Need To Vent

mdicurn · 02-18-2007, 02:28 PM

I saw the Nutritionist and the NP friday, for my 3rd visit, and I am so disheatened that I am about to give up. My highest weight was 205 pounds which might not sound like a lot, but when you are 4'11" it is a living hell. I have been on every diet known to mankind and "yoyo" myself in and out of hundreds of pounds. Deciding to get the band was a big deal for me - as it is all of us.

When I went to the Dr in December I weighed 195 pounds with a BMI of 39.4. I do not have any of the big co-morbidities (hypertension, high cholestrol, diabetes, sleep apnea) -- YET! But I do have PCOS, a fatty liver, arthritic knees, chronic back pain, a hiatal hernia and reflux. My insurance will pay for the surgery without any "supervised weight loss" attempts for a BMI >35 and 2 comorbidities. However, the NP insisted that they put me on a pre-op diet for a couple of months before they submitted me.

I was determined to do every single thing that they told me so that I could prove to them that I was willing to follow the directions they gave me. I met with the nutritionist, and made goals for myself that she suggested, eating breakfast, cutting down on my carbohydrate intake, no carbonated beverages, learning to eat without drinking at meals, exercising at least 3 times a week (they insisted that you join a gym as part of the program). I did all of these things thinking that I was finally going to be able to find a permanent solution to my weight problem.

So now, I have lost 13 pounds in 2 months and you would think I would be happy. But now with a BMI of 36.6 and no "major co-morbidities" the NP doesn't think that my insurance is going to approve me. I lost it. They could have turned me in for approval at my very first appointment. I brought copies of my labs, my xrays and all my history. I sat in the office crying. I can lose weight. I have gained and lost weight MY WHOLE LIFE!!

I told her it sounded almost like she wanted me to stop what I was doing and get back up to 205 so that I could get approved. She looked at me and I swear had the nerve to tell me "WE are not the enemy." I was balling my eyes out thinking I had been working SO hard and for what... She didn't even have the decency to offer me a tissue.

I have already spent nearly a thousand dollars out of my pocket for testing. Now, she wants me to have a sleep study which I highly doubt my insurance company is going to approve as I have no signs or symptoms of sleep apnea. I am considering not only if I want to go through with this, but also if I am sure that I have the right physician group if I even choose do to so. I am a nurse. I deal with people every day, and I would treat a patient of mine that way.

I know that I could finance the surgery if the insurance is not apporved, but I am concerned that if something goes wrong and I have something else done, my insurance wont cover it because the original surgery was not covered. *sigh*

I have been working my ASS off literally to try and do exactly what they asked of me and now am just angry and depressed and ready to rip the head off a NP with the bedside manner of Cruella Deville...

Thanks for letting me vent. :pout:

DooneyJC · 02-18-2007, 02:39 PM

Quote:

Originally Posted by mdicurn

I saw the Nutritionist and the NP friday, for my 3rd visit, and I am so disheatened that I am about to give up. My highest weight was 205 pounds which might not sound like a lot, but when you are 4'11" it is a living hell. I have been on every diet known to mankind and "yoyo" myself in and out of hundreds of pounds. Deciding to get the band was a big deal for me - as it is all of us.

When I went to the Dr in December I weighed 195 pounds with a BMI of 39.4. I do not have any of the big co-morbidities (hypertension, high cholestrol, diabetes, sleep apnea) -- YET! But I do have PCOS, a fatty liver, arthritic knees, chronic back pain, a hiatal hernia and reflux. My insurance will pay for the surgery without any "supervised weight loss" attempts for a BMI >35 and 2 comorbidities. However, the NP insisted that they put me on a pre-op diet for a couple of months before they submitted me.

I was determined to do every single thing that they told me so that I could prove to them that I was willing to follow the directions they gave me. I met with the nutritionist, and made goals for myself that she suggested, eating breakfast, cutting down on my carbohydrate intake, no carbonated beverages, learning to eat without drinking at meals, exercising at least 3 times a week (they insisted that you join a gym as part of the program). I did all of these things thinking that I was finally going to be able to find a permanent solution to my weight problem.

