Margie122

I will try Less of Jess. I have appointments with nutritionist and ekg on 5/6 and I meet with the surgeon on 5/26. Prior to that I have to schedule psych evaluation and sleep test. It's exciting. I need to keep a food journal.....it will be rough but I have to do it.

Thank you elode. Honestly I am a bit scared to go through the process again, do all the testing, and get my hopes up. I'm afraid my insurance will deny me again. I have new insurance since the last time I tried and they seem better but you never know.

swimsuits4all.com had a great variety and all sorts of sizes and options. And they weren't overly pricey.

Awesome job! I hope to have stats like you soon

esskay77 thank you for your input. I appreciate it. I am 99% positive that Tufts dropped the mandatory 6 month diet program they made everyone go in before approving the surgery. I'm just hopeful that I won't get screwed again like I did in 2007 by UHC because I didn't have a 5 year weight history. I'm so ready to be a lower weight, not because I will look better but because I will feel better and have more energy. I don't care if I am ever a single digit size, a 12 or a 14 would be wonderful. Just to be able to go into a "regular" store and shop off the rack would be delightful. I can handle 3-4 months. If I could pick, I would like to have the surgery mid Sept or early Oct. That is when I will have sufficient vacation time logged at work and it would just be easier for everyone.

Hello everyone. I seem to not be able to type or post today, every time I attempt a post I accidentally delete it! I am in the very beginning stages of trying to get the sleeve surgery approved through Tufts. I have my first appointment at St. Elizabeth's on 3/31. I'm going to see Dr. Nicole Pecquex (or her Nurse Practitioner) for the first visit. Does anyone have any experience with St. E's? I was told that there is a possibility they will request diagnostics like a sleep study, etc? Any idea how long from the first visit to surgery request? I am 290-295lbs, 5'11" and have high blood pressure and likely sleep apnea (I snore terribly and wake up a lot). Thanks for any info. Back in 2007 I went to BIDMC and attempted to get the lap-band done. UHC was awful to deal with and denied my surgery the night before because I did not have a 5 year weight history. I missed a doctors apt the third year, and even though I was considered morbidly obese for years 1, 2, 4 & 5 they used that missed visit as means to deny the surgery. The staff at BIDMC was no help, they basically left me on my own. I did file an appeal on my own but it didn't work. I changed insurance and now I am hopeful that it will be approved.

Hi, I am on my pre-op diet, although I don't have a surgery date yet. I'm trying to wait at least a 1/2 hour after eating before drinking any liquids. Is this what other people have been told to do? Also, I'm confused about liquid BEFORE eating....should I also try to wait a half hour after drinking anything to eat? Thanks! Margie

I got a call today from the surgical scheduler at my surgeon's office. She said UHC has given us 48 hours to "show proof of documented weight loss attempts in the last 5 years". I called my PCP (who is fantastic) and he sent over a letter. Per the scheduler, it wasn't good enough, they needed the notes. He sent over the notes. I'm guessing it won't be enough to satisfy UHC. You see I lived in NY for 3 years, but knew I was coming back, so kept my PCP here. He only has my weight documented for 2003 and early 2007. UHC didn't care that I faxed them my Weight Watchers cards from 2005 and 2006, they will only take PCP info. It doesn't matter that he's been my PCP since 1990 and can show a weight history over 17 years (that's always been too high!) So while it isn't totally a "NO", I'm not expecting good news tomorrow or Thursday. If I do get denied, I've decided to put on my big girl panties and APPEAL. I'll pay an attorney to file the appeal for me. I went to Obesity Law and Advocacy Center and they seem like just the people to do it. I've worked too hard for UHC to say NO. :frusty: If I have to, I'll self-pay. I won't be able to afford it for a while, but I'll do it. I would really appreciate any and all POSITIVE thoughts sent my way because I really was looking forward to being a Halloween Bandster. Thanks for listening. :ranger:

Hi, I noticed there was a thread for shorter bandsters, but I couldn't find one specifically for taller bandsters. I'm 5'11" and right now at 282 I am a size 24. I wear a size 11 wide shoe. I have some questions for people who have already started this journey...do you go down in shoe size too? I would really love that. I would love to find out from people closer to goal - what size are you? Is it realistic for me to think I could be a size 12, 10, 8? Thanks in advance! :ranger:

NYtrink (Kat), I hope Walter and Kelly can help you! I'll keep my fingers crossed for you. Please let me know how you make out :confused:

I just got an email from Walter...they're taking my case and I don't have to pay! :whoo::whoo::whoo: This is the best news I've gotten in weeks!!!

