princess_sophie

Hi, Anybody out there? I live in Maryville and I'm going to a seminar on May 10th at Blount Memorial. I don't have high hopes that my insurance will pay. There may be an exclusion for any obesity treatment, but I hope to find out more at the seminar. If my insurance doesn't pay I will have to decide if I want to self-pay or ... what I don't know. I have so many fears, questions, concerns running through my head. I probably need to write them all down. One of my biggest worries with self-pay is what if I have complications. Aside from all of the fears for my life and my health due to complications from the surgery, would I be opening this huge financial hole if things don't go well and i'm self-pay. I probably need to post some of my fears on the general discussion board too. And maybe after the seminar I will be able to ask some of the questions I have to ease my fears. I don't know. I just don't know. PS

My insurance has an exclusion for all obesity treatment. Which means that if I want to do this I will have to self pay $17,500. That will cover the first year of all post op and fills. My concern is, if I'm self pay and I have complications during surgery or even a couple of years after and the band has to be removed, will i have to self pay all of that too? I need help. I posted a similar post on the general discussions board, but I thought I would post a few different places to try and get more response. Even though I'm not sure if anyone can help me. I'm just really disappointed. :faint:

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I'm not banded yet and I keep reading how after banding you have to take small bites and chew, chew, chew. The chewing I understand... chew 20 - 30 times until it's the consistency of mush or applesauce, but I need a visual for the samll bite. What does a small bite look like? For example a 4oz serving of meat is the size of a deck of cards, or 1/2 cup of rice is the size of a tennis ball. Thanks, PS

thanks everyone for your input, it really helped give me an idea of what I need to do. girlie2shooz ....the marble gave me the visual I was looking for.

This may be a stupid question, but I'm having a really hard time understanding the difference between all of the food stages. I'm not banded yet, so I don't have my instructions from the surgeon. Maybe after I have my pre-op nutrition class I will understand more. I read a lot of posts from people saying they are on Clear liquids but they are allowed to drink protien drinks. A protien drink doesn't sound like a clear liquid to me. Or their on full liquids but are allowed to eat cottage cheese or yogurt, or something like that. Or someone will say they are on liquids for x amount of days. Is that clear or full or both? Can someone explain the difference between: a clear liquid and a full liquid? A full liquid and pureed food? Pureed food and mushies? Mushies and soft foods? They seem to overlap somewhat. I would just like to fully understand what the different stages are so I know what to eat and what not to eat when the time comes. I've been reading all of the posts about how important it is to stick to the pre-op diet and I want to make sure that I do. Thanks, PS

Thanks Losingjusme.

I'm not banded yet and I will be self-pay. If I have my surgery at the hospital it is 17,500 and if I have it at the surgery center it is 14,000. My surgeon still requires a psych eval, a nutrition/exercise class, an addiction class, a body image class and then a pre-op surgery nutrition class. I think it's really great that he requires this and I understand why he requires it. But I've been dealing with my eating issues most of my life too, with therapy, support groups, programs, retreats, self-help books, books about nutrtion and addiction, diets, etc. My therapist could probably fill out the MPPI test for me. Because of my years dealing with my eating issues, I don't expect to learn much from all of these classes or the psych eval. I've already been to the nutrition/exercise class and I didn't learn anything I didn't already know. But like I said, I think it's a really good idea that my surgeon requires this, because there are alot of people who don't know this stuff. Even though I know all of this stuff and that the changes I'm going to have to make after being banded are going to be hard, I will probably still cry sometimes when I can't eat like I want to. Just because I understand something intellectually, doesn't mean that dealing with the emotional side of it is easy. When something happens that upsets me, I turn to food and stuff all of my feelings down and numb myself. When I can't do that any more I'm going to have to deal with all of those feelings. I rarely feel any of my feelings now because I eat so much, so when I'm not able to numb myself with food, my feelings may be very intense sometimes, until I get used to it. Not everyone will have the same reaction that I do to not being able to eat, and who knows, maybe I won't either. I won't know until I go through it. PS

Hi Jfran, I met you at Dr. Ray's about a month ago. It was really nice meeting you. I'm glad you're feeling better and by getting an unfill resolved your pain. It's also really nice to know that Dr. Ray met you at the ER and was so helpful. It makes me feel more comfortable having him do my surgery. I hope you're still feeling better and that you don't have to go through anything like that again. I can only imagine how scary that would be. I hope to see you soon, either at the support group or maybe I will run into you at Dr. Ray's again. PS

