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I had my annual physical in April with my PCP. She ordered blood work and since my last bone density scan was in 2007 she wanted me to have another. Bone density is an important test for post-bariatric surgery patients, since our bodies don’t absorb nutrients properly. We are told to take calcium daily, but even then it’s possible that our bodies won’t get enough, especially for female patients. Well, it turns out my Vitamin D was very low. Our bodies need Vitamin D for many reasons, one of which is to help absorb Calcium. So I’m on a high dose Vitamin D supplement and I scheduled my bone density test.

On Friday I went for the test. It was the same hospital where I had the last one done, it’s also the same hospital that has those nice oversized chairs in the waiting room. Well that seems to be where the obese patient friendly environment ends. The woman calls my name for the test, sees me, and then immediately looks at my paperwork. When I get to the hallway she politely asked if I’ve had the test before. I replied “yes, I had it here 3 years ago”. She then tells me that she can’t do the test because the equipment only holds up to 300lbs. I’m currently 380ish. She said they had moved the previous piece of equipment which I was probably scanned with last time; it had a higher weight capacity. I told her I’d be willing to go where ever the other equipment was, but that I did weigh less the last time the test was done. She went to contact the other facility while I waited. She came back with bad news, the other equipment only held up to 350lbs, so I was still too fat.

She then asked me if I had been told I had osteoporosis. I replied, “no, but my PCP wants to monitor me since I’ve bariatric surgery, in addition I’m taking Depo Provera which can cause osteoporosis”. She then told me “don’t worry; you’ll be fine…the fat actually protects your bone, you don’t need this test.” However, she was nice enough to give the name of the machine and told me I could call GE and ask where a higher weight capacity machine was located in my area. I told her I was very involved with an online obesity support website and that I would definitely get the information, if not for me, but for others. 

If obesity is one of leading health issues in the United States why isn’t more being done to help obese patients? How can we try to improve our health when not only medical devices, but workout machines can’t even hold us?

From Born2lbFat:



I accompanied a friend to his CT scan this afternoon. I’ve been to this hospital many times, they have recently remodeled the radiology waiting rooms and it was a nice surprise to notice they had a few oversized chairs to accommodate larger patients.

It was annoying and even comical to see two normal sized people approach it as if it was a two seater. One very slim couple successfully sat together. Another set of normal sized adult sisters tried their best to sit together, if I didn’t have manners I would have taken a picture of them squeezed (one half on, half off) in the chair. Eventually, one moved to the next chair. Perhaps the chair should have a fatty label on it.

“Your ass must be at least this wide --------- in order to sit here”

Thankfully, my ass fit comfortably in the regular chair. But it’s nice to know hospitals are thinking.

Posted on Born2lbFat.

Last night I attended my first WLS Support Group meeting since 2006. I am seeing a new surgeon, my third since surgery, and he wanted me to attend his meetings to see if might help me. He had inquired about my support group attendance post-op during my initial appointment. I explained that the hospital where I had my WLS was two hours from where I lived at the time, and so I was only able to attend a couple meetings. I typically either had class, was in the hospital, or recovering from a hospitalization during that first year post-op.

Then I moved to Miami.

After finally getting the recommended surgeon to take me as a patient I was REQUIRED to attend a certain amount of “support meetings”. The requirement and lack of meeting structure lead to a room of new post-ops wanting to get their attendance paper signed and leave. There were no topics, no speakers…just a group of people and a psychologist asking “anyone having issues they would like to discuss?

Either no one would reply, or the same question would be asked every month…by someone new “am I losing enough weight?”

To someone in my situation, the meetings were not worth the time. I got my support online at ObesityHelp.com. And honestly I did. Even when I attended the two meetings at my original hospital I felt out of place. First, I was usually the only one in attendance that had my surgeon, and second I was the only one who had such a large amount of weight to lose…this correlated with the surgeon issue since my surgeon typically operated on the “high risk” patients. And most people weighing over 500 pre-op have mobility issues, or in general don’t get “out and about” as often as I did. I’m not sure that is the exact reason, but from 3 different surgeon's support meetings at 2 different hospitals I have yet to find people who are in a situation similar to mine…even without the lymphedema and lipedema.

So back to last night…

My first issue was that the meeting was held in the same hospital where I admitted for my DVT, I have not set foot in that hospital since then. The parking garage to hospital entrance is a bit weird, and as I was following the path I had flashbacks to being in pain and near tears trying to “find the hospital” 6 years ago.

