Laura A.

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EMAIL ME@ Laura.Aaron@AM.JLL.COM

10/30/07 Wow almost a year since I wrote.  I'm a size 12 and I feel good.  Eating is still a challenge most days.  I am always hungry and I don't eat the healthest at all times but I'm really happy where I am.  I just pee'd on the stick, twice and both times... two lines.  I'm very excited and scared at the same time.  I want a happy healthy baby.  I don't care what sex it is.  I am a little disappointed that there are no books available on the subject of pregnancy after gastric bypass.  So hurry up and write one and send me a copy!
I'm going to see the doctor next week and I'm sure I'll ask 101 questions about this.

May 15, 2007 I had a suture removed from my esophagus.

Gallbladder removed April 24, 2007.

6/28/06 Ok this one's for the ladies. As you guys know I recently separated from my husband two months ago. I have lost 95 pounds in 4 months. So I went to Soma at Phipps and then to Victoria's at Lenox. I spent almost $250 but I bought 10 bras and some underwear. I had the ladies at Soma fit me and I tried on about 20 bras. I was wearing a 42D when I walked in. I wore one of the bras I bought when I walked out. A newly sized 38C.... I then went to the great Victoria Secret bra sale. You don’t have to spend all your money at the expensive places just buy one or just get fitted.
Now I have also spent about $300 more dollars on some sexy clothes. I bought pants and shirts I would never have worn… things that show cleavage and that are fitted not loose.
I was making over myself into the image I wanted to be.
I was a size 26 before surgery and am now in a regular size 16 no more plus sizes. I can even fit into some 14's. I also went from 3x shirts to regular Large.
I served my husband with divorce papers last week... after not seeing him for 2 weeks and wearing all new clothes. Not the baggy stuff that didn't fit. Got all dressed up in my new sexy stuff... needless to say he took one look at me, up and down, and quickly wanted to reconcile. So here we are going to counseling and working it out.
I have to say that buying those new bras made all the difference in how I feel, how I carry myself... My girls are perky! They are at attention for the first time in years. They are absolutely correct when they say you NEED TO GET FITTED FOR A BRA.
I might have gone down a size but I wouldn’t have gone from 42D to 38C. Now I can't help them when they aren't in a bra because they are racing to see which one can touch my belly button first but stuff those girls in a sexy bra and watch my husband go crazy!!!

6/7/06 Well I went for my Four Month Follow up yesterday and here are my stats. Pre-Op - 280 lbs Present Weight- 192.50 lbs (YES I AM IN ONEDERLAND) My Goal- 165 lbs Doctor's Goal- 145 lbs
I was a size 26/28 before surgery, I am now in Size 16W but they are getting too big. Shirts were size 3X and are now 1x
Bra size was 46D and now is 40D but I really need smaller bras and I'm going to go get refitted soon. Shoe was 9W but I can do without the wide now. Dr. Hobson kept saying why aren't you more happy... well I have kidney stones and I'm seperated from my husband... side effects/complications of the surgery. So I'm not as jump up and down happy as I should be but I'm working with what I've got. I'm happy, believe me.

5/15/06- Oh where to begin. My spouse and I are having problems and I am afraid that we will become a statistic of divorce soon. The funny thing about that is that I feel better about myself than I have in years. I’m down 67 pounds and starting to look good. I am wearing size 16W. I have no clothes in my closet that fit and I love it. Our problems stem from years of anger and hurtfulness that I am afraid we just can’t repair especially if neither of us is willing to try. What does one say to that? What does one do? I am in limbo and it sucks. One minute I want to fix it and the next I want to move on. I think I’d enjoy dating again it’s been 8 years and I’ve forgotten how horrible it was.
There is just so much going on in my life right now and I’d like to go to the loony bin for at least a week and get some much need rest but I just don’t have the time and someone has to be there for our son. I very tired of being the responsible one all the time.
So enough of my pity party and rambling. I HAVE LOST 67 POUNDS!

