marsha

Thanks for all your replys! I submitted on Mon. Nov 24th and am waiting now. I hope I don't get denied...I'm kind of expecting to get denied though since my bmi is 36 (but I do have several co-morbidities). I guess I just have to wait...(this is the hardest part!) Marsha

Hedy, The criteria for surgery is based more on your BMI then the number of pounds overweight you are. You can find a BMI calculator on many websites. BMI takes into consideration your height and weight. I'm about 75lbs overweight. I'm 5'6" and 222lbs. My bmi is 36 but I have a few co-morbidities. Usually if your bmi is 35-39 you need to prove you have other health problems related to obesity. If your bmi is over 40 you usually don't need related health problems (but every little bit helps). Every insurance company is different and some don't cover the surgery no matter what! I'm currently waiting for approval from my insurance company. I went to my first informational session at Cleveland Clinic in May. I saw Dr. Szomstien for the first time in June and completed all my testing and nutrition class in October. My file was submitted to insurance yesterday. I was told it would probably take 10-15 days for approval (as long as I'm not denied) and then my surgery would be scheduled for sometime in Feb. I don't want to be discouraging...just know this process takes a long time. I'll let you know when I get a surgery date! Marsha

Hi Everyone, Just wanted to give you all an update. Well, it's been over a month since I finished everything and still nothing! I emailed Michelle (the nutritionist) and she fowarded my email to Karen (RN), Karol (office coordinator) and Anita (insurance authorizations). Karol sent me a rather rude email telling me I needed to go through the process and wait. Karol sent a reply to Michelle (not realizing that I recieved a copy) with a really nasty remark. Anita emailed me to say she was working on the problem and couldn't find my file in the computer. She eventually found it and submitted to my insurance the same day! Anita was very professional and very kind to me! So, at least the ball is rolling again! Marsha

Joann, I am a nurse also. I was going to tell the people at work that I was having gall bladder surgery but after reading your post (you make a good point about maybe needing it done later)I'm going to use the hernia excuse also! I don't plan to tell anyone except my husband, mother and sister (my sister just had rny). My inlaws are all thin and already judge me because I have trouble loosing weight. I don't need them thinking "can you believe she had to have surgery to loose weight". I'm also not going to tell my best friend of 25 years! I tried to feel her out first...to find out where she stood on the WLS issue (she's obese too) and her opinion is "I cant believe people do that to themsleves"! So, I won't tell her either. I hate keeping secrets, but I have to do what's best for me! I too am a person that is an "open book" so keeping this secret isn't going to be easy. The hardest part will be when I will be on the liquid phase...I guess I'll just say it's a new diet I'm trying! Marsha

75 lbs should not be considered MINI ! You are doing great! I can't wait to get my band! Marsha

Karmamamma, Wow! What an experience! I will also loose my current insurance coverage in Feb! The insurance contract is being re-negotiated in Feb and I don't know if it will cover weight loss surgery. I'm willing to go through the process just like everyone else, but it seems the process is really unfair. If they were just upfront about all the waiting when I started all this I would have choosen to go somewhere else! On the other hand, Dr. Rosenthal and Szomstein have an excellent reputation with weight loss surgery and I feel comfortable in their hands...just wish they could make this process a little less crazy and stressful. In the mean time, it's been almost 4 weeks since they told me it would be 2 weeks! :cry I'm thinking of getting all the paper work and going somewhere else, I just hate to start over again! Karmamamma- let us know what you decide to do! It would be rough to do it day before Thanksgiving and good luck getting a flight last minute! Bebbly - I'm so glad for you that you didn't have to go through this! Take Care Marsha

I'm just curious...do any of you wear a medic alert bracelet now that you are banded? The dietician at my doctors office recommends it but the doctor says it isn't mandatory. What do you all think? Marsha:confused:

Thanks to all of you for your input. I think the card sounds like a great idea! Marsha

I'm a RN and I worked in the OR for a short time a few years ago. The underwear thing depends on the nurses and the doctor. Some let you wear it, others dont. If you have your period, they will place a pad between your legs and under you if they dont let you wear underwear. Don't be too upset, they are used to this...it's a natural occurance! Marsha

My doctor requires monthly visits with the nutritionist for the first year. THis also includes a pre-op nutrition class. They charge a one time fee that covers all the follow up visits. Hope this helps! Marsha

Hi Bill and Miss Narelle, I'm just a little bit ahead of you two. I just completed all the pre op testing and consults. The doctors office is supposed to call me by Friday with a surgery date. It probably wont be until Jan or Feb as my surgeon is backed up with lots of patients and I'm still waiting for the dreaded insurance approval. Right now, I'm just going to enjoy the holidays and practice chewing and not drinking with meals! Good luck to both of you! Marsha