While waiting in line at the security desk I played “are they here for the meeting too?” I get my visitor sticker and head to the conference room. But first I stop and get a bottle of Diet Sunkist at the snack bar. It was the BBGC in me…and I was thirsty.

So I get to the conference room and sign-in. The group leader, the surgeon’s nutritionist, was getting out his recent delivery of calcium chews. I say “oh, I have those at home they are good. But I haven’t tried the raspberry.” He was very nice, and I was impressed that there were samples at the meeting. There was also FOOD. Cheese and fruit platter for the win. I had run an errand before the meeting and while I had eating a protein bar before leaving my house, a few hours had passed since.

I sit next to another lady and ask her when she had surgery. “5 weeks ago”

Oh no…here we go….or so I thought. To my surprise there were 2 other patients there who were 7 years post-op, like ME. Unlike me, both appeared to be at goal.

The topic for the evening was “how to read food labels”. I was the star pupil by knowing that serving size the most important piece of information on the label. Next he passed out samples of the calcium, raspberry is pretty tasty! Then he opened the floor to general discussion “anyone having issues?”

A new post-op is having issues tolerating food and wonders if she is losing weight fast enough.

I raise my hand, and say I’m having the opposite issue. I can tolerate everything and that after my initial 250lbs loss, I’ve started to regain. I also let the nutritionist know I had an appointment to see him next month.

I forget his response to my issue, I think because he was interrupted the male 7-year post-op patient who said. “You know what I’ve noticed is there a correlation between members who regain and members who don’t attend support group meetings.”

I guess it’s better than him calling me out for my Diet Sunkist.

Trying to not sound defensive, I said “I’ve noticed that many people in my situation are often too embarrassed to seek help from their surgeon or a support group.”

Then the nutritionist said, “O.k. are you all ready to go next door?”

Next door? Huh? Oh, the post-ops go over the pre-op seminar and answer questions. Nice.

Honestly, I didn’t mean to not go, I stopped to ask the nutritionist what he would like for me to bring to my appointment then once I got next door, I saw all the other post-ops on stage, announcing how long it had been since their surgery and how much they had lost. OMG I was definitely NOT going on stage, especially since I weighed MORE than many of the pre-op patients. And, of course, I had not had surgery with that doctor so I really shouldn’t appear to be one of his products.

So as I listened to everyone’s stats…the average amount lost was 130lbs. That’s how much I’ve lost, even with the regain; I’m still down 130lb from my highest….at 7 years out.
 

It's Ri-frickin-diculous that I have to go through this crap every year to get a product that actually SAVES my insurance company money. I found out yesterday they still have not paid for the garments I got in March 2009. Now it's time for me to get a new pair and I can't until this mess from last year is cleared up.

The entire story and your lesson on Network Gap coverage is on my HealthInsuranceBitch blog.

I receieved an e-mail this week from the National Lymphedema Network annoucing that legistlation regarding Lymphdema treatment had been introduced in Congress. As I read the e-mail I began to cry, because finally my struggle was being addressed. There were others out there who understood, and better yet there were people in a position of power who were willing to make change happen. 

I immediately posted my personal story on my blog, and contacted my representive's office to get the word out.

Check out my blog Born2lbFat for more information on: H.R. 4662: Lymphedema Diagnosis and Treatment Cost Saving Act of 2010

I was diagnosed with bilateral lower extremity lymphedema in December 2001. From 2002-2004, I received manual lymph therapy and compression wrapping to reduce the swelling of my legs. During this same time I was hospitalized approximately 8 times for cellulitis, had a medi-port placed for IV antibiotics, and had weeks of home health care three different times. The cost of this care was hundreds of thousands of dollars. During most of this time I was covered by Ohio Medicaid. However, my last major infection in September 2004, which was accompanied with a deep vein thrombosis and required two weeks in the hospital, was covered by United Healthcare, which I had through my new employer.

In October 2004, I began three months of manual lymph therapy and compression wrapping. I was limited to 20 sessions of occupational therapy during my plan year. However, January 1st a new year began and I would have a new set of 20 sessions. There was a two week gap. Compression wrapping requires continued wrapping to avoid any set-backs and flare ups. Two weeks without being wrapped would undo the previous 2 1/2 months of progress. And yet, the insurance company refused to authorize the additional visits for the plan year.

