tmarie07

Lonestar - where is Aetna requiring Dr Marsden to do the surgery? Mine was the Lewisville Surgery Center. Tina

The show "Big Medicine" last night had a gal with Lupus that wanted a gastric bypass. I was only halfway paying attention, but for reasons I didnt quite hear, Dr. Davis recommended the lap band to her, but she needed the bypass due to insurance allowances. Her issues may have been more specific to her, but I know his recommendation centered on her lupus. If anyone else saw the show, maybe they were paying more attention then me and can remember what reasons he gave her for his recommendation. Good luck! Tina

Congrats Lonestar! I was keeping an eye on this thread waiting to hear about your approval! You're on your way! Tina

Wow, this is a shocking amount! My surgery (surgery center and doctor combined) was a total submitted charge of $14,500.00, and the anest. charge was $1600.00. I know insurance companies pay less then the submitted for their negotiated rates, but talk about upping your numbers trying to get the most out of them!

I'm stuck for sure, been messing around with the same 4 lbs for over a month. I did get my 2nd fill Monday, and with the liquid/soft foods diet I'm down another 7 lbs, but who knows how much of that will stick once I go back to solid foods. I know that I need to up my exercise, and I really need to start journaling what I'm eating every day and make changes as I find them. I am eating way less then pre-surgery, but I think my stall is due to things I need to change, combined with my body freaking out. I "feel" I'm losing inches, but unfortunately I didnt measure myself before surgery, so other then some clothing items being a bit looser, I dont have the actual numbers to back it up. Hang in there! Tina

I've lost around 35 lbs, but really the majority was during the 7 day pre op, and the 2 weeks post op. I've probably lost 10 since that point. So definately moving slow, but I know it's partly due to me. I'm trying to modify my eating habits, and I'm trying new things, and some days I'm just plain scared of eating something and having it come back up, so I'll eat foods I know are safe, like a soup that might be higher calories. It's a work in progress, and I'll get it down soon! I'm back on track with Protein drinks, so that's helping. No restriction from fill #1, and just had fill #2 on Monday, and am on soft foods till Thursday, so no idea yet if I have much restriction. I'm at a 4.5 in a 10 cc band, so I'm betting not much. I hope fill #3 gets me closer. Lord knows if I had will power out the wazoo, I wouldnt have gotten to this weight in the first place! It is good to see the poll though, as it shows me that I'm right along side of other banded folks! Best wishes to everyone! Tina

Suzanne - I totally understand! When I had my first PB, I had to check to make sure I could still breathe thru the pain and mouth watering waiting for it come back up! Once I confirmed I wasnt going to die, it was just the waiting for it to end! As horrible as it is, and as much as try to avoid them as much as possible, it sure is a great wake up call to pay attention to what and how you are eating! Definately eat only liquids or soft foods for at least 24 hours after - that is once you decide to eat again! And sadly, we all do. LOL. Tina

My doc and fill nurses have all said that the morning restriction is due to mucus the blocks the opening to your stomach. As the day goes on, it clears out, and you can get food through. This also makes sense Hot drinks "open" some people up, as it's aiding the breakdown of the mucus. The dcc and fill staff told me not to even bother trying to eat in the morning, and eat later in the day. This works for me as I can drink some Protein in the morning, and eat a late lunch and a dinner. Not a clue on how to stop the nighttime hunger, other then I try to eat a good dinner, not too late, and then try to focus on something else to keep me away from the fridge!

I thought my port was above my incision too, it even pokes out a big, but come to find out my port is under my incision. Doc said he'd only seen the hard lump above 2 times after over 3000 surgeries....the other one was the same day he saw mine, so he didnt have anything to really tell me, other then come back if it's not gone in 30 days, but he wasnt worried. It doesnt seem to be going away, so i'll go back. It doesnt hurt or anything, just a hard lump. Odd! Tina

Lonestar - glad to hear everyone seems to be getting all the docs. Since we both got that same letter, and I know True Results didnt refax anything of mine, I'd bet they pop that letter in the mail the minute they get a file in. Insurance companies, what can you do! Hang in there, and best of luck! Tina

