3/16/2007

Mar 16, 2007

Well, I called the surgeon's office today as I was told to do to be sure that the paper Dr. Stote handed me last night after my psych evaluation was what I needed to include in my insurance package.  The person I talked to knew right away who I was!  He said he had just sent me a copy in the mail along with info about support groups and some other info, even though Dr. Stote didn't say I needed to attend any.  He said he wasn't always sure when Dr. Stote gave the sheet to the patients and when he didn't, so he had put it in the mail to me just in case.  He said I could ignore the second one when i got it.   So then I called Dr. Reilly, my PCP to ask what was up with his letter and copies of his records that showed all my comorbids.  The secretary told me she had everything ready for me, so I guess they were just not bothering to call me like they said they would??  anyway, they close early on Fridays so I took a quick break and ran over there to pick that stuff up.  Dr. Reilly's letter was pretty basic, and I thought it was a little weird because he said I had high cholesterol/triglycerides and a history of gestational diabetes, but no mention of the high blood pressure, which is the only thing I'm on meds for!  And I never actually had gestational diabetes, I just failed the short glucose tolerance test, had to take the longer retest, and passed that.  But there are no records I'm submitting at all about that, plus Dr. Reilly's records are chock full of mentions of my hypertension and my meds for it and all that.  Actually reading his records was very depressing.  Probably 3/4 of all the entries were about weight, hypertension, high cholesterol, dieting, or depression.  An added bonus, he had records from the dietitian, which I hadn't expected to be there for some reason, even though he sent me to her. 

So I have everything I'm getting at this point.  I went at lunch to the post office and sent everything off priority mail with return receipt per the surgeon's instructions.  As best I can tell from speaking with the insurance this may be sufficient.  I have proof of my BMI, my co-morbids, and letters from both my dr. and surgeon stating I've tried and failed at conventional weight loss and they have a history of those weight loss attempts, including copies of the 9 months I attended a diet clinic and took Phentermine, and copies of the dietitian's records.  The only possible problem might be the diet history, I think.  Aside from the above, there's not a lot of proof of my diet attempts.  They've told me three times now that there is no 6 month diet history requirement, but they do state that I have to have tried and failed conventional weight loss methods.  They never said what they needed to see to show that.  I'm hoping that I have enough.  If I don't, I don't.  If I get turned down because of that, I'll just start getting those requirements met.  But man, I have to say I'd LOVE to get this surgery sometime very soon, like April or May.  It would be so cool to be down a bit before summer.  :0)

So it's off to the insurance for approval or not... As soon as I get my return receipt I'm going to obnoxiously call them and sweetly ask if they got my package and how long I should expect it to take to get an approval decision.  They say they don't really need to pre-approve it, but they will send it out if the surgeon asks for it.  I'm getting all excited about this now, although there were some moments today where I had a "what are you thinking?!" moment, and it was always about how I'd never get to eat xyz food again... And that just speaks volumes, doesn't it?  I'm not worried I'll die so much at the moment, I'm worried I can never have the yummy chicken tetrazzini I had for lunch today again.  Sigh.  Definitly gonna have some head hunger issues.  :0)

I'm off for now.  Too tired to stay up anymore!!
Kim :0)


3/15/07 - Psych Evaluation!

Mar 15, 2007

Well tonight was my psych evaluation with Dr. Stote.  I had heard on here and at a support group meeting some negatives about him or that he often would require attendance at several months of support group meetings.  I don't mind the support groups, but I didn't want to have to postpone things for several months. 

Anyway, he seemed a bit quirky from what I could tell, but very friendly and not at all critical or unsympathetic.  I of course, checked out his bookshelves and he had lots of intersting reading on body image and eating disorders and stuff, and that was comforting.

