Jumping Through Hoops to Get a Sleeve - Conroe, TX

Ok where to start. I've read several of these...

Ok where to start. I've read several of these reviews and finally decided to start my own since I have begun my own journey toward a gastric sleeve and lifestyle change. I've been overweight my entire life or at least for as ling as I can remember. I have no idea what it feels like to be an average weight or to not have my weight (and appearance) nagging at me in the background of everyday occurrences. After trying just about every weight loss option (programs, diets, gyms) I had given up and told myself that I'd just be 'the fat girl' for the rest of my life. The problem was, I still had a little voice telling me that I couldn't allow this to be my destiny. After all, I really hate the quote 'everything happens for a reason' because I feel that it removes any accountability and control we have over our own destiny. So here I am, taking control over my destiny.

I graduated from my Master's program about 1 year ago and have been working as a therapist in a hospital, which translates to MONEY! So I finally took the step to schedule my initial consult with Dr. Balette in The Woodlands, Tx on June 9, 2014. Before the appointment, I was still on the fence about the surgery. Sure, I wanted it but I worried that I wasn't able to make the life changes it required. During the time before my appointment, I was approached by a nurse at work who confided in me that she was thinking about having 'fat surgery', as she called it. I was elated! Someone that I KNEW was going through the same thing as me! From then on, we decided to go through this together.

Dr. Balette was great during my consult. He took the time to answer all of my questions and talked me through the requirements for insurance approval. He said ‘the biggest factor is if your insurance covers it or not, and luckily yours does. All you have to do is jump through their hoops to get approval’. So there it was, jump through hoops, get my surgery. I left the office excited but still hesitant, mostly about insurance and payment. I knew from then on that I wanted the surgery, without a doubt.

Dr. Balette pulled some strings to get me into the weight loss physician ASAP so I could start my 3 month prep, which consisted of monthly visits with a physician, nutritionist, and trainer. I met with Dr. Hill two days later. I scheduled my nutrition and trainer appointments for the following week and completed my H. Pylori blood work. Then I called my insurance again to confirm the coverage. That’s when I hit my first big bump in the road. I was told that the person I initially talked to was wrong, my insurance does cover the surgery and Dr. Balette is in network, but my employer doesn’t cover the surgery unless it’s at one of their hospitals. I panicked. I really liked Dr. Balette and was excited to start the surgery process.

After many tears and hours of frustration, it donned on me. Dr. Howard, which is one of Dr. Balette’s partners, operates at the hospital I work at, which meant I could possibly switch surgeons, but stay with the same office and surgical group. The best point of it all? Because I’m a hospital employee, my company will cover the facility fees at 100% after an $800 copay. So that leaves me with the surgeon and other physician fees. AWESOME! Rather than a 3 month prep, I have to do 6 months, but thankfully my appointment with Dr. Hill still counts as the start date of my prep.

Currently, I’m still trying to get everything sorted out with insurance requirements because I have Aetna requirements and specific requirements from my employer. Like I said, jumping through hoops to get my sleeve. Because I already had my initial visit with Dr. Hill, I have started the diet modifications she recommended so that I can form a habit by the time my surgery rolls around. This includes: drinking 60-80 oz of water per day, increasing physical activity, keeping a food journal, and (the most difficult so far) chewing each bite 15-30 times. Overall it’s gone well and I’m noticing that I have been slowing down during meals and eating smaller portions, simply because I feel full. I’m still waiting to hear back from the physician’s office to confirm that I can switch surgeons and the next steps required. Here’s to hoping there aren’t more complications.

So here’s the start of my journey. I hope to hear from you all soon and really enjoy reading everyone’s story!

Not feeling it tonight.

Today I went in for the pre-op psych eval that my insurance requires. It was a little nerve wracking because I wasn’t sure what to expect, but everything was fine. She basically wanted to make sure that I understand that the surgery is not a quick fix and that it’s a tool I have to utilize to lose and keep the weight off. She said she has no concerns and thinks I will adjust well. I’m relieved and am glad to have one more thing marked off the checklist.

