Official Decline Received from Insurance

Well, Chris finally heard back from the surgeon's office today. They have received the official letter from the insurance carrier (Blue Cross/Blue Shield of SC) stating that the surgery is excluded on the insurance policy. No surprise to us! So...now the quest for financing begins. They confirmed the cost of surgery as $13,920, if a filter is not required. Okay...I do not know what the filter is...but we did hear a couple of people talking about it in the support group meeting that we went to a couple of weeks ago. So, if he needs the filter, that is an additional $4,800. I don't know at what point it will be determined if the filter is needed...I am going to have to do some research on that issue. So it could be around $18,000-$19,000. (They did say that the $420 consultation fee will be applied towards the surgery.) This amount is to include: payment to the surgeons for the surgery; any/all pre-op appts; 90 day post op visit; visit to the dietitian 4 weeks post surgery; and, the hospital bill. Pray for no complications!

So, the quest now begins for financing. They gave him two local banks that they often refer people to, Bank of America on St Andrews Road and SC Bank & Trust on Gervais Street. I think we will start with SC Bank & Trust...unless I find a personal banker at BB&T to work with (seeing how BB&T is my employer). So...as always when it comes to finances, I am a bit nervous. Having been through some major credit issues a few years ago when we "shut down" our trucking company, my nerves are always on end when you start talking about credit approval. This is another issue for which we will gladly accept all prayers! We can come up with part of the money, which hopefully will be looked on favorably by the banks, but we certainly do not have near the needed amount in cash.

I can't remember if I mentioned this before but Chris has a eco-cardiogram (spelling?) scheduled for Friday. This is something that his family doctor scheduled due to the swelling in his legs that will not go away despite a couple of months on a very potent water pill...it is better but not completely clear. The surgeon actually had mentioned possibly asking for an eco-cardiogram so it is probably a good thing that his doctor has already ordered one...at least insurance will pay for it this way! We'll take all the small blessings we can get!

And...to finish for the day...I'll ask that everyone please keep my friend/co-worker, Janice Starnes, in their thoughts and prayers. Janice had a double mastectomy last week. I visited her this evening when I delivered dinner to her....our office is pitching in to provide 3 meals per week to her while she is recovering. Her spirits are remarkably high but she of course is having her "moments" of emotion. She is such a strong and beautiful person that I have no doubt she will come through all of this with flying colors.

Still no progress...

Still waiting...I hate to be impatient but just can't help myself! I am ready to move forward with this!

We had a call last week from one of Chris' doctor concerning high potassium levels from his last visit. It was apparently pretty bad because the doctor himself called and the usually slack office actually called again to tell him to come back for another blood screen. They are thinking it might have been an error which tells me that it must be pretty bad...I hope it was an error. It has me very worried. The only thing I can find concerning high potassium is that it is a kidney issue. With Chris having diabetes, anything to do with the kidneys scares me.

I really wish they would move a little faster with the surgery...I have a fear of damage that is being done to his body while we wait...most of all my fear is the damage that is not reversible no matter how successful he is with the Lap Band. I think I will encourage him to f/u with the surgeons office again on Monday and advise them that his health continues to deteriorate while we wait!

We went Blueberry picking this morning. That was fun...but very hot! We need to use the blueberries as a snack, they are really good for you. We are going to try them in a vanilla protein shake too. We talked about starting the protein shakes next week...bad thing is, if the Potassium is a sign of a kidney problem, high protein is bad for the kidneys too...you can't win for losing in this life!

...Still Waiting...

Yep...still waiting. Chris checked with the surgeon's office earlier this week and we are in a "holding pattern" waiting for the declination letter to come back from the insurance company. Chris advised them that we are intending to proceed as self-pay but they said that they are required to have the insurance information in their file. So...we wait...