My surgeon's office faxed Walter & Kelly at obesitylaw.com all of the information they had including my application. I sent 15 pages to them myself today. Now I have to wait to see if they will be able to take my case (for free) ... or if I will have to pay them to file my appeal. I'm hoping I fall under the guidelines for Allergan (parent company) to pay for them to fight this appeal for me. If not, I'm fully prepared to pay them myself. Waiting is so hard....:faint: Margie

Tomecia, I'm not 100% certain why UHC denied...but I believe it was for not having a 5 year history of weight issues or weight loss...The reason I can't be sure is because they REFUSED to send me their criteria in writing for the lap-band...they would only verbally give me the criteria. The nurse told me something totally different than the initial people I spoke with. UHC (just my opinion) is certainly NOT the easiest insurance company to deal with. I am currently trying to get additional records from when I was in NY to send to Walter & Kelly. So far I've been successful in obtaining OBGYN records from 2001 to 2003, an ER record with my weight on it from March 03, and surgery records from 2004 (ear). Those records, coupled with the info from my surgeon and my PCP records should *crossing fingers* be enough....(Oh and my Weight watchers cards from 06 and 07) Today was the day my surgery was scheduled for....by now I should have been napping in my hospital room, cheerfully drinking Water from a plastic cup and looking forward to Jello *sigh*.... :faint:

The nurse from UHC called me today. It was to "discuss a recent request" and to let me know I had other options like joining a gym (UHC must give some sort of discount) or help with dieting (I think they are launching a new website in 08. When I let her know that she was the first person to call me from UHC and as of today I still didn't have the full story about my denial. She asked me if "I had really given dieting a shot". Gee - I don't know...I've done Weight Watchers numerous times, Optifast, Nutrisystem, Carbohydrate Addicts Diet, Southbeach Diet, etc. and probably spent over $25,000 in my lifetime on gyms, diet crap, etc...but I guess I haven't really given it a shot. I had to tell her I found that INSULTING. To her credit, I don't think she meant to sound so condescending....it's probably some bullshit script they gave her. I'm appealling. My surgeon's office got the application from Walter & Kelly and I'm going in to their office tomorrow to sign it. I had my yearly physical today with my PCP. He's great...I really like him, but I know he's not 100% behind this decision and that is giving me cause to rethink it myself. I will still appeal UHC's decision.....and continue to think on this.... Thanks everyone for thinking of me.

Just got the call today...UHC denied. I knew they probably would, but it's still a blow. Looks like I have to fight them now, but I'm up for it.

Hello... My pre-op diet consists of three Meal Replacements and one meal of lean protein/veg....all of which should not go over 1,000 calories a day. I've been doing it since 10/14...and it's been a real biatch, but worth it since I've been losing weight. I'll find out tomorrow if UHC has approved my surgery....I'm hoping they do, because I really don't want to have to do this pre-op diet twice.

Sherry W - we must have similar sounding last names? We are both Angelic Disgrace's... Oh well! (Better than poison fartgas!)

Mine is "Angelic Disgrace" :car:

Just my .02 so take it for what it's worth. I read your other post. I understand why you are upset. Your surgeon should have had another band (the one you wanted) in backup. Mistakes happen....the band they were going to put in you broke. Were they really going to stop your surgery, wake you up, and ask if it was ok to use the older band? Would you have been satisfied if they just closed you up and said we'll have to do this on another day? Surgery is risky. It was your doctors call. Did you get it in "writing" that you would be getting the specific band you wanted? Like I said...my opinion may not be popular with you - but as my mother would say "get over it". You've been banded and the band you have is perfectly fine. If you make a big fuss at your surgeon's office, you run the risk of alienating the staff...the staff that you need to go back to for aftercare, fills, etc. You're angry - you've voiced your anger...and now you need to let it go. Concentrate on losing weight...and getting healthier. Again - this is just my .02, someone else may totally disagree and that's fine.

