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POSTED UNDER Gastric Sleeve Surgery REVIEWS

Jumping Through Hoops to Get a Sleeve - Conroe, TX

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

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jenalex11
$5,000
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!

Replies (15)

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June 18, 2014
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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June 19, 2014
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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June 19, 2014
Thanks. I feel healthier each day!
July 20, 2014
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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June 19, 2014
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.
December 24, 2014
I love your attitude and spunk. That is what is going to work in our favor this time. I need to get my before picture up. Cause I really want to compare with my after. Happy Holidays! !!!
December 19, 2014
I jumped hoops and it paid off. Surgery set for Dec. 30. I don't believe everything happens for a reason. I believe everything happens. Period! So, I'm going to make my future brighter and healthier. Hello sleeve, here I come-fears, anxiety, hope and all. Let's get through this together.
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December 20, 2014
Hey there surgery buddy! I'm tentatively scheduled for december 30 also. I haven't gotten my approval yet, but I'm still hoping it will come through soon. I agree, I'm taking control of my life and giving myself the gift of health for Christmas!
December 24, 2014
You go Ms. Jena. We will get through this together.Heard anything yet? My fingers and toes are crossed for you. That will be a great New Years gift. Best to you from La Quinta, CA
December 29, 2014
Jena did your approval come through? I'm on my final two days -clear liquids of course- and Tues. is my day. I hope your on with me dear buddy. Please let me know. Be well, Paula
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December 23, 2014
Are you with HCA? I'm asking bc I worked for them the past and I think that one of their requirements (to have your procedures at their facilities). Good luck to you! I'm about done jumping through my own set of hoops as well and hope for surgery someone in January-February when I can get away from work :)
January 7, 2015
I totally understand everything you're going through. I wanted to have the surgery also after I had a horrible accident with my knee and the recovery wasn't going smoothly because I weighed a ripe 350 pounds. I decided to attempt to get my insurance to pay for the surgery. What I found was that I had to wait six months do a psychological evaluation and do a diet/training course. I was so upset when I found out because I needed relief for my knee NOW! Not six plus months later. That's when I decided that I was going to Mexico and paying for the surgery myself. I'm now 50 pounds down and feeling better. Good luck on your journey and if you ever need support I'm right here in The Woolands.
UPDATED FROM jenalex11

Not feeling it tonight.

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jenalex11
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.

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UPDATED FROM jenalex11

AWESOME news!

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jenalex11
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.

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