julieandmaddy
Well, I am starting the process all over! I was on the wait list at Portsmouth Naval Hospital in Virginia for 8 months and have relocated to central Missouri. I have a support group meeting and Drs. appointments scheduled and I hope to have the surgery in the next couple of months. I am sad to find out that the surgeon here will not use my previous tests, so I'll have to start from scratch. That's okay, I am not getting discouraged!
11-10-04 I am so mad! I found out that even though Tricare initially approved my referral to civilian surgeon, I've been waiting for an appointment for 6 weeks for nothing. They took my referral away with some cockamaymie excuse about me not qualifying. They said that even though I was ready to have surgery in Virginia, different areas have different restrictions and guidelines. When I asked for the guidelines, they told me they aren't set in stone, they consult on a case by case basis. I guess being 5'1" and weighing 215 pounds isn't bad enough, having comorbidities doesn't count, in the words of the doctor, "It's not like you're going to die tomorrow"-- from pain in your joints, stress urinary incontinence, infertility, PCOS, increased (for me, anyway)blood pressure, history of cancer, high blood pressure, cholesterol, diabetes, heart and lung disease...all of which are considered problematic, but not deadly? I also found out that the doctor that I originally saw has a wife who suffered some very serious complications from gastric bypass, so apparently, he rarely refers anyone. Well, I am very sorry about his personal experience, but what about ME!!! Anyway, I am not ready to give up yet!!
2-8-05 I am absolutely amazed that I finally have convinced my military doctor that I need a consultation and I was approved! This has been nothing short of a nightmare and I have been working up the nerve since November to go back again. Well, this time, I saw my real PCP, who was on TDY last time. She grilled me, I cried, I begged, and when she got snippy, I snipped right back. She figured my BMI to the T--I am 5'1.6" and this resulted in a BMI of 39.8. She wasn't sure if that would qualify me or not. The end result? My initial consultation is in 8 days!! I can't believe it...now if Dr. Hornbostel is as gung ho about this as I am, I will hopefully have surgery before school is out in the spring...Keep the prayers coming!
2-17-05 Went to see Dr. Hornbostel yesterday. At 5'1", I am weighing in at 221...he said my BMI is 42 now. No questions, just asked if I was ready to proceed with surgery. We talked about the procedure, the diet pre and post op, asked me if I had questions, most of which had already been answered. I was very estatic when I left his office, I am so used to Military Dr.s and you have to fight your way through them. When I was speaking with Dr. H, he looked me in the eyes, he seemed very knowledgable, I am very comfortable with my decision. Now, I just hope that Tricare feels the same way, and we can get a date on the books! I am trying not to get too excited, for fear they won't approve me, but the Drs. office seemed pretty confident that there won't be any more problems or delays...I hope so, because he told me not to gain another ounce and to lose some if I can--we'll see what happens!
2-19-05 I hate waiting. Today would have been my 7th wedding anniversary, but we separated in August of last year. That is definitely for the better, we were very volatile together and I'm sure it was heading toward physical abuse. Back to the waiting...I talked to Tricare yesterday,and I know it had only been two days since my consult, but miracles do happen, ya know! I talked to a really nice girl at Tricare, which is unusual, of course, they didn't have an approval yet, but she said give it a couple more days, it might be there by Wednesday or so of next week...she also said she didn't know what made them deny or review, but we'll keep our fingers crossed that mine just flies right through the system! It is hard to stay positive when your life is in someone elses hands!
