I had surgery on Friday, 9/10/10 at around 12 noon. The two days prior and the past four days following the surgery have all been a whirl-wind...and kind of a blur (post-op narcotics will do that to you). :)
I want to record everything in detail...for future me...for future readers (I don't really have any right now, but maybe someday).
Well, my last few posts were about my pre-op appointments and tests, so I've got that covered. However, I didn't mention much about the emotional side of preparing for surgery.
Amazingly, I wasn't too nervous, but I was planning for the worst...you just never know. I had prayed A LOT about this surgery and I had spent the last five years researching and preparing for it, so my nervousness was at a controllable level. I prepared some documents so that my husband would know what to do in case anything went wrong. I made a binder with all of important stuff (birth certificates, passports, marriage license, social security cards, and typed up log in information, how to pay bills, made a list of important contacts, and my health care power of attorney). I wrote letters to my family (husband, parents, grandmother, sister & brother)...as if it may be the last thing I have to say to them while on this earth. I got a little emotional during that...it was like I was saying goodbye. My husband was to give the letters to my family if I didn't make it out of surgery. Some may find this extreme, but it gave me a feeling of preparedness, closure and peace.
The only members of my family that actually knew about the surgery was my husband and grandmother. In fact, they are the only ones who know...I didn't tell any friends either. That was a personal choice. I wasn't sure how my family would react and if they would honor my wishes to keep it private, so I decided not to tell them...that was one less stress for me. I don't have any friends that I feel close enough with to trust with all of this. So, I suppose in doing so I put a lot of pressure on my husband and grandma, because they had nobody to share the burden with.
My husband was a nervous wreck. He was VERY quiet the week of surgery, and when we got down to the day before surgery he just broke down. My husband is this 6ft polynesian...tough guy...man's man, so it takes a lot to bring him to tears. But, he just felt so lost. He was very upset and crying, because he was worried something would happen to me and he didn't even want to think about life without me. He said he didn't even know how he and my son would live if I didn't make it out of surgery. Of course that brought tears from me, because I didn't like to see him so upset, and the thought of leaving my two boys behind was heartbreaking. But, we talked about it. We reviewed the positives and negatives again. We talked about the risks and that while there is always a risk of complications with surgery, the statistics were in our favor. We talked about our faith and our belief in life after death, we fasted and prayed, which brought us both great comfort. We worked through it, and he felt a little better after that. I think he needed to get it out there and work through his feelings to help him cope. It made me realize how much he really loves me...and me him.
I heard from my Grandma often who was very nervous, but more composed than my husband. She knew it would go well.
And surgery did go well. I was in recovery for about three hours, which is always kind of the worst part...coming out of anesthesia. That is also when I was in the most pain, and I had an I.V. with my own pain med pump, but it wasn't working, so they give me something stronger. That is why I was in recovery for so long, because they couldn't move me to my room until my pain was under control. Then they transported me to my own room (thankfully didn't have to share), and that is where I stayed for the next three days. I was in a little more pain than I anticipated, but they kept it pretty much under control with some Oxycontin, which meant I was sometimes a little out of it. The first day in my room I couldn't even keep myself awake. I remember talking to nurses, but having no idea what I said to them. :)
So, the only problem with pain meds and anesthesia was that it made me vomit. Well, not really vomit...because there isn't a single bit of stomach acid or anything in that new stomach, but I really heaved, and that was SOOOO painful. It felt like all my guts were splitting open and getting ready to come out of mouth. They gave me something for the nausea, but it didn't always work. So, my nausea and heaving lasted for about a day. Then things settled down. The Oxycontin didn't make me nauseous and was pretty good at controlling the pain.
By the second day I was thinking a little more clearly and I was relieved to have the surgery done and didn't have any regrets like some have mentioned immediately following surgery. I was pretty excited, because I had waited so long to have it done.It was also time to take the catheter out and start walking around. I really wanted to get up and get going, but the first time was a lot harder than I thought it would be. My abdomen was so sore, and as soon as I stood up gravity was just pulling on it...VERY sore. I felt pretty weak as well, but I went and did a few laps in the hallway, which got my blood going and I felt a little better.
By my fourth day in the hospital I was feeling a lot better and could get up and move around a little easier. I was ready and anxious to go home. They discharged me and sent me home with some pain-meds.
I thought I would only be another week before getting back to routine, but boy was I wrong.
Thursday, October 14, 2010
Wednesday, September 8, 2010
Bad, BAD Girl Follow-Up
I'm all done with my pre-op appointments, and surgery is in two days! I didn't gain too much weight...5 lbs. It's sad that it's a gain when it should have been a 10 lbs loss (minimum), but it isn't as bad as I thought it was going to be. Nobody on the bariatric team mentioned anything about the gain. Nobody asked about how my pre-op diet went. Everything was about getting ready for surgery.
My Pre-Op Day:
-I started out getting my blood drawn...twice. They do this to verify your blood type, and I guess procedure requires your blood to be drawn twice by two different nurses.
-Then I met with my surgeon's nurse for some surgery education (pre and post). I was with another person during this meeting. She was having the LapBand procedure done. They gave us a notebook that explains all about what to expect surgery day, hospital practices, discharge, etc. There was also specific information about preparing for surgery. Two days before surgery you have to drink a "colon cleanse," and they put you on clear liquids. This one I won't have problems doing...it's only two days and my procedure REALLY depends on it. They also gave me an antiseptic wash that I have to use in the chest/abdomen/groin area the night before surgery and the morning of. Then there was all of the usual surgery day stuff: no nail polish, makeup, jewelry, contacts, etc.
-After that I met with the doctor (Dr. Cetin) for a check-up. He sent me down for another EKG (it had been over 9 months since my last one) and a urine test (possible UTI).
-I came back up and met with my surgeon's "Fellow." No, not fellow as in "guy friend," but he is a graduated general surgeon who is trying to specialize. Needless to say, I was a little disappointed I didn't get to meet with my surgeon. I have only met Dr Kroh once...for literally 2 minutes...about 9 months ago. I just thought it would be nice to talk with him since he will be rearranging my guts! Anyway, the "Fellow" wrote me a prescription for colon cleanser, something to prevent gallstones, a narcotic for after surgery, and an antibiotic.
-After meeting with Dr Kroh's "Fellow" (that just sounds so funny) I did what they call a "HealthQuest" test. It's a computer Q&A to prepare for the anesthesia evaluation.
-Which meant, after completing HealthQuest I did my Admit interview (insurance, identification stuff) and then met with the anesthesia nurse to complete my evaluation. She basically asked me all the same questions the HealthQuest program did. She took my vitals and made sure I could move my neck comfortably and open and close my mouth comfortably.
Through all of this nobody gave a darn about my gain (or at least they didn't say anything) or if I stuck to the pre-op diet. WHEW! I was beating myself up over nothing.
So, right now I'm sipping on a colon cleanser (as prescribed by the doctor). One word: NASTY! Tastes like salt water meets dirty-sock-water. While I am spending a lot of time on the "throne" it hasn't been as unpleasant as some have described. My irritable bowel produces WAY worse cramps and discomfort and diarrhea than this.
Tomorrow (Thursday)...all liquids until midnight, and then nothing after that.
