SpecialK

Be sure you all are aware of the insurance forum thread and then you can see what others have been doing on working with BCBS, Aetna, Cigna, etc. Here's a real testament to perseverance - this lady hung in there for 2 years and got her approval in the past week! What a blessing. http://www.lapbandtalk.com/f8/after-2-years-i-am-approved-47405/

Sue, sorry to hear about BCBS being so picky about the sleep apnea issue. Do you use a CPAP? My Sleep Medicine doctor is Dr. Joseph Cunningham and he encouraged me to consider bariatric surgery so he was really cooperative in writing my letter saying he felt I needed the surgery and my sleep apnea would be improved or eliminated if I got surgery and lost significant weight. Good luck in writing an appeal letter. There is a posting on this web site from a lady who went through 2 years of fighting to get her approval and she got some kind of an obesity law group involved to help her along the way. I'll see if I can find the posting and link it here later. I'm in Arizona this Christmas and today is our big holiday meal. I am planning to be as reasonable as I can. So far I've done okay in not getting into sweets especially. Merry Christmas!

I was sent this graphic and thought it was beautiful and couldn't think of a better place to share it than with Christian bandsters. God Bless You all.

I raised your family in prayer as I read your posting today. Our God is an Awesome and Powerful God, the mighty Healer. God Bless you and your husband.

I applaud your persistence!!! Congratulations. I'd have my pre-op admission testing and 2 week of Optifast or whatever diet done in January so I could line right up for surgery as early in February as he can schedule you. WOW! What a nice Christmas gift!

I just wanted to take time to thank everyone for all the insight they have provided to me via this web site. I really haven't encountered anyone else to talk with in person so far - no family has had weight loss surgery and no friends or coworkers that have ever admitted it to me at least. I'm off to spend the next 11 days in Arizona for Christmas with my brother and sisters. Can't wait! Merry Christmas!

I completed my echocardiogram yesterday. Was a little surprised to have a young male technician to have to do it, kind of like having a male technician for a mammogram but I just kept repeating to myself (silently!) he's a medical professional, you can do this! Yep, over and done with in about 25-30 minutes. I talked with my psych consult doctor and that appointment had to get rescheduled to mid-January because we're having trouble finding out if insurance will cover it. I just said the heck with it, we'll schedule it for that date and if I end up paying out of pocket for the test, that's what I'll have to do. Wish me luck and say a prayer I can get an Aetna approval pre-cert for the psych testing that they themselves require for the surgery to be performed. I also found out that there is an Aetna provider for dietician's that works with Mt. Carmel West hospital patients and she was super to talk with. She said she'd call the bariatric coordinator to find out exactly how many appointments I needed to do and what needed to be documented to be sure I got the diet counseling clearance check off I needed. Super nice! I'm looking forward to meeting her. I found out Michelle from Mt. Carmel that does all the other bariatric program nutrition work doesn't do appointments to help complete insurance clearances because she has so many hospital program patients to do just pre-op and post-op counseling and support group with. Sounds logical and she offered to refer me to someone but I thought I'd better just check the In-Network list of nutrionists on Aetna's list to have the most success at them paying for that. I'm a jumping hoops as fast as I can. There is a chance now I'm finding out that if I do 3 Nutrition appointments including the 1 already done with Michelle, that if I do one in January and one in February, they can submit for insurance approval. Instead of thinking I might be a May/June band surgery date it could be March. That's exciting to consider.

I called today for the RD that is on Aetna's list for my plan and they let me know its likely Aetna won't cover the dietician visits required for bariatric surgery and that it will be about $100 for a 1 hour visit so that means at least $200 out of pocket for that for me for 2 more visits plus the one I did this month with the hospital's dietician this week. Just keep on jumping through those hoops!

I have a late January birthday and I can't think of a better present than Aetna approving me by the end of January. Congratulations on your approval yesterday.:clap2:

I had a friend tell me her doctor told her she is too old to be banded at 60 and I thought I've seen postings of some on this website over 60 so I'm curious to see how old you were when you got your band or how old you are now if you're going through the approvals/insurance process to get banded in the upcoming year. I'm 51 now and will 52 by the time I get banded. Thanks.

Congrats Jess30. I can't wait for the day to get down from 26/28 and even 30/32 or 3x into a 22/24 as a milestone. I'm sure you will shine for your Christmas party! Enjoy. and... Feast on the compliments not the goodies!

I had a tough experience and was asked to pay $50 administrative cost for my PCP to get the paper records from the past 5 years out of storage since they've gone to computer only in the past 2 years and to give the surgeon's office what Aetna needed on my 5 year weight history, I had to pay the cost for the PCP office to have the paper file pulled from storage, copying done, then sent back to storage. I should follow up and see if my PCP has completed this after hearing your story. My PCP isn't supportive about weight loss surgery even for those she knows have struggled for years so I'm kind of pushing ahead without her if I have to. Good luck!

