sleepyjean

I have heard of this happening to other people. The "one" valuable thing I got out of weight watchers is when you hit a plateau, that means you need to "move the furniture around" - eat a little more or a little less. Eat at a different time of day. Eat foods you don't normally eat. Exercise at a different time of day or do a different exercise. The WW leader's theory is that this kind of wakes your body up and jolts you out of whatever rut that causing the plateau.

that's awesome! Congrats :-)

Bwahahahahaha! I am totally ok with the dentist but I am terrified of any other kind of doctor. In a couple of weeks, I have to go for my very first pap smear and I am just sick over it. It's going to hurt, the doctor will not only see how fat I am, but also all the chafing on my inner thighs, and then there's the fact that she'll be looking at parts of me no one has ever seen - including me! I hope your dentist visit - and my dr. visit - will be a lot worse in imagination than in real life.

I’m so glad to have found a group of people who really understand, but sometimes coming to this board makes me so sad. I’ve felt so alone in my struggles with my weight. I stood there and pretended like I didn’t care when my father told me I was fat, ugly and stupid, when my sister complained about gaining 5 pounds and having to buy a size 6, when my friends went to the club and flirted and learned how to date and talk to boys, while I sat there, invisible, when my friends went to the beach and I stayed home because I didn’t want to be the sweaty fat girl, when I went shopping with my friends who did not realize that if there was no Lane Bryant store, there was not one item of clothing in the whole entire mall that would fit on me. I see that so many of you have led similar lives and it makes me so sad because we’ve all been ashamed. We’ve all been the odd one out. We’ve all pretended like it didn’t bother us. We’re all in so much pain that we’re willing to put our lives at risk to lose weight. I know the surgery is safe, but it’s still surgery, you know? Maybe I’m just in a “mood,” but I can’t help but think how my life would be so different if ten or fifteen years ago, I had even ONE person who understood. It’s been so lonely. I’m just glad I found you all now.

EEEEEEEEEEEEE.Ok, I have totally done that too! One time I even turned the shower on so the pizza guy would think someone was in the bathroom! Heaven forbid the pizza guy think I'm fat! I just had another example of one of these. I was really psyched to find out that some medical expenses are deductible so I started making a list. And then I immediately thought "Oh no! I'll have to get someone else to do my taxes next year. I don't want my regular accoutant to see the surgery and all the different weight loss programs I've shelled out for this year."

ETA - crud. I figured it out. You can only deduct the amount that's greater than 7.5% of your gross income. Rats. Looks like I'm waiting until spring. Geez, I wish I could just get on with this already. For anyone interested, you can read the rules here:http://www.irs.gov/publications/p502/ar02.html#d0e288

I'm about to show my ignorance: what exactly does this tax break mean? Does it mean you get part of your money back? Or (gasp!) ALL of your money? Dangit, every time I calm down about this, I get all excited again. I'd resigned myself to waiting until the spring to get banded so the HMO portion of my insurance would pay for the whole thing. My other option is to have the PPO portion of my insurance pay for it and that would be just under $5,000. I have a consult next week just for informative purposes, but if I thought I could get my $5,000 back, I would jump on this like a duck on a junebug! If I could get the surgery done before the end of the year, I could file my taxes in early Feb and have the money back before there’s time to freak out about it. This site is dangerous! must calm down…must calm down…must calm down

((((((good luck vibes)))))))

I rotate grocery stores so I won't be seen in any one store too often. How sad.

In my situation, I've only told one person - a friend who lives on the opposite coast and doesn't have any contact with any of my family or other friends. Now she's worried sick over it. I'm definitely not going to tell anyone else.

