Robbenmel

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I called my husband with this news and he says, "Who with?" LOL...silly DH.

My date is for December 18, 2006. Probably at 8:00 a.m.
 
I was doing very well last week. I was waiting patiently for a phone call to set up the surgery date. But then on Thursday, my boss sent out an email calling for holiday leave requests. How can I answer him when I'm still waiting for the surgery date?

So I called. Talked to Louanne. She tells me it will either be December 11 or December 18. After a quick look at the calendar, it's obvious that Dec. 18 will be a much better date for me. If I can get that week off (five days), I can 1)  go to my family's Christmas  gathering on the 16th, and 2) I can  actually have two full weeks off to recover from surgery, since we're closed the week after Christmas. But I couldn't confirm this with Louanne that day (Thursday),  because by the time I talked to the boss, they'd already closed the office for the day. And the next day was Veteran's Day, a holiday.

So it wasn't until this morning, Nov. 13, that I got the confirmation. Dec. 18 it is. Yeah!!

November 3, 2006

So I waited two whole days, checking the AvMed site twice a day to see when my authorization number would hit. I called Shirley Wednesday and left her a message...she called back and left me a message saying she still didn't see it in the system and to let her know if I got the auth # before she did. I'm figuring it takes a couple of days for everything to shake out in "The System."

I had planned to wait until Monday, but couldn't stand it, so I called AvMed back today. Today, I talked to a young lady named Isabelle, who said, nothing's been approved that I can see. DOH! So I told her of my conversation with Katie from Wednesday, and that it was supposed to have been noted in The System. Isabelle put me on hold, and when she came back, she prefaced her remarks with, "Here's the thing..."

Uh, oh, I thought. I'm in trouble.

The thing, as it turns out, is a communication problem between various departments at AvMed. Nothing horrific like I've read other people having with their insurance companies. It's just that my request was directly authorized by the medical director of the company, after it was initially turned down. Someone was supposed to generate the actual auth # and put it in The System, and had not yet done so. Isabelle promised to chase it down and call me back this afternoon.

And she did! And I'm still approved! And I have an actual authorization number! It's still not showing online, but I have it right here in my hot little hand, and I've passed it on to  Shirley (via voice mail....argh) and I am SO hoping she will call me back TODAY because in addition to the authorization number, AvMed has issued a DATE (actually, two) for which this authorization is good, and those dates are November 20 & 21! Only TWO WEEKS! If I'm having surgery in two weeks, that means I have to start my liquid diet on Monday, two days from now. ACK!

I don't really know how this works. Can the insurance company possibly schedule the doctor's time like this? Do they just throw it out there and expect that for surgeries it will change? I don't know, and so I sit here typing away and hoping like crazy that Shirley, my angel, my lifeline, will call me back posthaste so I don't spend the entire weekend in this state of mind.

Post Date: 11/1/06 7:46 am
Topic: No date yet, BUT...
I'm approved!!

I called the insurance company this morning just on a whim. Shirley, bless her bones, sent in the request last week after I finally got her the TSH labwork. I thought it was time to call AvMed just to see if they had everything
 they needed.

So the girl I spoke to, Katie, said, Ms. Spears, the surgery request has been denied because you have not completed a physician-led weight loss program in the last six months. DOH! I knew that was a possibility, because I hadn't done one (at least not formally). So I was disappointed, but not surprised. I started to ask her exactly what they would need for an appeal, but then she said, Wait, wait, it looks like I have conflicting information...can you hold?

Could I hold? I've been "holding" my entire life, it seems, when it comes to my health. Yep, I can hold. No worries.

She finally came back on the line, after having spoken directly to the "pre-op" department, and said YOU'RE APPROVED!

No actual authorization yet (I guess they're still working on that) but it is definitely APPROVED!

I have no idea what went on, but it's not important to me right now. (I will find out, though, and post it in the insurance database here, for historical purposes.) The only thing I can think right now is, approved? Really? This is really going to happen...?

