Alexandra

I've had LOTS of experience dealing with Aetna for banding, none of it good. The two most important questions you have to have answered are: Is banding covered under your contract? Are you medically qualified for banding or other bariatric surgery? If both of these are yes, you will be able to get Aetna to pay for it but there are hoops they'll make you jump through. But if either of these are no, you will have a problem.

No calories? They must be made from string! I'd be very interested in hearing how they taste from a real person, too. But bear in mind that just because they have no calories it doesn't mean they'll be any easier for a banded person to eat. The problem is real estate, and if there's loads of fiber in these things you might only be able to have two or three bites before you're done. And there's no nutritional value in there, so it's backfiring in two ways on you. You need nutritional food as a banded person, not fillers. And certainly not "packing material."

Triple, quadruple, quintuple HELL NO. I have lost weight before, but NEVER to this extent and never for this length of time. This feels permanent and for once I feel that I have the power to make it so. I've never felt anything like that before in my life.

Wheetsin, you have two points of argument with your insurance company here. The bottom line is that this bill is NOT your responsibility. If the anaesthesiologist is in-network, then by definition they must accept the insurance carrier's payment as payment in full. If they didn't get what they think is their entire due, their argument is with the insurance carrier, not you. Your role is nothing more than being a facilitator for getting this bill paid, as a favor to the provider. Of course, you are being billed by the provider and they're telling you they want you to pay so you feel responsible. But your carrier must make it right; if you find yourself in collections you have grounds for a suit and believe me, they don't want to go there. The billing people at the medical office are just bulls moving forward--all they see is that someone has to pay. Don't let them scare you. If you don't get satisfaction from the insurance carrier, call your state department of insurance or health or whoever has jurisdiction. You're being billed for a cost that your carrier should pay, and you need help resolving it. Good luck!!

I just tried it and it works for me, IF I'm in a thread where there is a new page of posts I haven't been to before. If I click it now, in a thread where I've read all the posts or at least viewed the page with the last post on it, it takes me to the main menu. You don't have to use that button, though. If you click on the little blue arrow next to the thread title in the forum listing, that does the same thing as View First Unread. And if there are no unread posts in that thread, the little blue arrow doesn't appear.

Thyroid issues just have to be "managed" before you will be approved for surgery. As long as you're stable on medication, it's not a problem.

Margo, six months in the long term doesn't mean anything. Really, if this is something you are determined to do, there's no harm that will be done by a six month wait. So many insurance carriers have some kind of pre-op management requirement that I guess your doctor's office decided to make it mandatory. I know a lot of people complain about it, but I honestly think it makes sense. Weight loss surgery is a big, huge step and MANY people who think they need it or who medically qualify just aren't ready for it mentally. And that's the worst way to go into surgery; it leads to frustration and failure later on. Bite the bullet and start the process. Six months is nothing when compared to a lifetime of feeling and being healthier.

Laurend, I always say that an early call is in order just to make sure the carrier has all the information they need. If you wait two or three weeks you might just find out after all that time that they're missing this document or that test result, and you've lost all that time. So go ahead and call next week just to make sure their file on you is complete. In that phone call ask them when you can expect a determination. 30 days is the absolute maximum you should have to wait, and in most cases it's a lot faster. But that countdown doesn't even start until their file is totally complete. So that's what you want to confirm as soon as you can. Good luck!!

John, your BMI may put you outside of their recommended guidelines for approving patients, but that doesn't mean the door is closed. You and your doctor need to come up with reasons why banding is a better medical choice for you than bypass--make the medical case for it and you'll likely get that denial overturned. Initial decisions at insurance companies are made by fiat, by hard-and-fast guidelines read essentially by people thinking like computers. Just take it to the next step and ask for a medical review, and you'll get to a human being thinking like a doctor. Good luck!! Huberslave, CONGRATULATIONS!!! Patience pays off, and I'll bet you're better prepared now for surgery and all it entails than you were back in August. I went through a similar wait time--even longer, actually--and in retrospect I'm glad I did. Good luck with your surgery!!

That's wonderful Bandacat, and a profound change! I agree--perceptions changing are indeed among the best NSVs that come with the banded life. Keep it going, you're a winner!

