Well, I did at least try…and that’s what counts, right?

Last night was the first night of my Beginner Adult Ballet/Modern dance class at the YMCA. This is the class I mentioned being excited about, but has to switch sessions because I was sick and was going to be out of town and didn’t want to miss two classes of the last session.

So it was me, woman who minored in dance, and the instructor.

There was a kid’s movie event in the next room so we had an audience through the windows…and yes one kid stood with his face against the glass staring at us almost the entire time.

Things started out well. Warm up stretches seated on the floor. Pass.

Then she brought out the bar. Plies, position 1, 2 and 3…foot ON the bar. Total PASS!

Next…jumps. This is where the beginner part ended and I felt like WTH? Total modification time. Just bounce instead of full jump…and it was still a FAIL.

Ballet over time for Modern…Skip jumps! Diagonal across the entire studio. So we’re jumping and running. OMG

So I reach back into my kindergarten days and remind myself how to skip. And I give it the old college try. My 4 jumps would barely get me ½ across the studio while they made it all the way across. But surprisingly I wasn’t any more short of breath than they were.

Ok now skip jump forward, and kick slide backs. Near collision. FAIL

And finally choreography time. Because this is session II of Spring, they have already been working on this during session I and for Fall the YMCA rented a theater and all the classes performed.

Uh, I don’t think so.

While class is wrapping up, I see my normal Friday night water aerobics crew head to the outdoor pool and I thought “why the hell am I in here when I’d rather be out there?” And I could have taken my bathing suit and joined the other class late, but for the first night I wanted to just see how things went.

As I’m walking out I notice the “sponsor” of studio.

Not sure if I will return. Not their fault. Just doesn’t seem to be the right fit.

Originally posted on my HealthInsuranceBitch blog.

It has been more than a year since I got my last pair of compression garments for my lymphedema. One pair. I should get two pair every six months. Since I should have a pair to wash and a pair to wear each day and the elasticity begins to wear out after six months. But as hard as it is to get one pair I have NEVER gotten four pair a year. Instead I wear the one pair I have over again for several days and then wash them and hope they are dry by the next morning. At least at this point in time I have some old pairs that I can wear, even if it means the worn out elasticity will allow my legs to swell, it’s still less than swelling than if I wore no garments at all.

I bring this up because I’ve had my garments for a year and yet my DME provider has yet to be paid. I’m past due for a new pair and yet I how can I get another pair when the provider hasn’t been paid from last year?

Oh sure, I could just pay out pocket. However, I’m currently paying COBRA out of pocket because I’m out of work. It’s more difficult to find a job when you have a chronic condition affecting your legs. If I could go work at Target or Home Depot and be on my feet all day I would. But I cannot.

The better option would be if my insurance company would follow their OWN policy and pay the claim.

Here’s the issue…and your lesson for the day, so get a pen and paper.

NETWORK GAP COVERAGE

Since my insurance company has no in-network provider within a 50 mile radius of my home that can provide the medically necessary treatment my doctor prescribes my insurance company has to cover an out-of-network provider at my in-network benefit level.

Understand? I do. Obviously they don’t. Despite going over it EVERY YEAR…they still don’t seem to understand.

Due to the size and shape of my legs, my compression garments have to be custom fitted. Once made custom fitted garments cannot be altered. So if the measurements are not taken correctly, the $300 pair of garments are a waste of time and money. For this reason, the company only takes orders from certified fitters whom they train. So if a provider has no employees who are certified fitters, they cannot provide my garments for me.

My search begins with cross referencing the garment company’s list of certified fitters with my insurance company’s list of DME providers within a 50 mile radius of my home. That list indicated there were no DME providers in my network that could provide the garment I needed. To double check I called every DME provider on my insurance company’s list. I documented who I spoke with, and asked if they were able to provide the specific custom fitted garment I need. They all said no.

So then I contact my insurance company and request that I can go out of network at in-network benefit level. This process has gone different ways. A previous insurance company agreed and my out of network provider filed the claim and was paid. My current insurance company would not authorize, and the provider was leery of accepting direct payment because of past issues with the company. So I paid out of pocket and with the assistance of the provider filed the claim with all my documentation for reimbursement from the insurance company.

Last year, well about 13 months ago, in the hopes of saving the round-a-bout hassle that every time comes back to “there is no in-network provider”, I asked if the insurance company would just pre-authorize me to go out of network. I was told I would have to file the claim and appeal.