I have a serious emotional eating/food addiction too. I'm not yet banded, but I worry about being able to control my food addiction after I am banded. I've tried everything, all kinds of programs, therapy, self help books and the only program that has come close is called The Solution by Laurel Mellin. My problem is the catch 22 in that it's hard to deal with the emotional side of eating while still eating, because I eat so much that I'm emotionally numb and disconnected, and it's hard to give up "eating" (meaning eating in a way that I'm using food as my drug), so that I can gain the emotional skills to not use food. Does that make sense? So I'm hoping that the band will give me the extra help I need to cut back on my eating enough so that I can start doing the emotional/internal work and complete the solution program. I wish everyone the best with their struggle. PS

I'm not banded yet, but hope to be by the end of May or June. I have sleep apnea and use a cpap with a pressure setting of 11 or 12, I can't remember. I've always wondered if I lost weight, or when I lose weight with the band, how will I know to turn the pressure down? Do you have to have another sleep test? Do you have to take the machine to the Dr. and let them turn the pressure down or can I do that myself? I have a lot of weight to lose, about 170lbs. I would hate to think that I would have to have a sleep test every 50lbs or so. But of course my insurance will pay for the sleep tests, but they won't pay for any obesity treatment, including wls. :confused2: PS

Wheetsin, Can you share the specifics of the complications that were not covered for the people you know? My insurance has an exclusion for any obesity treatment, surgery or non surgery. As long as whatever medical procedure or treatment I have is submitted without obesity or weight mentioned, it would be covered. I hate to be sneaky like that, but.... Jeen423, I know what you mean. I often think I would rather just go ahead and die than continue to live the way I am now. And if I don't lose weight, I will probably die a very slow and painful death. With my health problems and complications from my long list of health problems, getting worse every year. And then I will have this little thought, but can I do it on my own? and for a moment I think I can, if I just try harder. But then I quickly remember that I've been trying and failing to lose weight, for over 30 years. Not only failing to lose, but being very successful at gaining. I started out at 11, thinking I was fat, starting crash dieting, which lead to bingeing and it has been down hill, or rather the scale has gone up, ever since. The really sad thing is that when I look back at pictures from when I was 11, I wasn't fat at all, I was just starting to develop. I wish you the very best. PS

Jeen423, I will be self-pay also. I don't know if my insurance will cover complications from the surgery, but more than likely they won't. I hesitate to call them and ask because when I called and gave the cpt codes for the lap band they said it was covered, but when it was submitted for approval, the dr.'s office was told that it was an exclusion. I talked to my work and they don't know why UHC said that it was covered, but it isn't and never has been. I'm afraid if I called and asked about complications it would be a 50/50 chance that they tell me the wrong thing. It is a very difficult decision. I've already had an ultra sound on my abdomen and liver and I'm scheduled for a nutrition class and a psych eval. All of this was done when I thought the surgery was going to be covered. One minute I'm positive I'm going to do it and the next I have all of these fears and doubts. What if something goes wrong during surgery? What if I have complications 6 months out? What if I fail at this like I have with everything else I've tried, only this time I will have all of this debt on top of the failure? I wish I could say something that would help, but I think I'm feeling the same way you are. :confused2: PS

