k_podski

Hi all, I cannot find any info on this site of anyone dealing with Harvard Pilgrim for this surgery, more specifically a band to sleeve revision.. My surgeon has approved me for this revision and said he is willing to help me fight to get it. I am no stranger to this site as I followed it over from lapbandtalk.com when I saw how many people were getting revisions and having beter success. The hunger with the band is killing me, and the constant fill/ unfill process is getting old. I am over the extremes of starving or sliming.. And always feeling hungry.. My doc feels as though the sleeve would be a better choice to address the hunger issues. I have lost 50lbs with the band since 3/19/08 (246lbs-195) and have maintained, which is considered average- but the surgeon thinks I could stand to lose another 50-60lbs.. At 5' 3.5", my personal goal is another 50, anything extra would be a bonus! Supposedly Harvard Pilgrim is one of the top insurance carriers now adays, and have always been great to deal with, and quick with descisions. The doc wants me back in 2 months to see what progress he's made with HP and for me to see the nutritionist every 2 weeks until then and get a print out from my gym of my visit dates to show a paper trail to help my case. He feels as though the sleeve will be the new band and that the band is already phasing out due to complications and lack of success. He also feels that now there is 5 year research out on the sleeve that more insurance company's will cover the surgery. As of now HarvardPilgrim.com states that it does not cover the sleeve, however when I called to inquire if I could get around it they suggested my surgeon call with more info and codes.. Any ideas or experiences with Harvard Pilgrim? Thanks in advance for any input, Kerri:)

Hi Christine and Penny, I've been lurking too.. For a long time now! I do get on here daily to see how things are going. I have been having some band issues lately that have me pretty frustrated. I've kept off the board for fear of bringing people down.. I am still trucking along, slowly but surely! ~Kerri

So I have been in contact with my insurance, Harvard Pilgrim. As I suspected, they currently do not cover VSG. However.. The woman that I spoke with said that between her and I (?!) she believed it was in the process of being a covered surgery as long as it's medically neccesary, well documented history, blah, blah, blah.. But she wasn't sure about a revision?? Is it possible for her to know this info?? And if the insurance company covers the surgery why is a revision considered a different procedure? I have thought a little about financing the surgery myself and heading to Mexico.. I'm not so sure I could afford what the payments might look like? Does anyone know what a finance plan looks like through Dr. A's office? I know they offer through a few different companys, but I'm curious if it's even worth looking into? Generally anything like that through an office offers an extremely high APR and outrageous payments. If I do a personal loan I'm sure it would be a high APR as well.. Maybe I should wait on Harvard Pilgrim and see what happens??? Even if they did end up covering the surgery, I wouldn't know where to start in the US with a surgeon as I'm sure that no one in Maine does VSG... (Although I believe there is someone in Boston?) So yah, a whole lot of questions here. Hopefully you guys can understand my thought process here, I'm working on negative sleep and lots of coffee today:) Thanks in advance for your responses! Kerri:)

This what is covered as of 10/2008: • Bariatric surgeries, including gastric stapling, vertical banded gastroplasty, gastric lap banding for obesity, biliopancreatic diversion with duodenal switch, and gastric bypass surgeries with required prior authorization from Harvard Pilgrim.

Yes Elisabeth, that was really helpful! I guess I hadn't given my BMI much thought.. It is now 35. I am 197lbs and 5'3". Could this compromise the possibility of a revision?? I would like to lose another 60lbs or so. As for my surgeon and nutritionist, yah.. You got the idea lol I should have known better at the beginning when my surgeon asked me which surgery he did on me and whenhe had done it, when I was there for my final consult pre op. Then for my second fill he asked me if I had a fill yet and how much I had in my band. Yikes! What was I thinking:( Thanks again for your reply, I really appreciate it!! ~Kerri

I am having SOME issues that I've been dealing with mostly all along. My GERD is back as I suspected it would be. When my doc was in there he said my hiatal hernia "wasn't that bad" so he did not fix it. I was without reflux for almost a year, then in January it started up again. My reflux now makes me nauseous so I am on meds for both now. The nausea med makes me want to sleep all day. I have also had a sore port since day one. I had a revision in Nov last year, and it continues to bother. There is a dull ache all the time, although when I sit, stand, or bend, forget it, it feels like it's getting ripped out. When I went to my doc for this he asked "does it hurt when you touch it?" I said yes, to which he replied "then don't touch it and you will be fine..." Thanks. 'Preciate that. I also am hungry ALLLLLL the time. I've been working with my nutritionist every two weeks for god knows how long now. I'm sick of being hungry. I've been hungry all my life. That's why I'm fat. No it's not head hunger, no it's not poor food choices, no I'm not an emotional eater.. I'm effing hungry, can't you just hear me out??? I'm sick of cramming in 75 grams of Protein a day to prove to them it's not lack of protein. "Add another 5g-10g in, you should feel better then." Ugh. I spoke with the nurse from the bariatric center who also has a band. She suggested I look into the VSG originally because of a possible hunger hormone issue. She is getting a VSG in July. When I brought this up to my Doc he pretty much laughed in my face. I think that he thinks I'm not doing the right things. Granted I don't exercise as much as I should, but I do damn good, and am a different person than I was a year ago. I wish they could follow me around for a week to see what I go through:( So yah, sorry to let loose, I kind of needed to get that out. lol I guess I'm confused about pre op and post op stuff if Mexico is chosen for surgery too. Will I need to do post op here in the US with my current doc? Because EEEEK, I don't think that will work out well.. And how does the pre op stuff work? Is it all done once you get there?? Thanks again for your time and responses! Kerri

