17 Days and counting....

First, let me apologize for the random order of my thoughts as I get this set up and get ready for surgery in just 17 short days. I find it completely incomprehensible that just 2 weeks ago, I was still wondering and waiting for the final word from BCBS of NC.

Now, for a little history...... I thought long and hard about WLS some 4-5 years ago. I had met several people who'd had Roux-en-Y gastric bypass and were doing quite well. At the time, I decided that I couldn't live without the ability to drink alcohol after asking some pointed questions about day-to-day life with that form of surgery. So back to Weight Watchers I went, and yet another attempt to lose more than 20 pounds. I battled it hard, and stayed at it for over 2 years in WW, only to lose a grand total of 29 pounds. I kept it off for a while, but it gradually crept back on.

Fast forward to Summer 2007. I saw an acquaintance at a cookout and she looked as if she had literally melted away! Bless her, Kris told me all I wanted to know and then some about this wonderful surgery of which I knew nothing - called the Duodenal Switch, or DS for short. Literally, I played 20 questions that turned into more like 200! And she was SO gracious to entertain all my stupid questions of minutiae. (Thank you, Kris, for changing my life!! I hope you one day know what an angel you have been!) I left there with the name of her surgeon and his web address. So the research and the journey began....

I started out with her surgeon, Dr. Hazem Elariny, in Vienna, VA. I really like Dr. Elariny, and he is a great surgeon. I just could not afford his fees, so I sought and found Dr. Dennis Smith, Jr. in Marietta, GA. I began with his office in March 2008, after waiting on a change of insurance at my old company and then a change of jobs to yet another insurance. I did all the required tests for both Dr. Smith and BCBS, and we filed for approval in early May. I was denied. Flat-out denied. I'll always remember standing in Logan Airport, getting the news and being so heartsick and yet livid at the same time. Oh no, the fight was on. They just didn't know I have the tenacity of a bulldog and was not about to give up and go away!

So I hired an ERISA appeals specialist who handled my appeals for me. Karlene Dittrich is an angel and a hellion all rolled into one!! I love her SO much, and I have never met her face-to-face. But you can bet that when I go to GA in 11 days, I will get to meet her and hug her neck!!! Karlene filed appeals and fought with insurance through 2 appeals. But her bigger job was to talk me down from the ledge as often as I'd climb up there! Which was often, let me tell you. She was the one person who told me time and again that "Patience and Persistence make you POWERFUL!" And now I'm a believer. For 2nd appeal, I got letters of support from my spine doc (I ruptured yet another lumbar disc in March 2008) and the PA of my orthopedic surgeon who scoped my right shoulder in October 2007. She filed that appeal the week before Christmas. I was sure it would be mid-January before I'd hear anything and that surely I would have to go before the grievance panel at BCBS to plead my case. So imagine my surprise when I got the approval letter in the mail on December 30th! It was approved on Christmas Eve, and once I stopped hyper-ventilating, screaming, and crying, I realized what a wonderful Christmas gift I had indeed been given.