Alexandra

Thanks, y'all! I've calmed down a little bit, but I swear, I was almost in tears when I got the news. Now in retrospect I wonder if the deal was ever really in danger at all. After all, Aetna had to comply with the directive of the independent review or risk being harshly penalized. Did my doctor's office really have to fill me in on the difficulty they were having negotiating? Did my intervention help at all, or did I just piss people off who were trying to do their jobs? Was I a pawn? There are such games that go on when money is concerned, I guess I'll never really know the answer. The recent trials were just the denouement, though. In the past year there were three appeals before the decision to overturn was made. I really wonder if I would have been able to stick it out through this whole depressing long process if I weren't an insurance broker myself. It helped me to stay inspired to look at the whole thing as a learning experience--knowing that I may someday be able to help someone else, perhaps a client. With that detachment it was possible to keep the search for information academic, even though at times I was inclined to passionate mood shifts (to say the least ). But it's all over now, and now I'm on to the next step. I can't believe a year has gone by since I started reading about the band and posting my frustrated questions--a year later I'm still sitting at the same computer, in the same chair, wearing the same size-28 shorts, but now the future looks entirely different. Next year, they will be size 18 shorts!!! :D

I hear a lot about how it's easy to "eat around" the band and therefore defeat its purpose. But from where I sit, eating around the band sounds like more work than just not eating at all. If understand it correctly (and please, let me know if I'm getting this wrong), when the band is properly restricted eating too much too fast leads to PAIN and DISCOMFORT. OK, so a milkshake might go down better than a burger or lasagna, but what if I don't WANT a milkshake? I'm not going to go make or buy one just because I know it's going to go down. I may be sad about the burger or lasagna I can no longer wolf down, but that's not necessarily going to make a liquid dessert sound good instead. I do worry a little about the times when my stomach is growling and I know I have to eat slowly. I'll have to make sure those moments will be few and far between, by keeping my head about me and not getting too hungry. (I think my current habit of wolfing my food was born during pregnancy, when intense hunger pangs could spring up out of nowhere and HAD to be quieted at all costs. Eating too much has been a lifelong problem--eating too FAST is more recent.) Someday my band and I will learn precisely when enough is enough, and the feeling of hunger will be easy to relieve with appropriate food eaten at appropriate speeds. In the meantime, I'll have to trust that I can find reasonable alternatives to milkshakes when I can't get that burger down.

Robin, you have absolutely made my day. :D Really, thank you so much for saying this--it's exactly and precisely what I want from the band. There may be hope for me yet.

Hey Alexis! Finally a difference of opinion...I guess we're really *not* the same person!

I'm not banded yet--soon (see sig) if all the stars align. Sounds like you had a great start!! It does seem that those of use that start over the 300 mark lose a good bit right away. Hope it's true for me too!!

Cindy, I for one haven't been told "3 meals a day." To my thinking, keeping yourself from getting hungry is more important than eating on a schedule. Are you losing weight? You may actually need to increase your calories somewhat--it sounds like you're barely getting ONE good meal before dinnertime! Anyway, for what it's worth, I'm certainly not going to worry about three meals a day. Especially between lunch and dinner--that can be 7 hours some days and that's just way too long!

I like having a scale. Even through the worst times it was important to me to know the real number--sort of "know your enemy" thinking, I guess. Now it's going to be "know my friend" time! But seriously, without a scale at all you're missing an extremely important tool in the control of your weight. From here on out YOU'RE in control, and the scale provides the information you need to help you stay that way.

Thanks for thinking of me! The appointment was more like a cattle-call for everyone scheduled for surgery in the next couple of weeks. I got my official "before" weight (317--shhh, don't tell anyone ) and they took my b.p., which was pretty high. Then I sat with several other people around a table and listened to the nurse practitioner tell us to read this form, and sign here, and read this form, and sign here, and so on. There were a couple of questions from the table but I was very happy to see that we were all pretty well informed already. The NP was a little impatient, and I didn't hear a thing about support groups or any followup besides our post-op checkups, so this doesn't seem a very touchy-feely practice. As it was I only waved to the surgeon. (He and I have had all of about 5 minutes face-time through this entire process, which started last October.) Happily all of my paperwork was in order and all my tests complete, so I just had to sign things and be on my merry way. We are, unfortunately, still waiting for Aetna to come up with a reasonable offer, but I'm fully optimistic about that. Everyone is on the same page--me, my doctors, the department of health, the department of insurance--and Aetna is out there by itself waaaay on the other end. And I have another resource to tap tomorrow. So I think my Monday or Tuesday this should be a done deal. 13 days and counting!

