Thursday, February 18, 2010

C25k - HUH?

I'm a bad Couch to 5K'er.  I haven't been in over a week and I'm pretty sure this means I'll be starting over.  Ugh.  Pinched a nerve in my neck last Friday and have been goofed up ever since.  Felt better by Sunday but just haven't been motivated to get my butt off the couch and MOVE.  And I've got to get on it.  I have my 3rd weigh in with Dr. Simpson next Thursday.  Not feeling very confident about that.  It's funny how everyone is told different things about their insurance.  My bariatric coordinator (fancy title for someone I only saw once and is apparently just compiling paperwork) has told me 2 or 3 times that the insurance looks at your starting weight but everyone else I hear from is being told not to let their BMI dip below 40 for fear of not being approved by insurance.  It makes me VERY nervous.  I realize that shouldn't be an excuse to not eat right or exercise but I can't get it out of my head.

In other news, I have an appointment this evening with the marketing guy for a local restaurant to talk to him about holding a fundraising night for The 3 Day.  I don't want to give the name of the restaurant until I know how this appointment goes.  If it doesn't go well, I'll have mean things to say about them, but if it does go well, I'll be gushing about how wondeful I think they are.  I'm actually a little nervous because I feel that it all depends on how this meeting goes and how I present the idea.  To make things even more nerve wracking, I slopped chili oil on my shirt at lunch today so I have to run out and buy a new one before the meeting.  As most financially challenged overweight people can relate, running out to buy a new shirt isn't always as easy as it sounds.  Luckily, there is a Catherine's Plus Size right by this restaurant so I'm crossing my fingers that they have something that matches the pants I'm wearing but isn't too expensive.  Wish me luck!


LDswims said...

I hope you can find a shirt you like, that's pretty (hence the reason you like it), that's cheap - although doesn't look it, and that goes with your pants better than what you started with!

As for the BMI's how it's affected me. My nutritionist and case advocate (that's what the paperwork compiler is called in my clinic) both say "lose it all, it's just fine". The nutritionist says that because that's what is best for me. The case advocate says that because, in my own words, legally, she has to. She can't tell me what the insurance company doesn't want me to know.

My RNP, on the other hand, someone who has been through this process as well, and is banded herself, can call it like it is. And she is the one that told me point blank - lose weight. BUT DO NOT fall below a BMI of 40. She also told me that if I gain weight this time, it's ok, because I'll still be down from the starting weight. They look at weight lost in the six months not from month-to-month. I don't really want to play with that did make me relax A LOT.

My insurance company also said that they use the starting weight to determine necessity. So if I lose weight, theoretically, I should be ok. But when I got hold of a copy of the rider for bariatric surgery it flat out says to "fail" this program. Some one of my blogs has the actual statement about how this program was supposed to work for me. But the word failure is the specific action that is supposed to happen.

So I'm failing. I HATE it...but I'm failing...because long term...I want to SUCCEED!

See if you can get a copy of the rider for your insurance company. Once I found it, I discovered I could search for the policy on their website, I had access to it all along.

I hope the restaurant comes through for you!

Jenny said...

Good luck with the shirt! I hate that when it happens. It can be so frustrating. I hope your appointment goes well, its certainly for a good cause!

Girl Bandit said...

Wow I don't understand all the insurance stuff you have to go through in the US/ Canada. IWe have private insurance here in OZ but there is still out of pocket expenses but we don't need pre-approval or diets or anything like confusing and also knowing that they probably want you to fail so they don't have to pay for it.....arghhhhhh. Good luck and I hope you work it out

THE DASH! said...

What a nightmare - things are so much simpler here in Oz. I had to pay a couple of thousand dollars for my op - but the insurance company paid six times (and a little more) that much. Hope you sort it through (and get a great answer in the end.)

Bonnie said...

I'm right there with you dealing with the insurance requirements. It sucks. Don't leave us hanging - how did your meeting go?