4/26/03 - I've been observing on the site for a long time. Hahahaha....I think I know exactly what to expect, and what will cure it, if I ever get the chance to have WLS surgery just from reading the great questions and answers on here!!!
Volunteerism - I volunteer alot at a local community center
Tattoo - Got 8 of them......so far
Martial Arts - Been studying Karate for over 5 years and absolutely love it
Click here to see interests of other ObesityHelp members.
Surgeon: John Dietrick M.D.
I've been battling this insurance thing for nearly 2 years. After being denied twice by my husband's ins., they finally agreed to create a benefit for WLS after I - in a round-about way - threatened them with legal action. Bad news is, they will only pay 50% up to $15,000 for WLS. I have had consults with BTC and WISH Center and am to understand that WLS surgery will cost around $40,000. Hahaha...I don't exactly have $25,000 on hand to pay the balance.
Since my last consult (with WISH Center) I've started a new job that I have my own insurance through. I'm still waiting to hear whether they will pay or not. The WISH Center costed me $800 out of pocket for just the initial consult not including lab work so I am a little leary of having to pay that out of pocket again....since it's been over 6 months since my consult, I would have to go back as a new patient and do the whole 4 hour consult over again and still not know whether my insurance will cover WLS or not.
I know that all this trouble will be/is worth it to finally get control of my weight, but it's so darn exhausting when you're taking 1 step forward and 2 steps back all the time.
Sometimes the whole process seems overwhelming and hopeless, then sometimes I get a burst of enthusiasm. Does anyone else ever get like that?
I'll try to keep posting with any news (hopefully soon to have weight loss markers).
I really love this site...the before and after pics are awesome and inspiring.
Ok, I have an appointment to go back to the WISH Center on 5/19. I'm starting to get enthused about this again...a little. I'm really hoping that this will not be a long drawn out battle with insurance again...I don't know if I could do that again.
Wish me luck...
Had consultation with Dr. Dietrick at WISH Center yesterday. VERY long day. Had all bloodwork done, urinalysis, ultrasound of liver and gall bladder, psych consult, consult with dietician, consult with sports physiologist and then finally got to see the Dr. He was a very nice person and easy to talk to. Apparently the initial consult ALWAYS consists of those labs. Plus, I have to go and get a chest x-ray. They also gave me a list of "goals" to meet before surgery.
All in all, the consult went pretty good. I have to go on a "practice" diet for the next 8 weeks, increase my exercising to at least 30-45 minutes per day, 6 days a week, and start taking the vitamins. On top of all that, I have to keep a log of my eating and exercising for the entire 8 weeks. When I go back in July, I have to bring in my log and show them that I've met my goals. If you don't meet them, they won't schedule surgery for you. I was kind of bummed, but on the other hand, they assured me that the patients that had met their goals had a very easy recovery after surgery, and the new way of eating was not a shock to them as they were recovering. Good point.
They certainly don't expect you to lose a bunch of weight by doing the practice diet....heck, if anyone could be successful at that, why have the surgery, right?
Anyhoo, it's a matter of insurance coverage now. Crossing my fingers there.
So, I go back on July 9th (which I have to bring a $2000 deposit) and if all goes well, I can schedule surgery 2 weeks after that. I really am hoping to have the surgery while my boys are still on summer vacation so they can help out around the house while I'm laid up.
(Crossing my fingers AND hoping to win a lottery...hahaha)
Ok, this practice diet thingy is harder than I thought. During the week it went very well...then the weekend came. I'm having a really hard time sticking to the practice diet. I find myself picking on things randomly and it's more difficult to focus on stretching out my meals, slowing down, and drinking enough water. I think because my work environment is so structured, it is alot easier for me to follow the practice diet on weekdays.
Family gatherings are not so fun, either. In my family, these usually become an eating-fest. I think I did pretty well, though. I tried to eat only the healthiest foods put out, like the fresh fruit and veg and plain burgers.
I still haven't started the vitamin regimen yet. I haven't been grocery shopping in about 2-3 weeks. Maybe I can hit the store tomorrow evening.
Tonight I will be updating my diet/exercise log (haven't made an entry since Thursday). Exercise is going ok...hubby said he will exercise with me, and today we went walking.
Trying to keep up the momentum....
