OMG the patient advocate just called!

Apr 22, 2014

That was so weird, just as I saved my blog post Stephanie called me from Dr. Floch's office!  She confirmed that my insurance (Medicaid) covers the gastric bypass surgery as long as we meet the criteria.  My BMI had to be at least 40 (without taking medications for hypertension and/or diabetes) and mine does qualify.  Also I have to go on a 6 month supervised diet with a nutritionist which I was already aware of but I was not sure what would happen if I dieted and went under 40 BMI.  She then said that I would no longer be a candidate.  Man, did I panic but then she said that I did not have to worry because I would have to lose like 50 pounds to be under 40 BMI.  Holy moly I was so surprised that I am that heavy!   I started to cry and she said that it was okay that I was doing something to help myself and not to worry, they would help me every step of the way.  She was so sweet!  Anyway, I have my first appointment with Dr. Floch on May 16th and I can't wait!  I will update again when I have more news.  Best wishes everyone on your journeys! 

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Seminar Completed!

Apr 22, 2014

Last night I attended the informational seminar for my surgery with my son.  I wanted him to come so he fully understands why I chose the gastric bypass and what the procedure is.  He is the only one of my children that live in Connecticut and since he will be helping me with my surgery and of course because he is very concerned I felt it was important for him to come which he wanted to when I asked him anyway.  It was a great refresher and I could NOT believe that Dr. Floch remembered me from our visit in 2008, man was I impressed and happy!  I can't wait to do my next step!

Seminar – 04/21/14  

 

 

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Just a quick update...

Apr 09, 2014

I am all signed up and approved for Husky D which is Medicaid for adults.  My insurance is now going to stay the same until next year when I renew it (it will most likely remain the same as my income will not change).  It will take 24 months of being on Social Security Disability before I get on Medicare which is fine by me.  I made my reservations for a seminar at St. Vincent's Medical Center for April 21st and my son Victor is going to take me.  I had discussed with him that I will be getting the gastric bypass due to my health, he wasn't too surprised as I have been through this before.  So I am ready to take my first step...again .  Only this time it will be easier since I am not working and can take pretty much any appointment time given to get all my pre-op tests in order to get the surgery done.  I am still following my diet, I lost 7 pounds since I was here in 2008 so this just shows me that I need the surgery because I need to lose more than one pound per year to get healthy.  I definitely think that one of my biggest reasons to get the surgery is to avoid having to take more medication for my high blood pressure.  The second is to try and to alleviate some of the pain I am in every day.  I probably won't be posting for a while because I don't have much to say at this point except for I wish everyone well and much success for your personal journeys!  

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No co-pays!

Apr 05, 2014

Friday after contacting Husky D/Medicaid I was told by the nice woman that I have no co-pays and she even gave me advice on how to get approved.   I e-mailed the patient advocate at the doctor's office about what I found out and I reserved my seat for a seminar on April 21st.  I am now just anxious to go through all the necessary tests and appointments and get my surgery done so I can start my new and improved life.  I know it will be hard but in the end it will all be worth it.  I am hoping all goes well, I get approval and get through the tests with flying colors.  My close friend is getting the sleeve done and she is ahead of me so I am following her journey and we are going through this together so that helps a lot. Have a great weekend everyone! 

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I received a nice message today...

Apr 04, 2014

Today, I received a nice message from the patient advocate at the bariatrics office and she did confirm that they accept my insurance.  Oh happy day!   I wrote back asking her if there is anyway she could find out how much I would have to pay out of pocket for the visits and tests.  I explained my situation to her in hopes that I can go ahead with my plans to get the gastric bypass surgery as soon as possible.  I don't want to be disappointed that finances are going to be an obstacle, what a nightmare that would be.   At this point I will be getting together with my son to discuss which informational seminar we can go to since we are going together and he works so we have to go by his schedule.  I have already attended a seminar in 2008 but it's good to go to meet people and have a refresher.  I want my son to go with me so he also has an understanding of the procedure I will be doing.  Well, that's where I am now and I am still keeping my fingers crossed that all goes well.  I hope everyone is having a great journey and best wishes. 

