Well this is my first blog so it will be a learning process. My sister, Vicky, told me to keep a diary of my Lap-Band surgery process so this is what I am going to do.

In January, 2009 I decided to have Lap-Band surgery to help me lose weight. I have a friend, Shelli Giardino, who was also wanting to have the surgery and she had investigated the process, doctors and what our insurance would pay. She works with my husband, John at Tallgrass Creek.

There is a clinic in Overland Park, KS, The Maley Surgical Clinic that does the surgery and they are on our insurance plan so I contacted them for information. The present seminars on the process almost every Saturday so I went to one of the seminars to see about the surgery. They have two doctors, Dr. Maley and Dr. Hitchcock. Maley is the main doctor but it would be 3-4 months to get into him so I made an appointment with Dr. Hitchcock. After the appointment, they contacted my insurance to see what they required to pay for the surgery.

Insurance required:

1. 6 month doctor supervised weight loss program

2. Psych evaluation

3. Nutritionist evaluation

4. BMI of 40( 100 lbs over ideal weight)

5. Co-morbidity factors. (high blood pressure, diabetes, sleep apnea things like this)

In January I started my 6 month doctor supervised weight loss program with my general doctor (GP), Dr. Wendi Bissett. What is so strange about this requirement is that weight loss is not required, they just want to see if you will stick with anything for 6 months. With my GP, I established that I have a BMI of over 40, I am borderline Diabetic, I had sleep studies done and I have Sleep apnea, my cholesterol is high, I have acid reflux and all of the medical issued are considered co-morbidity factors so I qualified there. I had my psych evaluation and also my nutrition evaluation so by the end of summer, August, I had all my requirements met.

Now the hard part started, getting insurance to approve the surgery. First we gathered all the doctor notes from all the doctors to be submitted to insurance because the doctor required a letter from the insurance saying that the surgery was medically necessary and it was a covered procedure. I required the doctors notes from my GP and was told that it could take up to 30 days to process the request so I went to the Medical Records department and gave them a sad face and Dr. Hitchcock office had them the next day. The nutritionist sent her notes over as well as the psych doctor. The nutritionist and the psych doctor were choices from Dr. Hitchcock's office so I thought their notes would not be a problem, I was worried about the notes from my GP. Everything was gathered and late in the day faxed, 30 pages, to the fax number insurance said to send them to for pre-authorization of a surgery. The next morning when the insurance person got back into the office, all 30 pages had been faxed back to her to say that they do not pre-authorize out patient surgery. This was a real problem because the doctor would not do the surgery without the letter. The insurance person said she was also told this but they would always go ahead and send the letter. Well my insurance would not do so, so she asked me to call them. I got the same answer she got. They would not send a letter for out patient surgery and lap-band surgery is done out patient. I argued with the insurance for 3-4 days and got nothing. At this point to have the surgery, I would have to pay for the surgery upfront $20,000 and take my chances with insurance paying for it, I could not do this so we had to have the surgery approved as an inpatient procedure. Stupid, instead of giving a letter, it would cost them more money to do the surgery in a hospital and stay one night. Well we got it approved by the doctor to it the surgery in patient at a hospital and sent the information in once again to the insurance but to their pre-approved outsourced company for the letter. I checked almost everyday to see that they had received the information and to see if had been assigned for review. Finally after 7 days it was assigned and reviewed and DENIED. It was denied because the psych doctor had not put in his final notes that I was a good candidate for the surgery and that I was released to have the surgery. This really made me mad because this was a doctor that had been doing these evaluations for my doctor for a long time. We had to get corrected notes which took 3 days and than it had to be reviewed again. Now it was the Labor Day holiday so everything came to a halt due to everyone being on vacation for I had to wait a few more days. Finally during the first week of September I received the letter approving the surgery and it has been scheduled for October 5, 2009.

Most of my family and friends are happy I am getting the surgery done but my older son, Ray, is not to excited. Not sure if it is because he is worried about his mom having surgery or if he thinks I should just be able to lose the weight, but either way I know he loves me and is just worried.

I had to get a big list of vitamins to take before and after the surgery and also started my 2 week pre-operative low fat, low calorie diet. This is needed to shrink the liver that stores fat and toxins. The diet is very exciting. Mostly liquid and one low fat, low calorie meal. Today I started this diet in earnest. I can have protein drinks, jello, broth, tea, coffee, one meal a day and 2 cups of sherbet a day. I am going to cut out the diet soda at this time because after the surgery, I cannot drink soda of any kind so might as well start now.

My weight today is 262.5 lbs and this is the most I have ever weighed. I hope to get down to about 150-170 after the surgery and I know I will make it. Lap-band is only a tool, not a quick fix. All for today.