SunnyinSD

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I was reviewing the bariatric surgery requirements for my insurance provider, BCBS of Illinois PPO. Right now, they have really good requirements – 3 month doctor supervised weight loss within the previous 24 months.

“Wait, what?? 24 months? ****!” I did HMR for 6 months and lost 45 pounds and it was medically supervised (and it cost a small fortune), but I started it in November 2008 – so it has now been 26 months. “SERIOUSLY???! Ugh, now I have to start another weight loss plan? Alright fine, whatever.” It’s going to take 3 months just to get all of the tests done most likely. “So, maybe I’ll be able to have surgery in March. That’s not too terrible. So what are the other criteria…?”

• Over 40 BMI with no comorbidities… Check
• No psychological issues that would make me ineligible… Check (although sometime my husband would disagree)

OK I think I’m set.

“But wait, what does “pending legislation” mean? Does that mean that they will be changing their policies? Hmmm….” So I open the link to read the new legistaltion… 6 month doctor supervised weight loss plan without success… “****!!!

“Wait, so this is pending legislation, does that mean it might not take effect before I’ve submitted paperwork for approval?” Great…. The date that the new requirements go into effect is March 15, 2011. Seriously??! I have 3 months and 1 week to do everything required to make this surgery happen??? Well, if anyone can do it, I can do it!

Now I just have to schedule an appointment with Dr. Mueller AND the Nutritionist within the next few days in order to meet the insurance submission deadline of March 15th. Well, I’d better get to calling…

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So, I am now eligible to modify my insurance for the coming year. My company offers 2 insurance plans, a “low” option, which has a higher deductible and a higher out of pocket expenditure, but lower monthly payment, and a “high” plan which has a lower deductible, lower out of pocket and higher monthly fees. I’m on the low plan option right now.

Decisions, decisions. Should I switch? It’s much more expensive to switch to the high plan unless I decide to have the surgery, and then it’s cheaper. So, do I take the leap? Do I make a rash decision that I now HAVE to get surgery in 2011, or I have just “blown” the extra money? I only have 2 days to decide.

“What the hell”, I think. “I’m gonna go for it”. So, I upped my plan. I’m now on the “high” plan. I had to give myself some incentive to get the surgery now instead of waiting. I know the insurance approval process takes a Loooooong time and I don’t want to give myself an “out”. This needs to happen.

I sat through probably the most comprehensive weight loss surgery seminar EVER. It took over 2 hours to complete. I was in a large auditorium with probably 50 other people - some as heavy as me, some much thinner, some older and some younger. But all were there to better themselves or to support a loved one as they explored their options.

My chosen doctor, Dr. George Mueller, went through each type of surgical offering in more detail than I could have imagined – and more than I really needed to know. LapBand, Gastric Bypass and Sleeve Gastrectomy. Lots of options; lots of pros and cons to each. Lots of things to think about. But it was a good experience. The seminar, and Dr. Mueller’s explanation of why I was so fat in the first place, helped me to realize that this was really the only permanent alternative to being free of my weight. It made me understand that it wasn’t all something that I could have controlled – it wasn’t a total and complete lack of willpower on my part. I wasn’t some horrible, pathetic loser who couldn’t get my **** together. Well let’s be honest, I am partly a pathetic loser, but mainly my brain was acting on signals produced by my hormones. This really is a MEDICAL condition and not necessarily a psychological one. Once I was able to understand that my weight and my lack of control over my weight was really something medical – a DISEASE – it was much easier for me to come to terms with needing surgery to correct it.

Initially I was leaning toward Gastric Bypass. But the idea of not being able to take NSAIDS, and the malabsorbtion issues, made me concerned about my future. I’m only 32 and I have no idea if, when I’m 70 years old, my body’s lack of being able to properly absorb nutrients will be more of a curse than being fat for the previous 38 years. I know it is the “gold standard” for weight loss surgery, but just not for me. So I narrowed it down to 2 – LapBand or Sleeve Gastrectomy.