Mike D

My problem is this. I was banded on Jan 22nd, and lost a total of 38 pounds so far. that was in the3 first 2 weeks since the operation, and the 2 weeks prior to the operation. I went in for my fill, and was given 5 cc's in my 9 cc band, and i still don't feel any restriction. I am scheduled for my next fill the 25th, but what happens if that doesn't work? I am worried the band isnt working for me. Suggestions to my predicament if you would please. I eat less, but the scale hasn't moved since the middle of February. What should I do? Mike

So sorry it has taken me so long to respond! I am out of town for work, living in a hotel, and trying to fit in normalcy where it is possible. Thanks for welcoming me, I appreciate the kind words. since my last post, I have seen my doctor, and had my first fill. I had no restriction before, and now I had my band filled 5 cc's. Is that a lot? He watched me drink that Berium under an x ray, so I know it was done right. But seeing as the realize only has 9 cc's, i am already more than halfway there and it makes me a little nervous. I don't want to gain any weight back, and I want to be thin, but how realistic can it be if I am already over halfway filled? Chime in your 2 cents, I'm interested in hearing what you all think. Mike

Whats up everybody!!! I was banded January 23rd, in Joliet, Il by Dr. Lahmann. So far I have lost 15 pounds since being banded. Mind if I join you guys? Mike

So as you read, I am a newb. My name is Mike, I am 34, live in Braidwood , Il, and I am kinda dissapointed. I received a letter in the mail today denying me of insurance coverage for the band. The letter said I did not meet their requirements. I really laughed at that. I did all of my pre requisite doctor garbage, and every one of them stated the band was an excellent idea for me. I am very healthy, just 151 pounds overweight, with a BMI of 45. So now I am debating my next step. What should I do, where should I go from here, that kind of stuff. Any words from you pros? Mike

Going to my information class tomorrow. I was finally approved by my insurance, now i just need to wait. I'll post how it all went tomorrow. Mike

Count me in, I'm being banded on June 26th, my boy's 7th birthday!!! I'm nervous and excited. I'm worried I will be able to feel the band. Anyone else? Mike

I have BCBS of Il, and I waqsa just approved. However, I have a PPO through the Carpenters union, so I had a different set of regulations. I had to meet a pre-set BMI, have a list of failed diets, be 100 pounds overweight or greater, and have a pre-existing medical condition. I also had to see a cardiologist, Pulmanologist, and a phsyciatrist. I was at first denied, so I had to re-weigh, write an appeal, and I got a written referral from all of my docs. I have since been approved. Good Luck to you on your journey!!!! Mike

First off, Thank you to all the well wishers. I didn't have that hard of a fight. I met 2 out of the three items for their criteria. I'm just glad I have finally been approved. I know my life is going to change for the healthier. As far as the weight gain goes, yes, I do have to gain back what I busted my butt to lose. And to answer the question yes it is for insurance. 43.9 is not the same as 45 as far as BMI is concerned in their book, so I need to maintain 45 or better. I will keep all of you posted, thanks again for the congrats and the well wishes!!! Mike

Well, as of Monday, I was approved by my insurance to be banded. my surgery date has been set for Tuesday June 26th. I am kinda nervous, but excited at the same time. I need to do an upper G.I., a blood test, and then do some education class for a couple of hours. That's not the worst part though. I also have to gain the 11 pounds I just worked off, back. Talk about some garbage!!! Well, enough for now! Mike

Don't think I can answer that. It all depends on the insurance. I know some of them only require 100 pounds overweight with a BMI of 40. My insurance wants a BMI of 45, with at least 100 pounds overweight. Because I was 149 pounds overweight, with a BMI of 43.9, I was denied the first time I applied. So now I am appealing, made a bmi of 45.5, told the insurance I have slight sleap apnea, and am hoping for a better result this time. Check with whoever will cover your surgery, see what they require, and go from there. That seems to be the way people are getting the surgery around here. Good Luck Mike

Well, time for an update. Since the last post, I went back to the doctor and re-weighed. I ended up hitting a BMI of 45.5, and my weight was 149 pounds over medically recommended. I had to handwrite an appeal to my insurance, which I did, and I got a letter of recommendation from my general practitioner. I also received letters from the phsycologist, cardiologist, pulmonoligist, and from the doctor actually performing the surgery. Hopefully my appeal turns the decision to what I want and need it to be. So for now, I am playing the waiting game. Mike

Not sure if this will be read in time, but for my doctor, a seminar was mandatory. I had a friend set up an appointment through her doctor, and was told to not even keep the appointment unless she attended a seminar first. I'm sure if you had to be at a seminar first, you would have been notified. Mike

I was told that I could expect to lose 80-90 pounds the first year. I think what was actually said was 82% of the excess weight. Either way, that is a lot to lose. I right now am still waiting for my approval through insurance. I did all of my consults, and have been turned down once, so I re-weighed, and re-applied. Just waiting for an answer. Good Luck to you on your journey!! Mike

The funny thing for me is, I am a union carpenter. You would think that they would realize if I had the surgery, dropped weight, they would get almost double the work out of me!!!! It just doesn't make sense. I guess we will see if on monday, when i weigh enough to have a 45 bmi, a note from my doctor relating she recommended this 2 years ago, and the letter also stating any medical issues I have now and what they will cost when I am 10 years older, if they will change their mind. I think as of now, one can only hope.

Well, my doctor just called me. What they plan for me is to come in and reweigh. Only to see if I am at the 45 bmi range yet. I was at 43.9 when I was there a few weeks ago. Also, they said I should get a letter of recommendation from my doctor to help things out. So I am going to do both, and then just wait to see what happens! Lets hope I can gain some weight to hit that 45 mark! J/K!!!

Well, I talked to my insurance company. According to them, I didn't meet their requirements in 3 areas. 1.) I have to be 100 pounds overweight, with a BMI of 45 or greater. 2.) I need to have documentation of failed attempts at traditional weight loss. 3.) It needs to be medically necessary. Meaning my weight has to have some sort of life saving benefit, or I must have another underlying condition, sleap apnea or the likes of that. So they are going to send me out an info packet explaining what exactly I need in order for the surgery to go through. Mike

I plan on calling the insurance company today, to see exactly what I may still need to do. I think I may actually need a doctors referral. I know what you're thinking, it isnt like that. About 2 years ago my doctor recommended the band to me, so after a long thinking process, I went to one of the seminars. So technically I did not get my doctors actual referral. I'm hoping that's all I need, I can always go see my Doc, and she will gladly referr me Mike