kjl315

I currently have a BMI of 41, so I fit the guidelines for WLS. Aetna requires me to spend 3 months jumping thru hoops, including doctor supervised diet and exercise. Do insurance companies base approval on the BMI at the beginning of the diet/exercise or at the end? If my BMI drops below 40 by the end of the 3 months, will they then say I don't qualify because I followed all their instructions. Anyone have any experience with this? Karen

Hi Kimberly: I imagine you're at the hospital with your mom now, but I wanted to let know know I'm thinking of you and yours and praying for your mom. I know it will all go well. Karen

Yes, I have 3 months of "multi disaplinary" appointments to keep, diet/exercise/psych/surgeon, to satisfy Aetna. I sure hope I don't jump thru all their hoops only to have them turn me down. The 3 months will be completed the middle of February, so I'm hoping to have the surgery by my birthday, March 15. Time to go. Nutritionist apppointment in one hour. Karen

Good morning Maziemommy: I've decided on the lapband. I have all the appointments scheduled, now it's just doing the work. My first visit for excercise is this morning, and the nutritionist is tomorrow morning. I was at the all day behaviorial health seminar yesterday. (didn't much care for driving into Springfield in that lovely weather!). You'll make it to 100 by Christmas and it'll be the best present you can give yourself. :-)

I'll be finishing up all the diet/excecise and other insurance requirements in February and hopefully they'll approve surgery quickly. My birthday is March 15, and I'm hoping to have the surgery by then. I'm crossing my fingers and toes!

I want to get out of the shower and be able to wrap a normal sized towel around me instead of a beach towel!

I took Cymbalta for about 3 months due to a ruptured disk (it's also used to treat nerve pain). I was effective at reducing the pain, but it also screwed up my eyesight and made it almost impossible to pee. :eek:

You should ask the surgeon about having a sleep study done. You said you snore like a freight train, which is a good indication that you may have sleep apnea which is a comorbidity accepted by most insurance companies. Good luck.

I had my first consult with the surgeon today, official start weight is 242, BMI 41.5. Now for 3 months of jumping thru hoops. Bye bye fat, hello healthy!

I had my first consult with the surgeon today and he said they submit my beginning BMI to Aetna, so it won't be a problem. In addition he's sending me for a sleep study because I'm certain I have sleep apnea. Once that's confirmed I can be confident they won't turn me down due to BMI because with that comorbidity I'd qualify down to 35. Now I can just concentrate on the diet and excercise and start getting rid of this *@$! fat for the last time.

Best of luck and I wish you a speedy and uneventfull recovery.. Karen

Thanks for the responses. I just worry too much. :nervous

I've been researching WLS for several years and stated haunting the message boards months ago. I've mostly been on OH, but when I went for my psych eval, the doctor suggested LBT, so I'vd been on here every day getting as much info as I can. I have my first consult with the surgeon on Tuesday and I'm putting together a list of questions for him. I just don't want to spend all that time and money trying to satisfy the insurance company if I'm going to end up being self pay. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p> Thanks for your help.

I currently have a BMI of 41, so I fit the guidelines for WLS. Aetna requires me to spend 3 months jumping thru hoops, including doctor supervised diet and exercise. Do insurance companies base approval on the BMI at the beginning of the diet/exercise or at the end? If my BMI drops below 40 by the end of the 3 months, will they then say I don't qualify because I followed all their instructions. Anyone have any experience with this? Karen

I was reading on another post where the woman stated she wanted to take up parachuting when she reaches goal, and I was wondering what others are also planning? I would like to learn ballroom dancing. So what are your ambitions?

I'm a pisces, hence the 315 in my name.

Hi sweetmo: How much research have you done on this doctor? If he's just concentrating on the cosmetic aspects of weight loss, he might be one of the "weekend seminar" doctors who are only in it for a quick buck. Try posting a request on the Doctors and Hospitals forum http://www.lapbandtalk.com/f11/ to see if anyone else has had any experience with you doctor. Good luck.

Highest BMI 44.8 Current BMI 41.2 Had my psych eval 11/20, first consult with Dr Edwards is on 12/4.

I haven't had surgery yet, and while I find the rapid weight loss from GB tempting, I'm leaning towards the lap band due to a point the doctor brought up at the WLS seminar. He mentioned that if you should get cancer some time after WLS, the band can be unfilled so your body can get more nutrition while you fight the cancer. With GB, there's no going back. We have a history of colon cancer in my family and I've already had one biopsy showing precancerous cells, so lap band may the the safest option for me in the future. Karen

I'm just starting to jump thru the hoops to get insurance approval. My first visit with Dr Edwards is on 12/4 and I had my psych eval this morning with Katy Waldron. (She's very nice.) I didn't leave in a straight jacket, so I guess I passed. :-) I'm not sure if I'll go with Lap Band or bypass and will decide that after the consult with Dr Edwards. I'm assuming some of you also considered bypass. What were some of the factors that made you choose Lap Band? Enquiring minds want to know. KJL

Try Dr Christopher Edwards at St John's in Springfield. 417-820-3800. KJL