Written by Melinda
Thursday, August 10th, 2006
My actual journey began in April 2006, just one month before my 37th birthday. I reached my highest weight of 251 lbs. My starting BMI (body mass index) was 43 which is considered morbid obesity. I knew I was overweight, but never viewed myself as obese! Let alone “morbidly.” I always told myself that to be 250 would mean I was FAT. But when I finally hit that 251 mark, I had to do something.
What’s the old saying: ‘Drastic times call for drastic measures’? So… I did something quite drastic according to the opinion of most folks. On October 10th, 2006. I had gastric bypass surgery (RnY, Lap). I reached my goal weight in 8 months and one week, three weeks short of what my gastric surgeon said it would take me… and now 15 mos postop, I am at goal and maintenance, weighing 118 – 121 lbs (approximately 130+ lbs gone forever!) I have taken my profile journal entries from Obesity Help website and placed them here. It was not the start of my journey, but hopefully you will be inspired as you read the frustrations that I endured as well as the highlights of the journey that made it worthwhile.
From May 14 til August 10, 2006, I was involved in a mandatory weight loss program through my employer to qualify me for surgery. My employer is self funded through Blue Cross and made an inclusion in the policy for weight loss surgery. However, they made it mandatory to attend and participate in a twelve week weight loss program which they called “Succeed.”
This program required attendance at eleven out of twelve weekly meetings, thirty-six exercise sessions at one of their facilities, and a weight loss of 10% of your overall body weight. Just to get into the program, you had to (1)get clearance from your PCP, (2)have the referral by a gastric surgeon, and (3)have psychological clearance from a licensed psychologist. So the process began…
Throughout April, I labored to get all three prerequisites fulfilled in order to meet the May 14th deadline. I heard of this same program two years prior, but decided it was too expensive and I would once again try yet another effort ON MY OWN to lose weight via the low carb diet (aka Atkins, South Beach Diet). After successfully completing the program, the bariatric surgeon’s office submits a request to Blue Cross and surgery is SUPPOSED to be easily approved.
This was not the case with me. I was denied twice, and had to fight like mad to get insurance to cover. It was a toss up as to losing the 10% body weight. I weighed in originally at a high of 251 lbs, therefore, Blue Cross expected me to lose 25 lbs. I had lost 23 lbs and they would not approve it (no rounding UP of numbers!) Finally, my PCP weighed and document the 10% weight loss totaling 26 lbs! *As soon as I received letter in hand, however, I began to experience “The Last Supper Syndrome.” I gained eleven pounds back prior to having my surgery.
I checked their website daily to see if the predetermination had been approved. I also called them daily, sometimes twice daily. Within a thirty day period of time, I had called Blue Cross a total of 40 times! They knew me, and one representative actually told me not to call back and to wait on the letter in the mail. I kindly informed her that I would be speaking to her next week (this conversation took place on a Friday afternoon). I decided to fight with everything in me… and when I received the denial, it made me realize how bad I truly wanted this surgery.
