Cadoodle

Pre-op hoops and hurdles almost got the best of me!!!

10 posts in this topic

I am about to scream because of the frustration the Bariatric Coordinator (that is her title but I would rename her and it would NOT be nice) has put me through the last 2 weeks.  She has proven to be very unorganized and careless in her job, so I have been extra careful to take very precise notes and keep up with my own case.  Originally, she guess-timated my surgery date would be July 10th.  One of the very first comments she made was that I would need to have a sleep study test. She said that when the person called me to schedule the appointment I should tell him to put my name on the call list if he had any cancellations. As it turned out he did call me and I had my first study on June 10th and had to go back on the 19th to sleep with a cpap machine because I did have sleep apnea after all.  During the period of time between these test I met with the doctor for my first visit.  I know from my notes that I cannot have surgery until I am fitted and receive my own cpap.  I also will need the second visit with the surgeon to discuss details of the 13+ test results. (no kidding 13) As time goes by and July 10th is only 7 days away, I have not heard from her and she will not return my calls. Out of desperation (and disgust) I go into the office and tell the receptionist I have to talk to her and would wait in the lobby until she could talk to me! I think she avoided my call because of the bad news she was going to give me.

The appointment to be fitted for my cpap could not be arranged because Medicare REQUIRES the sequence of events to be doctor, sleep study, fitting for equipment. Mine was sleep study, doctor visit, fitting for cpap. I reminded her that she had told me to ask to be put on the call list if someone cancelled their sleep study.  Since I was called in early I had that done BEFORE the doctor appointment (3 stinkin days before) and because of this, Medicare would not pay,. My Monday, July 10th date for surgery had to be moved to the next week, July 17, but "not to worry" she would work this out and it would happen. She did not contact me Monday, Tuesday, or Wednesday. I left daily messages and by Wednesday afternoon I asked to remain on hold until she was available. She then had to tell me I could reschedule another surgery date AFTER I had obtained my cpap and could bring it to the hospital when I had surgery!!! There was nothing his office could do until then! End of Story!

Early on when this error was first noticed by the manager of the medical supply business, he called me to explain the problem. He knew Medicare would deny the request so he tried to find info from the clinic to see if the dates were wrong. He said they KNEW the rules, but seemed unable to comply. He was also having trouble in communications with her and felt really bad for me. As the days progressed and he saw no solution to this he did the most wonderful thing! He requested from the company owner that I be given a Home Sleep Study as a complimentary offer. He  made arrangements for me to pick up a machine, be given instructions, and take the machine to my own home for another sleep study. I am so grateful!! Now I am looking to a new surgery date after the July 25th sleep study. 

I have headed into this entire decision with my faith in God to lead me in the right direction and "trip me up" if it was not the best direction. Time upon time I have felt confirmation and peace. Once when after I was literally in awe that I actually had sleep apnea, a friend called on me out of the blue and began to tell me that she had been diagnosed and was feeling SO good now that she had a cpap. I could not believe it!!! Then I told her my story that I had just been told!! Another time I felt God was helping me to have peace about the decision was when I told my new neighbor next door that I had this surgery coming up.  I don't know why I even told her because only my husband and 2 daughters are aware of this personal news. Come to find out, before she moved here she was a bariatric recovery room nurse in Dallas! She wants to help me through anything she can. Then again today the entire surgery was off until I had a cpap. The  generosity and consideration of the staff at the medical supply business came through!!.  I give God the glory much deserving of his care given to me.  I am confident of my journey forward and my drive to repair this body of mine from the years of wear and tear being unable to keep this weight off!! This new "tool" is one I do not take lightly and I am resolved to do my part. 

Now.....2 days of real food before I start anew on the liquid diet AGAIN. I feel better after getting this load out of my head and onto the written word. If anyone had the time or interest to read this book, hats off to you!!

