Wednesday, December 8, 2010

So scared to tell a soul!

Pst....the surgery date is scheduled. December 23rd...

I'm horrified to tell anyone...though I've told my closest friends. Last time I started blabbing about a surgery date the whole thing got cancelled. I feel like I will jinx it if I talk.

This has been a bit of a roller coaster ride for me. It all started back in May of this year when I went through the initial web questionnaire required by my insurance company. It asked 5 questions...do you have diabetes, sleep apnea, high blood pressure, high cholesterol or high lipids. My answer to ALL those questions was "No"...because it is for the most part true. I am one healthy fat girl! Insurance denied my request to go on to the next step.

But I need help with this weight loss thing. My disability makes it hard for me to exercise in a way that elevates my heart rate, making it almost impossible to burn any calories. I do well on some diets, but usually end up either hungry (i.e., Weight Watchers), or going crazy off plan (i.e., Atkins) and ultimately gain all my lost weight back. Clearly I can't do this on my own...I've been trying for 26 years.

So I sent all this information to the Obesity Law and Advocacy Center to ask for their help in getting my insurance to approve me for Lap Band surgery. After several weeks I finally heard back from them and coordinated a plan. I gathered all my own medical records and sent everything to them in July. In August they submitted my first appeal to the insurance. It was denied in mid-September.

The second level appeal was sent in late September. I received a rather "snide" approval letter from the insurance company on October 19th. It stated that my medical records indicated that I "obviously had high blood pressure and would have been approved the first time if the question had been answered correctly". My blood pressure is 116/70...but I'm not going to argue with them. I was FINALLY APPROVED for the next step.

So from that point things SEEMED to go into warp speed. Step two was to lose 5% of verified start weight before being referred to a surgeon. Piece of cake...I accomplished that quickly. I was referred to the surgeon of my limited choice.

From the 5 options I was given, I had selected a surgeon whose office is close to my office so that follow up appointments would not require a half-day off of work each time. I was told my insurance would not be covering this surgeon in 2011, but was assured repeatedly by the surgeon’s office that I could have the surgery done by year end and opted to self-pay for the fills going forward out of pocket to avoid taking time off work and dealing with the long distance travel. Everything was set to go. I met with the surgeon on November 18th, surgery was scheduled for November 29th. I went in for Pre-Op on November 22nd....smooth sailing.

And then I got the call on November 23rd. Surgery had been CANCELLED.

The hospital that my insurance would allow to do the surgery was opting to not renew its "Center of Excellence" designation and would therefore not be covered by my insurance, effective immediately. My surgeon did not have surgical rights at another hospital that my insurance would cover. So it was done. Over. Nothing more they could do.

I cried all day.

I made some calls to other offices. I could get in to see a surgeon 1 hour north of my house (but 2 hours north of my job) on November 29th or I could see Dr. Hunter in Federal Way (15 minutes north of my house) on December 21. I booked both but was fairly certain I didn't want to go with Dr. Hunter.

Unfortunately, Dr. Hunter...who is by all means the nicest guy on the planet, performs surgery out of a hospital where I had surgery in 2002 that left me partially paralyzed. Not a good experience. Not only was the outcome of the surgery bad, but while I was an "obese" inpatient at their facility for 5 weeks, I was treated horribly...as an "inconvenience" and a "hazard" due to my weight. While I was in rehab I was not allowed to transfer to a wheelchair to visit the recreation room because they didn't want to deal with the risk of transferring my 300 pound body from bed to wheelchair more often than required for physical therapy visits. I had nurses complain about the possibility of hurting their back right in front of me when they gathered to assist in changing my position as I could not do it for myself due to my paralysis. There were at least 2 nurses that I had to specifically request be re-assigned off my case because the way they treated me was so insensitive. No...the thought of having surgery there was simply terrifying.

On November 29th I took a half day off of work and drove the 2 hours north to visit the surgeon I thought I would end up going with. Boy was I wrong.

This man was just the epitome of a “jerk”. I disliked him immediately. He would ask me questions and then motion with his hands to speak faster…and I’m NOT a slow talker. He would cut me off mid sentence, minimize my concerns regarding bypass surgery, and arrogantly proclaim that I should be smarter in my reasoning since I’m a “data analyst” by profession (which, by the way, I gave a sound “analytical response” to his question to begin with!). He insisted that I would fail with Lap Band due to my disability (I walk with a crutch now, am no longer wheelchair bound). He said that 70% of lap band patients fail and that bypass was the only option for me.

I don’t want bypass. I have been researching what I want for 5 years…I know exactly what I want, why I want it, how to use it and how to be successful with it.

He handed me a list of additional tests that would still be needed (even though my insurance had already approved me for surgery), and called me a liar when I said I didn’t have sleep apnea. He said it was simply not possible that someone my size didn’t have it. I had a sleep study done in 2006…I promised to have the results forwarded to him to prove that I was not a liar.

I cried the whole way home.

All I kept thinking was “how can I possibly deal with this guy for the rest of my life”. I did not feel as though I could be successful with him as my surgeon. If I did opt for Lap Band, would he always say “I told you so” when I wasn’t losing weight as fast as a bypass patient? Was I making the wrong choice by opting for Lap Band to begin with? I was actually ready to give up on the whole thing. 

When I got home I talked to a friend and after rationalizing a few things, I decided the next day to start down Dr. Jerk’s path of extra testing while seeing if I could get in to see Dr. Hunter any earlier than December 21st. My new thought was that the few minutes of terror I would have to endure walking down the same hall I walked down for the last time as an able bodied person was better than having to deal with that other guy on a regular basis for the rest of my life.

I talked to Dr. Hunter’s office finally two days later. Since I was already approved for surgery, and my primary care physician and most of my medical history already exists within the same facility, they said it would be no problem to get me on the books without going through all the usual hoops. Instead of seeing Dr. Hunter’s assistant on December 21st, I’ve now been booked for surgery on December 23rd and will see Dr. Hunter himself on December 17th for pre-op. I will also visit with their nutritionist (I’m already on their pre-op program) and meet with anesthesiology that day.

I’m still immensely freaked out about walking down that hallway. I will discuss this anxiety with Dr. Hunter. I wish I could be knocked out before even getting TO the hospital…but I don’t think that’s an option. Oh well.

For now, I’m just trying to stick to pre-op diet and lose some more weight. I’m down 21 lbs from my “verified initial weight” and 30 lbs from my most recent “high weight”…not sure which one to use to gauge my progress going forward. Or maybe I should use my surgery “start weight”….decisions, decisions, decisions…

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