My first appts at MMPC

So I had my first two appointments yesterday at MMPC.  My first appt was with Dr. Karen Gawel.  It was to go over my medical history and do a physical.  Plus she did an EKG.  Overall it went well.  But unfortunately when we got the point where we discussed what surgery I was considering, she informed me that my insurance doesn’t cover the VSG (Sleeve).  I talked to her about my arm and that I do take Alleve/Naxopren(sp) for it, but she said “once a month was not enough to justify it with PH.”  She said she would suggest the “Roux N Y” surgery.  Plus she said that I would see better results with that surgery than the sleeve.  Needless to say I am a bit bummed.  I still think this is the right choice for me, I am just really nervous about the surgeries that move around things and mess with the intestines.  Obviously I need to start researching the RNY and decide if it really is the right one for me.  And then during the history part where we were discussing diets, etc that I have or have not tried, I started thinking “gee maybe I should try Weigh****chers again or that diet she just mentioned.”  She made me feel very comfortable and never once made me feel like a fat lazy slob sitting in front of her. 

 

 

My next appointment was for my 1^st of 2 psych evals.  I wont mention who I saw because I didn’t care for that person at all and it will come through in what I am about to say.  I don’t anticipate that anything I said or didn’t say during this eval will be a cause of alarm and make them think “yeah maybe she shouldn’t have the surgery.”  First of all this person reminded me one of my old supervisors and honestly the only supervisor I have never gotten along with in my life.  I went into the office and being an observant person I immediately noted that one of the degrees on the wall was from Calvin (a Christian Reform college here in GR) and there were other ‘hangings” on the wall that led me to believe this person was very religious.  From someone who has a counseling background, I immediately took offense to some of the other stuff on the walls.  I am a firm believer that as a counselor/social worker, your personal religious beliefs need to be kept out of your office, unless your office is located in a church or a private religious setting.  To give this person fair credit, I was probably a little touchy to begin with because I had started questioning if I was making the right decision and I had my hackles up over the “religion” aspect in the office. 

 

 

Throughout the conversation, I fully expected this person to say to me “well perhaps you should have tried harder at x program or done more exercise or done this instead…”  I kept having to remind myself that they see a great amount of people every day and I am just a number, nothing more…So we get to the “background” questions…ie) are you married, kids (how old)….okay fine we are moving along…when bam out of nowhere comes the next questions “Do you believe the Bible is true?”  UH?????  Did they really just ask me that????????  So me being me…”Define true…”  The look on their face was priceless!!  I wish I could have taken a picture…it was like “Oh one of those...”  After they mumbled and stumbled for a second, I was nice and saved them….”if you mean true as in 100% factual, then no, I don’t believe that…if you mean is it a good book to use as a guide for making good choices in life, then yes I think it is that…”  Seriously what does that question have to do with a psych eval for a WLS??????!!!!!????  They also asked how committed I was to my spiritual journey…I said a 10 because I think I am and I really don’t think my spiritual journey is any of their business.  And then to top it off, when they finally got around to asking me what my highest level of education was…I responded “A Master’s Degree”…”Oh, you do? In what?”  Seriously people like this **** me off!!!! 

 

 

After that appt, I had to complete two standardized Psych evals.  Both were standard and nothing too shocking…well except for few questions that were mixed in the longer of the two evals. I know those questions are there to see if someone is a pathological liar or just filling in the bubbles, but it was rather humorous!! 

 

 

Anyways so now I am off to research RNY and see if that is something I want to consider.   I am frustrated a bit and feel like I am having a minor setback, but I know that I need to keep moving and not give up easily!!  If you had any thoughts on the RNY, I would love to hear them!!!          

 

Kelly, I'm saying this as a 100% Christian and a pretty spiritual person: You need to report this person to the administration.  This really is totally and completely unprofessional.  I know that you are going through some things as you prepare for surgery, but please take a few minutes and make a phone call or write a letter.  This shouldn't happen to anyone else.

