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Last night, Chris and I went to CBSGA's seminar in Arcadia, CA.  We saw a slide show, watched videos of laprascopic gastric byass and lap band, met two of the surgeons, and had the opportunity to ask questions.

I selected Dr. LaMar as my surgeon and have an appointment with him on Sept. 11.  (Maybe I'll have something to celebrate on that date, rather than just remember the terrorist attacks...)  I asked Dr. LaMar about Dr. Kamoku's (my GP) concerns about iron absorbtion.  He acknowledged that it is a risk and said he has 4-5 patients with significant problems.  That is out of 2000 surgeries.  2000!  Wow... not as high of a risk as Dr. Kamoku thought.  Also, Dr. LaMar said that most patients who keep up with the recommended vitamin regimine can maintain healthy levels.

Oh, and the BEST part...

Linda was the admin gal who made my appt.  I explained about my insurance company's 12 month history requirement and my 5 month gap, then asked if I need to start over and document for 12 more months with my doctor.  Linda said they will often take if it's recent -- within the past 24 months!!!!

I was giddy when we left the seminar... Chris too.  Maybe THIS time it's really going to happen!

So much has changed since that day in Hartford that I posted about...

I've relocated to California, changed jobs as well as insurance companies.  So far it's looking promising.  My new policy DOES cover WLS.  Since confirming that yesterday, I've been buzzing with anticipation.  Certain conditions must be met, but it seems very doable.  

*  BMI > 40 or BMI > 35 w/ co-morbidities (check)

*  18-60 year age range (check) 

*  Understanding of risks of surgery and after-care (check)

*  Psych evaluation (been through that before...) - 

*  Weight management 12 consecutive months prior (hmmm...) 

The only snag I foresee is the gap in doctor supervised weight management when I relocated to Cali and awaited my new insurance to kick in.  I have monthly weigh-ins w/ my doctor dating back to the summer of 2005, except for a few months earlier this year.

I'm getting the ball rolling by attending a required symposium on Wednesday in Arcadia, CA.  After that, I can make an appointment with a surgeon if I so choose.

I'm praying this time it will finally work out.

After being denied for WLS in December of 2005, I learned that most Connecticut insurance companies, panicked by the growing number of gastric bypass surgeries, had instituted exclusion clauses.  While some states passed legislation to protect the morbidly obese pursuing WLS, Connecticut is not among them.  I began a letter campaign to my local and US senators/representatives, calling this issue to their attention and encouraging them to initiate/support WLS legislation.  Senator Catherine Cook notified me at the end of last week that the Public Health Committee was holding a Public Hearing on March 13, 2006 and a bill about Weight Loss Surgery was on the list.  She encouraged me to try to attend and share my story.

So today I did just that.  After waiting (and waiting) for over 11 hours, they called me to testify at 7:15pm.  Although, the hearing room was no longer packed and the Public Health Committee had dwindled to a handful of senators and representatives, I fought my nerves as I took my seat at the microphone.  My voice trembled with emotion and I fought back tears as I introduced myself and began to read what I had prepared. 

"I whole-heartedly support Bill #579, concerning health insurance coverage for medical services and treatment for morbid obesity.  My weight has been a daily burden, both literally and emotionally, for most of my 35 years.   I tried nutritionists, diets of pre-packaged foods, low-cal, low-fat, low-carb. I engaged in exercise and fitness programs.  I attempted therapy, meditation and even hypnosis to support my weight loss attempts.   Through various regimes, I lost 50+ pounds on three separate occasions.  Temporarily.  Each time I regained not only the pounds I had lost, but more.   A long-term solution has eluded me.

At present, I weigh more than 300 pounds and at 5 feet, 8 inches, my BMI (Body Mass Index) is over 50. All the weight is taking a toll on my body.   My blood pressure and cholesterol are rising to the concern to my physician.  My triglycerides are high and my doctor says I am pre-diabetic. I cannot ignore the growing pain in my knees when I walk and the shortness of breath after a single flight of stairs.   Clinically I am now labeled 'morbidly obese.'  My current path is leading to some very serious health issues like, hypertension, type 2 diabetes, heart disease, and stroke.

Last year I began researching weight loss surgery.   My interest at first was casual; part curiosity and part desperation.  To my surprise I found that weight loss surgery (WLS), is not a new or radical experiment, but a refined, proven treatment that is the best opportunity for someone like me to successfully achieve long term weight loss.   My BMI exceeds the NIH's guideline for WLS candidates, so I discussed it with my physician and was referred to a well-respected medical group who specializes in obesity surgery. 

I was required to provide detailed histories of my weight loss attempts, and attend informational and support group sessions.   I was examined by the surgeon, and evaluated by a nutritionist and then a psychologist.  My medical history and blood work were scrutinized.   Finally, I completed a very restrictive protein-sparing-modified-fast for 5 days and passed the subsequent ketosis urinalysis to ensure my compliance with the strict diet instructions.   Eagerly, I passed through each point of that checklist and after a final review, they concluded I am an excellent candidate for a laparoscopic 'Roux en Y' gastric bypass procedure.   They approximated that by following the post-op regime, 12-18 months after surgery I would reach and maintain a weight of 165 lbs., quite manageable for my height and frame.  I was elated at the prospect of finally having the 'tool' to help me ensure a better quality of my days and years to come.  I made arrangements with my employer and began to prepare for the upcoming pre-op testing and surgery. 

Then I hit the 'brick wall' put up by my insurance company.   Their policy has an exclusion which states 'no benefits are available for any service, care, procedure or program for weight or appetite control, weight loss, weight management or for control of obesity even if the weight or obesity aggravates another condition.'

Shock and dismay is how I would describe my reaction.   With the backing of numerous doctors and health professionals, how could I be brushed off so casually?

The surgical group referred me to an attorney who specializes in appealing denials for weight loss surgery.   Unfortunately, the attorney could offer no hope.  While other states have passed legislation pertaining WLS, Connecticut is not among them.   I was told by the attorney that 'Exclusions are very difficult to overcome. Connecticut State will review medical necessity decisions but not exclusions. In other words, we could assist you but I wouldn't give you a high success rate.'

And so I remain.  Qualified, yet ineligible.   Eager and committed to my WLS, but finding it outside my grasp.

My insurance company categorically denies coverage for weight loss surgery, but offers benefits for the medications I will need down the road to control my cholesterol and high blood pressure.  They will even pay for the numerous doctors and hospitalizations and medications that will be required after I suffer a stroke or heart attack as a result of my morbid obesity.

In a society where sex sells and snap judgments are made based on outer appearances, obese persons like me are often seen as lazy, unmotivated, stupid.   We are discriminated against based on a number on the scale and the amount of space we take up in this world.  Our health challenges are not taken seriously and we're scolded to stop whining and simply put less food in our mouths to drop those excess pounds.   It's just not that simple.

I think it's time we require insurance companies to treat morbid obesity as the chronic and serious health condition which it is and offer benefits in kind.   Let's be proactive and ensure that treatment is available for obesity health issues at their SOURCE, instead of simply slapping a 'band-aid' on the associated health conditions.

Thank you for your attention today and your thoughtful consideration of this bill."

**Afternote: That WLS bill and a similar one died without ever leaving committee. I hope that someday Connecticut legislators will take action to ensure the morbidly obese have access to life-saving WLS. Despite the disappointing outcome, I'm glad that I stretched beyond my feelings of shame, told my story, and did what I could to affect change. Maybe one person listening will think twice before passing judgement based on someone's size. That's my hope.