So now, I have lost 13 pounds in 2 months and you would think I would be happy. But now with a BMI of 36.6 and no "major co-morbidities" the NP doesn't think that my insurance is going to approve me. I lost it. They could have turned me in for approval at my very first appointment. I brought copies of my labs, my xrays and all my history. I sat in the office crying. I can lose weight. I have gained and lost weight MY WHOLE LIFE!!

I told her it sounded almost like she wanted me to stop what I was doing and get back up to 205 so that I could get approved. She looked at me and I swear had the nerve to tell me "WE are not the enemy." I was balling my eyes out thinking I had been working SO hard and for what... She didn't even have the decency to offer me a tissue.

I have already spent nearly a thousand dollars out of my pocket for testing. Now, she wants me to have a sleep study which I highly doubt my insurance company is going to approve as I have no signs or symptoms of sleep apnea. I am considering not only if I want to go through with this, but also if I am sure that I have the right physician group if I even choose do to so. I am a nurse. I deal with people every day, and I would treat a patient of mine that way.

I know that I could finance the surgery if the insurance is not apporved, but I am concerned that if something goes wrong and I have something else done, my insurance wont cover it because the original surgery was not covered. *sigh*

I have been working my ASS off literally to try and do exactly what they asked of me and now am just angry and depressed and ready to rip the head off a NP with the bedside manner of Cruella Deville...

Thanks for letting me vent. :pout:

:phanvan That is horrible how you've been treated!! Sounds like your NP is a little against the Lap Band idea in general, which is unfortunate for you. Have you tried a different group? Your surgeon may be able to recommend you to a different Dr that will be on the same page as you!!

I too have PCOS and fatty liver was diagnosed 4 yrs ago, were you able to have kids?

anonemouse · 02-18-2007, 02:43 PM

I think you need to find a new surgeon. This group sounds like they don't have the empathy needed to give you the support you will need. Seriously, look at finding another surgeon. You may have to wait a few months, but I think you would be better off than staying with this group.

mdicurn · 02-18-2007, 02:54 PM

Quote:

Originally Posted by DooneyJC

:phanvan That is horrible how you've been treated!! Sounds like your NP is a little against the Lap Band idea in general, which is unfortunate for you. Have you tried a different group? Your surgeon may be able to recommend you to a different Dr that will be on the same page as you!!

I too have PCOS and fatty liver was diagnosed 4 yrs ago, were you able to have kids?

Thanks! I really like the surgeon, it is the NP that is proving to be much less than desirable. I am going to see the surgeon for my next visit, but if I am less than 173 pounds I will be less than the 35 BMI. I refuse to try to GAIN weight!

I was lucky in that I had my children when I was very young. My oldest was born when I was 18 and my youngest was 21. I was told that my age was probably the key to having them at all. Although my periods were never regular, I got pregnant with my youngest right after coming off brith control pills and I think that helped some. I wasn't diagnosed with PCOS until about 6 years ago, even though I have had the symptoms since puberty.

Ariel · 02-18-2007, 03:10 PM

Talk to the surgon and tell him how upset you are with the care recieved. Also the weight they sumbit for the insurance should come from the first vist. That is what my doctor told me, becasue she wanted me to lose weight before surgery but my BMI was just 40 so I asked her about that. Hopefully the surgon will be more understanding. I am sorry for your bad experince.

**Kat817** · 02-18-2007, 03:29 PM

I too think you need to discuss the NP's attitude with the surgeon, he may have no idea!
I was told they submit the weight from your original request as well, that the required diet was for them to see you can and will follow the orders they give. I was self pay, so cannot guarantee that, but I do know I have read that is how they do it.
Hang in there----hopefully the surgeon, will get things going---keep us posted---we care!
Kat

Sunshine2 · 02-19-2007, 05:43 PM

I would copy what you told us, and send it to the surgeon. And FIRE HIM. Let him know because of this, you will be finding a new Surgeon! He is the one losing money and he won't like it! (Their greedy).

I'm so sorry you had to go thru all this, I always hate hearing stories like this because my ordeal was so fast & smooth, but I know a lot of people have horror stories.

Keep us updated on how it goes.....

