Alexandra

Soda is a weird one. For some doctors it's permanently forbidden, while other doctors don't mention it at all. I didn't know it was off-limits, and I tried one not too long after banding. The feeling it gave me was so very odd I've never been tempted again. If you think you have a Diet Coke habit that you won't be able to kick, you're probably wrong. There are lots of other things that deliver the punch of DC, and you may very well find that you don't like carbonation after you're banded. It creates a feeling high up in my chest that I find extremely uncomfortable. Oh, and Rica, sure, lots of people drink alcohol occasionally. There are good reasons not to, but they're pretty much the same good reasons as for everyone else--empty calories, etc. The only really negative band-related thing I've heard about alcohol was an episode where someone overate while drinking and was in lots of pain the next day. All of one's inhibitions are relaxed while drinking, including that famous "soft stop."

I can't see buying special furniture for this brief recovery period. I slept just fine, albeit on my back for a couple of days. Sure, I loved having a recliner to rest in, but I was only really "resting" for two days post-op. Then I was back on my feet. This is absolutely not as big a surgery as the RNY; if all goes well you'll quickly have no need for anything special. It's not like having a baby, where the need for a good rocking chair continues for years down the road.

We all know the support-group dynamic that those with problems are the ones who are most vocal. That's as it should be, and it's very important that it be so for everyone's benefit. We've been hearing a lot lately about erosions, slippages, leaks, infections, reflux, and I'm really glad people are sharing their stories. I love you all and hope very much that this post doesn't offend any of you. Sometimes it can seem like all bandsters have such problems. Certainly, everyone CAN have such problems and not having had them at any given point is no guarantee that they won't occur in the future. But people considering banding can also benefit from hearing that it is possible to have surgery without the body rebelling, and to live a banded life without constantly dodging health issues. So here's my story: I've been banded for almost 11 months now, and healed right up after surgery with no problems. Learning to eat like a bandster has involved plenty of unpleasant moments, but for the most part I've got it down now. I've had three fills and the worst experience there was a little bruising. At this point I have good restriction, I can eat comfortably but not quickly, and I've lost almost 60 lbs which was my private, secret, impossible hope for one year. That 60 lb "goal" was held close to my vest because I don't like to get my own hopes up. I've been morbidly obese for more than 20 years, so the very idea that so much weight could come off in a way that might be permanent was hard to accept. But here it is, and it's been a miracle right along. The risk of surgery and banding was and is acceptable to me, because even in the very worst case scenarios we end up pretty much as we were before, only thinner.

Leo, thanks for posting that! I completely agree, it's never worth getting bent out of shape about a plateau. Even if we kill ourselves trying to end it and we succeed, I think they're natural and normal and would probably end anyway without superhuman effort. And certainly without wasting mental/spiritual energy on worrying about them! All that matters is the top number and the fact that the current number is way lower. The smoothness of the route in between is immaterial.

OK, so maybe I'm a sucker but I just shelled out $20.00 for the PC version of Fitday. Even though I don't log my food or activities religiously, once in a while I think it helps a lot to focus me. But Fitday on the web had some shortcomings that really frustrated me, specifically the inability to create a custom food item using ingredients. So every time I had a deli sandwich for lunch, I'd have to enter the bread, the meat, the cheese, and the spread all separately. The PC version allows you to create a custom food called, say, "turkey sandwich lunch" and enter that all at once. It also has much more detailed and flexible reporting, and a host of other features I'm just beginning to explore. Does anyone else have it? Any hints I should know? It seems a bit complex but I know I'll get used to the interface. In the meantime, I hope it motivates me to keep better track. I don't want to lose sight of why I got banded in the first place, and it's time to do something to pick up the reins. Wish me luck!

Vera, hugs from me too. I hope you have many, many years of pain-free evacuation.

Jennye, congratulations on all the good tidings! What a relief it must be to be on the other side of the real estate hassle. The answer to your question is, I have no idea. Maybe you could try deleting your Cookies and re-logging in? That's my only suggestion, since I really have no special clue about the technical side of things. Nice to have you back!

Hi Organizer, welcome! You've asked a lot of big questions, and all I can give is my perspective. For my money--which wasn't my money, but if it were--it's worth the extra $$$ to get experienced local care. However minor it can seem, banding surgery is a big deal and followup is EXTREMELY important. So even if you do decide to have the initial surgery in Mexico or wherever, do make sure you have local care lined up. You don't want to find out there is none when you need it.

Teresa, that is exactly the crux of the matter. When we fight our insurance carriers we have to be sure we know EXACTLY what their issue is. If there's an ironclad exclusion against bariatric surgery of any kind, for anyone, in your policy, it'd be very hard to argue against that. The argument I had to make was much easier, since the ONLY reason I was ever given for denial was that "not safe and effective" b.s. Aetna had never said I wasn't a good candidate, or I didn't meet all their medical criteria, or my policy didn't cover it, or anything of that kind. In one of their denial letters they came right out and said they'd cover the RNY if I wanted it. No, thank you.