Oh my gosh! I got a letter from my primary insurance company today stating that I have been approved for WLS. I could hardly believe it!!! They even sent payment for all the lab work I had done at WISH Center....granted, they will only pay 60% because WISH Center is out of network, but my secondary insurance will pay up to $15,000, so I'm really hoping that this will work out so I end up owing nearly nothing!! My 2 1/2 year insurance struggle is over!! :D
I'm on week 3 of the WISH program. It's actually going really well. I've given up all sweets and carbonated/sugary drinks. I don't eat junk food (well, ok, a couple of potato chips now and then). I read labels at the store to find high protein foods and since I found Fiji water, I've been drinking water like a fish. I don't know what it is about the Fiji water, I bought it one day because it comes in a square bottle and has pretty flowers on it (yeah, I know...pretty dorky, huh? LOL) but it tastes like well water. I couldn't stand drinking other bottled water because it's TOO purified. This Fiji water comes from an artesian spring in the Fiji Islands. Ok, enough with the commercial...hahaha
I eat 6 small meals a day, I take my vitamins faithfully and I even got a stationary bike which I've started riding regularly. Pretty good, huh?
The only thing that baffles me is, if I've been doing so good on this diet/exercise regimen, how come I'm not losing weight this way???? I mean, I have lost a few pounds, but not like one would think. But, I guess that's why people like me need WLS to lose weight...even when we know we are doing the right things, it still isn't enough.
If all goes as planned, I may be scheduling surgery at the end of July.
Cross your fingers....
Who says Friday the 13th is bad luck??? I got a call from WISH Center today stating that they received the approval letter from my insurance and they wanted to schedule a surgery date. Wednesday, July 30th is my surgery date!!! :)
Got to have a few more pre-op tests done by my PCP, but those are scheduled and under way. She is soooo supportive, I'm really glad I found her. She wants to see me again right after I have the surgery. She says that she thinks this is a good decision for me. I agree.
Still haven't told my family yet, or my boss or co-workers for that matter. I don't plan on telling them, either. I feel that this is a very private thing for me, and I don't want to have to explain, or justify my decision to anyone else. My husband, mother, father, aunt, grandma, and one close friend knows, and I'm hoping to keep it that way.
Well, I'm still doing good sticking with the dieting and exercising. I'm getting bummed, though, because I feel that I should be losing some weight by sticking with it and I'm not. If this regimen is not helping me lose weight now, will it really help me after surgery???
Also, hubby got laid off from work so the $2000.00 deposit I have to bring on my next visit is going to be MUCH more difficult than I thought. I'm still working full time/overtime, but our bills are still coming in. I'm not sure if they will postpone surgery until I pay the deposit or what will happen.
I've been reading the Q&A on here alot, too. Does anybody ever NOT experience problems with their surgery? That's getting me kind of worried.
Pre-op jitters, I think.
Diet and exercise regimen is going great...still not losing weight, but am noticing more definition in parts.
Pre-op visit is on July 9th (when I am supposed to pay the $2000.00 deposit) and getting closer. I don't know what I am going to do about the deposit money. We are depleting our savings that I had intended to use on just paying monthly bills since hubby is still laid off.
I'm going to have to call WISH Center and ask them what do I do now.
Went back to WISH Center on the 9th. Everything went great. I found out from them beforehand that I could pay only half of the deposit, so that was a great relief.
Surgery is set to go. I met all my pre-surgical goals, and even lost a bit of weight.
I only have to let my boss know that I'm taking a medical leave and everything will be set. One thing that I'm not sure about is whether I can take all of my time off as a medical leave under FMLA, or will they make me use up my remaining sick time and vacation time. I'll have to check into that.
I actually am getting kind of nervous about the surgery. The nurse at WISH Center told me that the hospital would help me do a living will and a power of attorney. This scared me a bit. Not that I didn't know about the risks, but this just kind of hit me like a brick.
What do I do? Should I be getting all of my affairs in order? Do I tie up loose ends at work? Write goodbye letters to my family and friends? Or do I just sit back, relax, and have faith that all will go well?
Well, 19 days and counting.
5 more days to go. Strangely, I am not nervous or excited....truthfully, I don't really feel anything. Seems pretty bizarre to me to not feel anything this close. I do have this immense urge to get my house completely clean. We rented a dumpster and cleaned out the attic and the basement this past week. I've gotten rid of so much accumulated junk. It's amazing how much junk you can collect over the years.
What's really weird is that I still can't imagine myself having this surgery, or anything afterward. I am prepared for it, though...got all my meds and post-op foods/liquids and all.
