A Journey of a Thousand Miles Begins With a Single Step

Apr 22, 2008

Tomorrow at 2pm I will see my PCP to talk to him about my decision to have the RNY, and get on my six month PCP supervised diet and exercise program.  I'm so excited!!! I can honestly say that I've never been so excited to visit the doctor, or to start a diet and exercise program before in my life.  Now, if I could just find a way to speed up time...*smiles*.


I'm also going to ask him for a prescription for nicotine patches.  If I have a prescription for the patches, my prescription insurance  will pay for the patches and my co-pay will only be two dollars.   That's a lot better than the $50 a box that they normally cost.  As much as the patches are, if you don't smoke a lot (like me), it is cheaper to keep smoking- not in the long run, but in the short-term, which is what most smokers look at.   That's neither here, nor there.  In addition, I got a copy of "The Easy Way to Stop Smoking" by Allen Carr.  This book has been said to help a lot of smokers quit smoking.   I need to stop smoking at least two months before I have the surgery, per my insurance company's requirements, but I think it would be better if I quit now.  It will allow my lungs more time to heal before the surgery.


I'm also excited, because my consultation with the surgeon is on Monday....I can hardly wait.  I have a list of questions  that I am planning on asking him.  It is quite a long list, so I am hoping that he has time to answer them all.  I am also going to ask him about whether or not we can start the pre-op testing while I am doing the six month diet and exercise plan so that when my six months are up, all of my tests are complete and everything is ready to be submitted to the insurance company for approval.


Say a little prayer for me tomorrow, if you get a chance.

Thank God for Small Favors...

Apr 19, 2008

After I wrote my post yesterday, I logged on to my insurance company's website with my username and password and started looking back through the claims that have been filed with them on my behalf.  It only shows the last 150 claims total (not per person insured), so I was praying that I would be able to see back to 2005.   I scrolled through pages and pages of claims.  Finally, I came to what I had been hoping and praying for. There was a claim that was submitted by my former primary care physician from August of 2005.  Yay!!

I don't think I've gotten that excited over the thought of a doctor visit in a long time.  As I stared at the screen, I called the (former) doctor's office and asked the receptionist if I could put in a request for my medical records from their office, dating back to 2005.  She informed me that there was a 24-48 hour turnaround, and then she asked for my name and date of birth.  I gave the information to her, and she pulled me up on the computer.  To my surprise, the next thing that she said to me was "I'll just start printing these off as I go, since I have you on the phone". 

After talking to her, I got ready to go, and my husband and I drove to the doctor's office to pick up the records.  When I walked in, she had them ready for me.   I loved that doctor's staff, they were always awesome, it was just that he would not listen to me as a patient, and often ended up putting me on medication for ailments that I didn't suffer from.  I was really upset when I decided to find another doctor, because his staff at that office are genuine one-of-a-kind people that are hard to come by. 

I rushed home after picking up the medical records so that I could quickly look them over and make sure that my weight was recorded.  I saw my weights and put them in to the BMI calculator to make sure that my BMI was high enough in 2005 to classify me as morbidly obese.  As per my insurance company's guidelines, I have to be able to prove with medical documents that I have been morbidly obese for at least the last three years.   When the calculator was done, I said a final prayer and then scrolled down to look at the calculation.  I barely made it.  My BMI from 2005 was 40.1 - a far cry from what I am at now.  I've gained over 50 pounds in the last three years. 

I was rather certain that I was morbidly obese in 2005, but I was also very concerned that I wouldn't be able to prove it with medical documentation as required.  It just reaffirms my belief that if God brings you to it, God will see you through it.  Thank God for small favors- he gives them to us each and every day.  Sometimes I get so caught up worrying about every little detail that I can't see the forest for the trees.  I just need to stop and realize each of the miracles and favors that he gives me and those around me each day.

Next on the agenda- quitting smoking. I know that I have quite some time (at least seven months) before I'll be having surgery, but I want to quit as soon as possible.  The  sooner I quit , the healthier I'll be.  Also, quitting now as opposed to the required two months before the surgery will reduce my chance of complications even more than if  I were to quit two months before the surgery.  I'm not sure what I will set as my quit date yet, but it'll be within the next 30 days. 


Apr 17, 2008

I've been looking online at  my insurance company's website for information on their criteria for qualifying for gastric bypass surgery.  I've been reading everything that I can get my eyes on about insurance criteria here and there, but was never able to actually find the criteria set forth by my individual insurance company.  This morning, I found it. 

