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I have completed all my requirements according to the surgeon's office as of the end of June. Now we are on the battle that makes the biggest decision....The Battle of Insurance!

My file was submitted to insurance for approval on July 3rd. By July 6th, the rejection letter was sent. So on July 11th (after I called the insurance and found out about the rejection) I told the surgeon's office and they were going to find out why.

Round 2: The missing page ( that was there the whole time) was flagged and the file was resent through the Medical Director. So,....I called today and yup! I was rejected again. They don't like the page that shows I was knowledgable of the behavioral and nutritional changes I will have to go through.

Round 3: Now I am waiting for my surgeon's office to call me back to get the next step. Oh the headache.

7/25/12 Update: Well, I am now scheduled to meet with the surgeon tomorrow to have him produce a letter that says I agree to join Weight Watchers or Curves or something like that to help me stay on track. Then hopefully, HOPEFULLY I can get approved.

Last week I just finished all of my clearances for insurance submittal. Now I have to wait to hear if I am approved to proceed. I am nervous for a couple of reasons. One: What if I don't get approved? I would be devestated! I have been working really hard to get through all the requirements. Two: Am I really going to be able to handle this life changing surgery and all that I will have to do afterwards.

Excited to know that I have a chance to better my life and my family's life. I can't believe I am so close and (hopefully) it will really happen.

So I found it very clear yesterday that I cannot talk to my Mom about certain items in my life. Although I have told her about this in the past, I told her last week that I have started the process for Weight Loss Surgery. I could hear in her voice that she was not happy about that. I know she doesn’t believe in it. As a matter of fact when I told her last month that I had an appointment with my Primary and with the Weight Loss group, her reply was…”well your Primary is more important.” Not to me. I was meeting with my Primary because I was still getting my GERD attacks. The Weight Loss appointment was my initial consultation to see if I could qualify for the surgery. To me they were equally important.

So now skip ahead to this past week and yesterday. Lately,  Mom has been pushing me to make a decision on whether or not I will have kids. If I have the surgery, they ask I wait for at least 1 year for my weight to stabilize before getting pregnant. I could end up in high risk of problems if I don’t. So, I met with my Primary again on Monday for an EKG (one of my clearances for surgery) and asked her if I should be concerned or had I waited too long. If I have the surgery in June, I will be 36 before we can conceive and 37 before the child is born. (This is where the major frustration came in yesterday.) Mom then says, “Well I just think you waited too long.” I replied that I want to get my health in check so that when I get pregnant, the child’s health will be better too. But I am scared right now because of all the reports of Autism and Down Syndrome going around the news.

What I wanted to hear from my Mom is something like “Although I don’t think you should (or need to) have the surgery right now. I think you should consider having kids now and the surgery after. But whatever you decide, I will support you.”

Instead, I had to ask her last week if she would support me. I got a faint, yes. A daughter is supposed to be able to go to her mother to get some comforting especially if she is scared about what she is doing. I understand that she is not the same person she was before Grandma came. She now has this I don’t care what people do or say. I have seen in other conversations that she doesn’t have the comforting feel anymore, she is plain tired.

Now my husband supports me 100%. But he has a hard time (especially when he is sick) just sitting there listening and comforting. When I talked to him about all of this, he was just getting mad. But that doesn't help me now. Needless to say, we ended up changing the subject.

Just a couple of days later, I had a good talk with my Mom. She explained that she believes that I haven't gone through all the avenues of trying to lose weight and I jumped into this. She knows I have been looking at surgery for almost 10 years now. But she doesn't like the idea and is concerned about me when I do lose the weight and gain it back with a child. It was a good conversation and we both came out of there understanding a little more about how the other feels.

Then....I talked to my Dad. I was expecting another blow out like I had with my Mom at first. Boy did he surprise me. He too knew that I was thinking about surgery for quite some time. He is also very large and had diabetes. He see his doctor/nurse every week. When I told him that I have decided to do this, he said he thought it was the best thing for me. He knew that if I wanted to have kids, I was going to have to do something drastic and my health is already starting to so signs of going down hill. Aparently he had been talking to the nurse about me and my GERD. She asked him if I had considered it. He was not shocked by my news at all!

That goes to show that you really don't know how some people will react.

After the initial consultation, I felt a bit tired. I went from nervous, to excited, to deflated all within an hour. Nervous to start this process and if the insurance would cover it. Excited that I might be able to get the sleeve or even the RNY wasn't looking too bad. Then deflated when they told me that I had to go through 6 months of weight management. (Even cried a little).

I calmed down that night and started to get my brain and heart in line with the fact I was going to have major surgery.