I just sent this to a friend and I thought you guys might be able to give me some independent analysis. I’m so busy worrying about all this, I don’t know if I’m seeing this clearly. I know this is long, but any thoughts/ideas/feedback would be welcome. Thanks all, SJ I’m still pondering the whole lap-band surgery thing. I’ve decided I’m definitely going to do it. The problem is, I have a few options and I don’t know what to do. I’m pretty miserable in my current state so I want to do it now now now, but if I could be patient, it really would be better for me. Option 1: HMO Pros: everything (except $500) would be covered – pre-appointments, surgery, anesthesia, hospital, and after care and I’d have it done at UCLA which is one of the best places in the country to do this and is 15 minutes from home. Well…20 minutes in LA traffic. They also have all kinds of support groups and great after care. Cons: I have to be on a medically supervised diet for SIX months. That seems like forever. And I would spend the whole time being mental because I actually need to GAIN about ten pounds to qualify. I can’t imagine anything as crazy-making as trying to diet and gain weight at the same time. Anyway, after all that, only then can I apply and be evaluated. It could take up to three weeks for them to process my paperwork, plus there are classes to attend and appointments with the program manager, the surgeon, the nutritionist, and the shrink. Basically, this whole process could be 8 months. That’s JUNE for pity’s sake. I could wait 3 months. I could probably even wait 6 months. But eight? That’s practically a whole year! And in the meantime, I’d have to focus on not losing weight, so I’d be exactly as I am for almost a year. Option 2: PPO Pros: I set up a consultation for next week and maybe have the surgery before the end of the year. They could very well deny me if they use the same standards as the HMO, but they could approve too. I’d have it done Cedars-Sinai, which is also a great place – it’s one of the first places in the US where the lap-band surgery was done. It’s where Sharon osbourne had her’s done (although they really shouldn’t have done it because she’s bulimic) Cons: It’ll be about $5000 out of pocket, which sucks, but it’s a for good cause. I might have to pay for after care as well and that could add up. I don’t have all the details. I’m expecting a decent-sized tax return next year, so that would help a little. Option 3: Pick my own doctor Pros: : no waiting time. I could probably call today and have it done within a month. Cons: $$$$$$! Somewhere in the neighborhood of $18K, plus an extra $150 for follow up office visits and fills Option 4: Mexico! Pros: : There are a couple of reputable places down there where I could have it done. I’ve been visiting an online forum so I have an idea of what these places are like. I’d do a consult over the phone and I could be in surgery next week if I wanted to. The other advantage is they’ve been doing lap-band in Mexico for 10 years, whereas it was only approved a few years ago in the U.S. Cons: It’s Mexico. I’m being prejudiced, I know, but there is something that sounds really sketchy about going to Tijuana for surgery. They don’t have the same medical standards or legal recourse. If something goes wrong, I’m screwed. Like, if I get an infection, I have to keep going back down there for aftercare, etc. And if something major goes wrong, I don’t think my insurance would cover it beyond the usual emergency room stuff. Plus, I’d have to find a doctor in the US to do my fills and that’s another expense. $10,000 out of pocket – it’s way cheaper than in the US, but I’ve only just recovered financially from the whole BBM fiasco (those bastards) and spending that kind of money on the surgery would mean a major delay in my home-buying plans. [bBM was a personal training program that ripped me off for $5,000. I hate them with the white-hot passion of a thousand suns.] What to do, what to do. I wish somebody would just give me $20,000. Maybe I can raise some money online…

I thought I read a post the other day from someone asking about what the doctor can put in the letter to improve your chances of getting approved. I can't find that message to reply to, so I'll just post it here in case anyone is interested. I got this from Daniel Freeman Hospital here in L.A. http://www.danielfreemanmemorialhospital.com/HospitalServices/PayingForSurgery A Discussion of Your Insurance Options At some point, after you have spent a considerable amount of time exploring the option of weight loss surgery, you will need to determine how to pay for the procedure. A growing number of states have passed legislation that requires insurance companies to provide benefits for weight loss surgery for patients that meet the National Institutes of Health surgical criteria. And while insurance coverage for weight loss surgery is widespread, it often requires a lengthy and complicated approval process. The best chance for obtaining approval for insurance coverage comes from working together with your surgeon and other experts. Here are some of the key steps you should take to obtain insurance coverage for weight loss surgery: - Read and understand the "certificate of coverage" that your insurance company is required by law to give you. If you do not have one, consult your company's benefits administrator or ask your insurance company directly. - You may be required to start with your primary care physician. In some cases, he or she is the only one you can ask for a referral to a qualified bariatric surgeon. Even if you are not required to get a referral, it is a good idea to have the support of your primary care physician. - Before visiting the bariatric surgeon, organize your medical records, including your history of dieting efforts. They will be valuable documents to have at every stage of the approval process. - Document every visit you make to a healthcare professional for obesity-related issues or visits to supervised weight loss programs. Document "other" weight loss attempts made through diet centers and fitness club memberships. Keep good records, including receipts. - If your surgeon recommends weight loss surgery, he or she will prepare a letter to obtain pre-authorization from your insurance company. The goal of this letter is to establish the "medical necessity" of weight loss surgery and gain approval for the procedure. The following information is generally included in the pre-authorization letter: 1. Your height, weight and Body Mass Index and any documentation you might have as to how long you have been overweight. 2. Simply describing your condition as "morbid obesity" is not enough. A full description of all your obesity-related health conditions, including records of treatment, a history of medications taken and documentation of the effects these conditions have had on your everyday life is necessary. 3. A detailed description of the limitations your excess weight places on your daily activities, such as walking, tying shoes, or maintaining personal hygiene. 4. A detailed history of the results of your dieting efforts, including medically and non-medically supervised programs, medical records and records kept of payments to and meetings attended with commercial weight loss programs. 5. A history of exercise programs, including receipts for memberships in health clubs. 6. Ask your doctor to include information from medical journals regarding the effectiveness of weight loss surgery, particularly information showing the control or elimination of obesity-related health conditions. Thirty days is the standard time for an insurance provider to respond to your request. You should initiate a follow-up if you have not heard from your insurance company in that time. The Appeals Process Even if your initial request for pre-authorization is not approved, you still have options available. Insurers provide an appeal process that allows you to address each specific reason they have given for denying your request. It is important that you reply quickly. It is also recommended that, at this point, you enlist the help of an experienced insurance attorney or insurance advocate to properly navigate the complexities of the appeal process. Some insurers place limits on the number of appeals you may make, so it is important to be well prepared and that you clearly understand the appeal rules of your specific plan.

