Jeannee

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I just got home today from KC.  I had my psych eval and met with the dietician yesterday.  Today I had the pre op educational class.  Again, I can't believe how much better this group and program is over Solutions for Life!  Dr. Sabapathy (the psych doctor), immediately cleard me for surgery and emailed the surgeons office.  I have a date to meet with Dr. Hoehn on Oct. 1st.  I should get my surgery date then!!!  YEAH!  I'm so ready.  I will update again after my appt with the surgeon.....

FINALLY, the feeling that it might really happen some time in this century!!  I was so close to having my surgery back in June, then the mess up with Cigna.  Then, I thought for sure I'd have my surgery in August, until I chickened out about the surgeon.  I've now been waiting on KC, and FINALLY some things are starting to happen!  I've got my psych and nut eval scheduled for the 13th of Sept.  Then I've got the required preop class the following day.  When those are completed, they are telling me about 6 to 8 weeks until surgery.  So....I'm probably looking at November sometime for my surgery.  

In the mean time, school is getting ready to start.  I've enjoyed having the summer off from studying, etc....and I'm finding it hard to get myself back into the groove of things.  This year I've got to drive to Eldorado for class, as they don't offer A&P on any of the other Butler Campuses.  I do hope gas stays fairly steady for awhile.  I can't afford it as it is, and now I'll be driving an extra 1,000 miles a month!  

I've already planned our vacation for this coming year.  We're going to Orlando!  I had orginally thought I'd have my surgery in June, and would have a good head start on my weight loss by the time we go on vacation in January.  Now I'm hoping I'm well recovered by that time, instead!  I'm sure I will be.  Most people say they feel back to normal in just a couple of weeks.  But oh....it would have been so nice to have 30-50 lbs gone by that time.  I am working very hard on my own right now to take off what weight I can by myself.  I've been so miserable lately and know that I need to take off some weight if I want to enjoy myself in Orlando.  It's just so hard.

Anyway...that's about all for now.  I'll update again when I get my surgery date!

Here we go again.....change of venue once more!!  However this time it is my own doing.  LivLite in Junction City previously did not do lap band.  They have been waiting on their new surgeon to arrive...thus the wait.  He is scheduled to arrive in Junction the first of August.  I misunderstood some of the information when I first spoke with LivLite.  As it turns out, the surgeon that will be performing the LapBand has just finished up his residency.  They assured me that he is well qualified, and has performed over 250 lap surgeries in the last year.  However, when I made them get specific about how many of those surgeries were LAPBAND, well he's only performed 10 or 11!!!!   WHAT?   Nope, sorry......that is WAY TO INEXPERIENCED in my opinion!!  So I've started looking again.

I contacted the Bariatric Surgery Center of Kansas City, Dr. Hoehn, and Shawnee Mission Medical Center.  It turns out that the surgeon AND the hospital are both in network with my insurance.  The hospital was accredited as a Center of Excellence in January, as well as Dr. Hoehn, and his associate, Dr. Hitchcock.  I went to their required seminar yesterday evening up in Shawnee Mission.  It is quite a drive for me.....but I don't regret a moment of it.   Just from the seminar point.....I am SO impressed with the surgeons and the program.  I went through the entire program with Solutions for Life here in Wichita....and they don't even compare.  I am disgusted that I wasted my time and my MONEY MONEY MONEY with Solutions for Life.  I'm not saying that Solutions for Life doesn't have a good program.  HOWEVER.....I am getting all that Solutions had to offer, plus more and without the price tag.  I find it appalling that Solutions for Life is charging people for the education and information and support for pre op and post op patients, that other programs include in their programs as part of the entire sugery procedure without adding extra price tags!

On the down side.....I'm still waiting to have surgery.  I'm having to go through the entire process again of getting all my records forwarded to Shawnee Mission.  They are requiring me to redo my psych and nut evals through their "people".  It could be several more months before I actually have my surgery.  And then there is the drive, the inconvenience of distance and money.  But all in all I'm very happy that I am going there.  I feel so much better and more confident in the experience and the professionalism of this program over Solutions for Life, and the inexperienced surgeon at LivLite.  It will be worth the wait!

