Sharon1964

My psych told me that he had WLS about four years ago, so the dude has some street cred, not just "book learnin". I've never really trusted skinny-minny doctors or nutritionists, because I figured that they learned everything they knew in school and had never really been there. Of course, some of them could have had WLS too and I didn't know it.

So I posted about my colonoscopy from earlier this week. The day before the colonoscopy, I had my psych eval. These are some of the things that we talked about during my psych eval.
Ever since I decided that "enough was enough" and I wanted to have WLS, back in November 2014, my right eyelid has been twitching. Almost constantly. It drives me crazy, but it's what happens to me when I'm stressed. I couldn't figure out what I was stressed about, but I figured it had something to do with my decision to have WLS. I have spent a lot of time since that decision really exploring my past and how I got to where I am.
I looked at pictures of my childhood, and saw that during the time my father was telling me I had to diet because I was too big, I was actually normal. I was shocked. I was shocked at how much one person could really screw you up. I thought about all of the things he did over the years, and the things that brought me to cut him off about 10 years ago and stop all contact. He is a mean, toxic person and is no longer in my life.
I also thought about the time in high school when I weighed 195 (I'm 5 ft 7 inches tall) and thinking, "well, it's okay, because I'm not 200 pounds." I remembered in my early 20's weighing 281 pounds and thinking, "well, it's okay, because I'll never weigh 300 pounds." Now all through this time period, I was still dieting, losing weight, then regaining weight when I couldn't keep up with the demands of the diet. But hey, it was okay, because I wasn't XXX pounds, right?
Then in my early 30's, I got serious (or thought I did), and dieted down to 225. I married someone who liked big women and was not supportive in my efforts to lose weight. Two years later, at 350 pounds, I got pregnant. When our daughter was two years old I left him. I continued to struggle with weight. About 5 years ago, I got on the scale and it read 397. I was shocked. There was no way in hell that I was going to let the scale read 400. I went back to my go-to plan, Atkins. I lost 75 pounds. But I couldn't keep it up, I was still emotionally eating and eating out of boredom.
But hey, it was okay, because I have tons of clothes (thank you, internet shopping), boots that fit my fat calves, and even tights that fit. There was nothing wrong with being a BIG BEAUTIFUL WOMAN, because that's what I was hearing all over the place. Accept who you are! Accept your size! That's the message I was hearing.
People couldn't believe that I was 50 years old. They would say, "you have no wrinkles" and I would respond, "that's because I'm fat - only skinny people have wrinkles." And they would laugh and I would laugh. Because it was okay to be fat, right?
In November 2014 I got on a scale and it said 403. I felt sick to my stomach. I did some soul searching. I decided to stop kidding myself and to stop accept being fat.
I told the psychologist that Fat Acceptance did me no favors. It may have done wonders for other people's self esteem, but it just enabled me to be fat. Now most of you are younger than me, and you may not remember what things were like before "FA" became a thing. There was no such thing as "BBW" - the term hadn't been invented.
I told the doc that I was afraid of failing. That I had read a post here about someone who was afraid to get rid of her fat clothes, because every other time she had done that, she had to go back and buy that same size again when she failed in her efforts to keep the weight off. I told him that I had a hard time with failure (and had been my whole life, another thing to thank my father for), and I think that was what I was really stressed about.
I poured all this stuff out to the psychologist, things I had never, ever admitted, even to myself. And it felt great.
And then my eye stopped twitching.

