Julie Nolan

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I had the appt with my Neurosurgeon today! He asked me all sorts of questions then we ended the visit with a FULL recommendation from him for me to have the WLS surgery!

He truly thinks that this is a great idea and it will help the pain I have each and every day! 

He's very happy that I've made this decision! And he feels that I have really researched and thought this out enough!

I will receive his letter of 'medical necessity' within a week or so.

I'm so happy and relieved!

Next appt is with the Cardiologist on Thursday.

As the time goes on, I'm getting more and more excited about this decision I've made. So is my hubba-wubbins! I feel very blessed to have him as my lifetime partner!

Happy Tuesday!

I had an Arthrogram/MRI of my right shoulder today. I dislocated it when I was Active duty in 1997. I had surgery in 2002. Now I'm having more pain and such. My ortho said that part of the problem is because my bra strap is pulling down on it cuz of the weight of my breasts. Sad, huh? 

And...of course...while I was there...they weighed me...I've GAINED 2 freakin' lbs! Harumph!
 
Anyway, tomorrow is my visit to my neurosurgeon. Since he knows my structural problems the best, I will be asking him for a 'letter of medical necessity' for me to submit with Dr. Pohl's request to Tricare.

I HIGHLY recommend the following books...

"Weight Loss Surgery" by Barbara Thompson.

"Weight Loss Surgery for Dummies"

I have read them each once already and am reading them, yet, again! 

I have 17 questions written and ready for my first visit with Dr. Pohl.

Happy Monday!

I am so happy! I went to the support group at RW this evening and met SO MANY wonderful people!

The really nice people here on this board are EVEN NICER in person!

I feel even better about the psych eval today too. I am calling Tricare AGAIN tomorrow and see what they'll do to cover an eval with someone who has nothing to do with the Naval Base.

Another day closer to my first visit with Dr. P!

Had my psych eval done today at Newport Naval Clinic. It took 2 1/2 freakin' hours!!! And I'm exhausted!

I didn't get a pass or fail. Wish I knew.

I've got a lot going on in my life these days and I knew I'd have to bring it all up but didn't realize that my past history was so much of an importance.

I asked the Doc if he thinks I'm mentally/emotionally capable of handling the surgery and post-op. He said I have a history of depression when there is lot of stress in my life and gastric bypass surgery is extremely stressful but he doesn't think this will be a 'show stopper' for me.

I take Cymbalta (an anti-depressant) to help with the depression that has developed as a result of my physical disabilities and the chronic pain. He said that's a good thing.

I see the same counselor I've had for five years for the same reason. She helps me by giving me more tools to assist in dealing with every-day-life. He said that's a good thing too.

I told him that I don't feel depressed in any way but I do feel 'down' because I feel as though I'm missing out on life. The weight and the pain that it brings to all my joints, etc. keeps me from enjoying my life to the fullest extent. That doesn't mean I'm depressed.

I have an excellent support system too. Lots of friends and family surrounding me who are here, ready and willing to help out with ANYthing I need or even want.

He will send me a copy of the intake when he sends one to Dr. Pohl's office. I'm looking forward to reading what he had to say in just the 2 1/2 hours I've known him.

Meanwhile...

I can't wait to meet all my new friends at the support group tonight at RW! I've decided to go by myself because I really want to do this part on my own, you know? I share absolutely everything with my family and friends and just want this part of it for me.

Happy Thursday!

Okay, had my dietician appointment yesterday with Mr. Union at Newport Naval Clinic. He seems to know something or other about WLS. He goes along with recommendations by Dr. Bell @ Yale-New Haven Hospital in CT. I called a dietician on Dr. Pohl's list and decided to see her anyway. Tricare won't cover the visit but she has, very nicely, given me a reduced fee.

SO,

Dietician Appt. 3/7 at 10:00 AM

I have also continued working on my Insurance authorizations to make sure everything is appropriate! I have had to call my PCM a few times over. For instance, she put in my referral to Dr. Pohl as Consult/Evaluate and should have put it in as Consult/Evaluate & Treat. Otherwise, I would have to continue calling her for more referrals.

I've told many people in my family about the WLS decision. Everyone supports me! Even though hubby is deploying April 1st, I have all these people promising him that I will be well taken care of while he's away. 

I thank God for all the blessings in my life!

Tomorrow is my Psychology appt at Newport Naval Clinic. I'm kinda nervous about it because I'm afraid I won't get a thumbs up because of the stresses that come along with deployments. I've been there, done that. At least he's not going back to Iraq!

Happy Wednesday!

Today has been a very very busy appointment day!!! I also received  the book I ordered, "Weight Loss Surgery for Dummies" today. I'm looking forward to 'curling up' with it tonight.

I've made lots of progress with my primary care manager as well. She will put in my referral for the Sleep Study consult and the Sleep Study itself.  She will also update my referral to see my regular counselor, Susan.

2/26/08 Dietician @ Newport Naval 10:45 AM.

2/28/08 Psychologist @ Newport Naval 8:15 AM.

3/04/08 Neurosurgeon for Spine follow-up and I will ask him for a letter of Medical Necessity. 1:30 PM.

3/06/08 Sleep Study consult with Dr. Millman 1:45 PM.