After I recovered from the set back from the gap in care, I reached a point where custom fitted compression garments were ordered. Once the compression therapy reduced the size of my legs as much as possible, the compression garments would help maintain the size of my legs by reducing the daily swelling. Because of the odd shape of my legs, the garments had to be custom fitted, so the correct level of compression was provided. The average cost of a full pair of garments is $1000. Typically, garments need replaced every 6 months.

Now compared to the hundreds of thousands of dollars I previously racked up in medical bills, one would think $2000 is a much better deal. Especially given that I would have some responsibility to pay a portion of the $2000 through my co-pay or deductible for Durable Medical Equipment under my insurance plan. In the business sense, garments are a much better option than numerous hospital stays and costly medication for cellulitis.

And yet, every year I have to fight my insurance company to get my compression garments covered. Last March, I received prior authorization for my compression garments, even despite the authorization, my insurance company denied the payment to the provider. This was the first time the provider accepted direct authorization from my insurance, typically they ask that I pay in advance and file the claim for reimbursement myself. Now, a year later, the provider has still not been paid. I have recontacted my insurance company and they supposedly corrected the claim and are proccessing payment, but it has been weeks and no payment has been made. Every year for the rest of my life I am going to have to deal with this unless something is done.

This bill is very much needed. It's a shame it will take an act of Congress to make the industry understand that prevention of complications is less expensive than treating the complication. I know as a patient, no matter how uncomfortable compression garments are to wear some days, I'd much rather wear my garments than to suffer a case of painful cellultis.

From the NLN e-mail:

"I encourage you to contact your local Representatives and Senators. Urge them to co-sponsor H.R. 4662 and to introduce a similar bill in the Senate. Stress the fact that this bill is projected to save hundreds of millions of dollars every year in avoidance of costs of treating preventable lymphedema-related cellulitis. This is a quality of care issue affecting insured patients and is complementary to healthcare access issues. Time is of the essence for you who have had difficulty in obtaining proper treatment for your LE. We may never have a better opportunity!

You may find your Congressional representatives by going to http://www.contactingthecongress.org and entering your address."

 

A homemade chocolate, caramel, coffee protein shake tastes just as good if not better than an Iced Latte from Starbucks.

Carrots and dip satisfy my desire for "something" crunchy.

My sweet tooth loves strawberries w/ a squirt of Redi-whip or some cottage cheese and pineapple.

And last but not least.....I've done it before, I can do it AGAIN!!!!

We all know there is a risk involved with WLS. We all know people die. We've been touched by Jessica O, and many other member passings. However, this week's loss of Vickie J. has hit a little too close for home for me. It's made it all real. There are many people that I "know" on the boards, however there is an additional group of people who I know on the boards and have the pleasure of knowing in real life. Vickie and I met at the OH Orlando event in 2005. It was my first OH event and it was so nice to meet so many OH members in person. I also had the pleasure of meeting Charlie and Terri...and so many other great members whom I still keep in contact. Vickie chose to have plastic surgery in South Florida and while she was here I would visit her and her husband. We talked about her surgeries, her sons, her Christmas cookie party....we were friends. When I think about it, she is the first people I have "really" known who has died after WLS. It makes the possibilities so real, despite how much "we know"....I can't wrap my head around why this happened. Please say a prayer for Vickie's family....

Life is often like an amusement park ride. It can be fun when life is full of ups and downs like a rollercoaster. I mean the downs can be upsetting but make the ups so much enjoyable. On the other hand this friggin' merry-go-round I feel like I'm on is NOT fun. 

Here we go again, I find myself in this never ending fight with BCBS...not  just about PS...this time it's for lymphedema garments. It's so frustrating to deal with a rare condition that even some doctors don't have a clue about and to have to constantly explain your needs, etc to people who could careless about you and are only concerned with their money...and who when they screw up nothing is done...but whoa if I were to be late with paperwork or money my coverage would be yanked so fast I would have whiplash....but they can drag their feet and process claims incorrectly and disregard their OWN set timelines....with no repercusions.

Then I am trying to get my next phase of PS scheduled. So again I must balance the surgeon's schedules...this time 2 of them, with my schedule and my mom's schedule...since I am single and can't depend on friends in the area to meet my post-op needs. I would LOVE to move on with other areas in my life...but I seem stuck on this damn merry-go-round reliving crap over and over again. But have no fear, I'm making plans to jump off....and I'm trying to be careful as to not injure myself doing so.

