Have 39 BMI, sleep apnea, but denied lap band surgery
I am in the process of trying to get lap band surgery for being overweight. My insurance company has a policy that you have to wait 90 days before you can have the surgery.
In the meantime I had to go thru a series of things. Bloodwork ...pulmenology testing...EKG ...barium swallow test...chest X-ray...psychological work up...go to a seminar...watch a tutorial... Echo cardio gram...also had to see a nutrionist for 3 months and did a sleep study test... Also had to show proof of prior weightloss attempts....after all this and 90+ days later to be told I was denied because my sleep apnea was not severe enough ...
Yet I have a BMi of 39 and considered morbidly obese. So I'm going to appeal it. My question is : can I actually have more severe sleep apnea and the reason test showed mild because I felt I never got into a good sleep like I do at home...
I was in a strange place...constantly being woken up by the tech to check leads on my leg that kept coming off during night. Then being woken up again to be told to turn over ... Because at home my husbands tells me I snore loudly and at times I have woken up gasping for air or my heart racing... How do I fight this?
Reading your story makes me MAD, thinking that insurance companies are NOT interested in their patients' best interest. Unfortunately, this situation is not uncommon.
It's a stupidity to be denied for lap band surgery
just because your sleep apnea is not severe enough. By the way, how severe is your OSA now? And more importantly...how severe the OSA should be
for your insurance company to accept the surgery?
To answer your question, sleep apnea will worsen
over time. So the severity will increase, but the side effects will worsen as well. A sleep study will be necessary after a period of time, let's say 3 to 6 months, to diagnose correctly the severity of OSA.
However, you shouldn't avoid the CPAP (or whatever treatment you have) to worsen your sleep apnea on purpose
. Your heart can suffer irreparable damage, or a stroke can cause vision and memory problems, and even paralysis.
So...please don't stop
your treatment for sleep apnea.
If your coverage is denied, the best think you can do is to appeal
. While it's frustrating to have your request denied, please don't give up. If the severity of your sleep apnea is the only reason for denial, then this reason can be contested during the appeal process.
However, you should be prepared to meet obstacles from the insurance company, but with perseverance
you CAN succeed. A lawyer who specializes in this field can add huge support in your favor. I can recommend a lawyer, but unfortunately is too far away from New Jersey: http://www.obesitylaw.com
But it's a place to start... I'm sure you can find good lawyers in your city.
I'm also sure you will be accepted for lap band surgery. But only if you don't give up appealing.
I wish you good luck!
I hope it helps. Don't be afraid to comment back. Remy Thierry
Founder of Sleep Apnea Guide