Pamela E.

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My gastric bypass surgery was in Sept. 2005.  Today is January 5, 2015 and it has been nine years and three months since.  I have now gained back 60 pounds from what I call "grazing."  The surgery kept my weight off for about five years until the recession hit Arizona in 2009.  We lost everything and ended up having to move to another state for employment, leaving our family and everything familiar.  I retired in 2008, three years after my surgery.  We have now moved twice since then and I have found it extremely difficult to make friends.  I stay home with my dogs all day most of the time and eat all day out of boredom and laziness.  There have been several times that I tried to regain some control in my weight, but they were short-lived.  Most of the time I just don't care.  I have little motivation.  However, it's the new year and I am back at it once again. I have failed my surgery.  My surgery did not fail me.  

08/09/06 Today my dear friends at work took me out to lunch because on Friday I will be leaving them to start a new job.  As with any other major change in your life, the beginning of a new job is a stressful time, but I believe this will be a positive step and I am looking forward to learning something new.  The location is 8 miles from my home, versus the 35 I currently drive to work.  I will be getting back 5+ hours a week to do anything I want - which will allow me to exercise in the morning now.  That makes me happy. 

09/29/06  Today was my 1 year dr. appointment at Scottsdale Bariatric.  Randy said I looked like a movie star when he walked into the examination room.  It had been two months since my last visit and I was apprehensive about my one year weigh-in.  I SO wanted to make it into SBC's Century Club.  You see, SBC counts your beginning weight from your very first appointment with them.  On that date, I weighed 247, but my weight reached 256 that summer and by the time I had my surgery ten months after that first weigh-in, I was at 250 (that's where I start my weight loss).  In any event, I weighed in at 145, and Randy said "Congratulations, you've lost 102 pounds.  Let me take your picture!"  That meant alot to me.  He also went over all of my blood test results, and I've lost more fat, gained more muscle, my protein and water levels are great, my BMI is great, everything is FABulous!  I may consider trying to lose just another 5 pounds as a cushion for vacations, but 140 would be the lowest I'm interested in going.  Life is good.

10/25/06  Took 2 1/2 weeks off work to fly to Nebraska to see my mother, son and grandson.  The first day I got there, I started getting sharp pains in the abdomen.  By the third day I was calling Scottsdale Bariatric where I had my gastric bypass surgery and after describing the symptoms, they felt that it might be a twisted colon and advised me to get to the nearest emergency room asap.  I didn't feel comfortable going to an emergency room in another state where I wasn't sure if they knew anything about my new stomach or not, so I decided to catch a flight back to Phoenix that night.  I spent the entire night in the emergency room where they ran numerous tests and x-rays.  The next day Dr. Blackstone called me to say it wasn't a twisted colon, but she thought it may be an ulcer or problems with my gall bladder.  Two days later I was getting more tests run to find out which was causing the sharp pains.  I had an endoscopy, a gall bladder ultrasound and a HIDDE scan done and I am now having my gall bladder taken out on November 13th.  I am very happy it was not a twisted bowel or an ulcer.  Life is still good.

02-03-06  Had my four month check-up today and everything is right on target!  The dietician opened up my menu to include beef, pork and lamb, whole grain starches, alcohol if I must,raw vegtables including tomatoes and citrus fruits.  I've allowed myself to get in the habit of eating pistachios and/or almonds in the afternoon at work.  This will stop.  I know it's necessary to limit myself to THREE meals a day.  That's all.  Anything in-between meals encourages snacking - and we all know where that leads.  Right down the road to FAT!  I've been walking for 1/2 hour during my lunch at work Monday through Friday.  On the weekend I tend to do alot of gardening and yard work, but still ride my bike or walk around the neighborhood too.  I need to get out my resistance bands and balance ball now.  Resistance training is essential.  With 34 more pounds to lose, I plan on reaching my goal by June 1, 2006.  This is an average of 2 pounds a week, which is what I've been maintaining the past month.  Let's see what happens!