I’ve been trying to continue with the diet and activity modifications the doctor recommended. I’ve been eating smaller portions and making healthier choices. Keeping a food journal has shown me that I eat mostly carbs, so my main focus has been eating less carbs and more protein. I’m doing well with drinking the recommended amount of water. This week I have averaged about 70 oz per day of water. My main problem is being more physically active. I feel like I’ve slightly increased my activity but not by nearly enough. I also had to cook a dish for a friend’s birthday potluck and found myself grazing the entire time I was cooking. Then, I strayed from my healthy eating plan and overdid it with dinner. I’m probably being too hard on myself, but tonight is one of those nights where I worry that I’m not going to make the changes. I really want to lose some weight before my next appt (July 9) to prove (to myself mostly) that I’m on the right track. Maybe I’ll feel more confident after talking with the Nutritionist and will know specific diet modifications to make.

Tomorrow is a new day with a clean slate. I’m going to sleep and planning to wake up with my game face on. I WILL make this happen for myself.

AWESOME news!

I mentioned earlier that I would probably be forced to switch surgeons due to my insurance. I was really upset about this because I loved Dr. Balette. Today, my friend (and surgery buddy) called the office to get an update on the process of switching us over was told that we may not have to switch after all! Dr. Balette is personally trying to get privileges to operate at the hospital we work at just for us. I couldn't believe it! I really expected him to tell us to just find a different surgeon and never expected him to go out of his way so that he could be our surgeon. +1,000 awesome points for you Dr. Balette.

Some pics of me

NUT Assessment

I met with my Nutritionist for the first time today. She went over my diet after the surgery and gave me a whole stack of handouts to look over. She breezed through it all so my head is still spinning from all of the information. I discussed protein shakes with her and she recommended that I start trying a few brands to know what I like for after the surgery, so I'll have to add that to my to do list. I mentioned that I have been keeping a food journal and making an effort to replace carbs with protein and she seemed really pleased with that.

So far, I think I'm off to a decent start. It still hasn't fully sunken in yet. I definitely want the surgery but right now it feels unobtainable. At every appointment, they talk like it's a 100% sure thing but I guess I won't feel like it's real until I have a surgery date, or at least I'm further into the 6 month prep.

There still isn't any news on Dr. Balette getting privileges at my hospital. I was able to call the office yesterday and give him the contact information for medical staffing, so hopefully we'll hear something soon! My next appointment for my supervised program is on July 9th. So until then, I'll continue with drinking lots of water, adding protein to my diet, and trying protein shakes.

My first victory!

Today was my monthly weight check as part of the 6 month requirement from my insurance. As of today, I've lost 7 lbs! I was pretty shocked to hear that I had lost anything. I have been doing fairly well with eating right but have struggled with getting my butt off the couch and moving. I talked with the doctor about everything I've been doing and she was really impressed. I usually celebrate (anything) with food, but not today! I took my dog and went for a celebratory walk at the park.

Still no news with Dr. Balette. All of the paperwork has been submitted to the hospital so now we just wait for him to get privileges to practice there.

Here's to hoping the next weigh in shows another loss!

New NUT and more

It's been a while since I've updated this, but I haven't had much to report. I found out that the NUT I previously saw is not covered by my insurance. I was sooooo angry when I found that out, especially since I had asked several times if they verified my insurance. So that's $200 down the drain.

Last week I mwt with a new NUT and attended a 2 hour class. The handout she gave me was the exact same as the one I got from the other lady, but she did a MUCH better job of explaining everything. When I left the first NUT appointment my head was spinning with all the information. This time around, I felt more confident and understood the process. She also gave us lots of vitamin and protein shake samples that I'm looking forward to trying.