Anyway, it went very well!  He stated at the end that he thought I was one of the "better candidates" for this procedure.  He asked me what I thought my biggest challenges post-op would be.  I said the whole not drinking while eating meals thing, and the head hunger issues.  We talked a lot about my eating candy and chocolate all day at work, and I said that I was worried about how I would deal when I was thinking, "This day is awful, I really need some chocolate!"  He said he agreed and that he suspected that my eating candy at work was a coping mechanism to deal with stress there.  He said that his biggest concern was also that I would have trouble coming up with alternative ways of dealing with stress, especially at work.  He said I should sit down and write up a list of other possible ways of dealing with it, like going for a walk, taking a break, deep breathing, etc. and then going through the list to see what might work.  He also said that I should start exercising now and continue both to help maximize my outcome and to help with the stress.  He said if none of that worked, I could consider therapy on how to deal with my stress issues at work in a healthier way than M&M's.  :0)

Well, that is very long!  Now I just need to get that letter and medical records from my PCP.  He was supposed to have them for me a week ago, but I still haven't heard from him.  I'll call there tomorrow and see what is up.  As soon as I have that I'm submitting everything to my insurance.  I probably should try to get more records of my diets and stuff, but it is all old and probably wouldn't help that much anyway.  The only thing I'll be missing that might help is a copy of the glucose tolerance test I failed during my last pregnancy. 

But my plan at this point is to submit everything I have after I get that last bit from my PCP, and then see what happens.  If my insurance company denies me and asks for more information I'll get it at that point.  I *think* though from what the insurance has told me and from what I've read on here I should have what I need at that point. 

I'm babbling!!  I'm so excited to have gotten through this part of the hoop jumping!

Done now.  Bye!
Kim :0)


3/9/2007

Mar 09, 2007

Hi everyone!  I have had a long week.  On the WLS front I went to my first support group meeting this week on Tuesday at St. Vincent's.  I was going to go to the meeting in Anderson but decided probably more people would be in Carmel, so got a wild hair and decided to drive up there instead.  Long night!!  It was fun to see all the people who had had surgeries and had lost loads of weight.  And I met some very nice people. 

I had a rough week at work though, so I'm very glad that is over finally.  And then when I got home tonight I had the added bonus of receiving my package and insurance request letter from Dr. Jones in the mail.  According to my insurance on Monday after seing Dr. Reilly, my PCP, I shouldn't need anything more than what Dr. Jones sent me!  I will hold off on submitting anything until I get my referral letter from Dr. Reilly and my medical records from his office, and then next week I have the second half of my psychological evaluation on the 15th.  I did the written part at my consultation.  Now I'm getting worried about the out of pocket costs.  I just hope they negotiate the hell out of that rate so my 10% is manageable!!  Otherwise I might be really SOL.  I have a maximum out of pocket of $4000, of which I've already paid a whopping $50 for this year.  If I have to come up with $4K I will have to postpone until I don't know when.  I hate not knowing exactly how much I will need to come up with.  I think I've got about $1100 in my FSA, and I'm hoping I won't need a whole lot more than that.

Guess that's it for now...

Kim :0)


3/5/07 - Visit to my PCP

Mar 05, 2007

Went to my PCP today.  Here's what I posted on the boards about my visit:

I was so flipping nervous!  I still feel like I could throw up.  He wasn't exactly enthusiastic, but neither did he shoot me down.  He made me tell him what all the surgeon's office had told me, so I told him how I knew all about complications and it possibly not working as well over time and so forth.  He asked me if I'd been to a dietitian.  I wanted to say, "You're the one who sent me to one, for the love of Pete!"  Same thing when he asked me if I'd ever had my thyroid tested.  He also asked me if I'd ever tried Atkins (yep, dietitian put me on) and stuff like that.  In the end though, he said I needed to find out what my insurance required & he would write me a letter.  I told him I was having trouble finding that out (I have BCBS Federal Employee Program, and I've probably read 10 different things on here.  All they tell me is the BMI and age requirements).  He said he would write me a letter & have it ready by this weekend.  I chickened out of giving him the letter I'd written for him... I thought it might offend him.  So it seems as if he's reluctantly going to be supportive.  I did give him a copy of my diet history.  His secretary was a little snippy about making me copies of my medical records though.  Usually she's very nice.  I keep thinking that after this is over I should probably consider changing PCP's since I'm so uncomfortable talking with him about all this, but now I know he's going to write me a letter, I'll hold off on that.