Anyway, I joined a health club this week while I was on vacation from work. I have been going at 5:30am every day and working out for 1 - 2 hours each day, making sure I get a solid 35 continuous minutes of cardio first off. It's been nice because I have a couple of friends that I go with in the morning and we kind of keep each other motivated. I have been riding a stationary bike every day (well, almost every day) for a couple of months now, but actually getting out of the house and having to be somewhere to meet someone is great motivation.
Oh, another thing happened this week that kind of cheezed me off. I got a call from Mercy Provena Hospital to sort of pre-register me and give me pre-op instructions. Upon talking to the nurse, she informed me that my surgery is scheduled for 11:00am and that I should be at the hospital by 7:30am. I told her that she must be mistaken, because I am scheduled for surgery at 7:00 and was instructed to be at the hospital by 5:30am...that I am the first surgery of the day on that day. The nurse told me to call the WISH Center to straighten this out, so I did. WISH Center told me that I was bumped back to 11:00 because they scheduled someone else who is either having the lap procedure, or is allergic to latex and needs a pressurized room in the early am. I'm kind of upset about that because 1)now I have to fight the rush hour traffic to get to the hospital in the morning, 2)once I get to the hospital, I have to sit and think about the surgery all morning before I go to the OR, and 3)I know the Dr. does this surgery all the time, but I was happy in knowing that since I was the first one, the Dr. would be refreshed and energized...now I'm thinking that he's going to be tired from already performing a 3 hour surgery before mine. Probably sounds weird, but I compare it to getting tattooed...if the tattoo artist has been doing a tattoo for 3 hours straight on someone else, you can bet his hands are tired and his eyes are strained by the time he gets to you. I don't know, maybe my perspective is out of whack on this one.
Ok, I am officially post-op now. Actually, I'm still in the hospital. Very cool, they have a public access computer to use when you're up and about. This is an awesome hospital...the staff is wonderful.
Having some pain...still using the morphine pump, but hey, that's what it's there for, huh? Dr. says I may get to go home tomorrow. That would be nice.
Will update with more details later, when I can sit in the comfort of my own computer chair.
Thanks to everyone for their words of support.
5 days post-op. Not feeling TOO horribly bad, still a bit of pain, however. Moving is still a task. Feeling better than 5 days ago, though.
Found out today that I have thrush...yukky yeast infection of mouth. Actually didn't know what it was, just a white coating on my tongue, until the nurse from the WISH Center called to check up on me. She asked me if my tongue was coated and I said yup. She then told me that she would be calling in a prescription for some swish and swallow stuff and that I should go buy some Kefir to drink.
Got the nasty swish and swallow, but hubby couldn't find Kefir in any store in town. Think I'll try the health food store tomorrow.
Anyhoo, I go to get my staples - all 27 of them - out on the 15th. Can't wait, either, because by then I'll be done with the heparin shots..which don't really hurt, but just are bothersome..and maybe by then I'll be able to sleep on my sides or tummy.
Speaking of heparin shots, gotta go get one.
Hi all, been quite a while since updating. Well, 2.5 months out and down 57.5 pounds. Not too shabby, eh? Everyone keeps telling me how great I look, but I really can't see it. I still haven't told everyone at work, either, only 2 girls that I know will keep it to themselves.
Been exercising nearly everyday. Monday is fitness center day, Tuesday is Karate class day, Wednesday is fitness center and Karate class day, Thursday is Karate class day, Friday is fitness center day, Saturday is Karate class day, and Sunday is Karate class day. I do skip some days at the fitness center, but that's only because I usually go at 5:00am and sometimes it's just plain hard to get up at 4:30. This week I haven't gone there at all. I've been having pain in my left hip, more like in the ligaments at the top of my thigh. I think I pulled something doing the hip aductor machines at the fitness center...hahaha....trying to get rid of the big hips and floppy inner thighs.
Eating is sometimes tricky. I am so used to just popping dinners in the microwave that sometimes I am just too exhausted to do real cooking for myself. At those times, I usually have some cheese or lunchmeat for a meal. So far, I haven't dumped on anything yet (knock on wood), but I have also completely given up sugar, bread, and white flour. I only really miss bread the most. It's kinda funny, I was looking at a food catalog and everything I wanted was a bread item. Now looking back, I think almost every meal I used to eat had some sort of bread item in it. Sandwiches, dinner rolls, buttered toast, bread sticks. Probably a major contributor to my weight problem, ya think???? LOL
Back to eating....I try to measure my food to 1/2 cup, but I do find at times that I'm guilty of just guesstimating my portions. I still eat too fast, sometimes, too. I have to work on slowing down.