An appeal only costs me time and a stamp, while it costs the insurance company time and an hourly wage to pay some to process it. When in the end I will win, it’s been established, I am right in this matter. So since my employer is self-insured I asked if the Benefits Administrator could order my insurance company to give the pre-authorization. I was told yes.

So I spoke with the Benefits Administrator about the issue. She knew me well, as I have filed and won other appeals. She knows I know my stuff and I’m not asking for anything unnecessary. She said “send me and e-mail”. I sent her the details. And within a few days I had a case manager calling me to set things up with authorization and wanting to make sure I got exactly what I needed. I should have known NOTHING IS THAT EASY.

That was March 2009, fast forward to February 2010, I get a phone call from my garment provider stating my insurance had denied the claim, and all their appeals…even though they had an authorization number.

I was pissed.

I immediately call the insurance company and was told that the claim was processed as out of network and therefore I would owe my out of network deductible. I corrected them and explained the authorization from the Benefits Administrator indicated it had to be processed as in-network. The woman claimed the authorization never specified in-network. WTH, there would be no need for the Benefits Administrator to intervene in the matter if this was a normal out of network claim.

So I e-mail the Benefits Administrator, recap the entire situation. She replies back the next day and cc’d someone from the insurance company. The next day the woman from the insurance company replies and apologizes for the mistake and states the claim will be reprocessed correctly and the provider paid. That was February 2, 2010.

I wait a couple weeks and checked my claims online. No changes. I call the provider; they state they did receive the information but still no payment.

So today, I check my claims online. No changes. I call the provider. No payment.

I fired off yet another e-mail to Benefits Administrator and woman from the insurance company. I remind them that by wearing my compression garments I SAVE them money because the garments have reduced my hospitalizations due to cellulitis.

Ri-FRICKIN-diculous

I know my last post joked about the idea of being paid to eat.

But this woman’s story is just disturbing…and disgusting.

From someone who has been over 500lbs, I would never WANT to do that to myself.

It’s suicide.

Interview: NJ Woman Paid to Gain Weight – From MyFoxPhilly.com

A New Jersey woman weighs 550 pounds. She does not want to lose weight. In fact, she is gaining weight and getting paid to do so!

Fox 29’s Sharon Crowley interviewed Donna Simpson. She is a 42 year-old mother of two who hails from Old Bridge, NJ.

The Guinness Book of World Records claims she is the heaviest mom to give birth. Now, she posts her pound-packing-progress on her own website.

Her loyal followers pay to see her provocative pictures. They watch her eat. They send her food.

Donna is now going to try and get up to an astounding 1,000 pounds.

Her fans are excited and so is Donna.

Donna’s unique take on this all? “I’m taking it as it goes. I’m accepting myself as is.”

Hello? I’m accepting myself as it is too. And I’m taking the responsibility for my health. It’s a battle to stay healthy, but I’m doing it. There is a difference of between being yourself and taking drastic measures to change yourself for the sake of publicity and money. The money issue of this gives me the creeps. I’m all for Google ads, and various ways to make money off a blog. But pictures of her eating, and various other poses for chubby chasers to pay to see and get their kicks….ewwww.

I can see as compared to site where men pay to see big breasted women what’s the problem??? I guess where breast enhancement surgery does come with risks, not as many risks as being SUPER MORBIDLY OBESE. And this woman has kids???? How irresponsible as a mother.

My heart goes out to people who are SMO and struggle with their condition, I know how difficult it is to be SMO and to find help in losing weight. It’s a tragic condition.

So I have little sympathy for someone who purposely does that to themselves.

From MumbaiMirror:

Wanted: a pro couch potato who’ll get paid to eat more!

By ANI
Posted On Tuesday, March 16, 2010 at 04:18:06 AM

London: A company is looking to hire a “professional couch potato” who will be required to do nothing but eat more junk food – and get paid for it.


The firm Proactol Ltd is inviting applications to test their fat binder, which allegedly absorbs up to 30 per cent of fat intake, the Telegraph reported.


Officials are willing to pay £23,750 to a “worker” who will eat 400 extra calories every day in high fat meals such as chips and pizzas during the initial in-house monitoring period to test the fat binding properties of a weight loss product.


“It’s the ultimate work-from-home-job,” the company said. The successful applicant will get to work from home, with supplies being delivered to their door.


The ad reads: “We know it’s incredible, but it’s true. We are willing to pay you £23,750 a year to continue doing EXACTLY what you do every single day, and all we ask is you eat 16 per cent more calories a week – or 400 more calories a day – whilst introducing Proactol to your diet.