Thanks, Suzanne

 

 

 

tracyringo, LeeC, Havamal and 1 other like this

Share this post


Link to post
Share on other sites

I'm a great believer that everything happens for a reason. Sometimes we just don't know what that reason is. My surgeon ended up delaying listing my surgery for 6 months after my husband died. I'm glad he did. It gave me the extra time I needed to put myself in a better place to handle the surgery when it eventually did happen.

BurgundyBoy and Jen581791 like this

Share this post


Link to post
Share on other sites

Hi Cadoddle!  Sorry for the frustration, but one thing from personal experience to share.  I had to have a pre-exisiting condition in order to "qualify" for WLS with my insurance company, since my beginning weigh was borderline.  So in January I was sent for a sleep study, and lo and behold - Yeppers I have sleep apnea.  So I was relieved - insurance would now pay for my WLS.  On the flip side, when the sleep study place asked me to return for another study with the CPAP, I declined because 1) the sleep study place was a REALLY bad experience (long story lol), and 2) Why do I need a CPAP since I am having WLS soon-ish?  So I kept going through all the hurdles/requirements for my surgery.  June 14th I was sleeved.  I am in recovery after surgery and guess what?  I had bad oxygen issues.  It turns out that the anesthesia lowers your oxygen level significantly, and that with the sleep apena and NO CPAP meant that I simply could not get enough oxygen.  I needed a level of 90 in order to get released to my hospital room for an overnight stay.  I was in recovery for 7+ hours!  All due to not having a CPAP machine.  They finally late afternoon tracked down a CPAP for me, and within 30-60 mins I could be released from recovery.  All this to say, I am happy you have a CPAP.  Make sure you bring it to the hospital.  I had NO idea of the anesthesia effect on my oxygen levels....

Jen581791 and BurgundyBoy like this

Share this post


Link to post
Share on other sites
13 hours ago, Cadoddle said:

...He  made arrangements for me to pick up a machine, be given instructions, and take the machine to my own home for another sleep study. I am so grateful!! Now I am looking to a new surgery date after the July 25th sleep study. ...The  generosity and consideration of the staff at the medical supply business came through!!. 

What a wonderful person! and such a big impact for you!

22 minutes ago, TammyP said:

Hi Cadoddle!  Sorry for the frustration, but one thing from personal experience to share.  ... All this to say, I am happy you have a CPAP.  Make sure you bring it to the hospital.  I had NO idea of the anesthesia effect on my oxygen levels....

Gee @TammyP I bet your sleep apnea was much worse than you suspected. For it to have that impact even after the anesthesia wore off is pretty sobering. MIne was much worse than I had thought too. I'm really glad you guys have started this thread, both to vent about the tribulations of the insurance stuff and the apnea issue.

Sleep apnea can really be bad news... and sneak up on you. I found myself waking up at night with a racing heart and unable to get a good night's sleep. A couple of times was unexpectedly sleepy driving in to work, and had to shut the door to my office and take a nap. In retrospect this was all classic sleep apnea stuff. My wife had had to start sleeping in another room because my "snoring" (sleep apnea) was so loud. She kept telling me that my breathing was irregular but I wouldn't listen. One time when I was getting a therapeutic orthobionomy treatment I fell asleep and did not breathe for over 30 seconds - which really flipped out my therapist, and thus me. It was the proverbial straw on the camel's back that helped cement my resolve to get my weight issues taken care of in a definitive way - all those links to heart attacks, hypertension, strokes, etc. Unlike you two, I was unable to tolerate a CPAP machine and used a soft plastic device that pulled my tongue forward. It helped some, not as much as CPAP would have, ... I was surprised to find out that half of the people with sleep apnea can't tolerate the CPAP machine either. 

@Cadoddle sorry for your delay, I suppose the meeting your neighbor, the kindness of the medical supply house, the getting your sleep apnea diagnosed... all for the good. Very trying though! and you should let your surgeon know about the behavior of the coordinator. I bet they know already but a letter from you may galvanize some action on their part. Your sleep apnea is not going to suddenly disappear for having the surgery, it will take some time to melt away.