My Pre-Op Day:
-I started out getting my blood drawn...twice. They do this to verify your blood type, and I guess procedure requires your blood to be drawn twice by two different nurses.
-Then I met with my surgeon's nurse for some surgery education (pre and post). I was with another person during this meeting. She was having the LapBand procedure done. They gave us a notebook that explains all about what to expect surgery day, hospital practices, discharge, etc. There was also specific information about preparing for surgery. Two days before surgery you have to drink a "colon cleanse," and they put you on clear liquids. This one I won't have problems doing...it's only two days and my procedure REALLY depends on it. They also gave me an antiseptic wash that I have to use in the chest/abdomen/groin area the night before surgery and the morning of. Then there was all of the usual surgery day stuff: no nail polish, makeup, jewelry, contacts, etc.
-After that I met with the doctor (Dr. Cetin) for a check-up. He sent me down for another EKG (it had been over 9 months since my last one) and a urine test (possible UTI).
-I came back up and met with my surgeon's "Fellow." No, not fellow as in "guy friend," but he is a graduated general surgeon who is trying to specialize. Needless to say, I was a little disappointed I didn't get to meet with my surgeon. I have only met Dr Kroh once...for literally 2 minutes...about 9 months ago. I just thought it would be nice to talk with him since he will be rearranging my guts! Anyway, the "Fellow" wrote me a prescription for colon cleanser, something to prevent gallstones, a narcotic for after surgery, and an antibiotic.
-After meeting with Dr Kroh's "Fellow" (that just sounds so funny) I did what they call a "HealthQuest" test. It's a computer Q&A to prepare for the anesthesia evaluation.
-Which meant, after completing HealthQuest I did my Admit interview (insurance, identification stuff) and then met with the anesthesia nurse to complete my evaluation. She basically asked me all the same questions the HealthQuest program did. She took my vitals and made sure I could move my neck comfortably and open and close my mouth comfortably.
Through all of this nobody gave a darn about my gain (or at least they didn't say anything) or if I stuck to the pre-op diet. WHEW! I was beating myself up over nothing.
So, right now I'm sipping on a colon cleanser (as prescribed by the doctor). One word: NASTY! Tastes like salt water meets dirty-sock-water. While I am spending a lot of time on the "throne" it hasn't been as unpleasant as some have described. My irritable bowel produces WAY worse cramps and discomfort and diarrhea than this.
Tomorrow (Thursday)...all liquids until midnight, and then nothing after that.
Monday, September 6, 2010
Bad, BAD Girl!
After my 6 days of sticking to the liquids...it went downhill. I decided it would be okay to cheat one day. Then one day turned into 5 days! I have been eating regular meals...even went out to eat and haven't touched my protein in 5 days! Haven't exercised in 5 days!What in the HELL am I doing?! In two days I go for my pre-op testing and meetings. When they see my weight I'm sure they are going to kick me to the curb. Overall I've come away with a loss. However, I have gained about 6 lbs since my last weigh-in. I should have lost 10-15lbs by now on this liquid diet.
Now I'm questioning myself.
Am I meant to have this surgery if I can't even stick to the pre-op diet? Do I really deserve this now? I am totally kicking my ass over all of this and I'm in panic mode. It's like I'm trying to sabotage myself - WHY?
I'm having a hard time parting with food, but I need to keep reminding myself that I will be able to eat again. I don't ever want to eat again like I have been, but it's not like I will be on liquids the rest of my life. The liquids just seem so restrictive...and I was missing my old pal. Why do I have to feel like this about food?
Hi, my name is ---------------- and I'm a food addict!
I wish I could run. That use to be my release before I gained 150 pounds! I feel like I need to run until the craziness goes away. That would feel so good right now. But, instead I turn to food. Perhaps that is why I started eating during my liquids diet? Once again I use food as a coping tool. As my therapist has pointed out in the past...I go on "auto pilot" so I don't have to think about how I'm feeling or why I'm doing what I'm doing. I should have been seeing here during these two weeks.
Gosh, I'm just rambling and babbling.
I feel really alone right now. I read about people on OH or talk to people from my bariatric program that are doing so great in preparing for surgery. They've all lost weight. They are all focused. They are all doing what they are supposed to.
I think I'm going to go exercise and release some of this. Maybe it will help feel a little better. BLAH!
Now I'm questioning myself.
Am I meant to have this surgery if I can't even stick to the pre-op diet? Do I really deserve this now? I am totally kicking my ass over all of this and I'm in panic mode. It's like I'm trying to sabotage myself - WHY?
I'm having a hard time parting with food, but I need to keep reminding myself that I will be able to eat again. I don't ever want to eat again like I have been, but it's not like I will be on liquids the rest of my life. The liquids just seem so restrictive...and I was missing my old pal. Why do I have to feel like this about food?
Hi, my name is ---------------- and I'm a food addict!
I wish I could run. That use to be my release before I gained 150 pounds! I feel like I need to run until the craziness goes away. That would feel so good right now. But, instead I turn to food. Perhaps that is why I started eating during my liquids diet? Once again I use food as a coping tool. As my therapist has pointed out in the past...I go on "auto pilot" so I don't have to think about how I'm feeling or why I'm doing what I'm doing. I should have been seeing here during these two weeks.
Gosh, I'm just rambling and babbling.
I feel really alone right now. I read about people on OH or talk to people from my bariatric program that are doing so great in preparing for surgery. They've all lost weight. They are all focused. They are all doing what they are supposed to.
I think I'm going to go exercise and release some of this. Maybe it will help feel a little better. BLAH!
Tuesday, August 31, 2010
Only 2 weeks until surgery!
I have a little less than two weeks until I have my surgery. My bariatric program requires me to do a two week all liquid (protein) diet prior to surgery. I started it on Friday (8/27)...so now on day five.
It's been kind of rough.
The protein drinks (while not the most delightful) are somewhat filling, so I don't feel like I'm starving. But, I do feel like I want something more substantial than liquid. I miss chewing and tasting and texture and enjoyment. I think I'm mourning my food a little. Evening (after dinner) is the hardest for me, probably because that used to be my prime snack time. It's my unwind time in front of the TV and food has always been there with me. So, during that time of the day I eat popscicles (I'm allowed sugar free popsicles and jello).
I found these great Crystal Light popsicles...it's just like eating frozen Crystal Light...so you can pretty much eat as many as you want (within reason...they do have 15calories, but no sodium, carbs, sugars or anything else). That helps me a little with craving chewing and texture...and they taste pretty good.
I've also been exercising more. I have this DVD: Walk Away the Pounds (by Leslie Sansone). I really like it because it's low impact and there are different levels on the DVD so I can handle their beginner level and not get discouraged with exercise.
Overall, I am REALLY looking forward to having this surgery, because I'm looking forward to be healthy and getting my life back. But, surgery is surgery, and I'm nervous about the procedure itself. I'm sure I will be really nervous come next Friday, but I can't "weight" to start my new life!
It's been kind of rough.
The protein drinks (while not the most delightful) are somewhat filling, so I don't feel like I'm starving. But, I do feel like I want something more substantial than liquid. I miss chewing and tasting and texture and enjoyment. I think I'm mourning my food a little. Evening (after dinner) is the hardest for me, probably because that used to be my prime snack time. It's my unwind time in front of the TV and food has always been there with me. So, during that time of the day I eat popscicles (I'm allowed sugar free popsicles and jello).
