Monica Fugate Success Story

I want to give a very special thanks to Monica Fugate for sharing her story with us.  I am sure we will be hearing more from Monica in the months to come:

I am pleased to tell you that I submitted my information to the Century Club today. I have now lost 136 pounds since July 17th when I had my gastric bypass surgery. I started out at 543 pounds and I feel better every day. It seems like I have so far to go some days but in 6 months I have been able to do so much and I actually look forward to my future now and waking up, when before I dreaded each day of struggles and pain both physically and emotionally.

I thank God every day for this miracle and for saving my life. I am able to walk across a room now without getting terribly out of breath and I am shopping again in the stores instead of sending my husband with our grocery list to do it for me because I couldn't make it through the store anymore. I cry every time I think of what my life had become and how different it is now and the changes in the future. I cry tears of joy instead of tears of pain and frustration.

All my life I was overweight. In the 2nd grade I weighed over 100 pounds and then by high school I was over 300 pounds. My mom took me to our family doctor when I was maybe 8 or 9 for the first time and he said I would grow out of it. Well, I didn't grow out of it. I just grew. We tried diets like Shak-lee and Weight Watchers all during those years but nothing really helped. I would lose maybe 30 pounds or if I was lucky 50, but I would hit plateaus and get discouraged after months of eating right but not losing weight.

My mom and my sister were wonderful support to me. My mom taught me unconditional love does exist. Without her I would never have had the self-respect that I have. I hated my body and what I carried on the outside with all that went with it, such as laughs and sneers by people who didn't even know me. But my mom taught me to love me, the person that I am inside. She taught me to treat others the way I want to be treated even if they weren't doing what was right in how they treated me. Maybe by setting that example they would see that I am a human being just like them with feelings and emotions. I am forever grateful for that.

Despite her support I quit school as soon as I turned 16 because I just couldn't handle being made fun of everyday. It was terrible. I started working full time and into my adult life continued to gain weight. I tried every diet you could think of, TOPS, Weight Watchers several times, Herb-a-life, Nutri-bolic, Slim-fast, as well as joining an exercise club, and over the counter diet pills too. Nothing brought me any real results.

My family Doctor told me that I just needed to quit eating and he was very cold and unsympathetic. The last time I saw him I was 22 years old and 340 pounds or so. He wrote me a prescription for a 1-month supply of diet pills and told me that was all he could do. I went in asking him to help me with some sort of diet plan and regular weigh-ins to monitor and help me but he didn't care. That was my last visit to him. I found another doctor who I had heard good things about and my husband had seen him. At my first visit I told him my history and struggles, and that I was very tired a lot. He asked me if I had ever had my thyroid checked, I said yes but they always said it was ok. He told me he really thought that was part of my problem and checked it anyway. He said there was a more accurate test. Well sure enough I did have an inactive thyroid so he put me on Synthroid. I thought it was really going to help me lose weight. He expected that I would be able to lose at least 50 pounds, but I didn't. Over the next 2 years I just kept gaining.

I had heard of gastric bypass surgery through TV ads at the Bariatric Treatment Center and in my heart I knew that was the only thing that would help me. Finally, I had stable employment and insurance so I decided to actively pursue the surgery. The insurance had many requirements before they would even consider covering my surgery. They wanted me to go through a 6 month program that they recommended to help me lose weight. They said I need a documented history of my attempts to lose weight, even though by this time I was over 400 pounds and my doctor said I needed it to save my life. I started to have more symptoms of the obesity, high blood pressure and arthritis in my knees. At 28 years old I was miserable, I couldn't walk across a room anymore without gasping for breath, let alone get out on my own to do shopping. I agreed to follow a diet plan and weigh in every week so we could document it and then ask for the referral to the
surgery center again in 6 months.

I did all that they said I needed to do for those 6 months. My Doctor filled out the request again but they said that the requirements had changed and that I had to do this for 18 months instead of 6 months and that I had to go to a doctor they recommended which meant the previous 6 months were wasted. I was devastated, depressed and about to give up hope of ever getting this to happen. Even with the depression though there was something inside that kept driving me. I had and still have an incredible zest for life, to live this life that I have been missing out on because of my weight limitations.

I had heard of others that had the surgery and knew that insurances would cover it but I just couldn't figure out how they did it. So with the help of the Internet I began looking up things about the surgery, anything and everything I could find. In the meantime my Doctor said we needed to document my medical problems associated with the obesity and prove that it was medically necessary, so he sent me to a heart specialist who wrote a letter supporting the surgery and that it was needed to save me from a heart attack. Then I saw a pulmonary specialist for my sleep apnea who also supported the surgery. During this time I was still actively gathering all the information I could.

