One Day at A Time,

Jul 12, 2008

Still hoping insurance approves my request for surgery! It will have to wait anyways until my blood clots in my varicose veins go away. I met with my new PCP, she is awesome! I was expecting her to say I was good to go back to work, but as the exam was ending we noticed another clot sprang up on my leg. I mean it was again hard mass and new swelling in new spot, so off I went to get yet another sonogram to make sure it was not venturing to deep vein and that indeed my deep veins were in good shape.

Sonogram cleared my deep veins but as this is new varicose clot she wanted me off my feet until Tuesday when I return to see her. I am just glad it was noticed before I left, really would have been nuts if it appeared late Friday or on the weekend. I don’t like to go to emergency room and I likely would have.

I chatted with my brother who just came back from my father’s wedding . I wish I could have gone but with the clots, no airplane travel allowed. 

As for me, I am also scared from all this drama with the clot and my new MD says she thinks I have heart murmur; I have the Echo cardiogram appointment set up so this can be confirmed or ruled out.

This weekend I did my shopping at whole foods, and brought home more fresh foods than usual. Veggies and fruit, and the usual meat alternatives we generally eat. My two kids were happy to see the healthy foods. My son Jon, BBQ‘d chicken breasts, and made an awesome salad, I made fruit plate.  It’s nice we are all on the same page at home.


Happy 4th of July!!

Jul 04, 2008

My foot no longer hurts all the time; I ended up getting a blood clot in my varicose vein up the same leg. I noticed the hard lump on the backside of my knee last Friday evening, so I went to emergency room. They examined me, after a sonogram the Doctor told me it was varicose clot and would just go away.   She asked if they should call my MD, and this was weird because new one does not know me yet and old one I left, well forget her! I promised to call new one during the week and see if she could see me before my scheduled appointment on July 10th.  Emergency room doctor told me to keep leg elevated and wear support hose.

Saturday I was down most of the day and I noticed that inflammation of my varicose vein was getting worse moving above the knee and also below the original spot that caught my attention, Sunday more rest and hot compresses and still the inflammation was like on the move??

Sunday night went back to emergency room where another MD agreed that my leg looked bad and I needed medications immediately. Pain killers, something to fight the inflammation and an antibiotic. I went home and felt scared that this is serious stuff now. Emergency room MD said that varicose blood clots can migrate to deep vein and my clot was definately moving up my thigh towards the deep femoral vein.

 I called my new Doctor’s office and they advised me to go to the practice’s urgent care facility, they have technology on site to do another sonogram. The doctor there was really worried. Half my leg was inflamed and getting close to femoral vein, he sent me for scan right away. Scan showed clot was “really nasty one” varicose thrombosis and I now had acute phlebitis. I asked him for the Big guns in medicine, he said he was giving me nuclear weapons to take this nasty clot down. Off I went to the pharmacy, happy this new practice has a doctor that took me seriously and took care of my health issues.

Now my leg has improved, it seems like dark brown spots are appearing up and down the vein. Vein is dying? Well at least the redness, swelling and pain are gone. I see the Doctor again tomorrow, I am happy leg has improved, if not he was going to have me admitted to hospital.

I told my boss why I was out of course and somehow he thought it was okay to tell my colleagues, Hmmm… I mean here I am blogging on net about it, but shouldn’t it be my choice if my colleagues know why I am out of work? I am off work until Doctor clears me which will likely be next week, My boss told me to do FMLA so the week off would not count against me for attendance.

Now for some happy news!! My surgeon’s office called and I was told they finally received my medical records for the “doctor supervised diet visits” OMG, I had given up on them ever providing them! And the request for approval and these records are being forwarded to insurance (with previous doctor supervised diet from nutritionist this means I dieted nearly a whole year.)  It will be awesome to hear “approved” from insurance.

We plan to BBQ and watch fireworks today this 4th of July. I think I may even allow a few pictures to be taken of me today after all this may be the last time I will be so FAT on the  4th of July.


De-junking my way to a simpler life

Jun 21, 2008

Onward to a new, MD, a new Internal medicine MD.  I have appointment in early July. I really can barely wait, as my foot hurts all the time, burning pain and numbness, weird! I sometime have to limp which is annoying when I am trying to get my daily walks in.

I likely will do another 6 months dieting, seeing MD and writing every morsel I eat down. I am looking at it differently this time, I see this time as a way to prepare for life after the surgery.

Watching protein totals, avoiding fried or fatty sweet foods. I am having hard time with the “no drinking liquids while eating.” Most meals I consume my drink first, this way I cannot chew then have a sip.

