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1 hr till VGS surgery, How could this happen last minute!


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#1 determination

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Posted 19 January 2010 - 03:05 PM

I dont know if you know my history, but I was sched for RNY surgery last week. I decided I wanted to change to the sleeve. There was an opening today 1/19. They got a pre-approval for the surgery.

I showed up today, got my IV. 1 hr before surgery and we were told that the surgery was denied. The CPU was for "Laproscopic WL Sugery" Not Laproscopic Vertical Sleeve WL Surgery"

SO. I was denied. The surgeon, 2 coordinators and I were on the phone in the pre-op room trying to get the actually person on the phone that denied it. She was NO where to be found.

Im depressed. REALLY depressed. I dont know where to go from here. Ive never even thought I would have to consider the apeal process because I thought i was APPROVED.

Im SO mad right now. My husbands off for a week. NOW what do we do... :(

I feel like Ive done everything right, Ive done 1 month of a Milk Diet, and lost lost 25lbs Ive waited 2 years. Now.. i feel lost. Im so mad right now... I believe everything happens for a reason.. but right now I want to know the reason!!

Im sorry to vent.. Im at a loss and really depressed.. Im supposed to be on the losers bench with youtoday as of 2pm.
__________________________
RNY - 6/1/10

WT: 279/ 254/ 189 / 175
Highest/surgery/current/goal
Updated 6/12/10

"Dance like no one is watching"

#2 thinn2010

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Posted 19 January 2010 - 04:05 PM

Hang in there and keep trying to contact them. Would you consider doing the RNY if you are only able to get approval on that? I will keep you in my prayers because I know how you feel. I got a week away and had to cancel and it just doesn't sit well.....

#3 soon2bthin

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Posted 19 January 2010 - 04:11 PM

Good luck I hope you get everything worked out.

#4 hollycerniglia

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Posted 19 January 2010 - 04:11 PM

I am so sorry! I hope you get everything worked out and get to have surgery soon. Take care sweetie!
Holly


Onederland 3/29/10


Start/Current/Goal 273/ 195/ 150

#5 rsw

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Posted 19 January 2010 - 04:20 PM

How awful! You must be feeling pretty furious. I cannot believe what you've been through! It will eventually work out, but I know how hard it is to work out all the details, and how maddening to have to waste that. Good luck to you and keep us updated!
Roxy


Banded Feb 2004, Band revision Feb 2007, Revised to RNY May 2010


DOS/Current/Goal [updated 5/18/11]

200/160/130

#6 ardita

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Posted 19 January 2010 - 09:23 PM

How did it go today? Any luck getting it appealed? I am so sorry you got yanked out of the OR like that. You have the right to feel incredibly frustrated...

Inspiration from TT friends:

Alleusion: "YOUR best may not be MY best."

SweetP: "Be grateful for what you have; not ungrateful for what you don't have."

Kantonucci: "I refuse to dig my own grave with my knife and fork."

LisaM: "When I was sated emotionally, I was no longer starving physically.... Find out what you're really hungry for... It may not be food."

Cynthia:"There is never a mistake too big to change, never a misstep that cannot be corrected, and there is never a wrong time to start over."

(and someone had a great quote about not letting immediate gratification derail long term goals-but I cant remember who or exactly the wording. It was good, though...)


BMI=27.4. Just overweight. It's happening!


#7 joy1968

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Posted 19 January 2010 - 09:36 PM

I'm sorry you're going through this. Get up early tomorrow and start your appeal
Cheryl
No matter who you are, no matter what you do, you absolutely, positively do have the power to change. ~ Bill Phillips

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#8 rdollen

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Posted 19 January 2010 - 09:47 PM

Sorry to hear that. You must be steaming right now. It will all get worked out. What insurance do you have. I'll be sure to never pick them as part of our benefits package at work
7/28/09 Kaiser SSF orientation 392 lbs
2/4/10 Preop appt's 336
2/24/10 LAP RNY and hernia repair (5 1/2 hr surgery)
3/23/10 100 pounds lost (45 since surgery)
5/29/10 130 pounds gone (75 since surgery 2/24)
7/24/10 150 pounds gone (95 since surgery, 1-2 lbs per week comes off at this point. Wearing size 38 pants (was 52) and 1-2xlt shirts.
9/15/10 160 pounds gone

#9 Aviator

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Posted 19 January 2010 - 09:50 PM

So sorry to hear about this. Just know everyone here supports you. Please remember, this is not your fault. There is no need to be depressed. Use this to be "determined" to achieve your goals. Adversity makes victory sweeter in the end. Hugs!