I thought that getting WLS was going to be hard. Turns out, it was pretty easy. I had great insurance and got approval and had surgery six months after starting my process.
I thought losing the first 100 pounds was going to be hard. Turns out, with my LapBand, it was pretty easy. My body cooperated with my band and when I ate right, the weight came off.
I thought leaving my emotionally abusive husband was going to be hard. Turns out, once I took control of my food and my body and got out of my food coma, leaving him was pretty easy. Logistically tricky, but with reliance on friends and family and a good lawyer, leaving was only temporarily difficult.
I thought the divorce process would be hard. Turns out, it is stressful and emotional, but the actual tasks put in front of me, although tedious and time consuming, are just tasks. I am blessed with a good job and resources that many women don't have. The slowness of it is harder than the tasks in front of me.
I thought walking for exercise was going to be hard. Turns out, it is the one exercise I love and have not grown tired of. I can walk for miles with ease.
I thought asking for help was going to be hard. Turns out, like exercising a muscle, the more I do it, the easier it gets.
I thought being kind to myself was going to be easy. I was wrong.
Oh, was I wrong.
Oh, I've learned it's okay and necessary to treat myself to little things, like a manicure, or a foot massage, or a movie. But then there's the other things.
And I can't help wondering if these other things have a lot to do with why I overeat and stayed obese for so long.
Like saying no to people. I say no. But then I go into "shoulda woulda coulda" and feel guilty about it.
Like reaching for comfort food or wine once in awhile. And then I start the tape in my head that says I'm bad, I'm lazy, I'm never going to get to my goal weight because I don't deserve to.
Like going out with friends and holding my head up high because I feel pretty for the first time in years. And when a musician in a band notices and makes a sweet comment about the "beautiful women in the room tonight" and points directly at me, I find the next opportunity to gather my things and call it an early evening, because to flirt would be bad, and I don't deserve that kind of attention.
Like getting a strong lawyer who is fighting for my financial rights and future, but crying at night because this divorce would go so much faster if I just didn't fight for the college money for my girls or maintenance for myself; because if I wanted out so bad, shouldn't I just cut my losses and end this?
Like not losing any weight for the last six months even though I have fifty left to goal, and telling myself it will never happen because I've never followed through on a goal weight before and what makes me think this time is any different?
Like standing up to my mom's criticisms in person, but in private wondering if she is right about me -- that I'm making a big mistake doing this or that or the other thing, and remembering how judged I felt my whole childhood and adolescence and wondering if she was right about me all along?
This is what is hard. Calling bulls!# on these thoughts and patterns and habits.
My higher self knows it. But it's so DAMN HARD to stop the negative thought cycle, that shi##y committee in my head.
Attitude is everything. I just turned 54 over the weekend and birthdays make me reflective. I have what may prove to be my best year ever ahead of me. God willing, I may see divorce papers signed in 2015. Maybe. I'm 100 pounds lighter than I was a year ago and healthier than I have been in decades. I may be moving into a new home by the end of the year. There is every reason to be hopeful.
So why does my sick brain still gravitate toward self blame and misery? Why, why don't I believe I deserve happiness?
I may never know why.
I'm a practical person. I believe in results. So what I'm planning to do about this is purely practical. It may or may not have any basis in psychology, but it seems reasonable to me.
I plan to abort those thoughts the second I sense them in my head. Literally catch myself and interrupt it with the opposite thought.
I do deserve joy. I do choose healthy food and I will meet my weight loss goal. That person that said I was beautiful was telling the truth. I choose to believe my older daughter who just told me I am strong and a role model. I believe my younger daughter who just told me I've always got her back. I am deserving of financial security and what is rightfully mine. I am deserving of a slim body and to feel pretty. Accepting attention is not shameful. I make good decisions. I take care of my loved ones and I am a good mother. I am smart and strong and pretty and nobody's fool. I am precious in God's eyes and I will live my best life.
This is the hard part. This is the only hard part. The head is always the hardest part to change.

No, no, no. If you pray for strength then you also have to pray for bail money. Pray for patience instead.
My gut reaction to the condescension in the original post was something along the lines of, "it must be difficult wearing that cloak of condescension every day. Glad I'm not you."

