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I have a DATE! on November 13, 2006 8:53 am
I called my husband with this news and he says, "Who with?" LOL...silly DH.
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My date is for December 18, 2006. Probably at 8:00 a.m.
I was doing very well last week. I was waiting patiently for a phone call to set up the surgery date. But then on Thursday, my boss sent out an email calling for holiday leave requests. How can I answer him when I'm still waiting for the surgery date?
So I called. Talked to Louanne. She tells me it will either be December 11 or December 18. After a quick look at the calendar, it's obvious that Dec. 18 will be a much better date for me. If I can get that week off (five days), I can 1) go to my family's Christmas gathering on the 16th, and 2) I can actually have two full weeks off to recover from surgery, since we're closed the week after Christmas. But I couldn't confirm this with Louanne that day (Thursday), because by the time I talked to the boss, they'd already closed the office for the day. And the next day was Veteran's Day, a holiday.
So it wasn't until this morning, Nov. 13, that I got the confirmation. Dec. 18 it is. Yeah!!
More APPROVAL!! on November 3, 2006 12:53 pm
November 3, 2006
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So I waited two whole days, checking the AvMed site twice a day to see when my authorization number would hit. I called Shirley Wednesday and left her a message...she called back and left me a message saying she still didn't see it in the system and to let her know if I got the auth # before she did. I'm figuring it takes a couple of days for everything to shake out in "The System."
I had planned to wait until Monday, but couldn't stand it, so I called AvMed back today. Today, I talked to a young lady named Isabelle, who said, nothing's been approved that I can see. DOH! So I told her of my conversation with Katie from Wednesday, and that it was supposed to have been noted in The System. Isabelle put me on hold, and when she came back, she prefaced her remarks with, "Here's the thing..."
Uh, oh, I thought. I'm in trouble.
The thing, as it turns out, is a communication problem between various departments at AvMed. Nothing horrific like I've read other people having with their insurance companies. It's just that my request was directly authorized by the medical director of the company, after it was initially turned down. Someone was supposed to generate the actual auth # and put it in The System, and had not yet done so. Isabelle promised to chase it down and call me back this afternoon.
And she did! And I'm still approved! And I have an actual authorization number! It's still not showing online, but I have it right here in my hot little hand, and I've passed it on to Shirley (via voice mail....argh) and I am SO hoping she will call me back TODAY because in addition to the authorization number, AvMed has issued a DATE (actually, two) for which this authorization is good, and those dates are November 20 & 21! Only TWO WEEKS! If I'm having surgery in two weeks, that means I have to start my liquid diet on Monday, two days from now. ACK!
I don't really know how this works. Can the insurance company possibly schedule the doctor's time like this? Do they just throw it out there and expect that for surgeries it will change? I don't know, and so I sit here typing away and hoping like crazy that Shirley, my angel, my lifeline, will call me back posthaste so I don't spend the entire weekend in this state of mind.
Approved? APPROVED?!?! on November 3, 2006 12:52 pm
Post Date: 11/1/06 7:46 am
Topic: No date yet, BUT...
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I called the insurance company this morning just on a whim. Shirley, bless her bones, sent in the request last week after I finally got her the TSH labwork. I thought it was time to call AvMed just to see if they had everything
So the girl I spoke to, Katie, said, Ms. Spears, the surgery request has been denied because you have not completed a physician-led weight loss program in the last six months. DOH! I knew that was a possibility, because I hadn't done one (at least not formally). So I was disappointed, but not surprised. I started to ask her exactly what they would need for an appeal, but then she said, Wait, wait, it looks like I have conflicting information...can you hold?
Could I hold? I've been "holding" my entire life, it seems, when it comes to my health. Yep, I can hold. No worries.
She finally came back on the line, after having spoken directly to the "pre-op" department, and said YOU'RE APPROVED!
No actual authorization yet (I guess they're still working on that) but it is definitely APPROVED!
I have no idea what went on, but it's not important to me right now. (I will find out, though, and post it in the insurance database here, for historical purposes.) The only thing I can think right now is, approved? Really? This is really going to happen...?