Thank you Brenda for those comments!!!   I am also a Christian and in fact in the process of joining a new home church.  I am obviously a little nervous about "contacting" the administration because he is an actual employee of the practice that will be doing my surgery.  But I know that I need to say something. 

Good for you!   I wish you the best in researching and learning about surgery and other options.  You can always post here with questions

Dr. Karen Gawel also told me that my insurance would not cover the VSG and that I should have the RNY.  When I saw Dr. Foote he asked me which one I was interested in and I told him the VSG.  I cant have the RNY or DS since have already had resection of small intestine and colon.  And he agreed that the VSG would be better then the lap band for me and they sent in an appeal to BCBS.  Took six weeks but my insurance agreed with the doctor and I will be getting my sleeve next month.  My insurance normally covers the VSG as a first step to DS and with a BMI of over 50.  Talk it over with the surgeon there may be a way to get what you want.  You may now only be taking medicine once a month but that will probably change with time.  Good luck. 

Hi Kelly -I had the exact same experience with the exact same staff at MMPC.  Gawel told me that I couldn't have a VSG because of the Gerd that I have.  Dr Foote had no trouble with that.  My insurance didn't pay for it because it has an exclusion against any surgery but there are many people that have had insurance pay for their VSG.  So don't go by her.  Go to the VSG site and see how some got it. And the Psych did the same to me.  He went on to talk about gluttony and sin, get my drift or should I say his drift.  All I did was play his game and got the approval and got out of there.  I was insulted by his tactics but if he neded me to swing a dead chicken to get my ok I would have! Everyone else I have liked.  Dr Foote is great!  The nuts are good and there is only one PA that I don't care for. Anyway, don't let anyone deture you from you goals. Carole

Aww - Kelly.  I am sorry that your insurance doesn't approve the sleeve.  Will the Drs office try to get it approved for you? I liked Dr Gowel too.  AND I know who else you are talking about.  I didn't give the religion part of  it another thought since - well for one, I too was put off a bit just by personality.  And also since I am kind of in the prodigal child mode, I was taking it more as that they wanted to know that I had some sort of spiritual support.  Although I haven't been to church in over 2 1/2 years, I still remain in contact with my minister....if I don't she tracks me down!   I was way more concerned with trying to explain the lack of support from my totally dysfunctional family.  I stumbled thru that part by trying to not get into it too deep, but he hasn't called me back in for another eval - like he said he would if my therapist's review didn't sit well with him - I am in the clear. I hope that things work out for you and you can get the sleeve like you wanted.  (I am wondering now if I should go for RNY since I happened to talk to an old friend who had RNY done by Dr Foote  just over 2 yrs ago is down over 200 lbs!) Keep us posted!! Gwen

Wow! Kelly, I am sorry your are experiencing all this with your pre-op appointments.  BTW, Dr. Foote was my surgeon and I was pleased with him although I saw little of him once the surgery was over.  Dr. Baker was the one that actually visisted my in the hospital.   But, it was on a Saturday, so I figured it was his weekend to be on call.  However, I would have preferred to see the dr. that did the actual surgery seeing as I had already built a professional relationship with him. As to the Psych Eval.  Were the persons initials SG?  Just curious. Keep us posted as to how you come out.  All the best to you! Pam

Kelly, I forgot to mention that I did have the RNY and am quite pleased with it.  My weight has been stalled for a while but that is my fault for not working the program as I should. Pam 

sounds like these types of questions are a regular thing with the psych guy. i am right there with you. i answered.. grudgingly.. and just moved on to other things.  don't get a surgery you are not 100% comfortable with. if you went in wanting the sleeve, i believe they will help you appeal for it. if not, ask about the duodenal switch with "plans" to do the 2nd part at a later date (read: never.).  good luck with your next appointments and the journey in general. i had my preop orientation on feb 4 and i am having surgery on apr 23.. so they can move you along pretty quickly. jodie ETA: i was at MMPC at 1pm for an appt on the 15th. we might have been there at the same time! ha. i just remembered that. i was there for my 'product check' appointment and 1-week weigh in. i lost 20 pounds the first WEEK of the preop diet. awesome, eh?