My surgery consultation (long)

[karpouzian 94]

Today my wife and I went to the surgeon consultation/nutritionist appointment.

First of all, my provider's website emailed me a message that I had an appointment at 2 with the nurse practitioner... Odd, I thought, the letter I got in the mail said 1pm. Well, I called to clarify, and the nutritionist was at one, and the LNP was at 2. So, we were told to arrive 15 minutes early per the instructions received. When we arrived, we were told that the office is at lunch from 12-1, and so it would be A few minutes before I was helped...

Well, that is perfectly understandable, but then why was I asked to come 15 minutes early? So we sit in the waiting room, waiting for the siesta to end. About 5 till, another patient/SO walk in, and up to the window... They took all of his information, and assisted him... Yet we were there, sitting, waiting for lunch to end

Ok, so we were then helped, and went in to the nutritionist.. (That was one of my few complaints, otherwise I was very happy with the whole event, and all things considered, it was very minor). Especially since we went into the nutritionist basically right on time.

The four of us, myself, my wife, and the other couple went in to the nutritionist, and this woman, in the 56 minutes she saw us did not stop talking for breath once. She went over, in plenty of detail, the Protein we're expected to take, the different supplements that the different surgeries require, and then went into detail on portion sizes, the Importance of staying hydrated, the pre-packaged foods/utensils common to a weight loss surgery patient, and then the five different phases of the diet, pre and post surgery. The 2 weeks pre-op is Clear liquids with the exception of orange juice, Tomato juice, and Protein shakes. After the surgery, 2 more weeks of Clear Liquids. Whole liquids/soft foods for a month, puréed/soft foods for a number of months, then normal foods after that. She was quite knowledgable, and as I mentioned before, a very fast talker (I'm grateful I read all of her handouts-they were online) before I went, otherwise I would be lost...

We then went to speak to 'the insurance lady' one of the surgeon's staff who handles the maze of insurance for the patients... She knew I had Cigna... She admitted she didn't deal with them often, but she had just worked with a patient who had them, and offered to look through her file to see what hoops (if any) they had to jump through... She asked me if I knew cigna's requirements, and I handed her their requirements. She told me I would need a PCP supervised diet for three months, I let her know I had completed that, she told me they would make an appointment for the psychiatrist, I let her know I had an appointment set up a month ago to take place next Wednesday. She then looked at me, told me that I had pretty much everything well in hand (sincerely, not sarcastically), and that she would submit to insurance after the psych eval. She said it typically takes 7-10 days for approval after that, and then we would get all of the testing scheduled. She gets them all taken care of on one day, then the test results go right to the dr. If there are any serious conditions that would prevent the surgery, they would get taken care of, then the surgery will scheduled, otherwise after the tests results came back, a surgery would date would be set. We asked how long in advance a date for surgery would be scheduled after approval and test results are back, and she made it sound like less than a week or two if the patient wants. She did ask if I was using my Cpap machine, and I was honest she stated the importance it played, and I contacted my pcp by email when I got out of her office, and asked if I could get a script for a Cpap machine based on earlier test results/titration. Then, because I had the insurance issues 'well in hand' (that meeting usually takes more than ten minutes I hear), I guess my OCD paid off in this case

Well, the office was trying to be efficient by having the other couple in with the LPN, while we were doing insurance stuff, but since we were through with that pretty quickly, we had to wait a while in the waiting room.

Then we met with the LNP, and she was great. She went over my medical history, reiterated about the Cpap machine, and then asked about my medical history... She found out that I had a dvt and asked some questions about it. She admitted she was not a hemotologist, but she was going to add a hemotologist to my staff. She said that the hematologist would either have a more extensive test done to see if this (DVTs) are something I have a genetic predisposition for, or if they would just 'put me on lovenox shots for a while after the surgery. I HATE Lovenox! It does awful things to me, but I'd rather jump through their hoops. If it comes down to it, I'll ask for an alternative treatment method. If none exists, I'll suck it up and take Lovenox shots. She asked what surgery I was leaning towards, and I said barring any advice she had, I was looking at the sleeve, Nd went into details on why. She was very impressed I had actually done my homework (much like 'insurance lady'). We talked about commitment to the surgery, and to the program, and if I wasn't on board 100%, I should just not do it-wasting my time and theirs. She said it much more respectfully than that, but I respect their program much more because she said it. My wife and the LNP shed a few tears when they were discussing my support system, and she commented on the hand squeezes, or Arm around the shoulder we wold occasionally give each other, which showed her I have a great support system-she was 1000% correct I'm very lucky. That was my day, any questions?

[T'snewstart 251]

Awesome sounds like you are well on your way to the new life! Good luck on the rest of the journey!

[AuntB 19]

I'm glad it went well.

[karpouzian 94]

Me too , thank you.