4/5/08 – FORMULATING A PLAN
I’ve been working to get the insurance approval, apparently the office sent to the wrong BCBS office. I got a call last Wed. that the info is in the right place now. My surgery date is May 5th now! (so I’m a ‘shrinko-de-mayo’ bandster!) In the meantime, I’ve been looking at message boards and researching to come up with a plan and to make sure I understand what commitment I’m making. This is kind of scary – it’s a lifetime commitment to changing how I behave with food. I noticed on the boards that a lot of people want to keep the old relationship with food after the band. Seems like the successful ones make the switch in their head.
I got pretty much over the Easter ‘food fest’ without major damage, now I’m trying to think more long-term. I have a trip to Baltimore for the next 20 days, so I’m going to concentrate on 3 meals a day and avoid mindless eating and snacking with the guys – we’ll see how I do…
I read an article that said that couples tend to be heavier than singles, caused by:
• Eating out too much
• Not enough exercise
• Too much TV (more than 2 hrs a day)
We are guilty of ALL of it!... I talked to max about it. We’re joining a gym, there’s one within a mile of us. I will get us signed up when I get back from Baltimore. We’ve been talking about the bicycles, but he is less interested. I told him I’m getting one, he can if he wants. I’ll wait until after surgery for that.
We talked about our schedules. He goes in to work early, gets home around 4:00 most days; I get home around 5-5:30. He could go ahead and eat if he’s hungry and just leave me a couple ounces of the protein for me to make a meal later. We can do the gym in early evening rather than sitting around. He wants to ride the stationary bike and treadmill at the gym – they have TVs on each piece of equipment so he can watch while pedaling! He doesn’t want to do strength training, but might want to later. I’m going to set up some session with the personal trainer – 1 or 2 before the surgery, then a couple after the surgery. I want her to set me up a plan for workouts at the gym. Then I will have one or 2 sessions a month to adjust as I lose weight and start building strength. She said she will also set me up some interval plans for walking on the treadmill and outside.
As for restaurants, we plan to stop eating out so much – limit to 1-2x per week. When we do I will order salad and share some of his protein, or just order appetizer. When out on the motorcycles, I’ll carry a snack, but otherwise just concentrate on the water to stay hydrated and sated.
So, we’re formulating the plan for success together, which makes a difference when we work out together. I can’t express well enough to him how much it means to me to have him as a support. He is wonderful, probably the best thing that ever happened to me! I love him more than he will ever know!
4/14/08 – WORKING A PLAN
I talked to Kathy @ Lifeshape today. BCBS STILL doesn’t have the info. She faxed again, and mailed a copy as well. We’ll see. I think they may require a 6-month supervised program before I can be approved for WLS. I sure hope not! If so, it will be November or December before I can get the surgery completed!
I got the Beck book (The Beck Diet Solution) and I’ve been reading it while on my trip to Baltimore. It’s not a diet per se, but a cognitive therapy approach to understanding and modifying behavior. I found another BCBS IL person on the board also going thru the 6-month program at the same time. So, I’ll have a buddy along the way, if I have to do the 6-months.
I’m joining the gym when I get back from the trip.
4/19/08 – JOINED THE GYM
I joined the gym today. Insurance still has not yet approved my surgery, but we need to start anyway. To make sure that we follow through, I committed to the whole year and pre-paid. I have a session with the trainer on Tuesday. I got Max set up with a first trainer visit as well. Max is actually looking forward to it, so that’s good.
4/22/08 – FIRST DAY AT THE GYM
We had our first session at the gym. Max’s session was at 6, mine was at 7. He didn’t want me there early watching him, so I showed up a little before 7 and did 10 minutes on the treadmill. Max set up a plan with the trainer that was more than just walking on the treadmill. I was surprised; he’s never really done any weight training before, apparently. I had my session with Dori. I got the impression that she was kind of going through the motions with me. I’ve done a lot of different exercise programs over the years, and I’m not a stranger to the machines or the free weights. But, she didn’t really ask what my goals were or anything. I stopped her in the initial sit-down session and made her listen to me. I wanted her to understand what my goals are and why I am here. After the consultation, she took me on a tour of the equipment. We started with the exercise ball, putting the ball against the wall with our back against it, and doing squats. We then went around the machines. It didn’t seem very orderly, and we didn’t get finished in the hour. I’m holding off on the next session until after the surgery. I finished with another 10 minutes on the treadmill. I was surprised how fast my heart rate went up, to stay in the 70-80% zone, I had the treadmill at 2.7 mph and 1.0 incline. That’s not very fast or very strenuous. Hopefully my fitness will improve and I will be able to do more with less rise in my heart rate!
4/27/08 – WE’RE BECOMING GYM RATS
We’ve made it to the gym every day this week. Max is an animal! I definitely have a workout buddy now! Thursday, he asked me if I felt better after working out. He said people have said that before, but he never believed it until now. He’s sleeping better and both of us don’t have back pain any more. It’s amazing how quickly you start feeling the results! I’m doing either 20 minutes on the treadmill and 20-30 on the weight equipment, or I am doing 20-25 minutes on the treadmill alone. I’ll work up to at least 30 on the treadmill each time, but for right now, just getting the habit of daily exercise is significant. I am doing the weight machines, trying to push myself more.
Still no word on the insurance. They asked for proof of a medically supervised weight loss effort in the last two years. I provided a matrix of 8 consecutive months of weight loss through Jenny Craig and Weight Watchers, with copies of the JC sheet and the WW meeting records. With that I had dates of lab work and doctor visits, and visits to the certified diabetes educator for nutrition counseling. Kathy at Lifeshape said that this is more than enough and she is sure that the insurance will be approved.
I completed all of the office visits this week. I saw Donna, the after care coordinator at Melbourne Same Day Surgery Center. She was Dr. Fusco’s first lap band patient! I saw the anesthesiologist, I had blood work and an EKG, I had a visit with Dr. Fusco, the surgeon. I paid the $3700 administrative fee for the first year (WOW! And it’s not part of the surgery cost!!!), so I’m committed. Everything is in place for May 5 except for the insurance approval.
4/29/08 – DAMN THE INSURANCE COMPANIES!!!
Documentation is not good enough, I found out Monday that they’ve denied the surgery. Reason – documentation of medically supervised weight loss effort is not sufficient. I have been so down, I don’t know what else to show them. It seems like the letter from my doctor and the documentation should have been enough.
Today, I went to my primary doctor to review results of lab testing that she had requested and to discuss the insurance denial. She was mad about the insurance company, felt that the letter along with my list of dates should have been enough. We talked about the requirements of medically supervised, I believe that it needed to come from her, not me, and had to say that she was supervising my activities and my progress, and that we discussed diet, exercise and behavior modification at each visit. She is going to write another letter.
I talked to Kathy at Lifeshape, we have to do an appeal. I also emailed Obesity Law and asked what they could do. They indicate that I have a strong case, and that I qualify for cost free appeal through Obesity Law with a program with Allergan, the maker of the band. Kathy said that the doctor’s letter needs to come to her, and she will put together the appeal package. But for now, my May 5 surgery is off, will need to be rescheduled…. So, even though we are moving forward with behavior modifications, the saga of the weight loss surgery continues….
