GeauxForIt

Thanks Brent! I really appreciate your feedback. Dr. Allain did my gallbladder surgery in 2009 and I really like him. Unfortunately for me, he's not in-network as a bariatric surgeon under my Aetna plan. All it would take is a quick call to Aetna requesting a Non-Participating Provider Request for him to do my surgery as in-network. That call is the difference between my paying $250 vs. ~$3500 for my surgery. I have gone around and around with his insurance coordinator for 3 weeks now and she flat out REFUSES to make that call. Her last email to me said, "you have to use your out of network benefits since we are out of network". I found out today that Jonathan Taylor (BR Clinic) is in-network. I made an appt w/ him for June 12, but I've kept my appt w/ Dr. Allain for June 19, just in case. The bottom line is that I trust and like Dr. Allain very, very much, but a $3000+ difference and a rude staff may make me turn to someone else for surgery and that's upsetting to me.

How about Jonathan Taylor at BR Clinic? Any feedback at all?

Rock it, girl!! And I LOVE your shoes!

Mawtam, any word from Taylor's office? I went ahead and made an appointment with him since it takes a couple of weeks to get in, but I'm keeping my other appointment with Allain for now...just in case! ANOTHER obstacle, for me anyway, is that my Aetna plan no longer covers BR General and that's "his" hospital! Geez...always seems to be some challenge... Does your plan still cover you at BR General? I had my hysterectomy there and they are great. I hate that we lost that facility.

Of course I'm not expert, but here is my interpretation based on my experience with insurance companies... If you use an in-network provider, Aetna will pay 50% of the cost of your surgery, up to $10,000, after you've met your $750 deductible. The way I read it though, they will never pay more than $10,000 for the surgery no matter what, so if their part goes over that, you'll be responsible for the rest no matter what the lifetime maximum is. For instance, let's say your surgery costs $15,000. You will pay your $750 deductible, leaving $14,250. They will pay 50% of the remainder which is $7125, leaving $7125 remaining. BUT since your max is $5750, you'll pay $5000 of that and they'll take care of the $2125. So...if I'm interpreting it correctly (BIG IF!), for a $15,000 (total cost including hospital, surgeon fees, anesthesiology, etc.) surgery, you'll pay $5750 and Aetna will pay $9250 (b/c it's under the $10k limit). Confused?!

GREAT day... Yesterday I was 1200 OVER on My Fitness Pal. Today? 10 calories left over!!

I'm just beginning my journey and hope to have my surgery in early September. In the meantime, I'd like to start making some incremental lifestyle changes in anticipation of post-sleeve life. I'm buying a stationery bike and some hand weights to start an exercise routine, but I really need help on what diet changes will be most helpful at this point. I know that I will need to taper off of caffeine and eliminate my Coke Zeros all together. I also know that I'll need to get used to drinking water pretty much all day long. What about protein shakes? Sweets? Carbs? Medicine? I feel like if I'm focused on what I can control, the "long" wait wont drive me so crazy!!! Any advice is very much appreciated!!

And to bend over and tie my shoes without giving myself a mini stroke!

And the smock at the salon too! I want to face my arch nemesis head on...the LAWN CHAIR! Weather it's a plastic one I'm afraid wont hold me or a lounger I can't get up from without embarrassing myself, I can't wait to plop my butt down without a second thought!!

Started using My Fitness Pal again yesterday. Yesterday's breakfast? 1000 calories Today's breakfast? 290 calories WIN!!

I love this thread... :wub:

Hi! Weird question...did anyone's feet get smaller when they started losing weight? I have lots of cute, but too small, shoes in my closet that I'm hoping to wear again. Is there hope?! I'm wondering if pregnancy and years of working on my feet made my shoe size bigger or if gaining weight did. Probably a combination of all three.. Thanks!

I'm just beginning my process and would like to start developing some good habits before surgery. I would like to start replacing a meal with a Protein shake several times a week. - Which meal would y'all suggest? - Where do I shop for Protein shakes? - Any good "tricks"? - Anything I should stay away from that will be "bad" post-surgery? Any advice is very much appreciated! Thanks!

Thanks for your responses! Pdx, no costco in my neck of the woods. The truly sad thing about my eating is that my family and I eat pretty well at home. I have small children and I really want to teach them better habits than I was taught. I have two big issues...portion control and the food I "sneak". At work, out running errands, etc., I eat garbage and a LOT of it. It's humiliating to admit, but I have to start owning my bad behavior if going to change it. From candy bars at the drugstore to chips at the gas station to Sonic blasts on my commute. Sometimes I even stash junk food on my desk and vehicle. How horrid to see that in print... Sounds like I'll have to do some taste tests with shakes before and maybe after, too!

One more thing...if I try to replace a meal with a protein shake, which meal is best?

THANKS Kathy!! I appreciate your taking the time to comment. I'm hoping to replace some bad habits with good ones prior to surgery. My hope is that by taking tiny steps instead of one giant leap, I'll be better able to manage post-surgery life. I'm ready for a change and only I can do it!

Ok, so I had coffee today but I'm going to limit myself to ONE Coke Zero today and no other caffeine. I also made sure to eat breakfast, which is not the norm for me. Baby Steps, right?!?

I've had my initial consultation with Allain, blood work, EKG, chest X-ray, and upper GI. I sill have to do all 3 official visits with him, the nutritionist visits and class, the physical therapist visit and the psych eval. I would think all of the testing I've done so far would still count for Aetna even if I change surgeons, right?? Allain is in-network as a General Surgeon on my plan, but he (& the other 3 docs) do bariatric surgery under a different tax id. >

Where is Dr. Sartor? Shreveport?

Darn autocorrect!! HOT Stuff!!!

Hit Stuff!!!

I have Aetana and , sure enough, Dr. Allain isn't in network. Where is Dr. Taylor? You like him? I couldn't find ANYONE in-network in BR!