4/24/06- We went to the OH meeting on Saturday night. It was a lot of fun and great meeting everyone who posts so regularly on here. I met Rebecca who had the surgery one day before me and has lost 1 pound more than me. I lost another two since Saturday! I'm so happy. David and I have found a wonderful house to have built in Hampton, GA. We are going to put some money down this week and start watching our happy home being built. I tried pork chops on Sunday and it went down wonderfully and tasted yummy. Some women at the Oh meeting said they could eat filet at my age of post op so I might try it soon. It was good to hear stories and compare things that have worked and things that haven't. Also, to see everyone in varying stages of the experience. I'm looking forward to the Renaissance Festival next month. I know I need to start exercising more than just walking. I don't think I'll ever tone up everything though and look forward to plastic surgery some day.

4/21/06-OK so today is my 10th week. I have lost 51lbs. I am wearing a size 18 pants today!!! I love clothes shopping again and I've missed it.
I read these boards and I post some and I realize how truly blessed I am. I have been on here for over a year now and you guys have helped me when I was frustrated, sad, angry and happy. I am so more energetic than I have been in a long time.
I am asked a lot of questions about this surgery from everyone and I tell strangers on the street about it.
How much weight have you lost? 51 lbs in 10 weeks- do you know any diet that could do that?
What do you eat? The same as everyone else except very little fat and sugar and much smaller quantities. It’s ok to throw away food. It wouldn’t get to African in time to help any starving babies anyway.
Have you thrown up? Yes a few times, mostly because I've always been a super fast eater and I have to retrain my body to eat slowly, chew better, and stop when I feel full.
Have you dumped? No but then I don't touch sugar. Don't even want to. I do have two sugar free cookies every night.
Do you exercise? Not at a gym or in some routine. I park my car father out. I walk to lunch instead of drive. I shop more. So I'm slowly working on making it a lifestyle change. I realize that I am going to have to work on toning soon but for now with the selling of my house and moving this is all I can do and I'm not going to beat myself up about it.
Would you do it again? IN A NEW YORK MINUTE. I ask myself why I didn't do it sooner. It's not for everyone. I don't talk people into it. It's hard not being able to eat a bowl of pasta which I used to live for. I want the 3rd helping of garlic bread still but you know what....
I'M WEARING SIZE 18 PANTS!!! I WEIGH 229 lbs. I haven't weighed that since 1999 and I'm going to weigh 165 lbs some day soon. Thank you for your support, friendship and help!

4/12/06-Today was a milestone for me. I started my journey at 279 pounds with a BMI of 48.2 which at age 33 and standing 5'4" is Morbidly Obese. I had my LIFE SAVING operation on February 10, 2006 and after 8-1/2 weeks I am down to 232 pounds (a loss of 47 lbs) with a BMI of 39.9, which according to the charts make me obese. No longer Morbidly so. This might not seem to be such a milestone to some but for me it was big, especially after a three-week stall. I have had my difficulties but stepping on that scale really does make it worth it. I have also lost several sizes and am not sure what to do about clothes. I have size 24’s and 22’s if anyone needs them. I’d be happy to bring some stuff to the Meeting next weekend and Morrow, GA just email me.

4/11/06- Well we moved into my mom’s this weekend. Very stressful. Our house is under contract and was supposed to be sold today but they are having trouble financing. We may have to put it back up for sale. The mover come this weekend to put the rest of the furniture into storage. While David and I try to find a new house. Andrew loves living with pa-pa and follows my father around like a puppy. It’s good for him to have some more male companionship. I hope David won’t get jealous. I am just trying to find clothes from my closet that fits. I have several sizes but the Goodwill pile gets bigger with each thing I try on. I’m wearing size 22’s right now but they are hanging off. I don’t have 20’s but I think I’ll try making the 22’s work and buying some 18’s. We’ll just skip 20’s all together. :o)

3/29/06- It has been 6-1/2 weeks since my wonderful life saving surgery. I have lost a total of 42 pounds. I lost 31 the first month but I haven't lost any in two weeks. This is depressing. I am walking and trying desperately to drink all that god awful protein. I don't eat very much so it can't be that I'm eating enough to sustain this 237 pound body.
So what's up? I go to get a B-12 shot today and I hope to talk to Dr. Spates. Everything I'm eating is going down well and I've only had one instance where I threw up. (Salami is high in fat-lesson learned). I'm down two sizes and am excited about looking better but I don’t want the weight loss to stop or slow down.
I drink Crystal light with Unflavored Walgreen’s Beneprotien. I have tried Isopure and Profect with Crystal light which makes them both tolerable but all these protein products just taste awful and chalky with horrible after tastes.