One day I came across an article after typing in the key words “bariatric surgery.” I found a woman who wrote a story for McCall's magazine named Lenay Yorko and I started reading it. As I read I broke into tears because not only was she from a local town but she had the same insurance company that I did, Physician's Health Plan, and she had gone through the same thing with them but she fought and won an appeal to get her surgery. This was the tool that I had been searching for.

I called information and got her phone number and she told me more about what she did and how she won without having to keep going through the run-around with the insurance. All I could think is that I was going to spend another 18 months of my life doing exactly what they wanted me to do only to be told in the end that they were still going to deny my request for the surgery.

Another step along the way that was devastating for me was that during this time I actually got to weigh in on a scale that was accurate. All this time I thought I was around 420 pounds. Wow was that way off. It turned out the scales in my Doctor's office weren't accurate. They didn't weigh bigger people like me but we didn't know I weighted more than they said. I weighed in at the pulmonary specialist's office and the scales said 566 pounds.  I couldn't believe my eyes and was literally in shock. I couldn't believe I was that big. I knew I had a hard time but I always managed to work and keep a full time job and lead as full a life as possible. How could I possibly be that big? I had heard of others who were home and bed-ridden not being able to walk anymore at this weight.

During those next few weeks I gathered all the information form the different doctors and the insurance company was sent another request with all this medical support. Then came the waiting game, first 2 weeks then 3. I kept thinking how long could it take them to look at this and make a decision? To me it was so simple. This would save my life! How could they say no? But that is exactly what they did. They said it wasn't medically necessary. Yeah right!!!!

Well, anticipating that would be what they said I talked to the attorney's office that Lenay told me about, Walter Lindstrom. His associate called me back and we talked about what to do if they denied it again. They gave me their fees and they were reasonable. Walter had the surgery himself years ago and helps others now who are fighting to save their lives with this surgery.

After researching and talking to so many people, I finally got to the point that I quit apologizing for being me. I am obese. It is a disease that would kill me if I didn't get help. I called the insurance company the same day that they denied the referral. I talked to the Medical Management department who works with the Medical Director in making these types of decisions. I really didn't know what I was going to say. The words just flowed out of my mouth.

I talked to a woman named Roxanne who was sympathetic but doing her job in telling me what their decision was and why. I told her that I was not taking no for an answer and that she could tell her Medical Director that I had been in touch with Lenay Yorko and her Attorney and that I was going to fight it. Well I had no idea that just saying Lenay's and Walter's names would give me this result, but  the insurance company called my Doctor's office the VERY NEXT DAY with my approval to go to the surgery center!!!

I will never forget that phone call. It was December 21^st, 2000. The nurse called me from my Doctor's office and told me they had approved it. She cried, I cried, and the girls in the background at the doctor's office cried. I was shocked. I really thought they were going to make me battle it out. I tell everyone in this situation now to not ever give up, don't take no for an answer and to fight for yourself. You have rights too and don't apologize for them.

I have a positive outlook for my future now. I feel better everyday and look forward to what is to come. I still have a long way to go but now I can do it with the help of this wonderful life-saving tool. I would do it again in a minute. It isn't by any means the easy way out. Yes, I had people actually say that to me. It is hard and you have to be dedicated to it. But anyone who has lived this life with all its limitations aches for a better life.

I am 7 months post-op now and enjoying my life for the first time in a very long time. I am so grateful for all the support I have been able to get at the touch of my fingertips anytime I need it. I have people contact me who have read my profile and ask questions before they have the surgery. It makes me feel good to help others get through the process. I cherish them all and look forward to sharing this wonderful journey and bond that we share.

I have had very few complications and the ones I have had I deal with as they come. I have experienced some hair loss but not big handfuls as mentioned in a previous newsletter. But it is pretty evenly distributed over my head and no one can really tell but me. I also occasionally get a little nauseous and it is hard to eat and get my protein in but again it isn't a lot and doesn't affect me everyday.

My incision is still giving me a few problems, the most irritating and painful side effect so far. At the incision site I get these places where it swells up like a boil and it seeps this yellowish stuff and leaves an opening. I have had about 8 of them now and they heal up then I get another one. I have gone back to the surgeon but he says this happens sometimes with incisions in bigger people like me because of the fat tissue and being so deep. If anyone else has had the same thing happen, I would love some tips.

I just had to share at least some of my story with you. I don't know if you remember me or not but I asked you for help last year right before my surgery because I was so scared and couldn't find anyone big like me around 500 pounds and you put me in touch with Sue Barr, and for that I am forever grateful. She has been an inspiration to me to have someone who was so close to my weight and to see her success, it makes me believe in myself and that I can do it too.

Thank you so much for your newsletter, I look forward to it.

Monica talks about Walter Lindstrom in her article.  Here is his website: http://www.obesitylaw.com/index.htm