Plan B

From my last post you can probably guess that I’m frustrated and angry right now.

Last Wednesday (October 25th) I got news from Hurley that my doctors had NOT recorded the conversations about my diet over the past year and that my insurance company would not approve me for surgery without that documentation.

A little history...

I've spent the last 14 months of my life on a diet and exercise program that my doctors didn’t care enough about to record in my medical charts. My own food journal entries, weight charts, workout tracking, scrapbook pages and all the hard work I put in doesn’t matter one little bit to the insurance company – they require that my doctor record this information, not me.

As I said earlier, I have been to my doctors (2 of them) a total of 8 times in the past year. In all those notes there was only one time when a notation was made ("Patient continues to diet") - which obviously is not sufficient for anything!

And after 14 months of dieting and working out I’m right back where I started at the beginning. I lost 24 pounds within the first few months of dieting, but that didn’t last very long… the weight has all come back plus a few extra pounds. And yes, the weight came back even while I was dieting continuously. So you can imagine how devastated I was feeling when I finally resorted to the weight loss surgery option. I have dieted for years and the results are always the same – failure.

Plan A ...

In July, nearly a year after I started dieting I realized I couldn't do it on my own and decided to pursue surgery. Then I got my hopes up. Everything was going smoothly for weight loss surgery. It might have taken a bit of persuasion to get my medical records sent and reviewed, but there were really no major set backs. So I was all set for a surgery date sometime before Thanksgiving or at the latest the first week in December. But the news last week hit me pretty hard.

Devastation sets in again!

It’s been a really tough week for me emotionally. Even the thought of having to start over on yet another diet-doomed-to-fail was just too much to wrap my mind around. I cried a lot. Prayed a lot. Leaned on my best friend a lot. And, in the midst of it all, started making plans for how to deal with this next hurdle. As much as I wanted to curl up in the corner and hide, I knew I couldn't let them win. I knew I needed to keep fighting.

My new plan was two-fold. 

1. Talk to my doctors to request they amend their medical notes about the diet I’d talked to them about throughout the past year, using my own charting records as back up. 
2. Get started on a new diet/exercise program and have it documented from the very beginning, just in case this was the route I had to take. 

Well, from my last post you can tell that the first option didn’t work out so well. My doctors said they would "support" me in having the surgery and do whatever they could to help. But obviously that didn’t include amending their notes – even after I showed them all my own record keeping information.

Plan B ...

So yesterday I met with Bob at Hurley Health and Fitness Center. The Hurley Bariatric Center has a program that patients can go through to fulfill the insurance requirements of the diet history for surgery. It’s called Hurley Bariatric Exercise & Education Program (BEEP). I pay one flat fee for the entire year of appointments and once a month I check in with Bob to record my weight, blood pressure, heart rate and discuss my dieting program and nutrition. All this is recorded monthly and at the end of the 12 months the information is forwarded to the Bariatric Center so I can move forward with surgery.

Of course the hope is that I lose enough weight that I don't need to have surgery. But right now (and with my history), I'm not holding out much hope on that front.

I chose the BEEP program rather than my doctor for a few reasons. 

1. Obviously I don’t have much faith in my doctors right now and I don’t trust them to do the right thing for me
2. With a fee of $55 for the entire year, this turns out to be cheaper than visiting my doctor monthly and paying the insurance co-pay on appointments 
3. I know the paperwork will be done correctly and that at the end of the program I’m done – no more fighting with my doctors.

So to answer the question of the commenter on the previous post.

YES! I’m still planning to have surgery.

But it’ll have to happen next year instead of next month. Today, November 1st marks the first day of my 12 month documented dieting history. Yes, I’m sad and frustrated. But I refuse to let the insurance company or my idiot doctors win this fight. So I’ll march on.

And I’ll keep posting here over the next 12 months to let you know how I’m doing. Posting here helps me as well – makes me more accountable because the whole world knows what my goals are, so the pressure is on. LOL! And it gives me a record of how things are progressing so I can look back and see how far I’ve come.

My diet and exercise plan is going to be pretty simple and straightforward. I’ll share it with you soon.

Thanks to everyone for the outstanding support you’ve shown me. Hold on for the ride… it’s just begun.

~Pam