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Old 10-17-2013, 06:49 AM   #91
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Originally Posted by chewiegand View Post
I went to a local job fair today. I think it took me longer to put my makeup on than I was at the job fair. It was a waste of time. I did stop at a consignment store up that way and found 3 beautiful jackets. I rarely go there and it was just pure luck plus she had 30% off the fall and winter stuff. One jacket is the softest leather jacket ever---and it's red. The second is a wool Pendleton blazer--black and white check, very cute with pants but I'll never wear the pants. I'll wear black slacks or skirt. The last is just a plain black blazer. With the additional discount I got all 3 for $68!!!!!!!!!!!! That's not even the price of one brand new! Woohoo.
THAT stinks. But score on the clothes. I new to me clothes. I've been hitting the thrift stores for sweaters. I sold/donated most of mine from last season over the summer so now it's time to restock! Even though I'm in a small I like to buy my sweaters bigger - sometimes a large - so they are fluffy and I can snuggle down in them. Comfy!
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Old 10-17-2013, 06:54 AM   #92
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I'm cold and all my sweaters are too big, so I had to go shopping darn it! I didn't really find any sweaters I wanted at Penny's but they had a bunch of nice v-neck t-shirts marked down to $2.97 and I can always use those, so I restocked on t-shirts that actually fit me. I got 6 t shirts and a cardigan that was also on clearance and after using a coupon and rewards bucks I paid .... $5.39. Not too bad. I also went to Dress Barn and bought some work pants. I remember last fall around this time I was so so so happy when I went shopping and discovered I had shrunk from a 22/24W pants to 16W pants and from a 3X to an XL shirt. It still lives in my memory as one of the best days ever, and will remain so. Today was pretty good though too, I bought size 8 pants and size M shirts ~ I love my sleeve
I had a little voice in the back of my head about a month ago telling me to go to Penneys one day after work and I hit the motherload. I probably picked up about 15 shirts, a super cute printed pencil skirt, a few pairs of casual shorts, two pairs of printed skinny jeans, 2 pairs of running shorts, a pair of yoga pants and the 6-pack of black socks that ironically happened to be the ONLY thing I went in there for. Everything but the workout gear and socks were marked down to $2.97 and $1.97.
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Old 10-17-2013, 07:08 AM   #93
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Y'all are crazy lol. What kind of women are you?

We must shop at the same place for bras. I spent almost $300 on 4 of them not too long ago. Actually, it might have been almost a year ago... time for more?

I've been in the same size clothes for a while now and I STILL replace my wardrobe as often as possible. We all know my "problem" with shopping and buying new things. I just spent $80 on two pairs of running capris just because. One was $50, the other was $30. Um, and I bought a new Coach swingpack and wallet yesterday because I was in an all day meeting, was bored and it was super cute.
I buy my bras at Victoria's Secret. I LOVE the body by Victoria bras. My workout bras come from dick's Sporting Goods. I buy the Under Armour bras. I have big girls and need decent workout bras.

I am currently obsessed with workout clothes. I can't pass them up

I got up this morning and did a 5:30 kickboxing class. It kicked my butt.
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Old 10-17-2013, 07:27 AM   #94
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Ok--can we talk bras? I need new bras. Right now I'm wearing some cheapo stretchy type bra that was $10 at wally world. It is super comfortable but doesn't lift real well, just kind of holds them in place. I am 198 and have no clue what size. In tops, I'm an XL, in blazers I'm in a size 16. Would Victoria bras fit me? Do they go big enough????
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Old 10-17-2013, 07:28 AM   #95
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I had a little voice in the back of my head about a month ago telling me to go to Penneys one day after work and I hit the motherload. I probably picked up about 15 shirts, a super cute printed pencil skirt, a few pairs of casual shorts, two pairs of printed skinny jeans, 2 pairs of running shorts, a pair of yoga pants and the 6-pack of black socks that ironically happened to be the ONLY thing I went in there for. Everything but the workout gear and socks were marked down to $2.97 and $1.97.
Wow, great little voice you have there. LOL
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Old 10-17-2013, 08:02 AM   #96
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Ok--can we talk bras? I need new bras. Right now I'm wearing some cheapo stretchy type bra that was $10 at wally world. It is super comfortable but doesn't lift real well, just kind of holds them in place. I am 198 and have no clue what size. In tops, I'm an XL, in blazers I'm in a size 16. Would Victoria bras fit me? Do they go big enough????
Probably. I'd be willing to bet you're wearing the wrong size, but what size are you in bras?