Need a little support and encouragement This is really, really long and I apologize. I just wanted to give my history for better understanding and if anyone has a similar history. To anyone who actually takes the time to read this…. thank you. I’m 43, or will be in a few weeks. I’m 5’-4” and weigh 300lbs. I started dieting when I was 11 years old because I thought I was soooo fat when I was maybe just a few lbs over weight. That started the cycle of dieting and bingeing and I honestly believe that if I had never started dieting I would not be 300lbs today. The more I worried and beat myself up about my weight, the more I tried to diet, the more I tried to diet, the more I ate. I managed to keep my weight around 140 – 145 lbs, until I was in my mid 20’s. Something happened during that time that I can only explain as something like a nervous breakdown. My life went spiraling out of control and so did my eating. I’ve had several periods where I managed my eating for 3 or 4 months and I would always loose 20 to 30 lbs, but then I always went back to my old habits. I lost 70-80lbs on phen-phen, but of course that all came back, plus 60 more lbs. I’ve been researching the lap-band for 5 or 6 years. But every time I would end up thinking that I’m just not finished trying on my own yet. When I first started researching the lap band I didn’t have any health problems, now I have sleep apnea, high cholesterol, high blood pressure and type 2 diabetes, all controlled with medication. I have a vitamin D deficiency and very low ferritin. I’ve been taking iron supplements for a couple of years now trying to raise my ferritin with little success. I’m having all kinds of stomach problems and joint problems. Every 6 months or so, I start having some other ache or pain somewhere and another health problem pops up. And of course there are many social and psychological problems as a result of being obese for so many years that are too many to mention. Last year I decided I was finished trying on my own and get the lap band, but when I checked with my insurance, it wasn’t covered. There was an exclusion for any obesity treatment, surgery included. I went to the seminar at my local hospital and was told that if there is an exclusion than there is nothing they can do. I’ve been on the fence for the past year whether or not I should self-pay or not. The only thing that was holding me back, was if there was complications during surgery, I could have mounds and mounds and mounds of medical bills, that I can’t even fathom the actual amount. A couple of weeks ago I found out that there are at least 2 people from where I work who are getting WLS and our insurance is covering it. I don’t know if the policy was changed at the first of the year, I don’t know what I happened. I called my insurance last year and gave the CPT code and was told that it was not covered. Someone else called a couple of weeks ago and gave the CPT code and was told that it is covered. So, I went to the seminar again and I have an appointment with the surgeon on March 11th. My two biggest concerns, aside from complications, are what and how much food I will be able to eat and will I be able to lose all of my excess weight? I want to be able to eat healthy, whole foods and have a balanced diet. Plenty of fruits and vegetables, lean sources of protein, whole grains, healthy fats, etc. I hope I don’t have to live on 800 calories a day. Right now I can lose weight eating 1900 – 2000 calories a day. But I wonder if I will be able to actual reach my goal without going really low? I know I will have to reduce my calories from that eventually, but I don’t want to trade one disordered way of eating for another. I know that there is a big debate on these boards about what and how much to eat and believe me I’m not trying to get another debate going, nor do think what someone is doing or not doing is wrong for them. This is just what I’m thinking and feeling for myself. I would love to lose 170lbs and get down to 130lbs. But I also know that the longer you have been obese, the harder it is to lose all of your excess weight. And I know there is no way to know how my body is going to respond until I get there. I know it will take a lot of hard work and I will have to make a lot of changes. I know that I will have to work up to exercising about an hour or so most days of the week. Actually I think I will probably like to do that. I would like to do cardio, strength training and yoga. I always feel better after I exercise and I never finish and think, “I wish I hadn’t done that”. I have a lot of emotional work to do also. I guess that is another concern too. Will I be able to do this without sabotaging the band? I don’t want to, and I don’t have any plans to and I will work as hard as I can for that not to happen. But I’ve been trying to lose weight for over 30 years and I have failed for 30 years. I just can’t help but wonder, will this time be different? Will I succeed this time? I know that no body can tell me what my personal experience with either of these is going to be, but I guess I would just like to hear from people who have a similar history to mine or have similar goals in eating and weight loss, how successful they have been. Of course, any words of encouragement from anyone, is always nice too. Again, sorry for such a long post. All of these things are just spinning around in my head and it feels good just to get them out, down on paper and shared with someone. Thank you, PS

Snowbird, I may not be able to tolerate that much or lose weight with that much food either. There really isn't any way to know until I get there. And if I can't, than I guess I will just have to deal with it then. As far as me being disciplined, that is definitely yet to be determined. PS

Thank you all for your words of encouragement. Snowbird: I'm not reluctant to accept that I have to eat less. Eating balanced meals of fruits, veggies, Protein and healthy carbs and eating 1500 - 1800 calories a day is eating a lot less and very different from the way I eat now. I want to eat in a healthy, balanced way, that's all. I think having my cake and eat it to would be continuing to eat the way I do now and expecting to lose weight and change my health. But thank you for your input. PS