As far as dieting goes, I've fallen off track with that. I'm pretty sure I've gained the 7lbs I lost back. I've been really hard on myself about it, but I also have to remind myself that's why I'm getting the surgery, dieting doesn't work. I'm doing my best to make healthier choices and have been replacing breakfast with a protein shake. I meet with the doctor on Wednesday and boy am I dreading stepping on that scale.
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Hang in there, I'm sure all the hassels (and time to learn & prepare) will all be worth it in the end. My insurance excludes gastric surgery so I'm paying $18,000 for this surgery. Since I'm paying I'm pushing to keep things moving. Went to free seminar last Saturday, called today and made appts for in 2 weeks with internalist, then 4 days later psych & Dr. visits. I'm going to keep pushing this cart uphill until I come down the other side a much lighter person.....you must do the same. I'm far from perfect with my eatting but I am getting more exercising and hoping that is helping.
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Well done! Exercise seems to be the hardest thing for most of us, hopefully as you lose even more weight you'll feel more like it. You've done so well.
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I totally understand the frustration of the wait and the confusion on the supplements, vitamins, etc. It took 9 months for me to get my approval following setback after setback (tested positive for H pylori, allergic reaction to antibiotics they gave me, final combo of antibiotic made me sicker than a dog). My insurance co made me lose weight for at least six months before they would even discuss the possibility of surgery even though I had high blood pressure, sleep apnea and was borderline diabetic. Anyway, I stuck it out and I am 2 weeks post surgery. I have lost 20 pounds in the first 2 weeks (even with the complication of developing A-fib after the surgery). I have more energy and feel better than I have in years...I am still working on the vitamins and stuff because they are ALL gross as near as I can tell but getting used to them.
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I feel your pain, at every appt everyone talks like this is going to happen. The number one question in the class I attended was "what are the reasons for non approval ?" They told us that the surgeon won't approve the surgery if you have any medical issues that would cause surgery to be to risky, smoking, and mental issues. Meaning physic didn't clear you. While I know I'm good to go there, I still feel nervous that I won't be approved.
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I fail to understand why they wouldn't pay for something that is needed, apart from the reasons you describe. In the UK they realise that continuing to be obese puts more pressure on socialised healthcare. And this is a service you're paying for! I'm keeping my fingers crossed for you, it's the best thing I ever did.
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Thank you so much for the support. I have an appt with the surgeon on the 25th so thats when I figure they will tell me if I meet the criteria needed for the surgery. As to why they wouldn't pay, I'm just as confused as you. I think theres a lot of reasons why they don't. One of them being the stigma attached to obesity.
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Hang in there! I'm 2 weeks post op and down 24 lbs already! It's a new challenge finding foods I like (my taste in food has changed), but it's so worth it! As for protein shakes I like premier protein shakes... You can find them at Sam's and Costco. They taste pretty good and are 30g of protein! Best of luck to you in your journey!!! :-)
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What a pretty lady!
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Ps. I'm loving Dr. Balette, what a guy. Tell him I'm rooting for him lol.
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Thank you! I really liked Dr. Balette when I met him, and now I like him even more!
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I'm pleased to here from you! I'm with you on the 'everything happens for a reason' that's the world's biggest cop out. I wasn't meant to be this heavy and neither are you, we are meant to be normal, functioning, healthy units, it's free choice (and addictions) that got us here. I was sleeved this past weekend, luckily I live the UK and we have free healthcare, so the only hoops I had to jump were losing 5% of my body weight and an ECG. I was lucky in that I don't 'yet' have any co morbidities. But I would have done anything to get this done. It's only day five and I can't wait to be the boss of my eating rather than food being in charge of me. I've wasted so much time, but not any more. We'll all be here for each other.
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There mY be bumps in the road but it will all be worth it! I am 7 weeks post sleeve and have lost 30 lbs. I could never have done that in the past!
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Oh trust me, I'll deal with hundreds more bumps in the road, as long as the end result is being healthy! I'm more or less being impatient, lol. It took me so long to take the first step toward surgery, and now I want it RIGHT now haha. I'm glad to hear the surgery went well and you are losing weight!
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Thanks. I feel healthier each day!
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I am going for my first consultation on Wednesday and am worried about the insurance and surgeon approval too. Now that I finally have my mind made up I'm ready and not feeling patient at all! Good luck!
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