(drum roll please).
Insurance APPROVED the surgery. I will be having Roux-En-Y gastric bypass surgery on August 28th!!!
I'm still processing the news. I've been speaking with my cousin, who recently had the Gastric Sleeve procedure. And I've also been talking to my friend and co-worker who had the same procedure as I'm having.
As far as the process goes, I simply need to see the surgeon on Monday August 4th. After that appointment, I will attend a class with the dietitian to learn more about pre-op diet and procedures. So far they have me down for a THREE day clear liquid diet. It beats TWO WEEKS. So I'm relieved; and pray that doesn't change. After class, they will send me down to the lab at the hospital for all the necessary pre-op work. Then they will need nothing from me until the day of surgery.
I should expect two nights in the hospital and 10-14 days off work. Surgery is laproscopic; and my lap-band will be removed in the process. This is a HUGE relief for myself and my immediate family, who want it GONE.
The best news is I'm still able to have it before my high school reunion....although my friends won't see a drastic change in me until perhaps the next one. And it won't impact our upcoming vacation or my cousin's 40th birthday celebration.
More deets to follow as they unfold. I expect that I will continue to blog throughout the journey.
Thank you for your continued support, love and encouragement.
Lori
http://www.webmd.com/diet/weight-loss-surgery/gastric-bypass
http://en.wikipedia.org/wiki/Gastric_bypass_surgery
Thursday, July 24, 2014
Monday, July 7, 2014
Hurry Up and Wait!
For those of you following along on my never ending journey to gastric bypass surgery, here are the latest "rocks" I've been moving..............
On June 24th I had my follow up with the bariatric surgeon, Dr. Scott. I had been diligent about logging my food intake and physical activity in a journal, of sorts. So I had that on hand. When I met with the doctor I was down a total of 12 pounds from the date I began seeing him, one year prior. So I did lose some weight; but nothing significant. And given the band, I should have lost more. But we all know the lap-band doesn't work for everyone; and it's clearly not working for me. Soooo, I did not get a band adjustment. Rather, the doctor reviewed the documentation we had and felt confident that we had more than enough to resubmit to CIGNA for insurance approval to have the surgery.
There were only two things missing (information wise) that insurance required. A surgical clearance from my internist and a psychological evaluation. Both had been completed; but since it's been right at a year, I needed to refresh them.
The doctor explained that he was confident we could get approval and offered to do what they call a "peer to peer" conference with the Medical Director at CIGNA, if necessary. Always one to prepare myself for the worst case scenario, I asked him "WHAT IF" they deny me again??? He went on to explain that it wouldn't be the end of the road that we could take legal action. And he has referrals for me, if it comes to that. Whew! So I will try to remain optimistic. I liken the process to that which some of my peers have endured in qualifying for disability!!!
Because I wanted to "get the show on the road", I made an appointment for the psych eval for the following week (July 2nd) and immediately contacted my internist for a surgical clearance. Fortunately, I have a wonderful doctor who typed it up immediately and had it ready for me to pick up on my way to the psych eval.
At the psych eval, Dr. French just went over the information from last time and updated accordingly. He was also very careful to document any and all comorbidities (other illness or symptoms as a result of my obesity).
I submitted my clearance while I was there. So now they have everything they need to submit to CIGNA again. And we wait...............
Once the paperwork is submitted to CIGNA, they have 30 days (legally) to approve or disapprove. Typically, the doctor has a response back within 2 weeks. Until then, I'll be on the edge of my seat with anticipation.
The surgery itself can be done laproscopically. Typical hospital stay is 2 nights. And average time off work is 2 weeks.
I've done some research on my benefits at work. I have 2 weeks of sick time that must be used first, then Short Term Disability would kick in. What I need to be sure is that my vacation time will remain untouched.
My goal would be to try to get it in as soon as possible so I can start losing prior to the high school reunion that I'm planning.
Again, thank you for the continued encouragement; and I'll keep you posted!!!
On June 24th I had my follow up with the bariatric surgeon, Dr. Scott. I had been diligent about logging my food intake and physical activity in a journal, of sorts. So I had that on hand. When I met with the doctor I was down a total of 12 pounds from the date I began seeing him, one year prior. So I did lose some weight; but nothing significant. And given the band, I should have lost more. But we all know the lap-band doesn't work for everyone; and it's clearly not working for me. Soooo, I did not get a band adjustment. Rather, the doctor reviewed the documentation we had and felt confident that we had more than enough to resubmit to CIGNA for insurance approval to have the surgery.
There were only two things missing (information wise) that insurance required. A surgical clearance from my internist and a psychological evaluation. Both had been completed; but since it's been right at a year, I needed to refresh them.
The doctor explained that he was confident we could get approval and offered to do what they call a "peer to peer" conference with the Medical Director at CIGNA, if necessary. Always one to prepare myself for the worst case scenario, I asked him "WHAT IF" they deny me again??? He went on to explain that it wouldn't be the end of the road that we could take legal action. And he has referrals for me, if it comes to that. Whew! So I will try to remain optimistic. I liken the process to that which some of my peers have endured in qualifying for disability!!!
Because I wanted to "get the show on the road", I made an appointment for the psych eval for the following week (July 2nd) and immediately contacted my internist for a surgical clearance. Fortunately, I have a wonderful doctor who typed it up immediately and had it ready for me to pick up on my way to the psych eval.
At the psych eval, Dr. French just went over the information from last time and updated accordingly. He was also very careful to document any and all comorbidities (other illness or symptoms as a result of my obesity).
I submitted my clearance while I was there. So now they have everything they need to submit to CIGNA again. And we wait...............
Once the paperwork is submitted to CIGNA, they have 30 days (legally) to approve or disapprove. Typically, the doctor has a response back within 2 weeks. Until then, I'll be on the edge of my seat with anticipation.
The surgery itself can be done laproscopically. Typical hospital stay is 2 nights. And average time off work is 2 weeks.
I've done some research on my benefits at work. I have 2 weeks of sick time that must be used first, then Short Term Disability would kick in. What I need to be sure is that my vacation time will remain untouched.
My goal would be to try to get it in as soon as possible so I can start losing prior to the high school reunion that I'm planning.
Again, thank you for the continued encouragement; and I'll keep you posted!!!
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