It's all relative.

It’s hard not to compare yourself to others, and yet we all know that no two people are the same. I had to remind myself of that while talking to my mom after her recent doctor visit. She was telling me that her various levels are good and that she lost a few pounds since her last visit…then she told me her weight.


Excuse me? What was that?

She repeated it.

OMG, I weigh 80lbs MORE than my mother. My mother who wears 2-3 sizes larger than I wear? The mother who was JUST complaining about a store having neither electric carts or shopping carts so she wasn’t able to shop that long because she needs to either site and ride or push and lean. Now this is the SAME mother who works 12 hours shifts as a nurse, so I’m in no way saying she is lazy. By all means she does what she needs to do no matter how difficult it is for her to physically do it…I am thankful for that trait.

My mother and I are about the same height, I might be an inch taller than her, and of course she is double my age so the years have taken their toll.

But 80lbs?

Where am I hiding it? Oh that’s right in my legs…while my mother does have signs of lymphedema; it’s nowhere near the extent to which I suffer. But still, this makes no sense to me…and it’s not so much the numbers. Nor, is it just my mother. I have read of other people who weigh even 100lbs or more less than me and wear larger sizes. I don’t wear my clothes tight. It just doesn’t make sense, but is an example of why we can’t compare ourselves to others.

Anyone having issues?

Last night I attended my first WLS Support Group meeting since 2006. I am seeing a new surgeon, my third since surgery, and he wanted me to attend his meetings to see if might help me. He had inquired about my support group attendance post-op during my initial appointment. I explained that the hospital where I had my WLS was two hours from where I lived at the time, and so I was only able to attend a couple meetings. I typically either had class, was in the hospital, or recovering from a hospitalization during that first year post-op.

Then I moved to Miami.

After finally getting the recommended surgeon to take me as a patient I was REQUIRED to attend a certain amount of “support meetings”. The requirement and lack of meeting structure lead to a room of new post-ops wanting to get their attendance paper signed and leave. There were no topics, no speakers…just a group of people and a psychologist asking “anyone having issues they would like to discuss?”

Either no one would reply, or the same question would be asked every month…by someone new “am I losing enough weight?”

To someone in my situation, the meetings were not worth the time. I got my support online at ObesityHelp.com. And honestly I did. Even when I attended the two meetings at my original hospital I felt out of place. First, I was usually the only one in attendance that had my surgeon, and second I was the only one who had such a large amount of weight to lose…this correlated with the surgeon issue since my surgeon typically operated on the “high risk” patients. And most people weighing over 500 pre-op have mobility issues, or in general don’t get “out and about” as often as I did. I’m not sure that is the exact reason, but from 3 different surgeon's support meetings at 2 different hospitals I have yet to find people who are in a situation similar to mine…even without the lymphedema and lipedema.

So back to last night…


My first issue was that the meeting was held in the same hospital where I admitted for my DVT, I have not set foot in that hospital since then. The parking garage to hospital entrance is a bit weird, and as I was following the path I had flashbacks to being in pain and near tears trying to “find the hospital” 6 years ago.

While waiting in line at the security desk I played “are they here for the meeting too?” I get my visitor sticker and head to the conference room. But first I stop and get a bottle of Diet Sunkist at the snack bar. It was the BBGC in me…and I was thirsty.

So I get to the conference room and sign-in. The group leader, the surgeon’s nutritionist, was getting out his recent delivery of calcium chews. I say “oh, I have those at home they are good. But I haven’t tried the raspberry.” He was very nice, and I was impressed that there were samples at the meeting. There was also FOOD. Cheese and fruit platter for the win. I had run an errand before the meeting and while I had eating a protein bar before leaving my house, a few hours had passed since.

I sit next to another lady and ask her when she had surgery. “5 weeks ago”

Oh no…here we go….or so I thought. To my surprise there were 2 other patients there who were 7 years post-op, like ME. Unlike me, both appeared to be at goal.

The topic for the evening was “how to read food labels”. I was the star pupil by knowing that serving size the most important piece of information on the label. Next he passed out samples of the calcium, raspberry is pretty tasty! Then he opened the floor to general discussion “anyone having issues?”