We attended a support group meeting on Wednesday night. It seemed like a slow start but in the end it was well worth our time. The success stories of everyone there was just really wonderful. The amount of weight loss and the improvement in every one's health is just wonderful. Not a single person there had any regrets for having had the surgery....there were people there who had the surgery very recently and there were people there who had it several years ago. We met one guy in particular that we were very happy to get the chance to speak with. His "pre surgery" story sounds very similar to Chris with his weight and health issues. He is the ideal "buddy" for this I think...he looks wonderful, he is very excited about what the Lap Band surgery has done for him, and he is very down to earth. He told us that one of the best things he has discovered to fight his cravings (physical not mental) is Fiber One cereal. We will make sure we try that...he said the mental cravings is something that you will just have to learn to conquer over time. I assume we will go to the next group meeting in August.

We traveled this weekend for the 4th of July. We had a good time...but it is always good to get back home. While killing time today before we could pick the dogs up from the kennel, we went by GNC. We bought a protein powder to try. The flavor is Orange Creme and smells wonderful...we'll see what we think when we try the first one. Keep your fingers crossed! I plan to go Blueberry picking in a week or two so we are thinking about getting the vanilla flavored protein powder so that we can try to make a smoothie of sorts with the blueberries. Once Chris gets his appointment with the nutritionist, we'll have to start drinking two "shakes" a day and one sensible meal. I already have Chris' permission to call him Mother Fu*&%r when he starts acting like a jerk...which we both know he will. This is NOT going to be easy! :)

The Waiting Game

We have not heard back from the surgeon's office since Chris had his psych exam. I have urged him to contact their office on Monday to check the status of everything...I feel like we are playing an eternal waiting game although I know it really has not been that long. Chris will also ask if we can go ahead and attend the support group meeting this Wednesday night (they meet the first Wednesday of every month). One of the items on his Bariatric Checklist (given to him at the first seminar) is to attend a support meeting. I think they will actually assign him and "angel." That is, someone who has already had lap band surgery, someone that he can call on when he has questions and/or is struggling with anything. I think that is pretty cool.

I added a couple of links to the blog. One is for the surgery center that Chris is using. The other is for a guy by the name of Todd who had Lap Band just over one year ago. I stumbled across Todd's blog while doing some of my endless lap band information searching on-line. I read his entire blog from start to finish and it was very enlightening and I thought it was a great idea (hence why I now am blogging...such a copycat!). Anyway, I had emailed Todd to say how proud I was of him and all that he has done, etc. He has been so sweet and has emailed back and forth several times on different issues. I think that is just wonderful that he is willing to help out and offer support for someone who is in process. So...check out his blog if you get a chance. One thing I am going to go back and re-read is the section about his friend who changed his diet to somewhat match what Todd is doing as part of his Lap Band process...and he lost weight. I am going to attempt to "eat with Chris" but I know that I will be hungry when he is not so I have to plan out what I will do for "in between" meals...a piece of fruit or some sort of protein shake or something...not sure yet.

Oh...found out this week that my brother's wife (Paul and Janice) is in process of preparing for Lap Band too! My mom called to tell me about it, not knowing that Chris is already in process too. Chris has not told anyone in his family about his decision yet. His father is 85 years old (pictured on this blog with Chris) and we are concerned that he would be overly concerned and worried about it. So...we likely are not telling anyone in his family until it is done. We hope that with Chris' success (yes I am thinking very positive) it might be inspiration to his two sisters, Cheryl and Rebecca, who are also overweight.

Psycho Exam

Well, Chris had his psycho exam earlier this week and all went well. I told him that I am surprised the did not commit him! LOL Anyway, I think he got some good information out of the visit. I found it interesting that she talked to him about things like her wanting him to eat his meals at the table instead of in front of the TV (that will certainly be a change for us), he is to eat with good posture, not with slumped shoulders, put the fork down after each bite. She also told him to find a way in his crazy schedule to work in 10 minutes of exercise two days per week. From there he is to build that up to 30 minutes twice per week, then 30 minutes three times per week, etc. She said 30 minutes is all anyone needs unless they are a professional athlete...I think I like her! :) I think giving up soda will probably be one of his biggest challenges...he has drank diet soda for years but he drinks a whole lot of them. She was going to issue her approval letter and get it over to the surgeon's office by the next morning. We will likely hear from the surgeon's office early next week for an appt. with the dietitian/nutritionist.