03/02/06 This past Saturday my 10 year old grandson and I were involved in a five car pile-up on the West I-60 in Tempe.  My Corvette was car number three, so we were smashed up pretty good.  I managed to avoid hitting the car in front of me when she hit her brakes hard, but when I looked into my rearview mirror and saw the car behind me, I knew we were going to be rammed hard - and we were.  This pushed me right into the car in front of us.  I was quite dazed, and asked Tyler if he was hurt.  His back was sore, but he was able to move.  Next thing I knew, a paramedic was putting neck braces on us and lifting us both onto stretchers and into separate ambulances.  We were taken to different hospitals, which made me frantic, as I knew Tyler would be all alone.  His mother was in Laughlin for the weekend and we were babysitting.  I spent the rest of the day in the emergency room on morphine and getting catscans done.  It was truly horrible.  I had a concussion and the biggest black eye you've ever seen, whiplash of the neck/back, and serious contusions of the chest/abdominal area and side from the seatbelt. 

I called SBC and spoke with Randy Hamilton about the pain killers they prescribed at the ER, and he recommended I also take some Pepcid to prevent an ulcer because of the stress.  I was already sick to my stomach.  The next few days have been fraught with migraines and great discomfort.  Tyler missed just one day of school, but he's alright too.  Thank God for watching over us and being with the medical teams that cared for us that day.  We were truly fortunate. 

My beautiful corvette coupe was totalled.  Two days after the accident I went for about a 45 minute walk and ended up running a fever.  So I am temporarily unable to exercise and my weight loss has stalled again (grrrr!), but I'll get back into my walks a little at a time.  Life is good, and I'm just happy to be alive.

It's been 9 weeks since the accident.  The insurance experience was a nightmare!  The physical therapy is over and I'm better, but the ribs are still sore.  Unbelievably, the weight is still coming off and I'm very happy about that.  I feel great, and am having the time of my life buying new clothes and shoes.  I've gone from a size 26/28 to a 10/12.  My shoe size even dropped a size!  I'm so fortunate to have a secure husband who loves and supports me in all I do.  Thank you God for all of these blessings.

06-02  It's been a couple of months since I've written here.  I am now wearing size 10 and 12.  The 14's are baggy on me.  I believe that by the time I reach my goal, which is 145, I will be wearing a perfect size 10.  That seems small to me.  I can't even remember when I wore single digits.  I'm sure I must have at some time or another, but it was probably elementary school!  I was always one of the tallest and biggest girls in my class pictures.  All of the tiny, short girls got to stand in front of the group, while the tall, big girls got to stand in the back with the boys.  I hated that.  One of the things I enjoy right now is the astonishment on people's faces when I tell them what I used to weigh.  They can't BELIEVE it!  My husband is now on a weight loss program to catch up to me.  He says that he wants to experience the same energy and youthfulness I exhibit.  I'm glad he is exercising and eating healthier because I want him around for as long as possible.  I love my husband so much.  He's my rock!

6-9-05  OK, I'm back and fighting.  I just couldn't accept what Tish told me on the phone.  So the following week I called Carol Cognata, SBC's Office Manager.  My experience with Carol was very positive.  She is very understanding, accurate, and she gave me hope.  She said Tish was entirely wrong.  That day, Carol said I would not have to pay anything if I decided to do the 6 months diet over again.  Then she said what the heck, she didn't feel the 10% was justifiable since state employees' new insurance coverage wasn't supposed to change last year during open enrollment.  Carol said she would devote the next day to going over my files and preparing an appeal for me.  In the meantime, I worked on an appeal letter of my own.  SBC has already mailed theirs, and my Second Level Appeal letter is ready to send tomorrow morning.  It's 9 pages long, plus enclosures!  If I am denied again, I am prepared to go to Obesitylaw.com, or Obesitylawyers.com.  If I am approved, I will copy & paste the letter here on my profile.  I actually think it's pretty good, but time will tell. 

6-29-05  I sent my appeal (about 20 pages) letter "certified - signature required," and they received it on June 13th.  I think my insurance has 15 business days to answer the appeal, however, they received the appeal (just over one page) sent by SBC on June 8th.  Sure hope they got both documents hooked up!  I expect to hear something one way or the other by July 8th.

8-1-05  Still waiting!  I did receive a letter from Arizona Benefits Administrator, Harrington, dated July 23rd, which stated "Your request is being reviewed at this time.  There will be a delay while we investigate this matter.  We will give your request the utmost attention.  You can expect to receive a response within the next thirty days."  I called them last week to see if there had been a decision made, but the Harrington customer service representative said she could not find any information at all, and would have to call me back in a few days.  Unbelievable!  It's already been TWO months!

