Sunday, July 6, 2014

Revision Update...another month gone

Let me just get this out of the way-- I'm having a HATE/HATE relationship with my band right now.  It just cannot decide what it wants to do!  I've had ZERO restriction for 9 months and suddenly now, what, I can't even drink a glass of water without a PB episode?

It's hormonal.  I was driving to my parents a few nights ago and felt so so crampy, and by the time I got there there was a tinge of blood (sorry, TMI).  And that's when this trouble with my band started.  Although the blood stopped, I guess the hormones are still there.  I haven't eaten solid food in 5 days now.

All I want is my revision!

And much to my dismay, the nurse at my doctor's office FORGOT to submit my appeal to my insurance company.  She FORGOT?!!!!
IT JUST SLIPPED HER FREAKING MIND...

I should mention that this woman is a fellow WLS patient and has been promising things she can't deliver for a couple of months.  Promising me that she's not going to let me get denied, and then denial came.  Then promising she was going to make sure they fought it with everything they had.  Well, I'd say my doctors have done everything they can, but when the administrator forgets to submit, that's a HUGE FREAKING PROBLEM.

So what now?!  I've wasted a month for NOTHING.  If you all have forgotten, I have until the end of 2014 to resolve this because I can't afford to continue paying $334/month for insurance to have "better" bariatric coverage.

So we're going straight to a Peer to Peer review between my doctor and the insurance.  Fingers crossed.  Tomorrow I'm going to go in for an "emergency unfill" because my  band is tight and it will be a stressful week at work.  My study is locking and I can't physically afford to continue depriving myself of healthy nutrition.  While I'm there, I intend to tell my doctor/PA that if RNY is my best chance of getting approval for revision due to the moderate reflux they saw on my last EGD, I will take it.  I will do whatever it takes at this point.  I need to do something.  I hate this band today.  I'm thankful for all of our hard work together but it's becoming really troublesome for me.

3 comments:

  1. Hope you get approved! Crossing my fingers for you!

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  2. Hey Hollee! Tell me how you decided that sleeve was better than bypass for your revision. forgive me, I am sure u covered this, but I know I won't find the time to go back...just shoot me a few dates to go back to, if you want.

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    Replies
    1. Hi Tina! Honestly, I've always been a little afraid of RNY since I do research for my career. Before I take medicines or have surgeries, I tend to look at the Adverse Events associated with the procedure/medication to decide if they're 'worth it'. Also, the fact that the surgeries haven't been around 'that long' scares me... I'm hoping to live 50+ more years and RNY causes malnourishment due to bypassing the small intestines, so I feel like we don't fully KNOW what the effects of that can be. But at this point, I am willing to find out. The good news is Band to RNY revision is safer than Band to Sleeve due to the fact that with revision to Sleeve, they have to cut through and repair the area where the band was, which will have scar tissue. With RNY they can just eliminate that area altogether.

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