Sunday, September 13, 2009

Ist Two Seminars & the Initial Consultation With Surgeon

Hey Y'all,

As I said in my prior post, as soon as I got the go ahead from my wonderful husband to look into the surgery, I found a local Surgeon that did the surgery right out of our local Hospital!  How perfect was that?  So, I immediately set us up for their next Seminar.  Unfortunately, it happened to fall on my birthday, but hey, it was a necessary step & I didn't want to wait another month to get started!

So we attended the Seminar & were very impressed.  So we decided to go through with it!  The very next day, I faxed in a copy of my Insurance card so they could look into what our Insurance would cover & what my portion would be.  Low & behold, to my dismay, our Insurance didn't cover their group!!  Say what?  The Surgeon was on the Preferred Provider list, so why not?  She said that our Insurance required us to use a COE, whatever that was! 

So, I called the Insurance company up to find out what was going on & what I needed to do to get this surgery approved.  They said that the only requirements they had, were: 1) my BMI had to be 40 or higher or 35 with at least one co-morbidity (not a problem here), 2&3) I had to have a Psych Evaluation & a Nutritional Evaluation, then last but not least, 4) I had to use a COE for the Surgeon & Surgery Center.  What the hell is a COE?

So I quickly looked up what a COE was (Center of Excellence-basically saying that the Insurance Co approved the center, as the center was willing to accept whatever money was agreed to).  I immediately set out to find the closest COE to me (which was about 10-15 miles away (my Surgeon of choice was only 5 mi away), not much unless you don't live in a large area with horrible traffic like we do) & found out that this COE wanted an ADDITIONAL $3500, Up Front, Out of Pocket, Non Negotiable, Non Billable to our Insurance!!  They claimed it was for the classes, & the 3 month follow up etc.

Of course, I looked up the next closest COE, (which happened to be about 50 miles away, but what the hey).  They wanted $3000 extra, etc, etc, etc, for the same reasons.  I thought this is stupid!  The first Surgeon wasn't charging these horrible fees, so why should they?

So, I expanded my search to within 50 miles from Truckee, as that is the last Calif city before the Nevada border (my husband had a hunch that they would have a center in Reno).  I found a COE in Reno, NV (out of state I know, but within reasonable driving or flying distance (did I mention that my fantastic husband has a pilot's license?))!!  So I contacted them & they DO NOT charge these fees & found it amazing that the others were milking their patients for the money they are not getting from the Insurance Co!  I totally agree!  So we made sure to attend their very next Seminar (in Reno of course) on August 26th (our Grand Daughter's 6th birthday!  Luckily, she understood, we got her a great gift & told her we would take her out to lunch where ever she wanted to go for missing her cake & ice cream party!).

So off we went to Reno.  By the way, we drove up (not my favorite way to get there as there is a ton of road work being done on I-80 over the Sierra's, plus my husband likes to drive fast!).  So we booked a room in Reno for the night, planning on driving back home the next morning.  At the end of the Seminar, they gave us the option of making our 1st Initial Consultation appointment with our Surgeon of choice that night (there are 4 Dr's in this group).  So we did.  As our luck would have it, he had an opening on the morning of Friday the 28th.  So we agreed to it & booked our room for a 2nd night to get the ball rolling!

At the consult, the surgeon tried to convince me to have the Gastric Bypass instead of the Lap Band/Realize Band because of the type of eater I am.  I am a grazer as well as addicted to sugar.  He said that the Bypass would keep me from eating the sugar's, but that if I chose to go with the Band, I would have to be very diligent & have a lot of will power to keep on the straight & narrow of the new diet.

At first, my husband & I thought it sounded ok & was going to do it.  But when we got home on Friday, I had an appointment with our Family Doctor (Internist).  He just about went ballistic!  He begged me not to have the Bypass surgery!  He said that if I felt I must do this, to do the Band instead as it doesn't alter my Internal Organs. 

So, I left his office still wanting the Bypass, but decided to check out some sites that patients of Bypass surgery use.  I read their comments for 2 days!!  Most of what I read was horrible.  It scared the s--t out of me!  So I told my husband that I didn't want the Bypass, just the Band.  He was very relieved to hear this, as what the Dr had said alone, had scared him to death!  So I called the Surgeon's office back the following Monday & advised them that I had changed my mind & would be doing the Band instead.

So what an eventful 2 weeks!  By the way, at the Initial Consultation, they checked my height & weighed me.  I always thought that I was 5'3", they said that I was 5'3.4", & my weight was 228.6 that morning (up from 226 the last Dr visit I had had)!  So ends this posting, on to another....

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