The Medi-Cal Provider Manual has this to say about gastric surgery:
Approval of a Treatment Authorization Request (TAR) for
is required and must include all of the following documentation: ◾The recipient has a BMI, the ratio of weight (in kilograms) to the square of height (in meters), of:
◾Greater than 40, or
◾Greater than 35 if substantial co-morbidity exists, such as life-threatening cardiovascular or pulmonary disease, sleep apnea, uncontrolled diabetes mellitus, or severe neurological or musculoskeletal problems likely to be alleviated by the surgery.
◾The recipient has failed to sustain weight loss on conservative regimens. Examples of appropriate documentation of failure of conservative regimens include but are not limited to:
◾Severe obesity has persisted for at least five years despite a structured physician-supervised weight-loss program with or without an exercise program for a minimum of six months.
◾Serial-charted documentation that a two-year managed weight-loss program including dietary control has been ineffective in achieving a medically significant weight loss.
◾The recipient has a clear and realistic understanding of available alternatives and how his or her life will be changed after surgery, including the possibility of morbidity and even mortality, and a credible commitment to make the life changes necessary to maintain the body size and health achieved.
◾The recipient has received a pre-operative medical consultation and is an acceptable surgical candidate.
◾The recipient has an absence of contraindications to the surgery, including a major life-threatening disease not susceptible to alleviation by the surgery, alcohol or substance abuse problem in the last six months, severe psychiatric impairment and a demonstrated lack of compliance and motivation.
◾The recipient has a treatment plan, which includes:
Pre-and post-operative dietary evaluations and nutritional counseling, counseling regarding exercise, psychological issues, and the availability of supportive resources when needed
◾Authorization for bariatric surgery will only be approved for a Centers for Medicare & Medicaid Services certified Center of Excellence (as designated by the American Society for Bariatric Surgery or certified Level I Bariatric Surgery Center by the American College of Surgeons).

It sounds like you took an assessment called the Minnesota Multiphasic Personality Inventory, or MMPI. It's about 400 true/false questions. You may have answered some questions showing you subconsciously had some lingering regret about your marriage, your husband, or your divorce.
I know there weren't any questions specifically about marriage, but that's the way these things work.

Soooo, ummm... were you in Target?

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.
The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.
The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.
I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??
The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.
I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

@@Alex Brecher
That's not the problem, this is something new. The first time I reply to a thread, I auto-follow it. The next person who posts, and those thereafter, trigger notification.
In the last two days, my FIRST post on a thread generates a notification that someone posted on a thread I'm following. This hasn't happened before.

This person is not a psychologist as that requires a doctorate. She is likely a marriage and family therapist (MFT), licensed clinical social worker (LCSW) or the equivalent in your state.
Not only would I complain to your surgeon, I would file a complaint with her state licensing board.
And by the way, you are being way overcharged. A Master's level therapist makes about $50 to $75 per 50 minute session in a mid-sized city. I would mention that to the surgeon as well.
Sharon
(before I changed careers to running a pain management office, I ran mental health offices for about 13 years)

This person is not a psychologist as that requires a doctorate. She is likely a marriage and family therapist (MFT), licensed clinical social worker (LCSW) or the equivalent in your state.
Not only would I complain to your surgeon, I would file a complaint with her state licensing board.
And by the way, you are being way overcharged. A Master's level therapist makes about $50 to $75 per 50 minute session in a mid-sized city. I would mention that to the surgeon as well.
Sharon
(before I changed careers to running a pain management office, I ran mental health offices for about 13 years)

No, no, no. If you pray for strength then you also have to pray for bail money. Pray for patience instead.
My gut reaction to the condescension in the original post was something along the lines of, "it must be difficult wearing that cloak of condescension every day. Glad I'm not you."

