Alexandra

You have a lot to be proud of, Pete. You must be a hero to your doctor's office!!

Insurance carriers have specific protocols they follow with regard to how they assess the suitability of medical treatments. This is something I hear doctors talk about all the time, and unfortunately it's hard to fight. In my experience, different carriers have different protocols, but pretty much none will pay for a fill prior to 6 weeks out (as that is the standard medical regimen). You could argue with the carrier you have, but by the time you're done arguing the time will have passed, so what's the point? They would just cite studies that say waiting three months gives a better outcome (and they are out there, I know), and use that as justification. Good luck!

OK, OK, that's enough with the personal comments. Let's start again. This was a reasonable question and it's not so surprising that we were curious. Faith must have missed your answer to me, that's all. No personal attacks, everyone. Thanks!!

PENNI!! How great to see you and awww, what a gorgeous little guy! Congratulations on your 8th grandchild (wow!). How are you doing, in other respects?

Oh my word, Annabeyta, what a horrible thing to have happen! I'm so glad you pulled through and are able to share your story with perspective. No question, surgery is a HUGE decision and the reason for that is the possibility of stories like yours. Thank you for telling us your experience, and best wishes for continued healing and strength.

Thanks, WClady! I'm starting to get excited about this again, as the weekends roll in faster and faster. August 15 will be here before I know it!!

They wouldn't be bad for you, no. The general thinking, though, is that once you're on solid food you should get all your calories in that way--from solid food. Replacing a meal with a liquid if you don't have to could lead to your taking in more calories without realizing it. Protein shakes do have a place in many bandsters' lives, most often as breakfast for those who have more restriction in the mornings. But it's really easy to drink too many calories, so it pays to be careful.

For a time after surgery you're going to be on a total liquid diet, and Optifast is as good a protein shake as any. What are your doctor's instructions for postop eating?

Oh, and for what it's worth, the statistics come from the doctors reporting their results. There are all sorts of procedures for that, which almost never involve interviewing the patients.

Ann, I'm sorry if I missed a thread somewhere, but can you explain what exactly happened to you? That sounds like the most severe bout of complications I have ever heard, and I'd love to hear more about it. What was your doctor's assessment? What did they say went wrong? How did you end up in the ICU, especially? I mean, even the very worst cases, band removal is pretty simple. What happened?

I think this is just CYA language that they can't really enforce. Any insurance carrier is obligated to cover emergent care, so if you have a complication that really requires instant attention they would have to cover that. The alternative would be a lawsuit, and no carrier wants to go there. However, they are within their rights to exclude coverage for some complications that might be seen as elective in their own right. The good news is that even the very worst complications of banding are easily handled, and won't bankrupt you. In the very worst case you would have to have surgery to have it removed--an operation that isn't likely to exceed $20,000. On the other hand, I think it's a big concern that if you go into this thinking that your insurer won't cover anything, you might be inclined to ignore symptoms you shouldn't ignore. And that's the path to big complications. Successful banding requires close attention and if you don't think you can get the care you will need this could be a problem.

Hi Heather, congratulations on your banding! The best advice I have is to TAKE IT SLOW. Listen to your body and when you have had enough just stop eating. Start with the soft solids, and don't be surprised when you have no reaction. :car: Take each bite with care, and pay attention so you'll know when you're no longer hungry.

Glad to hear it, Brad. You had me worried there for a moment. You ask how we deal with the ads? I just turned the TV off. It really is amazing, isn't it? During my postop period I read a lot of books. :car:

I'm with Becky, Judi, but wholeheartedly applaud your initiative!! For me I know that losing weight can't be the focus of my day/week/life or I start to resent it and sabotage myself. That's the reason I tend not to participate in these things. (Not that I don't recognize their value--being a moderator forces me to come here regularly, and I know beyond a doubt it's made a huge difference to me over the years.) I'll be watching from the sidelines!

A PB can happen at any stage, and even take us by surprise when we think we're not at all restricted. Eating too fast or taking too big a bite can cause it, so take it slowly no matter what stage of the adjustment process you're in.

