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My insurance requires a 5 year history of obesity. I was assuming that meant the minimum BMI to be classified "obese". But the surgeon's office says it has to be a 5 year history of over a BMI of 40. I don't go to the doctor very often (typical male). So my weight checks are very limited, one per year if I was lucky. Well, my BMI was 40.1 in 2006, but it dropped to a low of 34.7 in 2007. In '08 it was about 35.9. By '09 and '10 I had a BMI over 40 again. So minus those two freak years, it has been over 40 for the past 5 years. I hope they don't give me any problems approving surgery because I had temporary success doing Weight Watchers. What have you experienced with United Healthcare that requires a 5 year history? I go April 12th for my "intake" appointment. Should I wait until then to take my weight checks to the surgeon’s office or send them on ahead of me? I would hate to spend the $250 fee if I am not going to get approved. Thanks for reading this long, rambling post. Jim

Now see...you guys are not helping my confidence. But thanks for your honesty. I work at UPS...hopefully I will get approved.

I have run across a couple of people from KY. I am in Louisville. DayDreamer is in Etown. I can't think of who else is from KY.

well that certainly is a boost to my confidence. Thanks for that.

Yeah the lady at the surgeon's office said that she had just sent a packet for approval for someone that has the same insurance as I do and works for the same company. She sent theirs without the 5 year history. she was going to let me know if that one got approved or not. I think I will send her my history and see what she says. Maybe I will need to cancel my appointment if she doesn't think it will get approved. My wife is working through a different surgeon. Hers has said that she needs two weight checks for each of the 5 years. If that's the case, I'm screwed. However, they also told her that she had to do a 6 month supervised diet. We called and talked to a coordinator and they told us that they we do not have to have a 6 month diet. just the 5 year history.

I got my call today...Intake appt is April 12th. I have to produce the 5 year history now. good luck on your appointment next week.

I got out of the Army in 1997. I was overweight then but not to the extent I am now. i have actually gained about 100 lbs since then...twice. I did LA Weight Loss for a while and lost about 50 lbs. Gained it all back and then some. Then we did Weight Watchers and I lost 70 lbs and have gained it all back and then some. I guess i have only been to 2 seminars, but that is enough for me. I can't blame you for going to the Bluegrass again, if Dr Oldham wasn't there when I went, I would have gone again too. By the way. I didn't realize I was replying to your post again. I hope you don't feel like you're being stalked. lol I tend to read the posts about the KY docs and such.

I went to the Bluegrass seminar on 3/9. I thought Dr Oldham did a good job of explaining things too. Today I sent my packet in by email (cool feature). My wife is doing the band at the Bariatrics Associates of Louisville and she mailed her packet to them today (I cant do the band due to a previous Nissen). now the race is on to see which one of us gets contacted first. I hope the email wins the day. we have United Healthcare. our policy is a little different from others, I guess. We do not have a 6 month diet requirement. but we have to show a 5 year history of being overweight. I wonder if me being barred from re-inlistment in the Army due to being on the overweight program will count...not a BMI of 40 but still overweight.

You'll probably get one of the other doctors, Dr Lusco said they rotate giving the seminars. They were pretty good, my wife will probably get banded with them and I am still going to try. I read that some surgeons that do the sleeve will "take down" the Nissen. If they are going to take it down anyway, why can't they just take it down and do the lapband? We'll see. Dr Lusco was very good about hanging out and answering questions. He was doing the question part at the end of his presentation and one lady kept asking question after question...he finally told her she had reached her limit and to get with him after...it was pretty funny. I guess the bad part for you is that they only do surgeries at St's Mary & Elizabeth and the bad thing for me is theat they only do the lapband. Glad to hear that the Bluegrass group does not require the Bariatric Advantage stuff...it looked expensive...imo. I am going this Wed to the Bluegrass seminar. I have a couple of questions for them and I just want to be as informed as I can. It's funny, my wife is a nurse and I know more about the lapband and sleeve than she does.

I have heard the phrase "6 months in the last 2 years". I would ask the insurance if they can accept it even if you don't have six consecutive months since it sounds like you have five years worth off and on. just a thought.

TNT, I was looking at the Bluegrass Bariatrics website, did they require you to use their Pre-op Meal Replacement kits that they have on the Bariatric Advantage estore on their site? Just curious. I am registered for the March 9th seminar in Louisville to check it out.

Thank you for the prayers. I have almost gotten comfortable with the idea of the gastric sleeve now that I have done more research on it. I was so ready for the band though, it's just depressing knowing that it may not be a possibility. oh I'll still fill out the questionnaire and go to a consultation, but I won't let my hopes get too high.

That's what I am afraid of... Dr Lusco is the one that did the seminar on Tuesday, but they are in the same practice. He said the Dr Schuster has done one lap band on a patient that has has the nissen done prior to banding...but they didn't know she had it done until they got in there. she just told them that she had a hernia repaired. He said they were able to place the band but would probably not schedule a surgery knowing a nissen had been done. I really don't want to go with RNY. I think that and the sleeve are too invasive...(like the band isn't invasive...lol).

TNT, sorry to jump in on your conversation, but I have a question for you. Did you have the Hiatal Hernia repaired at the same time as your banding or was that before? I have had a hiatal hernia repaired in the past and went to the seminar with Louisville Bariatric Group last Tuesday. The doctor there said with the type of surgery I had (Nissenfundoplasty?) to repair that hernia, they may not be willing to schedule a banding surgery. He said that the wrap in the nissen would typically go in the same place as the pouch and the band would go. If LBG is not willing to do the banding, I would be willing to go to etown to see Dr Oldham (I live in Louisville).

Well, I got some sad news at the seminar last night.... I may not be a candidate for the lap band after all. They said that if you have had any other stomach surgeries before that it would have to be handled on a case by case basis. In the past I had a hernia repaired. The procedure is called a Nissenfundoplasty(sp?). This is where to correct the hernia and the GERD they wrap the top of the stomach around the esophagus. Since that is where they would place the band, the doctor wasn't sure they would schedule the surgery. I was almost in tears. It's not a pretty sight when you see a man 6'2" tall weighing almost 350 lbs in tears. So while my wife excitedly filled out the pre-op questionnaire, I went to my room and watched the biggest looser and cried with Arthur and the rest of the black team...the finished it off with some UK basketball.

I did weight watchers before and bought myself a watch after I lost 50 lbs. of course I've gained all of those pounds back and then some.

We (my wife and I) go tonight to the info seminar. getting excited. I'm ready to get the process going. I haven't been to the doctor in years so I have my initial appointment with a new primary on Friday. We'll see how many comorbidities I actually have. Some that I know of are Sleap Apnea, Knee pain, possible Diabetes, umbilical hernia, etc, etc. I registered on FitDay.com today and started logging my food intake. I guess that will be a habit I will have to continue after I am banded. who knows...maybe I'll loose a couple pounds before I'm approved for the band.

Save the Kohl's card for the new clothes you are going to need...Good luck