Sorry for the rambling note...

 

TammyP likes this

Share this post


Link to post
Share on other sites

@Cadoddle I can relate to some of your frustration, and in my case, I felt things changed for a reason and am really glad they did.  At first my insurance required the 6 months of consecutive md supervised weight loss, I went through every single step, meeting, appointment..... surgery was scheduled for 6/29/17, I had all of my PREOP testing done, got a call about a week before surgery that due to a technicality between insurance company / medical provider / my personal employer health insurance - that I will go into if someone wants me to but will leave out the gory details for this post - they could not do the surgery.  I spent about two days really upset and trying to move a mountain and then finally said OK, if insurance will not cover this facility but WILL cover this facility (further away) guess I will check it out.  Did so and after some really great people going above and beyond to help make it happen, I had my sleeve this past Tuesday.  I felt really good about it, nothing bad about the other provider or place, but the second one was different and I liked it even more.  Also, some personal challenges at the same time as the denial - made me sure the change was for the better.  Good Luck!!   Sometimes you have to get through the incompetence with grace to find the super competent stars that will help you soar, that was my experience and I wish you the very best!!!!

@TammyP I feel like some of our experiences were similar, I was also borderline but due to the sleep apnea, it put me over, don't want to say thankful for it, but, I battled that 100 lbs for decades up and down and I never had a steady weight my entire adult life!  I'm curious about your oxygen / cpap experiences since the surgery if any?  I was diagnosed prior and brought my cpap to hospital but during my recovery period my pulse ox kept dipping when I was sleeping.  Finally they let me go home but had to have oxygen hooked into my cpap at home for sleep at night.  Here's the bad part, I haven't been able to use it one night (been home for 3 nights)  I'm so wide awake (due to lack of energy to be very active during the day I think) but I lay awake forever and finally take it off and eventually sleep without it.  Also they said that I needed to expand my lungs more and they sent me home with thing to blow into (think they may have called it an "inspired breathing" apparatus) well, they wanted me to get up to 3000 or 3500 on that and I haven't got much past 1500 on that either.  I know these sound like questions for a doc, jw if you had any of this as well.  

Gretta likes this

Share this post


Link to post
Share on other sites
9 hours ago, 2BMyBest said:

@Cadoddle I can relate to some of your frustration, and in my case, I felt things changed for a reason and am really glad they did.  At first my insurance required the 6 months of consecutive md supervised weight loss, I went through every single step, meeting, appointment..... surgery was scheduled for 6/29/17, I had all of my PREOP testing done, got a call about a week before surgery that due to a technicality between insurance company / medical provider / my personal employer health insurance - that I will go into if someone wants me to but will leave out the gory details for this post - they could not do the surgery.  I spent about two days really upset and trying to move a mountain and then finally said OK, if insurance will not cover this facility but WILL cover this facility (further away) guess I will check it out.  Did so and after some really great people going above and beyond to help make it happen, I had my sleeve this past Tuesday.  I felt really good about it, nothing bad about the other provider or place, but the second one was different and I liked it even more.  Also, some personal challenges at the same time as the denial - made me sure the change was for the better.  Good Luck!!   Sometimes you have to get through the incompetence with grace to find the super competent stars that will help you soar, that was my experience and I wish you the very best!!!!

@TammyP I feel like some of our experiences were similar, I was also borderline but due to the sleep apnea, it put me over, don't want to say thankful for it, but, I battled that 100 lbs for decades up and down and I never had a steady weight my entire adult life!  I'm curious about your oxygen / cpap experiences since the surgery if any?  I was diagnosed prior and brought my cpap to hospital but during my recovery period my pulse ox kept dipping when I was sleeping.  Finally they let me go home but had to have oxygen hooked into my cpap at home for sleep at night.  Here's the bad part, I haven't been able to use it one night (been home for 3 nights)  I'm so wide awake (due to lack of energy to be very active during the day I think) but I lay awake forever and finally take it off and eventually sleep without it.  Also they said that I needed to expand my lungs more and they sent me home with thing to blow into (think they may have called it an "inspired breathing" apparatus) well, they wanted me to get up to 3000 or 3500 on that and I haven't got much past 1500 on that either.  I know these sound like questions for a doc, jw if you had any of this as well.  

