Truths! Birthdays, Graduation, and pics

I'm really trying to stay honest, and embrace the truth even when it hurts.  Here's my latest confession - I love butter/ margarine.  This is embarrassing - but I've loved it since I was a child.  My mom tells about me climbing out of my highchair and onto the thanksgiving table to sit down and chew on a stick of butter at my grandmother's while everybody was in the kitchen when I was 15 months old.  I used to stick my finger into the tub of margarine and scoop out a little once in a while as a kid.  As I grew up I grew out of it - or should I say changed things I liked to eat that weren't good for me. 

Since my surgery, really in the last couple months, I have rediscovered my taste for margarine.  That sounds gross doesn't it?  I think part of it is craving fat - which even with a tablespoon or two of margarine a day my consumption stays low (yes, I have been logging it).  That melt-in-your mouth feeling is part of it.  There lies a truth - if it melts in your mouth, it's liquid calories - a BIG NO-NO and major rule breaking.  So, just like I had to make a big change when I realized I was starting to compulsively eat popcorn, I'm going to have to make a big change here.  No more buying tubs of margarine.  I will buy sticks of butter, which I have no craving for, whatsoever.  Logical?  Of course not - it's a crazy psych thing.  Oh the webs our tricky brains weave.  I can use sticks of butter for everything cooking-wise that I use tubs for, and not be tempted.  Yesterday I threw out the tub that was in my fridge.  Wonder what the next thing is my brain will try to tempt me with...

On to a more positive truth - I got my new driver's license!  The truth part is that I actually put my REAL weight on the license for the first time in my life.  Not even my lowest weight, but the pound higher that I was on the day I renewed it.  I thought I needed to renew it by my birthday but it turns out I didn't have to renew it until next year.  Yeah, it was written right on the license, I know... But I decided to renew it early because I don't look like my license anymore.  And I'm 50 pounds lighter than the LIE I had on my old license.  But I took pictures of my old and new license (with all the potential identity theft info blocked out) for memories sake (and this blog). 

 

OK, so that's my old license.  I listed my weight at 190, which was 53 less than I weighed at my highest.  When the picture was taken I might have been 235.  I remember being relatively happy with the picture, because it only showed two chins.  I spent a lot of time on my hair and makeup that day, too. 

... and here's my new one!  I LOVE looking at those two pictures next to each other.  An added bonus is that people will actually believe it's my I.D. when I am asked to show it :) 

I still think that they should just have a digital scale built into the floor at the license bureau.  That way when you step up for your turn it would automatically weigh you and the they wouldn't have to ask your weight.  It's embarrassing for the average person to say their weight out loud to someone, and mortifying for the obese.  Plus, it's not like most people tell the truth!  Heaven forbid something had happened to me two years ago and they found my body.  I can see them saying "Oh, this probably isn't her, she's much heavier than the person we're looking for..." 

My birthday is in two days, and my mom offered to come spend the morning with me for a "girl's day" - something we used to do when I was little, and have tried to make time for occasionally now that I'm a grownup.  I asked my boys (10 and 13) for the birthday present of them watching themselves (without killing and bugging each other) for a few hours for my birthday present.  My mom is going to come and go on a nice long walk with me and my dogs.  Then she's going to come with me to a jewelry store.  All of my rings are WAY to big.  I'm guessing I'm wearing a 6 1/2 now - my old rings are 8 1/2.  I don't feel the need to spend the money to resize everything, but I've been wrapping medical tape around my wedding band and engagement ring for over a year now and want to get that done!  I'm thinking about instead of having several rings resized I would look at combining stones into a new setting.  I have no idea how much that will be, but want to explore options and get a sense of how much money I will have to save up.  Then we might go to a bookstore and browse...aaaah, the luxury of doing that without having the kids interrupt me twenty times.

I got an email this morning inviting me to my Center for Bariatric Surgery graduation!  In our program, if you have met your goal and kept it off for over a year, you are invited to that year's graduation party.  It's a formal event at a really nice hotel, and will be happening in October.  The only sad thing is that my surgeon has left the practice.  So I'm sad that when I walk across the stage with a slide show of my before and after pcitures I won't get to shake Dr. Ben-Meir's hand.  :( But, I'm really excited to be in the graduating class of 2013.  I need to start looking for an AWESOME dress.  Oh, and saving up for it, too. 

Bariatric Betty Talks Truth, Lies, and Money

I am three months out from surgery, and VERY happy with the results.  In addition to no longer being diabetic, I have lost 36 pounds since surgery, for a total of 66 pounds lost.  I have my 3 month checkup next week, and feel confident that they will be pleased.  They told me that the average person loses 50% of their excess weight by 6 months post-op.  I am 3 months out and have lost 40% of my excess weight (from time of surgery).  Yippee!!!  My energy is super high, my mood is improved, and I have the ability to do things I couldn't have done a few months ago.  I look forward to getting my labs done and making sure I'm doing well with my vitamins - I will be honest and say that I have forgotten to take them a few times (but only a few) and want to make sure my levels are good.

