Dena W.
In the beginning ...
September 2006 ~~ 297 lb, BMI 54
My sister and I do almost everything together, including pursuing weight loss surgery together. You may see her name appear here from time to time. Her name is Amy Helms, and she is also in Concord, NC. We are trying to do most, if not all, of our appointments at the same time, as well. Since we are both registered nurses and work the same very small company, we will have to schedule out operations at a different time so that only one of us is off at a time ... and so that we can also take care of each other! Plus, our boss threatened to kill us if we both took time off together for major surgery. :)
9/11/06 -- I sent my letter to WellPath regarding medical necessity/request to cover WLS. They called me back saying I need to have my MD contact them with request/proof of medical necessity. Complete physical appointment scheduled on 09/14/06 and surgical consult scheduled on 09/20/06.
09/14/06 -- I had my complete physical today. Weight 294 even. MD agrees with WLS. All required labs drawn today (11 tubes of blood!). Anxiously awaiting next week's surgical consult. Begun on Topamax for migraines, which has a nice side effect of weight loss. Who knows, maybe I'll get lucky and experience that while waiting on approval for WLS!
09/15/06 -- I made my psychiatric appointment for 10/09/06. Attempting to make nutritionist appointment but keep playing phone tag with that office.
09/20/06 -- My appointment with Dr. Bauman went very well. He is very upfront and to the point. He tells you what you need to hear, not necessarily what you want to hear. He told me I need to begin on a multivitamin, Biotin to keep down the thinning hair that can come with the surgery, and a diet/exercise program preop. He said that all of that will make the surgery easier in the longrun and that any weight I lose will be a plus. So, I'm going for it. Slowly but surely. I called WellPath again yesterday and they said they don't pay out of network benefits, and he isn't on their providers list. So, I'm going with plan B. Next month is open enrollment at the hospital where my husband works. I will have him add me back to his Cigna insurance plan. The coverage won't take effect until January for me, but that is okay. Cigna requires 6 months of MD-followed diet, weight, measurements, etc., anyway. That means next March/April before I could schedule the surgery for the first time. I've waited this long, the next few months will fly by so I'm not worried by that. I still feel like I have a light at the end of the tunnel and something to look forward to!
Still waiting on my PCP to fax his information/notes/lab work I had done last week at my complete physical over to Dr. Bauman's office. He has time to do that now, at least! I also need to call and make the nutritionist appointment since I haven't been able to get in touch with that lady yet. No rush ... I have some time!
09/22/06 -- WellPath Insurance says I have a written exclusion (from employer) that does not allow for WLS. I'm going to call the guy that sells our company insurance tomorrow and see if I can get a rider or whatever added to my policy for an additional premium amount that might make it possible for WellPath to pay; if it works, fantastic...and if not, then I'm still working on the Cigna idea as an option. Either way, I still feel like I'm moving forward.
10/08/06 -- Mini update. All lab work has returned and my PTH was high, vitamin D was low. I had to have some repeat labs drawn. Not a big problem. I'm now on a vitamin D supplement. All of my results got fax'd to Dr. Bauman, except that I have now completed my upper GI series and those haven't been sent to him yet. The only "abnormal" finding was a hiatal hernia, which the radiologist said was small and that most people have them and it should not be a complication that would prevent me from getting WLS. My psych eval. is scheduled for tomorrow, and my nutritionist appointment is on Thursday this week. I did send an "appeal" letter from my doctor to WellPath because they denied the first request. We'll see what they say now. I'm supposed to have an answer from them within 15 days of the date of that letter, so somewhere in the next 2 weeks I should know something from them. I'm still planning to go with Cigna and looking forward to hopefully having surgery this coming spring! I'm just not ready to totally accept "no" from WellPath until I know I've at least exhausted the appeals process. Dr. Bauman said don't hesitate to mention that my lawyer would be in touch with them, but I don't know that I want to fight them that hard when I don't care for them in general as my primary insurance company.
Photos
 297 Pre-Surgical Consult |  |  297 Pre-Surgical Consult |
12/01/06 -- I have now completed my nutrition evaluation and psychological evaluation since my last update. Both of those went well. I have also had a few more physician office visits (for the required 6 months of physician-directed weight loss efforts). Oh, yeah ... Wellpath denied my 2nd appeal so I did have myself added back to my husband's insurance policy (Cigna), and coverage begins in January 2007. My weight was 295 at my nutritionist's evaluation and my last physician's visit, which is good because I'm told that Dr. B frowns on proceeding if you gain any weight during your preop period. Things I have tried with the physician-directed weight loss the last few months are Topamax (not a good choice for me, as it gave me uncontrollable tremors), and Metformin (also not a good choice for me, as it gave me frequent diarrhea). Instead of trying other medications, I've opted to just try to watch portion control and try to incorporate some exercise (not an easy task for a 295-lb woman!).
I'm now taking Vitamin D weekly and will have a repeat blood level drawn the end of December to see if we have successfully brought the level up any.
My sister is now working on the postop unit where my surgeon's patients go. The hospital will open a brand new postop unit on January 2, 2007. I'm told that the bariatric unit is gorgeous and very accommodating. I can't wait to be one of the patients on that new unit! And, perhaps my sister will end up being my nurse there. You never know...