A new post-op is having issues tolerating food and wonders if she is losing weight fast enough.

I raise my hand, and say I’m having the opposite issue. I can tolerate everything and that after my initial 250lbs loss, I’ve started to regain. I also let the nutritionist know I had an appointment to see him next month.

I forget his response to my issue, I think because he was interrupted the male 7-year post-op patient who said. “You know what I’ve noticed is there a correlation between members who regain and members who don’t attend support group meetings.”

I guess it’s better than him calling me out for my Diet Sunkist.

Trying to not sound defensive, I said “I’ve noticed that many people in my situation are often too embarrassed to seek help from their surgeon or a support group.”

Then the nutritionist said, “O.k. are you all ready to go next door?”

Next door? Huh? Oh, the post-ops go over the pre-op seminar and answer questions. Nice.

Honestly, I didn’t mean to not go, I stopped to ask the nutritionist what he would like for me to bring to my appointment then once I got next door, I saw all the other post-ops on stage, announcing how long it had been since their surgery and how much they had lost. OMG I was definitely NOT going on stage, especially since I weighed MORE than many of the pre-op patients. And, of course, I had not had surgery with that doctor so I really shouldn’t appear to be one of his products.

So as I listened to everyone’s stats…the average amount lost was 130lbs. That’s how much I’ve lost, even with the regain; I’m still down 130lb from my highest….at 7 years out.

Making Waves

I went to water aerobics at the YMCA tonight. I took a friend with me. I kicked his ass, nearly had to save him in the deep end. It was reminiscent of when we got caught in the riptide last April. He blamed the flotation device, not sure if he meant the float belt or well um…I’ll be nice. =) Sure fat floats, but that’s part of the skill of deep water exercise is using your core muscles to balance and control your movements.


After class, I went to the members’ desk and asked if I could get a refund for credit for my dance class. I filled out the form, stating my reason as “class above my skill level”. Hopefully, I’ll at least get partial credit.

Jamie Oliver's Food Revolution

Tonight Jamie Oliver's Food Revolution debuts on ABC.


The series focuses on the people of Huntington, West Virginia. In 2008, Huntington was named the Nation's Unhealthiest City.

I am particularly interested in watching because I grew up just an hour down river from Huntington. I would guess that my hometown was used in calculating the over all tri-state area level of health. A sad reality I've noticed when I grocery shop at home is that the healthier foods I buy cost more in my hometown than they do here in Miami. Only recently has the WIC program covered fresh fruits and vegetables. I look forward to see what progress Jamie was able to make, and how many eyes across the nation will be opened.

So you think I can dance?

Well, I did at least try…and that’s what counts, right?

Last night was the first night of my Beginner Adult Ballet/Modern dance class at the YMCA. This is the class I mentioned being excited about, but has to switch sessions because I was sick and was going to be out of town and didn't want to miss two classes of the last session.

So it was me, woman who minored in dance, and the instructor.

There was a kid’s movie event in the next room so we had an audience through the windows…and yes one kid stood with his face against the glass staring at us almost the entire time.

Things started out well. Warm up stretches seated on the floor. Pass.

Then she brought out the bar. Plies, position 1, 2 and 3…foot ON the bar. Total PASS!

Next…jumps. This is where the beginner part ended and I felt like WTH? Total modification time. Just bounce instead of full jump…and it was still a FAIL.

Ballet over time for Modern…Skip jumps! Diagonal across the entire studio. So we’re jumping and running. OMG

So I reach back into my kindergarten days and remind myself how to skip. And I give it the old college try. My 4 jumps would barely get me ½ across the studio while they made it all the way across. But surprisingly I wasn’t any more short of breath than they were.

Ok now skip jump forward, and kick slide backs. Near collision. FAIL

And finally choreography time. Because this is session II of Spring, they have already been working on this during session I and for Fall the YMCA rented a theater and all the classes performed.

Uh, I don’t think so.

While class is wrapping up, I see my normal Friday night water aerobics crew head to the outdoor pool and I thought “why the hell am I in here when I’d rather be out there?” And I could have taken my bathing suit and joined the other class late, but for the first night I wanted to just see how things went.

