The whole reason I got into these blogs to begin with was that I was looking for other people's experiences of bariatric surgery. Either I wasn't looking for proper way or whatever, but he didn't seem like that many people had recorded their personal experiences of going through the surgery. So I promised myself that as I went through the process I would blog my experiences so that other people when it came time for them to make a decision about maybe getting the surgery themselves when police have my experience to use as a yardstick. You know, I don't have any idea if my experience is typical or atypical or normal or abnormal, but this is the real live experience of somebody who made the decision to get bariatric surgery and then have the surgery.
I had the surgery exactly 5 days ago. And I thought for this first blog post about it I would summarize what the experience was like leading up to it. I think I mentioned in previous blog post that I have a really strong family history of heart disease. My grandfather was 42 years old when he died of a heart attack in the middle of the day when he was working as a clothing store as a shoe salesman. My grandmother on the other side of the family was 49 years old when she died of a heart attack on the way home from visiting my mother pregnant with my little brother. I was five months old. I believe that her husband, my grandfather (who may or may not actually my grandfather, but that's a whole another story believe me) had a heart attack at around 50 years old that was nonfatal. My own father had a nonfatal heart attack at 55 years old and a triple bypass. Since then he's had at least two more heart attacks and a stroke.
Six years ago my husband and I weighed about 300 pounds apiece. We each lost about 60 or 70 pounds. And we've kept that weight off for about four or five years but in the last two or three years I've started gaining it back. I've been diagnosed with sleep apnea, high cholesterol, I've 60% blockage in one coronary artery, and I still weigh about 240 pounds. I've been exercising pretty rigorously four or five times a week and trying to watch what I eat. But it hasn't worked.
I weigh myself every time I go to the gym and that weight is almost always the same. it's about 238 pounds, but it's been creeping up. I find that I play games with myself. I give myself little food reward when I do something good. It so easy to grab a sample at Starbucks of the gingerbread cake or to have a piece of burrito as I shop the aisles at Costco. "That doesn't count" I tell myself. It does count.
My cardiologist recommended I go to this informational meeting about bariatric surgery at the hospital. He said one of the most useful aspects of the meeting was that I would meet people who'd actually had the surgery and I would see the kinds of people who consider the surgery and I would see if I felt like I was one of those people or not. Maybe I'd feel like I just wasn't one of these people at all. That sounded reasonable to me. I wrote a blog post about my partner and I going to the informational meeting about six months ago. These people did seem like me.
The next step was filling out an application that was included in the packet of paper that we were given at the informational meeting. Also included in the packet of paper was a list of four or five psychologists that would be willing to do a psychological assessment. A few days after I turned in the application I got a phone call scheduling the first nutrition meeting or class.
For the class we checked in on the 17th floor as if we had a doctors appointment and then were directed to sit in some chairs and couches near one particular door where the nutritionist would stick her head out and announced when the class was beginning. I noticed that hardly any of the chairs in the area had arms on them -- a nod to the special needs of the super overweight. And as we fatsos gathered together trying simultaneously not to be embarrassed but also not to look at each other in the face we were finally called back for first our weighing, politely giving each other privacy, and then we were seated in the class. I didn't know it at the time, but if we gained 15 pounds or more over the course of the classes we would be ineligible for the surgery. These monthly classes are partly a test to see if we can put some of these lessons into action.
And this first class is pretty basic. One woman in the class seemed particularly nervous and asked particularly stupid questions but I suppose there's one in every group and it only made me feel better that as nervous and as stupid as I felt, there was somebody even worse off. The class went a little long which I didn't appreciate, because I had clients of my own and I so had to get back to my office to see them.
What I did learn that the class is that some of the students, that is some of the pre-bariatric patients were far more organized than I was and were further along in the requirements. The requirements include the psychological assessment, and assessment by your primary care physician and making an appointment to see the surgeon himself. I realized I had to get on it. When I got back to my office and started calling psychologists trying to set up an assessment appointment. I spoke to one answering machine after another.
The first psychologists called me back, her earliest appointment was one month away. Since I didn't know how that would compare to the others, I took it. The next psychologist who called me, had an appointment just 10 days away. I would have to rearrange my schedule a little bit and he wanted me to bring $200 in cash. (I expect that that it was the result of some bad experience.) He turned out to be a very nice man and a colleague of the woman I share an office with. He swore a lot and made me realize that it didn't make me take him any less seriously as a psychologist when he swore. Maybe I don't swear enough in my practice.
