Approvals

So the process of being approved for surgery through my insurance is an extensive one.  (As it SHOULD be...this is fucking serious surgery!)  The steps required here are to go through an afternoon long seminar where you are able to speak to the nutritionist, surgeon, nurse, etc.  You find out about each of the 3 surgeries available.  What is involved in each surgery, how your body will change, what changes you need to make in lifestyle, what is required for you to be eligible for surgery, what to expect, and they can answer any questions you may have about the surgeries.  To be approved you also have to then pass a psychological evaluation and attend 2 support group meetings.

My seminar was supposed to be in August of 2013, but was pushed back until September.  So in the beginning of September I attended my seminar.   I had attended this back 3 years ago, so I had already decided which of the 3 surgeries I needed to have.  3 are available.  2, the Lap-Band and the Roux-En-Y,
are approved by my insurance (Tri-Care).  1, the Gastric Sleeve, is not.  However, they are willing to do it here on post, so you are able to still have the procedure done if approved.  I had to have Gastric Sleeve done due to my Bi-Polar disorder.  With the sleeve the surgeon goes in and cuts off 2/3 of your stomach leaving a small sleeve of stomach left to digest food.  Because of this, it still leaves part of my stomach for my psych meds to enter, digest, and work it's way through my blood stream.  The Roux-En-Y (commonly known as your standard Gastric ByPass) bypasses the stomach completely and re-routes just past it so it leaves nowhere for food (or meds) to digest long enough for my meds.  The Lap Band puts the band around the tube leading to the entrance of the stomach.  This too does not allow the meds to get to my stomach for digestion. 

I will say this.  The approval process is anxiety inducing and so terribly nerve wracking!  It's an emotional roller coaster, but if you go through and have the surgery your whole life is going to be shoved into an upheaval, you may as well start getting used to it now.

My psych eval was scheduled for mid-September.  I had already had that appointment made when they called me for the seminar in August.  They tear you apart.  Okay, MY Doctor tore me apart.  I wish all of them did this for patients, I've met a few who maybe shouldn't have been approved that were because Doctors weren't so hard in their psych evals.  It consisted of 3 separate appointments.  One to meet and talk about why I wanted the surgery, my knowledge of the surgery and the changes it would cause in my life (no, not the weight changes), he talked to me for probably a good hour and a half with a constant barrage of questions.  I left in tears thinking there was no way I was ever going to be approved.  (The Bi-Polar is a huge issue with this surgery, in fact ANY mental illness is...hence the psych eval)  The second appointment came a few weeks later.  I spent 3 or 4 hours in a little room answering questions on a computer until I couldn't remember which way was up or if I really played kick the can as a kid or that was a dream or what the hell IS kick the can anyway?  The third appointment was a few weeks after that in mid-October.

I was so sick with anxiety that day.  I was so nervous whether or not I was going to be approved.  I went into his office and he basically went through my whole entire computer session asking me more questions, asking for clarification, telling me things about myself that I already knew.  I can imagine for a lot of people this is a very either angry or eye opening experience.  A lot of people aren't blessed with the situation I am in.  I know, I know...bi-polar disorder is NOT a blessing.  In this case it is though.  I have been blessed in the fact that I have been in therapy for so long that I am able to take good, honest looks at myself and really see who I really am.  Faults and all.  He told me nothing I didn't already  know about myself or that, had he just asked, I could have told him that first day.  But for people who aren't in therapy for more than half their lives some of the findings can be shocking.  Some people are NOT going to like to hear the things that the test reveals, despite the fact that they are true!  LOL   In the end though I was approved.  Big red check of approval and the evaluation was going to be sent to my hospital and surgery team for their records.

The next day was another support group meeting and I was so excited to go in and tell everyone the good news.  Immediately after group I high tailed my butt up to the surgery clinic to make sure the report was faxed and to let the head nurse know that I was a go.  All boxes checked, all set and ready to slice!  I ended up arriving at the same time as another gal and we talked to the nurse together and she actually just ended up scheduling our surgeries on the spot!  She said she'd call to confirm when she got the evals but as long as that got to her inbox my surgery was scheduled for mid-November.