I was at a with my daughter and at a restaurant the waiter kept asking if I wanted some more ice tea, each time I said no.  Surely he thought I was nuts. Do WLS patients explain to wait staff why they eat kind of different?

My family is vacationing in Brazil.  I did not go because I am holding all my vacation hours for later when I have surgery.

I have been keeping busy cleaning out closets and cupboards, de-junking is so therapeutic! Once I got past the realization I must be crazy to have multiples of same item again and again, I felt liberated to create huge bags for the Goodwill. Nice benefit was that I found a few things that I was looking for.


Saying goodbye is sometimes a healthy thing to do!

Jun 13, 2008

Oh my, today was no fun! I had to go to my PCP office and speak with her about my records. Because my foot hurts and is also numb on top side the RN put me in a room to be checked out. My blood pressure very high, and also the large lump on the right rib cage is getting bigger (this is what my md refers to as a simple fatty cyst) so I wait and when MD comes in I ask “what’s going on? Send my records! And she kept saying they have been sent, and well why would I be in her office asking for them if my surgeon had them?????

As for my current symptoms; no discussion. No care. We just kept arguing about the records.

 She went off on me about my lack of “real” progress losing weight.  I told her she needed to get over the fact I did not lose 50 pounds under her guidance.  She said she would send her notes, hmmm… we shall see.

Upon leaving, she told me to get a new MD, exactly what I have wanted to do for so long. Funny thing is once I get a new doctor, I will need them to forward my records. Hopefully they will consider the $30.00 they charged me today for sending essentially notes on 7 visits as payment. Or maybe the $10.00 Copay for today’s office visit in which I received no care.

My real worry is that this thing getting bigger on my ribcage is something really bad. And the foot pain (like a high heel stomped through my foot) and numbness on the top, is that neuropathy? Oh Diabetes is a very real reason I need this surgery.

Somehow I am not sad. I feel kind of liberated, like when one breaks up with a boyfriend and decides to move on. She was tired of me and I was really not benefitting from her.

Please if anyone is starting the Doctor supervised diet, make sure it is a doctor that the Bariatric surgeon has worked with before, one that will really be there for you and guide you to getting ready for the surgery. A doctor with a proven record on providing records for the insurance requirements. I have experienced doctors who do not take the time to document what plan they put you on, and when you think you are done, you find out the records are crap and insurance will not take them. 

So onto positive things, hooray it’s the weekend!!!!  My family is preparing to take a trip to Brazil. I like my nutritionist I am seeing now, she is guiding me to make changes to prepare for surgery.

My to do list with her;

Do not drink liquids during or after a meal ( wait 30 minutes)

Give up caffeine

Exercise daily with walks

Log my food in a journal

And give up carbonated drinks.

These are all important to learn as a habit, so I am onboard with her to change. It will be my way of life when I have the surgery. Which stubborn me still see as happening someday.


Optifast

Jun 08, 2008

My Optifast came on Friday, so I began full day on Saturday. Really it's not so bad, I kept busy out of the house running around taking care of errands,

Strawberry is my favorite! I twice took full tray of ice and blended until mostly crushed, added 1.5 cups water then the optifast. It takes longer to finish and well I LOVE ICE.

Anyone else have an addiction to ice? I seem to always be eating it, I don't crunch down and make it obvious, my family and colleauges would be quick to get annoyed. I just wait till it softtens and then crush quietly. When I am in my car I crush with abandon. Seem I started doing this about 4 weeks ago , and in some weird way it relieves stress. Good benefits are that I am getting plenty water and my skin is much clearer.

hmmm... thank goodness my favorite snack is calorie free.


$30 dollars gets me nothing

Jun 04, 2008

Yep, was told to pay $30. for medical records fee, so that PCP office would send my "supervised diet records"

And what they sent was Nada, zilch on diet records. The surgeons' office called me to tell me they received, pulmonologist notes and the surgeon's notes on my last visit! nothing from the PCP doctor. GRRRRR

After some urging the office girl said she would call MDO and talk with office manager and or Jennifer Rn. I told her do not bother with Diane. Or better yet talk to my doctor, she knows exactly what Kane wants, she has the sheets his office provided.

No word back from her today. Hmmm

My colleagues at work think I should go to PCP office, but really I am not sure I can be calm. After spending 7 months going there monthly and noting what I ate and tallying up my WW points, journaling exercise, blood sugar levels and for a month the daily steps I took, it's too much that they pretend they have no records to give to surgeons office.

