MY WLS JOURNEY
08/21/04- I am 27 years old. I have been on Weight Watchers twice. The Slim Fast diet once. I used a nutritionist once. I was on a Healthy Choice diet. I refuse to use weight loss medication, because the side effects have always seemed to outweigh the benefits. Some people say that while you are probably happy with your weight after surgery, that a person's quality of life decreases. Well, I'm very tired of my quality of life being based on the food I eat. The food I eat is making me miserable. I can't go to amusements parks, or white water rafting. Eating is a true addiction. Unfortunately, it is also a necessary component of living (unlike tobacco, alcohol, or drugs). Well, I want to do more things with my life. I want to run around with my nieces and nephews. I want to have a relationship, and children of my own. I want to live life. To really LIVE it. Not just survive. And lately it sometimes feels as if I am barely surviving. Despite the "No" 's from others, I believe this is the choice for me. I just got a new job with a union and have a chosen Blue Cross PPO-Prudent Buyer. My insurance starts September 1st and I am planning on making appointments with physicians right away.
10/8/04- I have filled out a 20 page packet for Coastal obesity and they are going to submit it to the insurance soon. I actually turned in the packet last month, but since I moved they were unable to contact me. I e-mailed them to find out if they received it and they just e-mailed me back saying they now have all the info and will turn it in to Blue Cross for approval.
,center>
10/15/04- I HAVE BEEN APPROVED FOR SURGERY!, after the first letter and on the same day they submitted it. Now they are going to send all of my pre-op labs and tests prescriptions and my paperwork and then they will schedule my consult.
11/11/04- I finished all my labs, EKG, and Chest X-ray, but my surgery coordinator called and said the lab did not send some results which means they either didn't do them or or didn't send them. They also need a sleep study (I will ask my doctor to refer me for one today) and a gallbladder ultrasound (I just had one done on 11/05/04 because of severe abdominal pain i.e. stomach flu).
11/12/04- My sleep study has been scheduled for 12/02/04. The sleep diagnostic place said that results will not be available for two weeks, but I hope they get them sooner becuase I have already arranged time off at work for the surgery. I have been told that I can probably have surgery in the beginning to middle of December and I hope to have it done Laparoscopically for a faster recovery time. I work for a school district and I would like to be able to go back to work right after winter break.
11/15/04- I had some bad feelings this weekend about my surgery, so I called the surgery center to see if they have all the paperwork and if everything is okay with the insurance, etc. They informed me that I need to pay a $3000 co-pay on the day of my consultation, because they are not in-network. I then called my surgery coordinator and said that I was unaware of this cost since the group is operating out of a primarily PPO hospital and the surgeons are listed in my provider handbook. I said that I will have to look for a surgery center that is in-network or wait until I can save up the $3000. So now that is why I had a bad feeling. That is some wrench that has been thrown into the works.
11/16/04- I discussed this dilemma at my support group and found out that others are having the same problem or are receiving bills after the fact for surgeons that are out-of-network. My very nice coordinator is playing activist on my behalf and is trying to help me find a solution. In the meantime, I am continuing with my tests as ordered and looking into other surgery centers. I called two centers today and they both have the same or even a larger co-pay. One lady told me that the centers pretty much make it that way to get cash from their patients. I don't understand. My insurance covers 100% and these surgeons are listed in my provider handbook. The lady from one surgery center said they usually use a surgeon or assistant surgeon that is out-of-network to obtain this fee. I picked Blue Cross because it seemed to have the least problems and covered the best but now I have to pay $3000 when other people in my support group received the surgery at no cost or with just a program fee of $500 or less. Am I worth $3000? Definitely!!! But nobody is going to pay for something when they know it is covered 100% elsewhere, and especially if they don't have the money.
11/20/04- Well, I went to a required WLS seminar and I pretty much received information that I already obtained on my own, but I was at least able to encourage people to go to support group. I have been attending since August and it is a great way to get info, to let off some steam, and to get help.
11/23/04- I went to my support group meeting resigned that I will have to delay surgery until I can raise the money or find a covered surgeon. When SURPRISE!!! My surgery coordinator said that they were able to work it out that I can pay in payments and that they will schedule surgery for Dec. 9th. Yee Hah!! I was very happy and overwhelmed at the same time. I was probably more silent in this meeting than ever before. I was concerned that my sleep study would not be ready in time, but members of the group told me not to worry and to just let the sleep center know when I am having surgery and they will have it done on time. I kept looking at the calendar on the wall realizing that it is just two weeks away. I have to order the required one month supply of food, have my gallbladder ultrasound faxed and finish my labs. When I left school today, everyone knew there was a delay in surgery and that they didn't need to worry about coverage. Now, when I go in on Monday, I will tell them that I will only be working for a week and a half and I will have to put in for a medical leave of absence. I can't lie. I was all of a sudden scared. My biggest concern of course is making arangements for payment and also still feeling like I shouldn't have to pay. I think I will call Blue Cross and get their story. I was told by the surgery center that although the surgeons are covered in my handbook, they are covered under general surgery, not bariatric surgery, which is why I must pay the $3000. My internal response to that is Blue Cross doesn't cover bariatric surgery unless it is medically necessary, so of course there is no in-network bariatric surgeons. If they deem it medically necessary, then the general surgeons should be covered 100%. Let me tell you something smells fishy!!! I am in a dilemma. The desire for immediate gratification is severe, but at what cost? I AM worth $3000. I will take this option and call my insurer for more info and if all stories are correct then I will gladly pay this $3000 over time and I am VERY grateful that the surgery center is giving me this opportunity to do so.