8-25-05  I'm APPROVED!  Melanie Toniazzo at Schaller Anderson called me at work this afternoon to tell me I got approved.  It was so nice of her to call.  Tomorrow Dr. Blackstone's office will call me to schedule my surgery date and set up some appointments.  I'm pretty sure I'll have to wait until sometime in November, but that's OK.  I've developed a healthy habit of patience the past four months.

8-26-05  First thing this morning Scottsdale Bariatric Center called me with a surgery date.  I'm scheduled for Monday, November 7th!  In the meantime, I'm two weeks on the medically supervised Optifast diet right now and have already lost 14 pounds.  This will make me healthier for surgery and hopefully improve my recovery.  This is so great!  I just didn't expect this.

8-29-05  This morning I spoke with the scheduler at SBC and my surgery date has been pushed ahead to 10:30 am, September 28th!  I can't believe this is happening.  Somebody pinch me!  All of my pre-surgery appointments had to be moved up as well and I will just barely have time to get them all in by the day I see Dr. Blackstone on the 21st.  However, the really hard thing is preparing mentally.  I will remain on the Optifast diet the rest of this week and anticipate a 20 pound loss by then, a very positive step toward surgery.  WOW!  

9-26-05  Only two days away and I am starting to get a little scratchy in the throat and having difficulty swallowing.  I pray I'm not coming down with a cold, and that it's just my CPAP making my throat dry.  I called SBC and they said I could take Benedryl or Claritin if needed, and also Vitamin C.  So I'm drinking plenty of water, hot tea, taking the C, and hoping they don't cancel my surgery.

9-27-05  Today I spoke to Noreen, the surgery scheduler. to update her on my cold.  As we spoke, Dr. Blackstone walked by and Noreen asked her whether or not we'd still be doing the surgery.  Dr. Blackstone said I should show up tomorrow morning, and the surgery would be the anesthesiologist's call.

10-1-05  The big day came and went without incident.  I weighed in at 250.  There was no fever nor chest congestion because of the cold - only head congestion.  So the anesthesiologist approved the procedure.  I woke up  in my private room and my handsome husband's face was he first thing I saw.  He's truly my rock.  My pain was controlled extremely well, and the nursing staff at SBC was fabulous.  The worst problem was the thirst and dry mouth.  No water or ice chips until the second day when I had the barium swallow done to see if there were any leaks in my stitches.  I never knew my mouth could get so dry it was difficult to speak.  I went home the afternoon of the third day.  No complications thus far, and I feel pretty good.

10-06-05  Went to see Dr. Kohler for my first week discharge appointment.  She removed my bandages, examined me and said I looked fantastic!  I weighed in and have lost 15 pounds my first week.  The only medications I need to resume are the hormones and migraine meds when needed.  They will take a look at my cholesterol in a month when my blood tests come in.  Goodbye to meds for acid reflux, swelling, and hopefully my CPAP in a few months.  I'm getting really happy!!!!! 
 

10-18-05  Twenty days out and by my scale I have lost 22 pounds.  I am getting in 1 hour of walking on most days, and also do some light gardening.  My diet consists of soft protein until my Nov. 4th appointment with the dietician at SBC.  Refried beans are so filling I'm full within 10 minutes.  I have trouble with chicken and fish getting stuck in my esophageus, but tuna/mayo seems to go down fine.  My one disappointment has been a little acid reflux coming back.  Not enough to need medication yet, but nevertheless, it's still there.  I have good days where I feel more energy, and bad days where I can hardly get around.  Dr. Kohler said that's perfectly normal.  Tomorrow I'll have my blood tests done so the results will be at SBC by my next appointment date, Nov. 4th.  At that time, the doctor will decide which of my medications I need to resume, if any.

10-28-05  One month out today!  I have lost 28 pounds and 15 inches.  I can visibly see the changes in me when I look in the mirror!  No complications and no problems sticking with my soft protein diet.  I walk 60 minutes about 5 days a week, get in all of my vitamins and drink 70-80 oz of water daily - although this does not seem to help my constipation problem.  I take Benefiber, and must use Dulcolax suppositories about every 2-3 days to make my bowels move.  Laxatives are forbidden at this point because the doctor does not want to damage my intestines at the point where they RNY was done.  Monday I'll return to work and hopefully will be prepared to maintain my healthy routine by walking on breaks and lunch time, drinking my water, and being good to my pouch.

