arrrrrrrgggggggggggghhhhhhhhhhhhhh and not of the pirate variety

So I finally get a message from the psychologist who was supposed to write my evaluation for weight loss surgery. It has been about a month since I went to the second of two visits to her office. She acted like she was going to get on the evaluative report right away but I was WRONG with capital letters. Apparently since the hospital is not scheduling any more surgeries until February (according to her message) she finds it unnecessary to write my report until the new year. Now call me CRAZY but the way i look at it. If they under high demand and cannot fit anyone in until February that means that my psych report should get in there as early as possible so that I can get into the queue as quickly as possible. I want to be ready the first part of Feb not F***ing March!!!!

On a good note we got really cheap tickets to visit Madrid for spring break. One of my older daughters will be studying there for a semester. I think it will be fun! I was hoping to go a bit slimmer but at this rate Ill be on liquids if im lucky-and likely have to go to Spain for one last fling before I get to have the surgery. arghghghghghghghghg

Tina

I have a bruise on my butt the width of the edge of the bathtub

Its Sunday-there is one more wall to tile; all the walls to grout and the floor needs grouting too. The toilet is still in the bathtub, the bathroom cabinets are in my entryway and the sink and counter top are in my office. To top it all off I have people coming over on Tuesday for a Christmas get together. Hmm am I going to finish the bathroom in time? Cross your fingers--if I manage it I will take a picture and post it. I got the bruise from sitting on the edge of the the bathtub reaching in to apply the tile adhesive and put the tiles onto the wall. Ouch...it hurts!

Tick Tock......

The Weight loss saga

Ok well another week has come and gone. I called the doctors office and They said I was missing the Psych evaluation and a blood test. I did the blood test in their office! So she ruffled through some papers, making excuses as to how busy they were yada yada yada....She then found the blood test results. and then she actually opened my record I'm not sure how she was telling me the other information without opening my file but who knows the system right?? She confirmed that I was missing my psych evaluation.

So I called the Psychologist who was supposed to write a letter and short report to the doctors office. She acted like it was going to be quick when I was sitting in her office but..despite my message of instructions, she had not written the report. She called and left a message asking for the contact person and further instructions (instructions and a name I had given her a week before). I called her back and retold her the contact information. (You never actually talk to each other just phone tag!) ARghghghgh. Maybe next week I will have all of my tests done??

Glasses

My husband went back to the eye doctor with me to see if there were any less expensive options. It turns out the lenses were the big ticket item on the bill (read below if this is vague). So we talked about my options or according to the sharks lack of choices. I felt like I as trying to buy a used car!!! Some of the statements from them were...."this is the same lense you bought last time"... "Those other places are like Pay less shoes not a quality product"..."We cant sell you a less anything that is that much cheaper"..."You aren't going to find this product cheaper anywhere else"..." They even passes me off to another salesperson!!! We left the shop and drove over to Costco. Within 20 minutes I had a perfectly nice pair of glasses for $179 and that is without my insurance paying a dime!!!! I sure hope this is a business specific problem and does not represent all of the glasses industry!

Bathroom Remodel

We gutted the main bathroom a few weeks ago and I have been working like a dog to get it finished. Last night I put up white subway tile on the walls. Today I am hoping to finish the rest of the room (shower stall to the ceiling and wall behind a toilet and cabinet). The toilet has been sitting in the bathtub while we put the floor tile in...I cant wait to get it online again so I can get the kids out of my bathroom!!!

No word yet and what is with the glasses industry these days?

well its been more than a week since I completed my final test. I haven't heard from the doctors office yet. I will call on Monday and see what is going on. I'm sure there is some sort of Murphy's law curse on my head and they will have lost all the records or spilled barium on them or something.