@2BMyBest, I too had to have the "aspirator" (I think it is called) after I went home for a week.  It was to curb the chances of fluid in my lungs I think.  I only had to blow a 1500 on it - and it did really help to clear up coughing/fluids.  I just got it out of the closet, and 6 weeks post-OP I can only blow a 2000, so 3000-3500 seems extreme to me.

I never had a CPAP, and still don't.  The only issue I had was the first night home from the hospital, because I did not know to prop myself up, so I woke up with gas pain/reflux, as I was flat on my back.  Did you use the CPAP successfully before surgery?  Are you drinking any caffeine at the moment?  If you have a CPAP though, I would definitely check with your doc, if you should still be using the CPAP.

Share this post


Link to post
Share on other sites

@TammyP yesterday after I wrote that my family ended up making a "game" out of the aspirator (probably is the name), my 21 y/o daughter really tried hard and got to 2500, my husband similar, only two were 2 athletic friends of daughter that got above 3500 almost to 5000!  I feel better about that part now.  Re: CPAP - I was diagnosed before the surgery and couldn't sleep well with it then either, I know it is a MD question and I will figure it out, truth be told, I'm really hoping the weight loss will improve my sleeping / sleep apnea or eliminate it altogether, sometimes it does.  Tried a little decaf coffee in my shake the other day and didn't even get through it - so, no caffeine currently :) 

Share this post


Link to post
Share on other sites
14 minutes ago, 2BMyBest said:

I'm really hoping the weight loss will improve my sleeping / sleep apnea or eliminate it altogether

Generally, sleep apnea has to do with a fatty neck/airway. Once you lose enough weight that you lose some in the neck area, you should notice a huge difference.

cinwa and 2BMyBest like this

Share this post


Link to post
Share on other sites

My program wouldn't do surgery without a sleep study, and if you were found to have sleep apnea, they would not do the surgery until you'd had your cpap for at least 2 weeks.  I was sure I didn't have sleep apnea as I never had daytime sleepiness or trouble sleeping through the night.  I was highly annoyed to find out that I did indeed.  My Dr. Told me that the only patient they have had that died was a person they allowed to not do the cpap.   He took pain meds and went to take a nap...never woke up.  I was like ok, I want to die even less than I want a cpap so I'll do it lol. Happy to say I was able to stop using the cpap several months after surgery. 

Res Ipsa and 2BMyBest like this

Share this post


Link to post
Share on other sites
On 01/08/2017 at 0:59 AM, Michael_A said:

Generally, sleep apnea has to do with a fatty neck/airway. Once you lose enough weight that you lose some in the neck area, you should notice a huge difference.

Good thing that the neck is often one of the first places we notice weightloss. :)

I was diagnosed with severe sleep aponea when I was at my highest weight. Due to a paperwork delay by the time the respiratory specialist recievef it I'd lost around 30 kg (66lbs). The test was re-ordered due to the weightloss and the sleep aponea was all but gone. I was never going to be happy with a CPAP, but the specialist did make me have the nasal surgery I needed for CPAP use in the future. I had a nasal issue that meant I couldn't breathe through my nose which would have to be rectified before I could ever use one anyway. Two weeks after the surgery, I fell over and broke my nose, so as it turns out would have to undergo that surgery again if ever I need a CPAP in the future. The ENT specialist was not impressed when I turned up at my post surgery checkup with raccoon eyes....but he did have a good laugh about it.

Res Ipsa and Jen581791 like this

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now