Wednesday, October 22, 2008

Can I get some cheese with this whine....

Feeling frustrated last couple of days. I am mad at myself that I didn't just have RNY 5 years ago and yet I am thankful that I have found the new WLS's I didn't know about like DS and VSG. I really want to have the sleeve but after going through all the paperwork, seminars, testing and money, I just now start really looking at my insurance policy. (Much thaanks to all the OH folks for all the advice, especially about researching before you choose a surgeon or surgery...wish I had known that before) My insurance policy lists all the surgeries...RNY, DS, VSG, LAP, BPD, GB..then it lists all six requirements of eligibility and gives CPT codes for surgery...flip to the next page...lap is not covered for BMI's over 50, oh and we don't cover sleeve gastrectomy AT ALL annnd, no 2 part surgery requests will be approved. Hmmmm sounds like RNY is all that is left!! Why should the insurance company get to decide??? If my surgeon, myself , PCP and enocrine dr. all think VSG is a good way for me to go then that is how it should be. So I blew the smoking thing out of the water...Bought a pack, smoked them....bought another pack. I just don't understand. My surgeon's office is submitting for VSG anyway, we shall see but my hopes are not very high!! I need to win the lottery so I can self pay and decide what is best for me not the insurance company. My advice to anyone looking into WLS for the first time...Spend months researching WLS options, lurk and ask questions on all forums on OH (, know your policy inside and out, choose a surgery, choose a surgeon and then JUMP!! Then again, maybe my subconscious knew I would back out if I didn't get my way so I invested all the time and money so I would do something, whether I wanted RNY or not. Nahhh, that's not it!

Sunday, October 19, 2008

The Smoking Caterpillar

That was what my dreams were about last night...the smoking caterpillar from Alice in Wonderland. Whoooo Arree Youuuu? I had several other weird dreams...all involved smoking ofcourse. I am attempting to quit. Yes I am such a pessimistic, I said attempting! Part of me really does want to quit..I don't like the hold I feel it has over me. I would rather be able to smoke for enjoyment but I am a true addict so I smoke like a freight chain, like a crack addict who hadn't had a fix in a while. But the other part of me...oh how I miss that first drag in the morning after sipping my coffee. I hate how it smells embarasses me that people complain that their stuff smells like smoke when they leave my house. Wow, that is a great memory to leave behind...My niece saying ..oh smell my blanket, it smells like Aunt Teresa's house....smoke!!! NOOO, you want her to say it smells like baked cookies or my perfume or ANYTHING but smoke. I did pretty good last night with the smoking thing... I slept most of yesterday, I have tried to stay away from triggers like talking on the phone or the internet or driving. I decided not to shower this weekend..I know gross but if I shower I WILL go to the store and buy a pack!! I have to do laundry today so I will try to stay busy...worse case scenario, I just go back to bed. Tomorrow will be tougher because I have to go back to work. Uggghhhh. The caterpillar did turn into a butterfly and left his smokes behind eventually. That is the first and foremost reason I am have this surgery so I can release myself from this cocoon of fat and become my own butterfly.

Advice from a Caterpillar
The Caterpillar and Alice looked at each other for some time in silence: at last the Caterpillar took the hookah out of its mouth, and addressed her in a languid, sleepy voice.'Who are you?' said the Caterpillar.
This was not an encouraging opening for a conversation. Alice replied, rather shyly, 'I - I hardly know, sir, just at present - at least I know who I was when I got up this morning, but I think I must have been changed several times since then.
''What do you mean by that?' said the Caterpillar sternly. 'Explain yourself!''
I can't explain myself, I'm afraid, sir' said Alice, 'because I'm not myself, you see.
''I don't see,' said the Caterpillar.'I'm afraid I can't put it more clearly,' Alice replied very politely, 'for I can't understand it myself to begin with; and being so many different sizes in a day is very confusing.
''It isn't,' said the Caterpillar.'
Well, perhaps you haven't found it so yet,' said Alice; 'but when you have to turn into a chrysalis - you will some day, you know - and then after that into a butterfly, I should think you'll feel it a little queer, won't you?
''Not a bit,' said the Caterpillar.
'Well, perhaps your feelings may be different,' said Alice; 'all I know is, it would feel very queer to me.
''You!' said the Caterpillar contemptuously. 'Who are you?'

