secretstolen

I had the same problem. I work for a non-profit health organization that runs a hospital and multiple medical facilities in the area. I have insurance through work, which is a self-funded plan administered by Aetna. When I called Aetna to find out, just to make sure I covered all my bases, I was told by the Aetna rep that there were many hoops I had to jump through in order to get the lap band covered. He even mailed me a copy of the documentation in their policy - which was about 30 pages - regarding bariatric surgery. However, I had already talked to our benefits department who assured me that our insurance covered bariatric surgeries at 100% with no list of requirements to meet, other than what the bariatric surgeon requested prior to authorizing surgery. The way a supervisor in our benefits department explained it is as such: The fact that my employer's insurance is a self-funded plan, of which Aetna merely administers, means that our policies and guidelines for certain services do not always adhere to those of general Aetna plans. Plus, the fact that we're a health organization also plays a slight part. It could be that yours is similar. Good luck!

I went in this morning thinking everything would be fine. The EGD/endoscopy was a little uncomfortable, but that was expected. What I didn't think would happen is my bariatric surgeon (who also did my endoscopy) would tell me I had a hernia. He took pictures of it and everything. *Sigh* He says it's not exactly a "No" to the banding surgery. He did give me a prescription for Nexium and one of the endoscopy unit nurses gave me a pamphlet about treatment for hernias. The surgeon said that he could try to repair it when the banding is done, but I think he wants to see how well I can adjust to the Nexium and the guidelines as such.. cutting back on coffee, caffeine, chocolate, peppermint, that sort of thing. If that doesn't help and they do another scoping and find that it hasn't improved, then I'll probably need to be referred elsewhere for surgery just for the hernia. So, I've taken my first purple pill. I guess at the moment that's all I can do. I cried in the endoscopy unit. The nurses were like, "Cheer up, things could be worse," and they're right. It's just that I'm trying my best to get everything done and to move on with my life. *Sigh* Just needed to vent. Thanks for the opportunity.

I'm listening to Feist's The Reminder, specifically "Sea Lion."

From my own experience, I support the right to bear arms.<br /> <br /> About 1.5 years after my dad died, my widowed mother started dating and I was assaulted one night by her boyfriend. He attacked me in front of my mom, who did nothing to stop it. He cornered me, slapped me, and screamed at me in a blind rage of anger that he would rape me and kill me, that he would hunt me down wherever I went so that he could hurt me over and over again, and that he would even kill my puppy just to be hateful. The guy was a freaking psycho. It was the 9mm that my father taught me how to target shoot with when I was 16 that saved me.<br /> <br /> I ran to where I knew it was safely stored and he chased me through my house. Once I had that pistol in my hand, had the safety off, and pointed it squarely in his direction, the tables were turned. He suddenly backed off, calmed down, and never laid another hand on me or raised his voice to me again. That was the first time (and only time) I've had to use a gun to defend myself, but believe me.. there was nothing more comforting than watching the douche bag who hit me and taunted me with threats of rape almost wet himself at the sight of a gun barrel pointed to his chest.<br /> <br /> I'm a little bit more of a liberal than I was raised to be, but when it comes to self-defense, I'm all for the right for law-abiding citizens to own firearms for their protection. If it hadn't been for that pistol, I don't know what would have happened that night.<br /> <br /> (But I respect everyone's opinions. I think it's a highly sensitive topic and everyone has their reasons for why they do/don't support gun control. Just throwing my humble opinion in.) Edit: And just to add, I live on my own and I currently do not own a gun. I feel safe without one right now, but in an issue such as the one I did go through, it was certainly comforting to know that if that 6'3", 320 lb., man charged me again to choke or hit me, I had the ability to stop him in an instant with a bullet.

Hi there, everyone. I'm Secret (obviously not my real name.. heh) and I'm looking into having the lapband procedure done. I'm 23 years old and I've been unable to keep my excess weight off over the past 4 years. Finally, I started seriously considering the lapband surgery and I have a conference to attend on August 23rd, and from there, I can set up a consultation with a local doctor. Basically, the reason why I'm using a goofy alias is because I don't have the most supportive people in my corner. Some friends of mine do not agree with surgical weight loss, and some family members are extremely critical and can be biting at times when it comes to my weight. Despite that, there are others in my life who are wonderful and who understand why I'm doing this. Still, I'd rather keep it on the low to avoid any awkward conversations.. especially when I don't even know that this is going to happen for me. Currently, I'm 247 pounds and I'm 5'8". We'll see what happens though! For now, I'm going to click around here and read everyone's stories and get a decent understanding of what I'm in for! Thanks!