Popcorn and I get along REALLY well. I still order the extra-jumbo size, but what's different is that now my husband actually gets to eat some. And more often than not there's quite a bit left at the bottom when we're done. I was really worried, because from what I'd heard getting hung up on popcorn is not a good thing. But I've had it lots of times with no problems. Everyone is different.

I'm with Donali in thinking there's not much that we can do about it. My thinking is that any bodily trauma will result in hair loss, including surgery. After having my children I lost lots of hair starting about 4 months later, which continued well into the second year of their lives both times. But it never got to a point where anyone *else* noticed, and it definitely stopped. Same thing has happened to me now. All I've done is to cut my hair a bit shorter, which makes the thinning less noticeable. LOL!! I love it.

Nancy, wow, that's interesting! And sounds like it makes sense. Can you find out what the liquid is? I'd be very interested in knowing. Thanks!

Ain't it the truth? And thanks be.

I really really like it and think it was well worth the $20. It blows the online version out of the water! Even though I have DSL, getting online and waiting for the website to come up was frustrating. Now I leave it open all the time, which means I'm much better about logging info. I now log my activity and weight daily in addition to my food, and have made sporadic attempts at a diary. Online all I did was my food, and then only occasionally. As I've said before, the custom food feature is the one I like the best. But it also lets you report much more flexibly on whatever you want. Anyway, I'm sold, and I highly recommend it!!

How beautiful you look!! Congratulations, Shelly, that's absolutely remarkable--we're so proud!! (wiping my eyes, sniff, sniff) :D :D :cool: :cool: :cool: :cool:

Following Sue's lead, here is the text of the letter that ultimately won my external appeal of Aetna's denial. This version was originally sent to Aetna, but I just recycled it for the external review board. The arguments remained the same all throughout the process. Note: This is just a sample letter with facts that no longer apply. Anyone considering adapting this letter should look for more recent medical citations to support your case. ---------------------------------- I hereby request a review of the abovereferenced denial of authorization for Laparoscopic Adjustable Gastric Banding (LAGB). The reason given for the denial was: “[LAGB] has not been proven to be a safe and effective procedure.” It is hard to fathom how Aetna can classify the procedure this way, and I hereby request reevaluation of this decision. Aetna’s own Coverage Policy Bulletin #311, dated November 22, 2002, includes the erroneous statement that “Laparoscopic gastric banding, including laparoscopic-adjustable silicone gastric banding, has not yet been approved by the food and Drug Administration for treatment of patients with medically severe (morbid) obesity.” In fact, this procedure was approved by the FDA in June of 2001, more than eighteen months ago. The medical community has long endorsed bariatric surgery as an effective treatment for morbid obesity. Procedures and techniques have evolved over time to be safer while continuing to provide substantially effective treatment. However, there are still significant risks involved with RNY or other invasive bypass surgery, and the relative safety of the LAGB is absolutely undeniable. Please share with me your basis for the statement that it is ”not proven” to be safe. The long-term goal may be to reduce my excess body weight by 80-90%, but a loss of even 50% of my excess weight would drastically improve my health and nearly eliminate the long-term risks caused by morbid obesity. LAGB patients achieve their weight loss in a more gradual manner than RNY patients, with only a FRACTION of the risk. But achieve it they do, and the evidence is multiplying all the time. There are significant advantages to this procedure over bypass surgery for certain individuals, specifically those like myself who, although suffering from morbid obesity, are in otherwise good health. I have two small children and simply will not take the risks inherent in more drastic surgical procedures. The fact that the weight loss that will follow the LAGB procedure is more modulated than that following the RNY--but no less permanent--is precisely one of the major reasons I believe it is preferable for me. Indeed, I personally have previously experienced a 75-lb loss in a period of 12 weeks, and can attest to the physical, emotional, and psychological disruption that followed. LAGB will result in precisely the result necessary to greatly improve my health without endangering it--in other words, “effective.” The surgeon I am working with, Dr. Alexander Abkin of Florham Park, NJ, has carefully evaluated my suitability for surgery. I’ve had a psychological test and nutritional counseling, and he and my other physicians support my very considered conclusion that I am a good candidate for LAGB surgery. From the journal Obesity Surgery, 12, 380-384, “Laparoscopic Adjustable Gastric Banding at a U.S. Center with up to 3-Year Follow-up”: Percent excess weight loss averaged 27.2 at 6 months (range 1-68), 38.3 at 1 year (range 10-77), 46.6 at 2 years (range 16-89), and 53.6 at 3 years (range 21-94). Conclusions: In this study up to 3 years, LAGB provided a safe and sustainable weight loss. Significant resolution of serious co-morbidities was common. From the same issue, in “Laparoscopic Adjustable Esophagogastric Banding: Preliminary Results”: Conclusions: The technique has a re-educational function, in that patients are induced to chew thoroughly, to introduce small morsels of food and to prolong the mastication time, in order to avoid dysphagia. Laparoscopic adjustable esophagogastric banding gave no problem if well positioned, and promoted new alimentary habits through a dysphagic mechanism, inducing significant excess weight loss. From Obesity Surgery, 12, 83-92, in “Outcome Predictors in Morbidly Obese Recipients of an Adjustable Gastric Band”: Conclusions: Lap-Band was associated with a good outcome and with a low rate of severe complications. The outcome was more influenced by physiological and technical reasons than by psychological or behavioral factors. Most other major insurers in the state of New Jersey readily approve this procedure for patients meeting the diagnosis criteria. The few and minor complications that may occur have been decreasing steadily in occurrence as US surgeons gain experience, and the procedure has been used internationally for a decade with no significant incidence of serious complications. Compared to the other bariatric surgery options available, the LAGB is profoundly safer and proven to be effective in achieving the goal of significantly decreasing the health risks associated with morbid obesity. No less important, I’m sure, is that the procedure’s costs are a mere fraction of those related to RNY surgery, particularly since at Morristown Memorial Hospital it is outpatient surgery. With these facts in mind, I request that Aetna review Dr. Abkin’s request for coverage verification of my LAGB treatment and reverse its earlier decision.

