Alexandra

Alizmarieo, every carrier is different with regard to their medical review procedures. And large group policies vary considerably with what is covered and what is excluded--the only way to find out what's excluded on your plan is to read your plan documents or speak with your benefit adminstrator. There are some general rules, however, for coverage of bariatric surgery. They are: --Your plan must cover treatment for bariatric surgery for medically qualified patients. --Medically qualified people are those who: Have a BMI of 40 or above; or who have a BMI of 35+ with two co-morbid conditions (these are health conditions that are caused or made worse by excess weight). These are the criteria necessary for a patient to be diagnosed with morbid obesity. --In many cases, insurers also consider that people with a diagnosis of morbid obesity must have been MO for at least five years befor they will approve bariatric surgery as treatment. --A psychological screening is necessary to test for eating disorders or psychological conditions that would interfere with treatment.

Thanks, y'all!! I've talked to my bosses and it seems a sure thing that I'll be changing carriers in July. So I called my surgeon's office to let them know, and to see if I can get on the schedule for sometime this summer. My NEW tentative surgery date is...August 13! This is exactly one week shy of four years from my original band placement. Now the next hurdle is, once again, insurance approval. First I have to do the paperwork to change carriers, get it approved and get ID numbers, then have my doctor submit the request for precertification. Whew!

It's called the AP band.

Awwww, thanks, Katie! I think these surveys are always skewed when they're posted at places like this, because the responders are those who are in the midst of the best part of banding--the losing phase. Of COURSE people are going to be enthusiastic about a procedure they voluntarily undertook to help them lose large amounts of weight when they are either fresh out of surgery or in the process of watching their bodies shrink. It's the very rare person who's going to say they made a mistake this early out. Taking a long view is harder--but to me it was more important. How do people feel years afterward? Did it do the job AND leave them healthy and happier? Unfortunately (or maybe fortunately) there aren't a lot of long-term bandsters online to talk about their experiences--but I see that as an indication that they've moved on and are out living their new, healthier lives. Anyway, this is just a long way of saying that if I knew then what I know now, I'd DEFINITELY still have chosen the band. It did what I was told it would do, nothing more, nothing less. And it left me healthier and still whole.

She's up to her eyebrows in schoolwork, having taken on a full load in one accelerated session. She said she's going to be MIA for another month or so. But I'm sure she's thinking of us! :girl_hug:

Congratulations to your daughter! She sounds like a remarkable young woman who can be very proud of herself. You'r doing exactly the right thing by redirecting your frustration with family here, where it can't do any harm. I wish my stepson showed half the initiative and determination that your daughter does. He's graduating in two weeks with no next step in mind. :girl_hug:

My worst fears came true and my band was removed on April 9 due to slippage. That was preceded by about a month of very uncomfortable refllux, an inability to eat, an overall unhealthy feeling and fear. So I'm a good person to ask if I'd do it again. The answer is YES, and I'm tentatively scheduled to be rebanded on August 13 (insurance gods willing). Even with the negative experiences, and there were some, there is no other tool I've ever come across that made it POSSIBLE for me to lose the weight I needed to lose. And though my weight loss stopped before I got to anyone's idea of a goal weight (my lowest was around 210, giving me a BMI of just under 30), it was the very first time in my LIFE that I had any hope of staying at anything close to a normal weight. It was a lifesaver for me, and I am eagerly anticipating the day I get a new little silicone buddy to keep me from falling prey once again to morbid obesity.

Hi LBT family! I'm back from surgery and the news is that the band was removed. All in all, everything went VERY smoothly, and all my fears were alleviated. Yesterday and this morning I'd worked myself up in to quite a state with all the what-ifs and could-go-wrongs, so it was such a relief to hear the doctors tell me that everything is just fine with me internally. The removal went smoothly, and I'll be back at work on Wednesday or Thursday. In three or four weeks I'm going to follow up with the doctors, and at that time I'll start thinking about replacing it with the VG band. But one step at a time. For now I'm healing and drinking and being grateful for good friends (shout out to Alexra!!) and great doctors, and this support group which keeps me going. Just another stop on the band journey. :biggrin1: :biggrin1: :biggrin1:

In my honest opinion, the lap band is not a good fit for people battling short-term weight problems (like those brought about by pregnancy). It's for people who have fought and lost a long-term battle with morbid obesity, for whom weight has become a serious health concern. You've only had a baby 8 months ago? Give it time. Is your baby still nursing? Contrary to popular belief, it's just as likely that nursing mothers can retain weight through the whole nursing relationship, rather than lose it quickly. I kno that I only was able to drop the extra baby pounds when my babies weaned. Having a baby is a huge physical ordeal. As your baby grows you will become more and more active, and perhaps the weight will come off more easily. In my humble opinion, weight loss surgery is not a good idea for you. Congratulations on your new baby!!

The only supplement I've ever tried that had any effect at all was ephedra, which is also now off the market. It didn't reduce my appetite that I recall but did increase my energy to the point where I really would rather be doing something than sitting still. Time would fly by and I'd forget to eat. My biggest eating trigger was and still is boredom, so anything that gets me off my butt is a great anti-nibbling influence. I've tried to replicate the effect with caffeine, but that just makes me unpleasantly jittery and irritable in the bargain. I'd love to find something like ephedra again--I lost 30 lbs with it in the year before I was banded. If I could combine it with being banded? Watch out, mama!!

