Today I spoke to the bariatric nurse at the surgery center who said that since I have been approved to enter into the case management program this means that as long as I complete my checklists within 6 months and there are no unknown medical conditions that would interfere, I have ben approved to have the lap band! They said that after I meet with the surgeon the insurance company will give the go ahead for surgery. I also have an insurance case manager who confirmed this. So now I'm waiting to schedule my medical test appointments to complete the checklist. I also gave to loose 5% and go to 2 suppor groups. I'm excited, but don't want to get my hopes up too much. It seems this dream will soon become a reality! Shop now I'm going to do what I have to to get this done. I know it will be hard, but it will be worth it!!
Yesterday I confirmed that my doctor sent the referral into my insurance company so I assumed it would be at least a week until I heard anything. Well today I received a call from the ghc bariatric surgery office scheduling an interview with the head nurse. I was told that she is going to discuss my surgery options and explain the entire program. I don't want to assume, over-think, or stress on this. I'm glad that they got my referral and I'm hoping that the phone interview is just another step in the right direction. Maybe they just want to confirm that I'm serious before making me drive down to Bellevue, which is over an hour away from where I live. See, here I go worrying about it. Thankfully I have some other things going on with work and at home to distract me. Unfortunately one of those things is my carpal tunnel, which was just diagnosed and is slowly driving me mad. Just when I thought I was as crazy as I could possibly be, I go ahead and surprise myself
Today was my appointment with my pcp. I am not sure what I was so worried about. I guess I figured he would find a reason to say he wouldn't refer me to my insurance provider's program for the lap band/bariatric surgery. Boy, was I wrong. He was very much on board. We went through my chart and documented all the problems that I have had that are attributed to my weight. Tomorrow I am going to have blood work to check some things that he didn't at my physical earlier this year just to make sure we aren't missing anything. The nurse said that I should hear in a week if my referral was accepted. If it is then I would start the process for being evaluated and considered for the surgery. I also found out today that I am shorter than I thought which brings my BMI up to 48.6. Unfortunately for me my insurance requires a BMI of 35-49 with out of control diabetes, or two other comorbidities. For sure I have one, high cholesterol, and it looks like possible hypertension. The other qualifying problems my insurance accepts are heart disease, pickwickian syndrome, and obstructive sleep apnea. My pcp was very supportive and said that any other insurance company would accept me on my BMI alone, but lucky me I have ghc so there will be several hoops. PCP stated that he has had a lot of people not qualify, but he has had others that do and he believes he had ghc accept someone who's BMI was lower. I guess there isn't anything I can do until I hear back from insurance. Considering my health history and family health history, my weight issues since elementary school, and the constant dieting you'd think that I'd be a shoe-in. Oh well. I have to be patient and patient I will be. According to the paper I printed off today from ghc I also have to maintain a diet and exercise program, maintain a 5% weight loss until surgery,attend support group meetings, keep all appointments and of course follow all the counseling and nutrition classes. I'm so ready! Bring on the red tape baby, cause I'm willing to do what I have to in order to being a new, healthy life!!
Like many other people, I have never blogged before so please excuse any mistakes I may make. I'll start with my story. I have been over weight since I can remember. I know that in first grade we made posters with our height and weight on it and I weighed more than anyone else. I went on my first official diet at age 14. My mom and the program (I think it was called Formu3) lied about my age so I could 'officially' take part. That phase passed and although I was bigger, I tried to stay active.
The beginning of putting on serious weight began in high school. In college I began kick boxing which I loved, but I still gained weight. When I was 21 I started Weight Watchers and lost 10 lbs and gained that and more back. The next year I did the same thing. I've since had two kids and am now at the heaviest I have ever been at 311 lbs. I just turned 30 and realized that something has to give. I have tried fad diets which only seem to work for a time. With both of my children I had gestational diabetes and high blood pressure. Thankfully the diabetes went away once my children were born, but my blood pressure is not as good as it was. I have done a lot of thinking and research and decided that I want to do the lap band. I not only want to watch my kids grow up, I want to participate in their lives. I don't want to be tired all the time and out of breath. So the decision has been made on my part, now comes the doctors and insurance.
I have an appointment with my PCP early next week. I spoke to my insurance company and they said that I have to have a BMI of 35 or over (mine is 47) and 2 significant medical problems attributed to obesity. I will need to have a test to see if I have sleep apnea, but I don't know if I will qualify since I don't have diabetes at the moment. I have a family history on both sides, including my mother, of diabetes, high blood pressure, obesity, cancer, and heart disease. I don't know if this will be considered when my insurance, GroupHealth Cooperative in WA, takes a look at my case. I'm not even sure if my PCP will refer me, but I'm hoping that he will. I'm anxious to get things started because once I come to a decision to do something I want to get it done NOW. I've read about the time it may take and am willing to do what I have to. I want to change my life and will do what is necessary to do it.. If my insurance will not cover it, I will have to try to find a way to pay for it myself.
So maybe this is too long, or drawn out. I have only told two co-workers and my husband of my plans as I am not sure how my family will take it. If I am approved I will talk to them about it, but for now it is between us, so don't tell them, ok?? I trust you, no worries
Anyway, if you read this thanks. I needed a place to put my thoughts through this journey to my new life.