I found these great Crystal Light popsicles...it's just like eating frozen Crystal Light...so you can pretty much eat as many as you want (within reason...they do have 15calories, but no sodium, carbs, sugars or anything else). That helps me a little with craving chewing and texture...and they taste pretty good.
I've also been exercising more. I have this DVD: Walk Away the Pounds (by Leslie Sansone). I really like it because it's low impact and there are different levels on the DVD so I can handle their beginner level and not get discouraged with exercise.
Overall, I am REALLY looking forward to having this surgery, because I'm looking forward to be healthy and getting my life back. But, surgery is surgery, and I'm nervous about the procedure itself. I'm sure I will be really nervous come next Friday, but I can't "weight" to start my new life!
Saturday, July 17, 2010
SURGERY DATE!
Well, after 9 months of dieting, a 4 week binge eating group,several psychology visits (not sure what that says about me), multiple tests, monthly weigh-ins, daily food journaling, working out my PCP chart notes, and many follow-ups with the insurance submittal team at Cleveland Clinic...(whew)...I was approved on 7/13/10 and scheduled for surgery the next day!
YEA! I am so excited to finally be done with the whole insurance approval process! I'm so excited to move on to the next step! I'm not so excited to start my 2 week liquid diet towards the end of next month...but I won't let that spoil the moment.
My surgery date: 9/10/2010!
When I think about all the work I had to put into just getting approved for this surgery it gives me hope that I can work hard and persevere and be successful with this new tool I'm about to get.
I can't wait!
Now the hard part...keeping myself on track...and avoiding a month of "last supper" mentality.
YEA! I am so excited to finally be done with the whole insurance approval process! I'm so excited to move on to the next step! I'm not so excited to start my 2 week liquid diet towards the end of next month...but I won't let that spoil the moment.
My surgery date: 9/10/2010!
When I think about all the work I had to put into just getting approved for this surgery it gives me hope that I can work hard and persevere and be successful with this new tool I'm about to get.
I can't wait!
Now the hard part...keeping myself on track...and avoiding a month of "last supper" mentality.
Wednesday, June 23, 2010
On-Ward and Up-Ward!
The "Up-Ward" part: I met with nutrition this past Friday. I GAINED! :( So much for reaching my goal of being below 300lbs! My last weigh-in I was 299...this weigh-in I was 302. I shouldn't be too surprised. The week before my weigh-in I was a voracious eater...when it's "that time of the month" I feel like I could eat non-stop. I NEVER feel full...that's kind of scary. It's gotta be head hunger...something I'm going to have to work on. In fact, I think it will always be a struggle, and I should just accept it and get a firm hold of some coping strategies.
The "On-Ward" part: I gave my notes to nutrition, and after reviewing them she said they looked great, and she gave me the number for the insurance lady in their program (the lady who submits to insurance). I called the insurance lady yesterday to make sure they had everything for submittal. She said I had completed all of the necessary requirements and she would be submitting in the next few days!!! I asked her how long CareSource usually takes to make a decision, and she said on average it's about two weeks!
I'm here...FINALLY!
I just hope there aren't any problems with approving the procedure.
The "On-Ward" part: I gave my notes to nutrition, and after reviewing them she said they looked great, and she gave me the number for the insurance lady in their program (the lady who submits to insurance). I called the insurance lady yesterday to make sure they had everything for submittal. She said I had completed all of the necessary requirements and she would be submitting in the next few days!!! I asked her how long CareSource usually takes to make a decision, and she said on average it's about two weeks!
I'm here...FINALLY!
I just hope there aren't any problems with approving the procedure.
Thursday, June 10, 2010
SCORE! (Addended Medical Notes)
Hurdle #1 has been successfully HURDLED!
I took the adivce of both Dr. Cetin and my Psychologist (Dr. Windover) and prepared some S.O.A.P notes based on the information on my poorly recorded medical records. I had to type them up for Oct 09 - Jan 10.
I've never typed a S.O.A.P note in my life, and I am in no way familiar with medical terminology or acronyms. So, I had to do A LOT of research to make sense of my medical records and type it into a more detailed note. I also had to research the S.O.A.P note format. It went pretty quick once I figured all of that stuff out.
So, I took my typed up notes to an appointment I made with my PCP. Dr Windover (my psychologist) advised me to approach my PCP the right way so as to not offend her. For example, I really shouldn't tell her that she never listened to anything I told her about the details required in the medical notes she took, and that I painstakingly did all the work for her, so now she should just sign it. So, instead I started my approach by putting the blame on the Bariatric Program at Cleveland Clinic. I told her per their request/suggestion I prepare these notes and have her sign them as addended notes. I guess that was the right approach, because she reviewed them really quick and agreed to sign them without any protest.
WHEW!
I now have copies of these signed and addended notes that I will be taking with me next Friday for my appointment with Nutrition! (Or maybe I will fax them, so they are already scanned and in their system by the time I come for my appointment). I'm really excited, and I hope these notes will now be up to spec for insurance submittal. If that is the case I should be getting my surgery by the end of the summer!
Perserverance and hard work have paid off...now on to Hurdle #2!
I took the adivce of both Dr. Cetin and my Psychologist (Dr. Windover) and prepared some S.O.A.P notes based on the information on my poorly recorded medical records. I had to type them up for Oct 09 - Jan 10.
I've never typed a S.O.A.P note in my life, and I am in no way familiar with medical terminology or acronyms. So, I had to do A LOT of research to make sense of my medical records and type it into a more detailed note. I also had to research the S.O.A.P note format. It went pretty quick once I figured all of that stuff out.
So, I took my typed up notes to an appointment I made with my PCP. Dr Windover (my psychologist) advised me to approach my PCP the right way so as to not offend her. For example, I really shouldn't tell her that she never listened to anything I told her about the details required in the medical notes she took, and that I painstakingly did all the work for her, so now she should just sign it. So, instead I started my approach by putting the blame on the Bariatric Program at Cleveland Clinic. I told her per their request/suggestion I prepare these notes and have her sign them as addended notes. I guess that was the right approach, because she reviewed them really quick and agreed to sign them without any protest.
WHEW!
I now have copies of these signed and addended notes that I will be taking with me next Friday for my appointment with Nutrition! (Or maybe I will fax them, so they are already scanned and in their system by the time I come for my appointment). I'm really excited, and I hope these notes will now be up to spec for insurance submittal. If that is the case I should be getting my surgery by the end of the summer!
Perserverance and hard work have paid off...now on to Hurdle #2!
Friday, June 4, 2010
Not So Good News: Hitting the "Required" Diet Brick Wall
I wanted to separate the good news from the bad. My last post talked about my 2lb loss and finally weighing below 300 lbs. This is all great, right? However, I got some bad news during this last visit as well.
Dr. Cetin reviewd my PCP notes from September 09 - January 09. I was meeting with my PCP to complete the required doctor supervised diet mandated by health insurance. She knew of and supported my decision to have Roux-en-Y. She also knew that she had to take thorough notes in order to be acceptable by insurance standards. However, after Dr Cetin reviewed them he said that none of the months had the necessary documentation required for insurance submittal.
That is NOT what I wanted to hear.
