Reporting back from the consult

Friday was a blur. We arrived at Dr. Jawad’s office 30 seconds late (how I HATE being late!). After backing my truck into a tree (no damage), I scurried into the doctor’s waiting room that was filled with folks for today’s consults. I signed in, paid my program fee, and took a seat near my mom. I was immediately called back to a desk where a medical assistant took my blood pressure, weight, and temperature. I went back out into the waiting room and within 5 minutes Nicky (office administrator) came in and gave a short presentation on insurance, how the process works, how the day will go, etc. Once Kevin–the office’s Nurse Practitioner–arrived, he took over and started a PowerPoint presentation. Unfortunately, it was the exact same one I had seen at one of their information sessions so it was somewhat redundant.

After Kevin’s presentation, they started calling people back into exam rooms in the order we had arrived. Since I was last, I waited about an hour and a half to be called into my exam room. Kevin came in, asked which procedure I was interested in (and agreed RNY is right for me), went through my chart and medical history, and answered a couple of questions for me. Then he listened to me breathe, listened to my heart, and examined my abdomen. Kevin left the room, handed my chart off to Odalys (insurance coordinator) who then came in to discuss insurance and what I need to do next.

I loved Odalys. She seems like the kind of person I can hand my original physician’s letter of medical necessity to and not worry that she’ll lose it. She was, of course, impressed with my preparedness. I brought my 5 year weight history, notes from my 5 month supervised diet (1 month left!), recent labs, a letter from my first physician who retired, and my medical policy bulletin. We talked about timing. In the next 30 days, I will:

  • have my 6th follow-up with PCP for 6-month diet
  • have PCP write a letter of medical necessity (actually, I’ll write it, she’ll sign it)
  • have my 6th follow-up with my nutritionist for 6-month diet
  • get a gallbladder ultrasound
  • have a psych eval
  • get blood drawn to test for H. Pylori, Complete Blood Count, and Complete Metabolic Panel (no TSH necessary since I’ve had that tested twice in the last 6 months)
  • Nutritional eval for weight loss surgery (either with my regular nutritionist or a bariatric specialist)

I’ll have documentation on all of this sent to Odalys by October’s end (note to self: schedule everything October 22nd or earlier), and then she will submit everything to BCBS. BCBS has 14 days to give an answer (according to my policy), so I ought to have approval by November 15th or so (barring any insurance hold-ups). Once Odalys gets a faxed letter of approval/pre-determination from BCBS, my file goes to the surgery scheduler.

Now. Assuming the scheduler gets my file my mid-November (and yes, I realize I’m compressing what could take weeks of phone tag between me, Dr. Jawad’s office, and insurance), I will begin begging the scheduler to squeeze me in for the beginning of December. Very early December is ideal for a number of reasons:

  • I get about 11 days off over Christmas / New Year’s so combined with a week of sick time and a week of vacation time, I’ll have almost the entire month off to heal
  • My sister’s wedding is December 29th, so I’ll be able to lose that quick first 30 pounds or so before the event
  • I’ll have this done before I turn 26 in January and something just feels good about going into the new year and my 26th year of life in the recovery phase rather than the preparation phase
  • I’ll be able to get through the holidays without gaining weight like I normally would
  • I’ll be healed in time to teach my spring classes which started January 7th without having to either (1) have a substitute for the first couple of weeks or (2) have to give up the classes (and income) for the entire semester
  • I’ll have time during my month off to work on some very important PhD materials due in early January (which I haven’t even had time to begin thinking about)

In some ways, December does present a problem:

  • My fall classes don’t end until mid-December, so I’ll have to work with my profs to wrap them up early (which would actually be very nice!)
  • I have to wonder… will I really feel good enough to host Christmas at my house and be my sister’s Maid of Honor on December 29th if I have surgery that same month? All indications point to yes, I’ll feel normal after just a couple of weeks, but that’s assuming everything goes well.

Dr. Jawad’s office normally schedules a month and a half out, so I would normally be scheduled for early January and I’ll deal with that if it’s the outcome. But Odalys said that they fill up 3 surgeries per day in December first, and then go back and do a 4th surgery each day if they’re busy enough. I have my fingers crossed that I’ll be able to be a 4th surgery on one of those early December days. Right now I’m debating on whether I should go ahead and contact the scheduler to keep her informed of my situation, or if I should wait and let it unfold without bothering her (yet). I’ll probably just wait for now.

Ok, so that’s about it. I’m moving right along, taking the necessary next steps. And I’m very excited to be nearing the end of this pre-op hoop-jumping phase! Onward!


4 Responses

  1. WOW! this is all sounding very good!

    and i must say, your organizational skills are to be admired! hope all continues to go smoothly for you.


  2. Wow.

    Just. Wow.

  3. @ Deb – I’m so excited!! I do realize I could be wrong on the timing in about 100 different ways, but I can’t help but make predictions anyway. : )

    @ Beth – I must have overwhelmed you with my list-making tendencies. My bad! : )

  4. I cannot wait until I am as far along in this as you are! You must be so excited!

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