2-23-05 Holy Cow!!! I called Tricare last night, not really thinking that they would have an answer, but hoping I would be pleasantly surprised. Well, they didn't have an answer, but while I was on the phone, she said,"Well, I've never seen anything like this, before!" Of course, I always think the worst, so I said, what, they denied me--No, it just popped up, you're in review! Well, as it turns out, that is a good thing, she said I would know in a couple of days one way or the other. I couldn't hardly sleep for wanting to call. I managed to make myself wait until after class today, which is noon, and called while I was on my way to my car. I got this really great guy at Tricare, he was so helpful! I asked if there was an authorization for surgery, but didn't specify GB...he immediately said YES!! He didn't even have to search, it was right there! This never happens so easily for me!! Anyway, he said, Oh, you're having GB, can I ask you a couple of questions? I said sure, and we had a great conversation about the pros and cons of the surgery, I just wish him all the luck! Anyway, I had them fax it to Dr. H's office and now am just waiting on the date and preop stuff...Yeah for me!!
2-28-05 Well, if there is a hoop, I must jump through it!! Last Wednesday, I called Tricare, they gave me an approval number and said YES!! I was surprised and excited all at the same time! So, I called Friday, the first phone call was forwarded to a desk where the people were standing around talking to each other, so as I was YELLING "HELLLLLLLOOOOO" they were laughing and having a grand time. I am thrilled that the girls are going out this weekend and they are gettin' their groove on, and why not come too? Yeah. So, after about 2 minutes of trying to get the attention of the rep, I finally hung up and called back. This time, I got the woman who was "just so swamped with phone calls, she didn't know if she'd have time to fax my authorization or not, at least until late in the afternoon". Now mind you, all I am asking is that you type a command into your call center computer, which I have had done for me before while I was on the phone with them! Anyway, I called the Dr.s Office Monday to be sure they got the fax, and what they got was the authorization for my Consult, which has already been paid, not for the surgery! So, I called Tricare back, they said I am not approved yet, they now need more information. EEEEEEERRRRRRRRR!!!!!! I just wish they would make up their minds and make sure that it is in the computer correctly, and then leave me alone!!! At any rate, Deanna at Dr. H's office faxxed them whatever it was that they supposedly needed, so now it's back to waiting....hoops hoops hoops, I should have been a circus act!!!
3-1-05 Called Tricare tonight. What an emotional roller coaster!! The first girl I talked to said Oh. Yeah. Here it is, it's denied. She used the most flippant, nonchalant tone I have ever heard!! Then, she scrolled around a bit and said, Yep, it's denied. I asked if she could tell me why, she said no, it's just denied. I welled up with tears and asked if there was anyone in the US that could tell me why, because I've been fighting for this for almost 2 years now, and just 7 days ago, I was approved. She said, Oh, don't cry, this is normal. They are always denying things! SSSSHHHHHHUUUUTTTTT UUUUUUUPPPPPP!!!! Of course, I didn't say that, I just waited for her to come up with her own brilliant bimbo plan! I shouldn't talk like that about people. That is not nice! Anyway, she transferred me to a woman with compassion and a brain in the approval dept. She said that amongst the paperwork mix ups that had been experienced with my request for surgery, I have not been denied, but put into Medical Review. The original request was on the 18th. They needed more information, but before my dr. knew that, they resubmitted the claim because Tricare had yet to reply to the first one. When they found out they needed more info, that was faxxed too. Unfortunately, last week when I was "in review" it meant they were looking to see if they needed more info, not actually checking my paperwork out. Now, they have all the info, supposedly, and I should know something within 1-5 business days from the 25th. Big relief. I'm not approved yet, but I am not denied like the other girl was insisting. Thank you to the second rep who had the heart to dig through my file screen by screen to sort out the whole thing, which is very confusing! Now, let's all say our prayers that I get approved, I should know by Friday, the 4th of March. I hope so, because they are already scheduling early April, and I don't want to go much later than that because I'll be into finals week in school the first week of May, I can't afford to miss all those classes, but I sure ain't putting off the surgery if they schedule it! Oh, it will all work out, it always does.
