seanmama

Hello everyone, I have waited for a couple of days to post as I have been overwhelmed with hopelessness and anger. I recd my denial letter from United Healthcare in the mail on Thursday evening. Of course this came as a shock as I was completely pursuaded that uhc would pay- I am a nurse and we do lots of bariatric surgery at my hospital- frequently pts that are around my weight with the same insurance. So of course, that, combined with most everyone conveying the attitude of " oh you have uhc, no problem, lucky you"- had me in a fools paradise. I never doubted for a second that it would be covered. The reason is that my plan only covers "wls for the morbidly obese" and although I am severely obese, with 100lb + to lose and at least 3 comorbidities, they are sticking to the rules. Can some one please help? I know I am not the only one who has been here. I feel so hopeless and frustrated. I have already tried to contact all the drs I have seen in the past 10 years or so to get my medical records, so that I can offer proof of comorbidity. Unfortunately I have only done 2 medically supervised wt loss attempts and don't even know if one of those companies (LINDORA wt Loss clinic, Glendale/Pasadena, Ca ???) still exists. And as for pursuading my husband to go for the Mexico option.....That was met with contempt and a flat NO! His advice was- go on the exercise bike every day and you will lose 2 lb a month. can y'all imagine how that made me feel? That would only take me 50 months right, lets see, thats about 4 years. Boy I can see my resolve lasting that long. LOL. Thanks for allowing me to vent! :think :cry

Hello, Just a quick word of encouragement...I have had my band now for one year and have reached my personal goal of 155lb. I now plan to go beyond my wildest dreams and attempt to get down to my "medical" goal of 135lb!!! I am posting because I want to give encouragement to everyone- it is a long, hard road, but well worth it! Merry Xmas to all Seanmama

Thanks for all your kind replies guys! Zoe, yes actually I have had to buy a new wardrobe- I have gone from a size 22 to a size 10/12. No doubt if I lose more, I will have to again- can be pricey! Advice for new bandsters- FOLLOW THE RULES. Your band is NOT a magic bullet it is a tool- you must still use your brain! Be tenacious about finding your sweet spot- you should be able to eat almost anything, without discomfort, BUT only a tiny amount of it. I am unable to eat more than about 2 tablespoons at any given time- and depending on what I ate, I will stay full a really long time. I never, ever drink and eat (I have 2 friends who have been doing this ever since they were banded and they have lost a fraction of what I have lost, so...) And, don't believe what the literature says about losing all your weight in the first 6 months- this is not necessarily true- heck, it took me at least that long to figger out how to live with my little best friend! My loss has been slow and fairly steady. Each day is a little different and I can't always eat the same thing one day from the next, but variety is the spice of life right?!! And, watch out for high calorie fluids like ice-cream- try to avoid. I drink Protein shakes every day- have become quite the master of smoothie blending- I had to do this because my hair was falling out in bunches from too low protein. I try to focus mainly on consuming around 60 grams of protein every day- one smoothie easily takes care of 30-45g. Sorry if I sound like I have all the answers!! But I know when I was first banded I felt so insecure and petrified. My mantra was "what if it does not work for me?" Well guys it has and is and I am living la vida loco!!! YEEHA!!!

Also go to the following groups on Yahoo Groups: BandsterInsurance Smartbandsters Venting-bandsters This is where I got a blueprint for my appeal letter.

I was also denied amd then appealed the denial myself and got approved. I basically wrote a really long and detailed letter about my obesity history and the related medical and psychological problems, attached a whole bunch of medical records relating to my "comorbidities" and was approved about 3months later. Good luck!

Does anyone have heartburn? I used to get it frequently and badly before my surgery, but it stopped after I lost weight. Now it is back and really bothering me. Tums, etc does not help. It is a burning throat/chest sensation and not connected to eating or drinking. Help!

Thanks ladies! I am currently at what I think is my "sweet spot". I only have 1.25cc in, but can eat almost anything, only a very small amount though! This is a far cry from 2 previous fills when I have been too tight and ended up unable to swallow anything. The difference is now it does not hurt every time I eat- which is what happened before.