The following Tuesday (March 6th), I went in for my Nutritionist Evaluation and 1st Weight Management date. I walked in and they had me weigh in again. Then got me to a room when a nurse came in. WHAT!?! I no longer have to do the Weight Management? Blue Cross Blue Shield of Illinois (although I'm in California) as of 2/1/12 changed their requirements that I no longer have to go through 6 months of doctor montiored Weight Management. However..... my current weight was on the cusp of allowance without comorbalities needed. So they weighed me again (this time with my shoes on) and gave me that last tip over.

Now all I have to do is get through my clearances and I will be good to go. I need an EKG, Chest Exray, Gallbladder U/S, Psych Evaluation, and Upper GI. Then, I may need an EGD before I go in.

In the meantime, I had some blood work done becuase I had a pretty bad attack last month. I got the results on that earlier this week. Cholesterol was a little high, Thyroid was a little low, but I have a Vitamin D deficency. Also, my primary doc told me that I am at risk (although still low) for diabetes, which I took as a matter of when not if especially if I don't do something soon.

So the EKG is scheduled for this coming Thursday. I then have to figure out how to get the others done. The one thing that is still getting to me is that my husband says he is okay with it, but I think there is a little hesitation there. I need more support to get through this. 

Today I have my first meeting with Dr. Krahn. I have my list of questions and reading some more on the types of surgeries. I hope all goes well and I feel better about this. I have been getting so nervous because I am acting on this. I will update this post after the meeting this afternoon.

I really like the sleeve, but I am starting to think the RNY is going to be better for me health-wise.

3-2-12:

After running around between doctors yesterday, I can finally relax and start my process. First I met with my Primary yesterday to talk to her about my GERD attacks. I had a severe attack last week that left me not able to eat for a day and a half. The Prilosec is not working for me. So we are trying Prevacid now and getting blood tests. She also told me that I need to consider seeing a Gastroenterologist to get a scope and seeing if there is anything more going on.

After meeting with her, I rushed to my appointment with Dr Krahn's office for the surgery consultation. They weighed me in and told me I have a BMI of 39.1. Then we talked. I told his partner Dr. Chin about my GERD attacks lately. I also talk him that I am interested in the Sleeve but I understand that because of the GERD, I might need to go the route of RNY. He told me that actually, he doesn't see a reason why we couldn't do the Sleeve. But he did say that after all the evaluations and scopes, I may need to go with RNY for my health.

Then...the insurance meeting. This is where my balloon deflated a bit. I am on Blue Cross/Blue Shield PPO. The first thing she told me...they require 6 months of weight loss management! I thought PPOs didn't require that. I was wrong. According to her, more and more PPOs are requiring this for acceptance. She said she has seen only one insurance not ask for this.  Another 6 months to wait now!

So we talked a bit and she helped me to calm down and remember that there are still other things I need to do too. I have to get clearance from my Primary that I am medically clear to have this surgery, I need an Upper GI, Gallbladder Ultrasound, and an EGD. I also have to have a Psych Evaluation, and a nutrition evaluation done. Then closer to the end of the 6 month management, I need to have an EKG and a Chest xray. So, looks like I will be busy during the 6 months.

First date for the weight management is March 6th and I will also be meeting with the nutritionist too.

Here we go!

Okay, so the office called me back to (very quickly) go over my insurance. Because the Medical Assistant is not part of my network, I will have to pay around 2400-2500 out of pocket. Otherwise, my insurance covers everything else. I don't even have a co-pay. So, my first appointment to meet with the doctor is March 1st.

Now I get to sit and wait for a month. I will let you know what happens.

I have been looking forward to the seminar being held by the Western Bariatric Center in San Bernardino now for a while. But in less than 2 weeks time, I barely made it.

About 2 weeks ago, my husband had a really bad cold and cough that looked much like bronchitis. I spent the time taking care of him while do much of my research here on OH. He started getting on the mend when suddenly I started not feeling so good. Then last week, BOOM! Full blown SICK!.

I had the couch, I had the stuffiness, but I also had severe sinus problems and very little energy. I could barely breathe, started to lose my voice. It was bad. I tried going to work, but one day made it for 2 hours, took the next off and the 3rd was able to do 3 hours. Oh and I had the fever too.

But the hardest was last Thursday was the seminar. There wasn't going to be another for 1 month. I contemplated not going, but I really wanted to. So, I went. I sat there listening trying not to start a coughing spree in the middle of it. And.... I am so glad I went.

