Insurance Hoops Again

It's funny.  Often, I think I need to write a post and I'll ponder it for a few days and just when I'm about ready, someone will leave a comment or email me asking how I'm doing.  This time, that person was Bonnie and it much appreciated and coincidental timing.

This week, I checked off 2 to-do items for insurance approval of a revision to a sleeve.  I had my psychological evaluation and nutritionist consultation.  I'll break these down and since I've already done both of these, I'll compare it with my first experience (which you can find here.)

Psychological Evaluation: My first psych eval was fairly uneventful.  I was creeped out by the guy who did it and spent 20 minutes chatting and had to fill out a HUGE questionnaire.  This time, it was obvious that this woman only approves people.  The questionnaire was fairly short in comparison and mostly focused on figuring out if I have an eating disorder.  I had to laugh because a couple questions totally aim to get you to admit to something (they're all agree/disagree type things) "My current bad mood is impacting how I answer these questions," "I'm answering these questions to make my life sound worse than it is," etc.  Cracked me up.  The psychologist wasn't creepy and she was actually very nice.  She basically just said "You've already been through this once, you know what to expect.  Let me get some details for your letter and you'll be on your way."  Such a racket.

Nutritional Consultation:  In my first consultation, I was really irritated with the nutritionist.  This time around, it was still annoying but not as bad.  Once again, the woman was rail thin.  I'm pretty sure it's a requirement to be rail thin.  I will say this for her though, while she was a bit condescending, she didn't treat me like an idiot.  At one point, she even said "I can see knowledge isn't a problem for you so I'm not going to bore you with telling you the type of food you should eat.  You already know that.  What I will tell you is Dr. Uchal's opinions on how you should eat (slowly, chew well, etc.) and a little about pre-op."  It wasn't awful.  I liked her so much more than the first one but was still a useless conversation.

Diet History & Medical Records:  My old lap band doc sent all the records over and I filled out my diet history form.  Check and check.

So what's next?  I have a fairly small to-do list of clearances that need to be handled prior to submitting to insurance:
EKG - Make sure I don't die in surgery?
Chest Xray - Ditto to top?
Thyroid Test - My insurance apparently makes you try to resolve this issue with medication before approving the surgery
Esophogram - To ensure my stomach is healed from the band removal
Pre-Op Class - To learn how to eat before and after surgery

Once all this is complete, we'll submit the packet to insurance for approval.  They are thinking sometime in late May and then surgery in late June/early July.  They don't seem to have any doubts the insurance will approve it.  I, of course, have many.

It's interesting that I'm just not as excited this time around.  When I was jumping through hoops with the band, I was constantly researching and working towards insurance approvals.  I was reading tips on appeals and how to get approved.  The time seemed to be dragging and the whole process seemed to take FOREVER.  This time, if I don't get approved, I doubt I'll even appeal it.  Is it that I'm unsure that I want it or unsure that even if I get it, that it'll work?

A New Journey?

My band was removed Monday, February 23rd.  Avery unceremonious way to end a 5 year journey.  I highly recommend if your band needs to be removed (and you're not revising the same day), try to find a doctor who can do it endoscopically.  Other than having a REALLY sore throat for a few days, no stitches, no incisions, no staples, no cutting.  I felt really good.  It's interesting to take a pill and not worry about it getting stuck.  It's weird to be able to drink carbonated beverages again.  I had my first beer in 4 years and it was GLORIOUS.  It's weird that it's gone and other than those little things, I don't feel any different.

Not unsurprisingly, I can eat anything and as much of it as I want.  And I am.  Despite my best efforts, I just can't seem to stay on track.  I need to bite the bullet and purge my house of any unhealthy food.  I need to FORCE myself to go the gym.  But going to the gym hurts.  It's hard on my knees, my lungs, my ankles, my arms and it hurts.  I remember it hurting.  I also remember it NOT hurting after a year of going religiously and taking 2 classes a night just because I wanted to challenge myself.  I remember it NOT hurting to walk miles and miles or even run a few of them.  I remember it NOT hurting to lift heavy things and lift my body weight on a rope.  I don't know what hurts most now…my pride or the joints.

I have decided to attempt to get insurance approval to a revision to a gastric sleeve.  I was unsure of how I felt about undergoing yet another weight loss surgery.  The lap band was my "last ditch effort" after everything else had failed and as invasive as I was willing to go.  And it failed.  I failed.  I think a part of me believed I didn't deserve another chance of getting help with this.  A part of me believed that I now needed to sink or swim on my own because even surgery couldn't help.  It was illogical, I realize that but I think I was punishing myself.  I'm done with that.  I need help.  I'm not saying I could never do it completely on my own but I remember how good it was having help.  I want help again.  My current insurance does cover a revision but I have to jump through all the same hoops as I had previously.  I have to do a psych eval, dietary evaluation (nutritionist) and a nutritional class to talk about preop/postop diets.  I have to prove my diet history and have all my records faxed over again.  Doc wants to let the stomach heal from the erosion for at least 4 months.  That gives me plenty of time to jump through the hoops.

I'm actually not holding out much hope that insurance will pay for it.  I had to fight like hell the first time and I don't think I have that much fight left in me but it's worth a shot.  I'm going to do all I can do.  It's a new and different journey.  But as long as I'm walking down a path, I'm going to hope it's the right one.

Do It Well

"In many lines of work, it isn't how much you do that counts, but how much you do well and how often you decide right." - William Feather

This quote really hit me yesterday.  This is taken out of my Leadership planner so it's not specific to weight loss or anything like that but it got me thinking.  If we take just the "how much you do well" piece, I feel it encompasses so much of this journey.  Obviously, how long you spend working on something isn't going to make much of a difference if you aren't working hard or well.  You can go to the gym every day but if you don't push yourself each time you go, you won't get faster, stronger or better.  You'll just stay the same.  Obviously, there's a peak physical place you can be but I doubt most of us are there.  There's always room to do it better.  Then there's the "how often you decide right." This right here, is HUGE.  It's all about the choices we make and how often we make the right one.  Do I eat the piece of cake?  Do I opt for a lean protein snack instead of chips?  Do I go to the gym today?  Every single decision we make counts.  We're not always going to pick the right one even when we know we're making the wrong one but what REALLY matters is how often we decide right. How often are we making the right choices day in and day out.  Out of 15 choices in a day, how many are you choosing correctly?  If you chose correctly 13/15, I think you're doing pretty great!  If you chose correctly 2/15, you've got serious work to do.  

So how did I choose yesterday?  Not nearly as badly as I had the week before.  I chose to stay under my calorie limit and I chose to go to the gym.  I pushed myself at the gym after walking 3 miles, opting to ride the bike for awhile as well.  I opted for a healthy dinner and no snacking after that.  Yesterday was a good choice day.

I used to love trashy TV for entertainment during cardio.  This time around, I have been downloading movies and TV shows to watch on my phone.  In some ways, it pushes me to go longer so I can see how they end.  What tricks work for you?