According to the criteria that has been set forth by my insurance company, my medically documented BMI has to have been over 40 (over 35 with co-morbid conditions) for at least three years.  It used to be five years, but they have since revised it.  The problem?  I know that my BMI has been at or above at least 35 for well over three years, but before I married my husband I didn't have insurance.  When I didn't have insurance, I didn't go  to the doctor very often at all, so I'm not sure that I have medical documentation of my weight. 

This is extremely frustrating.  People hoping to have WLS already have to jump through hoops to get approved by their insurance companies, and the waiting period for approval isn't exactly short.  In order to gain approval, I have to have completed the six (actually seven, as the first month doesn't count) month physician supervised diet within a year before applying for approval.  I may go through all of this and have to turn around and do it all over again because I do not have enough of a medically documented history of obesity. 

At this point, I want to cry.  Instead, I am going to call the doctor that I was seeing before my current primary care physician, and ask what I have to do to get a copy of my medical records from them.  I don't think that they can keep them from me.  Once I get those, I'll be able to see how far back my obesity has been documented, and whether or not I should proceed with my seven month requirements, or wait until I am positive I have three years of medically documented obesity.

Pick yourself up, Angel.  You can't let yourself get knocked down this easily. 

Surprise, Surprise...

Apr 16, 2008

I checked my e-mail last night and noticed an e-mail from the surgeon that I have a consult with on the 28th. It had gone to my "junk mail" folder.  I'm so glad that I decided to check that folder, because I usually don't.  The e-mail was sent last Sunday, so it would have been gone forever in another couple of days.  I added his e-mail address to my "whitelist" (That's what the cable company calls it- I've never heard of it)  so that should he feel the need to e-mail me again it will be delivered to my inbox.

I opened the e-mail praying that they were not writing me to have me call them to reschedule my consultation.  I really thought that the e-mail was going to tell me to call them for a reschedule, and I could already feel my heart sinking.  As I started to read the e-mail, I was pleasantly surprised.  My doctor had sent me an interactive video that explains the Lapband
®  procedure, what happens during the procedure, your decision to have the surgery,what will happen or need to be done before the surgery, explains that you should tell your surgeon everything, that you should have someone with you during the surgery, what will happen after the surgery, how recovery will be, and a few more important points. 

To be honest, when I first started the video, I was a little upset.  I felt that someone at the surgeon's office was not giving me any options regarding the surgery.  I felt as though I was being "pushed" in the direction of the band.  I thought about it for a few minutes (about 5), and realized that the reason for the video may be that they just want to get me educated on the different types of procedures individually, or they mistakenly thought that I *for sure* wanted the band.  In any case, I was thankful that I was given the opportunity to watch the video on the band, because in my opinion, you can never be to informed. 

Honestly, I want to learn more about the RNY procedure.  I really do not like the idea of having a banding device in my stomach and a port just under the skin.  For some reason that really bothers me, whereas the thought of staples doesn't bother me.   It might have something to do with the fact that five of my family members have all had the RNY and none have gone with the band that makes me feel more comfortable with it.  In addition, I'm not to fond of the idea that in order to have adjustments a needle will have to be injected into the port.  (This is coming from an insulin dependent diabetic...lol).  I'll talk to my doctor about all of this when I see him on the 28th.

The Beginning of a Long Journey...

Apr 15, 2008

Today I called my insurance company to see what is required of the patient in order to gain approval for the bypass surgery.  According to my insurance company I must complete a six month physician supervised program that consists of nutrition and increased physical activity. The attending physician must maintain documentation of the program participation, and progress or lack of progress of the patient. 

I wanted to ask if they also cover a procedure for the removal of excess skin, but the customer service rep. that I got on the line seemed rather rude and kept referring me to to look online at the Blue Cross website.  I tried to explain to her that I had done that, but that our benefits booklet had not yet been uploaded and therefore was not available to me, but she kept insisting that I look online.  I decided that I was most likely not going to get anywhere by talking to her, so I hung up the phone and found an F.A.Q. at the Blue Cross website about the gastric bypass surgery requirements, but that is all that I've found so far.  If I cannot find anything else tonight, I'll call back tomorrow, and hopefully get a different CSR. 

I did call and make an appointment for a surgery consult last week, and today I called and made an appointment with my primary care physician so that I can speak to him about getting started on this six month diet and exercise program.  My surgery consult is on April 28, and my appointment with my PCP (Primary Care Physician) is on April 23.  I have a list of questions that I saw here and decided to print out to ask the surgeon.  In addition, I want him to explain everything to me, from start to finish.  I'm excited, and can hardly wait to get started.

About Me
Cloud 9, AL
Apr 13, 2008
Member Since

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Latest Blog 5
A Journey of a Thousand Miles Begins With a Single Step
Thank God for Small Favors...
Surprise, Surprise...
The Beginning of a Long Journey...