New Hope

Wow, hopefully both of you can refile those bills with your health insurance company! I guess the drs. are trying to clear out the 2004 bills. Bad timing!

Phyllis, didn't you have to give Dr. Spivak a list of all your routine meds. and dosages on your initial visit? I also brought my daily meds with me to the hospital and showed them to him the day of my banding. He was able to visually see their size and tell me which ones to change. With improved health, I was able to get off of several permanently.

Christy, if you're losing weight, don't feel like you have to get a fill in 4 weeks. Everyone is different. I waited 2 months for my first one. I wanted to be sure that I was doing my part first. The bouillon and soup have a lot of sodium (salt). Sodium causes you to retain fluids. And too much is very bad for your heart and kidneys. The meats and cottage cheese will help you get your 60 grams of daily protein. Now that you can eat real foods, you should feel "full" longer than you did on the liquids. Chart your intake on fitday. If you're not getting enough calories, you won't lose weight. Congratulations and keep up the good work!

Tracey, Congratulations on being banded! Hope your losing journey continues smoothly!

Tim, Congratulations on getting your band! I hope your recovery continues to be this smooth.

Can you tell us a little bit about yourself? How old are you? How tall are you, your current weight, your BMI? How much weight do you want to lose? Do you have any co-morbidities (weight related health problems)? Who are you wanting to be your band dr. and where will you be banded? Research, research, research, before you even schedule your initial consult. Be sure that you are aware of all the different aspects of the band. You can go to www.inamed.com and download a copy of the patient's handbook. It explains everything from a to z. Also forums like this have a wealth of information. Do a search through several old posts and you will find answers to just about anything that you (or your family) would like to know. The more informed you are, the better your chances are of being a successful bandster. If you've chosed to tell your family about the band, then be sure that you give them plenty of information so they will understand how the band works. The band does not alter your anatomy, like the RNY. You will not lose weight as quickly as the RNY, giving you time to adjust to the physical and mental changes taking place within you. Most bandsters have tried to lose weight on their own, some have lost huge amounts of weight. But, unfortunately, it always returns, bringing more than we originally started out with. It takes a lot of courage to say you need help with WL and then work with your band. It is not an easy fix. The band gives us the boost in the right direction, to eat less and feel full longer. But we have to be able to do the head work (the hardest part). We have to make wise food choices, exercise regularly, avoid excessive starches and sweets, for this to work. If a person makes bad food choices all the time(ex. excessive soft foods, like puddings, ice cream, starches), it is possible to eat around the band and gain weight. Best of luck to you!

Hopeless, have you gotten actual denial letters from your insurance company in regards to weight loss surgery? If so, how exactly were the letters worded? What are they writing you?

Well, I had an unfill (to 0.5) last week (due to reflux), I'm eating too much,I'm not exercising, and I've got the croupy crud. Feel yucky. Only good thing this week has been my 2 hats from Teresa and Becky. Thanks, gals, you probably saved what little sanity I had left! I can't get a refill for 2 months. Scared to get near a scale! I need my fill back!

Not until I got the jacket home and had it next to your Boucle hat. I feel so fashionable!

Becky, I bought a boucle jacket on clearance sale yesterday. I really liked the color and texture. After I got home, I was looking at your hat. They look like companion fabrics! What are the odds?

Please check www.inamed.com . That's the official website for the Lapband. They should have a list of doctors in your area. Then contact the drs. individually to get correct information. Good luck!

Pat, check with Leatha. I think she had some fruit flavored protein powder (mixed w/water?). Have you tried the premixed Atkins canned drinks? They're pretty good and convenient. A can has 20 grams of protein. You only need to get in 60 grams a day. When I do the unflavored protein powder, I use fat-free milk, and add fruit (fresh banana, frozen strawberries, blueberries, and/or peaches, etc.). Just don't put in too much fruit or it gets too thick (and too hard for a new bandster to drink). Hood's Low Carb comes in a delicious chocolate flavor and is ready-mixed.

'Cause you will puke like a buzzard!

Tanya, you can have a close relationship with us Texas gals! We're a friendly bunch.

