So right before the surgery, I made the big disclosure that I was having the surgery. I didn't go into much detail at the time, so now I want to spend a little more time talking about each phase.
First, I want to talk about the decision to choose surgery and the steps leading up to it.
I was soooo against surgery at first. In my work, I see first hand the train wrecks for the patients that have complications related to this surgery. So I saw the bad, and it was ugly, and I did not want to put myself into that type of situation. Without getting too graphic, there are patients that don’t heal well and develop fistulas – which are basically open wounds inside your body that make their way to the surface and you end up with a draining wound and usually it is long process to heal completely. But the truth is, it is very rare – very, very rare – and because we are specialists in this type of condition, we usually see all the bad.
But then came a moment of inspiration – and his name is Greg Stanley. I was so proud of him and his decision and his results that I could not deny this was an option I needed to look into. Immediately after the first time I saw him after surgery, I checked my insurance to see if it would cover it, and of course, the answer was no. So I waited. I waited and waited until the next year, when my husband’s insurance changed, and I tried again. I looked into whether it was covered at all and how much it would cost me.
Success!! It would be covered. Buuuuuttttt – only at 50% and IF I qualified. Crap. Another brick wall in my mind. After the initial pout, I thought about it. How would this work? How could I MAKE it work? This is where my current work experience came into play. I remembered that my deductible was $500 and my out of pocket is $5000. So the MOST I would ever pay is $5000 total. I sat with my husband and we figured it out. We figured out how we could save the money and make it happen.
Now – I want to side step a little here and fast forward to the end. How it worked for me was that they only thing that was covered at 50% was the surgeon himself. Everything else, the hospital, the labs, anesthesiologists, etc were all covered as they normally would be which was usually 80-100%. So it turned out that all I paid out of pocket was a little less that $3000. I say this because, for those of you who want to research this on you own – it may be worth trying to figure out how each PART of the process pays out. I do not know this answer and it varies insurance to insurance and policy to policy. It may be worth it to you to find out if the surgeon isn’t covered for the actual procedure, but the hospital, etc are covered – you may be able to work that out.
Okay – back to the beginning. I know it will be covered, I know I can afford it. Now what? At the end of January, I went to my PCP because I had a nasty head cold and at the end of my exam, I went there – what do I do? Where should I go? Who do you recommend? She agreed it is a great option and gave me names, but they were just names. So I texted Greg – rather get a name from someone who can speak from experience. He texted immediately and I called immediately. They wouldn’t give me an appointment until I attended a seminar. Guess what, they were having a seminar that night – like in 3 hours – fine – sign me up.
Okay – most of you who know me know, I am not a kumbaya kind of girl – I am not into group therapy. I am terribly private and prefer to deal with things one on one and then talk about it publicly later. So I dreaded the idea of going to this seminar. I did not want to sit in a room of fat people listening to skinny people tell me how not to be fat. But, I put my big girl panties on (no pun intended) and headed to the seminar.
There was paperwork to fill out, general info, insurance info, etc and then the doctor spoke. With the little research I had done, I walked into this meeting thinking all I wanted was a lap band. Quick, easy, little down time – POOF! Skinny Becky! Well, I am really glad I went to the seminar and I am really glad I had an open mind to listen to what the doctor had to say. He was very thorough, explained all the possible surgeries, pros and cons of each, and I walked away with a lot of information and a lot to think of before my first appointment.
For me and my insurance, I had a 4 month process to go through before I could be approved for surgery. Again – everyone’s situation is different, some less, some more. During that 4 month process I had monthly weight maintenance appointments where I talked with someone about my weight loss plans, goals and actions. I had an appointment with a dietitian who explained how to prepare for the surgery and what life would be like in the stages after surgery and how my life would change forever. I also had an appointment with a psychologist to make sure I was sane enough to have the surgery. I often questioned my sanity during the pre-process thinking – what? Are you crazy? You are going to voluntarily ask someone to remove 85% of your stomach?!?! What the hell are you thinking?!?!?!
During those 4 months, I worked hard. I exercised, I dieted, and I made major changes. I was sure that I was not going to win this game and eventually the result would be that insurance denied me and I was going to have to lose weight on my own. I just knew that this was a lottery ticket, and I don’t win lotteries. I went through the motions, but it was VERY hard to have a positive outlook. I had to prepare myself for the fact that it may not happen and I could not put all my eggs in that basket. If it did work out – then great – I was just that much further ahead. I would be healthier and more prepared for the major surgery.
Then the call – it was approved. I hung up the phone and I cried and cried and cried. I won this lottery. I was excited and scared. I was excited that this could actually be coming true and I was scared because now I realized the severity and finality of the decision I was now making. I was going to permanently alter my body in hopes that the body I got back would be a healthier one.
Next blog – the surgery…..