In fact, I couldn't hold back the tears. Practically 6 months down the drain! I was so upset, and Dr. Cetin was very understanding and talked me through my frustration. He was very kind and upfront about things, and offered a suggestion. He recommended that I ask my PCP to ammend her notes to include the necessary information for insurance submittal. He gave me a template/example of formatted notes and even encouraged me to prepare them myself for my PCP to review and sign off on. So, that is what I'm working on now. Luckily I kept some notes of my own in my food diary...and hopefully my PCP will not take offense and sign off on them. If she does then we will be ready to submit to insurance!
I hope this works. It's been a long road. I won't say it hasn't been worthwhile. I've learned a lot and I feel very prepared to succeed with this weight loss surgery. However, I don't want to spend another 6 months doing this. I want to move on to the rest of my life.
Dr. Cetin reviewd my PCP notes from September 09 - January 09. I was meeting with my PCP to complete the required doctor supervised diet mandated by health insurance. She knew of and supported my decision to have Roux-en-Y. She also knew that she had to take thorough notes in order to be acceptable by insurance standards. However, after Dr Cetin reviewed them he said that none of the months had the necessary documentation required for insurance submittal.
That is NOT what I wanted to hear.
In fact, I couldn't hold back the tears. Practically 6 months down the drain! I was so upset, and Dr. Cetin was very understanding and talked me through my frustration. He was very kind and upfront about things, and offered a suggestion. He recommended that I ask my PCP to ammend her notes to include the necessary information for insurance submittal. He gave me a template/example of formatted notes and even encouraged me to prepare them myself for my PCP to review and sign off on. So, that is what I'm working on now. Luckily I kept some notes of my own in my food diary...and hopefully my PCP will not take offense and sign off on them. If she does then we will be ready to submit to insurance!
I hope this works. It's been a long road. I won't say it hasn't been worthwhile. I've learned a lot and I feel very prepared to succeed with this weight loss surgery. However, I don't want to spend another 6 months doing this. I want to move on to the rest of my life.
Goal #1: DONE!
Last week I met with Dr Cetin...he is the Cleveland Clinic Bariatric Program Doctor. Of course my visit started with a weigh-in. I was nervous. I wasn't sure if I would have a loss because of my horrible eating the 2 weeks prior. But I managed to lose two pounds! Yea for me! I was glad it wasn't a gain, however I thought about how much more weight I could have lost if I would have tried even harder. I won't beat myself up over it, but it was a good reminder.
So, with this two pound loss I met my first goal...breaking the 300 pound barrier that I've battled with for many months now. It's not by much (My weight was measured as 299lbs), but it doesn't matter, because I've done it and I'm going to continue to lose.
I will NEVER be 300 lbs again.
So, with this two pound loss I met my first goal...breaking the 300 pound barrier that I've battled with for many months now. It's not by much (My weight was measured as 299lbs), but it doesn't matter, because I've done it and I'm going to continue to lose.
I will NEVER be 300 lbs again.
Friday, May 21, 2010
Meeting with the Doctor
Next Friday (the 28th) I'm meeting with the program doctor. I will have my weigh-in. I'm a little nervous about that, because these past two weeks I've been on an eating rampage. I've just felt insatiable...partly because of my "monthly visitor" and the other part...well, I'm not sure. I think it's because we had the food in our house and I have no freakin' will-power. Prior to this rampage there wasn't a piece of junk food in sight, but now that we are moved and settled we've got chips and donuts and cookies and cake in the house...and I've been eating it. :(
As Napoleon Dynamite would say: "GOSH!"
I should know better. In my binge eating group we learned about removing the triggers. I know my family would be fine with not having those things in the house...all I have to do is ask. But, part of me wants those things in the house...so I can have some if I want.
This is when I feel like screaming...when I feel a little hopeless. I feel like I'm never going to get myself under control, and it scares me because I'm working towards this lifestyle change...this surgery. I want to be successful with it. I've posted before about behavior changes and how important I think it is to change our behaviors before surgery.
I feel so empowered when I am able to avoid these triggers ...but why can't I feel like that all the time? Why don't I remember that empowered feeling when I'm stuffing my face with potato chips? I wish someone actually read by blog so they could comment. Maybe I will post this post on Obesity Help and get some feedback. I want to know if anyone else struggled/struggles with this and how they coped.
Well, you'll be hearing from me next Friday...after my appointment. I hope it's all good news!
As Napoleon Dynamite would say: "GOSH!"
I should know better. In my binge eating group we learned about removing the triggers. I know my family would be fine with not having those things in the house...all I have to do is ask. But, part of me wants those things in the house...so I can have some if I want.
This is when I feel like screaming...when I feel a little hopeless. I feel like I'm never going to get myself under control, and it scares me because I'm working towards this lifestyle change...this surgery. I want to be successful with it. I've posted before about behavior changes and how important I think it is to change our behaviors before surgery.
I feel so empowered when I am able to avoid these triggers ...but why can't I feel like that all the time? Why don't I remember that empowered feeling when I'm stuffing my face with potato chips? I wish someone actually read by blog so they could comment. Maybe I will post this post on Obesity Help and get some feedback. I want to know if anyone else struggled/struggles with this and how they coped.
Well, you'll be hearing from me next Friday...after my appointment. I hope it's all good news!
Monday, May 3, 2010
11.5 pounds lost!
I haven't been as regular on here this past month, because I've been crazy busy with a move...and without internet for almost 2 weeks.
So, at the end of March I met with the nutritionist and had gained a few pounds...weighing in at 314 lbs! I made the mistake of going to Golden Corral (I feel like a cow just saying the name of this buffet..."Corral")...and ate WAY too much (will be avoiding all future buffets) right before meeting with my nutritionist (how dumb is that)! I swear 3-4 pounds of that gain was all of the food just sitting in my stomach.
Now it's the end of April. I just met with my nutritionist today...weighed in at 302.5! I've been pretty focused this past month and it has paid off. I've had to replace my morning meals with a protein drink and I've been more active. My eating has improved, but still not where I want it to be. I've gotten better at controlling portions, but there is still room for improvement in my food selection.
But, right now I won't go down that road. I'm celebrating my loss! YEA!
So, at the end of March I met with the nutritionist and had gained a few pounds...weighing in at 314 lbs! I made the mistake of going to Golden Corral (I feel like a cow just saying the name of this buffet..."Corral")...and ate WAY too much (will be avoiding all future buffets) right before meeting with my nutritionist (how dumb is that)! I swear 3-4 pounds of that gain was all of the food just sitting in my stomach.
Now it's the end of April. I just met with my nutritionist today...weighed in at 302.5! I've been pretty focused this past month and it has paid off. I've had to replace my morning meals with a protein drink and I've been more active. My eating has improved, but still not where I want it to be. I've gotten better at controlling portions, but there is still room for improvement in my food selection.
But, right now I won't go down that road. I'm celebrating my loss! YEA!
My Name is ****** and I'm a Food Addict...
Is there such a thing? An addiction to food? Well, if there aren't any documented cases then I guess I'm a scientific breakthrough. I don't know if it is food or sugar or both. It's almost as if I feel the "high" the most when I eat sugar, and I often feel withdrawls as well...strong cravings, irritability, insatiable hunger...
