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WILLOWBAST's Photo WILLOWBAST SparkPoints: (7,652)
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Posts: 200
9/29/11 9:36 A

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I am not in any kind of rebellion against the delay. I can't get in to meet with the surgeon until November and his office gal has me on a list if there is a cancellation. I can be over at his office in 5 mins. I work at the hospital where the surgery will be performed, so I know how busy our docs are. The 6 months of physician supervised weight loss sessions is a requirement of the insurance and will not be waived. They are cracking down on a lot. I have a procedure done on my back and since it is for fibromyalgia and soft tissue (in other words they can't look at an MRI and say I have a slipped disk, etc), the insurance ruled that the last time I had it done it was deemed "not medically necessary" and that in the future, I would have to get it pre-approved.

Mind you, this is a covered service. They changed policy mid-term (our insurance renews in January!!). I am in a PPO and can self-refer, but they are now requiring referrals for everything!!! Heck, I am in an HMO in all but name only. I feel for our lap-band patients. Our insurance will pay for RNY or lap band. For lap band they now have changed their tune and will only pay for two fills for those patients and it cost $600.00 a fill (there is a lot involved, contrast swallow tests, etc. when they do each fill). Our plan will pay up to $20,000 for weight loss surgery and related expenses. Then we are on our own. Scary, right?

Oh, and those 6 months of visits of course are another 6 months of bills they are going to have to pay out with the end result being the same. Thing is, we all better get used to it because the insurance companies are really cracking down on all kinds of things and sad thing is, these are legit. diagnosis and treatments.

I am not upset about the 6 month wait. I have started to change my eating habits and make some healthier choices. I have tests I need to have run. I was recommended for this surgery a year ago, and I was not ready then. I spent that year doing research, reading, working through some things, so while I am continuing to do reading and learning things (we never stop learning new and wonderful/helpful things), mentally, I am ready.

I am also using this time to get my house in order. I have been remodeling. Yes, I was given an exercise plan from my doctor at our first meeting. Currently, my exercise plan is painting, furniture moving, installing flooring, etc. (and taking Advil and Tylenol!!) Next month or shortly into the next month, I hope this renovation will be complete and then it will be on to the fall garden preparations and leaf raking. After that the basement and garage. Since I know I won't be able to do a bunch of heavy lifting post surgery and because this is one of my steps in getting things together in my life (this has been major stress for me - my house not being in order), I need to do this now. I need to off-load the clutter, just like I need to off-load old recordings from the past that rear their ugly heads from time to time. Time for a fresh start. This is the start of my new life. My new path.

The surgeon's nurse also told me it was ok to lose a little right now, but not to go crazy for the very reason that the insurance could deny my surgery. She also said, and yes, I totally agree with her, if I could do this without the tool of the pouch, I would have long ago. I know I need this, so for now, we work the system. Loose a little at least until I meet with the surgeon in November and once I have his pre-surgical recommendations, then things will be more settled. Thanks for the ideas Cindy. I do appreciate it.

Live well, play hard and enjoy life. It really is too short.


 Pounds lost: 129.0 
 
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CINDY-K's Photo CINDY-K SparkPoints: (28,090)
Fitness Minutes: (27,868)
Posts: 5,855
9/29/11 1:49 A

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Is it the insurance that is making you wait or the doctor? If it is the doctor then I would speak to him and tel him what you said here. If you are in pain and the surgery would ease the pain then you need to schedule an appointment earlier. If is the insurance then speak to the surgeon and the insurance and see if you can get a waver.

In the mean time. Start exercising. Start eating healthy and start cutting back on carbs and increasing your protein. Start reading and researching the various surgeries. Use the time wisely and you will benefit from what you learn. If you have food issues then seek out a counselor who specializes in food addictions. Work to change your eating issues before surgery and it will make recovery a lot easier. Do what you can for you. Not out of rebellion against a delay. Also start to track your food and exercise. Note your emotions and things that cause you to eat. This will also help you to identify whay you eat too much so that you can work on those issues.

Good luck.

cindy



Cindy - A Co-Leader on Gastric Bypass Sparklers
Proximal Laproscopic RNY 9-10-10
Start Wt: 228 5-21-10
Surgery Wt: 205 9-10-10
Goal Wt: 135


 current weight: 176.0 
 
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184
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WILLOWBAST's Photo WILLOWBAST SparkPoints: (7,652)
Fitness Minutes: (5,010)
Posts: 200
9/28/11 4:03 P

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And this scares me being pre-surgical. I lost 55 pounds using Spark before, but like many of you, I gained most of it back. I know I need this tool. I am worried about what I might lose before the surgery with these 6 mos. of physician visits. I am sure I could lose that 50 pounds again if I did all the same things, but I am not sure that, with out this new tool that I am asking for, that I will be able to sustain it. My track record speaks volumes!!! Heck, if I could, I would have by now. My knees are also in pain now and they were not a year and a half ago. I was doing Zumba 3 times a week and then weights, treadmill, and swimming the other 4 days. My back and knees are now not up to that task. I need to get some of this weight off first.