Lonestar - I wouldnt worry! Same thing happened to me when I knew True Results had sent it - got the same letter. So I called True Results (I dont check my mail every day, so the letter was probably a week old) and said - what the heck? They said, no we sent that, so Flora had me call the insurance gal who said - oh, you've already been approved, did they not call you? So apparently this letter is pretty standard. Plus my approval was done over Thanksgiving, so Dr Marsden's office hadn't really had much time to call me. Hopefully your scenario will be the same as mine! Don't stress about the letter, just check it out on Monday, and if the approval isn't in yet, I bet it will be in a week or so. Tina

True Results was great in getting all the paperwork together - although they did have some hiccups with mine, as they couldnt seem to figure out if I was considered Lap Band Solutions patient, or their patient, so there was some conflicting info there, but once they got that sorted, it was all good. I'm sure that doesnt happen often! In submitting the paperwork, they seem to be very thorough and leave no stone unturned! Good luck to those waiting on approval!

Same thing with me - The doctor/surgery center bill is "pending approval" because they want more records from the doc...uh, hello...he gave you enough to approve the surgury! But I'm sure this is just how they operate to make it a more annoying process for all because they look for any way to get out of it and delay it. I'm sure they'll pay that part eventually. Now, I did get paperwork saying they've denied the anesth completely showing me as owing $1600 to him - I'll wait a few weeks and see what happens because again, pretty normal with insurance companies. His people will probably get it pushed through and approved, and if not, I'll call and argue with insurance, because again, they approved the doc, they assigned me WHERE I could have it done, and NOW you're telling me that the anesth that location uses isn't covered? Like I could know that. Should I have asked EVERY person I saw that day if they were accepting Aetna. No. With an previous insurance company I had to have a CAT scan, and while the hospital it was in was in network, they didnt consider the person the HOSPITAL sent the test results to to be in In Network. Once I reviewd with them that I had no control over who they sent it to, as I'd assumed it was all in house since it was a hospital, they agreed that a patient can't always have a say in who a hospital/etc sends things out to. The gal acted as though this was common practice to get these calls and to "fix" them to be covered. So don't worry, give it a month and see if anything changes. And remember, the doctors office wouldnt have done the surgery without cash upfront if insurance hadn't of approved it, so they're used to working this stuff out. So absolute worst case scenario, if it can't be approved for some insane reason, they'll work out payments with you. And I doubt they'll "take the band back!". Tina

Surgery was 12/17 and 1st fill was 4 weeks to the day, and I'm scheduled for another one on Feb 18th. I'll keep going back every month until we have the right amount! Tina

I had my first fill on the 17th of Jan, and I've not had any real restriction kick in yet either. One PB issue, so I learned that I "may" be more restricted in the morning, but other then that, nada. The only difference is I cannot "chug" Water either anymore, it actually hurts - like it's getting backed up from too much too quick. I'd like to see this more with food, to keep me on track, but I go for my 2nd fill on Feb 18th, so maybe that will get me closer to good restriction! Tina

I had to switch insurance companies to get it covered. Husband's company had exclusion on it with UHC, so waited a year to switch to my companies insurance, which is Aetna. And then after Aetna's apparent usual requirements, 6 months later was approved. Out of pocket was deductible and some other items,and it came in around $1500 out of pocket including office visit copays. Tina

Ok, had to report in that I had my first "PB" today. So not fun. I havent been eating junk food at all, but this morning, right after I made my Protein shake, I did something silly and grabbed 2 of my husbands fries from Chick Fil A, and ate them fairly slowly, but bam, right after the 2nd one, I had a horrible feeling in my esophagus. 3 minutes of my mouth watering like crazy, a small amount of burping, then finally a real burp, back came the fries. I had to stop in the middle of the awful pain and mouth watering to realize that I could breathe just fine, so no, I wasnt going to die! I tell you what though, that first time it happens, it's a strange extremely uncomfortable feeling. So here's to hoping we have as few of these as possible as we continue our journey! It will certainly remind you to think about everything you put in your mouth! I had my fill on Thursday, and so today was my 2nd day of being back solid foods, but yesterday I had minimal solid foods, and it was later in the day. This happened early in the day, so while I havent really felt any real restriction from the 3 cc's I had in my 10 cc band, it does seem to be more restricted in the morning. Which is what I've heard a lot of people say can happen. Can't wait to hear everyone else's experiences as we all begin to get our first and second fill's! Tina