I've done well with my eating this week. Not perfect, but much better than in the past. I'm trying to lose weight by the end of April, which is my next weigh-in with the Nutritionist. I'm trying to follow her guidelines...not just because she asked me to, but because I want to change my relationship with food...I want to change how I think about it so that I can be successful after I have this surgery.
So, my eating this week: I've been replacing one meal with a protein drink. I've been making healtheir choices and been more conscious about portions. I've been avoiding late night snacking...and junk in general. LOTS of water.
Then I made brownies...chocolate peanut-butter brownies.
I made them for a family treat. I figured I could handle that because I'm not a big fan of brownies, so it won't be hard for me to avoid them.
Well, I decided to have one...just to try it (never had it with peanut butter). BIG mistake. I ate that brownie and it was like my body was saying, "wow...haven't had sugar in a while...haven't had chocolate in a while...NEED MORE!" Then my cravings started again. I guess I've been eating so crappy for so long I never noticed my body's response to foods like this. It wasn't just a mental craving...my body was physically wanting sugar. Why is that?
I know most people are overweight or obese because of a simple rule: MORE INPUT THAN OUTPUT. However, the "input" part is a little more complicated for me. At some point in my life food became more than just fuel for the body. Whether I consider it an addiction or not...there is a certain dependency there. Maybe a little bit of physical dependency, but for sure a mental dependency. That seems to lead to a horrible cycle. Mentally I eat out of habit or emotion - to numb myself or to "feel good," and it's almost always in excess. I do this long enough (8 yrs) and my body adapts in order to try and process eveything I eat...only it isn't meant to handle all of that extra fat...but it's been functioning for so long at that level it's as if (in the beginning) my body doesn't know what to do with itself when I try to take it in the right direction. I don't know if that makes sense, but it seems to correlate with obesity and diabetes.
My diabetes education nurse said it best (para-phrasing of course): "As a diabetic your body is used to having a higher than normal blood glucose level. So, as you begin to control the insulin in your body it will regulate the blood glucose level to a normal level. When levels start to even out you will notice (in the beginning) that you may experience the sensation of "low blood sugar," (jitters, dizziness, irritable), but when you sample your blood glucose level it will not be low, but will be within normal range. That is because your body is use to your glucose levels being higher."
So true! I also think my body is used to having certain food and my mind is definitely trained to overeat...so as I start changing all of this it's almost as if I'm putting my physical and mental state into "shock." Maybe not quite that dramatic...but you get the idea.
Then I binged on 4 pieces of toast with peanut butter and jam because I was trying to avoid the brownies and ended up eating all of that. WTF!
I was going to rip myself to shreds in this post, but the OLD me would do that and then give up and binge the rest of the week. But, I'm trying to break these nasty, self-defeating habits.
The NEW me says, "You screwed up...forgive...forget...make the next meal count and start exercising."
I've done well with my eating this week. Not perfect, but much better than in the past. I'm trying to lose weight by the end of April, which is my next weigh-in with the Nutritionist. I'm trying to follow her guidelines...not just because she asked me to, but because I want to change my relationship with food...I want to change how I think about it so that I can be successful after I have this surgery.
So, my eating this week: I've been replacing one meal with a protein drink. I've been making healtheir choices and been more conscious about portions. I've been avoiding late night snacking...and junk in general. LOTS of water.
Then I made brownies...chocolate peanut-butter brownies.
I made them for a family treat. I figured I could handle that because I'm not a big fan of brownies, so it won't be hard for me to avoid them.
Well, I decided to have one...just to try it (never had it with peanut butter). BIG mistake. I ate that brownie and it was like my body was saying, "wow...haven't had sugar in a while...haven't had chocolate in a while...NEED MORE!" Then my cravings started again. I guess I've been eating so crappy for so long I never noticed my body's response to foods like this. It wasn't just a mental craving...my body was physically wanting sugar. Why is that?
I know most people are overweight or obese because of a simple rule: MORE INPUT THAN OUTPUT. However, the "input" part is a little more complicated for me. At some point in my life food became more than just fuel for the body. Whether I consider it an addiction or not...there is a certain dependency there. Maybe a little bit of physical dependency, but for sure a mental dependency. That seems to lead to a horrible cycle. Mentally I eat out of habit or emotion - to numb myself or to "feel good," and it's almost always in excess. I do this long enough (8 yrs) and my body adapts in order to try and process eveything I eat...only it isn't meant to handle all of that extra fat...but it's been functioning for so long at that level it's as if (in the beginning) my body doesn't know what to do with itself when I try to take it in the right direction. I don't know if that makes sense, but it seems to correlate with obesity and diabetes.
My diabetes education nurse said it best (para-phrasing of course): "As a diabetic your body is used to having a higher than normal blood glucose level. So, as you begin to control the insulin in your body it will regulate the blood glucose level to a normal level. When levels start to even out you will notice (in the beginning) that you may experience the sensation of "low blood sugar," (jitters, dizziness, irritable), but when you sample your blood glucose level it will not be low, but will be within normal range. That is because your body is use to your glucose levels being higher."
So true! I also think my body is used to having certain food and my mind is definitely trained to overeat...so as I start changing all of this it's almost as if I'm putting my physical and mental state into "shock." Maybe not quite that dramatic...but you get the idea.
Then I binged on 4 pieces of toast with peanut butter and jam because I was trying to avoid the brownies and ended up eating all of that. WTF!
I was going to rip myself to shreds in this post, but the OLD me would do that and then give up and binge the rest of the week. But, I'm trying to break these nasty, self-defeating habits.
The NEW me says, "You screwed up...forgive...forget...make the next meal count and start exercising."
Saturday, March 27, 2010
Current Status of Insurance Approval
Well, I can't be approved if I haven't submitted yet. I just wanted to make a quick post as to where I'm at in this insurance approval game.
Before my bariatric program will submit to my insurance I had a To-Do List:
9 month doctor supervised diet
Pre-Qualifying blood work, EKG, X-Ray
Psychological Evaluation
Binge Eating Group
As you can see I only have one more thing on my list, and only 3 more months of the diet left to go! Then they will submit all of my stuff to the insurance. If I'm lucky it will only take a few weeks for them to approve it. I'm getting anxious!
Before my bariatric program will submit to my insurance I had a To-Do List:
9 month doctor supervised diet
As you can see I only have one more thing on my list, and only 3 more months of the diet left to go! Then they will submit all of my stuff to the insurance. If I'm lucky it will only take a few weeks for them to approve it. I'm getting anxious!
The Mental Preparation
When I first found out that I had to complete a 9 month supervised diet I wanted to throw in the towel. I had already decided what surgery to get...done all my research...been fat for WAY too long - I was ready to have this surgery NOW!
BUT - this 9 month wait has been a blessing in disguise. It's given me time to educate myself more and prepare myself mentally. It has actually gone pretty fast and I only have 3 more months left of it.
Which leads me to AH-HA #2: Preparation
We all know that WLS is only a tool...not an answer. But, I have to be honest,when I first made the decision to start the required 9 month diet for surgery I didn't really want to think about lifestyle changes. I just figured I would stuff my face and exercise when I felt like it (which was rare) and it wouldn't matter if I lost or gained any weight before the surgery, because the surgery would take care of it for me. I was also counting on the surgery to change a lot of other things too:
"When I have surgery I won't have any cravings, so I won't worry about them now."
