My Journey

I decided to pursue WLS surgery in April of 2009 after a friend of mine had such great success with their surgery and I knew it was covered by my insurance provider. I went to a seminar my surgeon was holding and I knew that adjustable gastric banding was the surgery for me. I began the process by starting the 6 months of doctor-supervised weight-loss.

After 6 and a half months, I submitted my paperwork to the insurance company in early October of 2009 and ran across snag #1. They needed one more month of supervised weight loss visits because even though I had gone 6 times, I was a few days shorts of their required time frame. AND, I did not have documentation of my weight for 3 of the 5 years they required. This was an oversight on my surgeon's office, so that was frustrating because they were supposed to be helping me make sure I had the information needed.

I had the extra month (November) of supervised weight loss and began collecting all the information I could from all doctors I had ever been to trying to get record of my weight. I had been over 350lbs for so long that doctor's scales were not able to weigh me, therefore, they didn't write anything down.

The holiday season kicked in and I became busy, so I had a hard time keeping on top of the task. I continued to see my doctor every single month for updates and weigh-ins because I knew the insurance company would be hard to deal with if there was a lapse. Finally, in late January 2010 I had to call the insurance company and explain that my weight was simply undocumented for several years due to my extreme size and inadequate scales at the doctor's office. I asked if photographs would be good enough and they simply told me that I could try it. So, I did...I found photos from more than the past 5 years to give them proof. I'm slow, so that took me a little while to this point, I was getting so frustrated at the process that I had almost lost hope. Finally, it was March of 2010 and I had gotten all the photos together along with proof of the dates.

Snag #2 - I found out that they had been holding my submission for several weeks. The reason for this was because my surgeon was moving from the clinic he was at to become part of the hospital. So, at a time when I thought I would be getting a letter, I was finding out that the process had stopped. He was able to improve his resources considerably after the move, so it was great for him, but it was a little bit of a hassle for patients who were in the middle of the process. I had to get all my documentation and records forwarded to his new office and that required written consent and forms to be filled out.

In April of 2010 (one full year after I began the process) my information was submitted via fax with the copies of the photographs.

Snag #3 - The faxed in copies of the photographs were too dark and they couldn't make any determination from them. I had to wait, of course, for this news to come via letter, so that made things slow!

I immediately had photos made at a photolab of all the ones I submitted and overnighted it to my insurance provider. FINALLY, I was getting closer to an answer. I was so afraid that I wouldn't have enough comorbidities to qualify, but I was approved in May of 2010.

The last hurdle was finding time in a busy summer to have the surgery done. We had several travel plans that could not be broken and my husband also takes classes during the summer. So, ultimately the best thing for us to do was wait until summer traveling was over and he was on break so he could care for me while I recovered. That left me with a surgery date of August 11, 2010.