Wednesday, April 4, 2012

Once upon a time. In a land far, far away....

*** WARNING! this is a long post! But worth it :) ****

Today seems like a good day to go ahead and tell you my story thus far!

I have actually been thinking about the Lap-Band Surgery for many years. My mom and I actually attended a seminar back about 3 or 4 years ago. At that time it was just a dream...completely unattainable. My insurance at the time excluded bariatric surgery or weight loss help of any kind. With the price tag of $16,000 it looked like this dream would only become a reality if I got all 6 numbers on the mega millions! Popped out a couple kids... I was still struggling with my weight despite numerous efforts to shed the lbs on my own and with the help of programs like Weight Watchers, gym memberships, diets...etc.

Enter a friend... a great friend...(she knows who she is!)  she got the Lap-Band. She was self-pay. She was motivated. I watched her struggles, her successes, her highs, and her lows. She is now oh so close to her goal and I couldn't be more proud of her. The whole time she's losing weight she's sending me subliminal messages about me getting the lap band... Ok, she was flat out telling me I should SOOOOOO do it!

Enter new job.... with new health insurance. Hmmm.... noticed here that there is coverage for bariatric surgery. Hmmmmm indeed. First though I had to squeeze me out a little baby, then it's on! So when I was pregnant I asked my OB her thoughts on the Lap-Band. She said she thought it was wonderful and that I would do great!

The wheels kept turning... Hmmm...

I worked up the courage to call my insurance company and ask them for the criteria for getting approval for the surgery.

Here's where this momma gets a little mad. Here I am, trying to do everything I possibly can to ensure an easy process... The insurance company sends me the requirements, AND verbally gives them to me over the phone. They were presented to me as follows:
* Over 18 (check)
*BMI 40 or greater (check)
*Nutritionist evaluation
*Psychological evaluation
*Tried losing weight in the past. Example Weight Watchers, adkins, gym etc... (check omg check)

Wow! 3 outta 5 ain't bad!

So I scheduled an appointment at the surgeon's office for my consult. It went great. The Dr. explained all the WLS options and verified I am a great candidate. The insurance coordinator calls my insurance and is given the exact same criteria listed. YES!

Next to the nutritionist... Learned alot about how I would be eating pre and post band. VERY informative.

On to the psych eval... Wow, 3 1/2 hours of telling my life story!

So I'm done right? The Insurance coordinator at the surgeon's office sends off my little paperwork packet to my insurance company for approval. She said she usually hears back within a week.


I get a call... APPARENTLY my insurance company is in the business of LYING to their policy holders and to physicians.... They now magically need a 6 consecutive Dr. supervised diet.

I was devastated. I think I cried for 3 hours that night.... I was so ticked that I just said whatever and kind of forgot about it. I realized this was still just meant to be a dream and nothing else.

Enter my lap-band friend AGAIN. We spent a day together and she lit a fire underneath me. I can't even remember exactly what was said.... but she just has a way of motivating me! I love her!

I called the surgeon's office and explained how I got discouraged and gave up for a couple months but that I was ready to do my 6 months but needed a recomendation for a Dr. since I don't really have a primary, just my OB. She said "We actually have a Dr. in our office now that does the supervised diets. Let's set you up!"
I scheduled all my appointments right then and there.

Yes, i'm on my way... I see the light at the end of the tunnel.

I have an appointment on April 26th and then my LAST one on May 29th. After that is the week waiting game again. I will probably not sleep that whole week!

I'm going to go ahead and end it here for now.  I'm sure everyone wants to know where i'm going, who my surgeon is etc. I'm sure some of you aren't familiar with the lap band and would like to know exactly what it is. This will all be answered in part 2.

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