This is not to say that others can't or even have not done so and my huge congratulations to them. I just know that for me, I need this. So, until I see the surgeon in November, I am only giving this a half hearted effort. I know, it sounds crazy!!! You are living my fear. I figure if I lose just two pounds a month and not the two pounds a week at least until I see the surgeon, then I am ok with that for right now. I have however, started to make changes in what I am eating. No more KFC, etc. I am starting to increase my water and decrease my diet coke and other things. All of which are beneficial to my health. I will wait for him to tell me how much he expects to see me lose prior to surgery as a minimum and go from there.

On a brighter side. Hats off to you. That is a lot of weight. You should feel wonderful about your accomplishment!!!!

Live well, play hard and enjoy life. It really is too short.


 Pounds lost: 129.0 
 
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ROWINGFOOL's Photo ROWINGFOOL Posts: 39
9/28/11 12:47 P

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First of all, congratulations! It is a GOOD thing not to get surgery! You don't want this if you don't 100% absolutely have to have it!! Surgery does not guarantee anything; it's all hard work, with or without the tools surgeons can give us. I'm sorry it seems disappointing, but really, if I could have done it without surgical help, boy howdy, I'd be there!

Dr. Phil brought it home to me when (many years ago) he said "surgery does not guarantee anything. All it does is speed up the process." If you're willing to be patient, you can get the same results with time and effort. If you want to be in a slimmer body, you have to do the work to +stay+ there, otherwise you're going to go right back to where you were. It doesn't change the direction of travel (up or down the scale), it simply changes the speed.

or, Look at it this way: In part of my screening process, the question was posed that if I only lost 5% of my weight, would it still be worthwhile? I had to think about it, but decided yes, anything that can help with my weight would be worthwhile. By that measure, I've been successful. I'm both disappointed that it's not more (who doesn't compare themselves to the story of the month?) but also thrilled that I'm a whole 100 lbs lighter and healthier than when I began! 300 lbs to lose was why I turned myself in for surgery. I couldn't do it on my own; I couldn't exercise due to my size and joint problems, and couldn't lose weight on even a (I thought) reasonable 2400 calorie/day diet. Surgery has given me a window of opportunity. I have to make sure I have healthy habits in placed NOW, that I start exercising NOW that I can, or the weight will come back as surely as anything.

I don't know if this was helpful at all, but please, don't feel bad about having some success!! Surgery is a last ditch thing, and should stay that way. You do NOT want to risk your life if you don't have to.

~ Emily



Day of 1st consult: 467
Day of surgery: 420
Today, 1 year out: 367

 current weight: 395.0 
 
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CINDY-K's Photo CINDY-K SparkPoints: (28,090)
Fitness Minutes: (27,868)
Posts: 5,855
9/26/11 11:12 P

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I agree with the others. We have all lost 20-30 pounds or more in the past. The problem was not that we could not loose it. The problem was that we always put it back on and then some. I think that scares me the most my past weight loss/gain history. The knowledge that so many times in the past I have lost 20 ot 30 pounds and then withing in a year it was back on with a few additional pounds. I am a year out now and it is very hard to loose weight at this point. I have to work hard at it. I am still loosing but it will take a long time before I am confident that I can keep it off! Even with the pouch tool I have to watch how much I eat and what I eat.

If you can loose and keep it off then that is fantastic. But if the pounds start to come back do not wait to gain everything back. Get thee into a different surgeon's office! I lost 23 pounds before surgery.

Cindy - A Co-Leader on Gastric Bypass Sparklers
Proximal Laproscopic RNY 9-10-10
Start Wt: 228 5-21-10
Surgery Wt: 205 9-10-10
Goal Wt: 135


 current weight: 176.0 
 
228
206
184
162
140
MOM2CALLIEBELLA's Photo MOM2CALLIEBELLA Posts: 1,933
9/26/11 2:09 P

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I, too, would like to congratulate you on the weight loss. I don't know of anyone who lost so much weight that the surgeon said no to surgery. I would also voice the concern with Julie that the problem most of us have is not losing weight, but keeping it off. That is where the surgery can be a valuable tool. Keep up the good work and don't get too bummed out about not having surgery!

I believe in taking a positive attitude toward the world. My hope still is to leave the world a little bit better than when I got here.

Jim Henson


 Pounds lost: 69.0 
 
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SHADOWSPROPERTY's Photo SHADOWSPROPERTY Posts: 359
9/26/11 2:00 P

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First and foremost CONGRATS on losing the weight!! I too lost "enough" before surgery but my surgeon realized this was a rollercoaster that I had lifetime tickets for. Lose, gain, lose, gain back even more, etc...

You might want to check with another doctor, then again you might do great on your own. Either way I wish you the very best of luck!!

Julie

HW 315#
1st consult 241#
Day of Surgery 228#
Current Weight 98#
RNY Surgery 8-5-10
Magic happens every second of every minute, just be open to see it in the little ways!


 Pounds lost: 217.0 
 
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SNL79OHIO's Photo SNL79OHIO Posts: 39
9/26/11 1:55 P

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The surgeon says with all of my health complications and the fact that I have lost so much weight on my own, he doesn't want me to have the weightloss surgery. I'm excited, glad and bummed at the same time. I think what kept me going was the thought of the surgery as a tool. Now I'm starting over with my thinking. Anyone know of anyone else in this situation or someone who HAS been in this situation.

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