Off topic but highly interesting in a What the F*** kind of way. I went to the eye doctor today because it is time and because my eyes are killing me at the end of the day. Anyway she changed my prescription and I went out to the opticians part of the office to pick out some glasses etc Well I did. They were kind of expensive but I asked the optician (AKA shark) how much my insurance covered and she said something like 250. The frames were 300 so ok not so bad right? Ill pay the difference. When it was all done she billed me 600 dollars for a freaking pair of glasses and that was after applying the insurance coverage. I have never had to pay more than hmm 125 over the insurance and that was for a pretty nice designer set of frames. I am not going to spend as much as it costs to buy a new couch on a stinking pair of glasses! Who pays that kind of money? I called my parents who have no eye insurance and also wear bifocals (yes I am old and need granny glasses) and asked them how much they paid at Costco for theirs. Their bill was 240 and they had scratch coats, included the exam, high index plastic and progressive bifocals. Well sheesh-why the heck are we paying for eye insurance if we can spend 1/3 the money without the stupid insurance.

I am not a happy camper and I am hoping that somehow the woman screwed up big time-1100 dollars before the insurance was applies 600 after. arghghghg there is no way im paying that.

The dog was missing

On Wednesday I went in for my second Psych evaluation meeting. I found out that my doctor is a psychologist (as per her business card). I was instructed to take an evaluative test for weighloss surgery patients. It was a really bad test as far as I could see. One of those true/false things created by the evil test companies who also own the text book companies written with the express purpose to make as much money as possible-arghghgh. I did it though-went through each of the 100 or so statements dutifully with the number 2 pencil marking false false false false false-i think there were maybe 5 statements that I could even remotely mark as true. It was really a test to see if I was certifiably crazy, had huge eating disorders etc. Not subtle at all. I took it in about 10 minutes while the psych left the room (she said she would be gone for 20 min to make phone calls but really she ran down to the local coffee shop for a quick cup of jo-came back with it in her hand). I spent the rest of 20 minutes reading my book (Karen Armstrong..hmm up the spiral staircase i think??) It was really a good read! Anyway back to the topic.

the psych asked me if i wanted to say anything more-I didn't. She tried to call the drs. office to find out exactly what they wanted her to do. She got a receptionist on the phone and asked the following questions: We are done what do you want me to do with this information and what format would you like it to have? The receptionist could not comprehend the questions. When the psych asked to speak to her superior the receptionist freaked out, put us on hold for a very long time and the psych finally hung up the phone. It was both surreal and typical of my experience with the practice of medicine in the big city. Once a medical practice gets too popular the attitude shifts from one of welcome and patient centeredness to one of filtering. The staff around the doctor or doctors become more and more a shield and the patient gets little information until they are allowed through the shield to the inner sanctum. I feel that I am basically a well educated, proactive person but there are times when i am ready to say screw it I dont have time for all of this testing, reintroductions phone calls, demanding answers crap. The problem with this attitude is that I really want to get the band! and hope with all of my fibre that it works and that I can work it. sigh....

Well after my psych gave up I called them back and played a little phone tag until I got hold of the person in charge of scheduling (I think this is her job anyway). She curtly answered my questions (I just asked the same ones as the pscyh-what does she need to send to you). This person said a letter stating your suitability for the surgery. I answered that is all? she does not need to include some sort of psychological work up? Then the person said oh yes that too. I said and what form is this supposed to take? Do you have a desired format? She said no just a letter. arghghghhggh So I called my psych back leaving her a message that said. They want a letter stating my suitability for the surgery and to then write a report that looks like a pcyhological evaluation. I told her in the message that I did not get a clear answer as to format but that the best strategy in my mind was to wing it!!!

arghhhhhh So after all of this testing crap I find they dont really know what they are looking for?

So now I wait. Im not sure what I'm supposed to do. Will they call me? should I call them? the clock ticks. I would really really like ot have the surgery before Christmas but Im not holding my breath.

