J A.
September 24, 2005
I have finally taken the first step and contacted a doctor about Lap Band Surgery. Dr. Watson's office wants me to get the approval of my insurance company before I make an appointment to see him.
Who am I? I am a 61 year old grandmother who has been battling weight for years. I gained too much weight with each of my three pregnancies and never lost it. I have tried regular doctor supervised diets, pills, fad diets and I've hopped on the wagon of every diet guru that rode into town. I have lost a lot of weight and a directionally proportionate amount of money in the process. The weight always found its way back and brought more with it. Then as I got older the weight loss became harder. I decided to have WLS in 1999. I had chosen a doctor, had insurance approval and was ready to go when I was diagnosed with breast cancer. I spent over a year with surgery, chemo and radiation. During this I lost over 50 pounds. The after-cancer drug I am required to take for 5 years causes weight gain. I am approaching the 5 year mark within a few months so I'm looking at surgery again.
Monday, January 2, 2006
I will go for my first appointment tomorrow with Dr. Watson in Johnson City. Hubby is opposed to this, he does not want me to go, keeps asking "WHY".
I called both my insurances and both said they did not cover WLS. The lady at the doctors office said Medicare does cover it and she will apply once I have my initial consult.
Tuesday January 3
I met with Dr. Watson today for my first consult. I was given several things to do, such as a gallbladder ultrasound, 3 consecutive week diet diary, a 5 year medical history of weight loss attempts, and a psych evaluation. When I have these completed I am to call for a second appointment. The office staff was unable to give directions to his office. After talking with 3 people, neither of whom could provide directions, one finally told me to go online and use a program that most people use. She gave me the web addy of Mapquest. Duh!
Friday January 13
Had the upper GI and gallbladder ultrasound today. They identified a hiatial hernia with reflux into the hernia. Is that spelled correctly?
January 30
When I called Dr. Watson's office two+ weeks ago I was told they were working on my forms to send to the insurance company for approval. Since I haven't head anything from them, I called back this week. I was told that they would not submit that until AFTER I had all the tests and came back for my secong consult. Isn't this backwards??? Why should I take all these tests with different doctors if my insurance won't approve the surgery?
I finally told my daughter, and she is questioning everything. I know she is concerned and I appreciate that. Her recurring question is, "Do you really want to risk your life for an elective surgery?" She is model thin and has no clue of what obesity is all about. Her solution is to exercise more. She also thinks I will fail. Maybe she is right. I've never been able to stay on a diet in the past. She has talked with someone whose doctor was very opposed to the lap band and gave her a load of negative possibilities. However, she says if I am determined to do it she will support me. She thinks I should wait though until I know more about the band. She thinks it's too new. I'm 61!!! I don't have a lot of time to wait. And I HAVE been researching this, SHE is the one who just learned of it's existence.
Feb. 3, 2006
Had my psych evaluation today with Dr. Cantor. Liked him a lot, we talked for a long time about weight related issues as well as other things. He understands the problems of dieting since he has battled obesity too. I asked him about having the surgery and he may consider it a little later. He is about the age of my oldest son.
March 1, 2006
I called Dr. Watson's office to tell them I will not be able to get a 5 year medical history because a fire destroyed records. I was told that it wasn't necessary to have this with Medicare. I have spent weeks completing these requirements!!! Also, the food diary is required by another insurance company - not mine. Grrrrrr
March 20, 2006
I have decided to transfer to another doctor for the surgery. I met with Dr. Sass in Lebanon on Friday. He seems very knowledgable but the new rule for Medicare patients raised it's ugly head. The hospital where Dr. Sass works is not an approved Center of Excellence yet. They have applied and will be inspected this week. There are only 132 (I think) approved hospitals in the entire USA!!! That just doesn't seem right. If this hospital isn't approved I can go to MCV in Richmond for the surgery. That's 7 1/2 hours away! And I would have to start all over. This is discouraging. Is this surgery meant for me?
I also learned that I will be responsible for paying anything Medicare doesn't cover. Stephanie from Dr. Sass and Kramer's office estimated
around $1000 for my part.
May 3, 2006
It's been a long time and I've been at a stand still because of Medicare and the new requirement for centers of excellence. Well, I'm moving again. Today, I'm going for blood work, EKG, chest xray etc. Tomorrow I have an appointment with my PCP. This may happen yet!
May 26, 2006
I just got the call from my doctor's office and they have set a tentative date of June 8 for my surgery. WOW! It's really happening.
June 28, 2006
It's been a month since I updated. I had to postpone surgery on June 8 and am ready to go into the hospital early tomorrow morning for a Greenfield filter. I will be released and will go back on Friday morning for Lap Band surgery. Medicare requires an overnight stay in the hospital. I'm getting nervous. My brain is saying I should try one more time.
July 16, 2006
My surgery on Jun 30 was textbook, according to Dr. Sass and the hospital staff. While in the hospital I disciplined myself to walk every hour and gradually increased the distance. I was discharged with no pain meds because I didn't need them. My weight loss began within a few days and moved rapidly at first. It has slowed down now that I am eating food, even if it is soft mushies. Tomorrow is my first visit and official weigh-in. I'm anxious.
October 14, 2006
Wow! I didn't realize how long it has been since I wrote anything. I've lost 37 lbs. and feel great. I've had 2 fills and am ready for another. This surgery has been a godsend for me. I can eat anything and have had no problems, so far. I'm eating healthy and much smaller portions. My PCP is very supportive and I'm no longer taking meds for high blood pressure.