3-2-05 Do they EVER get the story straight? I started out this morning, walking into my building at CMSU. Phone rang, it was Deanna at Dr. H's office. She had received a fax in the middle of the night saying Tricare needs more information, primarily, documentation of sleep apnea and arthritic joints in my knees. I am not happy with this conclusion, because before I knew the system, many of my medical records were lost (a perk of being in the military system, I suppose) and I was not really sure how to get ahold of my surgeon who began my case in Virginia without it taking days and plenty of voice mail tag. I decided that after class, which by the way, was the longest 3 hours I have endured for a long time, I would go to the clinic at WAFB and talk to someone until I was able to go through my medical record myself and find the information that they think they needed. As I was pulling into the parking lot at the clinic, Deanna calls me back and says "Guess What! You're approved!! I just got the fax and have already sent it to Bothwell, we're just waiting on them for an okay. Your tenative date is April 12!!" HOLY COW!!! I did not believe her! I wasn't sure how to feel, so I asked her if she really had the approval letter in her hand, and she did!! I am so excited!!! I can't believe it is finally REALLY going to happen!! Thank you, Lord, and thank you, Deanna!!! Funny, how when you finally start to grasp the lesson God is trying to teach you, the ball really does roll!
3-10-05 Finally have a date!! It's set in stone!! I am to report to Bothwell Hospital at 0615 the morning of April 12, 2005 to rearrange my insides!! I am so happy, it seems that it isn't real! I have been fighting to make this happen for so long that when the Dr.s office called me yesterday, I was excited, but not surprised...I knew it would happen, I just didn't know how long we would have to fight about it. I did have to laugh though, I got a copy of the authorization in the mail a few days ago. When I got home yesterday, another letter awaited me, they are requesting more information. Gotta love em. The requests crossed, I suppose. All the problems, and I have 2 requests in the system, no one was smart enough to look and see that they had already taken care of all of it. It's the joy of computers, I suppose. Anyway, I'm happy, I have preop on April 5, then surgery 1 week later. Talked with my family about it last night. They don't understand why I want to have the surgery done. They don't feel that I am "morbidly obese" as that is a term used only for people so large they won't fit through the doors, who can't walk at all, whose health is so declined they are confined to bed. We had a lengthy discussion of why I am going through this, and my mom's final question was "What if you die, because that's what this surgery does, is kill people." I can't make them understand, I can give them information, but they don't see it from my eyes. My mom said, if you're "morbidly obese", then I guess I am too. I said without knowing your specific statistics, yes, you probably are, she's about my size and height. I don't know, I get so tired of justifying my actions, and I know they love me and they want the best for me, but they also need to realize that I am their daughter, but not their child. I have made my decision, and I am not asking their permission. I hope I have their support, but if I don't, I will make it without them.
3-12-05 Happy day!! My pic is now posted! I am standing in the right corner above my dad. My sister is next to me, my mom, my daughter Maddy, and my neice, Jenna. As you can see, pics are hard to come by and I don't have any of just me. I am usually the one to man the camera, so as to avoid that issue. Clever, huh. I hope that changes after surgery, because I want my family to remember what I look like someday! I don't want to be afraid to look at pictures of myself anymore!
4-16-05 Wow, it's been a minute! I'm home from surgery now, it was on the 12th. Had surgery on Tuesday, came to my mom's on Thursday, and now, Saturday is my first day in my own house. I'm a little sore, run down, but overall, I'm absolutely amazed at how much easier that it has been so far--I had myself really psyched up for unbearable, and although it has not been even close to easy, the pain hasn't been awful like I'd expected and I seem to be bouncing back pretty well. I'm off work and school until next Friday, so I have a week to get caught up on all my school work, and hopefully, I'll be able to tolerate a whole 12 hour shift on Saturday and Sunday night next week. We'll see...I'm not going to kill myself over it! I can't wait to get through the next few weeks to see what they hold...I still can't believe that after all of the fighting with the insurance, I've actually acomplished the surgery! It still seems kind of surreal to me, I guess. Well, I hope the rest stays as good as it has been so far, I'll keep it posted! Oh, I am down to about 195, I went into the hospital at 204, so 9 pounds this week, I'm not complaining!