I started to realize that my heart is no longer into the Lap Band. Between what I am reading here on OH and what the doctor told me. The lap Band is no longer an option in my book. So, now I am into RNY or the Sleeve. I love the fact that the sleeve has been showing so much positive outcomes lately. I am worried that because it is still relatively new, that the big problems are just not seen yet. The RNY however, could actually solve many of my health problems. Not like I have too many, but any problem is bad.

The biggest hurdle...GERD. I have read that RNY can pretty much cure it. Even the doctor said that. I mean because of the GERD, the RNY will probably be the suggested route by the doctor. But what about the Sleeve? It is so new, some say that GERD remains but also remains controlled under medicine. Some say GERD was gone.

So here I am. I am now waiting on a call from the Western Bariatric Center about my file and make an appointment with the doc. I am just torn between RNY and the Sleeve. What I do know, I can expect 65-75% excess weight loss with either (Lap Band was only 50%) .

I will keep you up to date once I get that first appointment. There will be things I need to do before I get a date for surgery so I have a little more time to research before making up my mind.

It can come around again....the New Year. Many are out there making (and already breaking) their New Year's resolutions. I asked my husband the other day what his resolution was for this year. He told me "To start enjoying life and the people around me". You see 2011 was a very stressful year for us. It did end on a positive note, but it was very stressful getting there.

So what is mine for 2012? I really had to think about that. Then it came to me..."To start enjoying myself!" I cannot remember the last time I actually looked in the mirror and told myself..."You look good. You are a good person. You are special." My husband tells me these everyday, but it is not quite the same thing unless you can say that to yourself.

I have been thinking about WLS for a while now, about 5 years when the Lap Band had recently come out. I even went through some of the evaluations and "hurdles" required for the surgery. Something always stopped me. As I think about it, I can't figure out what it was that stopped me.

This last week, I have been really analyzing WLS and my life before and after the surgery. I can officially say now, I will be getting surgery done. So what are the first steps to this process. I think the first thing I will be doing is attending some seminars and support groups to get my questions answered and build up my support. Right now, my husband is behind me 150%. My parents are more like 75%. That is all I have. There is some seminars and groups this weekend so after those, I will post again to let you know how I am doing and especially how I am feeling.

It is now the end of 2011 and I am still at 275! I "chickened out" of continueing the process. My doctor then wanted me to go through a 6 month weight loss period with her before she would help get me through the insurance. I changed my diet a little, lost a little weight, gained it back and developed yet another condition.

Starting 2012, I want to go full force at this. My husband (Jeff) started a new job back in October that offers great insurance so we added me to his insurance and I will be dropping mine.

I want to have WLS done because I am tired. I am tired of being heavy. I am tired of being tired all the time. I am tired of being unhappy with the way I look. I am tired of having high blood pressure. Jeff and I have talked about starting a family and he is very concerned. He knows that my weight with high blood pressure and the stress of carrying a child could but my health at a great risk. That is one risk, he is not willing to take.

So now, to start all over again. There is a surgeon that is holding seminars in January that I will be attending again. Then this time, I will actually fill out the paperwork and give it back to them.

Wish me luck. I am scared as all hell. Jeff is extremely supportive, but I know the rest of my family doesn't believe in this.

   Since I was in the third grade, I was on and off diets. One diet nearly landed me into the hospital. Nothing ever seemed to work. My brain was looking for the quick fix. I have tried diet books, Weight Watchers (3 times), websites, on my own cold turkey. I have even tried some of the pills out there. Nothing!

   For the last 5 years, I have considered surgery. I started researching everything you can find about Gastric Bypass surgery. (LapBand wasn't very well known then). I went through all of the processes until my HMO said I still needed 6 months of weight loss review by Doctor before they will consider me. I don't want to wait another 6 months. So instead I waited for 3 years.

   For the last year I have been reconsidering surgery again. Now that Lap Band is more popular, I started researching that. Now I have changed my insurance to PPO, I just went to a seminar given by Dr. Krahn in San Bernardino. I came from there feeling more confident about pursuing this. Am I scared? You better believe it! My whole (immediate) family is big. My Dad was diagnosed with Diabetes about 4 years ago and I have been watching him start to fall apart. He was also diagnosed with Sleep Apnea last year. My Dad, My Mom and I have High Blood Pressure. I was first dianosed with High Blood Pressure about 10 years ago.

   I am also scared that if I do not go through with surgery, my small amount of health problems I have now will only get worse and although I am currently looking at 33 years this March, My body is already feeling like I am in my Forties. I have had back problems since the 8th grade. I even got into a depression in high school. I don't want to continue this.

   I"M DONE!

   So, I am starting the process now. My goal is to have the surgery as soon as I can and start living my life. My husband and I want to start a family soon. I need to be healthier so that our babies will be healthier.