tedthelightbulbexpert
My Path to Surgery, Pt. 1 - The Revenge of Sisyphus
Dec 20, 2010
Armed with a new sense of purpose and the knowledge of the procedure, I consulted several surgeons in the area. I was very eager to get the surgery, and consulted with the one who could see me the soonest. Who that surgeon was is unimportant to the story as I only saw him once; once it became clear what insurance I had (Tricare), I was effectively dead in the water. At the time, weight loss surgery was still a novelty for Tricare and they would not consider approving me for surgery. Dejected, I opted to wait until the next year so I could find another job and another insurance provider.That next job's health insurance provider proved to be Cigna, which was another insurer that proved wary of WLS. Granted, as opposed to Tricare obstinacy, Cigna was at least willing to consider approving surgery on a case-by-case basis. My case, as was the requirement at the time, required extensive documentation: everything ranging from a supervised dietary and exercise regimen, psychological screening, counseling, etc. 8-9 months later, after I'd jumped through all the required hoops, I was laid-off of that particular job. Unable to spare the extravagance of WLS while looking for a new job, I had to again postpone my quest for surgery.
Next, I found another job which provided a variety of insurance alternatives. I researched what was available well in advance and opted for Blue Cross Blue Shield Federal (FEHB), which I'd learned on this very site was one of the best insurers to have for WLS candidates. Armed with this more accomodating insurance, I went to Dr. Christina Li of the Baltimore Sinai Memorial Hospital's Bariatric and Minimally Invasive Surgery Department.
Dr. Li was wonderful. She was infallibly personable, warm, and understanding. She seemed to really enjoy her work as a surgeon and looked forward to helping her patients achieve their weight loss goals through surgery. I actually looked forward to seeing her, which is something I can only say for a handful of doctors in my life. What's more, I very much looked forward to having surgery with her. But, that did not prove to be what Fate would have in store for me. The problem resided in the way the Bariatric office handled pre-surgical testing and workup, and the staff's clear 'lack of enthusiasm' for assisting patients in setting up appointments. This may have changed since my time with Dr. Li's office, but there was no centralized scheduling of the necessary appointments, leaving patients with little more than a packet of doctor's orders and the numbers of different providers of necessary diagnostic measures.
This didn't seem particularly troublesome at first, and I assumed there'd be little problem in arranging testing myself. But, the combination of disparate service providers with a tight, yet overlapping schedule for required tests meant I ended up missing deadlines and repeating a lot of tests, wasting hundreds if not thousands of dollars in copays and lab fees. For instance, there'd be a requirement for a chest x-ray three months prior to surgery, lab work two weeks prior to surgery, and a psychological screening one year prior. Of course, I opted to complete the psychological screening first, but that would prove to be the single most difficult one at arrange. None of the providers seem to have appointments any sooner than six months before surgery, most wanted to see me for multiple sessions before they would approve or disapprove. I opted to see my old psychologist in Arlington, who was willing to do the screening and had the questionnaires sent from Dr. Li's office. What I had presumed would take only 2-3 weeks ended up taking three months of repeat sessions before I had an approval letter. By then, I needed to get a chest x-ray, among other tests, and found that I couldn't arrange such testing until it was perilously close to the scheduled surgery date. Without the chest x-ray, several other necessary tests (Upper GI, etc) couldn't be completed: I was pushing it perilously close. Too close, in fact, because by the time the psychological consult and chest x-ray came through, it was too late and my surgery had to be pushed back another six months. That of course meant repeating the majority of tests I'd already taken: blood work, chest x-ray, cardiological consult, EKG, etc.
As if that weren't enough, I had the misfortune of developing a blood clot in my leg after returning from a very arduous trip abroad. Understandably, but disappointingly, this put a halt on my surgery as I had to be treated with blood thinners for six months. That of course meant having to redo all the testing I had completed yet again. Once I was 'cleared' and taken off the blood thinners, a year had elapsed, meaning I had to do the psychological evaluation all over again. The same problem presented itself: either no one accepted my insurance, they weren't accepting new patients, they couldn't see me for 4-6 months, or they wanted to see me for an untold number of 'developmental' sessions before even committing to the surgical consult. It was a nightmare, and I was completely dejected. It had now been five years since I first sought out WLS, and now I faced having to go through the process all over again.
This situation was further complicated by the fact that my wife and I had two children during this time and opted to move to Virginia where it was easier to buy a house. The prospect of driving back and forth between Baltimore and Northern Virginia was just too much, especially when there was no guarantee that some unforeseen development would again hinder my surgery. I just threw in the towel, resolving to just 'live with myself' and my weight.
It seemed a reasonable enough prospect at the time, the only thing that was damaged was my physical vanity, something that married life had conditioned me to stop caring about quite as much. However, my two children provided another, unexpected reason to reconsider surgery. At 4 and 2 years old, my son and daughter are balls of boundless energy, who are always anxious to play with their parents. But it's been impossible for me to keep up, I'd always find myself aching too badly after a modest chase, or drained by the exertion of simply carrying my girth around through the course of the day. I thought about my children's future, the sort of eating habits I was inculcating in them. I became worried that I'd pass on my bad habits to them and I didn't want them to go through life the same way I had.
What really did it for me was a trip to a local park on a temperate spring day. As my kids ran around on the grass and my wife and I set up a picnic, I found myself sweating profusely and out of breath at the most trifling of physical gestures. It had been a long, slovenly winter and I was suffering for it. While considering my fate, I saw a father/son team running down one of the many jogging paths, keeping pace with one another, father encouraging his son along. That sight stirred me in a way I hadn't been since my son and daughter were born, and in that instant, I knew what sort of father I wanted to be. I knew what I had to do to become that father, to get in better shape, to have more energy to play, to inculcate them with an appreciation for exercise and good food and being healthy in general.
I needed to pursue surgery one more time.
