Monday, February 24, 2014

New surgery Date and Insurance Approval!

I work at a school and have a day off the week before my surgery.  My surgery was scheduled for a Monday.  I called the scheduled and politely asked if it was an option to have the surgery the week before at some point.  That way I would have to use less sick time.  To my surprise, she said that since my insurance has now approved the surgery I can have the surgery a week earlier.  My new surgery date is March 17th!!!  Wow, I was just hoping for a few days but hey, lets do this!  Three weeks from today I will hopefully be out of surgery and on the road to recovery. 

Lets talk about insurance for a second.  I am like astonished that my surgeons office sent the paperwork on a Friday and that I have an approval on Monday.  Amazing.  Having said that, I am sure it was helpful knowing that there was a checklist of stuff that the insurance company wanted and a checklist of stuff that my surgeon wanted before they would even send for approval.  But still, I thought 10-30 days.  Not 24 hours!

I had about two days of panic after I was given the date.  But now I am back to being ready to get this over with and work on my new lifestyle.  I have high hopes and I sure do hope that I succeed the way I want to.


Sunday, February 23, 2014

A surgery date...

Much to my surprise, just a few hours after my last post, I received a call from the surgeon's office.  She was calling to give me a surgery date.  What?!  Already!?  The date is March 24th.  She then said she was submitting my file to the insurance company to get me approved.  I am hoping there are no holdups there.  But I am thinking they probably wouldn't have scheduled me if they thought there could be an issue.  At least that is what I am telling myself.  The insurance company did tell me that they have up to 30 days to make a determination but that it is almost always within 10 days.  One of my primary doctors said that my BMI alone would get me approved no problem.  My BMI is about 43.  Anything about 40 is considered class III obesity-MORBID OBESITY.  And apparently if you have co-morbidities you can be approved with a BMI of 35.  When I started this process I did not think that I had any co-morbidities, but I have since learned that I do after going though the testing process for approval.  I have sleep apnea and high blood pressure.  Right there that is 2 of the 4 big ones.  Cholesterol and diabetes are the other two big ones.  My cholesterol was not checked but I am 99.99999% sure that would not be pretty.  So, I am thinking that I am in good shape (haha) for approval.

So for now I am going to wait...and prepare.  I have pulled out my meal planning sheets they gave me.  Some are pre-op, some are post-op separated by week.  Its time to buckle down on how and what I am eating.  I am looking them over and planning.  I need to give myself the best shot possible.  Although I did lose 6 pounds between my first and second appointments, I did not make the effort that I should have and that I know that I can.  They wanted 5% loss from me.  That was about 12 lbs.  I gave them 2.5%, but I could have done so much better.  I have a little bit of shame about that.

I have received so much support and I am so happy(and surprised) about this.  My family, friends, and fellow bloggers have been wonderful.  Now that I have a surgery date, its time to ask for the time off from work.  I am hoping that goes smoothly.  This is where I stress a bit about whether this is elective surgery or not.  I feel a future post coming on about this :)


Wednesday, February 19, 2014

Bariatric surgery-Tests complete

I met with the nurse practitioner at the Bariatric surgeon's office Monday.   I was only down 6 of my 12 lbs required (5%) in order to schedule surgery.  Obviously I have never been through this process before so I wasn't sure what to expect.  Before she came in I heard the nurse giving her a quick "recap" about me.  I almost fell over when I heard her say that my required tests were all done and that "she isn't that big so 6 lbs should be good enough weight loss to schedule her".  I have to say that I do hide my weight well but I was still surprised to hear that.  On me, 250 lbs is a size 20 and I carry most of it in the front of me, instead of being wide.  But nonetheless, my 250 lbs puts me at a BMI of 43.  Anything over 40 is considered class III obesity, also known as MORBID OBESITY.  So when she came in she reviewed my chart and told me I was ready to be scheduled for surgery. 

All of a sudden it felt real.  All of the hoops have been jumped through.  The EKG, the Psych clearance, 2 sleep studies, letter of med necessity, blood work, etc. I felt a bit nervous.  And excited.  So now I wait.  My first visit with the surgeon was January 21(the info session was January 7).  My second was Feb 17. Things had moved much more quickly than I anticipated.  This might be the part that takes the longest.  Apparently what happens is my chart goes to the scheduler/insurance approval department.  So I am guessing she will write up my letter to the insurance and if/when it comes back with approval I will get a surgery date scheduled.  From what I got from my insurance it can take 30 days but is almost always approved within 10 days.  But who knows how long the surgeons office will take to send out for approval and then call me with a date.