Measure around your bra line. Then measure around your boobs. what are your numbers?
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Old 10-17-2013, 01:45 PM   #97
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Ugh. Bras. I hate them right now. I am too heavy to wear anything truly cute! Watch out lingerie stores, by next summer!

HT... definitely thinking of you and hope you are feeling better and on the mend <3

Guess what!? I GOT MY SURGERY DATE TODAY! WOOT!!! It's November 29th.

Mair, did you get your date? Either way, I'll feel so much better knowing someone going through WLS around the same time as me! I forgot to mention that last time!

One eyebrow-raiser... my surgeon does not prescribe actigall. The dietician said there's a very, very small chance of that anyway. Hmmmm.... so questions for you guys: 1) did you all take actigall? 2) Did you not take actigall and still have a gallbladder? He does prescribe the anti-ulcer meds.

I have been low-carbing my patootie off since my last dietician visit, eating very slowly, eating less I think, more active than I've been, taking all of my vitamins religiously so my levels are great for the PCP visit/surgery clearance.... same exact freaking weight. Sigh. The dietician said it doesn't matter, insurance/surgery-wise if I lose some weight, so I've been still fighting the good fight. But it won't budge! I know I'm sort of a "light weight" as far as getting WLS goes, they even commented on that at the support group, which did not feel so supportive really, but the fact my weight still won't budge, even on mostly meat and eggs, makes me even more certain I am doing the right thing! I'm going to add back in some veggies so I am not deficient in anything before my surgery starting now. *grumble*

The new avi is a bit old, by the way, but I hated looking at my progress pic that is no longer my progress! I am not stepping anywhere near a camera until the day of surgery! No way! LOL
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Old 10-17-2013, 02:11 PM   #98
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Ugh. Bras. I hate them right now. I am too heavy to wear anything truly cute! Watch out lingerie stores, by next summer!

HT... definitely thinking of you and hope you are feeling better and on the mend <3

Guess what!? I GOT MY SURGERY DATE TODAY! WOOT!!! It's November 29th.

Mair, did you get your date? Either way, I'll feel so much better knowing someone going through WLS around the same time as me! I forgot to mention that last time!

One eyebrow-raiser... my surgeon does not prescribe actigall. The dietician said there's a very, very small chance of that anyway. Hmmmm.... so questions for you guys: 1) did you all take actigall? 2) Did you not take actigall and still have a gallbladder? He does prescribe the anti-ulcer meds.

I have been low-carbing my patootie off since my last dietician visit, eating very slowly, eating less I think, more active than I've been, taking all of my vitamins religiously so my levels are great for the PCP visit/surgery clearance.... same exact freaking weight. Sigh. The dietician said it doesn't matter, insurance/surgery-wise if I lose some weight, so I've been still fighting the good fight. But it won't budge! I know I'm sort of a "light weight" as far as getting WLS goes, they even commented on that at the support group, which did not feel so supportive really, but the fact my weight still won't budge, even on mostly meat and eggs, makes me even more certain I am doing the right thing! I'm going to add back in some veggies so I am not deficient in anything before my surgery starting now. *grumble*

The new avi is a bit old, by the way, but I hated looking at my progress pic that is no longer my progress! I am not stepping anywhere near a camera until the day of surgery! No way! LOL
My gallbladder was already gone so it was a non issue - however rapid weight loss will almost always cause gallbladder issues in my experience with others I know that have had WLS>
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Old 10-17-2013, 05:33 PM   #99
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I was not given meds for the gallbladder and I have not had an issue and I'm 10 months out, with a sleeve. Maybe it depends on the type of surgery??? I don't know.
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Old 10-17-2013, 05:33 PM   #100
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Heather, I have to find a tape measure and then I'll post my measurements.
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Old 10-17-2013, 06:57 PM   #101
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I was not given meds for the gallbladder and I have not had an issue and I'm 10 months out, with a sleeve. Maybe it depends on the type of surgery??? I don't know.
Ditto, but I am three and a half years + out
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Old 10-17-2013, 07:39 PM   #102
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Heather, I have to find a tape measure and then I'll post my measurements.
I went to Macy's and got fitted by a great gal. She pulled,and adjusted until she was satisfied. We tried on six or eight different bras before she declared me properly fitted.
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Old 10-17-2013, 07:47 PM   #103
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I had to kill an hour so I went to Target. I bought some cold weather compression pants ($28), a new dry max running shirt and a pair of running shorts on clearance for$4. Deal.

