Update and Follow-Up

So today was my follow up appointment with the blood results and I was NOT happy about it.

My cholesterol was low and normal (yeah), and most everything else was good, but I was extremely annoyed with my body's ability to keep iron! I am STILL Anemic! It doesn't matter how much iron I take, it seems, I still come up short. I mean I knew I was "low" but this is rediculously LOW!!!

Iron 23 normal range is 50-170
Saturation was 6 and normal is 21-42 !!!
The binding capacity of my iron is excellent though at 377 and the normal range is 261-478

Ferritin level was a 4! A freakin' 4 and "normal" is 10-291 but 50 is "ideal".

I'm boarderline diabetic and am now on metaformin, which I figured was inevitable and wasn't that big of a deal to me as the iron levels.

So now I am on 4 meds, Metaformin, some 300mg iron, and Rx Vit D, and a BP med.

I also finally got confirmation today that my paperwork has been submitted for insurance approval, which I can probably guarantee a denial knowing how the system works. I'm already working on how I can possibly appeal the denial once that comes in. I guess in best case senario I'll be pleasantly surprised with an approval. If that happens that I would be extremely shocked and grateful!

So now I am back to waiting. {{SIGH}}

COBRA News

The COBRA payments really have me worried the most. Since the Stimulus plan changed COBRA I've been even more anxious on how much I'll have to pay and if my husband's former company will be up to date and ready when I need to make my first payments.

Last night I was surfing and looking things up and finally found some useful information as to when this COBRA plan is supposed to go into effect! COBRA Plan

It says:


COBRA premium subsidy

The Act includes COBRA subsidies for any employees (and their qualifying dependents) who lose their group health plan coverage because of an involuntary termination of employment between September 1, 2008 and December 31, 2009. These individuals will be allowed to pay only 35% of the COBRA premium, with the employer (your company) paying the remaining 65%, which you will then deduct from your federal payroll taxes or, if necessary, obtain in refunds from the government. Curiously, the law does not define what “involuntary termination” means, though we hope for clarification from the Department of Labor or the Internal Revenue Service. (Keep in mind that characterizing a termination as an involuntary termination may have an impact on eligibility for certain benefits, such as unemployment benefits and severance benefits.) The subsidy does not apply to the continuation of health flexible spending accounts under COBRA.


The subsidy applies to periods of COBRA coverage that begin after February 17, 2009. A period of coverage is the monthly (or shorter) time period for which premiums are charged. If the period of coverage under your plan is a calendar month, your company will have to start providing the subsidy beginning March 1.

Ok so it begiuns March 1st. Phew! I will probably call them at the end of the week to get clarified information since they should be ready by then since it's supposed to start up on March 1st.

I am even more excited now.

I will be calling Hurley soon to find out what's next. I have my next PCP appointment on Thursday. I am hating all of this waiting.

Psych Consultation

For me I am kind of impatient. I feel like this is taking F-O-R-E-V-E-R!!! Still when I talk to other post-op WLS friends they say I am moving fast with everything, which is really good I guess since I am on a time table here.So today was my Psych Evaluation with Dr. Williams. It was not at all what I expected. I expected I'd be talking a bit to the doctor about feelings and understanding of the WLS process and how emotional eating is effected etc etc etc.Nope! Instead i was basically talked to. He explained the above mostly in a DVD he made himself. I spent the first 10 minutes with him going over the histroy of WLS and why psych evals were needed. Then he explained the process of the "tests" I'd be taking after I watched his dvd. Asked if I had any questions and escorted me into another room for the DVD portion.

So I sat at a desk and watched a DVD about WLS. Well it talked mostly about the RNY side effects and how it can change a person psychologically and how friends and family may change, etc etc etc. Basically everything I already knew. I was bored for most of it and cleaned the desk I was at from some nasty sticky stuff that was stuck to it, all the while listening AND taking notes. I wasn't just in la la land. There was a computer there and got sick of the screen saver staying on forever when I accidentally bumped the mouse so I changed the settings on that. Come to think of it I probably could have played solitaire, LOL.

So after the 45 min video, it was on to the computerized test. I was repeatedly told that if I "failed" this test then I'd have to take another one. But it wouldn't be that I "failed" but that the first test just put up red flags. The results would be instant and reporting of the Eval would be complete and sent to Hurley Bariatric by 5pm that same night. So NO PRESSURE right?! LOL

Thankfully I "passed" and was given the green light. There was very LITTLE discussion on my history of emotional eating as I had to interrupt him to tell him a couple things, which he didn't seem TOO interested in. In fact he basically gave me a card of someone else if I needed to talk to someone. He suggested I keep a journal of my emotions to figure out what I was feeling why I was over eating, blah blah blah. I had already started a journal long before I met him and I have already figured out where things started and how it morphed. I tried discussing it with him, but again I was cut off and he didn't seem too interested, and referred me to the card for additional help.