I faced the same problem with my carrier, Aetna, back in 2002. I eventually won on my third appeal, which was an external appeal provided through New Jersey's dept of insurance. I don't know if California offers a similar third-party review of carrier decisions, so you might want to find that out. If you are willing to fight the carrier on the "experimental" label, it most definitely can be done. The chance of success largely depends on who will ultimately make the determination. Insurance carriers have internal medical review departments, but if everyone in that department is on the carrier's payroll you can bet they'll toe the party line. Aetna didn't hesitate a second to deny my first and second appeals of their initial denial, because it was their company policy to exclude banding no matter what. This was upsetting but not surprising. But then the decision got taken out of their hands, and I quickly got a notice that their denial was overturned. The external review board didn't agree with Aetna's policy that the band was investigational/experimental, and now that some time has passed Aetna has even embraced the band a bit more than they used to. I think all carriers will come around, eventually. If you don't want to wait you should just proceed with your request for precertification and then follow the carrier's instructions about appealing. If there is a possibility for external review at any point I'd say you have a decent chance of winning. If California does not provide for any external review of insurance carrier's decisions, then you'll likely be out of luck until BCBS of CA comes to the obvious conclusion that the band is neither investigational or experimental. How much time that could take is anyone's guess.

Nuh-uh, I won't give up weighing daily, nope. I'm definitely addicted to that thing, but manage not to obsess over it. My weight is a point of information, not something I worry about overmuch. But I'll play. This morning I was 260.

Thanks for letting us know, Penni. We miss her--it's too quiet around here! Let's send some of the ubiquitous white light and healing vibes to Lisa's computer!! :Bunny

Hi Blossom, welcome! Good luck with your insurance issues, and we look forward to hearing you have a date. Nice to meet you!

This sounds like a good tip, but please bear in mind that there is no need to engage a third party to submit paperwork. I assume there is some sort of fee or commission for this service--otherwise why would they do it?--but submitting claims is something everyone can do for themselves. Good luck with it, Penni. I hope they net you some bucks back!!

Yeee haaaaa, Donali!! I wish we could have seen your face when you saw the numbers drop. Take a picture of your ear-to-ear grin when the first number is a 1, ok? You go, girl!!! :) (Note to Casper: Good job!! Keep it up, baby!)

I hope more people will chime in with their stories of smooth living! There's so much more to this journey than just numbers on a scale, and we should recognize and applaud whatever personal goals people are reaching. Let's hear about them!

Hi Tasha, welcome!! I took the liberty of resizing your photo to avatar size. Right-click on the picture below, and save it to your desktop. Then go to the User CP button here at the top, click on Edit Options, and at the bottom of the page you'll see Avatar. Click on Change Avatar and upload the file that you saved to your desktop. That should make this little photo into your avatar, the pic under your name. Nice to meet you and your furbaby!!

Lisa, I don't think it's weird at all that drinking has been an outlet for you recently. You've been dealing with a LOT of stress and don't have the outlet you used to have--that of food! But replacing one excess with another is counterproductive, and even more so when that new habit is really getting in the way of healing. Healing should be Job 1 right now. We have to give ourselves permission to be very selfish during times of healing. It's very very hard to do, particularly for people with demanding jobs, spouses, or kids. But it's vital to take care of ourselves so that we can be available to take care of these others. You can't do that if you're forever running to doctors' offices and worrying about another infection. Be good to yourself!! :)