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!!!
Lori, I applaud you for your moving forward to the gastric bypass. I have one suggestion for you. I have a client who had it March 27th, 2014. He didn't have problems with the actual surgery, but the psychological impact was enormus. I suggest you have a heart to heart with the doctor who is going to do the surgery , as well as a dietician BEFORE you undergo the surgery. Your life sytle will change greatly. You will have to deal with daily diarrhea and trying to adjust to what you can eat and the quantity at one time. Taking your MEDS is a must, and yoiu will find that after you do that, you may not have room for food for a while. There are a multitude of things to consider. I am here to answer questions, since I have been dealing with someone close up and personal each week who has had this surgery.
ReplyDeleteHe has lost 120 pounds to date and is just now getting into a normal routine.