The psyco exam was $220, not sure what the next appointment will be. I have been checking into setting up a Health Savings Account (HSA) so that we can at least get some tax advantages out of some of the money for the surgery. I found out that Chris qualifies because his health insurance has a $3,000 deductible. The HSA will have to be set-up for just one individual since we do not qualify for the family limit due to my health insurance deductible being only $1,000. Oh well, we'll take any tax break we can get, every little bit helps.

Interesting that Chris found out yesterday that one of the owners where he works has a cousin that had lapband surgery. They gave him her phone number and he called and talked to her last night. Turns out that her daughter had lapbad surgery too. The daughter has lost more weight but it seems that might be due to her commitment to exercise. I think the more people he talks to about their successes is really helping him a lot. I told him that we have to find something that interests us and let that absorb us rather than our love for food which has absorbed us for way too many years. We have spent this week eating those things that we love and should not eat...I am about to the point of not loving some of these foods anymore after eating way too much...am actually looking forward to starting the pre pre-op diet next week. It is simply reasonable eating with portion control. He will be required to do that until such time that they tell him to start the pre-op diet. Now that is where I think the challenge will begin...protein drinks. Sure hope we can find some that we really like...if anyone has a recommendation please share it!

More to come!

1st Consultation

Today was the 1st consultation with the surgeon. Everything went well...I really like Dr. Strickland. He went over some information about the different types of surgeries and looked over Chris medical information. His biggest concern, of course, was the diabetes and the need to get rid of that. He was trying to help us make a decision which would be most beneficial for Chris, not ruling out any procedure as an option. When he realized that we were self-pay, he agreed 100% that we should go with the lap band. He said all of Chris' medical problems are weight induced and the lap band should solve the problem. He did warn him against "overeating the band" so we'll have to make sure we stay "in check" with reality after the surgery. I think Chris has some concerns about not having any "punishment" from eating things that would make him sick if he ate them after the gastric sleeve or the gastric bypass. The risks are so much higher for complications with those procedures and the doctor said the cost is at least double that of the lap band...so lap band it is. Which I am very comfortable with. He said Lap Band cures Diabetes in 47% of patients; the % is much higher if it is Type 2 Diabetes which Chris has. Plus, even if not totally cured, the meds would likely be reduced to near nothing. There is $300 a month for us just accounting for the meds alone! So...we are on the road of trying to come up with $14,000.

The next step is the psychological exam. And...the doctor is writing a letter to the insurance company just to see what happens. And he advised us to have an attorney send a letter as well.

As an added note to some issues in the prior posting...we purchased a new washer and dryer...and Chris sold the 4-wheeler. Now if we can just sell the pick-up truck! :)

Appointment Scheduled

The good news is that Chris finally got his 1st consultation appointment scheduled with the surgeon...June 11, 2008 at 3:30. The bad news is that the appointment will cost us $420...ouch! Chris has listed his old pick-up truck and his 4-wheeler in the Carolina Trader in hopes of selling them to raise money towards the surgery. Hopefully we'll have a good response but with the economy the way it is right now, you just never know.

I'll add that he also got a call from the Columbia Heart Center today in regards to the sleep study that he had done back in May. The results were terrible...something like 13 or 14 times that he stopped breathing during the night. They have schedule him to come back for another sleep study this Saturday night (June 7th) in which he will wear the "breathing machine." I guess this is to see how much it would help him to have the machine at home. I can't help but keeping in my mind that he has a $3,000 deductible on his insurance so all of the costs involved for these sleep studies and/or for the machine will be "out of pocket."

Adding to the financial quest of this whole situation, our dryer decided to stop working this weekend! Now, we really can't complain...the washer and dryer are 21 years old and we have never, ever had one single problem...it just HAD to pick now of all times to decide to stop working. Guess that's the way it goes!