“The ideal candidate should not already be on a diet but eat a healthy balance of carbohydrates, fats and proteins and be prepared to increase their existing calorie intake by 16 per cent a week by eating fatty foods such as Chinese takeaways, fish and chips, pizza. Essentially we want you to be yourself. No strings.”

How do I apply??? 400 extra calories a day really isn’t that hard to do…this is a bit more amatuer than pro. Let’s see I typically eat a balanced diet, with an occasional dining out or home delivered meal. Seriously, I could so do this job. Although the drug sounds a bit too much like Xenical aka Alli…and uh no thanks.

 
I’m watching the premiere episode of Jessica Simpson’s new reality show The Price of Beauty tonight at 10 PM on VH1.
 
Then I’m moving to Uganda. No fat hut needed.

Yesterday, I set out to find an inexpensive bed frame at IKEA. As I examined the bed in the store I noticed there was a foundation of some time under the matress, not just wooden slats. Since my box spring is still in good shape and the bed slats I was going to buy cost $120, I wanted to find out if I could possibly just use what I already had. I asked a salesman and he said that I could use the box spring I had, no need to purchase slats.

GREAT! That allowed room in the budget for the Expedit bookcase, drawers, and doors I wanted!

So after the adventure of finding our merchandise in the warehouse, loading it into the car (some of it had to be taken out of the box in order to fit), getting it all inside the house, taking down the old bed, manuvering the clutter in my room to work, and putting the metal frame together. My friend puts down box spring then puts the mattress on top.

I burst into laughter. The bed was sooo high! I’m only 5’3″.

The matress is pillow top on both sides. I can get one cheek up on it, then wiggle the rest of me up. It feels VERY sturdy. Despite the price, this is heavy metal, and a solid steel midbeam. I feel much better on a box spring which I know can hold up to my weight and motion.

So Big Girl is happy with the bed, Short Girl is getting used to it.

Off topic: I have to give big thanks to my friend who helped me get my bed. The loading, unloading, putting together. I have to say growing up that process would have been filled with yelling and cussing. I remember the first time my old roommate’s family came to put her day bed together, I was amazed at how quiet they were. They were even missing pieces and still no one got upset. Wow…is this how normal people do things? So yesterday instead of cussing and yelling, it was laughter. I think the only time I cursed was saying “oh damn” when I saw how high the bed was.

Let’s start with a moment of silence for the innocent furniture victims whose lives I cut short: 1 recliner, 1 plastic lawn chair (honest only 1), 1 tree house step, 1 wooden dining room chair, 2 couches, 2 box springs, and 1 metal bed frame.

You know how difficult it is to find JUST a box spring??? Probably about as difficult as it is to get information from IKEA.

My current full size bed is 7 years old. My mom bought it for me after I had major surgery. At the time I had given up on bed frames and had my broken box spring and mattress on my floor. When my mom bought my current bed she bought an extra support beam. Thanks Mom!

However, it wouldn’t matter how many support beams were underneath because the beams tip over. Currently, both beams are tipped over so I am only supported by the perimeter frame…and it’s still holding up!!! But, the frame has wheels, and my floors are wooden. It’s the easily shifting frame that causes the beams to fall. I could just be turning over in bed, the wheels move, the beams fall. It’s annoying. Also, I got rid of the brass headboard two moves ago because it never stayed secure to the frame.

In the end, I decided I want/need a new bed. I don’t have a lot of $$$ for this. I want to keep the mattress so I figure just stay with full size for now and in few more years I can upgrade to a queen bed (or king…I think that discussion is still on the table).

So looking around I found IKEA has some inexpensive bed frames. I have bought several chests of drawers, office chair, and other items from IKEA and have been impressed. But a bed? I mean a chest of drawers made out of particle board and foil is one thing…but a bed?

I asked for some opinions. I Googled. Then I did what any smart person would do and I asked IKEA!

I flat out told them what I weighed and asked for the weight limit/capacity of the two beds I was interested in.

This was there reply:

Hello Sarah,

Thank you for taking the time to contact us.


This product does not have a published weight limit. It is a well designed product and will provide good function for which it is designed. The design, weight capacity and function of each product undergoes test to ensure the product will hold up to normal use. If the product is used for something other than the designed function, IKEA is not responsible for loss to personal injury or property.

We do hope that this information has been helpful, and we thank you for your inquiry.

Best Regards,
IKEA Customer Care Center

So can I get the weight capacity at which you test the product??? And what is “normal use”. My mind could twist that in all sorts of directions. But basically I want to know, will the bed hold my fat ass and an occasional slumber party buddy?