This is what I think….. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p> I think there are some obese people whose personality and confidence outshine their weight and it does affect how most people treat them. There is no doubt that personality, confidence, how you dress and how you carry yourself can affect how people treat you. But I also wouldn’t be surprised if there are a lot of things being said about them that they don’t know about. I’m not saying this is happening, but that it is very possible. I’ve read stories about formerly obese people who get to hear things that other people say about obese people, when the formerly obese person is around someone that doesn’t know they were ever obese. <o:p></o:p> I’m not a type A person, I never will be, fat or thin, and I’ve never had an abundance of confidence, which I think personally was a factor in me gaining as much weight as I have. When I was a teenager I was between 10 and 15lbs overweight and thought I was huge. Of course the worse I felt about myself and the more I isolated the bigger I got. There is a huge difference in the way people treat me. Part of it is probably the way I feel about myself, I’m depressed a lot, etc. But if I wasn’t obese or overweight, and if I was thin, I don’t think it would matter if I went into the store in my sweats, no make-up, hair on my head, etc. Or if I was feeling depressed and withdrawn. So what if I’m not extraverted, or bubbly, or happy, or confident, or outgoing. If you are obese, you have to be that way in order to be treated the same as everyone else, but a non obese person doesn’t necessarily have to have those personality traits or be perfectly dressed all the time. As an obese person I feel that I’m just not given the same flexibilty or benefit of the doubt as non obese people. Everything I say and do, or don’t say and do, is judged much more harshly than a non obese person. This has been my experience. <o:p></o:p> PS

I'm from E TN....Maryville, about 30 min. southwest of Knoxville. I'm still on the fence about having it done. I think about it all the time. One minute I just know it's the right and best thing for me to do and the next I'm postivie I shouldn't do it. If I do, I will be self-pay and I'm thinking of going to Mexico to Dr. Ortiz. One of my biggest concerns is complications and will my insurance pay for complications from the band. If they don't, I could be financially ruined for life. I know there isn't any way to predict the future, I could have it done and it be the best thing I ever did, or it could be the worst thing I ever did and there is no way to know. Anyway.... just rambling. PS

"Long story but here's the rundown: banded 5/05; lost 90lbs;want to lose 10more; prior to band-severe reflux;hiatal hernia repaired; another surgery 2mos later for the band; 3days later lung collapsed; in ICU 9days; all okay for a while; severe reflux while on Nexium reoccurs; unfilled band completely;little relief;endoscopy -all okay; band in place,no erosion; very miserable with the reflux-can't sleep, vomit 3 times/day;mostly eat liquids and mushies; dr says only choice remove band and do fundal plication (wrap top of stomach around esophagus to make stronger valve to prevent reflux)-not sure if he can replace band-paid cash ($16,000) for 1st band and cant afford another (insurance wont pay); says he might be able to put one on and not charge for the band. I am terrified he wont put one back on and I'll gain weight. I have been through so much to get here. I hope I've changed my eating habits but dont know how much that rides on the band as a "governor". I'm so scared! What if this doesn't stop the reflux and I gain wgt back!!" Kalamazoo, I'm really sorry to hear about all of the health problems you are having. I'm still trying to decide if I want the band. One minute I'm sure I want it, and the next I'm don't want it. If I do I will be self-pay also and my biggest worry with that is if there are complications. I don't know if my insurance will pay for any complications I may have caused by the band. Did your insurance pay for your collapsed lung and the time you were in the I.C.U.? Did your insurance pay for all of the reflux problems you are having? I hope everything works out for you. ps<!-- google_ad_section_end --><!-- / message -->

My insurance has an exclusion for any obesity treatment. So I will have to self pay if I want to get the band. My concern is, what if there are complications during surgery? Will I have to pay for all of that too? What if there are complications 2 or 3 years out? Will I have to pay for that too? What if the band needs to be removed? Will I have to pay for that too? It would cost $17,500 to have the surgery and that would include one year post op care and fills, etc. But what about after that? If there are complications and I have to self pay for that too, I could be financially ruined for life. Any comments, suggestions, advice? I don't know what to do.:faint:

goodtimes, How old was the woman who died? Did she have any health problems besides being obese? :cry ps

Does anyone know if they are using the new AP band in Mexico? ps

I know what you mean lap dancer. My fear of not having the surgery is starting to out weigh my fear of having the surgery. Something needs to change and change soon. But I do worry about the emotional side of my eating. I don't purge, but I overeat and binge often. I know that even if I have the surgery, I will have to work on the emotional side of my eating. I don't have a problem feeling physically full, but just still want more, more, more. Give me more. There is a program that I want to work, know that I need to work, wish I could work, that deals with self nurturing and effective limits, to help turn down that desire for more, more, more, but it's really hard to do by myself and while I'm still eating all the time. So I was thinking that if I had the surgery to put a limit on my eating, I would be able to do the internal/emotional work. And maybe by doing both surgery/emotional, I could finally find some peace and freedom from the more, more, more monster. PS

Maybe if this was posted on the General Discussions board it would get more responses.

I definitely have a bingeing problem. And I would love to hear from people who have been banded and how that has affected there bingeing. Either by physically not being able to binge, or if the desire to binge lessens. PS