October 13, 2006
I know you're all just DYING to know what happened at my doc appt. yesterday (yeah right), but here goes anyway.

Signed in. Waited a while. Was given some forms to sign, and a questionnaire which cleverly asked the same question worded several different ways. Basically, it asked did I like being overweight. *sigh* Turned in the forms and questionnaire, and waited some more.

Was called back for weight and vitals. I found out I'm down ~7 lbs; probably due to walking all over Boston last week. Back to the waiting room, waited some more, again.

Went into a "group" session with one other woman (and my husband.) We were shown a short video explaining why arbitration agreements were good for public health. Underlying message...if you don't sign the form agreeing to binding arbitration and giving up your right to sue, we won't do your surgery. Yeah, okay, I knew that already. Signed the damn form.

More waiting, still in group format.

The dietician came in, and told me exactly nothing I didn't know before. Hey, I'm an EXPERT dieter. Still, I understand why they have to do it, so that was okay.

Wait, wait, wait.

THEN came the Main Attraction. Dr. Brient came in to talk to us. And boy, can this man TALK! He likes to draw, too. He drew diagrams of the different kinds of surgery that had been done in the past to lead up to the way they do things now, both with the gastric by-pass and the gastric band (which I am opting for.) He explained the pros and cons of each kind, and the things that can go wrong. He went into detail about the relative risks of each surgery. Lots of stories, lots of anecdotes about his own training and about various patients and what happened to them. He told us about the three deaths that had occurred in his patients and exactly what happened to cause those deaths. (None had had the band surgery.)

Then he saw us individually. He went over my records, asked a lot of questions, gave me time to ask questions of my own. Seems to think it will be no problem with my insurance, though that remains to be seen.

I went home with a copy of the two-week pre-op diet, which is...protein shakes morning, noon, and night. That's to shrink my liver so it will be easier to move out of the way during surgery.

That was it. It was after four by then, and we got Ben, went home, and I went to bed. At six.

And now, we wait some more. ;^)

October 5, 2006
I've been busy getting together the stuff needed for my surgery consult, and I finally managed it. I have my first consult next Thursday, Oct. 12. It's supposed to be a four- or five-hour deal. I told my husband about the appointment but I forgot to tell him that he's going to need to go with me. I'm in Boston at the moment but I have to remember to tell him! Hope he can make it.

Oh, and I thought I had to have the approval before the first consult, but evidently not. I thought that was kind of weird because wouldn't the insurance companay want to know what this doctor thinks about me getting WLS? Anyway, I still have to get my bloodwork done first thing Monday so they'll have that, too. They mainly need the thyroid study.

September 17, 2006

Type 2 diabetes
Hypothyroidism
Varicose veins
Sleep apnea
High blood pressure
High cholesterol

I have very little energy. My house has more dust bunnies and cobwebs than your average haunted house because I just cannot get up the energy to clean. Cleaning the bathtub leaves me gasping...I have to do it in parts so I can rest in between. Vaccuuming one room is all I can do at a time.

My dad is dealing with the effects of 30 years of diabetes. He's on dialysis three times a week, and has heart disease and a host of other ailments. His health at age 70 is precarious at best. I don't want to be there, but that's straight where I'm heading. I can't afford that...my family, especially Ben, needs me. I feel panicky when I think about leaving them. I'm not worried about dying, not for myself...I know there's a better place for me on that other side. But for them...I know it would be so hard on them if something happened to me. That's why I have to do something.

Besides, there's lots of stuff I still want to do. My BID (Before I Die) list is loooooooong, lol! I want to go to England and New Zealand and Europe. I want to try skydiving and scubadiving. I just want to ride rollercoasters again!

I am working on getting everything together so that I can have my first consult with the surgeon. They won't schedule that until my insurance approves the surgery, so the first thing is to get all the info together for that. I have AvMed HMO, and I have no idea whether they will approve the surgery or not. I've been told it would be approved if it's "medically necessary", but of course there's a world of wiggle room in that little phrase.