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And the craziness begins again

Apr 03, 2014

So can I say here we go again?  First I would like to say a huge apology for leaving without saying goodbye to some of my friends on OH, they know who they are.  I was at a very bad point and I just stopped coming on here.  My plans for getting the lap band surgery totally went down the drain.  I can say now that it was fate and boy what a ride it was afterwards.  First I was having pain in my left leg (my bad one) and with all the running around I was doing at the time I just wrote it off as over doing it.  But it got so bad I could not stand it anymore so one day before work I went to the emergency room.  After nine hours of sitting there in a spare room with nothing to eat or drink and only having x-rays done a doctor came in and said you have cellulitis and gave me antibiotics and some pain killers and told me to follow up with an ortho.  He was not very nice I must add.  So I took the medicine and went to work.  I tried to keep it elevated while I worked but by the time I got home it was swollen and I was in a lot of pain.  Then I decided to follow up with an ortho that I found close to where I worked and that ortho looked at the same x-ray that was taken at the hospital and said "Who told you that you have cellulitis?" and I told him the doctor at the emergency room.  Then he just shook his head and said "you don't have cellulitis you have a serious infection in the hardware in your ankle".  Then he basically told me to go back to my original ortho that put the hardware in that he did not have enough experience to do it and I would be better off.

I went back to my original ortho and he confirmed that the hardware in my ankle was infected which was really unusual but he would take the screws out and clean it out really well and it should be okay.  So off to surgery I went.  It all went well but it did not work and the infection spread to the rod in my femur.  So off to surgery I went yet again so they could remove the rod and clean out my bones. It was kind of scary at the time because they had broke me knee originally to put the rod in but thankfully my ortho did not break it this time.  It was touch and go about the infection going away and that was scary because if it didn't work I could have lost my leg.  Everything did work out but it was a long road.  My work was not happy, what was supposed to be a short ordeal turned into a very long one.  This all happened between October 8th of 2008 and March 2009 when I finally returned to work.  Needless to say, my hopes of weight loss surgery was totally lost.

Now fast forward to today.  I worked until by doctors insisted that I no longer could.  I was quite depressed at first.  Financially I was wrecked but thankfully things are looking up right now.  No one realizes that if you have a very bad accident like I did, there are a lot of complications that happen as you get older caused by arthritis.  My back is deteriorating and so is my leg.  The pain is horrible every day and I am taking as much pain medication as I can without starting narcotics which is not a good idea for daily pain management.  Also my blood pressure is on the high side which is probably because I am over weight.  My problem is I am stuck in a catch 22, I need to exercise to lose weight but I can't because of the pain.  The pain would probably improve if I lost weight but again, I can't lose weight because I can't exercise due to the pain ugh!   It's so frustrating and I know I am not the only one stuck in this situation.  Walking has gotten beyond difficult because my back has gotten worse over the years so I've been using my wheelchair more and more which I really don't like to do.

I decided that since I was forced into early retirement and can no longer work, I would work on my health. So far I had all my dental work done and got new glasses.  I am continuously on a diet all the time and it's frustrating to not lose any weight.  I have stopped gaining for at least two years but I am still very over weight so I need to do something before it's too late.  My father passed away at fifty nine years old and I am turning fifty two this year.  He had high blood pressure and now so do I.  My mother passed away at sixty three years old and she was a diabetic.  Both my parents were over weight so things are getting to the point for me that I need to do something quickly to get this weight off if I have any hopes to live to a decent age.

My thoughts are that it was fate that I did not get the lap band surgery.  I have since changed my mind and want the gastric bypass surgery because I love salad and people I knew that had the lap band surgery told me that you cannot eat salad with the lap band.  Oh no, not for me.  After going through a lot of oral surgery (five months worth), I found that I totally missed salad way to much to give it up for life.  I love raw veggies and that is what helps to keep me from gaining weight right now.  A close friend of mine is having the gastric sleeve done and I am following her journey and I hope all goes well for her.  But I decided that the gastric bypass is the best for me.  Of course I will be discussing that with my doctor in order to make the final decision.

