New 60+ Thread

SueFromMichigan · 06-26-2008, 08:27 AM

Quote:

Originally Posted by carol snead

i just had a birthday i am now 62 i cant believe i am this age i have been wanting wt loss surgery forever i still dont have it i went to a wt loss surgeon and had all the evaluations and that is as far as i have gotten the wt loss ssurgeons staff is and has been from the very beginning been giving me a hard time i have had to jump thru hoops and more hoops every week it is something else i even paid them my money i am really agravated with them i have even asked and received notes from my drs stating that i am a good candidate for the Lap Band but the surgeons doesnt think.i am i am fighting them as i like the surgeon but his staff well that is a different story they dont even know how to relate to people and i hate that for the drs sake anyway that is my story hope to hear from u all soon

Carol, you didn't say where you live, but I bet there are other facilities near you that you could investigate. I had to have a Center of Excellence, as I am on Medicare-like insurance - none of the local facilities had that designation. But I was able to find several COE within a couple hundred miles.
My primary care physician sent the referral letter - she knew I had been trying to lose weight and really needed to - and I got the evaluations locally. A $60 round trip train ride got me there and back and I was able to find a great follow up doctor and get my fills locally. I worked through one of the facilitators that advertises here. The whole process took just over a month.
Look around!

opus · 06-26-2008, 08:58 AM

I'm going on Medicare Aug. 1 and am wondering if the Dr. has to submit a pre authorization to get approved. My insurance now is stalling and will not commit. They said I meet all the qualifications but will not say if they will pay. I had to change Dr. and Hospital to go to one with the seal of excellence. All I have left to do is the surgeons visit, The new hospital took all my tests and information from old hospital so I don't have to go through that again. Any information on Medicare would be appreciated.

SueFromMichigan · 06-26-2008, 10:12 AM

Opus,
My insurance was Humana Medicare, so I don't know about "real" Medicare, but they did follow Medicare guidelines. That means surgery must be done at a Center of Excellence, must be inpatient, and must meet criteria of BMI of 40, or 35 with co-morbidities ea. hypertension, diabetes, arthritis. Then Humana had a Bariatrics Dept., which had to pre-authorize. This only took a couple of days in my case. I would guess that Medicare also must pre-authorize.

opus · 06-26-2008, 11:08 AM

Thanks Sue. I guess I'll probably get banded in September then. I started my journey Oct 6. Thats a long time to wait but I have learned Patience over the years.

phyllser · 06-26-2008, 01:05 PM

Quote:

Originally Posted by opus

I'm going on Medicare Aug. 1 and am wondering if the Dr. has to submit a pre authorization to get approved. My insurance now is stalling and will not commit. They said I meet all the qualifications but will not say if they will pay. I had to change Dr. and Hospital to go to one with the seal of excellence. All I have left to do is the surgeons visit, The new hospital took all my tests and information from old hospital so I don't have to go through that again. Any information on Medicare would be appreciated.

Had my surgery last summer on Medicare. Was a fairly simple process. Surgeon office did everything. I don't think pre-auth was required, but they would take care of that if so. Seal of Excellence is their big thing. I didn't stay overnight, but I've heard that is a Medicare requirement. My hospital bill ($17K) was denied and I got all upset over that, but when I dug in to it, Medicare told me that the hospital coded it to deny??!! They told me to have them resubmit it and they would pay. So I did that and the hospital told me not to worry about it because they'd already written it off and my balance was $0!?? Go figure!! I still haven't figured that one out! I was also told that I would have to pay for the nutrition consult. Never got billed for that either. It was paid! Only thing I got billed was $200 physician fee, which I think was my co-pay. Hope it all goes smoothly and quickly for you!

opus · 06-26-2008, 01:46 PM

Good for you Phyl!
I have to pay dietitian one price and see her every month after surgery for a while. The hospital I'm going to in hands on and check you for a long time after to make sure you are doing ok. With all my medical problems, it is a nice feeling that they would do that.
I'll let you kids know whats going on with my progress!

