2/17/07

Feb 17, 2007

Havent posted in a while since not too much excitement is going on since I am doing my 6 month diet program.

I did get an appt for my Psyc Eval.. it is scheduled for March 7th at 9am.

I think I might talk to her about seeing me after the surgery, since I have read alot about depression and other issues coming up after surgery, I just want to be prepared.

I go back to my PCP on February 28th at 9:30am... I am going to see if she will speed up my 6 month diet.  I have been tracking my food and weight for months, I just havent "officially" seen her for diet program.   I guess I need to find a tactful way to ask, without sounding pushy or trying to get away with anything (kwim?).

I ask my hubby what he would think if after I lost my weight I became a "girly girl"... LOL... right now I am so far from a girly girl it is pathetic.  I think he would be happy just to see me happy again.

I guess that is it for now... 
Susan

02/06/07

Feb 06, 2007

Had my seminar with Dr. Avara.  I immediately liked him, he knew what he was talking about and answered every question, and didnt talk down to you.

I am in the process of my 6 month supervised diet (hoping they will count January as month 1).  My goal is to have surgery in August, so I will be done before Daniel goes back to school after summer break.

They said that I can do my Psyc Eval during my 6 month diet program, which will save some time in the end.  SO I might call to see if I can get something scheduled for next month.  I think I would really like to keep talking to the psychologist even after the evaluation, just to make sure my head is straight thru the entire process and post op with all the weightloss and emotions of that.  I dont think  that would be a problem.

So that is about it for today.
Susan

01/24/07

Jan 24, 2007

Today was my first visit for my 6 month Dr supervised diet/excercise program.   My doctor was fine with it... she told me to bring in my food sheets each month and we would go over them and to try to excercise.

My weight this time was 393.5 (up from my scale) and my BP is 118/80.  I requested lots of blood work to be done, incase it all has to be done later (so it will be done already).

My doctors nurse had Gastric Bypass in 2002 and she was asking why I didnt want to go that way (vs Lap Band).... so we chatted for a bit and now I dont know which one I want to do.   So it looks like I will have more research to do.

My Seminar with Dr Avara in Ocean Springs is still set for February 6th, so I will get even more information there.

I figure it is going to be August or later before I have surgery, since I have to do the 6 month diet thing.  Which is ok since I am still saving up all my money for the surgery aslo.

Happy Day
Susan

01/22/07

Jan 22, 2007

I talked to the surgeons office today, to see if I could skip the seminar and just do a consult... 

Yes I can, so we went over some of the requirements that insurance has so I can make sure I have everything ready.

Come to find out they are real sticklers for the 6 months diet/excercise and with all that has to be written down to verify it.  

I also talked about money with them to see what I will need to have up front before the surgery. WOW... alot of money... LOL

So I went over my budget and it looks like I will have all the money I need by the end of June, that is just before my 6 month diet/excercise is up.  So that is wonderful news... LOL

This makes me happy... :-)
Susan

01/18/07

Jan 17, 2007

Well l just spoke to the insurance people again today... and it is going to be difficult to get TOPS approved... but that is ok.

I am now going to go to my doctor (internest) and see what records that she has about my weightloss efforts.   It only has to be documented 6 times within 24 months... I just looked at my records and I have been there 12/3/05, 3/13/06, 6/29/06, 12/28/06.... so if I cant get her to write something stating that we talked about my weightloss efforts (TOPS, NutriSystem, LowFat Diets and excercise) then I am almost all the way there.
They dont open till 9am so we will see how quickly I can get an appointment with her.   I know that she fully supports my weightloss efforts (even though they havent worked)  and we have discussed WLS before.

I will update soon.
Susan

Updating... 
Well I got an appt with my doctor for next wednesday... so we will see what she will do to help me out.

01/17/07

Jan 17, 2007

Well I spoke to the insurance company today (we switched as of the 1st)... 
*********************Drum Roll Please**************************

Bariatric Surgery is Covered.... whoooohooooo 

I found the list of things you have to do before they will approve you, but it dosent look that hard.  They do request a 6 month weightloss program... and they say that Weight Watchers and Jenny Craig, etc. are apporved programs... so I am going to call back and ask them about TOPS since I do have records for going there.  If not, then I will join Weight Watchers and start next week.... even though I would love for it to not take 6 more months to get the ball rolling, I am glad that they will atleast cover it... as long as I jump through their hoops.