3/21/06- 238. Need I say more? Well every day is not an easy day. I have to tell myself to eat. HA HA. The girl who planned meals days ahead in her mind. But I am also having trouble with how I feel after I eat. Sick. Nauseas. Yucky. I don’t know if I’m eating too fast or too much. I know I have to get more protein in and more fluids. I’m very tired all the time. I’ve been walking and packing up our home (we sell on 4/11). I have a lot going on in my life and I’m just waiting for that nervous breakdown that I know is coming. But each day that I get up on that scale I smile. That’s such an improvement. I don’t feel like such a failure anymore. I’m in control of my weight for the first time in my life. It’s hard. Whoever says this is the easy way out ought to follow me around. I don’t fit into any of my clothes… some are too big some are too small… tags don’t help. I’ve think I’ve dropped two sizes but then some things in that size don’t fit… so go figure. When my co-workers ask me about this surgery I’m happy to share. My husband asked me last night did I regret it.
Well yes sometimes I do and no sometimes I don’t. It’s not an easy fix. It’s not for everyone. I look forward to the day when I can eat healthy. I want to eat salad. I want to eat a little bread but I’m in protein mode now. This isn’t a be all end all. I have to work on cravings, eating less, slowing down, exercising more. I had tuna fish on 3 crackers for lunch… I feel bloated and yucky. I eat less than my 2 year old son. It’s really weird. But this too shall pass. I’m going to conquer this; this is not going to conquer me.

2/28/06-I currently weigh 252. That is 17 lbs since surgery. I am eating lots of different things and moving around very well. I’m worried I’m not loosing enough fast enough. I am having difficulty eating too fast. It’s hard to undo 33 years of terrible eating habits. I have not throw up or experienced dumping yet but then I’m very careful about not eating anything that’s high in sugar. I have had a few nibbles of peanut butter cookies because they are high in protein and it gets rid of the, I want sugar reflex I have. Tonight I had a quarter of a refried bean and cheese quesadia.

2/20/06- Tomorrow I go to see Dr. Hobson for my two week check up even though it hasn't been two weeks yet. He's only in on Tuesday's. I'm excited to see how I'm doing. After 11 days I've lost the 15 lbs I gained in the hospital and 10lbs more! Which I think is pretty good.
I'm eating potato soup tonight. I've had cheese (fat free), scrambled eggs, pudding, little pieces of Chicken, mashed potatoes, small amount of oatmeal, popsicles, pudding, small amount of cereal, a very few pistachios and lots of various protein drinks. The doctor will tell me tomorrow if and when I can go back to work. It isn't even been two weeks yet though. I'm think more like 3-4 weeks but we'll see. I'm still getting tired out very easily.

2/13/06- STD called today to verify that I had surgery and told me I was covered (DUH). I also made a follow up appointment with Dr. Hobson on 2/21 at 10 am, he’s only in the office on Tuesdays so my two week appointment will be early. I'm hungry but taking in all my liquids pretty well. My headaches have gone away. I am taking one long walk each day and walking around the house every hour. Researching the price of treadmills. I am anxious to get out of the house a little. I am still past my pre-surgery weight of 265 at 273 but it's coming down. Curse those IV's and fluid retainers. I'm ready to start the real weight loss. My mother came over Sunday with flowers, a new nightgown and a cute outfit to wear around that's velour and comfortable. Not too much elastic to hurt the tummy. God bless you Mommy you think of everything. I showed my son my tummy. I’m not sure at 20 months he understands it but he though Mama’s boo boos were yucky. I took a shower again today. Just feels better to be clean even though I haven’t left the house. I had a long nap this morning and I think I'll go for my walk and then take another long nap. Nothing too stressful.