aJoneen.........................+1 75 pounds lost! Bandana....................... 0 92 lbs lost BrandNewLisa............0 80pounds LOST forever!!! evelas5000...................0 50 pounds Lost Desdemona...................0 Fenton...........................0 100 POUNDS LOST !! HarleyGirl....................0 85 pounds LOST! Hopeinapril................. .0 55 pounds lost! Kpodski......................... -4 Lynnt1215.....................0 NurseNiki......................0 Nycm00........................0 OUCH Potatie............................0 132 POUNDS LOST!! Scrappy_Friend........-3 160 POUNDS LOST!!!! SpecialK........................0 102 GONE forever! Sugarbean....................0 117 POUNDS LOST !!! Sharona.........................0 stellabella......................0 75 POUNDS LOST! Tess415..........................0 Thin2bme....................0 100 POUNDS LOST !! WestCoastMom............0 Wishin4...........................0 78pounds gone!! Back to onederland again! Down 13lbs of the 18 I gained while quitting smoking!

So... I have been lurking here on the VSG thread now for a while. You guys have posted so much useful information, and have definately struck some curiosity in me! I was banded just over a year ago, and have a love hate relationship with my band. I have had several fills and unfills trying to get to the right spot for me. I think I am about there now, although I am still hungry. As I always have been. I am at the point where I mostly eat mushy types of foods. Not many types of normal foods agree to go down. In the morning I am usually so tight I can't eat. Breakfast is usually coffee, which sometimes, even that gets stuck. By mid morning I can usually eat breakfast very carefully. I am currently working closely with the nutritionist from the bariatric center where I had my surgery. I feel like there is no happy medium for my restriction. Either I am loose, starving, and can eat a cow, or I am tight, starving, and can barely drink. Either way I am HUNGRY. All the time. I have done so well with keeping on track, logging food, and making good choices. I admit I slack on "exercise" but I am a fairly active person, always go go go, out and about. I feel stuck in a rut. I think I need something other than the band... I may have the option of getting the sleeve if I look more into the financing, but I am still unsure about the process. I also question my insurance. I have been told several times that Harvard Pilgrim is one of the quickest and easiest companies to work with. As of last October they said they do not cover VSG. Is it possible to challenge them? Or bring info to their attention? Also I'm curious with the VSG if things get "stuck". I've read posts about still having to chew chew chew.. I am so over being stuck and spending hours in pain, in the bathroom, waiting for things to come up or go down! I guess that's enough for now, sorry about writing a book on here! I've been curious for a long time, and just finally got the nerve to ask some of my many questions. Thanks in advance for your time and knowledge, Kerri

Very interesting! I will definately have to try this.. I have never heard of it.. My doc suggested doing this after banding to help the gas move from the shoulders.. I wish I would've know this when I was ohhhh soo stuck last night on a banana. Ugh! I was up until 1:30 waiting for that sucker to come up or go down! Thanks for the info:)

Hi Amanda, I was just looking up some info for my sister this morning about how to deal with a plateau. How frustrating! I found a couple interesting sites that I shared with her, so I figured I'd post the link here too:) Hopefully it can be of use to you?? This first one says to eat "something bad".. I'm curious how true this is? I've heard them say it several times on Biggest Loser.. Weight Loss Plateau - How to Deal with a Weight Loss Plateau I'm not sure how much I understand this one.. It suggests eating even less calories and exercising more. What happens when you go back to normal intake and reglar exercise? Sounded interesting anyway.. SmartShape.com.au - How to break a weight loss plateau And the last.. 5 Ways to Break a Weight Loss Plateau Hope these can be of help to you:) Kerri