One thing about being three months out from surgery - all of the claims have been submitted, processed, and paid (as much as they will be) by my insurance company.  Watching this (and paying the remainders) has been very interesting.

For those of you who may not have been reading my blog since the beginning, I will suggest you take a look at my first few posts - probably starting with Bariatric Betty Gets Sucker Punched, and the ones immediately following.  To summarize, I will say that the first hospital's bariatric program (Hospital A) gave poor/ false information in their information session and after I was all psyched to begin my journey I found out the costs were more than DOUBLE what I had been told.  I then attended information sessions at Hospital B and Hospital C - eventually choosing Hospital C in part because of it's relative affordability, and partially because I was so impressed with the warmth of it's surgeon and staff, and it's low complication rates. 

The truth is two-fold.  The warmth and skill of Hospital C was genuine and fabulous.  The costs they estimated were not.  Did they knowingly give me false information?  I don't know.  I'm dissappointed that they didn't give me correct information - and given the extraordinary care I have received and continued to receive I prefer to guess that they don't know what really gets billed.  That leads me to think that perhaps I should think less harshly of Hospital A and their mistakes.   Maybe I would have found the same thing at Hospital B if I had gone there.  It really makes you wonder: DO DOCTORS AND STAFF AT HOSPITALS HAVE ANY IDEA WHAT THEIR PATIENTS ARE BILLED?  At least in Northeast Ohio, I would guess the answer is No. 

Hospital C told me that for my surgery (RNY Gastric Bypass, laproscopic) and the typical hospital stay (two nights, three days) I should expect that the total bill of about $22,000 - not including anesthesiology (which for some reason, none of the hospitals bills for - it's all billed seperately by the anesthesiologists).  I was told that the average anesthesiology bill for my surgery would probably be a couple thousand by my patient care coordinator, but since she doesn't work for the anesthesiology groups, that was the best she could do.  They also estimated (based on past experience with my insurance and this surgery) that I would need to pay about $3000 out of pocket all said and done, and took a deposit for that amount during pre-admission testing. 

Ready for reality?  I had 10 bills between preadmission testing and surgery.  Radiologists, labs, the hospital, the surgeon, the anesthesiologist, the doctor who check in on me before I was discharged.  Total bills?  $54,539.30!  Yup. 

Now, once my insurance calculated what was "allowable" under their contracts (this was all in network and pre-certified) the total recalculated amount to be paid was $19,946.26 (big difference).  My insurance paid $17,464.24 and I was responsible for $2482.02.  Of course, I have had to pay for the bills not directly through the hospital out of my pocket and have to wait another month or so to get my refund of the remainder of the deposit - so as of right now I have paid about $3600, but I should be getting over $1100 back (eventually).  And yes - all of these numbers included anesthesiology: it was originally billed at $2800 for the surgery and an additional $100 for post-op pain relief (a bargain) and was negotiated to just under $1300 total under contract). 

So why the discrepancies?  I can only figure that the person I talked to who does the billing to the insurance was looking at the negotiated rates when she gave me the quote of $22,000 (plus anesth.) even though I asked her what the difference was between the billed amount and the contracted costs - she only had one set of figures and gave me the impression it was the billed amount.  I ended up paying less than they anticipated out of pocket for as perfect an experience as I could have hoped for.  It's hard to be mad.  But it does make me ache for everyone who doesn't know how to read Explanation of Benefits (I used to do that as part of my job in my former life), and it did give me some stress during my recovery (like watching the amount billed and then PRAYING that the allowable amount would be signifigantly lower). 

As I watched things "in process" and "approved" and bills come in I knew I would want to blog about this when it was all done.  Why can't hospitals tell us all the costs?  Why can't they bill the contracted amount instead of inflated figures?  Why can't we understand the real cost of healthcare BEFORE it's given?  We need to be educated consumers, and I thought I was.  Still, I was surprised.  I know I was lucky - so many people want this surgery and don't have any insurance (or no coverage for bariatric procedures, specifically).  People in Canada routinely wait 6 months - 2 years for their free procedures - I started this journey only 9 months ago and had excellent teaching and guidance (part of which was mandated by my insurance). 

I don't have a solution for what's wrong with healthcare in America.  I do know it needs to be available to and affordable for everyone, and it is neither.  I know my insurance company (and myself ) will likely save tens of thousands of dollars now that I am not a diabetic.  I am worlds healthier and will live years longer than I would have without the surgery.  I pray that everyone else gets the opportunity to have life changing operations like I did if they need them.