Wednesday, March 5, 2008

Medically Necessary

So it seems that Weight Loss Surgery is excluded from my insurance coverage. But the fine print says "unless medically necessary." I'm not exactly sure what that means, but I'm pretty sure it means that I can get lap band surgery and not have to pay for it myself!

My doctor will have to make a case for it being medically necessary, of course, and I will probably get denied the first time we submit the paperwork and have to appeal, but eventually I SHOULD WIN! Assuming my case goes the way of others I have read about with the same wording.

Between figuring this out and first finding out the surgery was "excluded", I have run the gamut of emotions. I've been angry, I've been depressed, I've had second thoughts. And third and fourth and ...

Getting surgery is a major step, of course, so I think second thoughts are natural. There is also a societal prejudice that fat people got that way through bad choices and only need to make good choices and their problems will be solved. I don't believe that intellectually, but I do sometimes fall into that way of thinking anyway.

My biggest fear is that I'll get this surgery and it won't work. I'll have had my body cut open and a piece of silicone put in and I'll still be hungry all the time. I am firmly convinced that my problems come down to hunger and adjustable gastric banding is supposed to curb hunger. But what if it doesn't?

I can never remember, even as a child, feeling full. I would eat dinner with my family and I'd gulp down my food and everyone else would still be eating. So I'd take a second helping and, sometimes, a third. I wouldn't stop until there was no food left or we kids were shooed away from the table. All that time I'd never get that feeling of satiety that other people supposedly get.

Of course, I could be fooling myself and my problems are all mental. I have this fear that as I go through the WLS process, it will come time to "shrink" me and they'll try to say that I eat to fill up an emptiness inside me or some other bogus psycho babble like that. It's true I had a crappy childhood. It's true that once I got boobs, my dad decided I'd make a better bedmate than his about-to-be-ex-wife. Plus there are lots of crazy people in my family and hints that depression is an issue for many of us.

But I don't buy that this is why I eat. If it was, my weight would fluctuate based on life events. But it doesn't. It just goes up and up. The only time it goes down is if I go on a diet. Then when I can't take the hunger any more and stop dieting, it goes back up. It does that without fail and has been doing that ever since I started puberty.

Plus I don't really feel an emptiness inside me. I know I'm supposed to be really screwed up because of what happened to me as a kid. But I don't feel like a victim. I feel like a survivor! I feel victorious because I got myself out of a bad situation and made something good out of my life when I was given crap ingredients to start with.

I am, by my nature, a happy person and that has helped me survive and get through bad periods. Not food. Food can be fun and food can be tasty, but mostly it's just food. I don't think about it when I'm not hungry and sometimes I don't think about it much when I am. I just want something fast and quick to make the hunger go away.

So I think if I could JUST NOT BE HUNGRY, that would be half the battle for me. More than half probably. And that's what lap band surgery is supposed to do -- tame the hunger.
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