Quoted from "Dirty Dancing", said by Baby after she found out that Johnny would still be fired despite him not stealing the wallet. This line played in my head today, very emotional and stressful day for me...and I felt the insurance fight was for nothing!!!

For anyone not familiar here is the scene...lol...yeah sorry if I didn't have my sense of humor I wouldn't have anything now would I?

J: They found the Schumachers.

Fingerprinted their water glasses.

Found out they were wanted
in Arizona and in Florida...

and they made a fortune
here this summer.


B: So then it's all right.
I knew it would work out.
- I knew they'd have to apologize.

J:- I'm out, Baby.

B: They fired you anyway
because of me.

J: And if I leave quietly,
I'll get my summer bonus.

B: So I did it for nothing.
I hurt my family, you lost your job
anyway-- I did it for nothing!

J: No, not for nothing
Nobody has ever done anything
like that for me before.

B: You were right. You can't win
no matter what you do.

J: Listen to me. I don't want
to hear that from you. You can.

B: I used to think so.

So as to why I feel this way....two words...6 months!!!!  Today I saw my surgeon to get the rest of my stitches out and I asked him about the next surgery, and he said what are we doing? I asked next surgery not phase 2...so I said.... MY ARMS!!!!....and he said "6 months"...we can do something else sooner but we can't operate on that area again for 6 months, you have to heal completely and have the swelling gone. I was sooo pissed....my insurance year switches to a new year April 1st. I wanted this over and done with by then. 

So while the PA is removing the stitches I'm ranting to her about all of this, about how I fought for over 4 months to get this covered and how it's holding up other aspects of my life and that I was suppose to get my breast lift combined with the second arms surgery...breasts by a diff doc, same hospital...and now this will mess that up too. Well she tells me to get dressed but not to leave....and then calls me into the other exam room where my surgeon was and he says well yeah we could do something else like remove some off the medial thighs. My LEGS....WHAT!!! I said Dr. T...I know this may sound funny...but I don't want to touch my legs because of my LE...which I know is why you are concerned about my arms!!! He said yeah, we could take off the little balls you have....o.k. I have no idea what he is referring too because my legs have waayyyyy too many issues to even touch...but yeah I know I have BALLS....HUGE ones figuratively!!!

I said Dr. M (my lymph doc) is o.k. with surgery on my arms, he even wrote a letter to BCBS. He said, he's being o.k. with surgery has nothing to do with how safely I can reperform surgery on you. I said I know, but will you at least take it ALL the next time. He said, I care about you I don't want to hurt you, I said I know, and I don't mean to be ansy but I've fought for this for so long, and this entire process is over 5 years now....I just want it done. He replies, but you also want it done right. Damn, how do you argue with someone who is trying to protect you????

So I leave to go have my arms wrapped, and everything is swirling in my head again. And I kept thinking I did this for nothing....the insurance battle, all the ups and down and all I have are scars. I'm so tired of LE controlling my life. I'm tired of doing everything asked of me and still being disappointed.

So I headed to Wendy's for lunch between appt. and while sippin my Diet Coke I re-evaluated what waiting 6 months would mean.  I will have to pay my $1500 dedcutable again. But on the other hand I get my time off work renewed July 1. So if I had surgery in March I would have to be able to cover my living expenses, whereas that money now will just have to be used for the deductable and I will be able to take even more time off. And perhaps in that 6 months I can get more weight off for the other touch ups that WILL be done. Still need to find out what "balls" he is talking about....lol.

So as Kanye says in my siggy "Now that don't kill me, can only make me stronger"

So when the lady from my benefits admin called me to tell me my brachioplasty would be coverd, she also said she wanted me to go to the most experienced surgeon do my surgery and their travel benefit would cover mine and my spouses or family members travel to get there. Well today a nurse case manager from BCBS called me, she had called yesterday and we chatted briefly, well today she calls me and tells me that the travel benefit is only for transplant patients. I called the benefits admin after I hung up the phone and had to leave her a message. I want to get to the bottom of this. However, in the end I will find a way to get there, perhaps stay at my moms (5 hour away) for some of the time instead of the hotel, etc. I've come this friggin far...everyone deserves a chance to fly...lol..oh wait I do have wings...

Check out my blog for more information regarding my fight and efforts to get to Pittsburgh...

http://flyingsarah.blogspot.com/