So I posted about my colonoscopy from earlier this week. The day before the colonoscopy, I had my psych eval. These are some of the things that we talked about during my psych eval.
Ever since I decided that "enough was enough" and I wanted to have WLS, back in November 2014, my right eyelid has been twitching. Almost constantly. It drives me crazy, but it's what happens to me when I'm stressed. I couldn't figure out what I was stressed about, but I figured it had something to do with my decision to have WLS. I have spent a lot of time since that decision really exploring my past and how I got to where I am.
I looked at pictures of my childhood, and saw that during the time my father was telling me I had to diet because I was too big, I was actually normal. I was shocked. I was shocked at how much one person could really screw you up. I thought about all of the things he did over the years, and the things that brought me to cut him off about 10 years ago and stop all contact. He is a mean, toxic person and is no longer in my life.
I also thought about the time in high school when I weighed 195 (I'm 5 ft 7 inches tall) and thinking, "well, it's okay, because I'm not 200 pounds." I remembered in my early 20's weighing 281 pounds and thinking, "well, it's okay, because I'll never weigh 300 pounds." Now all through this time period, I was still dieting, losing weight, then regaining weight when I couldn't keep up with the demands of the diet. But hey, it was okay, because I wasn't XXX pounds, right?
Then in my early 30's, I got serious (or thought I did), and dieted down to 225. I married someone who liked big women and was not supportive in my efforts to lose weight. Two years later, at 350 pounds, I got pregnant. When our daughter was two years old I left him. I continued to struggle with weight. About 5 years ago, I got on the scale and it read 397. I was shocked. There was no way in hell that I was going to let the scale read 400. I went back to my go-to plan, Atkins. I lost 75 pounds. But I couldn't keep it up, I was still emotionally eating and eating out of boredom.
But hey, it was okay, because I have tons of clothes (thank you, internet shopping), boots that fit my fat calves, and even tights that fit. There was nothing wrong with being a BIG BEAUTIFUL WOMAN, because that's what I was hearing all over the place. Accept who you are! Accept your size! That's the message I was hearing.
People couldn't believe that I was 50 years old. They would say, "you have no wrinkles" and I would respond, "that's because I'm fat - only skinny people have wrinkles." And they would laugh and I would laugh. Because it was okay to be fat, right?
In November 2014 I got on a scale and it said 403. I felt sick to my stomach. I did some soul searching. I decided to stop kidding myself and to stop accept being fat.
I told the psychologist that Fat Acceptance did me no favors. It may have done wonders for other people's self esteem, but it just enabled me to be fat. Now most of you are younger than me, and you may not remember what things were like before "FA" became a thing. There was no such thing as "BBW" - the term hadn't been invented.
I told the doc that I was afraid of failing. That I had read a post here about someone who was afraid to get rid of her fat clothes, because every other time she had done that, she had to go back and buy that same size again when she failed in her efforts to keep the weight off. I told him that I had a hard time with failure (and had been my whole life, another thing to thank my father for), and I think that was what I was really stressed about.
I poured all this stuff out to the psychologist, things I had never, ever admitted, even to myself. And it felt great.
And then my eye stopped twitching.

@@Shace
Dude, it's not you. It's the level of fat in your body and how that influences your testosterone levels. As men's abdomens get larger, their level of testosterone decreases. Fat cells can actually produce estrogen (from what I've read). So when a guy is heavier, he has less testosterone and more estrogen. When that reverses, he has increased testosterone, which can cause problems with anger.
Not a doctor, blah blah blah.
Oops, sorry, didn't realize this was in the guys room. Pretend I used my deep voice.

Actually, businesses with under 50 employees are not required to comply with FMLA. Most companies have a policy they will ask you to adhere to. Talk with your supervisors.

UPDATE
After peer-to-peer I was APPROVED!
My doctor said it only took 5 minutes to get it approved. Apparently the doctor she spoke to said it would apper that the person who originally denied the claim didn't even read the file because this one is a "no-brainer." I agree and that's why I was so shocked!
Thanks for all of your encouragement!
I will add that after about 2 days of being shocked and really mad, I settled down and was ready to go hard in the appeal process. Yet, I was actually so at-peace with everything that I was even okay with not having the surgery, if that's the way the appeals went, becuase I know that in the end, whatever happenes is the right thing.

Just wanted to stop in and give my support. In addition to the other things going on in life, most of the country is going thru a cold spell with less sunlight. That can certainly exacerbate the feelings you are talking about.

When they said "whatever is owed to the office has to be paid before the procedure is done," do they mean your balance has to be paid off or do they mean you have to prepay the procedure? If the former, then if your insurance allows $75 for each office visit, for example, then you would have to pay $75 each visit until your surgery (I doubt you would rack up $4000 in office visit charges).
Generally, a deductible is what you pay before the insurance pays. That can mean different things for different policies. Here are some examples, the first one is my own policy:
1. Office visit copays are $35, and the deductible does not apply. Everything else has a $1250 deductible (xrays, tests, etc.). Once the $1250 deductible is met, my insurance covers 70% and I pay 30%. The total I ever have to pay in one year is $5000, then insurance pays 100%.
2. The patient pays $4,000 in deductible before insurance pays a dime.
3. The first three office visits in a calendar year are $25 each, then the patient has to meet a deductible of $2,000, then the insurance pays 80% and the patient pays 20%.
So as you can see, depending on the terms of your policy, your deductible may work in different ways.

No, no, no. If you pray for strength then you also have to pray for bail money. Pray for patience instead.
My gut reaction to the condescension in the original post was something along the lines of, "it must be difficult wearing that cloak of condescension every day. Glad I'm not you."