The Referral

At the beginning of this journey, I had absolutely no clue about the cost or insurance. They sent the referral to the surgeon in November 2015 and I was promptly denied by my insurance company. I called to talk to the doctor’s office to see about self-pay or financing options. Um, $36k was a little hefty of a price tag. Getting denied this first time was probably the best thing that could have happened. It gave me the time to do my research to understand what I was getting into, and the starting point was talking to my primary care doctor.

She’s been along for the ride with me since about 2004. When I told her I was referred for surgery, she seemed encouraging. She thought with all of my metabolic challenges (more on that later) it might be a good option, saying it’s a tool, not a cure. That’s a phrase you hear a lot in the weight loss surgery community. It’s just a tool.

She started working with me and the weight loss center to pull together all of the documentation of my ongoing (and expensive) medically managed weight loss efforts, plus documentation of all of my co-morbidities that needed to be present for me to meet the insurance qualifications for surgery. All of this documentation was submitted, then promptly denied.

I decided to file an appeal following the insurance appeal process and addressed bullet point by bullet point all of their reasons for denial. Within a week, I was approved to take a 2 session nutrition class, which was biggest waste of time ever, but it was a requirement. By this time, it’s March. Within a few days of attending the last class, I got a phone call from my primary care doctor saying she had met the surgeon they would refer me to at a presentation the surgeon provided for the staff in the office. They briefly discussed my case and following that, I was instructed to go to a seminar to learn more.

I attended her seminar April 4 and learned so much more about the genetic and metabolic connection to obesity. I got enough information to change my desire to have the sleeve surgery to having gastric bypass, and I got into the queue for an initial consult. Until they have approval from the insurance company, no  appointment. It was within the week that I heard back that I was approved for the consult only and scheduled it for mid April.

The appointment was over an hour. I was able to ask my big huge long list of questions and Mike was able to get some reassurances about safety and complications (more on THAT later). We talked about my history, my knowledge of high protein, low carb living, all the efforts and work I had done. At the end of the appointment, she said I was a good candidate, waived the requirement to do nutritionist supervised weight loss, waived the requirement to have a psychological evaluation and set me up with a number of pre-surgical tests pending final insurance approval for surgery.

As I worked through each of the tests and requirements, the doctor submitted her statement of medical necessity and I was approved for surgery at the beginning of June.

I am exhausted just thinking about all that I had to go through.

The backstory

So someone doesn’t just out of the blue decide to have gastric bypass surgery.

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I call this my “before” picture. Honestly, I have been overweight since childhood, despite my parents’ best efforts to indoctrinate me to Weight Watchers at the age of 11. My weight gain was gradual over the years, and I swear all through college and beyond I was always on one kind of diet or another.  I actually have a stack of Weight Watchers passbooks from pretty much every city I have ever lived.

Talking to my doctor in 2009, I was connected with a weight loss center called Obesity Treatment Center (OTC), now the The Hernreid Center for Medical Weight Loss. I started that program, a Very Low Calorie Diet (VLCD), which consisted of protein shakes and one small meal a day.  I did great on that program. I lost 75 pounds which I managed to keep off for a while. I started running and did half marathons…then I realized the more I exercised, the harder it was to keep my weight off. I maintained about 50 pounds of the total loss over the next 5 years, going back on the VLCD several times over the course of time. My lowest weight was 150 pounds, which doesn’t even move me from the medical classification of Obese Class I to Overweight. At 4’11” — I don’t have a lot of room to hide a few pounds.

A series of events starting in 2015 set me on this path. I was a caregiver for my dad as his health declined in January 2015, I was stressed, I was tired, I wasn’t paying attention to what was going in my mouth, and suddenly I was back to almost 200 pounds. There is nothing more demoralizing than failing at weight maintenance.  I started back on the weight loss phase of the diet to try to get that under control, and of course, that program works and my weight was coming down again. When my father died in June 2015, that was a trigger for a free fall into a bad place.  I was stressed, tired, had horrible depression, was unable to sleep more than 6 hours a night, I wasn’t exercising, but I was still eating about 1,000 calories a day and gaining weight. My doctor at Hernreid told me that there was nothing else medically they could do for me, so she was going to refer me for a vertical sleeve gastrectomy.

I was devastated.  That made me feel even more like I was a failure. Let me just leave this here for a minute. This was really the start of the journey.

Where do I begin?

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I have an idea about what I want to do here, but how do you dive in to a story that has evolved over decades?

I am starting this blog as a departure from all other social aspects of myself, mostly revolving around my dogs. I want to tell the story of my lifelong struggle with obesity, a taboo topic. A topic that I have shared bits and pieces of over the years, celebrating the achievements and hiding during the setbacks. I’m going through something now that requires a lot of mental processing, and am hoping this will be a mechanism for that. And if I can help support or encourage anyone on their own personal journey –awesome! I’m hoping this will also bring some encouragement and motivation my way, too.

Here it is: on July 5, 2016, I had gastric bypass surgery.