UMM....NOPE! According to most post-op surgery folks they say they have to overcome a lot of "mental hunger/mental cravings" after surgery. Most cravings are mental, and often a response to an emotion we are feeling (even if we don't realize it). That's why I've been recently working on distracting myself when I get a craving...I got that from my Binge Eating Group. First, when I have a craving (or "think" I'm hungry) I have to wait 10 minutes to see if the craving/hunger is still there. I have to evaulate when I last ate to determine if I'm actually hungry or if it's a mental hunger. During those 10 min I find something else to keep my mind occupied (brush teeth, do some stretches, change rooms or activities, etc). Most of the time it works for me. In the beginning it was hard. First few days I gave into the craving. Next few days I would give into the craving, but replace the junk food with a healthy one. I usually crave sweets, so instead of going for cookies or sweet cereal I would grab a piece of fruit. After about 2 weeks I found I was craving things less and less. Maybe due to awareness? Maybe due to avoiding trigger foods? Maybe a combination of both.
(Side Note: my psychologist required me to attend 4 weekly sessions of a Binge Eating Support Group. When she told me that I thought to myself, "Right...like that is really going to benefit me." It has really helped me to be more concientious and gave me coping strategies)
"When I have surgery all of my old eating habits will just go away."
AGAIN...NOPE! I'm an emotional eater and a habitual eater. Meaning I eat when I'm down or upset...for comfort, and I eat out of habit - even if I'm not hungry. My worst habit is eating at night...around 8pm. It's my unwind time in front of the TV. It's like whenver I sit in front of the TV I feel like I need to have something to eat. Most of the time I'm not really even hungry...it's just this habit...this behavior of TV and food going hand-in-hand. This has been a hard one for me to break. I have good and bad days. Right now I'm just trying to focus on eating a healthy, portion-controlled snack...as I wean myself off of this behavior.
As far as the emotional eating, I'm also working on that. One coping strategy (learned in my Binge Group) is relaxation. When I'm emotional I sometimes don't think clearly...and I sometimes prefer not to think at all, which is why I end up eating until I'm so uncomfortably stuffed. By practicing my relaxation techniques it really clears my mind. It's kind of like a "restart" button when your mind is just overloaded. It works REALLY well when I do it. The part I'm having to learn is recognizing when I need to step back and take a chill pill before I self-medicate with food. It's a work in progress.
"When I have my surgery exercise will be so much easier."
Well, YES and NO. Yes, it will be easier on the body because I won't be carrying around all of that weight. But, I don't think getting into the habit of exercise will be much easier than now. Why not try and get into the habit NOW? Right now I'm trying these walking dvd's at home. They are perfect, because I get moving, but they aren't so hard that I never want to do them again.
Anyway, I've come to realize that if I truly want to be successful in using my WLS tool, then I need to prepare myself NOW and not count on the surgery to take care of it all for me. I'm glad I've had 9 months to figure this out and prepare myself. I'm glad I have a really good bariatric program that provides me with the tools to succeed after WLS.
BUT - this 9 month wait has been a blessing in disguise. It's given me time to educate myself more and prepare myself mentally. It has actually gone pretty fast and I only have 3 more months left of it.
Which leads me to AH-HA #2: Preparation
We all know that WLS is only a tool...not an answer. But, I have to be honest,when I first made the decision to start the required 9 month diet for surgery I didn't really want to think about lifestyle changes. I just figured I would stuff my face and exercise when I felt like it (which was rare) and it wouldn't matter if I lost or gained any weight before the surgery, because the surgery would take care of it for me. I was also counting on the surgery to change a lot of other things too:
"When I have surgery I won't have any cravings, so I won't worry about them now."
UMM....NOPE! According to most post-op surgery folks they say they have to overcome a lot of "mental hunger/mental cravings" after surgery. Most cravings are mental, and often a response to an emotion we are feeling (even if we don't realize it). That's why I've been recently working on distracting myself when I get a craving...I got that from my Binge Eating Group. First, when I have a craving (or "think" I'm hungry) I have to wait 10 minutes to see if the craving/hunger is still there. I have to evaulate when I last ate to determine if I'm actually hungry or if it's a mental hunger. During those 10 min I find something else to keep my mind occupied (brush teeth, do some stretches, change rooms or activities, etc). Most of the time it works for me. In the beginning it was hard. First few days I gave into the craving. Next few days I would give into the craving, but replace the junk food with a healthy one. I usually crave sweets, so instead of going for cookies or sweet cereal I would grab a piece of fruit. After about 2 weeks I found I was craving things less and less. Maybe due to awareness? Maybe due to avoiding trigger foods? Maybe a combination of both.
(Side Note: my psychologist required me to attend 4 weekly sessions of a Binge Eating Support Group. When she told me that I thought to myself, "Right...like that is really going to benefit me." It has really helped me to be more concientious and gave me coping strategies)
"When I have surgery all of my old eating habits will just go away."
AGAIN...NOPE! I'm an emotional eater and a habitual eater. Meaning I eat when I'm down or upset...for comfort, and I eat out of habit - even if I'm not hungry. My worst habit is eating at night...around 8pm. It's my unwind time in front of the TV. It's like whenver I sit in front of the TV I feel like I need to have something to eat. Most of the time I'm not really even hungry...it's just this habit...this behavior of TV and food going hand-in-hand. This has been a hard one for me to break. I have good and bad days. Right now I'm just trying to focus on eating a healthy, portion-controlled snack...as I wean myself off of this behavior.
As far as the emotional eating, I'm also working on that. One coping strategy (learned in my Binge Group) is relaxation. When I'm emotional I sometimes don't think clearly...and I sometimes prefer not to think at all, which is why I end up eating until I'm so uncomfortably stuffed. By practicing my relaxation techniques it really clears my mind. It's kind of like a "restart" button when your mind is just overloaded. It works REALLY well when I do it. The part I'm having to learn is recognizing when I need to step back and take a chill pill before I self-medicate with food. It's a work in progress.
"When I have my surgery exercise will be so much easier."
Well, YES and NO. Yes, it will be easier on the body because I won't be carrying around all of that weight. But, I don't think getting into the habit of exercise will be much easier than now. Why not try and get into the habit NOW? Right now I'm trying these walking dvd's at home. They are perfect, because I get moving, but they aren't so hard that I never want to do them again.
Anyway, I've come to realize that if I truly want to be successful in using my WLS tool, then I need to prepare myself NOW and not count on the surgery to take care of it all for me. I'm glad I've had 9 months to figure this out and prepare myself. I'm glad I have a really good bariatric program that provides me with the tools to succeed after WLS.
Sunday, March 14, 2010
My Hospital, My Bariatric Program, My Surgeon
I live within driving distance of the Cleveland Clinic...the #4 hospital in the country. It's about an hour drive for me to get there. I have some good hospitals that offer good bariatric programs within my own city, but they all had program fees (above and beyond what the insurance covers) and I just couldn't afford it. I had heard so many great things about the Cleveland Clinic in general I decided to check them out as well.