Let's talk vitamins.....or not. I have to admit, I've only taken my vitamins 4 or 5 times since surgery. The Flintstone Chewables can be a little much at times, but the thing I have a problem with is the TIMING of the vitamins. I'm supposed to do the multi-vitamin and the B-complex in the morning, the calcium citrate in the afternoon and in the evening. Calcium citrate wafers are HUGE....like eating a mega-sized Tums. Ikky. I am going to start taking them regularly, though...especially since I've noticed my hair starting to fall out (or maybe it's just a paranoid delusion since I've been worrying about it).
As far as how I feel overall...I feel great. I feel back to normal after having a major surgery. I can see that my stomach is shrinking and lifting a bit, so hopefully I won't need plastic surgery. I just wish my thighs and batwings would start shrinking more....LOL.
Lets talk money. Well, BCBS of IL dropped a bombshell on me. I found out after the surgery that they will only pay 60% for out of network...which I anticipated. What I didn't anticipate is that they will only pay 60% for what is allowed for in-network. My surgeon's fee is around $8,000, BCBS will only pay 60% of $2,400, because that is what the standard charge for in-network is. They will only pay $400 toward the $1500 assistant surgeon, and 60% of all my office visits and lab work. My hospital bill was $22,000. BCBS negotiated it down to around $6700 and will pay 90% of that. How on earth can they NOT pay my surgeon's fees when they just saved $15,000 on the hospital bill???? Secondary insurance dropped another bomb on me. After fighting with them for 2 years just to get them to cover 50% up to $15,000, they inform me that none of my office visits or lab work will be covered, that they will ONLY pay for the surgery and nothing else.
I am supposed to go back to WISH Center this month for my 3 month check up, but I'm thinking that I'm not going to go because, another surprise to me, every time I go, they add more charges on for office visits. I was under the impression that the 2 week, 3 month, and 1 year checkups were included in the cost of the program. Nope. Soooo, I owe WISH Center approximately $10,000 as of right now. I have no idea what secondary insurance has paid, if any. Looks like I'll be on the long term payment plan.
Advice for pre-ops....get all of the insurance details worked out before surgery.
Well, will update later. Hopefully with more weight loss.
Wow....been a long time since my last update!! Geez, life has been so busy for me in the last 3 months it's unbelievable.
So, I'm down about 98 pounds as of 1/7/04 since July 30th. I'm really happy about that. I still haven't dumped on anything, and unfortunately am able to eat cookies. I had a couple over the holidays, but have vowed to give them up completely. We had a death in the family which really stressed me out and headed me toward junk for comfort. Luckily, I recognized what was happening and put a stop to it.
I haven't been exercising as much as I'd like, either. I still do Karate class on Tuesday, Wednesday, Thursday, Saturday, and Sunday, but I'd like to get back to the gym. 4:30am is such a hard time of day to face....lol. I have noticed that my form and ability is greatly improving in Karate, though.
This past week has been weird for me. I can't even count the number of people that have commented on my weight loss this week. It's like people have just opened their eyes....or, it could be the fact that I was forced to go buy new clothes that fit, because all my old ones are starting to fall off of me. I have to admit that shopping is thrilling now because I can buy most items from Wal-mart and pay only $12.00 for a shirt instead of $35.00 at Lane Bryant or Catherine's. I do still have to buy pants from Lane Bryant because my hips and lower stomach are larger than the rest of me and their pants fit nicer.
Still debating with insurance companies at this point. Here's a big kicker. WISH Center is now IN network for BCBS of IL. I asked BCBS if they could resubmit my claims now that WISH is in network, but I haven't heard back from them.
I'm going to Hawaii next month! I've started tanning at the tan salon so I don't become a painful lobster for the entire trip, hahaha. I plan on hiking Diamond Head, if that's possible. I can't wait; I need a break from my job.
Hubby keeps telling me how beautiful I look. He's so sweet, he'll say "Not that you weren't beautiful before, but now you are even more beautiful". I love him to death. He really has stuck by me through thick and thin (well, getting thin). I can never figure out what I did to deserve this man.
I'll try to update more, especially if I hit my 100# marker.
BCBS of IL
Surprisingly easier than I thought. This is my primary ins through my job. Approved after first letter sent. When my husband's ins was my primary, I had a 2 year insurance battle with them to finally get them to agree to pay 50% up to $15,000 (a self-funded plan).