That is it for now... 
Have a great day,
Susan

Recap of what is going on...

Jan 14, 2007

01/14/07 -
I cant believe it has been so long since I have updated... probably because insurance was being a butt and they were too wishy washy and just wouldnt say YES.
So this year we have a different insurance (BCBS of IL) so I hope they will be alot easier to deal with.  I am going to call them Monday morning to see what they will cover and what our out of pocket and deductables might be.
I still have all my paperwork and things together from trying last time, so that should be easier... I just updated stuff tonight.
I will keep this updated on all my progress (thinking positive this time).
*****
03/29/06 -
Long time now update.
I havent had the surgery yet and I am going to re-try with our insurance again and see what happens. I am going to be trying with a different doctor also. My husband is going to be going to try for the surgery first, he has soooo many comorbidities that he almost has to have the surgery.
My husbands therapist works with the Ocean Springs office of Dr Avara and is highly recommending him for the surgery.
We will see how this all works out.
*****

6/30/04 -
First off... why does insurance have to be such a pain in the butt????

Dr Ludwigs office called to tell me that insurance said I do qualify medically for WLS, but they want a 4-6 month Medically Supervised Low Calorie Excercise Program and a Thyroid Study, Hormone Study, Endocrine Study and a Medobolic Study.
Dr Ludwig is sending me to Dr Lansden and Endocronologist who can do the entire thing (diet, excercise and tests).
The only good thing is that Dr Lansden is in network for my insurance... so the tests will be covered but nothing else. This doctor does the OptiFast program ( I DONT WANT TO DO OPTIFAST!!!!!!!!)
I have an appt to see her tomorrow at 3pm, so we will see.

Dr Ludwigs office also has a support group meeting tomorrow at 6pm, I am going to go to that also... since they said I can bring my son if need be... YEAH!!!! (since DH dosent get home till 6pm)

*****

6/23/04 - Well I am one step closer to having surgery..
small step but I will take it... LOL

Insurance faxed the surgeons office requesting more information, like a detailed diet history and a thyroid test. I already gave the surgeons office my diet history (I now have to fill out some form) and I had a thyroid test done in January so I will be picking up those results tomorrow.

I guess it is a good thing that they are requesting more information instead of just telling me NO. (well I am looking at it like that..LOL)

*****

6/9/04 - Yesterday I had my consultation with Dr. Ludwig. He seems very knowledgable and helpful to answer ANY and ALL questions that are asked. I also had a consult with the Nutritionist and the Nurse. At my one-on-one consult with Dr. Ludwig, I asked him about his record with WLS. He has only done 50 and only had one complication (blood clot that was taken care of). I am not sure how comfortable I feel with him only doing 50 WLS... he has done many other surgeries and has NEVER had a fatality. The office sent my paperwork to insurance, so now I just wait. If insurance wont pay, I can not have this surgery.
OH YEAH... when they weighed and measured me I am 356 pounds (not a big suprise.. same as home scale) but I am only 5'9" (I use to be 5'11 3/4"... I am shrinking.. OH NOOOOO)

*****

5/19/04 - Dr. Rose's office just called... I have a consultation scheduled for June 8th at 11am with Dr. Ludwig.
I cant wait... YEAH!!!!

*****

5/10/04 - I just called Dr. Rose's office... they are going to make decisions on consults this week... and I am the first one they are going to call (we will see).. I told them that I would probably call them back late this week too... LOL I am excited to get this process started.

*****

4/24/04 - I called the insurance company today... expecting them to tell me NO... but they said they do it on a case by case basis. They told me that I needed the Letter of Medical Necessity. I called Dr. Rose's office, found out the she is indeed moving to Virgina and they werent doing any consultations or anything till June, so I am in a holding pattern till then. I am getting all my diet and weight loss attempts put together so I will have that all ready for the appt.

About Me
DIberville, MS
Location
34.9
BMI
RNY
Surgery
07/31/2007
Surgery Date
Nov 24, 2003
Member Since

Friends 28

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