I have a ton of runs coming up.

Sat 5k
next sat 5k, sun 10k
Susan g Komen 3 Day
following sat a 5k mud/obstacle run
next sat a 5k run
then a 2-3 week break and another 5k

I'll probably find a few more between now and then.
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Old 10-17-2013, 11:05 PM   #104
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Hi everyone...have not been on in a few weeks. So my goal is to have my approval letter back that says I get to start the WLS process. My insurance lady at my doctors office sent my paperwork in to the insurance company today!!! I am so excited.
My denial letter came in the mail. So now what? I have 90days to appeal this. I think I will be writing a letter and sending pictures in with my next packet asking for approval. I need to talk with my doctor and see what she has to say. Do any of you have some advice?
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Old 10-18-2013, 07:28 AM   #105
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My denial letter came in the mail. So now what? I have 90days to appeal this. I think I will be writing a letter and sending pictures in with my next packet asking for approval. I need to talk with my doctor and see what she has to say. Do any of you have some advice?
Hugs. I'm sorry. I was not denied but it took 6 months to get approval because I was the clinic's first sleeve with my insurance. I would research other's appeals on Obesity help or other wls websites--they can probably give you some good advice. It is so worth it though.
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Old 10-18-2013, 09:11 AM   #106
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Did you get letters from your PCP and any other doctors that have treated you? Appeal as many times as you can.

My husband didn't get anything for his gallbladder and the doc hasn't mentioned it to me yet.
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Old 10-18-2013, 09:24 AM   #107
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My denial letter came in the mail. So now what? I have 90days to appeal this. I think I will be writing a letter and sending pictures in with my next packet asking for approval. I need to talk with my doctor and see what she has to say. Do any of you have some advice?
What was their reason?
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Old 10-18-2013, 09:38 AM   #108
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Don't be too discouraged.... I went to Mexico for my sleeve, but for my excess skin I had to appeal and then was approved.

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My denial letter came in the mail. So now what? I have 90days to appeal this. I think I will be writing a letter and sending pictures in with my next packet asking for approval. I need to talk with my doctor and see what she has to say. Do any of you have some advice?
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Old 10-19-2013, 02:47 PM   #109
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Hi Everyone! Lemme try to catch up here!

First, thanks again for thinking of me. I am doing quite a bit better. I did lose the temporary crown off my back molar today though! When does this all end for me!!! lol

I took donuts to the ICU nurses at the hospital to say thanks. They had to do absolutely EVERYTHING for me for a few days there, and a dozen donuts doesn't even begin to say thanks enough, but they seemed happy to see me and get the treat, too.

Let's see. Bras - Hate them, but love them. I absolutely NEED them, because without some padding I'm a bit flat. Side fat has me upset, though, and Vic's Secret bras just don't cover that part well. I'm going to have to look into maybe a plus-sized one with high sides - I'm not sure on that right now.

Hey 1Life - I'm really sorry about the denial letter. Fight that tooth and nail!!!

I never took meds for my gallbladder and I am just days from being 3 years out. However, I had a rushed gallbladder removal in July. That said, now I wonder if it wasn't really this ulcer they just found. I don't know, honestly.

Alisa - Congrats on the 11/29 date. You're on your way to fabulousness - although, by your pic, you're already there!

I'm sorry if I missed anyone. You guys move fast! It is very nice to be here, though!
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Old 10-20-2013, 01:15 PM   #110
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hey hey hey

Only been gone for like fifty five months

so sorry

hope I didn't leave things hanging....except my skin and boobs.

hahahaha so funny

I will try and read and catch up but it will be slow going

I hope everyone is okay

I got a job! YAY!!