2/11/06- I'm home and doing great all things considered. My surgery went very well and Pain Medicine ROCKS.
Actually the nurses were very proud of me. I made 12 laps around the 8th floor recover unit throughout the day and night and was discharged at noon. Now I'm going to take a nap and sip Popsicles and ice chips.
Thank you for all your wonderful recovery prayers. It's working believe me. I finally on the loosing side :O)
Love,
Laura A

2/10/06- Surgery was performed by Dr. Hobson. I don't remember falling asleep. I woke up with Brian in recovery. He was great. My two nurses, Lashandra and Darlene were absolutely the best. I had a moment of nausea and some light pain but I actually felt pretty good the whole time I was in the hospital. My IV came out and they had to re-stick me which was a pain but it went by so fast. The leak tests was awful tasting and discharging took forever. But I'd do it all again 20 times over.

2/8/06- I meet with Dr. Fields again for the Pre-op appointment after waiting for 2-1/2 hours. I weighted 268.5 lbs. Then I went downstairs to get blood drawn, an x-ray and meet with the person who puts you to sleep at the hospital as well as fill out the pre-admission stuff. They got my insurance wrong and tried to tell me I owed 20% but my insurance pays 100% after the $300 deductible. Since I'm on the Phosph Soda I was only drinking water and clear fluids. It was hard to take my blood because I didn't drink anything for 3-1/2 hours while I was waiting.... Drink your water people. So I went home and had a clear protein drink(Profect) and some jello. That helped a lot. Now I'm just nervous and ready for it to all be over with. What a stressful day.

2/4/06- I read Carnie Wilson's books today. She's the singer from Wilson Phillips who had Gastric bypass over the Internet and went from over 300 lbs to 150lbs. Size 28 to size 6. Her book was very inspirational and had some very honest moments. Great tips and advice. I really enjoyed it. Well my own surgery is only 6 more days away and I am excited and nervous at the same time. My job has brought in a temp for me to train this week to take over while I'm gone and guess what she had lap band done two years ago! Small world. My husband said that a lot more people have had these kind of surgeries but no one talks about it unless you say something. He's mentioned it at his work and found out that his boss had done some research and everyone either knows someone who's gonna do it or has done it.
Tonight I had wings for dinner and I'd like to have sushi one more time before the surgery but I'm not really doing the last supper thing. I have spend the past months, years, etc eating things I shouldn't in quantities I shouldn't so I don't really feel like I suddenly have to have everything. Plus I know I will eventually be able to have those foods again... just never the same way... you know. And given my weight, I'm not missing that. I only had one bite of my nephew's birthday cake today. It just didn't seem worth the calories. I'm happy my thinking seems to be changing even before the surgery. I'm not craving pasta, or starches like I usually do. I'm a carbo-holic but soon I won't ever be able to eat that stuff again and believe it or not I'm feeling a sense of relief about that. I want so desperately to be healthy. For me, for my son, and for my husband. But mostly for me.

2/3/06- Called my HR person about the Short term disability for while I'm out. The had me call our insurance company that handles that I had to answer some questions and then I called my doctor's office to have them fax over the release forms. I'd like to take off a month but we'll see how I feel and what happens. I get 70% of my pay while on STD so I don't want to go back part time because then I have to work and only get 50% pay. So I want to stay out until I'm 100%.

1/31/06- I have notified almost everyone I know. The reactions are quite funny. People really don’t understand this surgery. Some think this is a taboo subject or that I’m getting plastic surgery. People this is not plastic surgery. This is serious stuff. People also don’t understand what I am actually doing. I’m not just cutting my stomach into little pieces. I am altering my lifestyle, my life and my body. Yes this surgery alters your stomach. It also takes out some of your intestines. You know where all your food is absorbed. So it isn’t just that I am not going to eat as much… I’m also not going to absorb as much for the rest of my life. I didn’t go into this half cocked people. I weigh 268 lbs. I’ve tried everything under the sun. I’m not trying to alter my lips, boobs, or suck out a little fat here. I’m trying to alter my body, mind and life. So be happy for me. I am.

1/31/06- SURGERY DATE GIVEN. FRIDAY FEB 10, 2006!!! I have pre-op testing on 2/7/06.