Which brings me to AH-HA #1:
DO YOUR HOMEWORK. After you've researched and made your decision on what WLS procedure is best for you...don't forget to research surgeons and hospitals. Some people may be limited to what is in their area if they don't live in or near a larger metropolitan area. However, if you live in or near a larger city check out all of your options. There are three major hospitals that offer bariatric programs within my own city. I called each one and asked for all the basics: FEES, REQUIREMENTS, SURGEONS, INSURANCE. Most of them also had websites that already had answers to these questions. Once I gathered that information I was a little discouraged...they all had program fees ranging from $800-$1900. OUCH! So, I decided widen my search area and I came across the Cleveland Clinic. NO PROGRAM FEES! GREAT BARIATRIC PROGRAM! GOOD PATIENT FEEDBACK ON SURGEONS!
My Hospital: Cleveland Clinic.It has the Bariatric and Metobolic Institute that has a very thorough bariatric surgery program. This is how My Bariatric ProgramWorks:
1)You call and they pre-screen you by asking for your insurance information, height and weight, medical conditions (co-morbidities) and tell you if you qualify for WLS. If you qualify they send you a Patient Worksheet Questionnaire.
2) Once you send in the Questionnaire they review your medical history and make sure you are pre-authorized with your insurance for any pre-op testing and appointments.
3) If everything is kosher with your insurance they schedule you for the required WLS workshop
4) The WLS workshop is about 3 hours long. They encourage you to bring an immediate family member or support person so that they can learn with you. The workshop covers all of the different types of sugeries; all of the pre-op preparation, life after surgery, and the expected lifestyle changes that come with each of the surgeries. It's VERY thorough. At this point they also assign you your surgeon and clinic ID.
5) After completing the WLS workshop you make appointments for your pre-op testing. These test can vary based on your health situation, but some of the basics that most patients will go through are
- Bloodwork
- EKG (to make sure your heart is stable for surgery)
- X-Ray (to make sure your lungs are healthy enough for surgery)
- Psychology (to identify and work through and mental/emotional issues that might prevent you from being
successful after your surgery)
- Nutrition (to make sure you meet your insurance diet requirments, prepare you for the pre-op diet, and educate you on the new eating habits after surgery)
- Meet your surgeon
They do their best to schedule these appointments in one day so that you don't have to keep coming back for each appointment.
6) Once all of these things are complete and you met all of your insurance requirements they submit all of your information to your insurance for approval.
7) Once approved they schedule your surgery and you come in for a Pre-Op clinic visit, which includes a consultation with your surgeon.
8) After surgery there are multiple follow-up appointments and support groups.
My Surgeon is Dr. Matthew Kroh. I've only met him once thus far, and it was very brief. He seems like a nice man. I know I will be meeting him again for a more in-depth consultation once my surgery is scheduled. I think I will get a better feel for him at that point.
Which brings me to AH-HA #1:
DO YOUR HOMEWORK. After you've researched and made your decision on what WLS procedure is best for you...don't forget to research surgeons and hospitals. Some people may be limited to what is in their area if they don't live in or near a larger metropolitan area. However, if you live in or near a larger city check out all of your options. There are three major hospitals that offer bariatric programs within my own city. I called each one and asked for all the basics: FEES, REQUIREMENTS, SURGEONS, INSURANCE. Most of them also had websites that already had answers to these questions. Once I gathered that information I was a little discouraged...they all had program fees ranging from $800-$1900. OUCH! So, I decided widen my search area and I came across the Cleveland Clinic. NO PROGRAM FEES! GREAT BARIATRIC PROGRAM! GOOD PATIENT FEEDBACK ON SURGEONS!
My Hospital: Cleveland Clinic.It has the Bariatric and Metobolic Institute that has a very thorough bariatric surgery program. This is how My Bariatric ProgramWorks:
1)You call and they pre-screen you by asking for your insurance information, height and weight, medical conditions (co-morbidities) and tell you if you qualify for WLS. If you qualify they send you a Patient Worksheet Questionnaire.
2) Once you send in the Questionnaire they review your medical history and make sure you are pre-authorized with your insurance for any pre-op testing and appointments.
3) If everything is kosher with your insurance they schedule you for the required WLS workshop
4) The WLS workshop is about 3 hours long. They encourage you to bring an immediate family member or support person so that they can learn with you. The workshop covers all of the different types of sugeries; all of the pre-op preparation, life after surgery, and the expected lifestyle changes that come with each of the surgeries. It's VERY thorough. At this point they also assign you your surgeon and clinic ID.
5) After completing the WLS workshop you make appointments for your pre-op testing. These test can vary based on your health situation, but some of the basics that most patients will go through are
- Bloodwork
- EKG (to make sure your heart is stable for surgery)
- X-Ray (to make sure your lungs are healthy enough for surgery)
- Psychology (to identify and work through and mental/emotional issues that might prevent you from being
successful after your surgery)
- Nutrition (to make sure you meet your insurance diet requirments, prepare you for the pre-op diet, and educate you on the new eating habits after surgery)
- Meet your surgeon
They do their best to schedule these appointments in one day so that you don't have to keep coming back for each appointment.
6) Once all of these things are complete and you met all of your insurance requirements they submit all of your information to your insurance for approval.
7) Once approved they schedule your surgery and you come in for a Pre-Op clinic visit, which includes a consultation with your surgeon.
8) After surgery there are multiple follow-up appointments and support groups.
My Surgeon is Dr. Matthew Kroh. I've only met him once thus far, and it was very brief. He seems like a nice man. I know I will be meeting him again for a more in-depth consultation once my surgery is scheduled. I think I will get a better feel for him at that point.
Insurance
As I said in my Beginning post my new insurance covers WLS...sort-of.
I have CareSource - Ohio. They only cover certain WLS procedures (Roux-en-Y and LapBand) and only on a case-by-case basis. When I first contacted them to see if they covered it the customer service rep said NO. Then someone (on the Obesity Help website) suggested that I call again with the procedure code for Roux-en-Y (CPT code: 43645 - Roux-en-Y Gastric Bypass). When I did that they told me it's not usually a covered procedure unless it is deemed "medically necessary" by my primary care physician, and that I meet certain "requirements" for approval.
What are those requirements?
-9 month doctor supervised weight loss program (completed within the past 5 yrs). The doctor must document weight, dietary plan, exercise plan and progress on a monthly basis.
-Documentation of at least one obesity related co-morbid condition (diabetes, high blood pressure, high cholesterol, heart disease, sleep apnea, etc)
-BMI of 40+
•My BMI is over 50 - CHECK
•I have Diabetes, high blood pressure, sleep apnea - CHECK
•9 month doctor supervised weight loss program:
Right now I'm in month SIX...so only THREE more months to go! I know I shouldn't be too excited right now, because I'm not approved yet. However, I'm going through a program at the Bariatric and Metobolic Institute at the Cleveland Clinic and they are almost sure I will be approved.
The first six months of my "diet" (beginning Sept 2009) I started with my PCP and told her about my decision to have gastric bypass surgery. I told her all the information that needed to be documented and that she would need to write a recommendation letter. She agreed to work with me and also counseled me about the surgery (the pros and cons).
During the same time I had also signed up for the bariatric program thru the Cleveland Clinic. In November I went to a seminar and got registered with them and made all of my pre-op appointments. They handle all the insurance stuff and won't make appointments with-out pre-authorization from your insurance company. I double checked on this. Every appointment the clinic made I called their "insurance specialist" to confirm my insurance had authorized it...and every time (so far) it has. I haven't received a single bill. I will be continuing the last 3 months of my diet with the Nutritionist in their Bariatric Program.