I can now fit into 16 jeans...Eddie Bauer low waist that I saved from three years ago woot!

Today is a good hair day. So I put on makeup. Down a few pounds.

Have a great rest of the weekend.

Beautiful fall day here on the East side of the country!

Adios!
les
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Old 10-21-2013, 06:29 AM   #111
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Good morning, everyone.

1Life2Live, I'm sorry about the insurance denial. That's one of my big fears, now that I have my date. I hope your approval goes very smoothly on your resubmit!

HT, thanks, and I'm so glad you're feeling better! My Lane Bryant Caicique (sp?) bra has the high sides you speak of.

Leslie-- Congrats on the new job and new, smaller size!

As for me, I'm feeling very impatient. I've read every single book my surgeon's practice recommends and feel like I've reached the end of the Internet researching the surgery. Now there's nothing to do but wait...

I'm trying a local support group tonight since my surgeon's (been to that one once, so far) is so far away; it's five minutes from my house, literally. I have one other group to try, if that one doesn't feel right.

And I have to schedule my PCP appointment for medical clearance and get that EKG and CBC diff, yet.

One more dietician appointment in nearly three weeks and they can submit to insurance. Did I mention I'm feeling very impatient? I'm trying hard to keep myself busy!

Last edited by Matrigna; 10-21-2013 at 06:38 AM..
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Old 10-21-2013, 03:30 PM   #112
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Good morning, everyone.

1Life2Live, I'm sorry about the insurance denial. That's one of my big fears, now that I have my date. I hope your approval goes very smoothly on your resubmit!

HT, thanks, and I'm so glad you're feeling better! My Lane Bryant Caicique (sp?) bra has the high sides you speak of.

Leslie-- Congrats on the new job and new, smaller size!

As for me, I'm feeling very impatient. I've read every single book my surgeon's practice recommends and feel like I've reached the end of the Internet researching the surgery. Now there's nothing to do but wait...

I'm trying a local support group tonight since my surgeon's (been to that one once, so far) is so far away; it's five minutes from my house, literally. I have one other group to try, if that one doesn't feel right.

And I have to schedule my PCP appointment for medical clearance and get that EKG and CBC diff, yet.

One more dietician appointment in nearly three weeks and they can submit to insurance. Did I mention I'm feeling very impatient? I'm trying hard to keep myself busy!
I remember that feeling ~ I'm ready, let's get this done. Good for you for doing your due diligence. If you've researched a lot, then you will be ready to roll with whatever comes. For example, I was not one of those people who was out walking a mile 5 days after surgery, not even close I was one of those people getting IV fluids for severe dehydration instead. But because I had researched, I knew this was just a bump in the road, I didn't panic, I didn't regret, I didn't get depressed, I knew it would get better and it did. You'll do great!!! Hopefully you get your date soon.
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Old 10-22-2013, 02:06 AM   #113
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Hi everyone,
Thank you for the wonderful words of encouragement. I have been MIA for a few days only because I needed to regroup my head and thoughts. So my denial letter states "The information your doctor provided indicates that you need the surgery to treat obesity and low back and knee pain. These medical conditions do not qualify for the Health Care Authority reimbursement of bariatric surgery. This denial is based on WAC 182-531-1600(6)(d), which states that in order be eligible for the bariatric surgery program the client must be diagnosed with diabetes mellitus, degenerative join disease of a major weight bearing joint(s) (the client must be a candidate for joint replacement surgery if weight loss is achieved); or other rare comorbid conditions in which there is medical evidence that bariatric surgery is medically necessary and that the benefits of bariatric surgery outweigh the risk of surgical mortality."

I received my letter from my PCP and she states "Ms. *** doesn't meet DSHS criteria for bariatric surgery. They have stricter criteria for surgery than some other types of insurance. We don't have any other or new information to present that will help to appeal this. My suggestion at this point is for her to contact DSHS, the number on her card, and ask if they have any non-surgical weight management programs that she may join." So now what? The last three times I had my fasting glucose checked I was 117, 109 and 108. These where all taken a month apart. I have edema so bad that if I am not on my medication my legs ache. I can feel the swelling all the way into my stomach.