3/10/08 Cardiovascular Surgeon, Dr. Lanna. 2:30 PM.

My counselor, Susan, is on vacation in Florida so as soon as she returns (March 17-18), we will set something up as well. Because I have seen for for over five years (even though she is only a LSW) I think it will help if she also tells them I'm mentally capable of handling the pre-, during and post-surgery periods.

I asked my doc's nurse about my doc doing a letter of medical necessity/referral for the insurance company. She said that if my doc didn't think it was a necessary procedure, she would not have put in the referral to begin with.

I am getting all my ducks in a row like I wanted but I'm really pissed about the insurance aspect of things! Either the suggested specialists don't take Tricare or Tricare covers so little for a non-network provider that it's gonna cost me money I just don't have!

Because I'm a Veteran, I also called the VA Medical Center to see if they can help me with any WLS evaluations I need. They all said "We've never heard of anything like that". So much for that!

I literally spent SIX hours on the phone with facilities, specialists, referral management and going over authorizations with Tricare. Whew! I'm pooped! If this doesn't prove how much I want this, I don't know what else will.

I have problems with the area where I had an abdominal hernia removed. The scar gives me a lot of pain. I had a CT scan to rule out another hernia. No recurring hernia. Just nerve entrapment where the scar is. I will talk with Dr. Pohl about repairing this for me while he performs the WLS.

I am now leaning toward RNY. I do want to learn more about Distal vs. Proximal and what would be better for me.

I'll post tomorrow as soon as I can. My grandson, Adam, Jr., turns 4 tomorrow! He and his mommy live with us now so we are having a little bday party for him in the evening. Shhhhh, don't tell him!

Spoke with my PCP today. She put in the referrals I need for a dietician, a psychologist and a cardiologist.

I will call them as soon as the referrals are available. I want to get those visits 'knocked out' before my first appointment with Dr. Pohl on March 31st.

I've already downloaded all the suggested letter forms and suggested items for each specialist to cover during my visits. I will give these to them at our first meeting.

I have also contacted my Neurosurgeon for an appt to see him so he can give me a letter of medical necessity. I think it would be better for the insurance company to receive it from him rather than my PCP because he knows my history better and I've been seeing him for a longer period of time. Although I have had the military service for so many years, the PCP's there change almost as often as I change my undies.

Anyway, I also have a referral for a neurologist because of my migraines. I'm so fed up with pain!!!! From head to toe! Literally!

Well, another day,,,,another pound gained. 253 now!

Three out of five of my grandkids will be here all weekend. Oh My! My ex-daughter-in-law is living here with my grandson Adam, Jr. At least until April 16th. So, I have extra help right now but at the same time, I have extra activity going on all around me.

Okay, I'll stop my bitch session. Have a wonderful weekend!!!

I have an appointment with Dr. Dieter Pohl on March 31st at 2:30!
I called my PCP and left a message letting her know that I need appts with a cardiologist, a dietician and a phsyc eval. She needs to put in these referrals for me. I am also going to call my Neurosurgeon to get a letter from him stating medical necessity and how WLS will benefit me.

Still not certain which one is right for me yet. Lots of research. Lots of research.

March 31st is also the day before my husband deploys for a year. I was hoping John would be able to join me for, at least, my first visit so he can ask questions. I wish he was going to be here for the whole before and during periods but I know he's in my corner no matter where he is. I love him so much! I don't know what I've done to deserve such a wonderful man. I swear, he's Super-Human sometimes. He loves me no matter what weight I am! And that wasn't even one of the pre-requisites before saying "I Do" ( you know, in sickness and in health, for richer or poorer, etc).

I have a lot of support here! My husband and children are so wonderful and my best friend, Renee, lives right next door and is a CNA and a home health care provider as well. I couldn't get better physical and emotional help and support!!!

Well, so far, I went to Dr. Dieter Pohl & Dr. Jeaninne Giovanni's WLS seminar at Roger Williams Hospital on Valentine's Day. I called their office several times the following day and got busy signals each time. I will call again Monday until I have actually spoken with someone. 

I have met with my primary care doc and she has put in the referral for me to see Dr. Pohl. She definitely recommends the surgery for me.

I still want to talk to her again about the list of tests that need to be done prior to my approval for the WLS. I also want my Neurosurgeon to be made aware of my decision.

At this point, I have yet to make a decision as to which WLS to go with. Whether it be the Lap-Band or the RNL procedure. I'm not sure what's best for me and my family yet.

My biggest surgery fear is waking up from the general anesthesia with profuse vomiting. I have been doing this for every surgery I've had for the past six years. And I've had many. I'm praying that I will still be a good candidate once the WLS surgeons learn of this.

I have done lots of research, online, articles, tv and books, as well as, OR videos of each procedure. I just ordered WLS for dummies. I believe that you can never underestimate the power of knowledge.

I've recently found out that my insurance will cover the Lap-Band procedure too. I'm pleased about that. Perhaps that's what really prompted me to go forward with it. I am, however, prepared to 'fight' the insurance company all the way as they drag their feet. Hopefully, it won't be as big a battle as I anticipate.

I hope to keep journaling regularly. I'm not too good at this sort of thing.

Good Day!