Hi Dawn, Wow!! It's so hard not to get excited hearing about an experience like yours--not everyone can expect such super results, I know, and my mileage will vary. What was your starting weight, if you don't mind my asking?

Hi Babs--welcome! You sound like you're doing great and have a level head on your shoulders. I look forward to staying in touch and watching your (our) progress!

Yesterday I experienced a kind of doubt that surprised me. Things have been going pretty well for me lately, and it occurred to me that if everything else is falling into place in my life wouldn't it be sort of pushing my luck to try to be *thin* also? But then I remembered that even though my job(s) may be going well and my marriage is getting better every day, the doors that have yet to open for me are numerous. This morning is my presurgical appointment, and I go with a light heart and no more doubts and worries. Thanks, everyone, for chiming in!!

Babs, that's a wonderful letter. It's informative and not at all defensive or confrontational. And it says a lot about the integrity of the journalist that she wrote back to you and wants to follow up. Kudos all around!!

Tavey, that sounds very encouraging! When were you banded? You say you have yet to feel deprived with the band. Has that been the case from the start?

THAT is encouraging! And I'd like to say that I bear no animosity to any RNYers whatsoever. My animosity--if there is any--is to the medical community that influences and pressures people who are eager for help into taking unnecessary risks. It's not the people who choose it I am unhappy with, it's the doctors and insurance carriers who promote it aggressively. Medicine and insurance are for-profit industries and that means that patients are treated as commodities. And unfortunately, many people don't understand that and blindly believe their health is the primary concern of all involved. That just is not the case.

Hi Roxanne, I don't have any answers (obviously) but I wanted to say congratulations!! I'll be watching this thread to see how you're doing. Good luck in bandland!!

I'm with you, Nicole! August 20 is my date and I am so looking forward to learning a new way to live. Stick around here, we want to hear how you're doing!!

I completely agree, quakergirl. (Shocking, huh? ) It's astonishing to me that the medical community is so slow to accept the band, PARTICULARLY for young people or those with less than, say, 200 lbs. to lose who don't have significant comorbidities. To jump right in with the slice-and-dice seems to border on really bad advice now that the band is available.

This is a great tip, Alexis, and one I know I'll need to practice! I'm reminded of my mother always scolding me when I asked for seconds: "You've had enough. Just let it hit bottom!" I never felt it. Now the bottom will be a LOT closer, and I'll KNOW when the food hits it. Yay!!

I'm so glad you asked this question! This is such an emotional process as well as a physical one. I'm feeling like I'm about to step off a precipice into the unknown--much the way I did when expecting my first child. It was impossible to actually imagine the days, weeks, and months after THE BIG DAY. There's fear, certainly, so the current insurance fight is actually proving a semi-welcome distraction. This Thursday I go in for my presurgical appointment. (I guess that's where we'll finally nail down that "before" number.) Once the ink is dry on the insurance agreement there will be no more doubt--August 20 is the day my new life begins. I think it will turn out to be as important a day in my family as our anniversary and my children's birthdays. I've told several family members and almost all of them have had extremely positive responses (once I can explain what the band is all about, of course). No one who knows me at all has given me the old "why can't you just eat less?" speech, thank goodness. I'm starting to think about what I'll tell my coworkers who don't already know. I'll probably just tell them the truth because I can't lie and I don't want to try to hide anything from them--the truth is always easier. The sense of shame you describe I've felt too, but it passes in a moment or two. This is MY life, and MY body, and I can't care what anyone else thinks. The only person who has to approve is me, and I do. When I allow myself to imagine a more slender future, emotionally I board a magic carpet. I don't do it too often or for long, but I can get teary just thinking about how even a simple thing like looking at ALL the clothes in a catalog instead of seeking the ones with the "W" will be a dream come true.