Finally a bit of good news.  I found out today that Cigna paid for my gallbladder ultrasound at ViaChristi as in-network, after initially NOT paying it as out of network!!!  I didn't even have to appeal it.  I guess that I raised enough eyebrows by speaking with my employer's benefit specialist, and then filing a complaint with the Kansas Insurance Commission!  The reasoning behind the change was that Cigna DID have ViaChristi listed on their website as a particiapting hospital, as well as being TOLD by their member services personel that it was in-network.  DUH !!! ..... they should have to stand behind what they say!!!  However, I tried to access Cigna's website the last couple of days and it was down for maintenance.  I finally got on today....and they have their information updated.  ViaChristi is no longer listed as a provider.  They are making sure that I can't use that excuse as a way of getting my surgery done here in Wichita.  That's okay.  I've already got the ball rolling now with LivLite in Junction City.  Yes, I'd have prefered staying with Dr. Dort and being local.....but it's not such a big sacrifice that I'm going to die over it.  Good things are worth waiting for, and a few more months aren't going to kill me!

I have learned that when it comes to insurance companies not to take things lying down.  If they are not living up to their end of the bargain....MAKE WAVES!!!!  Let your voice be heard.....no MAKE your voice be heard.  Talk to anyone and everyone you can.  Call back as many times as you need to.  Write down names, dates, and take notes of your conversation.  At the end of the call, let the person you are speaking to know that you want this call documented and on the record for future reference.  This is why they paid for the ultrasound.  There is a disclaimer on their website that states information may not always be accurate and that to insure correct information you must talk to a member service personel.  So I documented those conversations....about a dozen to be correct.  They had to stand behind it.  

Anyway....chalk one up for the little guys!!!  It might not be a huge deal for the insurance company, but a few hundred dollars is a very big deal for me!!!  YEAH!

Well now that all is said and done here are the results with Cigna......
I have appealed my gallbladder ultrasound that was done at ViaChristi which they didn't pay due to being "out of network."  As far as my lapband surgery....because they are now saying upfront before surgery that ViaChristi is out of network....I have to go elsewhere.  Turns out my insurance doesn't carry the rider to allow for in-network benefits for an out of network facility....regardless if there isn't another in-network facility in the state!!  So I'm going to LivLite in Junction City.  

At least I don't have to start all over from scratch.  Everything is already done, they just have to turn in paperwork to Cigna for a change in surgeon and hospital.  That should be no problem and the surgery itself is already approved.  I'm just going to have to wait on LivLite to fit me in for the surgery.  At this point they are telling me it won't be before August.  I am somewhat disappointed...I was so looking to having it done in a few weeks, not a few months.  And I really wanted to have it done and be recooperated long before I have to go back to school.  But hey....I have to look on the bright side.  It could be worse.  At least I know my day is coming!!!! 

Well here we go.....with the insurance hassels.  CIGNA IS FULL OF S*IT!  When I began this journey 6 months ago, the first thing I did was check on the benefits...and to see if Via Christi Hospital has an "in network" provider.  I was so excited when it all came back positive!  So here we are....6 months down the road, and a tenative surgery date of June 26.  Everything has been turned into Cigna for approval...and guess what?  THEY APPROVED IT!!!.....and now the bad news.....
They are saying that VIA CHRISTI is OUT OF NETWORK.....and there is absolutely no coverage for bariatric surgery for out of network providers.  To make a long story short....although I've been "approved"......I've also been DENIED.   Yeah great.  Cigna lied about Via Christi being "in network"....and it seems there's nothing I can do.  I'm going to have to look at going outside of Wichita to have this done.  Back to square one.  Yippie. 

Everything is done now....just waiting on insurance approval which will be sent in for consideration in May.  I had a call last week with a tentative surgery date of JUNE 26!!!! (providing insurance approval) I was amazed at how quickly things are going now that I'm finally done with the process.  At first I was discouraged when I found out I had to go through the 6 month diet....but it has been 6 months of appointment after appointment to get all the requirements done!  I'm actually glad I had the time.  I'm ready to EXHALE! 

Wow.  Didn't realize so much time had gone by since I posted.  Here it is, April 4th already!  My pre-op classes are done and over with.  I decided to go with the Lap Band vs. RNY, due mostly to my physical risks of surgery and DVT's.  I met with the hemotologist, and he agreed to coordinate my care with Dr. Dort when the time comes.  WHEW!  That was my biggest fear, being turned down flat due to blood clot risks.  
     I had my sleep study done Monday night.  That was horrible!  Don't think I could have had a worse night's sleep if I tried!  Nothing like being wired up like an atomic bomb, being told I have to sleep on my back, (next to impossible for me).  At least it's over and done with.  I have a feeling they are going to put me on a CPAP machine.  
     I had my 2nd part of the psych eval today. You know...the test with the million questions.  All that's left now is the nut eval, and finishing up my 6 mo diet which ends May 16.  I've lost a total of 30 pounds since November....Dr. Early's requirement was between 14-30 or somewhere in that range.  Hopefully everything will come together quickly now.  I'm keeping my hopes up that the insurance will approve without any problems.  I've heard so many horror stories about people being denied by Cigna.  All I can do is try.
     Well that's about it for now.  I'll try to post on a more regular basis. 