Holy cow, Pete, seriously--that's a LOT of weight to lose so fast. You'd better hope that slows down! I'm sure you're in close touch with your doctors and I'll bet they're as amazed as we are. Congratulations!! (I hope no one else gets the idea that this is anything but an extraordinary rate of loss. It's NOT normal, and not something anyone should expect from banding surgery.)

Hip, this is a serious hurdle that you have to come to grips with. The question is, do you love pigging out more than you hate being fat? That's the decision that has to be made. You will still be able to love food--it's GORGING that you will not be able to handle. We all struggle with this. The blessing for me, though, is that it's not a decision YOU have to make every time using only your will power. This time, we have HELP putting the food down. Are you ready to lose weight? Can you imagine what your life and body might be like without 100 extra pounds? (I know I couldn't, before.) Clearly you've reached a point where being this size is no longer the way you want to live, or you wouldn't be here. Now you have to figure out how to hang on to that decision, remember that where you ARE is not acceptable.

Everyone's options with regard to financing are different. Some used credit cards, some used personal loans (which is what all "medical financing" really is), some refinanced their homes or took home equity loans. Your options obviously will depend on your personal situation. Good luck!

If your insurer covers the procedure, they absolutely should cover at least a few adjustments, or adjustments for a period of time. In paying for the surgery, they have agreed to cover the treatment for a medical condition. Without at least a few adjustments, the band is not a complete treatment and as such is not therapeutic for the condition. If you have an adjustment declined, APPEAL. The insurance industry is still adjusting (no pun intended) its policies as the band gains in popularity, and this is an area where we all can help. Have your doctor write a letter--which he probably has written before--stating that the adjustments are a critical part of the treatment. Bottom line: Adjustable gastric banding is not complete without adjustments, and they should absolutely be covered!

If your insurer covers the procedure, they absolutely should cover at least a few adjustments, or adjustments for a period of time. In paying for the surgery, they have agreed to cover the treatment for a medical condition. Without at least a few adjustments, the band is not a complete treatment and as such is not therapeutic for the condition. If you have an adjustment declined, APPEAL. The insurance industry is still adjusting (no pun intended) its policies as the band gains in popularity, and this is an area where we all can help. Have your doctor write a letter--which he probably has written before--stating that the adjustments are a critical part of the treatment. Bottom line: Adjustable gastric banding is not complete without adjustments, and they should absolutely be covered!

Everyone's options with regard to financing are different. Some used credit cards, some used personal loans (which is what all "medical financing" really is), some refinanced their homes or took home equity loans. Your options obviously will depend on your personal situation. Good luck!

Congratulations on your banding, Brad, and welcome to LBT! You asked on another thread about fills, and I was wondering how you could have come so far without having that explained to you. Or was it explained, and they just used different words? Anyway, welcome and I hope your recovery continues to go smoothly.

Brad, I just saw on another thread that you're already banded? Didn't your doctor explain the adjustment process to you before you made your decision?

The term "fill" is shorthand for the process of adding saline to the band to adjust it for one's personal anatomy. The (adjustable gastric) band that we all love is designed to work with a personal level of adjustment--the more saline that is added, the tighter the band. The usual protocol is that the first adjustment is done 6-8 weeks after surgery; this gives the band time to heal in place. Everyone's anatomy is different so there's no right "fill" level; it's a personalized process that everyone goes through. It can take several adjustments to find the right level, and though the process is simple and quick the first one is always a little nervewracking.

With a BMI of 36.6 your insurance carrier probably wouldn't deem the surgery to be medically necessary unless you also had co-morbidities. They don't have to be heart disease or diabetes, though; there are many other conditions that can be considered. Talk to your PCP and be brutally honest, give them lots of information they can use to make the case. But you should be aware that there are LOTS of people ahead of you, with BMIs of 40 and above. Every carrier must make decisions based on guidelines of medical necessity, so it wouldn't really be a shock if you were denied on those grounds.