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I was a normal weight child and really didn't let my weight get out of control until I was about 30 years old. Over the years I would lose 10 pounds and gain 20. Do this enough and you can have a real problem.
I was convinced in 2007, by my primary care physician, to seriously consider Lap Band or Gastric Bypass surgery. He told me that most of my health issues (HTN, hypercholesterolemia, joint pain, breast cancer hx, GERD, cardiac risks) and health risks would be greatly decreased or eliminated via this surgery. I agreed that refusing to acknowledge my weight problem is decreasing my life span. So, in light of this, I went to a EJC Hospital WLS seminar detailing the benefits of the surgery and comparing the differences between LAPB and Roux-en-y procedures.
After the seminar, Cindy, Dr. Hart's surgical coordinator, reviewed my data and told me I would need 6 months of physician supervised and documented weight loss efforts. I began to visit Dr. K's office on a near monthly basis for documenting my weight and labs, etc. I struggled to do this with his busy scheduel and the demands of my job as a Marketing Director, with my management team in Nashville and me in Atlanta. I was making monthly trips to Nashville, juggling deadlines, completing masses of monthly reports and more. Meanwhile, I had lost 50 pounds on Weight Watchers and was doing OK with maintaining it, even if I wasn't continuing to lose the excess weight that I needed to.
After about 5 months of this, I started to think, "If I just cut my food and exercise regularly, I don't need the surgery." As a result, I put the surgery on hold and continued with Weight Watchers meetings and maintaining the 50+ pound weight loss for 1.5 years. Then, slowly but surely, the weight began to creep back.
In June 2009, I was fired from the hospital where I had worked for over 20 years without warning. My life was in an upheaval like I'd never experienced. I decided that being out of work would be THE time to get the surgery process started again. However, I had changed insurers from Humana to BC/BS in 2009. When I called to verify benefits, I was told that bariatric procedures were not covered under any cirstances. This resulted in the surgery needing to be delayed again until Jan. 2010, when I could have the opportunity to revert back to Humana.
When I decided to get started again, one consideration was starting a new job in December 2009. I felt I needed to wit a bit of time before leaving a brand new job to have surgery. The end of February, I visited Dr. Chris Hart and told him I'd completed 2 bariatric seminars and was ready for Roux-en-Y. He scheduled me a visit with the dietitian and asked for documentation from my primary care physician (Dr. X).
Cindy, the surgical coordinator, from the very first meeting, was pleasant and friendly but demonstrated a real lack of organizational skills. She lost the first set of notes from the primary care doc and then when she found them, said they were incomplete and would not result in approval for surgery.
I made an appointment with Dr. X and asked him to amend the notes to include my daily swimming and to document my inability to walk due to a torn meniscus. He was aggravated and said, "I've submitted notes just like these for other patients and they were approved for surgery!" I really worried that he would not amend these to Cindy's satisfaction. He encouraged me to change surgeons, not due to lack of skill on Dr. Hart's part, but due to the disorganization and attitude of his office staff. He told me they'd previously lost/misplaced notes and test results from his other referrals, and he didn't want to work with them (Cindy).
I fretted over this for a day or so, then sought my friend's advice. I decided to call the EJC Hospital Bariatric Coordinator for advice. When I explained the situation, I asked about the possibility of changing surgeons. She advised me to be patient and said she'd talk with Cindy. I begged her to be careful and to not aggravate the situation further.
When the Coordinator called back, it was obvious she was swayed by Cindy's explanation/excuses. She told me that all insurers require specific information and that Cindy's requirement of a "template" was understandable. She assured me this was all to ensure my approval from the insurer. I saw there was no further need to discuss this with her.
Cindy called me later that evening to attempt to smooth over the situation. She sounded hurt or offended, but I stood firm and told her that I had no intent of changing my primary care physician. I also told her I'd been working on this process for over 2 years and I did NOT plan to start over. I couldn't wait that long, just because of a power struggle over this issue. I advised her to work with my doctor and to help him do what was needed to get my process approved.
I was also advised by the EJC Hosp Coordinator that changing surgeons would surely result in additional out-of -pocket expense for me. I decided to stay the course and to do my best to work with Dr. Hart's staff. Cindy told me that I needed a psych consult to see if I was an acceptable candidate for the surgery. They recommend Dr. Rick Van Haveren. Though I had problems with the office staff, I decided to take their advise, rather than go off on my own choice and later regret it.
I really liked Dr. VH, who administered a series of 4 tests, with almost 500 questions. The content of the questions was basically: Do you use drugs? Do you abuse alcohol? Do you hear voices? Do they tell you what to do? Are you suicidal?
If I had these issues, being fat would pale in comparison!
I passed the psych eval and Dr VH called to inform me and to advise that I really needed to work on finding a new coping mechanism, since food was my primary answer to being sad, glad, mad, happy, lonely, nervous, bored, anxious or tired!
After I received the call from Cindy that she had the correct documentation from my PC, Dr X, I started counting the days. She'd told me it could take from 2 weeks to 6 weeks for approval. When 2 weeks passed, I called Humana for the status. The insurer's bariatric pre-cert coordinator told me that they'd not received any documentation from Dr. Hart's office regarding me or my desired surgery. Needless to say, I was very upset.
I called Cindy and told her what Humana had said. She got huffy and told me that she had a confirmation that she'd faxed the info to them and they were wrong. I insisted that despite her confirmation, she needed to RE-FAX the info and to get the data in their hands! In about 30 minutes, Cindy called me back and asked, "What insurance company do you have?"
I almost lost it!
I thought it was a trick question.
For Pete's sake, I filled out paperwork in triplicate and we'd gone round and round over all of this. However, I played nice and told her, "I have Humana". She was silent for about 15 seconds.
Then she said, "Well, the paperwork was sent to BC/BS."
I thought to myself, "Why am I not surprised?"
This was a Friday. By the following Tuesday, I got a call from Cindy telling me Humana had approved my surgery and I was scheduled in 3 short weeks. These long delays and aggravation would have been avoided if Dr. Hart's staff were more organized and gave each patient the priority and attention each deserves. I wouldn't recommend this surgeon due to the surgical coordinator's inefficiencies and errors. (I have seen other reviews of this office on the OH site that mirror my own problems with the process.) I started this process for the last time late February/early March and had surgery on May 12th.
I had four weeks of nausea and exhaustion. All of a sudden, it was like someone flipped a switch and the nausea ceased and my energy returned. I am trying to do exactly what has been prescribed in the way of eating certain foods, avoiding empty carbs and taking supplements. My only other problem was extreme constipation with impaction. I went to my primary care and a gastroenterologist , both of whom prescribed a daily non-stimulating laxative. This is working beautifully and I am told it is NOT "addictive". (With some stimulant laxatives, the bowel becomes lazy and will cease to have proper peristalsis without the laxatives.) I don't want this!
If you are considering RNY or any WLS, do your homework. Consider the impact of staying obese. Weigh the costs of having the surgery. Each of us is different and our symptoms are too. Not everyone has nausea, vomiting, constipation, pain, food intolerances, dumping, etc. All in all, the results are lifesaving and life changing. In my mind, the WLS is worth every cent and every complaint or discomfort.