Well I had my appt with Dr. Early today after fighting with the receptionist or whoever that lady is at the front desk answering the phones.  Aughhhh!!!!!!  I've struggled with her ever since I started inquiring with Solutions for Life about wls.  I called once to talk to Kate Jance, and she wouldn't put me through.  When I called to make my appointment for my physical with Dr. Early, she didn't want to make the appointment.  She basically tried to tell me I couldn't do anything until I was approved by my insurance for surgery.  WELL...even today, when I was sitting in the waiting area to see the doctor...she came out and asked if I had my insurance approval.  When I explained to her for the umpteenth time, that no, I was still in my 3rd month of my 6 month diet, she again began to profess that I shouldn't even have an appointment with the doctor until I had insurance approval.  I told her.."Just let the doctor know I'm here for my appt."  (she finally shut up)  

The appointment went fairly well.  Dr. Early seems to think that I'm a candidate for surgery, but there is a concern about my history of DVT's.  He is calling the surgeons this week to consult, and calling a hemotologist too.  He seems to think everything can go ok, but that it will ultimately be up to the surgeons and if they are comfortable with my health history.  So i guess it's still somewhat up in the air, but i should know something for sure by next week or so.  They did go ahead and schedule me to start pre-op classes on Feb. 7th!  YEAH

Now for the down side.  I've been saving money for the pre and post op education classes.  I knew this was an expense that insurance would not cover, and that it has to be paid prior to meeting with the surgeons.  When i went to check out from my appt. with Dr. Early today, I was prepared to pay the $35 copay that my insurance required.  When that heifer at the front desk smuggly told me, "That will be $285 today."  I about killed over right then and there!!!   $285?!?!?!?!  What the hell??  Aren't you going to bill my insurance???  She informed me that $35 was for my copay.  And then she added that $250 was for the Administrative Fee.  WHAT THE HELL IS THAT?????  I was so mad.  So, there went HALF of my money for the pre op classes.  I'm still pissed.  $250 !!!! 

I have a list of "TO DO's"  I have to have a sleep study done.  I have to meet with a hemotologist.  I have to have my psych and nut evals done, and I have to lose between 14-30 lbs before my surgery date.  Oh...and I have to save some more MONEY....to make up for the REDICULOUS ADMINISTRATIVE FEES!!!!  LOL...yes i'm still venting.  I'm wondering how many more hidden costs are going to be thrown at me during this process. I did learn that the $360 price tag for the PRE-OP classes is actually $660.  They charge an additional $250 for education materials, and another $50 for some health assessment fee or something.  (probably nothing more than the weekly weigh in), afterall....I've had the physical exam already.  What other assessment will there be???  So far, that's almost $600 altogether that has been added on to the price I was told.  

At least the process is started.  I'm grateful for that.  Now I'm keeping my fingers crossed and saying prayers that the surgeons will feel I'm a candidate for surgery. 

Well here it is, 2007!!!  I've just returned from a vacation to Cancun...8 days and 7 nights of pure heaven.  No work, no school, no kids...and I loved every single minute of it.  Considering that I've never seen the ocean before, the blue water was breath taking.  My only regret was visiting at my current weight.  

Now that the vacation is over, it's time for reality to set in again.  I have to return to work in the morning.  Back to setting the alarm clock for 2:30am to be at work by 3:30...aughhhh.  School starts back up on Tuesday.  Back to the old grind stone.

I've been to my PCP twice now for weigh in on my 6 month diet.  Things aren't progressing very well...but I have lost and not gained.  I has terrified to weigh in this month as my appointment was the morning after flying in from Cancun.  This past month not only included the Christmas holiday with all the goodies and feasts, but my vacation as well.  (all inclusive, all day buffet, etc. etc. etc.)  I was sure I'd put on 10 pounds instead of losing.  I did however join the YMCA about a week before leaving for Cancun and had been walking and doing water aerobics every day before leaving.  I didn't work out while in Cancun, but we did alot of walking and excercising sight seeing and snorkeling.  So...to make a long story short, I was able to lose almost 4 pounds this past month, despite the holiday and vacation.  I'm down a total of 8 pounds for the past 2 months.  Not losing as much as the doctor would like me to...but hey...I'm satisfied.  At least it's moving in the right direction!!!