aJoneen........................0 75 pounds LOST! Bandana....................... 0 92 lbs lost BrandNewLisa............0 80pounds LOST forever!!! evelas5000...................0 50 pounds Lost Desdemona...................0 Fenton...........................0 100 POUNDS LOST !! HarleyGirl..................0 85 pounds LOST! Hopeinapril................. 0 50 pounds lost! Kpodski........................- 4 Lynnt1215.................0 NurseNiki...................0 Nycm00.......................0 Potatie..........................0 100 POUNDS LOST!! Scrappy_Friend......0 150 POUNDS LOST!!!! SpecialK.....................-5 97 lbs and closing in on 100! Sugarbean..................-2 112 POUNDS LOST !!! Sharona.......................0 stellabella...................0 HALFWAY TO GOAL! Tess415......................0 Thin2bme................. 0 100 POUNDS LOST !! WestCoastMom........0 Wishin4......................0 73 pounds gone!! After gaining a pound on vaca, then coming home to gain 3 more, THEN, eluding the scale, I decided to get my butt back in gear. 2lbs to go to be under 200 again!! Have a great week all! :smile2:

Hey all. Congrats on all of your hard work and success through out the past year! Love the pics!! Everyone looks amazing:) What a difference a year makes.. Soooo... I got back from an amazing vacation in Daytona a few weeks ago. Boy, I wish I never came home! It's freezing here, I demand spring!! It was 25 freaking degrees out today.. There's still 3 feet of snow on the ground. I just want to get out and move around in the sun! I gained 1lb while on vaca.. After a week and a half diet of pizza toppings, corn dogs, long island iced teas and white russians, I guess I was shocked to see only a 1lb increase?? I did work my butt off a few times in the gym, and did loads of walking every day, so I guess it helped me maintain? I did not expect to go so hog wild.. Ughh, I couldn't hold myself back. I'm glad it was only a pound increase, but it proves to me how much I need to work on my compulsive eating habits.. I have an appointment with the nutritionist tomorrow. I hope it helps me get back on track. I've really been struggling with what to eat for a while now. I can only eat something so many times and I'm over it from taste, to smell, to texture. It makes me nauseous to think about chicken, fish, and hamburg at this point. Once I can get a few more options/ ideas I know it will make meals and food choices so much easier for me. Unfortunately, I had my bandiversary 4 days ago and decided to wallow in self pity rather that Celebrate the 50+lbs I've lost... I'm more than half way there and I'm determined to turn this around so that next year I can celebrate at goal:) I can do this, I know I can, I just need to figure myself out and get the show on the road! So anyhoo, enough of my "Dear Diary" post lol.. I just wanted to pop in, vent, make myself accountable, and last but not least, wish everyone a happy one year bandiversary:) Congrats again on all of the accomplishments! You guys rock!!!!

I myself am no fan of Mondays as well. I have the weekend off, then work 25 hours to start the week.. Ugh, does it drag! I woke up this morning to 27" of snow. So much for the 8-12 forcasted. We just got 18" Thursday.. I was out at 6am in my flannel pjs trying to find my Jeep. What a cruel joke this winter has been! Hopefully this week moves along quickly, Daytona bound in 3 days!! Between frozen pipes, a chimney fire, 500 feet of snow, and a propane leak over that last 2 weeks, I've never needed a vacation so bad. Here's to my first time out of New England!! WOOT!! (:Hope you all have a great week:)

Congrats Teri!!!

aJoneen.......................075 pounds LOST! Bandana......................-2 92 lbs lost BrandNewLisa..........0 75 pounds LOST forever!!! evelas5000................-2 Desdemona.................0 Fenton.........................0 100 POUNDS LOST !! HarleyGirl..................-2 80 pounds LOST! Hopeinapril................0 Lynn1215.....................0 NurseNiki...................0 Nycm00.......................0 Potatie.........................0 100 POUNDS LOST!! Scrappy_Friend..... 0 150 POUNDS LOST!!!! SpecialK......................0 Sugarbean..................0 100 POUNDS LOST !! Sharona......................0 stellabella............... 0 HALFWAY TO GOAL! Tess415......................0 Thin2bme............... 0 WestCoastMom........0 Wishin4......................0 Kpodski............-1 BRATZ98363.......0 Only down one, but I'll take it. I will be on vacation for the next 2 Fridays.. I hope I can come back and post a few more lbs down?? I'm at 200 again, 8lbs to go to be back at my "pre-quitting smoking" weight.. It will feel good to be in the 100's again for sure!!