1/26/06- had our complications class today. There were about 10 people and because two were no shows we started 1 hour late. The class was very informative, thanks Jackie and Dr. Duncan. I relayed everything to my husband last night. I know I forgot half of it by then but I did stress that with any surgery you could 1. Bleed, 2. Get an infection or 3. Die. I loved that part of the talk. She was stressing that this could happen during any surgery even having a mole removed. This is serious stuff. You know me I was a gabber but I enjoyed meeting everyone and hearing their stories. There was one person who was still smoking, had been approved but couldn’t be given a date until she quit for 3 months. I will pray for her. BUT PEOPLE don’t go into this unless you’re serious. Do you know what it took for me to be approved and you walk in with your approval and aren’t serious about the surgery! There are thousands of people who are denied who need this desperately that would do/give anything to get approved and you aren’t even serious about it. I’m thru rambling. I can’t concentrate on anything but my upcoming surgery. I can’t wait until Tuesday – the day I am given my official DATE.

1/23/06- Shona @ P’Tree Bariatrics called this morning. She’s filling in for Yakima. She scheduled me for my Complications class on 1/26/06 at 8:30 am and my Pre-Assessment doctors visit on 1/31/06 at 11 am. At the Pre-Assessment they will give me my surgery date… Sometime in February, Happy Valentines!

1/20/05- I emailed and then called Yakima at P’Tree Bariatrics. She was out this week. So I am still waiting on the date of the complications class, Pre-Op Appointment and Surgery Date. I can tell you that this wait is killing me. I can think of nothing else. I can’t concentrate on nothing else. I have wanted this so badly for so long and it’s truly going to happen. For so long I have not dared to hope… you know.

1/17/05- I thought about this surgery a lot over my long weekend. I ran the gambit of emotions: scared, hopeless, sad, happy, etc. It is hard for me to believe that this is my last option that I have to resort to this extreme to be healthy. I even had a thought of well maybe some other diet might work but I've been down that road too many times. You start a miracle diet with so much hope and excitement only to feel like such a failure when the weight comes back or doesn't come off enough. I am struggling to loose the weight my surgeon suggested for the surgery in the first place. I have to say I know all the things that can go wrong. I've read a lot about the complications and even read some of the obituaries. That's so scary. I don't want my son to grow up without a mother, without me. But I also don't want him to grow up with me in the shape that I'm in. I get so tired all the time and with that comes some depression. Everyone on TV, in magazines and movies looks so thin. As a society, we are just now starting to look at overweight people with out the jokes. I have been stocking up my pantry for my post-op. I got some Protica protein drinks this weekend and tried one. My son, Andrew loved it, I was not so sure.
One thing is certain my life will be changing. I have read so many bios on this site. That’s why I wanted to update mine today. It really is a hugely beneficial resource. I read them and think… they are so much like me. Gosh she weighs what I weigh, she started out like me, she’s getting the surgery for the same reasons I did. Look at how much she’s weighed and how much she lost. I hope I do as well. I start this journey at 285 lbs. I have struggled with weight my whole life and have been morbidly obese (40+ BMI) since the year 2000. I had a BMI in the 50’s when I was pregnant and topped 303 lbs the day my son was born. He’s 19 months old now, my angel, my savior. My pregnancy was not fun, I was like a beached whale and I struggled to get thru it. I think I would like to have another child some day but not at an obese weight.
So here begins my story. Getting approval from the insurance companies was hard and frustrating but in the end I have to say it will be worth it. What people write is true. Document and stick with it. I think the insurance companies rubber stamp everyone denied the first time. Do not give up hope. Get mad and don’t give up. I went thru it feeling like… your not going to deny me I deserve this. My son deserves this. I knew that I did what they asked and therefore I would have hired a lawyer if I had to.

1/13/06- After much back and forth with BCBS over the fact that I was a pre existing and approve by Aetna already they finally approved me. BCBS faxed me over a letter of approval, which I emailed to Tracy @ AMC and Yakima @ Peachtree Bariatrics.

1/4/06- OH HAPPY DAY! I received my approval letter from AETNA today dated 1/3/06. I now have to get approved by BCBS since my insurance changed 1/1/06.

