KimM.

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1st PCP appointment for a 6-month supervised diet.

It went better than expected.  I have a great doctor but I didn't know how she'd react to wls.  But not only did she know my surgeon, she had good things to say about him and agreed that, while this is a major undertaking, it can be very effective if used as a tool and not a cure.

Previously, she had recommended South Beach as the diet to follow.  This time she recommended Weight Watchers.  Cons:  Meetings and program fees.  Pros:  Accountability and a better record for insurance.

Also has an EKG which was normal.  That's good news.  Blood pressure is too high and we're working on that.

I don't know how in the world I'm going to handle 6 months of this, but it's worth it to get approved and switched.  It seems like it will take forever, but it's already fall and I'm wondering where the time went from early spring through the summer.

The clock started ticking this morning.  I like that.

First call to UHC:  Your employers is not enrolled in the bariatric program.  Second call to UHC:  Your employer is not enrolled but regular insurance can cover it.  Third call to UHC:  You employer is enrolled in the program and you must register.

So I'm registered but I found out I have to undergo a physician-supervised 6 month diet.  Not jazzed about that, but it will give me more time to get healthy and put my affairs in order.  So I have to call my PCP.

I met with Dr. Overcash, who wasn't nearly as gruff as others have said, but I expect it'll show sooner or later.  He agreed to do the DS and we went over information and options.  I then met with his nurse, Madeline, who gave me the necessary paperwork and referrals.

It looks like the process is underway.  The next hurdle will be convincing my PCP that surgery - and the DS in particular - is the best option for me.  If so, it's six visits, six months of a diet and prepping for the switch.

So on my third call to UHC I was told insurance will cover the surgery.  My policy has this odd separate enrollment in a bariatric program, except that my employer opted out of it.  I was told that surgery can be covered without enrollment, but it's not the same answer I've gotten in the past.  I hope that answer doesn't change.  The major problem is that Dr. Gagner, one of the best bariatric surgeons in the country, isn't in UHC's physician network and my policy doesn't even have an out-of-network option.

How easy this would all be if insurance did the right thing and anyone who needed treatment could just get it, no strings, no appeals, no hassles.

I researched Dr. W. Todd Overcash in Ocala.  He's done fewer DS procedures and seems to lean toward RnY, but I contacted one of his DS patients who was very pleased with her experience.  I have a consult scheduled for July 25th, during which I hope to get get a much more concrete plan laid out.  Then it's approval, tests, scheduling...but first step first:  Find a good surgeon who's willing to help me change my life.

Dr. Gagner's office called me reschedule me to July 30 due to his travel.  I was disappointed but on some level putting it off relieves me of some stress.  I think I'm nervous about such a large undertaking.

On the positive front, I called UHC and was told they cover WLS.  I just need to make sure Dr. Gagner's in the network.  That's great news, as insurance seems to be at least half this battle.  But the thought that a better, more healthy life is possible makes the effort worthwhile.

I just rescheduled my consultation with Dr. Gagner from May 15 to June 20.  I'd like to do this sooner than later, but his office has not yet been credentialed by UHC and that day I have an extremely important meeting that will determine whether lay-offs at work are imminent.  Such a decision (and the subsequent insurance changes) may play a large role in this surgery.  So, another month.  Hopefully things on a couple fronts will be clearer; let's hope in my favor.

So a consultation is scheduled for May 15 with Dr. Gagner in Miami.  I'd prefer to do it via phone or email but I guess I'm lucky to be within 3 1/2 hours of a surgeon.

The biggest question is insurance.  His office is in the process of getting credentialed and while my UHC insurance says they cover WLS, there seems to be a mandatory program through which I have to go and my employer doesn't cover it.  I'll need to see if there's a way around this one.  I don't want finances to stand in the way of something that could change my life for the better, but the reality is that things cost money.

Still, I took the first step and set up an appointment.  I can't wait.

Well, I contacted Dr. Gagner in Miami Beach last week and he said his team would be in touch shortly.  This morning I received an email from Genevieve in his office introducing herself and saying she was going to forward a packet of information.

This has just started but for the first time - after months of research - it seems like a real possibility.  And that brings a certain amount of fear.  Can I go through with this?  Will I pass all the tests? If not, then what?  Will insurance come through?  Even then, what are the costs?  Who do I tell?  What do I say?  What about time off work?  Risks of surgery?

The questions flood in.  But I took the first step.  I don't know how many times I can read a post from someone who's said this procedure saved and transmformed their life before wanting to be one of those people.  So we'll see.