One sure thing is I did not lose much weight, is this why my PCP won't cooperate? She created plan, I did what I could to follow, records are what they are, nothing on her that I did not lose 50 pounds. Wish I had lost that.

So when I can be calm, I will likely go there and see what is up. I also asked if surgeon could call her and ask her to get the needed records to him, this may be the only way my MD will cooperate.

In the meantime I ordered some Optifast, and will begin liquid diet until I get surgery date. And I made appointment with Nutrionist that is supevised by MD, This one is ready to write whatever Surgeon needs for insurance.

What worries me is that if I need to do another 6 months - this would end december, and with my luck my insurance will add an exclusion rider to not cover the surgery in 2009.

So happy I can vent on this blog, as I would be really nuts if I could not get this off my chest.

Trying to get back to the positive cheery person I once was... maybe then I will bring positive results into my life.

Anyone have experience on that " you get what you expect" thinking?

Maybe I could just expect MD to cooperate and relax it will be done?

Sorry getting silly, I am very tired today, goodnight fellow WLS peoples.


Wait and see game

May 31, 2008

Slowy making progress.

I saw the Pulmonologist and he gave me clearance for surgery. CPAP is doing great job keeping my sleep apnea controlled. He told me that the data card showed I was sleeping about 4.5 hours nightly, well that would explain why I feel so tired. The good news is that it’s the best 4.5 hours I have had in many years.

I checked my CIGNA claims online and saw that they covered much of the bills that were re-submitted, so that was a huge relief! I do have benefits and they are finally paying out on the claims.

My surgeon’s office called me; the insurance girl has yet to get the medical records from my pcp. Called there right away to speak with Diane (who assured me that she had taken care of it and the records were sent!!)

Diane had told the insurance girl she left me a message the previous Friday and was waiting for me to call her. Hmmm…

When Diane answered the phone I told her who I was and we had spoken just the past Tuesday about the records. I told her “your exact words were – I have taken care of it, it has been sent”

She was like speechless, and she told me well it will cost you $30 and I said fine I will pay – just send the records and make sure they are the detail sheets on diet exercise ect. She said she saw no sheets in my record. Okay so now I am getting pissed because I am likely paying $30 for useless info being sent to surgeon’s office and I am back to SQUARE one.   I try to explain to Diane that my PCP know exactly what surgeon wants / please ask her/ she says “ she doesn’t know what surgeon wants!  I ask to speak with her and she says NO, she is busy. I ask for her VM, and am told she has none. So fine I will write her a note.

I really do not want to have to do 6 months of diet again with another md that would be so unfair. Is it my fault the MD does not take good notes – even when provided page to write just what is needed?


Hurdle number ?

May 24, 2008

The fight continues on, and the whole process has really yet to begin. Sound crazy right? Well latest insurance claims were all denied * explanation of benefits / they say I have none for bariatric surgery weight loss surgery ect. Again this is wrong, called Cigna and after nice agent named Agnes read all the notes she apologized,  She said she would submit with special note “PT DOES HAVE BENEFITS” same explanation as before,  my benefits must be loaded in wrong. Well they fixed it customer service side could they fix it on the Billing department side too please?  So now, I take deep breathe and wait for second round, hopefully the claims will come back partially paid.

Call to MD office’s girl to see what is latest and have they heard from insurance on request for surgery (Nutritionist said it would take about 3 weeks from my appointment with her – and that has passed) should be some news? After playing phone tag, I get in touch with the office contact and well she sounds apologetic, seems my file was in MD office for past three weeks and well nothing had been done. Asked about Nutritionists submittal to insurance company and was told that was actually sent to MDO – yeah it too sat in MD’s office. Grrrrrrrr….. Well good thing I called and they went looking for my file.

Okay so back on track, MDO contact needs a letter stating they may have my primary care physicians’ records.  Done, faxed letter right away, called next day to make sure it was sent! No, so she sent it while I was on the phone.

Get home Friday evening to find call to my voice mail from PCP office “are you sure you want all records’ sent? It would be costly for you!” and of course this is after the office is closed. So Tuesday will call and inform MA that they can send the sheets detailing my “doctor supervised diet” from Sept 07 and on. Now fear sets in as I know my doctor barely bothered to fill these out. I mean we did have a plan and we discussed each visit progress or more accurately my lack of progress, but she did not detail much. Oh Lord, help me now, I surely hope she has good memory and gives them what they need or here we go again. Surgeon’s office is going to say … These records aren’t good enough, you need to do 6 months diet with good records. ,

I did see the Pulmonologist. He was very nice. No second sleep study needed, first study was clear I have sleep apnea and need CPAP machine. He sends request to Apria and I and on my way.  Return to him in 3 weeks and he will likely clear me for surgery.