Hang in there baby. You're gonna be fine.

Aviator aka AeroBear - To learn about my WLS journey and what YOU can expect check out Aviator's Log Book

Procedure--- Date--------- Initial weight--- Lowest weight

SLEEVE----- 12.31.2008-- 310------------  225

REVISION--- 7.25.2013--- 258-------------195... at GOAL!  20 lbs. below surgeon's goal weight for me.

Total lost to date: 115 lb.


#10 Diann

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Posted 19 January 2010 - 10:01 PM

What an incredible roller coaster you are going through, I am thinking about you and hoping this will somehow work out for you. Diann
Saw Surgeon 7/21/09
Saw Psychologist and Nutritionist 9/4/09
Applied for Insurance Approval to BCBS FEP 9/18/09
BC/BS FEP Approved my surgery ! 10/1/09 :)
Endoscopy 10/12/09
SURGERY DATE 11/2/09 ;)

#11 determination

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Posted 19 January 2010 - 11:08 PM

Thinn2010 - No, as much as I feel RNY is fantastic for certain patients, I feel that the Sleeve would be the best surgery for my specific situation. Im giving it my all.

Thank you for your support.

My surgeon called me tonight (8pm) this was quite a "unique" situation and they have had meetings about it.

I was told that she is fighting first thing in the morning for a Peer-to-Peer review of the case with BCBS. She is confident that there was a mistake. A RN reviewed the case on Friday and denied it. She is thinking that she didnt look into the new codes and didnt realize that it is now approved as of 1/1/10. All I can do is pray. Ive got a great team on my side.
fingers and toes are crossed! Ill update you as soon as I know! Thanks again.
__________________________
RNY - 6/1/10

WT: 279/ 254/ 189 / 175
Highest/surgery/current/goal
Updated 6/12/10

"Dance like no one is watching"

#12 everleigh

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Posted 20 January 2010 - 01:00 PM

I'm SO sorry to hear of these turn of events! Please keep us posted on what happens. I'm crossing my fingers for you that they realize their mistake soon! ((HUGS!))
everleigh "I'm not there yet, but I'm closer than I was yesterday."
highest/surgery day/lowest/current/goal
280/272/179/212/140
The Glorious first 9mos post op VSG in 2010:
MONTH 1: -26lbs APRIL* MONTH 2: -17 lbs (-43 lbs) MAY* MONTH 3: -12 lbs (-55 lbs) JUNE* MONTH 4: -13 lbs (-68 lbs) JULY* MONTH 5: -11 lbs (-77 lbs) AUG* MONTH 6: -3 lbs (-80 lbs) SEPT.*
MONTH 7: -3 lbs (-83 lbs) OCT.* MONTH 8: -7 lbs (-90 lbs) NOV.* MONTH 9: -3 lbs (-93 lbs) DEC.

ONEDERLAND: 8.23.2010-5.11.2011 :(Recovering from major depression from infertility that was discovered a year post wls.
Still trying to tap into my wls tool and get my life back.

#13 sassy37

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Posted 20 January 2010 - 01:05 PM

My goodness carnt imagine how gutted u must feel !
still I believe 'THINGS' happen for a reason ...
It will get sorted and u will be on that losers bench in no time hun .
hang in there and dont stress xxx
Best Regards

Sas xx


Surgery date :Friday 26th Sept 2008

first fill 24.11.08 =6.5cc

Second fill 29.01.09=1 ml

Third fill = 1ml

Forth fill = 1/4 ml

10ml band filled to 8.45ml


Ive lost 133 pounds with THE BAND ! Im at Goal at last !

