At DHMC they list 8 “steps” before surgery. Honestly, those steps are really broken even further, but saying 8 steps makes it sound simple, easy, and really manageable.
These are the steps:
Step 1 – Attend Intro to Bariatric Surgery Session
Step 2 – Insurance Worksheet
Step 3 – Register Online
Step 4 – Program Packet & Checklist
Step 5 – Bariatric Educational Seminars
Step 6 – Weight Loss
Step 7 – Evaulations
Step 8 – Final Instructions
Now, to do these steps,
there is a hurry up and wait sort of mentality. To do Step #1 you have to
register. They hold these classes once a
month, on the first Friday of the month, and the space fills up quickly, so
generally have to wait about a month to take the first step. While at the intro session they give you the
insurance worksheet that is Step #2.
Step #2 - You need to call your insurance company and find out all sorts of questions. I should have kept a copy, for my blog, but I filled mine out on Monday and sent it right back in. Some of the questions are pretty basic like, what is your deductible, co-pay, do they cover bariatric surgery, if so what are the requirements. But some of them are pretty obscure like do they cover the assistant surgeon, do they cover revisions, etc. Plus you need to get the name of the person you spoke to at your insurance company.
There is no step for this, but I also needed to get a referral from my PCP into the program, which I did after attending the intro session.
After attending the intro session and confirming you have insurance coverage, Step #3 is registering online for the Bariatric Surgery Program at hitchcock.remedyehr.com It says that it takes about 30-40 minutes to complete this process, plan on closer to an hour. This takes awhile! It was pretty thorough, and not the most user-friendly program ever written. This site also has tons of information for you to use pre-surgery. It has forums (that are severely underused). There are journals for weight loss, daily food logs (again not user friendly), plus tons more. I actually haven’t had a chance to explore the site as much as I want to yet, but I am looking forward to it.
I am currently waiting for Step #4, which is the Program packet and checklist. While I don’t know everything that I will need I do know that I will have to have my height and weight confirmed by a medical professional. I will need a psychological examination.
Step #5 is about doing three educational seminars online. For each of these seminars there is an online quiz. You can do these at any time. Generally I am the type of person that wants to do everything YESTERDAY. But I think I am going to space these out. After, all I am going to be in this program for a minimum of six months.
Step #6 Weight loss. DHMC highly encourages weight loss, but doesn’t require it unless your BMI is over 50. My insurance company requires me to be under a medically supervised diet plan for six months prior to bariatric surgery, which should lead to weight loss. My current BMI is 49.8, sooooooooo yeah. I definitely will probably have some weight loss requirements prior to surgery. This week though I haven’t snacked between meals, which is HUGE for me (GO CORA!)
Step #7 Evaluations. While in the program at DHMC you will meet with a nurse practitioner, dietitian and the surgeon. You will meet with the dietitian for 3 months. You also have to have other tests prior to surgery, to determine which surgery is best for you.
Step #8 Final Instructions – you will attend a pre-operative class and receive more instructions once your surgery date is set. Two weeks prior to surgery you will also start your pre-op diet. Which is low to non-fat. This is to reduce the fat in your liver and to reduce the size of your liver, to get it out of the way during surgery. I will elaborate more on the pre-op diet more at a later time.
In all the time frame is 6-9 months from starting the program to surgery date, unless they give you a specified weight loss that you have to achieve, and then it is up to you on how long it takes you to achieve that weight loss over the 6-9 months.
They encourage you to start an exercise plan right at the start of the program, even if it is just walking. This is something I need to do. While I do exercise once a week, I definitely need to do it more often. I do belong to the local jazzercize but I haven't been good about going and that is on me. I enjoy it, but it is hard for me to get there. Currently we have one car and it is just hard to make it there. I am one of those people once I get home from work, I am home for the day, it is hard for me to get back out of the house, so when I had my car it was easier for me to head straight to exercise class. I know, excuses, excuses. I am not trying to makes excuses for not going I am just explaining my situation.
My husband and I will start walking everyday. I do wear a Garmin Vivofit everyday so I can see just how little I walk. Having a desk job has serious disadvantages.
So anyways, this is the start to the program. In the next few days I will elaborate more on me and my reasons for joining the program and my experiences in the program. I hope you will come to enjoy my daily (and almost daily) installments. Feel free to reach out to me. I promise I don't bite!