Thanks Ray for confirming that I just should get a January and February nutritionist appt lined up and then I should be close for maybe a March approval & banding instead of thinking I had to wait 6 months! Woo Hoo!:clap2:

Quilting is a big love but I haven't had enough time for it yet but the winter is a good time to curl up and do this. I also do water color painting, I've dabbled in stain glass, and I love gardening.

Have to confess that at my BMI 57, I gave up long long ago on even trying to flirt with someone because I hated the rejection. Even if I took the time to get to know the guy, and then tried to flirt, I was a flop at this. However, I have 2 sisters who seem to be able to flirt effortlessly.. go figure. Hoping when I get closer to a normal weight that I'll figure the flirting thing out - or at least get courage to keep trying if I get burned the first 10 times or whatever!!!

Mariposa - I just noticed your tag line says you were banded in 2004 and had a port revision in 2005. How has it been now that you've gone what 3+ years? Are you at your goal? I thought the big guys would win it all along - knew Neil was a likely winner but wasnt' surprised by the Twin brothers winning both the $100K and the $250K top prize. The only thing that bothered me this season was the Product Placements...ie. advertising... stop it please! That's what commercials are for. I hate that they keep renaming all the football Bowl games with big commercial product names too. Like it that they keep the Rose Bowl as just that .. The Rose Bowl!

<p><p>Dawn, it is so encouraging to know someone who has achieved the level of loss I need to do has done it. Thanks for posting. I'm 5' 5" and I'd love to be able to run any distance right now...just too painful on the knees and would get short of breath quickly if I tried too. So, save a space for me in the future on the starting line of a 5K or whatever!</p></p>

I'm not banded yet but almost finished with my clearances and this is something the nutrionist just mentioned yesterday - staying away from liquid calories - they go through the band fast and don't satisfy compared to eating something you have to chew to eat and that takes longer to digest. I can so relate to how hard being overweight, morbidly obese, is at Christmas, New Years's Eve and then a January birthday for me, followed by Valentines' Day no less so I always considered this period one of the hardest and loneliest for overweight single women like myself. Hang in there, one day at a time and with all the great suggestions everyone posted, I so appreciate the ideas in advance of getting banded.

I had my initial nutrionist consultation Dec 18 with my surgeon's hospital bariatric program nutrionist. I am hoping that counts as 1 of my 'intensive' nutrionist counseling appointments. I had to provide her food journals, information on diets tried including ones where I took Phentermine (not Phen-fen), trying WW actively now, etc. She was pretty cool about things. Told me diet expectations. If I need to do one nutrionist appt for January and for February before submitting to Aetna, let me know so that I get the 3 done.

I'm trying to be sure I also have the same things lined up that I need to go approved. Aetna PPO Choice II program. I'm finishing a cardiology clearance, have my sleep clearance, and finishing psych clearance in January that is required. I am having my PCP send any records she has from the past 5 years where we took weight and heights (she does every visit) and notes from any visits where she discussed my overweight and diet needs, and sending that to the surgeon's office who will do the submittal to Aetna. Now I'm trying to decide if you're saying if you have 5 years of PCP records documenting weight issues with hopefully a scattering of notes she made about my weight and advising me to diet, will that be enough to not have to do 6 months of physician supervised weight loss? Just to be sure I am scheduling a January PCP visit to keep talking with her each month about weight and diet so she knows it has to be documented in her notes. I had a physical in November, sent her the request for records for the surgeon's office in December and now have a January appointment. I'm hoping that counts at least as 2 of my 6 months of appointments. Any comments or help you can provide will be greatly appreciated.

I don't know if someone replied yet but Onederland means gettign down into 100s on your weight instead of the 200s.

Some eating questions for those of you who are banded already - the nutrionist mentioned these items as ones not recommended for eating that weren't things I'd seen any other postings about people having trouble with those after they got past the initial 4-6 weeks. Interested if you've had trouble or have given up these completely? Broccoli pineapple Celery Raisins (or any dried fruit) Marshmallows If you have others to contribute plus comment on these, feel free.

Hi girls. I did my initial nutritionist appointment today at Mt. Carmel so that's one more item off my checklist. I have an echocardiogram scheduled for Thursday to finish my cardiology clearance. The psych test is supposed to be this Friday but we're still finding out if my medical insurance will now cover the test because its their requirement for surgery clearance or if I'm going to have to pay for that psych test out of my pocket. If so, I'll put that into January so I can try to get my health care flexible spending dollars to help cover that to help a little.

Congrats Juli! You're just amazing.

Jess30, I had tried to coordinate a Columbus area get together to be in January at Polaris Mall Food Court but that was going to be on an evening. That sounds like a long drive for you but if you're interested, we'll keep posting once we settle for sure on a date and time. Some folks asked about maybe doing a weekend during the daytime. If that's better for you too, let us know. I am about the same size now as you when you started your band journey so its so encouraging to me to see how great you've done. Congratulations.