CPAP fitting at Apria was fine, they rep was really nice, my unit is auto titration and mask is mirage type. So far it has helped ---EXCEPT – I seemed to have picked up a nasty bug of a sinus infection. This is a challenge to breathe only through the nose while the nose is stuffy, I have had this bug since I left the Pulmonologist office hmmm… they do sterile all the breathing test equipment right?

Most nights I pull the mask off by 4 am, as I have accumulated water from the humidifier around my nose and my lack of clear sinus makes it all so hard. Off it comes and I mouth breath for next two hours, very annoying to my hubby. To add to my snoring, my Chihuahua sleeps in his crate near our bed and he snores every now and then. Yes he is also too chubby. 

Thank goodness for this site, all the supportive emails really help. There are days I wonder if I should just accept life as it is. Then I read some blogs, and get inspired again to hope for a new me.

Thanks to everyone who sends me support. You truly make a difference - luv you all.


Psych evaluation

May 03, 2008

One more appointment I can check off my list. 

Essentially the appointment consists of computerized 600 question True or False questionnaire. This was fairly easy until a fellow patient arrived and decided to chat it up with the administrator. GRRRRRRRR well, I just stopped and ask for some water. 

 Once he sat down and began I went back to it.  Funny that the administrator came to see if I was done, I told her “Oh I was distracted by the chatter and took a break" I mean after all they post a large sign that says "QUIET _ TESTING IN PROGRESS!!!

Maybe that was my test, to see if I would assert myself. my grade for handling the situation C+

The Doctor was pleasant and our chat was finished with him saying he would clear me for the Surgery. AWESOME.

  So where did I put that receipt for the visit? he was not in network and I had to pay myself. Thank goodness I had a MasterCard that is tied to my pre-tax flexible spending account. 

 Still where is that little yellow receipt! I think I will call Monday and ask for a more substantial looking one to submit to my insurance company.

Today I went to the dentist, it was not my appointment actually it was my daughter's. She had called few weeks back saying she really needed to get a cleaning, appointment was made for her. Now when I was reminding her yesterday, she says "Sorry I have tons to do before my Finals" So by default I went.

Really was a good thing I did. My dentist wants to get some major work done before surgery and well he says I should check with MD about this as I really shouldn't have any wounds tryng to heal before surgery. I will need root canal. Maybe wait until after the surgery?? 

 It turns out my dentist has sleep apnea too. We even see the same Doctor. He told me which CPAP mask he likes and told me about mini trampoline exercise is a great way to burn calories.

My to do list;Buy mini trampoline, also roller skates ( the outdoor kind) Just like I did in the late 70's - roller-skate   ( omg I even found a company that sells the same kind I had! blue sneaker with yellow  wheels - how funky is that)

 


Surgeon Consult

May 01, 2008

My consult was strange in a way because it was my 3rd one with this practice! I met my physician actually 5 years ago and was all prepared to go through the process, then I got cold feet and did not complete the 6month diet.

Anyways, he was wonderful and mentioned my primary care physician had called him to discuss me. hmm... I asked him if she told him how naughty I am? and he said, "well yes and she didn't need to, it's all in the chart." How true.

I really like that he is straightforward! What benefit do we ever get from sugar coated talk? I can appreciate his honesty and his true concern. I would run from a MD if they told me placating reassurances. The truth is better, serious surgery this is and currently my list of co-morbidities are growing that in itself is serious. No more paralyzing indecision about having the surgery. I am ready.

Now hopefully insurance will approve me and all the other pieces will fall in place.

Psych evaluation is tomorrow, was wondering why it takes 3 hours? The scheduler told me I will take a test then see the Doctor 2 hours later?

slowly making progress to an eventual surgery day! I am getting so excited.

 


About Me
Arlington Heights, IL
Location
27.8
BMI
RNY
Surgery
09/16/2008
Surgery Date
Sep 09, 2006
Member Since

Before & After
rollover to see after photo
Surgery Day
244lbs
working on taking off 42lbs regain (lowest 140)
182lbs

Friends 77

Latest Blog 27
Today is the day
MoviPrep - there is no movie in my box!!
7 days from now!
Last minute stuff
I have a surgery date!!!! yipeeeeeeeee
Benefits of surgery I expect to see
Less than a month from surgery
Back to work for me
Approved!!!!!

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