Saturday, June 30, 2012

Monday at 9:45

I will be having my Lap Band removed forever.  Originally I had planned to have my Lap Band replaced, but after much discomfort and a long talk with my surgeon, it has been decided that keeping the band just isn't a good call for me.  My surgeons feel that I am only prolonging the issues and that 3 months, 6 months, or a year down the road, I will be right back here.  Let me say... I am releaved.  I have had such a bad year and a half with my band.  I am tired of my new kind of disfunctional eating.  I feel like I traded one eating disorder for another.

The new plan... get me the sleeve.  My surgeon is working on an appeal currently and he is confident we can make this happen.  It is just going to take a little time.  Though it is not ideal to have another surgery... I think it is better than trying to make the band work.  I am very much looking forward to Monday and putting this all behind me.  Hopefully my next surgery will be the begining of a very successful bariatric lifestyle. 

To those whom are working their bands, I wish it could have been me... but I am very happy for you!

Monday, June 25, 2012

One More Week

One more week with my slip.  A week from today I will have my Lap Band taken out and a new one put in (hopefully).  There is a chance it could be such a mess that I won't be able to get a new band.  If that is the case... I don't know what I will do. 

Anyway, I have started my pre-op diet today.  Just like last time.  Full liquids for 5 days and clear liquids for two.  Though this isn't all that different from how I have been living.. I will have to stop with milkshakes, Starbucks and ice cream.  Hopefully I can drop a few pounds this week and get a jump start on things.

I am still so sad I was not able to revise to the sleeve.  However, I will make the best of my new band.  At one time I was not too far from 100 lbs lost.  Maybe I can actually make it to that 100 lb mark now.

Take care...

Thursday, June 21, 2012

Surgery Date

I have a surgery date... one week from Monday.  Cheers to that. 

Tuesday, June 19, 2012

Put A Fork In Me

It is nearing 5 weeks since my slip was diagnosed.  I still can't eat food.  I puke a lot and have acid reflux pretty much always.  I puked on myself in my sleep the other night.  I am tired of calling the insurance office and advocating for myself with my doctors office.  I have decided I am just going ahead to get a new band.  My plan is to start saving up to self pay for a conversion down the road. 

In the mean time, I need a band to at least maintain my weight loss and hopefully lose more.  If for some reason my surgeon is unable to reband me.... I am screwed.  But at this point I am just willing to deal with what I am dealt. 

I still don't believe my insurance coordinator did what she was supposed to.  I still believe my insurance would cover the sleeve... but I don't have the energy to continue down puke road.

Happy Tuesday all!

Tuesday, June 12, 2012

The Squeaky Wheel Gets The Grease

People keep telling me I need to make sure I am being heard and stay on top of things to make sure I am a priority... well I have been trying... but it doesn't come naturally to me to be "persistent/insistent".  Well... today I had enough.

I called my insurance company today to see if they got the paper work that was sent last week. They told me there is nothing in my file yet and that it would only be updated once the appeal was evaluated. I asked how long it would take... they said 30 days from receipt. I asked how I would know if it was ever received.. they said I wouldn't and my dr's office would have to follow-up.

I hung up and called Sue (the insurance person assigned to my case at the surgeon's office). She told me it is sent to a p.o. box and it takes 3-4 weeks for the insurance company to even get it. She told me not to bother calling until the 6 weeks was up. I was pissed.

I got off the phone and called the insurance company back. I talked to someone who was extremely nice (and actually took pity on me) and explained that my doctor's office is not properly advocating. She told me there was very little she could do but she would put me on hold and try to get me through to the executive  office. She did... they told me the doctor's office should have filed an urgent appeal that takes 72 HOURS from receipt to be reviewed.

It is now 3 weeks past my upper GI. The paperwork was sent on Friday. I am pissed so I called Kelly (one of the account gals at my insurance office).  I trust her, and though this isn't her department, I thought she could help. I explained that I was calling her because I trusted her and I am frustrated.  She was horrified.  She said this is totally being mismanaged and told me she would transfer me to the office manager. She was already gone, but Kelly assured me she would make sure she called me back right away tomorrow morning. I left a message explaining the situation. I feel like I might actually make some progress.

In other news, I puked 2 times today.  I read CJ's post about choosing Lap Band and if it was a good decision.  I have been thinking about this all day.  And even though I hate my band... and probably would have never chose it if I had a better option, I still think I made the best decision at the time.  I am not sure I would ever suggest the band to anyone though.

Monday, June 11, 2012

The insurance company makes my life miserable.

I am so frustrated with my surgeon's office and my insurance company.  My insurance company doesn't traditionally do pre authorizations.  They give the criteria and you either meet it or not.  Somehow my surgeon's office is having issues determining the wording of the criteria and if I do indeed meet it.  So... in this case the insurance company will do a review and pre authorize.  However... it takes 6-8 weeks (or so they say). 

First issues, the girl handling my insurance claim at the surgeon's office is not very helpful.  She keeps telling me it will take 6-8 weeks and that there is nothing she can do.  However, when I call the insurance company the customer service folks tell me she should be able to plead with provider services to expedite the situation.  She says this isn't true.  I am not able to contact provider services before it is only for providers.  This is all a pile of BS.  It has been 3 weeks since my Upper GI... and this is when my insurance information was sent in (why did it take her so long)?! 

Mind you, I am pretty much on full liquids and nothing else.  I puke a lot.. and have heartburn.  All of this the surgeon's office is aware of.  I called my insurance company today to see if they received the paperwork and they didn't have it on file yet... however she told me it is 30 days not 6-8 weeks.


Tuesday, June 5, 2012

A little jerk around

I met with my surgeon today because I had some questions about the rebanding surgery.  We talked and he again said he would rather have me revise to the he decided to write a letter to the insurance company including all my past issues and send it in.  We will see... I would feel better with a revision, and I need to know I did everything to make the best option happen.  Again, I am in the waiting game.

Friday, June 1, 2012

Banded For Life

I guess I won't be getting away from my band easily.  My surgeon wants to reband me instead of revision.  I am not excited, but I am okay with it.  He feels like I was originally very successful and that I can find that success again.  He did promise I could have the sleeve if this band doesn't work out.  I should have my surgery date soon... I am hoping for 2 weeks from today.  Here's to having the success I had for the first year and a half once again!