Saturday, October 18, 2008

The Nut, The Surgeon and the Shrink

So I had the last of my pre op testing and consultation this week. I met with the nutritionist Monday. I expected a lot of talk about diets and food choices but she was more interested in talking about the surgery itself and why I was doing it, I thought I was at the phychiatrist. Lasted about 30 minutes, it was painless and my inurance didn't pay for it so out of pocket I paid 55.00. At least it wasn't hundreds.
I had my consultation Tuesday. I have heard so many good things about Dr. Enochs, I was excited and nervous. My mom and daughter went with me so we can all have as much information as possible. The receptionist took my 400.00 consult fee...ouch! and a 30.00 co pay. This surprised me because I thought the point of the consult fee was to cover their costs in case you ended up not having surgery and got no money from the insurance company, which is why I didn't mind paying the consult fee but if I had to pay a co pay, that means they billed my insurance too. So they do get paid. I guess I should have asked but I was just so excited to have come this far in the process. I guess in the end, it really is all about money. My appointment was at 3:00, we arrived at 2:45, we were finally called back at 3:45, then sat in the room until 4:45..2 hours! I was irritated! I kept saying I hope they are having an off day because I would hate for them to be the top bariatric office in our area and this is how they operate. The nurse came in to take blood pressure and stuff and ask me what surgery I was looking at and I said possibly lap band or...and she jumped in to say "Your insurance won't cover lap because your BMI is too high" What??? What if that was the ONLY surgery I was willing to have? That would have been a good thing to tell me BEFORE I paid 400.00!! I said or the sleeve...she said oh they might do that but usually they only cover RNY. Well I don't want RNY. Why does it matter, it is my body! This just infuriates me. WLS is a choice I feel for lower BMI's but I think oncve you surpass 50, WLS is a necessity and it bewilders me how the insurance companies can look at it any other way. So Dr. Enochs came in and he was warm and friendly, made me feel very comfortable. He wasn't rushed even though he had to be somewhere by 6:00 and we were pushing 5:30. He skimmed over my chart and said he would recommend the sleeve for me as a surgeon because I don't really have many co-morbidies..I am somewhat healthy for a fat person! I do have a slight hernia and slight acid reflux and a fatty liver. The hurdle will be the insurance company. I know if they deny it, I will appeal...beyond that..I might push for lap band. I don't know what I will do. Try on my own once again I suppose. I didn't get to ask him all my questions, since most of them were surgery related I decided to wait until I was definately going to have surgery, plus he had to be somewhere so I thought I would be nice and not hold him up even though I had to wait for 2 hours but whatever, I am not bitter. LOL Really I'm not. I was a little irritated that day but Dr. Enochs was so nice, I got over it pretty quickly.
I met with the psychiatrist yesterday and she was super nice as well. I might have to meet up with her again. She specializes in bariatrics so I might need her down the road. I had to do a questionaire that asked questions like do I binge, do I closet eat, make myself throw up. Then we talked about the different surgeries and she said she has a lot of patients that are disappointed in their bands because they can cheat it and a lot of RNY's losing hair because they are not following the rules so she emphasized the importance of protein and eating right, lifestyle change. I know all these things but I think it really hit me for the first time in her office. I have just been so excited about what could be. She also helped me confirm my thoughts about not telling anyone at work. She said she has a patient that did tell everyone at work and they are not losing weight and people keep asking why isn't it working or can you get a refund. I don't want to face that pressure. I won't be lieing if they ask how I have lost weight and I say I watch my portions and excercise. A lot of people have surgery or get on medications to help cure a medical problem and end up losing weight. She asked if I was scared and if I thought about the changes I was going to have to make and I said I know the changes but I really don't feel I have a choice, it is kind of like if I had stomach cancer and they had to remove the cancerous stomach. It's a have to for me so "just jump" and figure out the rest later. She wanted to make sure I wasn't obsessed with being skinny...what did I want to weigh? I don't really care what I weigh...I just want to be healthy, to feel good, to be able to walk without hurting, to be able to really clean my house without relying on others, to be able to go places and have fun with my children, go on vacations and not stay in the hotel room or sit on a bench while everyone else around me is living. I want to live!

Sunday, October 5, 2008

First Steps

So in order to have surgery, you have to jump through some hoops with paperwork and testing. Ofcourse I attended an informational seminar back in May and filled out all the paperwork for the surgeon. I procrastinated for a couple of months on submitting verification of coverage to my insurance company...not sure why other than being scared of change. But I submitted it late August and then set up appointments. I saw my PCP first and talked about surgery, she was all for it. I came back in on 9-22 to do the EKG and bloodwork...piece of cake, I was in and out in 30 minutes. I went on 9-24 to do an ultrasound of my gall bladder..easy, a chest xray..easy, and a barium swallow...not so easy but not horrendous either. First they had me stand on this platform that was connected to a table in upright position against my back with an xray machine in front of me. I had to swallow these crystals that looked like pop rocks and I immediately had an overwhelming feeling to burp but I was told not to. Then I had to drink barium, this thick white chalky stuff, I had to gulp it while they took pics of it going down. Had to stop once, felt like I was going to spew! Then the table laid back...I had to literally roll around on the table to coat the barium on my stomach and lay in all kinds of positionsso they could take pictures and then drink some more barium and take more pictures. Talk about awkard! The next week, I felt a lot of gas and bloatiness, burped alot, had constapation, then diarhea, then constipation again. A co-worker gave me a nexium the following Wednesday and wheww..relief! Wish I had thought of that sooner!!! I scheduled my nutritionist and psychologist appointments and my consultation with my surgeon is October 14th. From there hopefully I can have surgery pretty quick since all should be done. I just have to quit smoking. My PCP prescribed me zyban..seemed to work the first day, last 2 days I couldn't get enough cigarettes but I made a quit date of Oct 20th...the plan is to put them down. I have had weird dreams last couple of nights on this med...real weird, like twisted stuff. I dreamnt I had a brain tumor, that I kicked my daughter out of the house and that someone broke in my house and we were fighting with knives. I told ya..weird!