Great NSV Harley!! Had to lol about crying in the HD shop:)

I too have had an issue with sweets. Since getting back on track a few weeks ago I started buying sugar free sweets again. Russell Stover makes small bags of sugar free chocolates that taste like the real thing, no after taste or fake sugar taste. They have all kinds to choose from. I have a hard time eating 1 so I keep them in the freezer. I know that I crave sweets after supper, so while I'm preparing supper I take 1 or 2 out of the freezer to thaw for my sweet tooth after I eat. They are IMPOSSIBLE to eat frozen so I only eat the 2 and am satisfied, and also know that if I want more, too bad, they're frozen. I also keep them at work in the staff freezer:) Also I found sugar free tapioca cups. I put a little cool whip free on top, and yum! It's enough for me. Also I do the same with SF jell cups. Just a few ideas, hope it helps someone out...:tt2:

Me too! Me too! Looks de-lish:)

Yah, I definitely can't wait for warmer weather in FL! Hopefully their cold spell is long gone by next week. I need to be more active, and the weather here makes it impossible to be out and about. I will be doing lots of walking, swimming, and riding (and maybe a little eating and drinking;)..) It will feel good to be outside in the sun for sure! So.. we had 2 more cord of wood delivered today. I am so over it! But I did get a good workout by stacking a whole cord by myself:) My arms are spaghetti, and my back feels like I've been run over, but it's kind of a good feeling lol Tomorrow I will do the other cord. Hopefully this all pays off on Friday, I am still aiming to be back to my lowest post op weight by the 27th. 9lbs and a week and a half to go.. I think I'm pushing it!! I will be content if I lose another 5 at least, I have been doing really well, so 5 should be more than doable. I will stop rambling now. I need to get started on homework! Have a great night all:) ~Kerri

Lynn, this post made me sad:( I am so sorry that you are struggling.. What an icky feeling. I am and have been struggling as well. In 3 months I have put on 18lbs.. I had a fill about 2 weeks ago and have lost about 9lbs of the 18, but still feel horrible about myself for getting so out of sorts. It is so hard to see the wonderful success of others and know I could be there... I'm not sure what I can say to help you feel better about your situation, but know that you are not alone! You have done a wonderful job, keep up the good work! This journey is definately full of bumps, and you WILL get over yours, just give yourself time:)

Wow, Fenton, good for you with your 6am gym visit!! Harley, thanks for the info!! It helps me to know what other people are eating.. It still gets confusing for me. I don't know whether to watch carbs, calories, fat, or all of the above.. I have faith that one of these days I'll get it! I have a much needed nutritionist appt on the 24th of March. Congrats again on your success:) Anyone else feel like sharing what a typical meal might look like for them with good restriction?? Hope you all have a great day! We're looking at another 18-22" of snow tonight into tomorrow.. Oh my. The count down is soooooo on for Daytona.. 9 DAYS!!

Wow! You give me hope!:thumbup: I also cannot stand the thought of exercise. I have been fooling myself for a year now having money deducted weekly for my gym pass. I have gone once. I have such a hard time getting motivated.. But when I do, the weight usually melts off. I just need to do it. You go girl! And thanks for sharing.. You can do this!! :)Kerri p.s. best of luck with your surgery, and have a wonderful birthday!

Wow Harley, great tattoo!! I love the colors! Congrats on the 80lbs lost as well, what an accomplishment! I must say I'm a bit envious:)... Do you mind if I ask what a typical day looks like for you food wise? How often are you exercising? Keep up the good work!! You're an inspiration!:thumbup:

I hope it's not an issue that I am posting late.. I have been unable to login from my computer to post my Friday numbers.:thumbup: aJoneen.......................-2 75 pounds LOST! Bandana.........................0 BrandNewLisa............0 75 pounds LOST forever!!! evelas5000..................0 Desdemona..................0 Fenton........................-1 100 POUNDS LOST !! HarleyGirl................ -6 80 pounds LOST! Hopeinapril................0 Lynn1215.....................0 NurseNiki...................0 Nycm00.......................0 Potatie.........................0 100 POUNDS LOST!! Scrappy_Friend.....-1 150 POUNDS LOST!!!! SpecialK......................0 Sugarbean..................0 100 POUNDS LOST !! Sharona......................0 stellabella...............-.4 HALFWAY TO GOAL! Tess415......................0 Thin2bme...............+ .2 WestCoastMom........0 Wishin4......................0 Kpodski............-4 BRATZ98363.......0

Howdy all:) I was psyched to be able to post on the Friday weigh in thread today:) I had a fill yesterday of almost 1cc. I amfeeling good, and hoping that this helps me get my butt in gear. We are headed out to Daytona bike week in 21 days and I want to be down another 10 by then.. I hope I'm not looking for too much, I think its attainable? I guess I'll just have to find out. I am all about planning ahead and have made plans for the resort I will be staying in. I WILL NOT be drinking and eating out for 11 days!!!! Anyhoo, have a great weekend all, and congrats to all on the NSV's and milestones for weightloss. Bravo!! :)Kerri