I am thinking of writing a letter to DSHS (state insurance). I think they need to know who I am. I think they need to know about me and my history other than what my doctor has laid out. Maybe even send some pictures of myself in with my letter. Not sure, just brain storming. I have 90days to appeal.

So how many of you have dealt with the denial process and what did you do? Thank you all so much for your wonderful support. I see how each of you are doing and I am so excited for you all. You each look wonderful and are doing such wonderful things with your lives. I want that chance. I want to be a participant not a bystander in my life. I just hope I get the chance. (Oh and I have already started working on taking better care of myself and eating healthier. I know I will have to prove to them I can drop some weight so figured why not start now!)

Thanks again everyone!!!
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Old 10-22-2013, 06:47 AM   #114
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"The information your doctor provided indicates that you need the surgery to treat obesity and low back and knee pain. These medical conditions do not qualify for the Health Care Authority reimbursement of bariatric surgery. This denial is based on WAC 182-531-1600(6)(d), which states that in order be eligible for the bariatric surgery program the client must be diagnosed with diabetes mellitus, degenerative join disease of a major weight bearing joint(s) (the client must be a candidate for joint replacement surgery if weight loss is achieved); or other rare comorbid conditions in which there is medical evidence that bariatric surgery is medically necessary and that the benefits of bariatric surgery outweigh the risk of surgical mortality."
So it seems your insurance doesn't have an automatic BMI over 40 qualification. You must have a BMI over 35 (which you do) and a serious comorbidity. How bad is your knee pain? Why didn't your surgeon call it degenerative joint disease? I'm sure that by this time, after having been MO for so long you've destroyed the cartilage in your knees beyond reason. If this is the case, perhaps an orthopedic consult could be included in your appeal.

I didn't have to appeal, mine was approved right off, but it couldn't hurt your cause to contact the insurance company. I know that some people have had good results this way. Send them pictures of their skin breakdown, send them pictures of their cellulitis, rashes, wounds. Talk about their inability to live a real life. Insurance companies have a strict guideline for approval for everything that you must meet, but if you can prove your case you might be able to fall into the "other rare comorbid" conditions.

Have you been tested for sleep apnea? That's one of the big three comorbidities.

ETA - Oh, and continue to visit your surgeon or PCP to follow a medically supervised diet in which you *cannot* lose weight so that can add fuel to your appeal.

Last edited by myyellowstang; 10-22-2013 at 06:49 AM..
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Old 10-22-2013, 06:55 AM   #115
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1Life, sorry I don't have any appeal experience. Just sending hugs and prayers and to say Keep up the fight. I think I suggested going to the obesity help forums and asking there.
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Old 10-22-2013, 09:20 AM   #116
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Thank you Heather and Chewie.
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Old 10-22-2013, 10:24 AM   #117
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1Life get to an orthropedic Dr so he can diagnose you with degereative joints disease or something. Being that heavy has to damage your joints. I know my joints are shot and although I have never been diagnosed with anything my Dr did mention arthritis in her report.
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Old 10-22-2013, 10:28 AM   #118
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Have them state that you are a candidate for a knee replacement.
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Old 10-22-2013, 12:50 PM   #119
Way too much time on my hands!
 
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Job hunting stinks. I applied for a temp position in our local university and took a few tests on Thursday, typing, Excel and word. Got a call today for a temp job but it's full time and goes through mid-December and only $10 an hour. They would like me to start tomorrow. The weird thing is I already applied for this exact job on their website about 2 weeks ago. I've been told that this temp thing often leads to an offer for a permanent job. I don't know what to do. GRRRRR I told the lady I'd call her back in a little while. What to do???????
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Old 10-22-2013, 01:39 PM   #120
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I am thinking of writing a letter to DSHS (state insurance). I think they need to know who I am. I think they need to know about me and my history other than what my doctor has laid out. Maybe even send some pictures of myself in with my letter. Not sure, just brain storming. I have 90days to appeal.
The advice on obesity help is pretty much exactly this. A key phrase I was taught is "affects activities of daily living".

I had to appeal for my excess skin removal surgery. I included copies of prescriptions, photos of "ulceration" of the skin, and a letter about how the excess skin affects my ability to do certain things, using the above-mentioned "key phrase".
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