I was under the impression my recovery time out of work would be about a week.  I think that's what the Dr said at the info session. The NP yesterday told me to plan for at least 2 weeks but that I could take up to 6 if I needed it.  I am so very glad that I was told about the statistic for morbidly obese people.  I keep reminding myself of it.  "Once a person reaches morbid obesity, there is a 5% chance of losing the weight and keeping it off".  The stats are 80% for those who have bariatric surgery.  My weight is something I will always have to battle.  But it will be nice to have a much better chance because of the surgery.

Wednesday, February 5, 2014

Steps to approval for Bariatric surgery

I mentioned in yesterday's post some of the steps that I have had to go through to try to get approved for the surgery.  In case you didn't see them I will repost them here.

Lose 5% of starting weight
Meet with nutritionist regularly
Psychological clearance
Sleep Study and clearance
Blood work
Several appts with surgeon before and after surgery
Support group meetings before and after surgery
Letter of medical necessity from primary dr.

To be totally honest, I just started to lose the 5%.  I figured I would have several months to get 12 lbs off right?  "I can do that in a few weeks" was my mode of thinking.  But, when I started scheduling my appointments I was able to get in with most of them much quicker than I thought.  So I have been trying to eat well and make good choices in the hopes that this may all happen sooner than I thought.

I figured my psych clearance would consist of an appointment and that I would have to wait for his report.  Nope.  He typed it up right there after our hour long talk and sent me on my way.  He also told me his wife had bariatric surgery which made me feel like I was in the right hands :)

I had my annual appt with my OBGYN last month.  I have kind of been using him as a primary dr for a few years now.  I called him a week before my appt and asked him if he would order the bloodwork that the surgeon wanted me to have and we could discuss it at my upcoming visit.  I figured it was a long shot but I got a call back and he said he would be glad to.  We discussed my results at my appt.  I asked him if he would write my letter of medical necessity and he said yes.  I figured I would have to wait for it.  Nope.  He typed it up, printed it and sent me on my way with the words "I will see you in a hundred pounds from now!".  He said he has seen me lose the weight and that he knows this will be a great option for me.  Huh.  Another person on board.

Because the questionnaire that I filled out at the surgeons office labeled me at risk for possible sleep apnea, the surgeon said I needed a sleep study before moving forward.  So I went and had one within a week.  Again, this was quicker than I expected.  I was hooked up to about 30 wires and wondered how I would possibly sleep.  Yet I did!  The results from this test took longer, about a week and a half.   And when they called they said I do in fact have mild sleep apnea.  I had 13 respiratory events per hour but the cause for concern was that my oxygen dipped down to 84%.  I also apparently had 50 periodic limb movements and was awaked 7 times per hour from those. Sooooo.  Now I go back and have a second sleep study with a CPAP machine to see if that helps.  Then after that I again have to wait for the results to be read.  If things are better then hopefully he will sign off on me having the surgery and I am sure order me a CPAP machine :(

Support Group...I was pretty iffy about this.  I wasn't sure how I would like it.  My awesome friend Laura again accompanied me and we made a fun day of it.  The meeting was actually pretty good!  The leader was nice, and there were people who were pre-op as well as some post-op.  It was a small, friendly setting with only 8 of us I think.  I liked it so much that I was disappointed when I realized I can not make the next one because we will be out of town. 

I have a nutrition class scheduled for March 3.  I did meet with the nutritionist on the day of the consultation with the surgeon.  She made me realize that I eat fast.  I never realized I did, but she said meal should be lasting 20-30 minutes.  WHAT?  More like 5 for me!.  And also to my surprise, my husband spoke up in the meeting and said he is realizing that his eating habits are not helping me.  Huh.  We are all growing here I guess.

And last, an EKG.  I have a meeting with a new primary dr close to home.  I cant use my OBGYN forever now that my babies aren't babies anymore! She was recommended to me from a nurse who works there.  Hopefully she will be able to do my EKG and send that along to the Bariatric office.

So, those are the basic steps that I am going though.  I figured I would do a post on it in case anyone else is tossing this option around in their head.  Before December I knew nothing(accurate) about bariatric surgery.  I have done lots of research and have lots of statistics .  Before December I never thought this was an option for me.  But, the further I get into the process, I am feeling pretty sure it is just the tool I need to succeed once and for all.


Tuesday, February 4, 2014

Some major changes...Bariatric surgery?

I have been missing for a while.  A looooong while.  And when I pulled up my blog tonight I was a bit saddened when I saw that my last post was labeled" How Jennifer got her groove back".  The truth is, like most disappearing weight loss bloggers, I was NOT able to get my groove back.  In fact, I hit my highest weight ever at over 250 lbs.  I am 5'4.
I have been miserable. 
Uncomfortable in my own skin. 
Feeling defeated. 
My eyebrows look atrocious because why bother?