How many times have we said that to ourselves over the years? I know myself it was an annual ritual, deciding once again THIS is the year I finally make the changes I need to make that will let me lose weight once and for all. My banding decision was made more than four years ago, but some things never change. In the last couple of months I've gained about 20 lbs, due both to poor restriction and poor decisions. Well here we are in another new year, and I'm making the decision again that the tide has turned. The scale is NOT going to go up again, I am NOT going to face the distressing fact of nothing in my closet fitting, and I WILL get moving once again. These holidays are brutal. My pre-banding prayer was always that I'd just be able to get through the holidays without gaining. This is the first time since banding that I've been unable to manage that. But with this little band of silicone that I still have in my corner, this will be the LAST time I have to undo the damage my loss of control does to me at this time of year. Posting about the struggle really helps, I know, and it's not for response that I do this. It's for me. I'm sure many of you are facing the New Year with similar thoughts and determination, so let's join hands and declare our determination to move forward in HEALTH and ACTIVITY. Happy New Year to everyone!! (BTW, I remarked to my husband this morning that even a rainy New Year looks much better when we're not dealing with hangovers! :party: )

Laura, you're not likely to get much response here from people who chose bypass. This is LBT, dedicated to issues surrounding banding. We all have reasons for choosing banding--mine were much like others mentioned here, safety, sanity, moderation--and you'll hear many stories about why people decided for banding. For stories about why people chose bypass you'll do much better somewhere else. Try Obesityhelp.com for a start.

You have my best wishes and thoughts for a HEALTHY 2007, Vines! Let this be the year you put Cushing's and everything else behind you and move forward as the strong, healthy woman you really are. :hug:

Are you guys all actually from NJ? Happy New Year to you! We're well-rested and ready to start the year off right. Time to start taking down the tree...

I had no meds prescribed at all. I think they gave me a few pain pills to take home, but no prescription was needed.

Welcome to LBT! A new year is the perfect time to undertake something new, and maybe banding surgery will be it for you. Keep reading!

What did the doctor say that changed your mind? Was it something personal about him, or you, or your health or other circumstances? Or were you just weirded out by the whole concept? There are loads of people here with all sorts of stories, good and bad. Just look around and you'll find them. Everyone had doubts about surgery--that's perfectly normal--but at some point those who decided to proceed had reached their own personal tipping point. If you share some of your specific concerns perhaps we can help you find the right answer for you.

Yep. Absolutely.

Yep, I'm another one who notices that my band seems MUCH happier if I'm drinking a lot. Good reminder!

I had one this past March to see what was going on with my band (I had terrible reflux). It's really not a big deal; they knocked me out and it was over very fast. It's the only way they can see inside your esophagus/pouch/stomach to see that everything is in order.

Hi Syrah! The reason your upper GI may not be covered by insurance is that it's not a diagnostic test ordered because you have symptoms. Insurance typically only covers things that are medically necessary to diagnose or treat disease; this seems like just a precautionary thing your surgeon does for his own reasons and as such, it may not be covered. I think it's very unusual for a surgeon to require an upper GI test on all of his patients, including those with no symptoms or history to suggest a problem. If I were more cynical, I'd wonder if he has a part-ownership of the testing facility.

Wow, Sunta, that's awful. Behavior like that is about as childish as it gets. I'm sorry someone at LBT stooped so low.

You are NOT alone. Since September, when I had a complete unfill due to being too tight and irritated, I've put on almost 20 lbs. :bananapartyhat: After Thanksgiving I just let all restraint go completely out the window, figuring my fill on December 14 would rein me in. But I seem to have forgotten that my fills take a couple of weeks to kick in, so I was surprised to be unrestrained over Christmas as well. This morning I got on the scale and was not pleased at all with what I saw. 2007 is a new year for me and this weight IS coming off. Grrrr....

I just saw a very accurate story, for once, about banding in the major media. Matt Lauer did a piece on the lap-band and other bariatric procedures, but the band was front and center. The only piece of inaccurate information they gave was to say that the band was FDA-approved in 1991, 10 years earlier than it was. But just about everything else they said was spot-on! Methinks there will be a lot of interest in the band come the new year.

Thank you, and right back at you, TOM! Glad to hear things are well with you; I hope you and your family have a warm and joyous time this holiday.