GKS

Good Morning!
I wanted to give you an update on my appointments yesterday. I first met with the nurse practitioner, the one I’ve known for about 10 years now. She said with the mild sleep apnea and BMI of 35 I have a very strong case for approval now, yay! She said what they do is pick an arbitrary surgery date and send it to insurance for approval. They know insurance will say “no you need to do x-y-z first before we approve”. She said it’s their way of having insurance lay out 100% what is needed before approval. So, we fully expect them to come back and say I have a 90 day waiting period and that I need to see my PCP for the “OK” for surgery. I started this whole process Sept. 15th so my 90 day waiting period expires mid-December. That all means I could have the surgery this year but she said that most of the doctors take the end of year off so I’m not hopeful. I think I’m looking at early January instead which is fine since it’s such a small difference. The only benefit to having the surgery in 2017 is I’ve already hit my deductible for the year.
Then I went to meet with the dietitian; that was stressful. I’ve barely eaten “food” the last couple of years. Like I’ve said previously I had 4 years of infertility that consumed me and that is also around the time my major food intolerance showed up. I basically drank my calories and consumed slider foods to gain all this weight back. So right now she wants me to focus on eating 3 meals a day and finding sometime in my day, even if its 15 minutes to work out. I’m pretty sure I can make it work but it’s going to be hard with my little one. He’s both a terror and a delight LOL! I can’t just put him in the pack and play and walk on the treadmill; he’d scream the whole time. The child needs his freedom haha. He does go to bed by 6PM though so instead of sitting on the couch I am going to hop on the treadmill. I use to walk 3 miles a day 6 days a week but that was pre baby and I think it’ll be years before I can do that again. Baby steps. I go back to see the dietitian on 11/27 and I’m going to try my best to make big changes between now and then.
I see the psychologist today and I’ll come and update you after the appointment!
Oh and confession………….I’m up to 215lbs, ugh. I hate that I had to GAIN weight to get my BMI to 35 to qualify! Good news is the nurse practitioner said I can lose all the weight I want and it will not affect my approval!

The other nurse practitioner called me this morning. She's the one that I've known since I had my lap band in 2009. She said I do not need to see pulmonary and that they are going to tell insurance they will treat my sleep apnea with weight loss. She said that my insurance is going to have the 90-day waiting period. So, since my initial consult was the end of September as long as scheduling works I should be able to have the surgery end of December. She said a lot of the surgeons take time off at the end of December so that may make it challenging but hopefully we can get it done!

So I had my consult yesterday! I know most of the nurse practitioners in the office so it was really nice seeing them and catching up as it's been a few years since I've been there for my band. I weighed in at 202lbs (I wore the heaviest clothes I own) and that only puts my BMI at 33.66 so right now the concern is that I don't weigh enough. They are confident that insurance will pay to have the lap-band removed but not confident that they'll pay for sleeve revision. So.......when I see the surgeon on 10/3 I somehow need to be 11lbs heavier. I'm going to have to figure that one out. If my BMI is 35 I need a comorbitity. The only one I used to have is sleep apnea. When I went through all these pre-op things with the band I had a sleep study and found out I had it. So, I'm going to be having an at home sleep study and hopefully I still have it. That feels so weird to hope I have it. Insurance is so twisted.
Anyway so next Friday 9/22 I have to go for a barium swallow and lab work. Then, on 10/3 I'm going to meet with the surgeon. I'm waiting for the sleep lab to call me but I am hoping I can get the sleep study done before I meet with the surgeon. If all goes well and the surgeon thinks I could be a candidate for sleeve I'll have to have an upper endoscopy too to check for erosion and scar tissue. It's possible that I may only be a candidate for bypass due to erosion so we will see. That isn't really what I want but I'll cross that bridge if I come to it.
There will be other with nurse practitioners and nutritionist if all goes well but for right now I need to have the barium swallow and meet with the surgeon and go from there! Oh, and I also had them remove some Fluid from my band and my heartburn has subsided. Hallelujah!