Oh well. I guess at least I "passed" the Psych Eval. I'm not crazy, and I am on to the next step.

Surgical Consult

Today I had my consultation with Hurley Bariatrics. They told me it would be a 3 hour visit, but I didn't think I'd be waiting for 2 hours of it.

I submitted the paperwork they asked for, had my gawd aweful picture taken, met with a nurse and had my vitals taken (BP 157/80 and temp 98.9) and my weight was taken again. It was a bad weekend and I was up 2lbs to 320.

Then I was moved into a room where I waited some more for the surgeon, Dr. Kurt Kralovich, to come in and discuss surgical options.

I went into this assuming I'd get the RNY based on what I thought my insurance covered and based on the directory site from OH that said Hurley and Kralovich only did RNY and the Band. So when he asked me if I knew which surgery I wanted and I responded with "Well I know what I want, but I know I can't have it." I was shocked when after I told him I really wanted the VSG and he said that it was possible since they started doing them at Hurley and that my insurance has started to approve them too.

It's a great option for me since I do want more kids and I have a history of anemia. So I was thrilled when I heard this, but I am still skeptical about it actually going through. I'm one who will believe it when I see it. When I finally have my surgery date and am in the OR preping for the VSG. Then I'll probably believe it, LOL.

So one more appointment down! Yeah! Now all I need is the Psych Eval, which I am nervous for.

Initial Appointment

It's all rushing by so seemingly fast now and I am getting nervous a bit.

Maybe I am not fully ready for this, I don't know.

Because of my insurance issues the doctor and even Bariatric clinic are assisting in getting me approved and into surgery before the insurance runs out.

I had kind of hoped for it but really and truly didn't expect it to happen so fast, and now because it is moving so fast, I am unsure about it.

Still I am at this point in the road where if I don't do it now I may not have the option to do it later. DH might not get his job back and another job might not have as great of insurance. Plus do I really want or need to wait a year or more to see how much more weight I might gain?

Still, though. My insurance doesn't cover the cost of the surgery I want, which is the VSG. I can get the lap band or the RNY surgery or possibly a DS.

I originally had thought about doing the lap band because it wasn't permenant and weight loss is slow and the bands don't always work well. The VSG was the next step but it's a newer proceedure as it only manipulated the stomach and didn't reroute the intestines, but has a great success rate with weight loss. Next comes the RNY the most popular surgery available today. It's the one we all hear about with the pouch stomach and rerouting of intestines. The DS it a hybrid of the VSG and the RNY. They make a tube/sleeve of the stomach and reroute the intestines. This is the most dangerous and complicated surgery but was also one of the first surgeries until the more popular RNY came along.

So what to do and what to choose. That truly is a difficult decision. I believe the VSG would be a perfect match for me, but this bariatric center and my insurance doesn't support it. . .yet. So I feel like I have one of 2 options.

1) Get the lap band done, it's reversible, it's not permenant, and I can use it until the VSG is more widely used, especially if the lap-band doesn't work or something.

2) Just get the RNY, despite the fact that it's not completely reversible (it can be but it is intensive and not normally done), and rearranges the "plumbing" more than I possibly would like. But I'd lose weight "faster" and would get healthier faster and sooner too.

I like option 1 but do I really want to possibly subject myself to 2 surgeries? Still there are no guarantees with either surgery options either.

I hate that I feel slightly rushed, but at the same time I know it's something I want and need. I am just really, really, REALLY, horrible at making decisions like this. Hell I can barely order from a menu at times without it taking 3 minutes.

Still a lot of this may still be put on hold if I can't get the doctor I have been seeing for nearly 2 years to sign off on my diet history. She's holistic and might not completely approve of the surgery, but then the PCP I saw seemed rather anxious (and easily bought) to push this through and "help" me any way he could, including saying he worked with me for a year on the diet, and that's without me even asking him to do such a thing.

He was very nice a understanding but se also seemed like a sell out. UGH!

LOTS to do today already, in preparation.

Had my initial appointment. Called the Bariatric Clinic and set the next appointment up for Tuesday. Called for the Psych eval already too (Just waiting for them to call back to set the appointment up).

Essentially I could very easily be having surgery in a month's time or less. That is mind boggling to me. Even more so, in 6 months I could very well lose nearly 70lbs by then with the WLS too.