Good luck Karen! You know these jitters are perfectly normal. Come back and let us know how it all went. :biggrin1:

I'm not sure what you mean. If there are more than a few pages in any thread, the page numbers have always been shown as "1,2,3,...last" -- haven't they? In any event, you can jump to a particular page by clicking on the little down arrow symbol to the right of the word "last" in the page number indicator; that lets you jump to a page number of your choosing. You have to be IN the thread to do that, though; perhaps you used to be able to do that from the forum page? Let me know if that's what you're referring to, or if it's something else.

Carlene gives wonderful advice and knows whereof she speaks. Listen to her. And take care of yourself. :hug:

For what it's worth, in both of my pregnancies there was no heartbeat detected until I had ultrasounds at 13 and 14 weeks. The doppler in the gyno's office couldn't hear anything through my ample flesh.

This morning I told my bosses that I really want to switch to Horizon...the conversation has begun! I'm confident that it will happen effective 7/1, and then we start the request for precert all over again. Now I just have to get through the next month or two without GAINING!!!

There is indeed a glimmer of hope!

Adele, there are no sure things. Lots of people who are depressed find that with weight loss, their lives improve immensely. Being lighter makes us more able to move around, which in turn lifts the mood. So right there, sure, losing weight improves our lives. But clinical depression is something else entirely, and weight loss may not be a cure for that. Only you can figure out if you're just depressed about your weight (which ALL of us were, or we wouldn't be here), or if you're suffering from something more profound. Have you ever been thin? Do you know if your depression is directly related to your weight? Desperation is not the same thing as depression, necessarily, and desperation is what leads most of us to weight loss surgery in the first place. So is what you're feeling desperation? Weight loss definitely improves lives for those of us who are morbidly obese. I can't imagine anyone saying anything different. That's not to say life is perfect afterwards--not all of our problems are caused by excess weight, so not all of them can be cured by weight loss. But life is definitely better with less weight to haul around, no question about that.

Well, sure, the port can move, but that's usually not something one can do TO it once it's healed. How long ago did you have surgery? Are your incisions healed up? The port is stitched to you internally so yes, it's possible to rip stitches if there hasn't been enough healing time.

Robin, all of the doctors I know of around here (in NJ and NY) do lap banding surgery as an outpatient procedure. It's in a hospital, but there is no admission and no overnight stay. It's routine!

It's probably muscular just like it would be after any strenuous exercise. It's nothing to worry about, but depending on how recently your surgery was you might want to take it easy. My doctor's advice has always been "if it doesn't hurt, go for it" with regard to post-surgery activity. So it follows that if it hurts or is uncomfortable, wait a little longer.

Yep, that's what that is. The usual prescription is an unfill, because something is going on inside that pevents material from exiting the pouch completely before you lie down. The condition itself can cause inflammation which can make it worse, to try to be extra careful for a few days. A medication such as Prilosec can help, and avoid trigger foods like coffee and acidic things. Take special care to NOT eat or drink anything for several hours before bed, and see your doctor if it doesn't go away. Good luck!!

Missy, you need to be thinking about taking care of yourself so that you can help take care of your family. You might seriously just want to stick to Protein shakes or bars, whatever's easy, so that you won't get malnourished or dehydrated during this time. There is certainly no downside to delaying your start with solid food, and if you don't have time to devote to chewing and eating carefully you might really want to just wait until things settle down. Take care of yourself!! Remember to drink, and don't worry about eating. Protein Shakes and bars have plenty to sustain you. Good luck with everything and don't forget to sleep!!

:myscared: This'll be hard--just now I was talking with someone about a client that has the word "landscape" in its name, and I said "lapband" instead. This is going to be a loooooong day.

I just need a few hours or days to process this, and once I get the denial letter in the mail I will have a better handle on my next move. I've appealed insurance denials in the past and prevailed, so I am inclined to give that one more try. The last time I did that I was a trailblazer, and I know my experience helped others in this state have their bands covered. So perhaps that's my path again, to fight this and win in order to help carriers see it as a treatment for a chronic condition, not a "cure" that can be abandoned once a certain goal is reached. Mark, you are of course absolutely right. And I will also be exploring the costs. If they truly would be limited to $10,000 that's doable, but I live in Northern New Jersey where hospital costs are astronomical. (Mexico is just not something I'd consider, since I have such good physicians so close at hand.) But I know my doctors will work with me and it is indeed possible that the cash cost would be manageable. So there's that. Right now I'm very disappointed and trying not to show it. Most of my work colleagues know nothing about this rollercoaster, and I'd like to keep it that way. I'll spill all over you, my REAL support system.

Not medically necessary. My BMI is in the very low 30s now, so I'm not morbidly obese. Evidently they don't care that it was a replacement. I'm going to proceed with a second appeal, and find out what my expenses would be if I paid myself. But I'm also going to have to face the possibility of facing life unbanded. Crap.