Monday afternoon, I had an appointment with the surgeon. I gave them the documentation they requested from my PCP/dermatologist. They gave me a list of the stuff they want me to have done for pre-op.. -Some lab work -Pulmonary function test/clearance -Psychology consultation/clearance -Sleep study -Abdominal ultrasound -Copy of my results from 7/07 OBGYN routine exam -EGD/endoscopy procedure I started scheduling everything on Monday after I left the surgeon's office. I had the ultrasound this morning when I snagged a great cancellation.. I have the pulmonary function test tomorrow morning.. the EGD/endoscopy procedure is scheduled for the 15th.. I have a follow-up with the surgeon on the 17th.. the sleep study is on the 22nd.. I received a copy of my exam results from my OBGYN's office in the mail the other day (so that's in my paperwork to take back to the surgeon's office on the follow-up appointment).. and all I'm waiting on now is the psychiatrist's office to call me with an appointment date and time. I'm trying to get everything done by the end of the month. There's some more stuff I have to do with their clinic, though. I have to go to a 3-hour long nutrition group session, then go to a private 1-hour nutrition session as well. Once that's done, I should be cleared for surgery. Also, although my insurance covers the procedure and all of the pre-op testing 100%, I still have to pay fees to the surgeon's office. Total, it's gonna cost me $550. Not bad. There's a $250 program fee that all patients have to pay, then there's a $300 fee that covers the nutrition sessions, plus a visit from the nutrition advisor to check up on me after the surgery, and I'm assuming all of the fills thereafter as it mentioned post-surgery follow-ups. Not bad, really. So far, things look like they're going to be fine. The ultrasound tech who did my procedure this morning was a former co-worker (I'm in the medical field) who informed me at the end of the exam that my gallbladder looked fine, and she didn't see anything abnormal or anything to be concerned with. That's good. Let's hope the rest of it goes like that. I'll keep this posted.

Aww man, goo in my hair? Seriously? Ew. *lol*

I've got to have one, too. Mine's scheduled for 10/22. I don't snore, never have, but I do wake up with headaches most mornings. The surgeon wants me to have it done just in case.

I went to the information conference on 8/23, then had my first appointment with the bariatric surgeon around the middle of September. Because I was diagnosed with melanoma (Stage I) when I was 19 (and it'll be 4 years since my diagnosis/treatment in 12/07 with no recurrences), the surgeon wanted some documentation just verifying that I haven't had any problems since then and there is no current cancer. They called me a week later and set me up for my second appointment with their clinic which was yesterday (10/1) and gave me the list of pre-op stuff I've gotta have done. Mine consists of the following.. -abdominal/gallbladder ultrasound (routine) (sched. 10/12) -EGD/endoscopy procedure (routine) (sched. 10/15) -sleep study due to AM headaches (sched. 10/22) -pulmonary consultation and clearance (routine) (sched. 11/2) -psychiatric evaluation (routine) (yet to be scheduled) -CBC/CMP/TSH lab work (routine) (can be done walk-in, doing tomorrow) I was hoping I'd have a surgery date possibly before Thanksgiving, but it looks like the pulmonary consultation is going to keep me from it. I'm calling every couple of days to check for cancellations. So, yeah, it varies. It's a little discouraging 'cause once you make up your mind that you're gonna do this, you want it immediately. (At least I do. *lol*) I have to remind myself to be patient.

I just got back from my consultation with the surgeon. It went alright. The surgeon looked over my medical history and advised me that with my BMI (38), I needed 2 co-morbidities in order to justify having the procedure done. Looking over my medical history I submitted, he said I only had one - joint pain. I couldn't remember everything I had marked down, so I listened as he told me that the best thing for me to do would be to come back for a follow-up in 3 months to see where I was.. was I gaining, was I losing, maintaining? Did I have any new problems? Then take it from there. He did suggest sending me to be tested for sleep apnea after questioning whether I snored (no) and I admitted my sleeping habits were irregular. I mentioned to him that I have had persistent acid reflux over the past couple of months and it's caused me to cut out carbonated beverages completely. He flipped back through my paperwork and acknowledged that he had overlooked that. I had checked it, and yes, that was the second co-morbidity I needed. Still, he wanted to do the sleep apnea test. He did say that first I need to submit some additional paperwork relating to my medical history. He wants a letter from my dermatologist (since I was diagnosed with melanoma in '03) stating I have clean margins and have had no problems since the diagnosis and subsequent treatment. He also wants a 5 year weight history for insurance purposes. (I've called in a favor at my PCP's office and I've got an appointment on Friday with my doctor to have him provide that info and give me a once-over skin check. I no longer see a dermatologist as mine stopped taking my insurance and the only other one in town is not accepting new patients currently. I'll need to have him write up a letter explaining the circumstances with my dermatologist so I can fax that with my weight history.) Once that info is received, then he says we can begin scheduling everything. He advised me of the routine pre-op stuff that he wants done.. a gallbladder ultrasound, (I believe:) a barium swallow, the sleep study, some lab work, and so forth. He told me that he thinks I'll be a great candidate for the surgery if I have it done, as I'm young and he says I seem very motivated and dedicated. He also told me that it'll probably be within 2-3 months. But once all of the test results are in, they'll set up a surgery date for me. So, that's how it looks for now. Should I start calling around to set up my procedures? I've got a friend who works at a radiological facility, so I'm hoping she can help me get squeezed into the schedule for the barium swallow and the gallbladder ultrasound. The lab work will be a breeze; I can do that on my lunch break. The sleep study is what I'm worried about. We'll see how it goes, though. There are more procedures he wanted, but I can't remember at the time. I'll keep this thread posted.

