lenses

I went to support group tonight.  At first I thought it wasn't as good as the last one, but then, on my walk I began to go over it again in my mind.  Tony (you remember the man who taught us the value of the squat?), the trainer, was leading again tonight.  He tends to run a fairly open forum and there were a lot of comments.
"I don't like to..."  "I don't have time to..." I hate..." "it's only for me, so I don't..."

Wow.  Can you feel it? The negative shift to the air?  Oppressive, isn't it? No wonder we're always tired.  How many of us think we're virtuous because we put others first?  How many of us sacrifice our health in the name of martyrdom?  We think we're being selfless...and we are...being less...less to be respected, less healthy, less whole, less happy, and ultimately less lovable.  Tony said it's a lens we look through.  If we can shift that lens to let just a prism of light come through, we can change. We can change.  We can change the way we think.  We can change the way we react.  We can change the rules we made up for ourselves.  We can change what we perceive to be success.

Success for me is not running up the mountain and raising my fists in the air for two minutes.  Even if I could possibly do that, that is a short lived victory, not success.    Success (for me) is becoming healthy enough to walk up the hill in front of me, and then...tomorrow walking up the next hill...and so forth.  Success is achieving the ability to realize that as long as I don't give up, I AM winning.  I'm only in a race with myself, so as long as I don't quit...I'm in first place.  :)  One small step at a time.

My surgery will be in October. Win!  I am averaging over 7000 steps a day. Win!  My appointment with Dr Trieu is next Wednesday (I asked to be on the asap list so maybe before!) and that means the surgery might be as early as Oct 3rd...but will probably be sometime the week of the 6th.  Can you feel it getting real?  That means in two weeks I could be starting liquid diet phase!  Holy Hanna!  That's exciting....and terrifying....

So, I challenge you.  Try being a little selfish.  Take time to make a plan for you.  You might not need to lose weight.  Maybe you just need to lower your stress, or you're looking to get healthier in general.  Make someone else wait.  You're worth waiting for.  Figure out what makes you happy and find time to do it.

I hope you take a few minutes to think about the lens you're looking through and how you can adjust it to let light in.  Remember, there is no such thing as darkness...it's only the absence of light.

Thanks for coming on my journey with me.  I hope I have helped you in some small way with yours.

~Mikki

Fantastic news!!

Keeping the faith!!

Got a call from Harvard Pilgrim today....they have agreed to approve my appeal!! How awesome is that?? They said because I was never given the information when I started, even they agreed it would be unreasonable to have to start all over!! :)

Now, I don't have a date yet...I have to have my second appointment with Dr Trieu and THEN I get the date!

I can't even tell you how excited I am!!

So, denial aside...I will say that Harvard Pilgrim is about the easiest insurance company that I've ever worked with.  The Appeals Analyst called me today before she'd even written up the decision.  As soon as she verified that I was all set she called me.  I was so happy!  She even went an extra step to make sure that everything else was ok before she told me so that I wouldn't get excited and then have another problem.  She verified with the physicians on the board that I've done everything I need to do!

Are you ready?  We're almost there!

If this was a test I guess hanging in there and not falling off the wagon ( oh lost 3 more lbs) really did pay off! Thank you all for the support! Prayers really do get answered!

Stay posted, I'll let you know when there's a date! :)

How's your water today??

~Mikki

oh yeah Baby! 10,557 steps! whoot!

Yeah!! So excited! ;)  Who knew it only took mowing ditches on top of my regular walk?  LOL

That's the good news.  The bad? I'm still waiting. I did get a call from Lori Charles of Harvard Pilgrim.  She didn't get any further with the "center of excellence" hospitals than I did.  She encouraged me to appeal the denial to Maine General and she put in a call to the appeals department letting them know I would be.  I did fax it to them, but haven't heard anything yet.

But, you know what? I think I get it.  It's a test. (Isn't everything?) I think maybe I was just a bit too sure of myself.  I was pushing through all these steps and, while it wasn't easy, it wasn't really a hardship test.  Maybe I needed to see what it's gonna be like.  Maybe I had to hit hard to know if I could keep pushing through.

When we were in the grocery store tonight my hubby said "look, Hon, they have reduced fat Pringles".  He knows I love Pringles...well, you know...I love all chips.  :) But I can't do it.  Chips would be my "slider" food.  (You know, kind of like a gateway drug) If I start again, I would just keep going. Maybe I can try them someday... on the other side....maybe.  I could have just decided to say "what the hell" and jump right back into them.  I've been pretty upset.  The idea of starting over and maybe even having to gain weight again has a knot in my stomach for sure.  But I really want to show myself that I AM ready for this.  I will only be successful if I can stick with it and really change how I think not just how I eat.