Sally, do you have access to your insurance company's website? A lot of insurance companies don't give you a hand booklet anymore. They say it's because there are so many changes that the booklet would never be up to date.

Lauri, if you decide to use this letter, you need to finetune it for accuracy. I'm not sure what your actual health problems are. I tried to use all the info. you had, but it could probably be reduced down some more. The main thing, is to get their appeals procedure and follow every little step. Appeals do work. I did it. Best of luck to you!

Once you get the proper appeals procedure forms from your insurance company, then you can compose your Appeals Letter. Clearly state the facts, don't get emotional, include any documentation that supports your stand. Try to keep it short and to the point. Rough Draft (Appeals Letter) Date Ins. Co. Name Medical Review Department RE: Denial #, dated Dear Sirs/Madams, I am appealing your previous decision to deny me weight loss surgery. My name is Lauri J. I am thirty-five years old and am morbidly obese. Dr. Cribbons at Plano Medical Center calculated my current BMI as 43.8 I have struggled with my weight for 27 years and I am losing the battle. I have sleep apnea, intense pain in my knees, hips, and back, high cholesterol, constant fatigue and shortness of breath, anxiety, depression, and high blood pressure. I battle daily with low self-esteem, societal rejection and prejudice, lesser work and income opportunities, marital, familial, social, and sexual problems - all directly related to my obesity. My mother (due to her morbid obesity) has been disabled since her forties. She has had both knees replaced, suffers from high blood pressure, and extreme depression. She currently needs both knees replaced. Heart disease and diabetes run in my family. I have spent countless amounts of time, money, and effort on numerous diets, low-calorie/low carbohydrate foods and drinks, exercise programs, and diet pills. These offered temporary relief, but have created a vicious cycle - lose the weight, only to regain more each time. Obesity is a major risk factor for serious medical conditions such as: Type 2 diabetes, Hypertension, Heart Disease, Stroke, Sleep Apnea, Respiratory problems, Cancer, Osteoarthritis, Joint pain. According to the National Institutes of Health, Morbid Obesity Surgery is the best option for people who are morbidly obese and cannot lose weight by traditional means or who suffer from serious obesity-related health problems. To deny me Weight Loss Surgery now will only cause my health problems to escalate, meaning much greater medical expenses later - for added prescriptions, tests, hospitalizations, surgeries, disabilities - as my health declines. Joint replacements, open heart surgery, strokes, cancer, and long-term rehabilitation are just a few very real possibilities. These increasing health care costs will be shared by my health insurance company and myself. Granting me Weight Loss Surgery will immediately improve my physical and mental health. Many of my health problems will be drastically reduced and in most cases - eliminated entirely. My prescription medications will drop. I will be able to get a full night's sleep without the c-pap machine. The serious health concerns listed above will cease to exist for me. Better health means less visits to the doctors, less prescription medications, less hospitalizations, less missed work days, more productivity, untold savings in medical costs. I want to live!. This weight has such a negative impact on the quality of my life and is shortening the quantity of my life with each passing day. I have four beautiful children that need their mother to be here for them as they grow up. I am asking you to carefully review my appeal and the documentation from my doctors and therapists validating the necessity of Weight Loss Surgery. Please grant that I may have this surgery and can begin living a healthier, happier life as soon as possible. Regaining my health means we all win! Most Sincerely, Lauri J.

Lauri, unfortunately, the insurance company only wants the facts. They're not interested in you as a person. Dollars and cents are what get their attention. Your letter needs to be no more than one page in length and clearly state your case. Please ask Alexandra to help you. She works with insurance and knows what is needed. Here's a rough draft (using your available information): Date Re: Denial Letter #, dated Dear Medical Review Department: Recently you sent me a letter denying weight loss surgery. I am appealing that decision and ask that you send me the proper forms and all information necessary for me to follow your appeals process. Please advise your reasons for the denial and include copies of any documentations you used to make this decision. Also, please include the correct address to mail my appeal to. Sincerely, Lauri J. Insurance Denial Letter #, date SS# Insurance Card # address home phone # e-mail address Lauri, right now, all you are dong is advising the insurance company that you plan to appeal their decision. You do not have to state your case yet. After they send you the proper forms, then be sure you follow their "Appeals Process" to the "t". Keep full copies of everything, document when they were sent, and to what address, and who's attention (if you can get a name).