Next, I called up my primary care physician and made an appointment to see him. He suggested all kinds of tests including a liver ultrasound and a cardiac nuclear stress test. One of the things I like about my primary care physician is that he's super cautious and he was going to be super cautious before surgeryand I gladly went along with it.
They kept telling me that the surgeon's office had a dedicated person-- I'll call her Britney-- who was going to make all the arrangements with my insurance and this was going to be tricky because I was on a COBRA and my insurance expired at the end of the year so I was on the deadline to get the surgery done.
A COBRA refers to insurance from a former employer that you're able to keep paying for all by yourself after you stop working for them. You're only allowed to keep this for 18 months total. I quit my job on June 3, 2011 to go into private practice. My cobra would run out in December I assumed the policy would give me the entire month of December iand it would run out at the end of the year. Later, I learned that it would run out on December 3.
At any rate, I showed up to my second class which was all about proteins. It turned out I hadn't gained any weight from the first class, but I hadn't lost any either. The dietitian seem to be disappointed. I learned that I was going to have to get a protein shake at a nutrition store and I would have to be taking in 60 g of protein every day. This didn't seem to be such a big deal but the dietitian made a big deal out of it. We were told that our homework was to go and try different kinds of protein shakes and find one that we liked. During the class I had asked another student, that is another preop patient, if he knew how to get in touch with Brittany. He gave me her phone number and email address. I was nervous that I hadn't heard from her. However, at the end of the second class, the dietitian said "Britney said she still needs to see..." and then she said my name. I was a little amused that with only at handful of students, the dietitian had not bothered to learn any of our names. I was a little anxious to see what Brittany had to say to me.
It turned out that, sure enough, Britney was being told that my insurance had expired. I assured her that it had not expired and that if she could have the three-way call with both me and the insurance person it would straighten everything out. We had This conversation on the phone one day in October, mid-to-late October. She said that she would get back to me in five minutes or so but that she had to do something for the surgeon first. I waited about an hour, and then called the insurance myself. They explained it all to me, the whole deal with the COBRA and how the policy was set to terminate each month pending a new payment. They explained that every time Brittany had opened an authorization it had closed mistakenly when the policy automatically terminated and then she had opened a new one. Because I wasn't fat enough to get this surgery outright, my doctor had to plead my case to the insurance and the insurance had to approve of it. the time between when Brittany would open the case and when the policy would automatically close was not enough time. They explained all this to me, but I wasn't sure how I was going to explain it to Britney.
after talking to my insurance for about an hour, I was driving in my car on my way to work, Brittany called and I spoke to her on the speakerphone in my car. I was really aggravated that she hadn't called me back like she said she would. I had a half hour drive to my office she got the insurance guy on the phone we had a three-way conversation and somehow she got it resolved. I'm not sure how. Day
with that out of the way, I would get periodic phone calls from Brittany telling me where the approval was in process. I would call the approval department at the insurance company. One day the nurse or does the approvals was out sick, another day was a company wide meeting, there were all kinds of reasons why my approval was not moving forward. I was despairing that this couldn't happen before my insurance ran out on December 3.
. And then, the Thursday before Thanksgiving I got a call. the only things lacking from my insurance file were an approval from a primary care physician and proof that I attended one of the classes. I desperately called my physicians office not really knowing what they wanted but knowing that he wanted me to get the surgery. I emailed him promising to messenger any note from his office to my doctor's office or whatever needed to be done I was so desperate.
The next morning, I got an email from my doctor saying he had no idea what I was talking about. In all his years he'd never had to give any kind of approval like that before. What to they possibly want? And then on my way to work at a hospital way out of the Western suburbs I get a call from Brittany as seem if there's anything I can find or anything I can think of where the physician might have given approval, and something clicked. He was a physician in the same group as the hospital I was having the surgery in. He used the same electronic charting system. on our last visit, just a couple of weeks ago, he must've made some notations that I was okayed for surgery. Could she access that? Britney said that she could! And when she did, she found that notation and she said that would be fine and that was all that they needed and that this would satisfy the insurance company and all I needed to do was wait. it was about 1030 in the morning. At about 3 o'clock that afternoon, I received word from the insurance company that I had been approved for surgery.
Bittany called later to say that my fourth bariatric class and my pre-op physical were scheduled for Tuesday. I was on my way.
No comments:
Post a Comment