As I’m walking out I notice the “sponsor” of studio.

Not sure if I will return. Not their fault. Just doesn’t seem to be the right fit.

March is DVT Awareness Month

DVT stands for Deep Vein Thrombosis. Click here to assess your risk for DVT.


My personal experience with DVT occurred in September 2004. I developed a severe case of cellulitis in my legs and was admitted to the hospital. Because the symptoms of a DVT are similar to those of cellulitis doctors typically ordered an ultrasound of my legs to “rule out DVT”. Now for those of you, who think the pressure of an ultrasound is uncomfortable, imagine that pressure when your legs are in burning pain. So during this particular ultrasound I hear the tech say “no venous flow”. I asked her if I had a clot and she replied “the doctor has to give you the results”. Well of course I knew enough that “no venous flow” meant there was a blood clot and as soon as I was taken back to my room the doctor came in can confirmed. I had both cellulitis and a DVT in my left leg. I was given heparin and antibiotics via IV and was in the hospital for 10 days.

That was just the beginning….

Two months later, I had been cleared to receive compression therapy for my lymphedema. One morning as I drove to my appointment the entire left side of my face felt numb. I told this to my occupational therapists and I could tell by their response something was wrong. They were concerned if I would be able to safely drive back to work. I assured them I was o.k. and promised to call my doctor. I called the doctor when I got back to my office. Her office partner told me to go the ER if the symptoms did not improve, but given my age and that I was on Coumadin, she did suspect a stroke.

The symptoms went away so I didn’t worry.

Until a few months later when I woke up and my right arm felt like it was asleep and nothing I did would make it “wake up”. I went to my doctor and she ordered a CT scan of my head. The scan showed evidence of a stroke, but in the right side of my brain, so since strokes affect the opposite side of the body it was still unclear what was happening. My doctor referred me to a neurologist.

The neurologist suspected the episodes were TIAs (Trans ischemic attack) or mini-stroke. Thankfully, this was after I had lost nearly 200lbs or I’m sure things would have been much worse. Next, the neurologist ordered blood work, ultrasounds of the vessels in my head and neck and a consult with a cardiologist.

I tested negative for Factor v Leiden, which I knew I would, my family are bleeders not clotters. After a full blood work up I tested negative for any clotting issue.

The ultrasounds all came back clear. My vessels were fine. However, the shunt study showed that tiny saline bubbles injected into my veins were traveling to my brain.

Tiny bubbles….

Were crossing through a hole in my heart, bypassing my lungs and going straight to my brain. Just like the tiny little blood clot did. This was all confirmed by the cardiologist, who did an echo cardiogram and also injected tiny saline bubbles and saw them cross from one chamber of my heart to another.

I was 28 years old and they were just discovering that I was born with PFO (patent foramen ovale) a hole in my heart.

Thankfully, after further consultation among all my doctors the hole was easily closed with a tiny screen via a catheter.

It took nearly a year for the hole to completely heal over. I have several more bubble studies, until finally one day there were no more tiny blips on the screen which indicated bubbles. I was so relieved I broke in tears. It had been a nearly 18 month ordeal.

I am thankful that today everything is “normal”. I will always be at higher risk for blood clot and the numerous infections have damaged the vessels and valves in my legs. However, my neurologist and cardiologist have given me a clean bill of health and say I’m at no higher risk of a stroke than any other person of my weight and age…wait is that good?

I take a daily aspirin, stay hydrated, and take extra precaution when flying or taking long car rides. While the ordeal was quite scary at times, I now look at it as a blessing in disguise. Had I not had the DVT and TIA, the PFO would have not been discovered and closed.

Ri-FRICKIN-diculous

Originally posted on my HealthInsuranceBitch blog.

It has been more than a year since I got my last pair of compression garments for my lymphedema. One pair. I should get two pair every six months. Since I should have a pair to wash and a pair to wear each day and the elasticity begins to wear out after six months. But as hard as it is to get one pair I have NEVER gotten four pair a year. Instead I wear the one pair I have over again for several days and then wash them and hope they are dry by the next morning. At least at this point in time I have some old pairs that I can wear, even if it means the worn out elasticity will allow my legs to swell, it’s still less than swelling than if I wore no garments at all.

