Sioux Falls
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    Default Re: Denied

    I hope he gets cited or works in my favor. When I told my dad he said that he has never lost a case and my dad said, well you've never lost an ADA case - one of you is going to have your first loss. I was caught off guard and not thinking on my feet when he called.

    My primary doc's nurse emailed me today and guess who called about a peer to peer!? They only called because I called them out on it in the hearing. I've been asking since March and quite convenient you call after the hearing. Doc said there was nothing he could add and they told them it would not change their mind. I tried.
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  12. Gastric Sleeve Surgery With Weight Loss Agents
  13. #81
    Gastric Sleeve Member
    I have not had a gastric sleeve.
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    Dr. Felix
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    Default Re: Denied

    Have you heard anything else since your last update?

    You are such an incredibly strong woman. It takes so much strength to fight battles like that head on and with such determination. I am so in awe. You are a woman who gets shit done and it's awesome!

    I'm hoping all these people coming into your life are just stepping Stones on the way to where you want and need to be.


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  15. #82
    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

    No update yet. My primary doc was eager too. The minute I know something I’ll post here. I’ll call next week if I font hear anything this week.

    Annie, how long does a judge usually take?
    HW: 245.4 SW: 243 CW: 160 GW: 135


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  17. #83
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
    Name
    Christie
    Surgery date
    11/03/2016
    Surgeon
    Dr. Wright
    Join Date
    Nov 2016
    Last Activity
    09-12-2019 04:13 PM
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    Default Re: Denied

    I was coming to see if any updates but see Donna already asked. Thinking of you Kristi!



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  19. #84
    Gastric Sleeve Member Ann2's Avatar
    I have had a gastric sleeve.
    Name
    Ann2
    Surgery date
    08/18/2014
    Surgeon
    n.a.
    Join Date
    Oct 2013
    Location
    Missouri
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    Default Re: Denied

    Checking in here, too, Kristi.



    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

    Second Surgiversary post

    Third Surgiversary post

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  21. #85
    Gastric Sleeve Member VSGtheNP's Avatar
    I have not had a gastric sleeve.
    Surgery date
    07/12/2018
    Surgeon
    Dr. Chandra Hassan
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    Oct 2017
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    11-04-2018 09:53 PM
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    Illinois
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    Default Re: Denied

    I'm anxiously awaiting too. Wishing you the best.

    "Again, I tell you truly that if two of you on the earth agree about anything you ask for,
    it will be done for you by My Father in heaven." - Matthew 18:19 KJV -



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  23. #86
    Gastric Sleeve Member
    I have not had a gastric sleeve.
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    Dr. Felix
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    Apr 2018
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    06-20-2023 02:04 PM
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    Default Re: Denied

    I hope good things are in the air this week.


  24. #87
    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
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    Was Thanked 134 Times in 78 Posts
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    Default Re: Denied

    Started the week off with antibiotic sickies - insurance finally approved the drug my doc prescribed 3 weeks ago. Its called Zyvox and mixed Flagyl I feel like poo! On the plus side I'm so nauseous that I'm not eating much. Down four pounds - haven't had the scale move in months! I put in a request for nausea meds this afternoon. Sipping on Sprite Zero. I hope these drugs help!

    Haven't heard anything. I have the office to myself for a week and a half. Will have plenty of time to make phone calls. I'm hoping no news is good news!
    HW: 245.4 SW: 243 CW: 160 GW: 135


  25. #88
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
    Name
    Christie
    Surgery date
    11/03/2016
    Surgeon
    Dr. Wright
    Join Date
    Nov 2016
    Last Activity
    09-12-2019 04:13 PM
    Posts
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    Said "Thanks" 978 Times
    Was Thanked 2,940 Times in 2,192 Posts
    Said "Welcome to Gastric Sleeve" 1,465 Times
    Blog Entries
    97

    Default Re: Denied

    I do think when it is a denial they seem to come quicker so hopefully that is good news.



  26. #89
    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
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    59
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    Default Re: Denied

    I'll cross all my crossables for you. And I hope you feel better soon!
    Peppermint tea helps me when my stomach is feeling yucky, usually. If you are a mint fan, it might be worth a shot.


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  28. #90
    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 sucked on mints and cinnamon candy today. It helped. I'm not much a tea drinker, but good to know for after surgery since soda is a no no and candy will be 99% of the time. I think my boss has some peppermint tea at work I can try. If not I'll get some.
    HW: 245.4 SW: 243 CW: 160 GW: 135


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