I am just starting the process all over again.  I know it's a long road but I am ready once again to take the reigns and do battle.  I submitted my insurance information to the surgeon I am hoping to have do the surgery.  I have Husky D if anyone is curious.  My friend has the same insurance so I know the doctor accepts it.   I am just waiting to hear how it goes and how much it will cost out of my pocket.  This year is the final year that I am able to receive a tax check so I figured it is now or never.  I am keeping my fingers crossed that all goes well this time.   Sorry for the long post but I wanted to catch up because I've been away a long time.  It sure feels good to be back!! 

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Surgery Date Down The Drain!!!

Aug 06, 2008


Ok, so it took me a day to come here and re-hash my day from hell yesterday.

Details From A Day From Hell

First, I find out that I had to pay $231.00 for Optifast shakes to do the pre-op diet.  After trying to get an alternate diet from my nutrionist who did come up with a plan, the doctor said NO exceptions so I did try and get the money up for that.

Then, I asked Kevin if there were any other hidden costs I should know about and he told me to contact Oxford to see if there was a pre-admission deductable.

Of course, there was a deductable of $500!!

So, I called the admission department at St. Vincent's to see if it all had to be paid up front before surgery.  First the woman on the phone said that maybe they would work out payments for the deductable and told me to speak to someone in the coordination office.  I left a message and they called me back to tell me that because of the type of procedure I was having they would NOT work with me at all.  They actually made it sound like I was having some sort of elective surgery. 

I was very upset after hanging up the phone with them.

When will people actually figure out that WLS is NOT an elective surgery it is a MEDICAL NECESSITY for some of us with health problems!!! 

It is not like I am having a boob job!!

Seeing that I have insurance that is going to pay a huge amount to the hospital, they could at least work out a billing process for the deductable.  But NO WAY!!

I can't help but feel like as usual, the rich can get the health care they need to live longer, but the poorer CANNOT.

After many tears and crying on the shoulder of my sweet dear son, I called my nutrionist Nancy who I really like and she said that she can work with me to design a diet plan suited to me.  I can't be on a regular diet because I have a sedentary life style due to my handicaps.

She said all I needed to do is contact my PCP and get a referral so my insurance will cover my visits.   So I called my PCP and they sent a referral stating that it was a medical necessity due to hypertension.  I actually asked if I was speaking to the right office and they said "yes, you are".  I was really surprised that it was that easy!!

So I accepted that I can't have the surgery but at least I have another plan. 
Another fork in the road. 

My friends at work were very upset to say the least but were very supportive of me.  They continue to support me on my new diet and were a little surprised at my determination.  They said that if it were one of them, they would not get over it as quick as me.  I said that I am not over it but I am determined to do something about my weight and my health is the most important thing to me right now.  So I have to suck it up and move on.

As they say, two tears in a bucket...

My son is soooo sweet and he is being very supportive of my new plan.  I am so glad he was with me.  He always finds a way to make me smile and even laugh at myself when I need it.

Another angel in my life. 

I will try my best to lose weight with the new diet plan and if I do not succeed by February of next year, guess where my tax check is going....to lap band surgery! or maybe I will consider having the gastric bypass surgery if I can have it done laprascoptically.  That was suggested by the PA at Dr. Ehrlich's office and what my PCP thought I was having done. 

Hmmmmm...that I will consider until then...

At least this time I will be financially prepared and know exactly what I need to do.

Until then, I will continue my journey through weight loss land and use this blog to vent and it will give me the encouragement I will need for the following months...

 - Diet Ninja




Yup, It Is A Date....August 15th Is The Big Day!!

Aug 01, 2008


Today, I finally got the news that the surgery was approved by the insurance company and I am officially booked for surgery on....
August 15th!

Thank goodness my friend and I made plans that if I got the news at work, she would go to the office to pick up the Optifast shakes for me...But when I spoke to the doctor's office while getting the good news...blam!  I got hit with bad news...I have to pay for the shakes out of pocket which was not what I was told by the Nutrionist at the meeting with her.  She even said that "good thing that they are part of the program because if you had to pay for them, they would be very expensive". 