On a side note, I did call my insurance again, and I told the lady what I was trying to find out and that when I'd called before they just referred me to my brochure.  She said that was honestly all they required - the BMI requirements, documentation of my co-morbidities and I have to be 18.  She even double checked it and came back and assured me that is all they require.  She said they don't even require any kind of pre-approval, but said a lot of the doctors want to do that to be sure they're going to get paid, and if they send it in, they will send an approval letter, but it isn't required.  She didn't mention any diet needed or even a letter from my PCP (may have gone through this nervousness for nothing!) or anything.  Weird.  I'm not going to get my hopes up at all.

But I'm really glad that part is over with.

Kim :-)

2/28/07 - Consultation

Feb 28, 2007

Today I went to my consultation with my DH.  I am feeling so much better about the idea of having surgery now!  I again worried they would kick me out of there because of my lower BMI, but I discovered it was actually higher than I realized.  I had thought for years I was 5'5", although I don't know that I was ever officially measured, but today they checked and I was actually only 5'4" so now my BMI went from somewhere between 35 & 36 to 37.4.  Still a "lightweight" but not as much as I'd thought.  When I spoke with Dr. Jones and heard her speak to the group I felt so reassured.  She told me that I was an ideal candidate because with the lower BMI I am very low risk for death or serious complications, but because I'm starting to see some problems with my hypertension and my cholesterol and I have had some early indications of things like sleep apnea and pre-diabetes (failed a glucose tolerance test during my last pregnancy but passed the longer version) that I was someone who could reverse the problems I do have, and could prevent getting any further issues that will likely arise without the surgery.  I told her that DH was afraid I was going to die, and she said "You won't.  As a matter of fact, you'd be like a poster child for RNY"  and went on to explain the stuff about low risk with the surgery and reversing and elimination the weight related problems I have started having. 

DH seems a lot more supportive after going today and learning what he has, and his fears were greatly alleviated.  That makes me feel so much better to know that I do, in fact, have his support.  He said she made some really valid points about why it makes sense to go forward with the surgery. 

We both felt that she was very informative and capable and intelligent and compassionate.  Also struck me as funny and personable.  All of which was good.

She did convince me that I probably won't tell anyone about the surgery.  I have told a few people - my parents and my best friend - and I may just leave it at that.  I'm afraid of getting a lot of crap from people who don't think I'm heavy enough for surgery.  But she basically said that if you tell people - especially before hand - then everyone's an expert, and you are hearing so much that it is hard to sort out the good advice from the bad plus people will freak you out!  I've already had that from my mom, so I think I will probably keep it to myself.  Nobody needs to know all my business anyway!  Might tell my sister in law, as she had it too, and I may want to commiserate with someone at Thanksgiving dinner and whatnot, but probably nobody else.  Maybe my in-laws so I don't have to worry about swearing my SIL to secrecy or anything... she is very open about hers.  I've even noticed her get a compliment about her weight loss, and qualifying to the person making the compliment that it was because she had surgery.  I think I'll just say thanks.  If they want to know what I'm doing, I'm eating a very strict diet and exercising under dr. supervision to get healthier. 

So now I have to get up the guts to go see my PCP about it, which I'm terrified of.  He's not a scary guy necessarily, but I'm worried he won't approve and will refuse to write me a letter of recommendation and all that.  Will also have to start getting whatever medical and diet records together that I can and I have scheduled my psych consult for 3/15/07 & did the 500 page questionnaire today while at the regular consultation.

Rambling like a crazy woman!  Nobody will ever read this far!  I'm just so much more excited now, rather than scared out of my mind.  I'm ready to go!

Kim :-)


2/21/07 Seminar

Feb 21, 2007

Well, I went to the seminar last night.  It was interesting.  I didn't really learn a whole lot that I hadn't already learned about on OH.com.  I did ask a little about long term complications and so forth.  And I did learn that they have been doing the RNY procedure for a lot longer than I realized.  there are some longer term studies that have been done - I want to say 14 year studies.  It isn't a 30 year one, but better than only 5 years.  I liked the Dr.  It was Dr. Diaz.  He's not the person I have my consultation with, but they are part of the same practice.  I felt very comfortable with him after hearing his talk.  I am a little concerned about insurance now.  There was a woman there who talked about costs and insurance, and she asked what we had.  I didn't say, but another lady said she had Anthem.  Sometimes doctor's offices will say the BCBS FEP is the same as Anthem, although none of my stuff every says Anthem.  The woman told the other lady that Anthem requires 18 months of diet before approval.  I read on here that state law says they are only allowed to require 6 months, so not sure what is up with that.  I will have to see what they say after my consultation next week.  I'm kind of looking forward to it now.  Will probably also talk with my GYN next week at my annual appointment and get her opinion, and may go to a support group in Muncie that meets on the 26th as well.  

