southerngeorgiagirl

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Spoke with Dr Voellinger's office today.  For medicare patients they have a year to year-and-a-half waiting list and I would have to redo everything I've already done.  Now I have to decide whether or not to wait until Dr Husted accepts Medicare or have rny.  Don't know for sure what I will do.  Will go ahead and complete the things that is needed for Dr Nye to do surgery while I decide. 

Seen Dr Nye yesterday.  Discussed rny vs ds, said ds is normally for people over 600 lbs.  I think he is talking about bpd with ds, not the one everyone else is talking about.  He said he would do rny on me and do a long one which would lead to more malabsorption and could probably get me down 100 lbs, so I am a little discouraged.  Had hoped he would say I could loose more, but maybe he is wrong.  Hopefully when I do everything I am supposed to do I will lose more than 100 lbs.  Another reason for rny vs ds is my psych meds.  I hadn't thought of that before, though I knew there would be malabsorption I guess I just overlooked about my psych meds.  He said I would do better with the rny because of that.  I just don't know.

I got information pack from Dr Voellinger who does ds, do I may go see him and see what he says then decide.

Meanwhile I have to get cardiac clearance and pulmonary clearance.  The doctors would not see me without referral from primary dr so I am waiting to hear from here.

Right now I am not even sure I should follow through with it for 100 lbs worried about what it will do to my psych diagnosises.  I haven't been hospitalized since 8/08, but from 10/07 to 8/08 I was hospitalized for 4 times.  Guess I'll discuss it with therapist today and psychiatrist Thursday.  Both know I am trying to get this surgery and both are supportive.  Psychiatrist is good about working with me on meds so he will probably continue to do so.

Anyway enough for now.

Well, I spoke with Geri at Dr Marema's office again on Tuesday.  The facility still won't reconsider their decision not to take Medicare anymore, so I thanked Geri for all of her help and support.  I will now go see Dr Nye.  When I worked at Tricare I sent alot of patients to him and have heard good things from the patients that I sent, but I chose Dr Marema because of the distance factor.  Oh well, I'll just have to see what Dr Nye says.

I've been doing alot of research on the rny and the ds.  I think I would really prefer the ds, but I can't find any provider that will take Medicare that is within a range of 4-6 hours, and I'm not sure I could afford to go somewhere else, so I guess I will have to stick with the rny.  I know several people personally that had the rny surgery and they did well, but they did not do revisions and according to my research it will be more difficult for me to loose the weight even if I have the rny, but I feel like I need the tool of the surgery to help me loose weight, and even if I only lost 100 lbs, that would be better than nothing.

I am more prepared for the surgery this time, so I feel like I will do better this time around than the first time.  I'll go for now, will write more after I see Dr Nye on Monday, the 15th.

Made an appointment with Dr Nye today.  Will see him the 15th.  I sent alot of patients to him when I worked with Tricare and have heard alot of good things about him and his office.  I chose Dr Marema because he is closer(2 hours vs 4-5 hours), but if hospital won't take Medicare then there is no way I can afford it.  I hope that things work out with Dr Marema(his office is supposed to be talking with the hospital to find out more), but I am supposed to start back to schoo, so I want to have the surgery ASAP, so I can recuperate and make it back to school without having to skip a semester.

Spoke with Sherry at Dr Nye's office and she was very helpful.  More later.

Spoke with Geri at Dr Marema's office today, I may not be able to use them for my surgery, so I am really disappointed.  I don't know what to do.  She states that Flagler hospital has decided to treat people with Medicare who are seeking revisions as the same as self-pay.  Apparently they haven't been being reimbursed by Medicare for the revisions for the past year, so most likely I will either have to pay them 31,000 dollars up front, or choose another provider.  Geri states she doesn't really know why this is occuring so her office manager is going to speak with the hospital person who made this decision and see if anything can be done.

I called and spoke with the Medicare people and they gave me the same guidelines that Dr. Marema's office had given me in February, and I have met all these guidelines and it is a covered benefit.  He doesn't know why the hospital is not being reimbursed by Medicare and suggested it may simply be a coding error on the hospital's fault.

After I spoke with Medicare people I called Geri back and told her the results of my conversation with Medicare in hopes that maybe that would help the office manager ask the hospital to get on the phone and call Medicare and find out why they are not being reimbursed when this is a covered benefit.

I don't know what to do.  I like Dr Marema's and his office staff and the only other place I found that does revisions and accepts Medicare is in Miami and that is 4-5 hours away, Dr Marema is only 2, but I need this surgery and may have to go that route.   Geri said she will call me back next week, so maybe I'll just wait until she calls me back and then go from there.

I'm trying not to give up, but it is so discouraging.

Spoke with the nurse, Kiersten, at Dr. Marema's office today, briefly discussed medical history,  Geri still has my chart dealing with insurance and she had already left for the day, so Kiersten is going to email her to see if we can proceed to the next step in my journey.  She says that based on what I told her today the only type of clearance I will need is a blood work, chest x-ray, and EKG, and another letter from my primary doctor.  I told her I already have a letter from my primary, but she said this one is different.  The one I have is saying that medically I need the surgery, but the one she will need is saying that he clears me to have the surgery.  She said she'd call me back, but if by some chance I hadn't heard from her by Friday to call her back.  I hope I can get the ball rolling as I start back to college the middle of August, and I want to be well on my road for recovery from the surgery by then.

I thought  before I seen Dr Marema about this "revision" that he would have to do it open and was pleasantly suprised that he is going to be able to do it laproscopically.  He said his partner, Dr. Koffman, would even be able to fix my 2 incisional hernias by laproscope.  I didn't know he would want to repair my hernias, I've had them since shortly after my first surgery in 1998, and doctors always told me that unless they were bothering me it would be more dangerous to fix them than to leave them alone.  Dr. Marema said surgery won't go as well if they are not fixed, so I get to have the bypass and hernias fixed at the same time.  One less time of having to be put to "sleep". 

Well, I have everything that Medicare requires for a revision done and faxed to Dr. Marema's office.  All that is needed is a nutrition class which Dr. Marema's office will provide.  Spoke with Geri today, states she has all I need so the nurse will contact me tomorrow or Monday to discuss if I need any additional clearances for the surgery, so I guess I'll know more then.  I hope I don't have to have any additional clearances.  I really want to have the surgery soon as I start back to class in August and I want to be fully recuperated and on my way by then, but I guess I will just have to be patient.  I am more mature this time go around so the surgery is going to work this time.