Thank heavens I am not alone in this! I feel embarassed to talk about it to anyone. The remedies you all post are great, thanks. The only problem is I am so tight that I can only eat or drink a very little at a time- like 1/4 cup at most- and then stay full so long afterwards, that I don't seem to be able to manage to get in enough water or fiber. I am going to try the Atkins bars- hope the consistency is tolerable for me.

Okay- now we will all be skinny, bald, with hairy legs and arms....and chronically constipated!!! What a hilarious picture!!!LOL!

I called my drs office this morning to set up a fill as I am starting to gain weight and feel no/VERY little restriction. The receptionist told me that they have a new procedure where the pt comes in, gets weighed and fills out a questionaire before getting set up for a fill. Okay, sounded fine. Well, I went in, filled out the questionaire (very basic, like how often do you vomit, how much do you eat, how often do you exercise, etc) and got weighed (- and payed a copay). Then the nurse turned to me and said , see you, bye, we will call you. I was a little taken aback, and asked her was I to wait in the waiting room for the dr ? No she says, we will call you. I said about what? She then tells me that "they will consult", decide if I need a fill based on the questionaire and will call me to tell me when the next available date is. BOY OH BOY!!! I do not like decisions being made about me, my body, my anything, without my personal input!! Right at this point one of the other surgeons walks past and overhears and interupts. He explains to me that many pts are mismanaging their fills and are requesting fills every 2 weeks, to the point that they are taking up all the slots and those pts that need fills are not able to get in. Mmmmm?!? Thanks for letting me vent... any comments?

Does Veninga still do bariatrics? There is one more here locally-(Plano Presby) Dr Horrileno- does mainly Roux-en-y here , but has done a few bands too. There are actually tons of surgeons who do em here in DFW, but the issue is getting one to take you on as a pt?

Oh, and, where did you get your band?

Hello Leatha, Thanks for your note- how nice to find a neighbour. Yes, I know Hamn and Cribbins won't take pts from other surgeons- and I believe they might sign off on you if you go elsewhere for a fill. I will stick it out and work with them- after all I have come this far. (One suggestion I made was that they get a Nurse Practitioner to help- something I would love to do, but I am about 3 years away from getting my MSN.) Now all I need to do is be a good bandster....

You know how it goes...one always thinks of how one should have handled the situation in hindsite. I plan to not let this go. I happen to be a nurse at the hospital where these guys practice and know them well. So, will make sure they know my opinion about their new "system". How would I get in touch with the Inamed person? I have actually wondered about this before.

Thanks ladies, I thought it was just me!! I recall seeing some info about a place here in the Dallas area that does fills- does anyone have the details please? I think it may have been a free standing diagnostic radiology place where they can and do use fluoro.

hello everyone, I have not posted in a while, but have tried to read posts as much as possible- you guys are my support group! So far, 4 months after arriving in bandland I still face daily challenges. I find that I don't really know from one day to the next whether any particular food will agree with me or not! Some days I can eat fine, other days, no way! I try to do the right thing- small bites, eat slowly, chew well, eat only till full. Heck, I have even learnt to be fairly accurate in eyeballing 2-3 oz and will persuade myself that I really am full when my eyes are too big for my stomache. But, here is where i need help- it is demoralizing for me when I eat (one or two bites, NOT a cheeseburger) and it hurts. This will happen some days no matter what I put in my mouth- smoothie, yogurt, Soup, hamburger helper, fish finger, you name it! (I have noticed that there are a couple of things that make it worse- for obvious reasons- like jalapenas and hot salsa, and them I now completely avoid.) I have not eaten bread or rice in 4 months. I think my point is this.... does anyone else experience the same thing? Am I doing something wrong? I sometimes know that there is absolutely no way that i am getting enough nutrition beacause I am frankly unable to eat. I am still losing, but would hate to stop and go into starvation mode or whatever; also I don't want to lose the little bit of muscle I have left!! I have spoken to my dr and done everything he advised, and yes, I can drink water- so don't have an obstruction.

Thankyou ladies for replying. I am always encouraged by the genuine caring shown by members of this website. My fill history- well, believe it or not, I have only had one fill of 1.5cc!! I have no plans to get another fill until I learn to live with my band successfully- it makes me way too miserable to hurt and not to be able to eat!