1-2-05  The doctor went over my sleep apnea test results and is sending me back to the sleep lab to spend the night using a CPAP to relieve my breathing problem.  They will decide how much air pressure I need.  Reports of the sleep apnea will be sent to Dr. Blackstone's office.

2-28-05  Weigh-in with Dr. Emershad and appointment with Dr. Messer, also of Scottsdale Bariatric, to discuss my psychiatric exam results.  20 lbs. are gone, but this 4th month was extremely difficult. The psych suggested seeing a food addiction counselor couldn't hurt, and he could recommend someone - but only if I felt like it.  So I said sure - it couldn't hurt.

3-25-05  Today I had my appointment with a food addiction counselor, Dr. Rosalyn Meadow.  I talked.  She listened.  Then suggested I try stop taking Wellbutrin and start taking PROZAC for my bingeing.  She wrote a note to Dr. Emershad, and asked me to take it to my next appointment.

3-28-05  This is the 5th month appointment with Dr. Emershad.  I've had such a setback this month!  Gained 3 pounds.  Even though I don't feel the Wellbutrin is working so well, she was absolutely against the Prozac, and felt I should continue the Wellbutrin.  Dr. Blackstone is still not in-network with Schaller Anderson (it's been 7 months since I was told she signed her paperwork with them.  How could it take this long unless something is wrong?)  All I can think of is that I don't stand a chance of my insurance approving this surgery anyway.  I feel like I'm just kidding myself about having the surgery this summer.  Last month I only lost a pound because I was already thinking about this.  This month I gained!  I probably blew my six month medically supervised diet now.  After I got done with Dr. Emershad, I had an appointment with Scottsdale Bariatric's dietician, Cassie Truran, R.D..  We just talked about me, food, and my understanding of what it will be post-op.  I was supposed to have my first appointment with Dr. Blackstone's co-worker, Dr. Jennefer Kieran (pre-op initial consult), but had to cancel because they aren't in-network with my insurance company yet.  

3-31-05  YAAYY!  Today I found out that Schaller Anderson has completed their credentialing of Drs. Blackstone and Kieran (it only took them SEVEN months!), and their contracts are official April 1st.  Sure hope this isn't a cruel April Fool's joke!  I promptly made my pre-op initial consult appointment with Dr. Kieran on the same day as my final appointment with Dr. Emershad.  On April 27th, I will have completed every single prerequisite Scottsdale Bariatric needs in order to submit my request for surgery to Schaller Anderson.  Whoppee!  I'm making progress!

4-27-05  My six month WLS boot camp should have been complete today.  Instead, I was informed that (unlike most insurance companies) Schaller Anderson requires the complete 10% must be lost.  I was taken completely by surprise - as at the beginning of my six month medically supervised diet, Dr. Emershad specifically told me that if I lost 10 or 15 pounds it would be perfectly acceptable, as the insurers simply need to know you can commit to losing weight after the surgery.  I accomplished exactly what Dr. Emershad told me.  However, on my last day of the six month medically supervised diet, I was informed that I would have to lose another ten pounds before Tish would submit my request for surgery to Schaller Anderson.  Not only that, I would be charged another $50 per month to see Dr. Emershad until I had lost that last 10 pounds.  I was so disappointed.

5-12-05  Today, Carol, the office manager for Scottsdale Bariatric told me they had decided to submit my request for approval to Schaller Anderson just the way it is.  I expect to hear something by the first part of June.  I believe the reality is that they will deny me the first time.  But they don't know me very well.  I'm not the type to walk away, and they can expect an appeal from me immediately.

5-16-05  WOW!!  Scottsdale Bariatric sent my request for approval to Schaller Anderson on May 10th, and received a faxed response practically the same day saying it is DENIED.  I didn't expect them to say "No" so fast.  Now we have to wait for them to mail the formal letter of denial to see why it was denied.  Tish, the Business Office Manager, says she doesn't understand why it was denied, because she feels I meet all of their criteria.  Once we find out why, she will prepare my appeal.  I expected this, but it's still very depressing.  Sometimes I just feel hopeless.  In the meantime, I'm gaining weight like nobody's business - I assume from the emotional turmoil I'm going through with this horrible insurance game.