Christine, did Dr. Lopez have you attend an informational seminar? Have you actually seen and felt a Lapband? Did he show you a presentation that shows where the band sits in your anatomy and how it works (creating a small pouch high above your regular tummy)? Most people have more restriction in the a.m. It gets better as the day goes on. If you can drink liters of water, that's great! It's really important to drink, drink, drink water every day (try for 64 oz.). But do not drink with your meals or for an hour afterwards - so your food will stay in your pouch longer and you'll feel "full" longer. Please follow Dr. Lopez' post-op orders about what to eat and when. It's very important to let your tummy heal properly and anchor that band before running food through. Too soon could lead to band slippage. Be sure that you are regularly on hard proteins (real foods) before you get your first fill. You may gain weight before your first fill. Please be kind to yourself and just focus on eating healthy food choices. You have your band. It's there when you're ready for that first fill. Best of luck to you! What is your beginning weight and height? What is your goal weight?

Lauri, really deep in his heart, he probably thinks he's helping you stick with your diet by the things he says. You got rid of the brownie, so he feels that he took care of the situation, has nothing to dwell on, rolled over, and is now sleeping peacefully. Maybe, when you're not tired or angry, try to talk with him (not at him) and let him know that you appreciate his support. But constructive criticism will get far more positive results than ridicule or sarcasm. Also, you might ask him to eat his goodies away from you - to help you resist temptation. Or if you don't think you can talk to him calmly, then how about leaving him a little note that's nicely worded, letting him know that you appreciate his support, love, and encouragement. " But, DH, please stop and think before you say something to me!" Let him know that you're trying so hard to live healhier, you're stressed out dealing w/ the insurance company, and you'd love him to grab your hand and go for a walk with you (often). You are doing such a great job, Lauri, and without the band aid! Give yourself a big pat on the back!

Penni, I'm so sorry about your sister. Hope she can get better. I'm so glad that your mother's test was clear! Did they remove the polyps when they did the scope? There are meds for the diverticulitis. They will probably want to rerun that test regularly now - to keep an eye on her. Benefiber powder is a great source of fiber and doesn't "gunk up" like Metamucil.

That's great, Betty! You'll be zipping right past us now. I can't imagine how great you'll do now! Blossom, who can figure these drs. out? I hope you didn't have to drive very far to his office. Good luck on Monday's fill.

Another reason to get moving as soon as possible is to prevent pneumonia. I got that after an open-method hysterectomy. Trust me, the last thing you want to do is struggle with breathing and continual wracking coughing spells after an operation! I only had to learn that lesson one time!

Congratulations on the 19 pounds gone and on becoming a Bandster! Your pains should lessen as time goes on. Really, walking around and drinking as much water as you possibly can is the best thing to do for that. It's really important that you get enough daily water in. Please do a search here for past posts about the importance of water. You don't want to get dehydrated. Tea and broth are o.k. But please don't overdo on the broth. It has a lot of sodium (salt) and that will cause you to retain water (which is hard on your heart and kidneys). Have you tried the flavored waters (like Propel) or crystal light? How about tracking your daily intakes on www.fitday.com for a few days? That can show you if you're eating enough, calorie intake, break down of proteins-fats-carbs, exercise, goals, etc. Your stomach making growling signs doesn't necessarily mean you're hungry. It's probably just digestive noises. You don't have any fill in your band so once the initial surgery swelling goes down, you will feel hungry. Any weightloss before your first fill is considered a bonus. Weightgain during this time is the norm. What stage are you in? Liquids, mushies, solid foods? Please concentrate on eating healthy right now. Follow your surgeon's post-op rules so your band will have time to heal properly before you start running foods through. This is not RNY surgery, you will lose weight steadily if you follow the rules. Best of luck to you and hope you get to feeling better soon!

Hi, Debbie, Congratulations to you too! How about going to our introduction section and tell us a little bit about yourself? We look forward to getting to know you! Hope your recovery goes smoothly!