Great job! I am setting myself goals in 10lb increments- that way it seems do able AND I will have many occassions to celebrate! hopefully!LOL! Which leads me to my next question.....how exactly did you celebrate? Just kidding!!!LOL

I had my first fill last Monday- 1.5cc.- 9 weeks post op, under fluoro. Just like most other people I was anxious to get a fill as I was concerned that I had so little restriction. I must say, tho, that i never really "pushed" it- I ate small quantities, chewed well, etc and lost weight. I did not experience trouble with any type of food such as meat or bread- so not being restricted was more related to the kind of food rather than the quantity. Okay, so I get the fill and stay on liquids for 2 days, no problem other than feeling super hungry! The first real food I ate- stew- got stuck! OMG what an awful experience! It hurt ! I thought I had chewed okay , bite may have been a little big, but I just chewed and chewed forever. Subsequently it seems I am having a problem with all textured food, especially meat. Could I please get some opinions on this. How small should a typical bite be? How much is normal to eat at one meal- a tablespoonful? A half a cup? More, Less? Is my band maybe too tight or are my expectations unrealistic? Is it reasonable to choose to have the band slightly less restrictve and be satisfied with a slower weight loss? Is this even a possibility? I feel a little silly being already 9 weeks out from surgery and asking these questions, but I am stunned at the difference before fill and after- I have to relearn and rethink everything! I had become so focused on what I have been reading from others on how hard it is to reach the sweet spot that I had assumed my first fill would be insignificant.

Thanks for your reply Sue. Makes sense. I can see how easy it would be to avoid discomfort by eating around the band- I can also see how unsafe and unsatisfying that would be. I had healthy choice ham and pea Soup for dinner this evening- such a relief not to worry that something is going to get stuck- and to feel nice and full afterwards! I actually chewed the soup!! just in case!!

I am having my first fill on Monday- yay! I was soo encouraged by a gal who was waiting for her appointment at the same time as me. she was banded last March and has lost 90lb. She looked fantastic! She assured me that weight just drops off once you get a fill- hopefully this will be true for me too! I could do with some restriction!!! I must confess I have had a little bit of the last supper syndrome happen since I made the fill appointment! I seem to recall a few of you saying that this does happen. Last night we had lobster for my son's birthday....... Uh-uh! Not a good idea! You just can NOT chew it finely enough! It caused me some pain and lots of salivation! Oh well my DH has lots of cold lobster leftovers today. This experience gave me an interesting insight. lots of people at work have commented that I "took the easy way out"!!!!! Well it occurred to me last night just what a drastic step I have taken- this is no "easy" way. Every single thing I place in my mouth for the rest of my life will be carefully considered and even more carefully chewed- this is not easy.

I think most of the drs will only do the procedure on persons older than 18. I know my surgeon has an age limit. It probably has something to do with legalities. Could she wait until she is 18 and of legal consenting age?

Hi everyone, I have not posted in a while and thuoght I would today! I am just short of 7 weeks postop and have lost exactly 20lbs! (Ilost 10lb before sx, so a total of 30lbs GONE) I am ready to pass along all my "biggest" clothes- its weird, but instinctively I want to hang on to them in case I gain it all back! Of course this time I won't! I have had quite an easy time actually. Lots of people ask me how I am doing it and strangely I am comfortable telling them that I have a band. (At first I was nervous because I was afraid I would once again fail, so kept it fairly secret). I have experienced some middle-of-the-chest discomfort like something is stuck, esp with meat. And have had soreness in the am around my port site, but my dr said all is well. Just like most bandees I have had confusion over not feeling much restriction- but it helped reading everyones posts on this matter. I just try REALLY hard to only eat till i am full- frankly if I eat too much it hurts! But struggle a little with food choices. I guess years of grabbing and gobbling while "multi-tasking" is a hard habit to break! I feel so good I even had "chunky" low and hi lights put in my hair on Wed insted of cleaning my house!!!!:confused:

Yes, I think the game is based on the movies, but it will make you a winner if you've read the books. Check out Amazon.com for the game-it may be cheaper than at Target.

Happy New Year to you too! On a personal note Alexandra- do you have the LOTR Trivial Pursuit game? It is great fun! Also the ROTK chess set is very nice- gave it to my 9yo for his b'day last week. We LOVED the movie!