12/27/05- I called Aetna and spoke with the nurse. The things I would do differently if I had to start this process over are…. My PCP didn’t keep great notes- the man was an idiot but after I started with him I wasn’t going to change, so every visit make sure they are writing everything down, the summary I had him sign wasn’t enough they said. Join a Gym that tracks your dates you come in like Curves (I worked there part time in 2002. I worked out there for a year; they fired me for not loosing weight. I did an excellent job of maintaining my weight thru them.) See a Nutritionist every week or have your PCP write down nutritional information like what diet you’re on and what is working and what’s not in the clinical notes. After 2 hours of back and forth she said it was with the Director and I‘d have a letter soon.

12/22/05- I wrote a long appeal letter. I included all the documentation of what they denied me for and I also stated: Throughout my 33 years I have spent hundreds if not thousands of dollars on diets, doctor’s visits, exercise programs and gimmicks. I truly believe this surgery is life or death for me. It is needed to improve my quality of life as well as save my life.
I am copying my Human Resources Coordinator, each of my doctors, and my attorney. I sincerely hope you reconsider and approve me for this life saving procedure. My life is depending on it. The quality of life of my son is depending on it. He would like for his mom to be able to play, walk and participate in the activities of his life.
***Now I don’t actually have an attorney but I looked up the name of the Obesity Advocacy one and copied him.

12/14/05- Received denial letter dated 120805.
• Coverage for this service has been denied for the following reason: After review of the information submitted, the specific circumstances of this member and Aetna’s Clinical Policy Bulletin: Obesity Surgery, coverage for the proposed obesity surgery is denied. The information received does not document that the member has participated in (1) a physician supervised nutrition and exercise program of 6 months duration in the last 2 years (including dietician consultation, low calorie diet, increased physical activity, and behavioral modification), or (2) an organized multidisciplinary program in preparation for surgery of at lease 3 months duration. A physician’s summary letter is not sufficient documentation.
I had done and provided documentation for everything that they denied me for! I participated in 6 months of Physician supervised nutrition and exercise program including a nutritional evaluation and psychological evaluation in the past 6 months. I provided documentation of a history of super obesity for the past 5 years. Not to mention that I have had a history of Obesity since 1994 (10 years). If the appeal is entered in Aetna’s records before 12/31/05 and they then approve it, it is seen as an existing with BCBS and I can still get the surgery. So if they deny it again I have to start over with BCBS next year.

12/7/05- Called Aetna, my file was with a reviewing doctor or director and I am not allowed to speak with anyone regarding status or information. I am getting quite nervous as we only have a few weeks until the end of the year and I'm not sure what will happen with my case if it is not approved by then.

12/01/05- I have come up with Doctor's clinical notes for 1997-2001 and we have submitted to Aetna. I was with Ashford Medical Weight Loss Center. I took several of the following during that two-year period Phentermine- Ionamin, Phentride, Fastin, Orlistat- Xenical, Pondimin, etc. You name it I tried it. God if only I had all that money back… what a waste. :o)

12/1/05- Tracey @AMC received a call from Laura @ Aetna on Monday 11/28 about my file requesting addition information for the year 2000. They usually only require 2 yrs of clinical files so we were both surprised by this request. When Tracy originally faxed my information to Laura @ Aetna she faxed it in two sets. The first set was 45 pages and the second fax was 43 pages with a total of 88 pages in all. Laura did not receive the second fax of 43 pages which is why she then requested the letter of medical necessity on 11/11. Laura @ Aetna called Tracy yesterday on 11/30 to say she had received the original files sent thru the mail and was complaining of the duplicates.
Tracy isn't sure if Laura @ Aetna will still need the clinicals for the year 2000 that I am still trying to dig up (Do you remember who your doctor's were from 5 yrs ago and if so do they still have your information? So far my old OBGYN did not still have my files.) However Laura @ Aetna has now acknowledged that she has received all of my files. I am still hoping to have this resolved in time for an end of the year surgery date.

11/22/05- Tracy just called Aetna to check if everything she sent on 11/11 has been received. She is waiting on a call back from the nurse assigned my case. Hopefully we'll hear back after the holiday with an approval letter!

11/17/05- Aetna sent letter stating they needed a letter of medical necessity on 11/11. They should have everything and stated they did on the call with me on 11/15. I have just re-called and again they stated they have received all information as of 11/16.