Doddie63 · 06-27-2008, 12:08 PM

Hi everyone. Just posting to say on June 5 has my port readjusted as it had flipped to its side making fills difficult. I am now experiencing a bit of irritation as I have some surgical thread sticking out. I tried to pull it out but it won't budge so will see my doctor today. I thought all surgical sutures inside are supposed to disolve. I really have no idea how my doctor is going to get it out but I sure don't want infection setting in.
Hope all is well with you all.

phyllser · 06-27-2008, 01:28 PM

Quote:

Originally Posted by Doddie63

Hi everyone. Just posting to say on June 5 has my port readjusted as it had flipped to its side making fills difficult. I am now experiencing a bit of irritation as I have some surgical thread sticking out. I tried to pull it out but it won't budge so will see my doctor today. I thought all surgical sutures inside are supposed to disolve. I really have no idea how my doctor is going to get it out but I sure don't want infection setting in.
Hope all is well with you all.

I had that happen after gall bladder surgery. I'm an RN, worked for health insurance at the time, so I showed it to our medical director and he told me to just snip it off at the skin and not worry about it. I did and had no further problems. It had been a little inflamed looking, but it cleared up.

Doddie63 · 06-27-2008, 02:48 PM

Thankyou, Thankyou. You have set my mind at ease. Wow! I love this website.

Doddie63 · 06-28-2008, 07:19 PM

You were deadon Phyllser. The doctor cut the stitch just below the skin, put on a antibiotic salve and told me to keep it clean to watch for infection. It feels a lot more comfortable now.

phyllser · 06-28-2008, 07:51 PM

Quote:

Originally Posted by Doddie63

You were deadon Phyllser. The doctor cut the stitch just below the skin, put on a antibiotic salve and told me to keep it clean to watch for infection. It feels a lot more comfortable now.

That's good! Yeah, I don't think it's too uncommon for one to work it's way out like that. But I freaked a little bit when I saw mine, too. Glad you got it taken care of.

phyllser · 07-07-2008, 07:46 PM

HEY??!!
Where is everyone???
No posts in over a week!!
Come out, COME OUT, wherever you are!!!

KarenIn · 07-07-2008, 08:42 PM

Hi Everyone I'm still here. Had a four day weekend for the holiday. What a pleasure!!! I worked around the house all day today, trying to get stuff done. I get my surgery date on Thursday, July 10th, so I thought I better get what I can done before surgery, so I can take it a bit easier after surgery. Hope everyone one had a good holiday. It sure got warm here in NW Indiana (about 87 today) and very dry.

SueFromMichigan · 07-08-2008, 07:54 AM

We're still here - just recovering from the long weekend.

We always have a long campout/family reunion over the 4th. All of my six children and 7 of 8 grandchildren were there, plus numerous siblings, nieces, nephews, and their families. This was my first real experience eating with others since my surgery. I didn't keep to my regular routine very well and the scale shows it.

Meals were irregular to say the least. I had real problems trying to eat six small meals a day like my doctor prefers, as everyone else wanted to eat only two or three. And I wanted to be able to eat a larger amount at those times, with them. Especially on the 5th, when we had our pig roast/carry-in. I was able to handle going out for breakfast, having bacon and eggs and 3/4 of a piece of toast on Sunday. But then, I don't feel restricted at all - I have only had one fill. And I still have never felt uncomfortable after eating anything.

So I'm kind of glad to be back home where I can watch, control, and record what I eat more easily.

sfeiner · 07-08-2008, 08:01 AM

I'm alive and well but so busy. I went from working 1 day a week to 2 days. Have physical therapy 2 times a week and spending a lot of time at the camp grounds. We now have a permanent site at our favorite campgrounds and have been doing some landscaping there.
One of my sons lost his home in the recent floods so have been helping them sort, throw out and wash up what they salvaged. It's so sad. Did any of you see the houses fall into the lake and wash into the river in Lake Deltan? That's about 4 miles from us. Still several roads in the area washed out. I got on a sugar frenzy and can't seeem o get off the carbs. I gained 2 pounds over the weekend. Blame it on s'mores! I just can't seem to get motivated again. I guess I need to come here more often! Hope you are all doing well and getting skinny!