I got the call from the clinic last Tuesday while I was at work. I'm scheduled to see the surgeon for the initial consultation with him on Tuesday (9/18) in the afternoon. That'll be fun. I'm looking forward to seeing whether he thinks I'm a candidate and hearing what he has to say. Also, in a strange note.. I got home Thursday afternoon and noticed one of the new tenants in my apartment complex was sitting in his car. He had just arrived minutes before me, obviously, and he was finishing up a conversation on his cell phone. I fumbled in my car collecting my things. When I got out, he had already started up the stairs and entered the apartment above mine. I didn't think anything more of it, other than, "So that's the guy who sounds like he's stomping around all day." I went to get my mail and started for the building as he came out of his apartment suddenly. We passed each other on the sidewalk and we smiled and exchanged pleasantries. The whole time I kept thinking, "Where have I seen him before? I know I've met him somewhere." Friday afternoon, another tenant and I were chatting outside briefly when she mentioned, "Yeah, you know one of those weight loss doctors lives in our building." BINGO! So, in a strange twist of fate, the surgeon I'm meeting with on Tuesday afternoon lives upstairs above my apartment! Apparently, the other tenant told me that she's spoke with him (because when she found out who he was, she went upstairs and proceeded to bother him at home with questions about the surgery for herself.. LOL) and he's living here while he's having a home built. Weird, weird, weird.. who would have thought, y'know? Anyway, I'll update after the consultation on Tuesday. Hopefully it'll be good news. (And hopefully it won't be awkward when he realizes I live in his building.)

The latest for me is as such.. I waited 2 weeks for the clinic to review my paperwork and finally, I got a call on Friday from one of the nurses saying that they looked over it and passed the paperwork to a dietician who passed it over to the insurance verification folks. As it turns out, I'm covered 100% for the surgery, which is a huge relief! The nurse stated that my chart has been passed over to the scheduling department and someone will call me in the next couple of days to set up my consultation with one of the surgeons. I'm really excited now! jetlagjane: That is so awesome! I can't wait to be that size! *lol* I can't remember ever being under 180 or so. I figure with the pre-op stuff, I'll lose some weight. Was your 20 pound weight loss due to the pre-op? nan42: Aww, I'm sorry he feels that way. As long as you're doing this for yourself, I think you'll be fine. Now, if you were doing it for him and he were feeling that way.. but sometimes you have to put yourself first and do what you know is best for you.

Thanks, everyone! So far, everything looks good to go. I filled out all the new patient information with stuff like health history and so forth, and faxed that over on Friday morning. I also called my PCP who signed off on the authorization form that the clinic required from our general physician. I called the insurance again just to double check and was told that if everything is done in my employer's facility (since I work for a non-profit health organization), I won't owe anything and the insurance will cover it all. (Of course I don't think that's true, so I'm planning ahead for deductibles and copays.) Now comes the waiting game. I have to wait for the clinic to call me and let me know if they think I'm a candidate and when I can come in for a consultation. The staff member who spoke at the conference Thursday night said that it usually takes a couple days to review over everything, but if you don't hear anything from them in a week, call to check on it. I'm hoping I'll hear something on Monday. We'll see! Thanks again, you guys! And I'm keeping my fingers crossed for those of you who are going for your first fills and your bands soon! How exciting! :huggie:

Hey everyone! Thanks for all the lovely words and advice! It's nice to have a place where I can go to read up on things and meet others who have gone through this kind of thing. Tonight is the conference where the banding doctor speaks. Our local weight loss clinic (which is new to the area, but the doctors are well experienced.. and I Googled them to read what others had to say about them) doctors require that you attend one of their conferences in the presentation rooms in the hospital before you can set up a consultation. Tonight's the night. I called the office about an hour ago to get an idea of how far out the consulatations are being scheduled, but the girl I spoke with was a little vague, but she told me I could call on Monday and get an appointment. (I'll probably call tomorrow just for good measure.) I've already checked with my insurance and my employer's benefits department and as of 8/1/07, my Aetna insurance covers the procedure as long as it's done by our new bariatric physicians. So, that's a good thing. Plus, the only screening for it is whatever tests/hurdles the bariatric doctors require before surgery. So, I'm hopeful that things are going to be okay. The friends that I've shared the news with have been okay with it. Only one has been exceedingly understanding about it. The others are kind of passive to it, which is fine, I suppose. At the end of the day, the really great question to ask myself is: If I'm active and I'm making healthy choices with my life and my diet and I can't take the weight off, then what's the sense in continuing to be overweight? I'm really lucky because I have low blood pressure, low cholesterol, and I'm in good health - but who's to say one day that won't change and my excess weight won't cause other problems to develop? Eh. I'm just keeping my fingers crossed that the conference tonight will be very informative and that the doctor will be able to see me soon for a consultation. I'm impatient, I suppose. Thanks everyone for the warm welcome and all the great words of wisdom! I can't wait to make some new friends here.