11/17/05- My HR person emailed the Aetna Representative. This is what they said, “The pre-certification nurse is stating that the only information they have on your file is a letter or medical necessity. They contacted the surgeon and informed what was needed. They also mailed a letter.”

11/15/05- Tracy @ AMC, called yesterday to let me know that Aetna contacted her on 11/11/05 requiring a copy of my clinical files. I called Aetna Pre-certification line this morning and spoke with Kristina. She stated that they did receive the information and that the file was in "pending status". I asked could I speak with the person assigned to that file she said "no". She said they would contact my doctor's office if they needed anything else. I asked how long it might be until I heard something and she stated, "it takes 30-45 days for approval".

11/3/05- Completed my 6 months diet and exercise program, I lost a whooping 10 lbs. I sent everything to Tracy @ Atlanta Medical Center to send to Aetna for approval.

11/3/05- PCP UPDATE Patients weight is 275. Patient continues to walk and decrease caloric intake. I still believe patient is an excellent candidate for Bariatric Surgery. I have given patient Letter of Medical Necessity and copy patients’ office notes for the past 2 years.

10/13/05- I attended my second support group meeting at AMC. Kera was the facilitator. It provided a lot of information and I wish I could make it to more of these meetings.

10/7/05- PCP UPDATE Patients weight is 280. Patient has increased walking for 30 minutes 4 to 5 times a week at gym or home. Patient will continue efforts in diet and exercise.

9/8/05- PCP UPDATE Patients weight is 280. Patient continues walking for 30 minutes 3 to 4 times a week at gym or home, is drinking lots of water and eating more fruits and vegetables. Patient was in automobile accident a few months ago and is having continued back pain. Requested referral earlier this month and is seeing a Chiropractor. Patient has completed her Psychological Evaluation and is considered an excellent candidate for Bariatric surgery. Patient is not loosing desired weight, suggested 1100-calorie diet and increased exercise. (Oh yeah like I could live on 1100 calories, who was he kidding!)

8/30/05- I started seeing a chiropractor. My back is killing me from lifting my beautiful baby boy….all 20 lbs of him. I saw the Chiropractor until the end of the year.

8/25/05- Psychological evaluation with Dr. Virginia Goetch $45 co-pay. Yes I am crazy but I’d be a very good candidate for Bariatric surgery. Like we didn’t know that already! I have to say I received a copy of her evaluation and it had a lot of errors in it. Example: She stated I was 33 years old on the first page and 35 on the last. I don’t think I would recommend her for someone else but it got the job done.

8/8/05- PCP UPDATE Patients weight is 280. Patient is walking for 30 minutes 3 to 4 times a week at gym or home, drinking lots of water and eating more fruits and vegetables. Patient has seen a nutritionist and attended two Bariatric support groups. Patient was diagnosed with strep throat and given antibiotics. Follow up visit on 8/9. Patient is having trouble swallowing and asked to switch antibiotics, included prescription for pain and nausea.

8/4/05- I met with Nutritionist, Jackie Oleski at Piedmont Hospital (404-605-3633). Need to bring Dr. Orders, Insurance Card, should take one hour, $98. Given the amount of research I had already done this wasn’t very informative but Jackie was very nice.

7/20/05- My 33rd Birthday. I vowed that I wouldn’t be this weight next year! It will be my gift to me.

7/19/05- Yearly Physical and OBGYN appointment with Dr. Johnson of Gwinnett OBGYN. We discussed Bariatric Surgery and ability to have children after. My doctor was very knowledgeable and happy to give me a referral if I needed one. She sent office clinicals to Dr. Whiteneck to help with prior weight statistics.

7/14/05- PCP UPDATE Patients weight is 284. Patient states she has met with Dr. Duncan and attended two Bariatric seminars. She has joined a gym and is walking at lease 3 times a week for 30 minutes. Patient has been following the Adkins Diet for 2 weeks and has had some success but is having trouble tolerating it. I suggested a 1200-calorie diet like South Beach and increasing daily water intake to 96 oz. Gave Patient referral to Dr. Virginia Goetsch for a psychological evaluation.

