013 The Wonderful World of Water

Water is literally all around us. It’s in the ground, the air, and our bodies. So what the big deal with water?

In June, Jimmy and I went to Youth Camp. If you don’t know or don’t remember, Jimmy is a youth minister. This was his first ever camp that he planned from the ground up and we were both really excited to see how it was going to turn out. I was personally really excited that the camp had a swimming pool because I hadn’t swam in probably 3+ years. The thing about camp in Missouri during June is that it is HOT and it is HUMID. You just can’t get away from it! So to escape the heat you have to make sure that you are drinking plenty of water, and why not take advantage of that nice cool pool I was just talking about. That’s when it hit me that water is really great for Jimmy and me in two distinct ways.

When it comes to losing weight—especially when you are severely over weight—there are two really great things about water!

#1 Drinking water helps you lose weight. It flushes out your body and keeps you hydrated. Hydration allows your body to function properly and to get rid of toxins and excess water. I know that it seems really backward that you get bloated and hold on to water weight when you aren’t drinking enough water every day but it is true! So it you are interested in shedding the pounds and keeping them off make sure that you are fueling your calorie burning engine (your body) with plenty of H2O!

#2 Water exercises/aerobics are a wonderful way to burn calories that is easy on your back, legs, and joints. When you exercise in water you have the natural resistance that comes with being partially submerged but you also have a buoyancy (lift/floating) that reduces the weight your joints are bearing during the exercise. That means that you can exercise more efficiently with less pain and probably for a longer period of time than if you were to exercise outside of the pool.

Yes, Jimmy and I saw great results from drinking water. We were able to stay hydrated. We didn’t get sick or overheated, and we lost extra weight. Still I have to say that we both enjoyed the benefits of the pool the most. Jimmy got in a few days for about 2.5 hours each time. He had a blast and the next day he told me that he could really feel the difference that exercising in the pool made versus the walking he normally. So it was a great experience all around—even if a dog did run off with one of Jimmy’s water shoes!

006 BCBS Pre-Approval Requirements

As I mentioned last post, we have Blue Cross/Blue Shield (BCBS) Insurance. I was going to tag all of this onto the last post and then I decided it would just be too much and more than a little overwhelming. Sorry to make you wait for it but rest assured that now you will get a more thorough answer to the insurance question.

Keep in mind that insurance coverage and requirements vary widely from one policy to the next. However, this is what Jimmy and I have been going through with BCBS. *Side note: I know that I haven’t mentioned this yet but we had considered WLS once before--about two years ago--and we had gone all the way through getting the insurance pre-approval before we backed out (due to circumstances beyond our control). So it was really nice to know basically what was going to be expected of us this time around which is why I think you will appreciate me sharing it with you*

The items below are the minimum necessary for approval of your weight loss surgery:

• BMI of 40 or greater OR...
  a BMI of 35 or greater with at least 2 co-morbidities.
*A Co-Morbidity is a disease that has been caused by excessive weight. Diabetes is one of many examples.

• Primary Care Physician’s Letter
• Active Participation and Documentation of non-surgical methods of weight loss.
• 6 consecutive months of a physician supervised weight loss program.
• 18 years of age (special consideration if under 18 with severe morbid obesity and special circumstances).
• Consult and recommendation from a weight loss surgeon.
• Psychological evaluation
• Nutritional evaluation

Policies Included in Coverage:
Blue cross Kentucky
Blue cross Virginia
Blue cross Wisconsin
Blue cross Ohio
Blue cross California
Blue cross Georgia
Blue cross Missouri
Blue cross New York Empire

Obviously this has all been a long time coming for us since we have had to undergo the six months of supervised weight loss. We will be talking more about this as time goes on, but now you have a better idea of what was required of us and what could possibly be required of you should you choose to pursue a WLS. Keep in mind that all insurance companies are different as is their coverage, but a good weight loss program/center/surgeon should help you collect and file all the insurance paperwork you need.

More Resources:

• Does your insurance policy cover WLS?
• FAQs about Insurance Coverage and Costs
• BMI Calculator

005 Insurance, Money and the Kitchen Sink

Last time we talked about the four main types of weight loss surgery (WLS) available. If you interest has been piqued then I am sure you are starting to wonder how much it’s going to cost you and what you may or may not have to do to get insurance coverage for a WLS. I can only answer these questions from our perspective and give you tips on how you can find out how these things are going to apply to you.

Let’s just go ahead and get the easy question out of the way...

Q: How much will a WLS cost me?

A: No one has an exact amount. It varies from person to person and hospital to hospital. However, for an estimate of the cost you will incur you should contact the WLS program/center/doctor you are planning to use. They should have a pretty good idea of how the money will come out in the end because they do this all the time.

Keep in mind that there are many factor that will determine the cost of your WLS:

• Surgeon performing the surgery
• Time spent recovering in the hospital
• Complications or lack of complications
• Number of care providers overseeing your case

Q: Will my medical insurance cover WLS?

A: Each insurance carrier is unique. Be sure to check with your insurance provider before undergoing surgery as the types of surgery covered and the requirements for coverage vary widely from one provider to the next. A good surgery program should help you to file your insurance paperwork and receive pre-authorization of coverage for your surgery before you ever schedule your operating room time.

Q: What are some common insurance requirements for WLS coverage?

A: I can’t tell you for sure about your insurance company but I can tell you about ours. But I am not going to do that until next time...

So stay tuned.

003 Let's Go Back...

I realized when I was looking back at my last post that I talked about why obese people in general consider Weight Loss Surgery (WLS) but I didn’t talk specifically about Jimmy and me. So I wanted to stop and take you back...

Jimmy is 36 years old. He is 6’3” and a BIG guy. Many people can pinpoint the cause of their weight gain to a specific event or series of events in their lives. Jimmy once told me that he doesn’t remember a time when he wasn’t the “Big Kid”. I don’t think that could be easy on anyone.

Jimmy doesn’t believe there were any specific things in his life that caused him to gain weight (and of course there is the continuing genetics debate about weight) but that doesn’t mean his life was easy. He was raised by his amazingly wonderful grandparents--Grampy and Grammy--who lived in Boonville, MO.

Grampy and Grammy did their best to help Jimmy be healthy and active. He participated in just about every sport he was eligible to play. They made sure he ate his veggies (however few of them he may enjoy), and they took him to the doctor in the third grade when they were still concerned about his size. Nothing any of them did seemed to change the weight.

Jimmy says that it wasn’t until he had free reign over his diet and he could eat whatever he wanted that his weight truly escalated. Like most people in America, Jimmy didn’t make very healthy choices when it came to eating. By the time he really realized he had a real and serious weight problem things seemed hopeless to change.

I can attest from personal experience that when you can’t see a way out of your bad circumstances you often choose to continue in them instead of trying to make a way. So here we are now. It’s been 18 years since Jimmy left home to go to college and the spiral began and we are just now really, seriously trying to fight out way out of the pit. It’s going to be a long hard journey but we know in the end it will be worth all the blood, sweat, and tears.