Kim :0)

2/20/2007

Feb 20, 2007

I should probably wait to add this post till tomorrow, because I'm going to my seminar tonight.  I'm excited to learn what I can.  I had a moment this past week where I had nearly decided to cancel everything, I was so afraid I would die.  I went out and got a diet book to read, thinking I needed to try diet/exercise one more time.  It actually nearly made me convinced I shouldn't stop exploring WLS at all.  There was a statistic they gave that for people who had lost 50 or more pounds by diet/exercise, after two years 95% had gained all their weight back.  Just made me feel so hopeless that dieting and exercising would help me.  Then they had an appendix about WLS, and I was surprised by it's saying that if you qualify, you should consider WLS.  It was written by two doctors, and of course the point of the book is to help people with diet, so I was surprised they would say this.  They gave another interesting statistic, which was that after the age of 50 if your waist was so many inches (can't remember the number, but mine was over it) than each year after 50 you had the same chances of dying from being overweight as you would have if you had been diagnosed with prostate or breast cancer.   Now, I'm only 36, so my odds are better than that, apparently, but there was just something so frightening about that statistic.  Really brought home to me how unhealthy and downright dangerous my weight is, even though I have a relatively low BMI of 36.  Just made me think that I absolutely MUST lose weight somehow and get back to a healthy weight again, or I really AM putting myself at risk of death.  Which made me decide to go ahead and go to the seminar tonight and then go to my consultation next week as planned.  

Anyway, in the mean time I got up the nerve to tell my mom I was thinking of WLS, and she prayed for me and begged me not to do it and mailed me a diet she thought I should try that her cousin had done.  I appreciate her concern, and I understand why she doesn't want me to do this, but I looked at that diet and just thought, "why in the world would this one work when all the others have failed... If I try this I'm just setting myself up for failure one more time."  I'm trying to have a good attitude and all, but it was just a little depressing and discouraging.  It is nice to know my mom & dad are so concerned and are trying to be helpful.  I know if I do decide to go forward, they will be there for me and will be supportive even though they don't want me to do this.

I will maybe write more after the seminar.

Kim :0) 

2/10/2007

Feb 10, 2007

Well, I've continued researching and reading books and things on OH.  All the profiles and blogs are so inspiring!  After doing even more research I've decided that if I do decide to do this, I am pretty sure I want to go to St. Vincent Carmel rather than Ball Hospital... just not enough info out there about Ball or the surgeons there.  Plus St. Vincent's has that whole "Center of Excellence" thing going.  I also think I want to go with Dr. RoseMarie Jones, and have set up a consultation with her for later in the month.  I may try to go to a support group meeting there next week, but it is a long drive for just going after work.  The one last week that is much closer to me got cancelled due to a bad snow storm.  I am going to an informational seminar on 2/20/07, and then my consultation is scheduled for 2/28/07.  That part made me very nervous... seems more real rather than just "research" now.  I am learning what I can about my insurance coverage and am trying to not get my hopes up just in case. 

Have spoken a lot more to DH, and he pretty much says he doesn't want me to do this, and he worries I will die and he isn't going to say anything else, and the decision is up to me.  It would be nice if I could get a bit more positive support from him.  Drives me crazy sometimes.  I mean, if I sit around thinking about how I'm going to die, that isn't exactly the positive attitude I think it would help to have!  I hope he will come around more if he attends the appointment with me or goes with me to the info seminar, although I'm not sure that he can do that unless we can find someone to watch the kids, since it is in the evening.  He should be able to go to the consultation with me if he can get off work.  I really wish he was not so negative about it.  Nothing I can do though I guess, but try to educate him as much as possible and hope he comes around.  Should've never told him that stupid 1 in 200 stat! 