7/12/05- Joined Gym in my office building $35 per month.

7/11/05- Doctor’s appointment at 7:30 am, will be at least 2 hours, need to bring driver’s license, insurance card, PCP referral & $20 co-pay. I met with Dr. Fields of Peachtree Surgical & Bariatrics for Pre-Pre-Op visit. They discussed everything we need to know, weighed us in and let us ask questions. Then they sent us over to AMC to speak with the Bariatric Insurance Coordinators. Tracy was thorough and wonderful! I need the following:
• Thyroid Panel/ H-Pylori Test- Done before I left Office
• Letter of Medical necessity with Medical Clearance- Must say “Patient is medically cleared for surgery”.
• Detailed Failed Diet History
• -6 Months Physician supervised Dies
• Copy of last 2 years office notes
• Psychological Evaluation
• Nutritional Evaluation
• Pre-Operative Support Group
• Loose 15 lbs…. 279-264

6/30/05- PCP UPDATE Patients weight is 282. Patient stated she is still trying to loose weight. We discussed Bariatric surgery. Patient completely understands risks and has researched the Bariatric surgery on her own. I think patient is a perfect candidate for weight loss surgery and I feel her health and quality of life would greatly be improved if she were to be approved for Bariatric surgery. I have given patient referral for Dr. Titus Duncan, a Bariatric surgeon.

6/28/05- I sent back the packet P’Tree Bariatrics gave during the Seminar. I wrote a weight biography. It included a lot of my pain and I must admit was therapeutic but to this day I have not let me family read it. I can’t even explain the humiliations that go along with being over weight but here are some I have experienced myself: Having to ask for the seat belt extender on airplanes, Getting out of breath easily, Not fitting into rides at amusement parks, Not fitting into restaurant booths, Not being able to go thru turnstiles, Not fitting into regular bath tubs, Being afraid of getting into back seat of a car with others, Not fitting into bathroom stalls, Not fitting into theater seats and most chairs everywhere, Being passed over for jobs/ promotions, Surpassing the weight restrictions on exercise equipment but most of all Not being able to “chase” my son.
I don’t want to be a super model; I just want to be an average mom. I want to live for a long time, as my weight slowly climbs so do my health problems and risks. I want to begin living my life again, spending quality time with my family and friends.

6/27/05- Attended Gastric Bypass Support Group on June 27th, 2005 at Walton Regional Medical Center. This support group is facilitated by Beth Melvin, RD, LD, CDE and Carolyn Abbott, RN. They have these once a quarter. They had a manager of a gym come in. He did a body fat analysis and gave samples of the Isopure drink line. They weren’t bad but they are very expensive at $3 a pop. The bottle lasts all day and has all your recommended protein so if you look at it that way it isn’t bad. (I bought a case months later for post-op drinking.)

6/23/05- Informed my Managers of my decision to have surgery and that I would have many doctors’ appointments in the upcoming months. I asked to keep this hush until I was ready to let people know.

6/21/05- 5:30 pm Attended Peachtree Bariatrics WLS Seminar at Atlanta Medical Center. Dr. Titus Duncan speaker. Boy people ask some stupid ?’s don’t they. People research this a little before you go to the seminar. Don’t keep everyone there for hours asking the same ?’s.

6/4/05- Andrew’s 1st Birthday. My little man, the 2nd love of my life. I decided to do something about this weight thing today. I started really researching this WLS thing.

5/27/05- My 4 year wedding anniversary, I have known my husband since 1998. I was a plus sized bride but my husband married me anyway. He is the love of my life even though I don’t tell him so nearly enough. He has never said anything about my weight even though I was a size 12 and weighed 165 when I met him. He just always says he wants me to be healthy. I want that too but I also want him to have a gorgeous wife.

5/3/2005- PCP UPDATE Patients weight is 285. Patient was seen for sinus infection. Patient stated she gets out of breath easily, is depressed and has tried multiple diets, exercise programs and weight loss attempts in past. I suggested walking 3-4 times a week.
*** I am including my doctor’s notes as we wrote them up for the Diet and Exercise 6th Month History Summary. I typed them and he signed it on my 6th month visit.


Laura
280165
02/10/06-RNY

About Me

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