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gentylwind

LAP-BAND Patients
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Everything posted by gentylwind

  1. gentylwind

    Can you feel your port?

    Yes, I can feel it. I also have a low profile port.
  2. gentylwind

    Will I really feel it?

    I just got my third fill and am only now starting to feel good restriction. It takes time.
  3. This is the way all doctors and hospitals who are contracted with a health plan work. They agree to take what the health plan is willing to pay for any given procedure or visit in exchange for being in that health plan's network, thus hopefully generating more revenue by volume of patients who come to see them from noticing that doctor is in network on their plan. This is also why a health plan pays a lesser percentage (and you a greater one) for an out of network doctor. No matter what, the health plan will shell out more money to an out of network doctor to an in network one. They require you to do the same in hopes you will choose to always stay in network and limit everyone's costs. The doctor can SAY they charge $17,000 or $80,000...it doesn't matter. The contracted rate is agreed to beforehand and the doctor is not allowed to bill the patient for anything other than what the patient's health plan outlines his or her responsibility to be. The rest gets written off. This also comes into play ONLY after the patient has met their deductible if they have one. Many plans require the first $2000 or more to come out of the patient's pocket before the plan pays anything at all, in network or out of network. Usually the deductible for out of network is twice the deductible for in network. Out of network doctors will get paid a percentage of what is "usual and customary" for a procedure. For Lap Band that is probably about $12,000 or so. So the doc gets somewhere around 60% or 50% from the health plan and the rest is up to the patient. But even then, the doctor can ONLY charge Usual and Customary, which is generally decided by Medicare. Anything above that amount has to be written off. So as an example: So for an in network doctor it looks like this: Stated Charge: $20,000 Patient deductible (as an example): $2000 Health plan pays: 80% of CONTRACTED RATE, which is (as an example) $2000 Patient pays : 20% of CONTRACTED RATE plus deductible Health plan pays: $1600 (which is 80% of $2000, the CONTRACTED RATE that the doctor accepts for being in network) Patient pays: $2400 (patient deductible plus 20% of the contracted rate) Doctor collects: $4000 (patient and health insurance payments combined) Doctor writes off: $16,000 as non-billable due to his contract with the health plan. He is legally required to do this. For an out of network doctor it looks like this: Stated charge: $20,000 Usual and Customary Charge: $12,000 Patient's deductible (as an example): $4000 Health plan pays: 50% of Usual and Customary after deductible is met Patient pays: 50% of Usual and Customary after deductible is met Insurance payment of 50% of U&C charge after deductible met: $4000 Patient pays deductible plus 50% of U&C charge after deductible met: $8000 Doctor collects $12,000 from patient and insurance combined Doctor charges patient an additional $8000 to make up the difference OR doctor writes it off if the patient was a good negotiator. He is not legally required to write it off.
  4. Third fill this afternoon of 0.5 cc. I now have a total of 6.5 cc in my band. I can definitely feel this one and I am feeling very optimistic! I have started exercising five times a week, going 3 miles on the elliptical in 45 minutes. I will start to incorporate weight lifting as I get it more into a habit. I like cardio much better than weights when given the choice. And I am down to 217 from 242 on the date of my initial consult. Yay!
  5. None of the NSAIDs are safe, just Tylenol. Call your band doc and tell him/her what's going on. They may have a suggestion.
  6. gentylwind

    Turned into a Junk Food Junkie

    Wow, that's a rather...um....extreme response. :scared2: Did she provide you with a reason? I am sure it wasn't on a whim.
  7. gentylwind

    Do you eat popcorn?

    Popcorn goes down just fine and it is my favorite food on the planet. But the gas it has given me since surgery is so incredibly painful that I doubt I will ever eat it again.
  8. gentylwind

    What Dr. Laura said :(

    This thread is from 2005. :yikes:
  9. I don't think I have ever seen anything that would make me stop eating quite like that link. :yikes:
  10. I keep hoping for one that looks like the Virgin Mary. If someone can make that much money for her image on toast off EBay, I figure...well..... *wrings hands together with evil plotting* Gross...Art....Fine... meet line.....eh? One good stinker and voila! I'm an artist! Self-made.
  11. gentylwind

    Bloody stool?

    Call your doctor. This isn't a problem for Internet speculation.
  12. Call your doc and get a prescription for Phenargan if you are having nausea. Some heaving probably isn't going to hurt you but continued heaving will. Nausea after anesthesia is common and Phenargan (liquid or suppository) is a medication that helps with that.
  13. gentylwind

    Pain

    I don't know how long ago you were banded. I am about 10 weeks out and when I get that pain now it is a sure sign that I overate.
  14. gentylwind

    Help me, possible change in surgeon

    Yep, definitely would not get upset until I talk to the surgeon's office. Hospitals make this kind of mistake frequently. If you aren't sure about the surgery for real, then don't have it. If it is just jitters because it is getting close, hang in there.
  15. I have started to get shoulder pain too when I have eaten a bit too much. Not pleasant.
  16. gentylwind

    Help me, possible change in surgeon

    Some are overnight, some are not. I would talk to your surgeon's office and find out what the deal is. It very well could all be a misunderstanding.
  17. gentylwind

    Focus on the issues!

    :angry::angry: NO Reese's on the band!! Do Reese's make you PB? Can I eat a Reese's before I leave the hospital from my surgery? How about at day two? Day five? Four weeks postop when I am starving? What's a PB anyway? Oh yeah...peanut butter... Can PB make you PB? /staying on topic :wink: Hav
  18. My friend has mentioned special "tables" in which it is done, and it is all a do-it-yourself affair. I personally would rather stick myself in the eye with a fork than go somewhere to poo in public.
  19. Yeah, I would personally count on a rather spa-like atmosphere. With plenty of candles.
  20. Do you think they have sound-proof rooms?
  21. gentylwind

    Need advice--from band to bypass???

    If you do a Google search on duodenal switch you will find a lot of information. There are a few points that stick with me: It has the best weight loss success long-term of any of the surgeries. It has the highest rate of complications as well, mainly due to nutritional deficiencies that can be severe. It also can make it difficult to stop losing weight when an appropriate weight is reached. It is the most difficult of the bariactric surgeries to perform. There are the fewest surgeons doing it and you will likely have to travel somewhat to get it done if you aren't in a major city. It is the most expensive of all the bariatric surgeries. Good luck with whatever you decide.
  22. Ever had a colonic? I have a crunchy new-age massage therapist hippy girlfriend who loves them. She pays someone to stick a hose up her backdoor and irrigate her insides. Apparently this is done at a place where other people come to have it done as well. So someone was in there using the facilities prior to your own use of the facilities. This can cost up to $60 or more for one "treatment". There are those who swear by the health benefits. I just can't imagine....both doing it at all (ie paying someone to let me crap in their office), but also the conversation in which I would tell Joe I want to take $60 (plus tip...I guess you give more if you let loose a good muffin?) to pay someone to make me crap. That would float like...well....you know.
  23. gentylwind

    Focus on the issues!

    If it floats it is much more likely to clog the toilet. I'm just sayin'.... Trying hard to think of a way to make that band relevant though, so as to keep this thread on topic.
  24. It should sink. Fatty stools float as fats tend to want to separate from Water and rise to the top. Stools with adequate fiber are "heavier" and thus sink. Ahem. HTH
  25. I was dancing at a family wedding with my cousins..we were having a great time, a little drunk.... and one of them said to me later on...."I think it is great you can still feel sexy...." I stopped dancing after that.

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