Play by Play of First Consult on October 17, 2006 1:04 pm
October 13, 2006
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I know you're all just DYING to know what happened at my doc appt. yesterday (yeah right), but here goes anyway.
Signed in. Waited a while. Was given some forms to sign, and a questionnaire which cleverly asked the same question worded several different ways. Basically, it asked did I like being overweight. *sigh* Turned in the forms and questionnaire, and waited some more.
Was called back for weight and vitals. I found out I'm down ~7 lbs; probably due to walking all over Boston last week. Back to the waiting room, waited some more, again.
Went into a "group" session with one other woman (and my husband.) We were shown a short video explaining why arbitration agreements were good for public health. Underlying message...if you don't sign the form agreeing to binding arbitration and giving up your right to sue, we won't do your surgery. Yeah, okay, I knew that already. Signed the damn form.
More waiting, still in group format.
The dietician came in, and told me exactly nothing I didn't know before. Hey, I'm an EXPERT dieter. Still, I understand why they have to do it, so that was okay.
Wait, wait, wait.
THEN came the Main Attraction. Dr. Brient came in to talk to us. And boy, can this man TALK! He likes to draw, too. He drew diagrams of the different kinds of surgery that had been done in the past to lead up to the way they do things now, both with the gastric by-pass and the gastric band (which I am opting for.) He explained the pros and cons of each kind, and the things that can go wrong. He went into detail about the relative risks of each surgery. Lots of stories, lots of anecdotes about his own training and about various patients and what happened to them. He told us about the three deaths that had occurred in his patients and exactly what happened to cause those deaths. (None had had the band surgery.)
Then he saw us individually. He went over my records, asked a lot of questions, gave me time to ask questions of my own. Seems to think it will be no problem with my insurance, though that remains to be seen.
I went home with a copy of the two-week pre-op diet, which is...protein shakes morning, noon, and night. That's to shrink my liver so it will be easier to move out of the way during surgery.
That was it. It was after four by then, and we got Ben, went home, and I went to bed. At six.
And now, we wait some more. ;^)
First Consult! on October 17, 2006 1:02 pm
October 5, 2006
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I've been busy getting together the stuff needed for my surgery consult, and I finally managed it. I have my first consult next Thursday, Oct. 12. It's supposed to be a four- or five-hour deal. I told my husband about the appointment but I forgot to tell him that he's going to need to go with me. I'm in Boston at the moment but I have to remember to tell him! Hope he can make it.
Oh, and I thought I had to have the approval before the first consult, but evidently not. I thought that was kind of weird because wouldn't the insurance companay want to know what this doctor thinks about me getting WLS? Anyway, I still have to get my bloodwork done first thing Monday so they'll have that, too. They mainly need the thyroid study.
September 16, 2006
Hey, I'm Rhonda. I'm 47 years old. I've been married to my best friend for almost 25 years now. I am 5'8" tall and I weigh 291 pounds. I am wearing 28s and 30s. I am seriously considering having WLS, probably the lap-band.
I had my psych consult yesterday, and I had to give a timeline of my weight loss struggles, so I might as well repeat it here. The first time I can remember thinking about "fat" in relation to me, I had to be about 5 or 6. A playmate (a boy, of course!) told me I had "fat arms." I was completely indignant, and I immediately ran in the house to complain to my mother. I don't remember what she said, but obviously the incident stuck in my head. I was maybe 10 when an uncle, trying to be nice, told me in front of the entire family that I was "pleasingly plump." Yes, he did.
I wasn't really heavy in high school, but you could not have convinced me of that if you'd tried. And anyway, nobody did try. There were a million small comments by my parents, all of which were well-intentioned, but all of which served to convince me of how heavy I was.
I wore mostly 14s and 16s through high school, but my best friend wore 5s and 7s. She was my measuring stick, you might say. I fell in the creek behind her house one day, and I had to borrow her mother's clothes until my mom could come and get me. More humiliation, and more evidence of my huge gross fatness.
I didn't really date until college. I was going so much and eating so little that I got down to my lowest adult weight, 158. Had a doomed relationship which sent my academics into the toilet, and left school without graduating. Just before I did, though, I met my sweetie. When we got married in 1981, I weighed about 220 and wore between a size 20 and 22. He weighed probably a bit more and wore a size 38 pants. Things have changed since then!