Am I psycho?

so yesterday I did part one of two visits to to a psychologist or psychiatrist (not sure which she is-she is a Ph.D. on her card). It was ok. Now im not a hater :) as my 18 year old daughter would say but can someone please explain to me what the implications are for a psych professional who spends all day with her dog in the office? Im sure old Sigmund would have a field day :). Is it a deep sense of lonliness and inability to spend time all alone? does the dog not deal well alone? I have to say it is a tad annoying as I am not a dog person myself. I dont have a personal hatred of the canine species but i would prefer that my hand remain unlicked and bits unsniffed when I am in a place of business.

so back to business-she asked me to tell her my 'fat' story. She didnt say those words I put her longer more sensitive question into the nutshell. So I went through the whole i was always big. Mom sewed my clothes because there weren't any that fit right or Husky sizes were too expensive. Of course I wasnt all that big looking at the pictures today but like most people my personal fat feeling was well in place quite early on. Soooo the medium chubby slightly overweight child hit adolescence and remained chubby until adulthood when I met a man and blossomed into a bit chubbier adult. Finally drum roll-the children and nursing F***** up my weight in a big way (or weigh) as the case may be. I went through my dieting history-the unhealthy high school starvation diet. Weightwatchers times 3, high protein yada yada yada. Then talked about my most recent diet. Again it was weightwatchers with a very successful friend who exercised her butt off and worked the program to a loss of 90 pounds. I lost a respectable 44 and stopped dead, gaining about 10 back before I gave up after more than 2 years of trying. Part of it was my sad ability to work the program while the other half was my inability to resist the deeeeeeep hunger that devleoped over the period of time. At one point i felt like-oh my I am going to use a dog comparison maybe I am all wrong about the psych lady :)-Those starving dogs who sit next to your table watching each morsel as it is carried to your mouth and then drooling all over the carpet. Well that was me. I craved foood, any food and i lost it sliding back to my high school crazy days of binge eating.

Ok so after the first meeting she wrote as I talked. In two weeks I will take some sort of a survey that they give to weight loss surgery patients that will either reveal my dieting and eating profile or allow me to pass onto the the long awaited big daddy appointment with his highness the drum rolllllll please.... surgeon. My big worry is after all of this the great and mightly OZ will say....holy crap what if he is behind the curtain! :) ahahahahah.

Getting a grip now- that the OZ will say..whoops sorry you failed the Upper GI or your insurance coverage changed in the last 3 months and you no longer qualify , or you dont qualify for lapband but we have this nice liquid protein diet you can try....the list goes on.

of course I would like to think that I would have a hissy fit if this happens, stand up for myself and demand that they treat patients with more respect and kindness and that they should have never let the tests continue if I was no longer qualified. However I know my real response would be blubbering bawl fest with red nose and puffy eyes even though I was really mad as Hell.

Slowwwww Poster

A lot has happened and not so much has happened. Since my last post I have passed (I think) three more testing hurdles in my quest to meet a real live surgeon.

Test #2-met with the Nurse Practitioner. She was very nice and thorough. The main purpose of this meeting was to document my medical history and tell me about all of the remaining tests to be completed.

Test #3-Upper GI test. This was not very fun. First I had to drink liquid poprocks (the most pleasant part of the test). I then had to swallow the foulest tasting shamrock shake :) not really a shamrock shake but very similar in its nastiness. I got to drink the magic milkshake in thick form, medium and even runny while standing up, laying down, spinning in circles etc. The technician found a haital hernia (small). I wasn't and am still not sure if this is a deal breaker but they have continued to call me for more tests so I am assuming it is not. I also popped in for some blood tests.

Test #4-Motility and acid test. All I have to say is pray you never have to do this test! They snake a tube up your nose and down your throat. I do have a pretty good gag reflex and it went into overdrive as they slide the tube down my throat while swallowing water. I puked every bit of water that went in back out again three times. After they finished the motility test they pulled the tube back out again and joy of all joys-they pushed another (although smaller) tube back in its place. They attached a computer monitoring devide and I had to wear it home (soooo beautiful and attractive!). I would highly recommend bringing someone to drive you home if you ever have to have this test (the drs office said i would be fine to drive. I could drive but I was not feeling good) It took everything I had to keep that tube in for 24 hours and click the little button everytime I ate, drank or reclined. I did it though and 24 hours later they yanked the thing out and I was tube free again.