#14 HRT

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Posted 20 January 2010 - 03:05 PM

i'm praying that they get it straight for you. Sounds like you have a great team!
Looking forward every day to a new tomorrow!!:D

Starting weight: 332
Surgery weight: 275
Current weight: 173

LOOK :) that's 159 lbs down!! SO excited!
I'm in ONEDERLAND!!

#15 mburgs

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Posted 20 January 2010 - 04:16 PM

How absolutely frustrating! Hopefully they can get it settled tomorrow and get you in surgery in the next week!

#16 Thinb450

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Posted 20 January 2010 - 08:06 PM

I'm so sorry this is happening to you. My surgery got cancelled the night before and I was absolutely devistated. I can just imagine how you must feel. I hope that they find a mistake was made and you get the surgery you want. Hang in there!!
Dalene


ONEderland!!!! 4/9/10
Century Club 12/2010

Lap RNY 1/25/2010
Pre-op/Current/Goal
254/150/140

#17 Pmil

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Posted 21 January 2010 - 06:51 PM

It has become a roller-coaster for you...I hope things are sorted out soon and your surgery is scheduled soon. All of us here are praying for you. Do keep us posted.
Gastric Sleeve Surgery, Mexico

#18 shiver

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Posted 28 January 2010 - 10:28 AM

I'm sorry I missed all this. But haven't heard from you in a while. What is going on? Hugs
Height: 5' 1/2"
Start weight: 229
Day of surgery: 214
Current weight: 127.8
My Goal: 135 made on 2/8/11
On to: Dr. Goal: 120
Normal BMI 4/19/11

#19 determination

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Posted 01 February 2010 - 12:37 PM

Well, long story short,

I may have cancer.

Colon cancer. So I have my "reason" why my surgery was cancled 1 hour before surgery.

I have been low on potassium, I had a colonoscopy and they found a polyp. it was 3cm. I have high grade dysplasia. The gastronologist wants me to get a portion of my colon removed.

Im scared. And mad. Im praying that this wont stop my WLsurgery process.

Appointment is at 3 to find out what is really going on with me.

I STILL havent had good results from Anthem Blue Cross Blue Shield of Califonia. My Dr. did a peer to peer review, Im now in the appeal process. I wish there was MORE I could do.. What can I do>???

SO frustrating..

I just wanted to update everyone on my situation. Thanks for your thoughts and prayers..
__________________________
RNY - 6/1/10

WT: 279/ 254/ 189 / 175
Highest/surgery/current/goal
Updated 6/12/10

"Dance like no one is watching"

#20 cinwa

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Posted 01 February 2010 - 12:51 PM

Well, long story short,

I may have cancer.

Colon cancer. So I have my "reason" why my surgery was cancled 1 hour before surgery.

I have been low on potassium, I had a colonoscopy and they found a polyp. it was 3cm. I have high grade dysplasia. The gastronologist wants me to get a portion of my colon removed.

Im scared. And mad. Im praying that this wont stop my WLsurgery process.

Appointment is at 3 to find out what is really going on with me.

I STILL havent had good results from Anthem Blue Cross Blue Shield of Califonia. My Dr. did a peer to peer review, Im now in the appeal process. I wish there was MORE I could do.. What can I do>???

SO frustrating..

I just wanted to update everyone on my situation. Thanks for your thoughts and prayers..


I'm so sorry to hear your news. But to be positive, colon cancer has a high cure rate when caught early.

My DH was diagnosed with that just as part of a routine physical (included colonoscopy).

He had 5 polyps - 3 pre-cancerous and 2 cancer. Thankfully, none had invaded the colon wall so he ended up having 11" of his sigmoid colon removed with no further treatment.

Stay positive sweetheart. I know it's a worrying time.

I'll he holding you in my thoughts and prayers.

9/24/07 - Lap. - RNY with umbilical hernia repair

10/27/08 - Open - removal of omental mass, gallbladder, appendix, adhesions

11/12/10 - Open - bilateral femoral hernia repair


"Many of life's failures are people who did not realize

how close they were to success when they gave up".

 

~*♥*~ Thomas Edison ~*♥*~