Sunday, November 30, 2008

Struggling with the Decision

I am not sure I have made the right decision. The drastic change to my internal organs just seem so much to me and the extreme risk of death. I do not know why but I have this overwhelming thought that I am not going to make it through this procedure. I am starting to get really scared about this.

Saturday, November 29, 2008

Getting Nervous

The date was moved up by several weeks thanks to my employer changing insurance coversage. So, now it is in about 3 weeks instead of several weeks away. I am starting to get really nervous about the whole thing and wondering if I made the right choice. Jeez, I know I have to do it. But, it is really starting to scare me. I was preparing to go through this whole process to prepare and that has all been escalated.

I am afraid of the pain and the potential for death. But, the death that I face each night as I glow to sleep with sleep apnea is a worse risk long term. But, I am scared anyways.

Did I make the right choice?

Iron Bowl

I can't let this day go by without mentioning the win of Alabama over Auburn in the Iron Bowl. It was a great victory 36-0 and the Alabama Crimson Tide certainly deserved this one. Hopefully, we can go on next week and beat the Florida Gators in the SEC Championship game. (Did I mention that I am a HUGE Alabama fan!!!)

Friday, November 28, 2008

To Tell or Not to Tell

I have wondered what to do about informing my employer about the procedure. I finally ended up telling my manager but I really do not want others to find out. In the announcement to my direct reports, I told that them that I was going to be out for an extended amount of time for health reasons. Nothing more. With the boss, I felt that I should be more specific.

But, I am sure that when it comes up in meetings, I will get the 3rd degree. I hope that they do not ask and I certainly will not tell.

How much am I obligated to tell?

Wednesday, November 26, 2008

An insurance curve ball...

I learned yesterday that my company will stop the type of policy that I had originally been approved with. My original surgery date was set for 1/6. But, with the change in policy I could not risk losing my coverage or an increase in amount. So, I decided to change my date to 12/17. My coverage with this policy would end on 12/31 so I wanted to get the surgery before that date.

This really sucked and was a last minute change by my company. (One of many bonehead decisions by these execs, but that is a blog for a different day.) This meant that I would have no last Christmas feast!!! Plus, there is an obvious risk of death. So, I would hate for something to happen to me in surgery right before Christmas. That would be really bad for my familty and children. But, decided to go forward anyways.

The Story Continues...

Well, around August of 2008 I tried to make an appointment with Dr. Ronald Clements at UAB. I chose him because he is supposed to be on of the best. UAB has a center of excellence in this area. Anyways, his assistant sent me a book to fill out and told me that they would make the appointment when they had received certain forms back with my proof of insurance.

To reach Dr Clements:
Department of Surgery
Division of Gastrointestinal Surgery
University of Alabama at Birmingham
1503 3rd Avenue South
Birmingham, AL, 35294
ronald.clements@ccc.uab.edu
Website


I finally got all of that together and sent it in and the appointment was set for October. On the day of the appointment, we were all put into a group. It was awkward. Everyone knew why we were there, it was obvious. Like a herd of cows meandering around Kirklin Clinic. Anyways, we had a group meeting with reps from the doc's office. Finally, we met with the surgeon as a group and then individually. I was certainly leaning toward the lap band but he strongly urged me toward the bypass. He seemed sold on the bypass and not so much on the lap band. He quoted the research that it was less effective. I had a lot to think about. Anyways, I was done with that and ready to move on to the real effort of getting the insurance approved.

Insurance approval came in the form of 1) Letter of Medical Necessity 2)Nutritional Consult 3)Pychological Consult. The problem was that no one really knew what the insurance took to satisfy these requirements. So, I started with monthly weigh ins with my family doctor and made an appointment for the Nutritional and Pysch Consults.

During the interim time period here, I decided to go with Gastric Bypass. I only had once shot here and it seemed that I could not risk a failure. There was a chance that the lap band could fail. I just could not risk it.

It was clear to me on the days of my Nutr and Psych Consults that the process was all red tape and a waste of time and money. To top it all off, I had to do the two consults on different days, which meant that I had to take time off from work two times. I was charged over 600 dollars fo the Psych Consult and it was a joke. I had a 45 minute discussion with Dr Lokken and then a series of pysch test. The testing seemed to be centered around research at UAB and had little to do with my case. The conversation with Dr. Lokken was basically a series of questions that she read off to me. It was a joke. Plus, the questions that she was reading had all been answered by me in the questions that they had been sent to me previously in the mail. The wait was horrendous and then to top it all off, it took them 2 weeks to get the report back to Dr. Clements. The Nutr Consult consisted of me sitting with another patient in a room and lectured by a diabetes educator for an hour about the 4 food groups and that "a 3 ounce piece of chicken fits nicely in the palm of your hand". I swear if I hear some pinhead nutritionist or Weight Watchers person say that to me one more time, I think I will lose it.

All the red tape out of the way and it was time for the Insurance coordinator(Jamie) with Dr Clements to submit to insurance. This was really a very quick process. Jamie said that it might take a few weeks, so that it what I was expecting. Instead it took a few days and I found out earlier this week that it had been approved.

Friday, November 14, 2008

Context...

Weight = 276

Well, let me start by telling you a bit about myself. I am a 40 year old male with 3 kids and I live in Alabama. I am around 270lbs and have been overweight since I turned 24. I have been consistently unsuccessful in losing my weight and have tried many methods to lose weight. Anyways, it has been a seesaw for most of my adult life.

Well, about 6 years ago I developed gout. This was the beginning, I was 34. Then, about 2 years later I developed low testosterone. Around this same time, I was having significant problems with fast heart rate and palpitations. I ended up going in the hospital a couple of times with these problems. Finally, I had a sleep study and found that I had sleep apnea. My fatigue had continued to get worse and things were just not good.

Anyways, with the positive sleep study, I get a CPAP and am sent home to go make this CPAP thing work. I cycled through a few doctors with all saying that I should go home and learn to sleep with the mask. The problem was, I couldn't. Plus, I was becoming increasingly worse and had started to disconnect from reality at times. I was absolutely so tired, I could not process day to day activities. I began to contemplate disability, since I was increasingly unable to work. I had severe panic attacks and just varying degrees of misery. Plus, the heart palpitations were really bad. I got an atenlol to lower my heart rate.

Add to all of this, the gout was worse than ever.

I went to a ENT, on research about pillar implants for the sleep apnea. It cost me $1800 dollars, since the insurance company did not consider it an effective treatment for obstructive sleep apnea(OSA). The procedure was incredibly painful and I was in pain for several weeks. The back of my throat felt like there was something there. Anyways, all of this, and it did not help.

My OSA continued to become increasingly worse. I was awakening several times a night and to top it all off, I had developed a serious case of insomnia. It was hell. I started to take Ambien for the insomnia but that made the OSA worse, which in turn made the sleep worse. It was a vicious cycle.

Meanwhile, the docs were pretty much worthless. Actually, beyond worthless, because they stole my hope and took my money. One pill to the next and one script after another. In case you haven't figured it out, I have a very low opinion of doctors and the medical profession. I should know I work in healthcare and know them. Most of them are sleazy and money hungry, they are also given way to much credit in the intelligence department and way too little credit in the ego department.

So, a few weeks ago I began to toy with the idea of a lap band, based on a nurse friend's recommendation. Nothing else worked, so I figured that the only path out of this living hell was something really drastic. The Lab band seemed like the solution. Out of this chaos, I started to make appointments and calls to begin the process of looking into this surgery.

To be continued...