I bring this up because I’ve had my garments for a year and yet my DME provider has yet to be paid. I’m past due for a new pair and yet I how can I get another pair when the provider hasn’t been paid from last year?

Oh sure, I could just pay out pocket. However, I’m currently paying COBRA out of pocket because I’m out of work. It’s more difficult to find a job when you have a chronic condition affecting your legs. If I could go work at Target or Home Depot and be on my feet all day I would. But I cannot.

The better option would be if my insurance company would follow their OWN policy and pay the claim.

Here’s the issue…and your lesson for the day, so get a pen and paper.

NETWORK GAP COVERAGE

Since my insurance company has no in-network provider within a 50 mile radius of my home that can provide the medically necessary treatment my doctor prescribes my insurance company has to cover an out-of-network provider at my in-network benefit level.

Understand? I do. Obviously they don’t. Despite going over it EVERY YEAR…they still don’t seem to understand.

Due to the size and shape of my legs, my compression garments have to be custom fitted. Once made custom fitted garments cannot be altered. So if the measurements are not taken correctly, the $300 pair of garments are a waste of time and money. For this reason, the company only takes orders from certified fitters whom they train. So if a provider has no employees who are certified fitters, they cannot provide my garments for me.

My search begins with cross referencing the garment company’s list of certified fitters with my insurance company’s list of DME providers within a 50 mile radius of my home. That list indicated there were no DME providers in my network that could provide the garment I needed. To double check I called every DME provider on my insurance company’s list. I documented who I spoke with, and asked if they were able to provide the specific custom fitted garment I need. They all said no.

So then I contact my insurance company and request that I can go out of network at in-network benefit level. This process has gone different ways. A previous insurance company agreed and my out of network provider filed the claim and was paid. My current insurance company would not authorize, and the provider was leery of accepting direct payment because of past issues with the company. So I paid out of pocket and with the assistance of the provider filed the claim with all my documentation for reimbursement from the insurance company.

Last year, well about 13 months ago, in the hopes of saving the round-a-bout hassle that every time comes back to “there is no in-network provider”, I asked if the insurance company would just pre-authorize me to go out of network. I was told I would have to file the claim and appeal.

An appeal only costs me time and a stamp, while it costs the insurance company time and an hourly wage to pay some to process it. When in the end I will win, it’s been established, I am right in this matter. So since my employer is self-insured I asked if the Benefits Administrator could order my insurance company to give the pre-authorization. I was told yes.

So I spoke with the Benefits Administrator about the issue. She knew me well, as I have filed and won other appeals. She knows I know my stuff and I’m not asking for anything unnecessary. She said “send me and e-mail”. I sent her the details. And within a few days I had a case manager calling me to set things up with authorization and wanting to make sure I got exactly what I needed. I should have known NOTHING IS THAT EASY.

That was March 2009, fast forward to February 2010, I get a phone call from my garment provider stating my insurance had denied the claim, and all their appeals…even though they had an authorization number.

I was pissed.

I immediately call the insurance company and was told that the claim was processed as out of network and therefore I would owe my out of network deductible. I corrected them and explained the authorization from the Benefits Administrator indicated it had to be processed as in-network. The woman claimed the authorization never specified in-network. WTH, there would be no need for the Benefits Administrator to intervene in the matter if this was a normal out of network claim.

So I e-mail the Benefits Administrator, recap the entire situation. She replies back the next day and cc’d someone from the insurance company. The next day the woman from the insurance company replies and apologizes for the mistake and states the claim will be reprocessed correctly and the provider paid. That was February 2, 2010.

I wait a couple weeks and checked my claims online. No changes. I call the provider; they state they did receive the information but still no payment.

So today, I check my claims online. No changes. I call the provider. No payment.

I fired off yet another e-mail to Benefits Administrator and woman from the insurance company. I remind them that by wearing my compression garments I SAVE them money because the garments have reduced my hospitalizations due to cellulitis.

Ri-FRICKIN-diculous