So, yesterday I had a noon appointment with Dr. Scott for what I thought was going to be my first lap band fill since 2009. My appointment for October 30th was cancelled due to my 3-4 week illness.
The anxiety that built up in the 24 hours prior to my appointment was off the charts. I got so worked up with the fear of puking every single bite or meal for another 3 years. I spent a good amount of time reminding myself that it had to be done, that it would be temporary, that it was a means to an end, etc. Nothing made me feel better!
I arrived to a standing room only waiting room of strange people. One lady who looked to be average (versus oversize) who was seated in a chair beside an empty chair. These chairs are super wide and cater to the clientele that would be typical of a weight loss surgery practice. As I approach the empty super size chair, she scoots over in hers as far away as she can get. I'm thinking to myself, "does she think I need my super size chair AND hers to sit down? Sheesh!" or "Does she think I smell? Like what the hell?"
But I sat quietly and remained well over arms length from her so I didn't get my St. Charles smelly ass near her!
My appointment was at noon. I arrived on time. I didn't get called back until close to 1 pm. It's like you have to take the day off anymore to go to the doctor........trying to do it over lunch is near impossible!
When the nurse took my blood pressure it was high....they took it a total of 3 times. Once it was like 97/110 and I forgot the other times (I've slept since then).
Dr. Scott eventually made his way to the exam room; and we discussed CIGNA's denial and what the next steps needed to be. Here's what he had to say:
#1....he wants to do my fill under a Fluoroscope machine (similar to an x ray machine). His reason is that he will have images he can SHOW CIGNA when trying to build my case for Gastric Bypass surgery, making it easier to prove that we're doing all the right things and the lap band is simply not working in my case. One word: DOCUMENTATION!!! I actually prefer this since it's his first time giving me a fill. I want to be sure he SEES where my port is and injects the saline in the right place. Unfortunately (unlike my surgeon in KS), he does not have one in his office. He uses the one in the hospital (his office is in a building beside Des Peres Hospital). Sooooo.....it had to be scheduled and couldn't be done at the time.
He only does them on Monday mornings, which doesn't leave many options for scheduling. Next Monday was out of the question as I'll have to take some time away from work on Tuesday for Fox's Autism screening appointment. So, I scheduled it for the following Monday, Dec. 2nd. It's embarrassing literally having to tell your boss that EVERY week you're going to be at this doctors or that doctors. And it seems like I can never just go several weeks without seeing a damned doctor!!!
#2....his goal is to try to prove the need for Bypass surgery and gain CIGNA's approval at the end of 3 months. This had me relieved because IF I do start puking all my meals again, I don't think I will make it long at all before I say "F this"! Hoping I can manage as long as it takes to get insurance approval.
#3....one of the other things CIGNA stated in the denial was that I needed to see a nutritionist and have a diet and exercise program and without that, I was "non compliant". Soooo......for every office visit I make to him, I will now also see the nutritionist. This is completely fine by me. And it usually only involves 10 more minutes.
#4....he did say that if I started vomiting my meals, it may involve additional testing of the ph levels and such in my esophagus (again building the case). When I think about it, it's kind of stupid, cos we're going to spend money (which insurance will end up being billed) to build the case.......whereas if they'd just approved the damned surgery to begin with, the tab would be lower over all. But what do I know? I mean, after all I don't have the PhD! Incidentally, the person at the insurance company denying the surgery IS a physician.
After my visit with Dr. Scott, I met with the nutritionist. She advised me that I need to be taking iron and calcium and mentioned that as a lap band patient, I could very well have nutritional deficiencies. No biggie, the hardest part for me is remembering to take them. I can't take them together, however, as the calcium can reduce the effectiveness of the iron.
She also decided that I should start with a simple walking system....stating that I need a pedometer and to keep a log of my daily steps. Ok, at this point I'll do whatever it takes to document all I can to get the damned approval! Now all I need is a pedometer!!!
I'm also going to be keeping a food journal (this ought to be way interesting). I do think this will be good as I'll be FORCED to look (on paper) at what all stupid crap I shoved in my mouth because I was hurried between conference calls to grab a bite for lunch, or whatever. Again, whatever it takes to get closer to approval.
So that's my plan...........and it begins today. I will be able to enjoy Thanksgiving in moderation and then it's ON..........December 2nd, first fill.........details to follow...........