Having had a taste of thin(ish) in the past I truly feel like I am missing out on my own life.  I miss my confidence.  I miss wearing clothes that I like and that fit.  I miss having energy.  I miss putting on a bathing suit and not shrieking.

And then it happened....

I went to Dr after I tried to break up a dog scuffle.  My finger was infected.  Of course the first step was the scale.  I got on and she put it at 150.  Then 200.  Then she looked at me with a strange look and put it on 250.  Ding ding ding.  We have a winner.  The words that she said next I believe will change my life. 

"Wow.  You really hide your weight well....I want you to know that I was your weight a year ago and had bariatric surgery.  Best thing I ever did."

I thought she was crazy.  Who was she to say that?  I had never met her.  I acted like I was interested as she was telling me about her bariatric surgeon and how great he is, about how it was the best thing she ever did, and how happy she is. But really I was just shocked by her reaction to my weight.

So on the way home I called my mom to tell her, still in disbelief.  At work the next day I told my co-worker.  Her response was that her daughter in law had the surgery and is quite happy with it.  Huh.  So at this point, the wheels started spinning.  I was sure it was a long shot but could this be an option for me?  She put me in contact with her daughter in law and we chatted a bit about the procedure, the pre-op requirements, her dr, etc.  All of her experiences were great, and get this... the SAME SURGEON as that nurse I had met.  I looked him up online figuring I would find something, anything, to steer me away.  Nope.  Amazing reviews.  That says a lot for a dr these days.   I talked with my husband, then my mom, my grandma, and a very few close friends who I knew would be honest with me.  After all, this was a crazy idea right?

To my surprise...they were ALL FOR IT.  Wait...what? I am not big enough for this surgery right?  I thought for sure those very closest to me would be against surgery.  After all, it is "elective" right? I figured the insurance would never pay for this.  My mom's response hit home for me.  She said, "it's worth looking into Jen.  You have never settled for being overweight.  Some people accept it as part of who they are, but you never have.  I watch you struggle everyday".  She is right.

With my army of unexpected support, my research began...and continued for a while.   Then one day I ran into that nurse while at the vet's office.  Seriously?  We chatted for a bit and all of a sudden it just felt like it was time to call the Bariatric clinic to see how this whole process works.  They were very nice.  The first step was a mandatory info session that they offer once a month.  So I went with my amazing friend Laura.  The surgeon who I had heard so much about was the dr who gave the presentation. He then answered any questions anyone had. And I had questions :)  I am a research geek and I like to be prepared.

I filled out the paperwork they gave me and mailed it in a few days later.  They then review it and decide if they feel you are a candidate for bariatric surgery of any kind. If they think you are a candidate they call you with an appt.  Much to my surprise I am a candidate.  And not only am I a candidate, I have a BMI of 43 which means the insurance most likely wont put up much of a fight.  I am morbidly obese...the highest category of obesity.

HUH.   Was this really happening?

I went to my first appointment with the surgeon and nutritionist on January 21.  I didn't really know what to expect. I also met with the nutritionist that day as well.  My husband came with me and even asked questions.  The dr said something that stuck with me when answering one of my husbands questions.
Hubs: "Can she gain the weight back"
Doc: "There is an 80% chance she will not, but if she doesn't change her eating habits she can become one of the 20%.  However, once a person reaches morbid obesity, their chances of getting the weight off and keeping it off are less than 5%...and that's what makes it a disease."

BAM....And that was it.  That was the turning point when I knew this was for me.  I have been yoyo dieting for years.  More than half my life actually.  I have been fighting an uphill battle for sure but I never knew the statistics were that strongly evidenced.

I would like to also say that I have done lots of research on the different procedures out there.  And this office is, in my opinion, VERY thorough to make sure that you succeed and that this is not a decision made on a whim.  You cant just make an appointment and go have surgery.  No.  There is a whole process, and a bariatric agreement you have to sign. There is a 3-6 month time frame or more before you can have the surgery.
Here are a few examples of requirements for both pre and post op patients:
Lose 5% of starting weight
Meet with nutritionist regularly
Psychological clearance
Sleep Study and clearance
Blood work
Several appts with surgeon before and after surgery
Support group meetings before and after surgery
Letter of medical necessity from primary dr.

I have most of these things completed but I am hung up on the sleep study.  I have been tired.  I chalked it up to my weight.  But now I find out I apparently I have sleep apnea and restless sleep. My oxygen levels drop into a concerning %.   It was concerning enough that I have to go back again for another test this week with a CPAP to see if it helps.  Hopefully it does and I can get the clearance.  This is just one more thing that reminds me that I need to get this weight off for good. 

So there you have it.  This brings me up to where I am now.  Tomorrow I will write about some of the tests I have had done and some of the reactions from friends(the few I have told anyway).  I hope this finds you all well.  I will be spending some time catching up on favorite blogs!