Soooo I have only one test left-The psych evaluation. I have an appointment for Tuesday and then again the next week i believe. After this I have nothing left but to meet with the surgeon. Hopefully I have really passed the tests-If I find out that I went through the tube and they arleady knew I didnt qualify I am going to be totally mad but I am hoping against all odds that No news is good news at this point.

I will try and post again after my psych appt. on Tuesday-hmm do you think she will think Im crazy? :)

Appointment 1: The nutrition filter

I went to my first appt. It was with the nutritionist. It went pretty well actually. My guess is that the purpose of this appointment is to see if they think I'm capable of making the changes necessary to be successful with this band thing. She showed me what my stomach would look like after surgery using a Nerf football a band and an egg with silly putty in it. I have to say it was a brilliant visual. She even opened up the silly putty to show me a model of what my food will look like when in the egg sized stomach. We went through the protein requirements, the pre-op diet (yay hooray no liquids), the post op diet (each phase will probably last about two weeks as long as my stomach can take the next level of food). We had a lengthy discussion about vitamins. I had no idea that you couldn't just toss all of your daily pills back and once and be done. I guess this is not a good idea when taking vitamins because there is only so much you can obsorb at once. She said that i shouldnt take iron with calcium (at least 2 hours apart) and that my calcium should be taken spread out over the day. Im not really a good pill taker but Ill have to give it a try I guess. The best part of the whole thing was that I think I passed. I made brownie points for having read up so thoroughly about the surgery and living with the band and she said so. So for now all is good. My next hurdle is the nurse practicioner next week.

The wheels have finally started moving! My records are at the bariatric doctors offices. I called to check and was allowed to have an appointment! well actually two. With the dietician and with a nurse practicioner. My first appt is September 7 and then another on September 14-Fingers crossed that at least this phase goes smoothly.

Sloooooow Dr's Office

Well....I was wondering why it was taking so long for the bariatric office to call me and I called. I decided it wouldnt be too pushy to call and make sure all of my paperwork was in order. Well I wish I had called sooner. Despite the fact that I had requested that my records get sent from my primary care doctor it had not been done! So almost a month later I called my doctors office back and they said that I was supposed to call the records department (not what the previous person said). So although irritated as heck I filled out the request form and faxed it directly to the records department. Well this time I wasnt going to trust them. I called the records department three days later to check and guess what! They didnt know what I was talking about! They needed yet another 24 hours to figure it out. So i waited another 24 hours and the person didnt call back. I called the records department and the doctors office (with no patience left at all!) Finally i got hold of both people and they suddely caught a clue that they had messed up big time. According to the records person both written requests for records had been placed in the back of the record and then refiled-Arghghghghgghgh. On top of all of that the record was not complete (not sure what was left out) and it all needed to go back to the primary doctors office for 'added' paperwork before it could be sent. This time my primary doctors office called me when the work was completed and the envelope was on its way to the bariatric doctors office.

Now Im all about privacy and personal rights but please there should be some way to share these records in a more timely matter-even electronically. So so frustrating. My guess is that I am not supposed to start counting the 4.5 month wait until I have actually seen a doctor. Goodness knows when that will happen! at this rate it will be another year before I actually have surgery.

Man all I have done is complain-does that mean im pessimistic? I'm definitely sarcastic-I keep trying to think positive but I think im spoiled. Maybe that is a U.S. thing? It annoys me that I have to wait for the doctors office to call me instead of be proactive and me calling them.

Two seminars and paperwork sent

Well i just noticed it has been a full month since i last posted on here. Since my first post I have attended not one, but two surgury seminars. When I posted last time I had an appointment for the seminar with one of our local bariatric surgeries but after that I called the other office and they invited me to a seminar in three days! So I will talk about both seperately:

seminar 1

The first seminar I attended was one held by the bariatrics office that is part of a research university. This session was very low-key. First there was a presentation by the dietician and then another by one of the surgeons. As a teacher myself I find that I am very critical of poor speakers sooooo beware :) The dietician was not a good speaker at all! She went over her PowerPoint slides faithfully and when the audience asked questions she managed to play the game of master politicians everywhere-Do not commit, avoid a straight answer and say nothing! The surgeon did a better job of explaining the various surgical options, results etc. I was a bit disappointed in that he didn’t talk about any research. He did talk a little bit about expected results, complication possibilities and basic rates of those complications. This surgeon stated that he preferred RNY surgeries solely because they had a longer track record in the U.S. (given that I am most interested in lap band this sits uneasily with me).