You could just drink the diet coke and let people think it had the rum in it or volunteer to be the designated driver.

Stinky UHC people.... Yesterday it was with the nurse... Today it's with "The Medical Director".... If my surgeon's office doesn't hear anything by Monday afternoon, they'll have to cancel. On a positive note, I heard from Walter at www.obesitylaw.org and he said if they do deny me that I've got a good case to appeal! This is what he said... "We are retained to represent patients with certain types of denials, like yours, at no cost to you. If you are denied, your LAP-BAND doctor/program gets the process rolling by getting an application for you to fill in, sign and fax to us with some information for us to evaluate (medical records, insurance communications, etc.) It costs you nothing to work with us through this program. There are some LAP-BAND practices who are very active with this program - others know much less or nothing about it. If I were to guess I'd say your provider may not know about it so you should definitely let them know because they are the only ones who can get you into it....if they don't have any idea what you're talking about, have them call Kelley here and she will walk them through the whole process....all LAP-BAND programs should be aggressively using this service - it doesn't cost them anything either!" So if I'm denied...I'm definately having my surgeon's office call them!

Losingjusme - WOW. That's just downright mean spirited. I'm so sorry someone said that to you. BTW - I've seen your photos and I THINK YOU LOOK FRICKIN FABULOUS! :whoo: It amazes me JUST HOW IGNORANT some people are.

Thanks to everyone who is thinking of me....It's been two days and I still haven't heard. I really hope I hear something tomorrow...It would be hell to have to wait the weekend.:violin: I called UHC today and asked for an update on the status. The said the nurse was still reviewing it. :rolleyes Anyway, I'm still sticking to the pre-op diet...it's been hard, but I'll continue to do it until I hear something.

My office constantly has food in it. We have vendors that drop off donuts, boxes of muffins, coffee, scones, and pastries on a regular basis. Halloween is coming up so now they are dropping off CANDY. At Christmas we get regular shipments from Harry & David, someone even got a smoked turkey. THERE IS ALWAYS FOOD IN MY OFFICE. We have FOOD DAYS. There's one next Monday. It's a fundraiser, so I can't really be too upset by it, but there will be tables UPON tables of food, hot food, cold food, Desserts, a regular smorgasboard. We also have a "snack shack" that they run to raise money. Luckily they stock it with those 100 calorie packs and other "figure friendly" Snacks, but it's tough walking by the open display of SNICKERS and MILKY WAYS and SWEDISH FISH (my fave). I keep healthy snacks at my desk and I always have a huge container of Water on my desk. So far, so good....I'm keeping my fingers crossed I can make it through the holiday season! :faint:

Appeal! They are probably hoping you'll just go away (because so many people do)...file the appeal, you are worth it. Call them and ask to speak to the person in the unit that made the decision and then ask WHY you were denied, and then ask for them to send it to you in WRITING. I am also sitting waiting for my insurance company to approve/deny me. I know I meet the criteria because I called and asked them. Now granted, I still expect they could deny me which is why I've already downloaded the appeal forms. I also checked out that Obesitylaw.com place and I may call them if my insurance company doesn't get around to approving me. My doctor sent in my surgery request on 10/5 and the clinical notes etc. on 10/12 and they still haven't made a decision....my surgery is scheduled for 10/31. I CALL THE INSURANCE COMPANY EVERY OTHER DAY TO SEE WHAT THE STATUS IS. THE SQUEAKY WHEEL REALLY DOES GET THE GREASE....AT LEAST GIVE THEM A HARD TIME ABOUT IT. Do NOT give up. :clap2::clap2::clap2::clap2::clap2: Make as much noise as you can with the company, and if you haven't already - WRITE DOWN THE NAME/DATE/TIME every time you speak to someone and what they tell you.