5-29-05  I QUIT. Tish, Scottsdale Bariatric's business mgr.,  called me the other day to say she can find no basis to write my appeal letter.  Since I didn't lose the whole 10% during my six month medically supervised diet, I did not comply with Schaller Anderson's (the State of Arizona's) criteria.  I told Tish that at the very beginning of the diet, Dr. Emershad said I didn't HAVE to lose the whole 10% (25 lbs. for me).  She said if I only lost 10 or 15 pounds, that would be enough to demonstrate my committment to weight loss.  I had lost 18 by about the end of the fourth month, but then started gaining it back.  They claim no other insurance company is that strict about the 10% loss.

It was on the very last day of my six month diet that Scottsdale Bariatric (Dr. Emershad) informed me they were now aware I was expected to lose the whole 10%.  By that time I was already on my way to gaining back the 18 lbs. I had  lost during the six months.  Their excuse was that all of the other insurance companies were satisfied if you lost ABOUT 10%, but that MY insurance company was very strict about it because I work for the State of Arizona, and this is one of their stipulations.  Tish said it wasn't THEIR fault they didn't know about the 10% until I had completed my six month diet.  I feel a little differently about that and hold them responsible.

My $500 for the six month medically supervised diet, along with all of the out of pocket expenses for the many tests I've had done to fullfill Scottsdale Bariatric's criteria has gone up in smoke, along with my hope for surgery.  Now they wanted me to start all over again and lose the whole 10%, and I just can't do it.  I feel like I've been HAD!  If I have to start over again, that means I'll have to do the psychiatric exam (out of pocket $$$) and other tests all over again too, because we'll be into another year and all of the records will be old.  This is just WRONG! After my phone call with Tish ended, I just sat down and cried and cried.  I just feel whipped.  I guess the State would rather foot the bill for all of my sleep apnea, arthritis, and future weight related problems until I retire.  I guess it's back to Weight Watchers or whatever is the diet du jour.

Here is my story, written in 2004:

In August 2001 and after reading alot about weight loss surgery, I decided against it and joined Weight Watchers instead. For about the 8th time in my life I lost a substantial amount of weight (91 lbs) - and gained it all back within a year and a half. I've gone through this over a dozen times in the past 20 years and now have come to realize that surgery may be the only way to keep it off - which is very discouraging to me. Will attend the Scottsdale Bariatrics Center's seminar on Sept. 23, 2004. Am very interested to hear what Dr. Blackstone has to say.

10-6-04 Have decided Dr. Blackstone is the only surgeon I would let perform my surgery. She is amazing! Submitted my information packet to her office, and now await Oct. 19 for my first appointment with my PCP, where I will request he recommend me for WLS.  I am a State of AZ employee with Schaller Anderson insurance.  They will approve surgery if it is determined that it is medically necessary.

11-2-04 My PCP has approved my request to see Dr. Blackstone, and recommends WLS surgery.  Dr. Blackstone is not yet "in-network" with Schaller Anderson, however, she has signed a contract with them and I now wait for it to become official.  I'm told that will be sometime this month.  Dr. Blackstone's office called to set up an appointment for me to begin a six month medically supervised diet to comply with my insurance provider. It will cost me $500 (insurance never pays for weight loss), but the Scottsdale Bariatrics Center will document this weight loss program every step of the way, and guarantees they will get my insurance approval or my $500 back. Scottsdale Bariatric will also let me pay $250 down, and $50 a month until the $500 is paid in full.  You must have been on a medically supervised diet for six months within the past year, and have lost 10% of your weight. This is mainly to show the insurance provider I can stick to the rules post-op. My first appointment was on 10-28-04 with Dr. Emershad.  She does not consider this a  six month "diet."  She calls it weight loss surgery "Boot Camp!"  During this six months I will learn how I must eat for the rest of my life post-op. I will see Dr. Emershad every 3 weeks now.  Dr. Emershad also prescribed Wellbutrin to help curb my appetite.  Today is the 4th day and I am having a never-ending headache from the detox my body is going through.  Other than that, I feel good.       

12-14-04  Have been in WLS Boot Camp for 47 days now, and have lost 14 pounds.  I eat three times a day (no snacking); 50-65 grams of protein FIRST - then veggies or fruit; then carbs (but limiting to 2 - 3 per day).  How easy is that?? Got through Thanksgiving and still lost one pound, but Christmas goodies are everywhere!