Keluliana · 02-19-2007, 05:58 PM

I definitely agree with everyone who has advised going to a new surgeon's office. I had the exact same fears - I gained a little weight before my initial conultation so I would qualify and my BMI was just barely 39.9 with shoes on. You need to have a bmi of 40 to get the surgery if you don't have serious co-morbidities with my insurance company. My doctor told me to lose 5 lbs to make the surgery easier (for him) and I said, "but won't my BMI be lower then? Won't that disqualify me?" He said that the only weight that matters to qualifying for the surgery is the one you get taken at your first consultation, and that he would 'round up' to report my BMI as 40!. :) It would be horribly unfair to tell someone they have to lose weight and then hold that against them so they can't get the surgery, like the np you went to did. That's ridiculous! Everyone knows that overweight people can lose weight, but the surgery is to KEEP it off. It sounds like your np is very unsympathetic and does not have a grasp of the genuine disease obesity, or of insurance practices (most doctors don't - their office staff usually do), and definitely no concept of bedside manner!

Most insurance companies will cover the sleep study because sleep apnea is a life threatening condition, even though you know you don't have it. I felt the same way and I don't have it, but my insurance company covered most of it anyway.
Please keep me posted!

DiscoDiva · 02-19-2007, 06:48 PM

What is PCOS? Hope I don't feel stupid when I get the reply... LOL

**Kat817** · 02-19-2007, 07:05 PM

PCOS is an a acronym for PolyCystic (sp?) Ovarian Syndrome. It causes weight gain, facial hair growth in women, irregular or absent periods....help!!! My memory is failing me!!!
Kat

kebsa · 02-19-2007, 07:07 PM

polycystic ovarian syndrome! nasty problem that makes you prone to gaining weight, hard to lose weight, potental fertility problems, insulin resistance and type 2 diabetes

As for poor mdicurn, I would certainly be talking to your surgeon about the np, if he is not really supportve and able to assure you that you will get the physical and emotional support that you need post op- RUN don't walk! to a new surgeon! You will have an ongoing relationship with the practice who does your surgery-it is so important that it is a positive and supportive experience. I have dealt with a technically great surgeon/practice, but the post op support was not great- when problems occured I came away feeling like a naughty child. THankfully we have improved our relationship but that is after a long time! I feel like this lack of support in the tough times cost me almost 2 yrs of weight loss.

mdicurn · 02-21-2007, 09:56 PM

Thank you all so much for your replies!! I can't tell you how much it means to me to have your support. I made the appointment for the sleep study and asked to see the surgeon for my next vist to the office. I fullly intend to tell him everything that happened to me with his NP and if he can not reassure me that things will change I will ask for a copy of my chart and walk out.

I am very happy to know that the original weight is the one that "counts" as I am down to 179.2 now. I might even call the surgeon Friday, as I am out of town right now.

The biggest reason that I have to get this surgery done is because my daughter is ill. She has a very progressive form of Multiple Sclerosis and most likely will not be able to care for herself in a couple of years. When I noticed that *I* was gaining so much weight that I was having a hard time getting up and down my steps I realized that if I could not take care of myself, how am I going to be able to take care of HER?

I refuse to let that happen.

rtgirl77 · 02-22-2007, 07:51 AM

mdicurn: I'm glad you are feeling better and I'm so sorry to hear about your daughter. For the record, I totally agree with what you've chosen to do. I had a big problem after I had my surgery with a newer surgeon in the practice trying to access my port. He literally kept sticking me until the numbing meds wore off and I was crying. I'm not a needle phob at all but it was awful. He wouldn't ask the NP for help. He was so rude and condescending about the problem I was having that I wanted to smack him. So, I sent a long email to the nurse practitioner when I got home and it got forwarded to my surgeon (the principal in the practice) and the office manager. I haven't seen him again nor will I ever. In fact, he doesn't manage lap bands anymore, just the RNY patients. You could send an email to the surgeon or the office manager and let them handle it. Detail exactly what happened and why you feel it was inappropriate. I don't think I'm an obnoxious person at all but I do demand decent care and if I don't get it, I let someone know. If that doesn't work, then I switch. I was on the verge of switching with the practice but things have been remedied to my satisfaction.

Good luck in getting your approval and congrats on your recent loss. It will definitely makes things in your post-op period a lot easier.