I'm usually a big picture person. I try to see what it the worst case scenario and then once I understand that I think "Ok, now what is best case scenario, and how do we go about doing THAT!"  I have a wonderful life. I have people that love me.  I have a great job and an even better dream for the future.  Worse case scenario?  I give up, keep getting even more fat plump and die of a heart attack at 52.  Ok, not pretty.  What is best case scenario?  I get to have my surgery in October, get healthy and have a long, healthy future in my RV with Jay. :)    Now, really anything better than step one is a win! ;)

How are you guys doing?  Everyone hydrated??  Have any challenges that are testing you this week?  Sometimes I guess we really do have to take a step back to move forward...at least that's what I'm hoping.  So in the meantime...I'm still moving!  Squeeze your butt!!  xo

10,000 steps!!!

Thanks for coming with me!
~Mikki

Hold everything...I seem to have lost an adjective...

That's right people, not only have I managed to not dive face first into the Doritos and gain stress weight...I have lost 1.5 pounds...which means I am no longer "morbidly" obese!

Just plain ol' obese here hanging out...  :)

Which of course is fantastic, unless I have to start over at this whole process.  You remember I said I need to have a BMI of 40 if there were no other weight related health issues?  Yeah, well I'm down to 37.9.  Still excessive amount of weight. There is not question about that.  I am certainly hoping that the insurance will just go by my original weight as they say they will,

So for those that don't know, HP (Havard Pilgrim) did actually reach out to me and they are trying to get the hospitals to work work with me on what I have already done.

You know how I said I was struggling to see a message?  Well, my mom has decided that the message is: Thank goodness it happened to me.  I know, right?  LOL  But her point is she knows if there is any chance to fight this, I will do it.  If it had happened to some other poor person they might not have had the fight to take it on.  And....HP has already agreed to change their policy to make sure to include the hospital information when they respond to any request about weight loss surgery in the future so I guess she is right about creating progress.  I don't mind paving the way, but I'd really like them to work with me and not have to repeat any steps.

The supervisor seemed to catch on right away that since my deductible is about met, doing all these steps again would now be out of their pocket.  Isn't it amazing how money can motivate?  I know it does me! :)

She seemed to think it should just be a simple matter of record review and any additional steps they require and then getting on with scheduling the surgery.  I hope she makes progress.  She is also encouraging me to go ahead and appeal my denial with Maine General, and is sending me the paperwork to get started on that.  I'd really, really love to just have it done here.  My surgery date would have been Oct 6th....

If I win powerball tonight it might be anyway...to hell with the insurance approval!!  What? I know!!  Sacrilege!!

I still like the flavored steevia in my protein shakes...still not eating bread or pasta...no chips since June 10th! Baby steps...before you know it I'll be telling you I'm just overweight!! ;)

Thanks for staying with me on this bumpy ride!

~Mikki

Not a curve...more of a hi-jack really...

So today was a total derail.  I didn't realize that was how it was going until it was too late.  I crashed hard.  See today was 3 weeks since my psych eval, so I decided to call the center and see if they had got any notes on it yet.

Marie tells me that "yes, we got them! And we submitted everything to your insurance company on Augusta 4th.  We should be hearing back soon."  YAY!!, Right?
So I pull up my Harvard Pilgrim website and click on authorizations.  Yep!
There is the request!  There's Dr. Trieu's name...can you feel the excitement starting to build??... I click into it...
status: Denied.

WTH??

So I pull out my trusty insurance card and call them to see what mistake they have made.  I mean...I did all the steps.  I jumped through the hoops.  They already told me that this procedure is something they cover and Dr. Trieu is in network. It's gotta be a mistake, right?

The lady that answered put me on hold...twice...trying to figure out why it was saying denied. She couldn't figure it out either.  Then, finally, she comes back on the line to say that the hospital (the only one that Dr. Trieu has privileges at) does not meet the criteria.

...

WHAT?  I called in April.  You knew it was a bariatric procedure.  You knew I was seeing Dr. Trieu for that procedure.  How could it possibly have escaped your attention to mention to me that hospital he is affiliated with would not qualify for this procedure?????

...

She did say she was sorry that no one had informed me.  Isn't that great?  $3000 out of pocket,  4 months of jumping through hoops -eagerly-, not to mention half way through my out of pocket expenses and now they're telling me I have to start all over.
Not only is it unlikely that I will get through every thing in time to have the surgery done this year...do you want to know the real kicker???
I've lost so much weight that my BMI will no longer qualify if I walk into another consult at what I weigh today.  How freaking sad is that?  I'd need to gain weight to get approved now.

I am just so mad that I don't think I can begin to process where to go with this.  I called one of the "qualifying" hospitals and sure enough she said "the first step is the seminar and then we'd get you scheduled for a consult"....ah deja vu!  I started crying.  I couldn't help it.  I was so mad and frustrated.
...
So...deep breaths.  I did not buy any chips. :)  I am going to wait until tomorrow and see if Marie has any luck at all when she calls Harvard Pilgrim to try and argue with them.  I am going to walk tonight.  And then tomorrow I will start figuring out how to fight this.  There has to be away.

I always say things happen for a reason.  I am having a really hard time seeing the message today.  But that's ok.  That's why there's tomorrow.

Thank you all for listening to this not so upbeat post.  I guess turbulence is part of the ride.

~Mikki