P.S. When you go to the surgeon...don't empty your pockets when you stand on the scale (you want to be as heavy as possible)! Let us know how it turns out. Marsha

Hi Julie, I'm 5'6 and weigh 222 lbs. My BMI is 36. I'm about 75lbs overweight. When I went to the surgeon, he said he thought he could help me. He sent me to lots of specialists and for lots of tests. We discovered that I have diabetes, gerd, osteoarthritis of the spine and mild sleep apnea and a family history of obesity and heart related problems. I have just submitted for approval to UHC insurance. The surgeon says he thinks I'll qualify due to the medical problems. If you have a BMI 35-40 some insurance companies will cover you if you have 2 obesity related medical problems (co-morbidities). So, when you go in...don't be afarid to tell the surgeon all about your ailments (the more, the better)!! Most surgeons offices understand how to get around the insurance game and will help you anyway they can. Unfortuneately, it doesn't always work with insurance but it's worth the try. I'll let you know if I get approved. If I don't, I'm going to Mexico! Good Luck, Marsha

Seanmama, CONGRADULATIONS on winning the good fight! You give so many others with UHC insurance hope (including me)! I'm really happy for you! Let us know when you get your surgery date. Marsha

Alexandra, You are always so supportive of others, I wanted you to know that I notice the number under your name keeps going down......CONGRADULATIONS! You're doing GREAT! You Go Girl! Marsha

Has anyone read any good books about emotional eating? Could you share the titles? I really need some help and want to get started before I get my band! THanks, Marsha

Thanks Elizabeth...I'm going to get it and start reading!

Seanmama, I'm in the same boat as you. My BMI is 36 I have arthritis, gerd, and insulin resistance. I've heard about a few obesity lawyers that are on the web somewhere that can help get insurance approval. I'm not sure what the cost is or how many people they actually get approval for but it might be worth looking into. I wish you a lot of luck and I'm thinking of you! Marsha

Seanmama, Why did they deny coverage? What was their explanation? I'm curious because I also have United Healthcare and will be submitting for approval soon (I just have to get results of one of my tests before submitting). I wish you a lot of luck! Don't give up..keep fighting! Marsha

Hi Everyone, Right now, I'm so discouraged! I've spent the last 4 months running from doctor to doctor, test to test, trying to get everything in order so I can submit to my insurance for approval for the lap band. See, my surgeon said since my bmi is ONLY 36 (as if that isn't enough) I need to show that I have co-morbidities. I already had diagnosed gastric reflux, polycystic ovarian syndrome and stress incontinence. Now, since all my testing, I have insulin resistance. It seems each doctor I go to has more tests I have to wait for before I can submit for approval and get a surgery date. Yesterday, I went for a sleep study and was told it will be 3 weeks before I get the results! I'm tired of waiting... After insurance approval, my surgeon is booked up for about 4 months (another wait)! By the time I get the surgery, it will be almost a year since I started this escapade! I'm beginning to feel it will never happen. Sorry, I know many of you went through the same thing, I just needed to let loose and get this off my chest! Thanks for listening, Marsha

::cry

My pre-op tests included an upper gi, gallbladder ultrasound, esphageal motility test (this was the worst test), chest xray and blood work! I'm also amazed at the differences in pre and post op testing and pre and post op diets! I guess there really isn't a "Standard" for what is needed prior to and after lap band surgery. It seems to be up to the surgeon. Marsha

Thanks to everyone for all your support. This process is so frustrating but I know that in the end it will be worth it. I just can't wait to live my life as a normal sized person! Marsha

I have not been banded yet but have been told that I am a canidate for lap band by my surgeon. My whole family thinks I'm not fat enough to have surgery...so I ask them "how fat do I have to get?" I'm currently waiting for insurance approval. I'm 5'6" 222lbs my BMI is 36. I don't have diabetes but I do have insulin resistance. My ankles hurt when I walk or exercise (I do my best to walk 1 mile twice a day despite the pain). I also have a family history of obesity, diabetes and heart disease and I will go next week for a sleep study to determine if I have sleep apnea. I've watched my weight go up and down all my life. I just cant bring myself to try another diet and watch the pounds come back on with a few bonus pounds for all my effort! Another failure will just add to my already low self-esteem! I think you will probably qualify but you should at least have a consult with a surgeon to see if you qualify. Don't give up before you even get started! Let us know how you do!!!!! Marsha

Hi Everyone, I'm wondering if anyone knows of a lactose free, low carb, Protein Shake. I'm lactose intolerant and will spend lots of time in the bathroom if I drink a regular shake. HELP! Marsha