I'm really not trying to stir any waters, which is why I've never gotten involved in the debates about this on Spotlight. RNY has its place, to be sure, but that place is fffaaaaaaaaaaaaaarrr away from me. Thank providence that the band found its way to our shores in my lifetime! :banana

Joanne, another point. I'm interested in a mechanism that will help ME gain control over my intake, and will be with me for life. Bypass operations reconstruct your body so that what you eat is not utilized completely. Your body knows that's not a normal state of affairs, and over time it will start to compensate for the malabsorption. That means that after some period of time, your body will begin absorbing nutrients at an increasing rate, and strict diet will become necessary (to a greater or lesser degree, of course) to keep the weight from coming back on. And if dieting worked...well, we know the end of that story. The band is infinitely adjustable. It can be adjusted again and again depending on one's needs. Even five years out, if I find the weight creeping back on, a visit to a fill doctor will give me HELP in moderating my intake again. That's all I need: Help. If I could eat small portions, chew slowly, and only eat a 1/2 cup at a time on my own AND BE SATISFIED, I wouldn't need surgery at all. RNY may create those possibilities in the short term, but if in the long term it starts to fail there's no recourse. You're stuck. And last, it just makes good medical sense to do the least possible damage to the body in the pursuit of good health. When presented with the choice of the invasive, risky RNY and the lap-band, I have absolutely no doubt as to which is the smart way to go. (Gee, Alexandra, tell us what you really feel. )

(I'm not going to hold back here on LapBandTalk.) IMO, the RNY or other bypass operations are hugely risky. If you are in generally good health--that is, not at death's door from your weight--and want to maintain control over your life, the band is the ONLY way to go. To me, the complications and side effects make the RNY reasonable only if you have serious health issues that need to be addressed *immediately.* Personally, I think that in the future the Band will be the recommended treatment for anyone with between 100 and 250 lbs to lose, with the RNY only being recommended for people above that threshhold. People call the band "the thinking person's WLS." I completely agree.

Hi Jennaband, The idea behind not drinking *with* your meals is that liquids can wash the solid food through your stoma faster, allowing you to eat more at one time. The whole point of banding is that when your pouch fills up, you feel full and don't want to eat any more. If you flush food through your stoma into your lower larger stomach, the whole process is circumvented. The conventional wisdom is that you should drink a lot BEFORE your meal, do not drink WHILE eating, then wait at least 45 minutes to an hour before drinking AFTER your meal. And a tennis-ball-sized pouch does sound sort of larger than what I've heard of before, but I am no authority. My guess is that when your band is adjusted the effect will be the same as it is on everyone else, and you don't have to worry that your pouch is too large.

Seanmama, every surgeon's office is different. But I'd suggest calling your insurance carrier the week *after* the two weeks have passed just to see if they've received the request for precertification. When they say no, be sure to ask them how much time it takes for such a request to show up in their system. (Sometimes a request can be received and then not logged in for a week, or two weeks, or whatever.) Then call back after THAT amount of time has passed and see if it's there. If they still say no, definitely call your surgeon's office and see when (or if) they submitted it. If they are efficient you shouldn't have to call them back, since your insurance carrier will tell you when it was received. But if they're not, there's no point in badgering them until you know for sure that they didn't submit it when they said they would. This is exactly what happened with me, and even though it took a while I was confident I hadn't antagonized the doctor's office. (I felt it was important to stay on the doctor's office's good side since they were doing me a favor.)

Hi Roxanne, Thanks for the info! I wasn't asking for myself, though--I'm just very interested in which plans cover the band and what their policies are. I'm sort of doing an informal ongoing survey. A lot of people seem to think that BCBS is evil, but I've now heard of several states' BCBS organizations that do cover it. Your experience is amazing! Do you work for a large company or is your plan a standard one? Can you tell me what "Alliance Select" means?