I've already told you how much I weigh now, and my sizes. While my weight has been anywhere from 160 to my present weight of 291 in the last 25 years, my husband's has steadily increased. He suffers from major pain in his back and feet. He has arthritis in his back and hands. He has migraines and severe sleep apnea. He wears 56 in pants, and 4x in shirts. At six feet tall, he weighs over 400 pounds, and is completely miserable. One of the hopes I have for my own surgery is that it will go so well that he will be inspired to try it as well. He's only 48 years old, and has nearly given up on everything that he once enjoyed, including working in the yard and going shopping. He always planned to buy an old car to fix up, but says now that he's "too old" for that. It breaks my heart.
Okay, this was supposed to be about me. After we got married, I put myself on a very low calorie diet; for about 7 or 8 months, I ate no more than 600-900 calories a day. It worked, and I lost 60 pounds, getting down to 160. And got pregnant. Of course, the diet went immediately out the window.
After our son was born in 1983, I had gained back a good bit of what I had lost. I was determined to get rid of the baby weight. But God had other plans. Six weeks to the day after Robbie was born, I got pregnant with Ben. (Yes, I remember the exact moment.) I had two babies in less than 12 months, we moved twice, Raymond was working 60 & 70 hours a week, we were living 4 hours away from my family and everyone I knew, and I had all I could do to take care of the babies. Robbie NEVER slept, and Ben was born jaundiced, and they both suffered ear infections like crazy. After two years, two more jobs for my hubby and two more moves, our lives consisted of work, taking care of babies, and more work. During this time, I gained back all that I had lost before I got pregnant, plus some.
I thought about trying to lose weight again, but life was so stressful that diet plans rarely got off the ground. I did make one effort that resulted in my losing maybe 15 pounds, but that came back just like before, and just like before, it brought more with it.
Our daughter was born in 1989, and with her came a happy surprise...I actually LOST about 20 lbs while I was pregnant with her. I still have not figured that one out, lol! I had no time to enjoy it, though...our oldest had major surgery to repair a skull fracture when the new baby was just three weeks old. (He was playing karate in a friend's treehouse and got "karate-chopped" right down to the ground.) By then we also knew something was wrong with our second son. Though we didn't get the right diagnosis for years, we now know that Ben is autistic. Needless to say, my worries centered on my children, and my weight problems (and my husband's) were at the bottom of the list.
I didn't forget about it completely, though. I would try the latest diet "thing" about once a year or so. It never lasted long. But in 1993, I went on a physician-supervised Optifast diet. I stuck to it for about three months or so, and lost about 40 pounds, but in the end you have to go back to eating solid food, and that was all she wrote for that plan. Soon after, I tried Weight Watchers. I lasted a while, but never really got anywhere with it.
In 1996, we moved to Florida. I again put myself on a diet, low fat this time. Again, I lost about 40 pounds, and again, the weight came right back, and more. After that, I pretty much gave up for several years. My last attempt was in 2003. This time, Raymond and I both went on the Atkins diet. We did very well, and we both lost weight. Gradually, though, the carbs came back, and with them all those awful pounds.
Just before the Atkins thing, Raymond talked to me about some coworkers of his that had had gastric bypass surgery. What did I think about it, he wanted to know. What did I think? I was horrified. I was thinking of all those horror stories about people dying or never being able to eat again. I was sure that was an option of last resort. And so I greatly discouraged it. I have apologized for that several times in the last few weeks! Maybe he would be leading a much happier, healthier life right now if I hadn't done that. I should have researched it, but instead I gave him my knee-jerk response.
And so here we are. I'm hoping that AvMed will approve me with no problems, and I'll be able to get started for myself and for my family. Robbie, our oldest son, is following in our footsteps. He's 6'3" and 375. He's only 23. He's married to a lovely girl, and she is at least 100 pounds overweight as well. Ben is 6'5" and nearly 300 lbs. My daughter is 17 and wears 20s and 22s. Her doctor just told her to lose 10 pounds and exercise more. I can't help but feel that their sizes are at least partly my fault.