I have read in other blogs that it is common to look around at fellow attendees to see where you measure up. My husband, and I were no exception. We looked around the room and found a mix of sizes in the audience-bigger, smaller, in wheel chairs, older, younger etc. Some of the questions-well as a teacher I don't like to say this but they were just plain stupid!-Why is it that people in all settings feel the need to make everything into a personal consultation for themselves?! The rest of us gain nothing from hearing the answer as to whether someone is a good candidate for surgery if he/she take 20 micrograms of coumadin. Thankfully the doctor limited the opportunity for personal questions like these by saying, “those of the kinds of questions we can address at your personal consultation.”

The dietician handed out a file of paperwork, documents to fill out and that was pretty much all to the orientation. I have gotten way more information from the web and reading research articles that I can get my hands on off the web.

The most valuable pieces of information I got from the orientation came from one sentence the doctor stated: we are now running four months from paperwork to surgery. And reading on my own in the file of paperwork about what records, and information I needed to send in to get my first appointment (they call you-you don’t call for an appointment)


Seminar 2

Well these guys were slick (almost uncomfortably so). I made this reservation first but had to wait three weeks to attend. From what I gather they hold one per month. My reminder card and telephone call came from a subcontractor company in Pennsylvania (very impersonal). The seminar, however was awesome! They had a speaker who had undergone surgery, everyone talked about research results over time. They talked about how much weight the average person loses, the long term benefits and risks related to the surgery. The number of patients treated by the clinic and the number of adverse affects (deaths, complications and everything). I really liked the seminar portion of this one. The downside however was that it appears it takes 6 months from paperwork to surgery.
The crowd at this seminar was much larger. As a result of the size or because the presentation was aimed at such a higher level of intelligence the questions asked were much more general. During the first seminar I felt like they were treating me like I was unable to understand things like statistics and results.

The decision:

So I know this is completely at odds with my seminar experiences but I am still going to go with the first site. Only because when they said 4 months I decided that sooner with the guys that don’t explain things well was better than later with an unknown. I will just grill them when i go in for the one to one meeting. I sent my paperwork off fairly quickly and it is now sitting in their office waiting for the “we will call you” moment. I called yesterday to make sure all of the paperwork had arrived and no one answered the phone or called me back after I left a message. Hmmm-do you think they take Fridays off? I bet they do! Being the U.S. consumer that I am I must say the ‘we will call you’ policy is slightly annoying but then after all of the think time the decision is made and I am now anxious to get going!

the journey begins

After reading the various websites, blogs and even some research on the subject and years of failed weight-loss attempts (more on that later) I have decided to pursue a surgical solution. I currently weight 281 (ala my scale in the laundry room). At 5'7" this means that I have a BMI of a whopping 44.

Today I called my insurance company (United Healthcare) and was told that although they have a policy on bariatric surgery i was not allowed a copy of it. Kindly, however, they could read it to me over the phone! (How generous of them!) I dont believe for one minute that this is a policy that is legal. When asked if they could tell me whether either of the two clinics that do bariatric surgeries was a preferred providor for my insurance I was told that i should call their offices to find out. sigh-such a run around.

So after I finished with my insurance company I called my regular doctors office to start work on the letter that the insurance company says is needed in order to gain permission for surgery coverage. for good measure i wrote up a dieting, medical problems, and weight gain history to fax to my doctor so that I could assist her in her letter writing. Then I called the two obesity clinics in my town and asked them if they were preferred providers for my insurance. One suggested I call my insurance company! haha and the other signed me up for the required information seminar. I hope I dont go through all this and find out there is no insurance coverage and the bill will be 100,000 dollars!

so now I wait-My seminar appointment is July 26. I'll try and remember to blog and let you know how it goes.