A-band-on-me, I'll be getting all my fills from a lady and her "assistant" that does only fills all day long, and uses the flouroscopy machine, so I was glad to know she's experienced! It's a True Results surgery center. It was so quick, they're like a well oiled machine, and it only lasted maybe 60 seconds, and I may be way over estimating it. It didnt hurt, it was more odd and slightly uncomfortable, but no real pain at all. I hope your fill goes the same as mine did! Best of luck, and don't be worried about it. I was worried, and found there was no reason to be! I did have some slight soreness around the shot area for that day, but that could have been my jeans rubbing against the area! Tina

I had what I thought was the start of a cold prior to my surgery (turned out to be allergies from the christmas tree!), but I told my pre op nurse I wasnt sure what it was, and she only asked me if I'd have a fever in the last week, and since I had not she wasnt concerned. So it sounds like as long as you don't have an infection of some sort, you should be fine for the surgery. Best of luck! Tina

II was banded on the same day (12/17) and I've got the AP band too - so far so good. I had my first fill today and it was 3 cc's. liquid for today and soft food for 3 days. The fill was a strange experience, as I sat in the waiting room after sipping the Water and waiting my 30 minutes, I had a vague feeling of nausea. Like I wouldnt have been shocked if I did throw up, but didnt completely feel like I needed to. Never did, and the feeling went away, along with a moment of dizziness, not sure where that came from. No problem with liquids today, we'll see how the soft food goes tomorrow. Tina

That's good news CN! I might try to have a small salad in the next few days! I'm pre-fill, but will be calling today to make my appt for next week if they can fit me in. Getting a bit worried about adjusting to after the fill, but I really want the restriction - I dont want to slide backwards, I want to keep the forward momentum! Tina

My doctor does fills 4 weeks after surgery, and not a minute before! LOL. I had my post op today and am officially down 26 lbs since weighing in with them back on 12/10. I have to call today to get my fill scheduled for sometime in the next week or so. Apparently they do all fills with the fluoro - thank goodness, it kinda scares me the thought of someone going in "blindly"! Also, I have a lump right above the large incision for the port. Dent in the port area, bump above. My doc has done over 3000 lap bands, and he said - "that's odd, I've seen thousands of people, but have never seen this. Until today, and you're the SECOND one today." It doesnt hurt at all, no redness, just a big bump. He thinks it's a big big bruise inside on the muscles and stuff. Said not to worry, and go see him again if it's not gone in 4 or 5 weeks. Tina

Hey guys - I love the idea of this forum! I know it's not easy for ANY of us to lose weight, but I do like being able to find the folks in the same sized boat as me! I was at 372 prior to my pre-op diet, surgery was on 12/17, and I've been holding in the 20 to 22 lb loss mark for well over a week which I consider pretty good considering I don't feel any restriction yet! I have my post op visit tomorrow (delayed due to the holidays) and he'll let me know when I can come back for a fill - scared AND looking forward to it. 200 lbs seems so far away....but one day! Maybe even before I know it! Best of luck to all! Tina

My doctor is Dr. Marsden - office in Hurst. Really nice doctor, listens to you, and answers all questions and more! He's done over 3000 lap band procedures, so I felt really comfortable working with him. Best of luck to you in choosing a doctor! Tina

I was banded on 12/17, and graduated to solid foods after 2 weeks. It's strange to try to "find" things to eat right now. I'm trying to avoid trigger foods as I dont "feel" as though I have any restriction right now, although I've been careful not to overdo it for fear of messing anything up! Of the things I've tried, chicken, beef, etc, the only item that didnt really feel right after I ate it was a small amount of rice I had from a canned Tortilla Soup. I'd been warned about the rice, and didnt even think about it being in the soup before I opened the can! So rice is the only thing off the list right now. I can do bread though, which I'm betting I wont be able to after I get a fill, so for now I'll have a little bit of bread, and chew it to a liquid. Anyone tried salad yet? For some reason, the idea of salad makes me very nervous! Tina