11/24/04- The surgery center called and scheduled my consult for Monday, November 29th. I will hopefully have all of my info then. Now for my last supper..... Hah hah. Just Kidding!
Actually I want to walk a lot more this week and cut down on certain BAD foods. I want to be as healthy as I possibly can for this surgery. I want to have it done LAP. Oh! By the way, I ordered the food, $320 for one month. Whew! Thank goodness after that I can choose my own supplements.
12/08/04- I was just called and my surgery has been canceled because, supposedly, the surgical instruments have not arrived. They are going to call me tomorrow and let me know the status. I know that since I am the second patient on the first day of surgery at a new surgery center that this could happen, but somebody should have done all the inventory checks before they made me pay an additional $500.00 today.
12/10/04- I had a weird conversation with the doctor's wife today. I called them to ask about the surgery and she told me she didn't think it would be scheduled before the first of the year and not to worry because she and the doctor had a talk and that they would not be leaving us. That I don't have to worry about coming to the office one day to find it locked. Maybe it's just me, but I wasn't worried about that until she told me. The one thing I am really ticked off about is the fact that I was willing to make the co-pay of $3000 as long as they were going to do the surgery during my winter break, but I can't afford the co-pay and unscheduled time-off work too. I am going to have to look into a new surgeon's office and I'll try to find one the is covered 100%.
12/15/04- I went to a symposium for Comprehensive Surgical Specialists. I already called and they are covered 100%. I can now call tomorrow for an appointment.
12/16/04- I was able to get an appointment for Monday, January 3rd at 3:00. Hooray! I have chosen Dr. Pehrsson because he looks like Sean Connery and he has a lovely accent(Oh! and he has great credentials too!).
01/03/05- Well, it's a new year, a new surgeon, and soon to be a new me. When they get the insurance authorized then I will have surgery scheduled. I need a nutrition class, an endoscopy, pre-op labs, and I need to fax over my other test results. I have to pay a $500 support group fee(which I was told from other patients that they received back because they never attended support group)and my deductible.
01/11/05- I was able to get my file from Coastal Obesity and I found out that I do have moderate sleep apnea, but who orders the CPAP machine?
01/18/05- I have been recertified for surgery! I will attend the nutrition class this weekend and they will call to schedule my endoscopy. I am on my way for sure this time!
02/03/05- My endoscopy is scheduled for 2/12/05 and since that is a Saturday, then I will go down on Friday and pay my co-pay and do my final weigh in.
02/11/05- Ok! What hell today was! The weather was awful, but I paid everything and then they had me go to the hospital, Arcadia Methodist(which is very pretty and the people are very nice) and I pre-registered and I did my labs. I got poked three time but I'm sure it will be worth it in the end. My weigh-in was 349 lbs, they asked about the CPAP machine and I told them that the ball was dropped. My PCP ordered the test but they did it on behalf of Coastal and no one ordered the CPAP and I didn't get back with my PCP to see if they could order it. I probably won't need it soon anyway.
02/12/05- Thank Goodness the doctor scheduled the endoscopy.I had the H. Pylori blood test which was negative but when I just had this endoscopy the doctor found a hiatal hernia, gastritis, duodenitis, gastric erosions, and he feels I may have an infection so he took a biopsy and he may call me in two days with an antibiotic prescription. I'm sure that he feels that it is H. Pylori. Right now I have to take Prilosec and he said I can go ahead with surgery, because they can fix the hernia in surgery. Weird thing is that I have been to the doctors and have been suffering off and on from stomach pain since the school year started and the only test done was a gallbladder ultrasound, but now I know it was the hernia. I have had this endoscopy done two years ago for severe stomach problems and the result was negative and I was soooo mad becuase the doctors couldn't figure out why I was so sick. Now I expect there to be nothing again and that's when the doctor finds several things wrong. Se la vie! Now I just wait for the surgery and hopefully no road blocks are too big to overcome and my surgery does not have to be postponed. It's my turn!
02/18/05- It's the day after surgery and I'm at home and doing great! I weighed in at 341 lbs the day of surgery so I have a pre-op weight loss of 24 lbs. Somebody made me perform too many sit-ups because my belly is pretty sore, but overall the pain is very manageable. The Surgeon was able to prescribe me some liquid pain medication that I don't seem to be allergic to. Thank the Lord!!! I keep sipping and walking which is helping with my back pain(from the gas and lying in bed all day), oh! and I'm belching like a trucker. All in all, I'm happy to be on the losers bench! I had my first case of head hunger. My body doesn't even want food mentioned but my head loved the look of the pizza my mom was eating. Thank goodness for support group and all the info I received about this side of life. I am very loved as is evidenced by all the calls I received in the hospital and I love that. What a way to get a start. How can anyone go wrong with such a strong team rooting for your success. To all my angels, I love you all very much! You are all like family. Let the party begin!
2/28/05- I had my first follow-up appt today. I am down to 330 lbs. So that is 24 pre-op weight loss and 11 post-op weight loss(11 days). Doing great so far. I need to increase my protein. I get shaky and I know I need more. I cannot deal with the chocolate shakes any more but the ready-to-drink fruit flavored protein is pretty good. I am doing better with that, but it's very expensive comparatively. Oh well! I am doing great with the vitamins. Tonight I have to start some medication to prevent gallstones called Urso. It could have some uncomfortable side effects, but hopefully not for me. Next appt in 4 wks.
Future Update
Future Update