Thursday, April 30, 2009

Am I Crazy

I am now two months out from my surgery. I have completed 4 months of doctor supervised weight management and begun a light exercise program that includes water aerobics and walking. I am feeling worse than I ever have. I have joint pain in my ankles, I am exhausted most days, and when I sleep I wake up several times throughout the night. I think part of it goes with age, stress, and worry but I feel that a lot of these issues will go away when the weight is gone.

I am scheduled to meet with the shrink as required by my surgeon. I am a bit nervous to meet with a stranger to discuss my decision to undergo this surgery. I have been told that my insurance company requires two separate meetings with the shrink. The build-up to the surgery is beginning to cost a lot of money upfront.

My monthly doctor appointments are a minimum of $85, I was required to undergo a scope that was $250 upfront, and the shrink visit could cost up to $300 depending on what insurance will pay. I am worried that I am going to do all the planning and jump through all the hoops that the insurance company requires and then be told "no" by the insurance approval team. The worst part of this wait is that there is no guarantee that doing all this will allow me to have the surgery. Bottom line the insurance company has to see a need once the documentation is submitted by the doctors.

Monday, April 13, 2009

Insurance Companies & Gastric Bypass

In the beginning my main concern was the financial cost associated with bariatric surgery. A reputable surgeon will cost anywhere between $15,000 - $30,000 depending on the type of surgery you choose. Many insurance companies cover bariatric procedures but require that you provide loads of documentation from multiple sources verifying the medical need for your surgery. For example, my insurance company required a BMI of at least 40, a medically documented five year weight issue, a six month physician approved diet plan documented and signed by the doctor monthly for six months, a six month physician approved exercise program documented and signed monthly for six months, as well as submission of any needs as seen by the primary physician.

The hardest part of the six months has been knowing that in the end everything will be very different. For me, the first month I packed on a few pounds because every time I ate I would think about all the things I would no longer be able to eat after the surgery. I have never been a snack eater or a binge eater - but with the bypass surgery hanging over my head I began to have horrible eating habits. The monthly walk of shame at the doctor's office has helped control this problem. I am now in month four and I am eating a normal somewhat healthier diet in preparation for the big day.

In the end, for my insurance company to accept my request for gastric bypass I have to provide very good documentation and an effort on my part, knowing that I can do all of the "hoop jumping" and then be declined by insurance has helped me get on track.

Sunday, April 12, 2009

Preparing for Gastric Bypass Surgery

It is hard to type what preparing for a life changing surgery is like... Let me start from the beginning. I have been overweight my entire adult life and as much of my childhood as I can remember. I have tried every diet scam, diet plan, over the counter pills, prescription pills, and yes even diet and exercise to drop the extra weight. The interesting part of all this is I successfully lost weight time after time.

So I am sure you are now thinking this was about weight loss surgery - But if she lost weight, why have such a drastic surgery? Well, it began with a big diet and a big weight loss, the back side of that great news is that it ended with an even bigger weight gain the second I stopped eating rabbit food and began to eat "regular" food. This cycle has run its course several times in my life putting me at a weight that qualifies me to be a pro football line backer.

I began to research bariatric solutions in late 2008 after watching many friends, coworkers, and even a few movie stars undergo massive transformations with credit given to lab band surgery or gastric bypass. Concluding my extensive research, considering my own medical record, and after consulting with my own doctor as well as a bariatric surgeon I decided to begin a 6 month plan to qualify myself for Roux-en-Y surgery with my insurance company.

In the following blogs read to see what the insurance company required, what my doctor required, and how the six months of preparation has been going.