Here's to hoping for approval!
I have CareSource - Ohio. They only cover certain WLS procedures (Roux-en-Y and LapBand) and only on a case-by-case basis. When I first contacted them to see if they covered it the customer service rep said NO. Then someone (on the Obesity Help website) suggested that I call again with the procedure code for Roux-en-Y (CPT code: 43645 - Roux-en-Y Gastric Bypass). When I did that they told me it's not usually a covered procedure unless it is deemed "medically necessary" by my primary care physician, and that I meet certain "requirements" for approval.
What are those requirements?
-9 month doctor supervised weight loss program (completed within the past 5 yrs). The doctor must document weight, dietary plan, exercise plan and progress on a monthly basis.
-Documentation of at least one obesity related co-morbid condition (diabetes, high blood pressure, high cholesterol, heart disease, sleep apnea, etc)
-BMI of 40+
•My BMI is over 50 - CHECK
•I have Diabetes, high blood pressure, sleep apnea - CHECK
•9 month doctor supervised weight loss program:
Right now I'm in month SIX...so only THREE more months to go! I know I shouldn't be too excited right now, because I'm not approved yet. However, I'm going through a program at the Bariatric and Metobolic Institute at the Cleveland Clinic and they are almost sure I will be approved.
The first six months of my "diet" (beginning Sept 2009) I started with my PCP and told her about my decision to have gastric bypass surgery. I told her all the information that needed to be documented and that she would need to write a recommendation letter. She agreed to work with me and also counseled me about the surgery (the pros and cons).
During the same time I had also signed up for the bariatric program thru the Cleveland Clinic. In November I went to a seminar and got registered with them and made all of my pre-op appointments. They handle all the insurance stuff and won't make appointments with-out pre-authorization from your insurance company. I double checked on this. Every appointment the clinic made I called their "insurance specialist" to confirm my insurance had authorized it...and every time (so far) it has. I haven't received a single bill. I will be continuing the last 3 months of my diet with the Nutritionist in their Bariatric Program.
Here's to hoping for approval!
The Beginning
I think the first time I heard about weight loss surgery (WLS) was around 2003...I was around 23...and weighed about 265 lbs. I had a co-worker that had heard about it and was considering it, but didn't know much about it. So we did a little internet research to find out more and it kind of freaked us out.
The first thing we came across was before and after pictures of people who had Roux-en-Y. They were very dramatic and graphic...with loose skin hanging all over the place...it looked like these people were buried in their skin. Then we read about what the surgery involved and all the risks and came across a few bad stories. That was enough to make my friend think twice.
From that point on, WLS was always a distant thought in my mind. My first thoughts were, "I would like to lose weight, but WLS is too extreme...what if I end up looking like a pile of skin?" I figured I would have to lose weight without surgery, so over the next few years I tried many diets. Diets I had already tried before...Slim Fast, Dexitrim, Atkins, South Beach, Weight Watchers, Low-Calorie...you name it. I found I lost the most weight with Atkins and Weight Watchers, so I would lose anywhere from 25-50 pounds...only to gain it back and then return to one of the two diets because I knew I could always get some sort of results.
Then I started hearing about famous actors/actresses having WLS, and it peaked my interest again. If these people were having it and they didn't look like a pile of skin then maybe I should research some more. In 2008, after spending several months researching I had decided to have the Lap Band procedure. I felt it was less extreme and more easily reversible...not to mention it was also much more affordable than Roux-en-Y. I had my money all ready, my surgery scheduled in Mexico...I was ready to go. Unfortunately, some unexpected events occurred that required me to use my surgery money. I was so disappointed, and had decided that I should just accept the fact that I will have to live the rest of my life as a fat ass!
So, if I was going to be fat for the rest of my life I might as well "enjoy" the only "fun" thing about being fat: eating whatever I wanted and not caring about it. Accept deep down I did care. I felt disgusting and fat and out of control and hopeless. That is when I peaked at my highest lifetime weight: 335 pounds! That is also when I was diagnosed with Type II Diabetes, Hypertension and eventually sleep apnea...all at the age of 29! It was all so overwhelming and depressing. I had to be a little more conscious of what I ate and began to lose weight…about 25 pounds.
And then in 2009 we moved to another state, and I got new insurance…and guess what? They cover WLS (with a catch – that’s for another post)!
I still wanted the Lap Band procedure, but a friend on the Obesity Help website recommended researching Roux-en-Y and a few other WLS surgeries before deciding. I’m so glad I did, because I decided to get the Roux-en-Y procedure. After talking to my Primary Care Physician (PCP) and looking into all the different type of WLS surgeries, and then attending a seminar on them I feel confident that the Roux-en-Y procedure will be the best tool for me! I can’t wait!
The first thing we came across was before and after pictures of people who had Roux-en-Y. They were very dramatic and graphic...with loose skin hanging all over the place...it looked like these people were buried in their skin. Then we read about what the surgery involved and all the risks and came across a few bad stories. That was enough to make my friend think twice.
From that point on, WLS was always a distant thought in my mind. My first thoughts were, "I would like to lose weight, but WLS is too extreme...what if I end up looking like a pile of skin?" I figured I would have to lose weight without surgery, so over the next few years I tried many diets. Diets I had already tried before...Slim Fast, Dexitrim, Atkins, South Beach, Weight Watchers, Low-Calorie...you name it. I found I lost the most weight with Atkins and Weight Watchers, so I would lose anywhere from 25-50 pounds...only to gain it back and then return to one of the two diets because I knew I could always get some sort of results.
Then I started hearing about famous actors/actresses having WLS, and it peaked my interest again. If these people were having it and they didn't look like a pile of skin then maybe I should research some more. In 2008, after spending several months researching I had decided to have the Lap Band procedure. I felt it was less extreme and more easily reversible...not to mention it was also much more affordable than Roux-en-Y. I had my money all ready, my surgery scheduled in Mexico...I was ready to go. Unfortunately, some unexpected events occurred that required me to use my surgery money. I was so disappointed, and had decided that I should just accept the fact that I will have to live the rest of my life as a fat ass!
So, if I was going to be fat for the rest of my life I might as well "enjoy" the only "fun" thing about being fat: eating whatever I wanted and not caring about it. Accept deep down I did care. I felt disgusting and fat and out of control and hopeless. That is when I peaked at my highest lifetime weight: 335 pounds! That is also when I was diagnosed with Type II Diabetes, Hypertension and eventually sleep apnea...all at the age of 29! It was all so overwhelming and depressing. I had to be a little more conscious of what I ate and began to lose weight…about 25 pounds.
And then in 2009 we moved to another state, and I got new insurance…and guess what? They cover WLS (with a catch – that’s for another post)!
I still wanted the Lap Band procedure, but a friend on the Obesity Help website recommended researching Roux-en-Y and a few other WLS surgeries before deciding. I’m so glad I did, because I decided to get the Roux-en-Y procedure. After talking to my Primary Care Physician (PCP) and looking into all the different type of WLS surgeries, and then attending a seminar on them I feel confident that the Roux-en-Y procedure will be the best tool for me! I can’t wait!
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