Today I’m going to IKEA and jumping on beds. If I get arrested for vandalism, please someone post my bail.

UPDATE
Withing minutes of posting this blog entry IKEA replied to my follow-up e-mail I sent last night asking if I could get the tested weight capacity. I think it’s just coincidence.

Hello Sarah,

Thank you for your reply. We are glad to hear from you again.

As the weight in a bed is generally not motionless an exact weight limit cannot be determined. However, for full beds the largest weight that has been placed on these beds is 440 lbs so we would not recommend exceeding that weight.

We do hope that this information has been helpful, and we thank you for your inquiry.


Best Regards,
IKEA Customer Care Center

As the weight in a bed is generally not motionless <—- I’ll be have myself. As for the 440lbs…guess that means no slumber party buddy. =(

I was hit on today. For real.

The story begins for my desire for a cute green dress from Old Navy. This week it’s on sale, and despite their plus size clothing being sold exclusively online (nice how they make that sound special, when it’s really not) the in store misses sizes go up to XXL and I can often fit into certain styles. I decided I wanted to save the $7 shipping fee and go to the store instead of ordering online…2 dresses, 2 shirts, 1 skirt, and 1 necklace later, I think the $7 shipping fee would have been the better deal.

However, it was nice to try things on. When I put on the green dress, it hugged my baby got back just right and I thought “oh that’s going to turn some heads”.

While I’m at the counter the young woman ringing my items commented on my “pretty blue eyes”, I explained I have blue eyes and blue contacts, thank you, yes that blue necklace will look nice on me.

So as I’m leaving this guy holds the door open for me. As we walk into the parking lot he comments on my “pretty blue eyes”. I laugh since I JUST had this conversation…and I wasn’t even wearing blue or a color that typically draws more attention to my eye color.
As a matter of fact, I was in black yoga pants, a gray t-shirt, flip-flops and a pony tail. I had been to the doctor, Starbucks, and was just running errands. No reason to get beautified.

So after my blue eyes with blue contacts because I used to lose my contacts in high school, blah blah blah explanation he asked me if perhaps his eyes would look as blue. I told him it depends, but he should ask his eye doctor for a free sample pair. Then he commented on the weather, somehow I made mention of being from Ohio. He said he was in from New Jersey. Then he said “Can I tell you something, I hope you won’t be offended”. I smile, “go ahead I have very thick skin”. –literally

“There is just something so attractive about a plus size woman who exudes confidence,” he said.
All I could do was smile and say, “I know. If I could bottle it I would.”

He went on to say the internet has brought more awareness to the BBW culture. He asked me if I was on any BBW sites or chats. I politely said I was aware of a few. For my non-fatty friends BBW stands for Big Beautiful Women.

He went on about how great it was that more women are confident with themselves. And he actually pointed out guys who drove or walked by and checked me out. Although I’m not so vain that I think everyone who looks at me is checking me out, some people just look and stare because of my arms.

“See there’s another one, I told you. Go to right up here to the mall and walk by some guy with a skinny hungry girlfriend, he’ll still take a glance at you.”

Yes, I realize this seems a bit creepy…and when the guy mentioned that there are even BBW who frequent the local clothing optional beach I was wondering where the heck he was going with all this. But in the end he was just nice and bestowing a very nice compliment. We probably stood and spoke in the parking lot for five minutes, as I headed to my car he said “well, see you around, you never know maybe next time I’m in town we can have drinks.”

We didn’t exchange names or phone numbers, so that is not likely going to happen.

What matters is that you always get back up!

Last week was a bad week for me. Some long awaited plans that were finally taking shape were suddenly put on hold again. I’m not sure if it was exactly that, or something else but this weekend was bad…pre-op bad. I’m a bit too embarrassed to give the details, but at least I realizes “whoa” what are you doing, and WHY are you doing it??? Was it this one let down that triggered a slip back to VERY bad habits? Why this ONE thing when there were several other highlights in the past two weeks. Despite years of dealing with these issues, things happen. I could dwell on them and continue the cycle of guilt, eat, guilt, eat…or I could pick myself up and get back to what I know is best for me.

Tonight I went to water aerobics, it wasn’t even the workout that I wanted. I needed the water. It felt good. It’s an hour of not thinking about anything but what the instructions are and listening to some AWESOME music tonight.

Nothing in life is easy, no matter who you are, what you look like, or how much money you have. I have fallen many times, each time I get back up, sometimes it takes longer than others, but what matters is I do it, and honestly when I look back at how many times I’ve fallen I realize nothing will keep me down for long…I build strength through each experience.