Needless to say, I was quite upset.  I wasn't sure what to do!  My rent is due and I don't have that kind of money on hand so I begged, "isn't there something else I could drink that isn't as expensive, otherwise I will have to forget the whole thing!!"  Kevin (the office angel) spoke to one of the PA's who called me back and they said that I could do Slimfast shakes for the weekend but Monday I would have to come to the office and get the Optifast shakes and pay for them.  My friend had to go to the store to get the Slimfast shakes and bars because I was already at work and I would not have had anything to eat until after 9:00 p.m. at night and then she brought them to me.  I thank God that I have a great friend that goes way beyond at times of need for me.  She told me that I can pay her on Sunday and not to worry about it. 

She's soooo awesome!!!  And quite an Angel!!

I am very upset because I am going to have to dip into my rent money just to get the shakes.

Now, I am very nervous that there will be more cost surprises and will I be able to pay for them without ending up homeless??!

Or am I going to do the pre-op diet just to find out that I can't have the surgery because there is some other cost that I am not aware of??

I sure hope and pray NOT.  I will call the office on Monday to see if there is anything else that I need to pay out of pocket before surgery just to ease my own mind....

Otherwise, I am very excited and happy but frustrated because it always seems to come down to money...even my health!

Well, I can't worry myself sick about it, I can only pray and take it day by day...




Could This Be There Is A Date On The Horizon??

Jul 30, 2008


Today, July 30th, I got a notice from Oxford asking for more information from Kevin for a service date of August 15th.

Am I excited...Yes! 

Could this be there is a date on the horizon and so soon?? 

I certainly am hoping so.  I just bought my blender with a food processor attachment and I can't wait to use it. 

I have all my pre-op diet supplies and I am READY! 
 - diet Ninja

I emailed Kevin to see what is up and hopefully he can give me a better picture of what is cooking. 

Til' tomorrow....

So Close Now....

Jul 25, 2008


Yesterday, July 24th, I got a message from Dr. Jumper saying that he cleared me for surgery but he would consult with Dr. Ehrlich and tell him that I would have to take a medication during surgery for a precaution...okay, that I can deal with.

Very good news!! 

Then, I went to work and there was a voicemail from Kevin (the patient advocate at Dr. Ehrlich's office).  I called him back and he said he had almost all the test results except for Dr. Jumper's.  I told him that I had just completed the cardiac tests the day before but Dr. Jumper had called me that day and said he had given me clearance.  Kevin said he had already started working on getting the insurance approval and since he has a great working relationship with Oxford Health, he had just about everything he needed to get my approval.  In fact, he said we should know by next week.  He is sooooo awesome and great to talk to.  He is always soooo enthusiastic and he makes me feel like I am the only person he is concerned with.  Which I know I'm not but he is such a great person!
You go Kevin!!! 

The only thing was that Dr. Ehrlich was out on vacation (which I am sure is well needed AND deserved) but still, we should know by next week.

This weekend I am going to pick up the rest of what I need for the pre-op diet.  I already have the SF popsicles and SF Jello so I only have to get some juices, decaf coffee, herbal tea, Splenda and some broths.

Tomorrow my daughter is coming with my new granddaughter for a short visit. She is such a little angel! 
They will be moving to Florida in a few weeks...  
I will miss them both but will be looking forward to taking a trip to see them...and hopefully be a thinner me by then.  I figure I could see my sister while I am down there. 

That would be excellent!! 

I am more than ready and getting very excited.  I can't wait to start my new life...


About Me
Milford, CT
Location
46.2
BMI
RNY
Surgery
12/19/2014
Surgery Date
Jun 20, 2008
Member Since

Friends 8

Latest Blog 13
Surgery Date Down The Drain!!!
Yup, It Is A Date....August 15th Is The Big Day!!
Could This Be There Is A Date On The Horizon??
So Close Now....

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