That being said, I do find myself worrying about what will happen to my kids if I don't make it.  but I think I just have to do my homework as far as facilities and surgeons are concerned and put my trust in them and have faith that they will do their jobs to the best of their abilities, and that they will take good care of me.

I'm  very happy to be meeting lots of people here on OH, and I am looking forward to  meeting more at the support groups when I am finally able to get to one. 

Guess that's probably enough for this week!
Kim :0)



2/3/07

Feb 03, 2007

Just starting to try to learn what I can.  I have a seminar I'm going to in a couple of weeks and am now thinking I will get some information from another hospital as well.  Am thinking initially I am leaning toward the St Vincent Carmel hospital in Indy, but will also check out the Bariatric Center at Ball Memorial Hospital in Muncie, as it is a lot closer to home.  Still trying to decide if this is the right decision or not, but the more I read, the more I think so.  Am a little afraid of the surgery, since my grandmother died a few years ago from complications from a surgery, but I'm telling myself this isn't the same thing at all.  She was elderly and was cut almost literally in half.  Hopefully I can do this laproscopically and that is just a lot different.  DH is not overly enthusiastic, but he is saying that as long as the insurance will cover it and I'm really certain it is what I want then he will support my decision.  Am just wondering if he will be supportive enough to go with me to the info seminars or to help with picking out foods and so forth.  Guess we'll see.  He doesn't really seem that interested at all.  I will give it time.

6/22/07 - 6 weeks post op - down 33 pounds.

I'm officially at 6 weeks post-op today.  It was a slow loss this week at only 1.5 pounds, but it was still a loss.  I find myself trying to figure an average for myself and then projecting how much I'll weigh at various points in this upcoming year.  Too silly.  

I can no longer claim to have never thrown up.  Sigh.  Tried pork-chops and peas last night.  DH made them super moist by cooking with chicken broth and also making a red wine sauce to go on top.  they were really good on the way down... not so great on the way back up.  I think it was just a matter of eating too fast, not chewing enough, etc.  That's OK though... vomiting once in 6 weeks isn't too bad.  And I had an excellent lunch of Wendy's Chili yesterday.  V. good.

My measurements keep going down, and I think that sort of made up for the low pounds this week.  My rings are spinning around my fingers now, and my shoes are even getting looser.  My coworker gave me a couple pair of 14 slacks which I tried on last night.  I could get them both on, but the one pair were still a little snug around the waist, but OK everywhere else.  I could get away with wearing them now, but they are white, and I think I need to find something to wear with them.  The others were sort of draw string pants, and they still bunched up weird around the waist too, so I still probably could stand to lose a couple more pounds before I can comfortably wear either of them.  Maybe in another week or two.  But it is cool that I'm more or less officially starting to fit into 14s.  My one 14 shorts are starting to feel a little loose around the waist, but I think they're cut big.  

I'm still struggling to get in 64 oz of water.  I think yesterday I ended up with about 32oz or maybe just a little bit more.  I'm determined to get it in today, but I'm still waiting for it to be 1/2 hour after eating my breakfast.  

Not too much else going on today I guess.  I'm happy it is the weekend and I'm not working tomorrow.  I feel like I could sleep all weekend.  Need to start thinking up stuff to cover in the trianing I'll be giving in August.  I'm a nervous wreck about that.  According to my projection I should be somewhere around 166 by then, so maybe that will help with the teaching confidence. LOL!!  I'm such a nut.

Kim

About Me
Yorktown, IN
Location
24.2
BMI
RNY
Surgery
05/11/2007
Surgery Date
Feb 02, 2007
Member Since

Friends 37

Latest Blog 40
12/06/2007 - Birthday Reflections
11/13/2007 - Six months (and a couple of days)
10/14/07 - 5 months and a few days - 144 lbs!!
9/12/07 - 4 months out (and one day) - 155 lbs - down 63
9/9/07 - Blogging
8/14/07 - Yet another recipe...
7/24/07 - 50 pounds down!!
7/11/07 - 2 months post-op - down 43 pounds
7/9/07 - Another recipe to try...
6/26/07 - Sugar Free Cookies Recipe

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