This probably isn't it, but it sounds similar to what you heard... http://www.neweighweb.com/

Oh my goodness. I'm certainly no expert, but that sounds crazy. Not only is it unhealthy, but who could possibly maintain that for any length of time?

Rene, you put the fear of God into me! I did a reverse phone number search and there was no match. I tried another website - still no match. Then a third website - still no match. I was about to look up the number for the FBI! But first I googled the number and I found it on the Society of Laparoscopic Surgeons, the Society for Bariatric Society, and there was a mention on one of the Spotlight Health message boards. Phew! I'm already paranoid enough about identity theft. Now my lips are sealed. The next person who tries to get info out of me will have to use a crowbar! ...still trying to decide whether to go to cedars though...

Thanks so much for your feedback everyone. You helped me get something that I really needed - perspective. This is a decision I need to make with my head, not my heart. My head tells me to wait. That is what I'm going to do. I really appreciate it, guys.:-) ------------------------------------------------------------------------ **warning** the rest of this message has nothing to do with anything. I just felt like sharing, LOL. Besides my head, I'm also listening to my gut. All week, I've been trying to schedule a consult at the Cedars-Sinai Center for Weight Loss Surgery. I made an appointment yesterday, but I’m really not impressed with them. I went on their website and it said to call them and they'd do a phone interview to establish my basic eligibility and then set up the appointment with the doctor. I called the contact number. It was the number for the main switchboard, so when I called, they transfered me to the The CWLS where I'd be on hold until I gave up and hung up. That happened a few times. I finally asked for the direct number to the CWLS and they gave it to me. (Why don't they have that number on their web page? Why send people to the switchboard? That's kind of dumb.) The first time I called (Monday), a guy took my number and said he’d call me back in 30 minutes. He never did. I called back a few hours later and a woman answered. She started asking for a bunch of information – a lot more than they really should need. She asked for my drivers’ license number but I didn’t have it with me. (I wasn’t at my desk. I’d snuck off to an empty office to make the call.) I had my health insurance card but that was it. I told her I didn’t have my DL with me and she said she couldn’t make the appointment without it. What? I can’t even schedule an appointment unless I give them my DL number? I said I’d call back later. On Tuesday, I had my license and health insurance cards and snuck off to a private area to make the call. No one answered so I left voicemail. I never got a return call, so I tried again later in the day. I was on hold for fifteen minutes. I hung up. Yesterday, I called again. A different woman answered the phone. She started to take down my information - I thought she’d just need my name, contact info, DL and health insurance info. Well, she needed a lot more than that: Name, Address, Home phone, Cell phone, Work phone, DOB, Marital status, Ethnicity, Mother’s maiden name, SSN, City and state of birth, Employer, Job title, Employer’s address, Emergency contact name, phone, and address, Supervisor's name, referral source, insurance company name, group number, subscriber number, type, and 800 number, and a few other things I don't recall. She said she needed the info so she could register me in the computer. And when I say she needed the info, I mean she needed every bit of it. I couldn't skip *any* of the items or she wouldn’t be able to complete the registration. No registration = no consultation. Things got a little interesting when I told her I don't have a home phone number. This really stumped her. It was almost comical. Not only is this a ton of personal info, but it took forever because her phone was constantly beeping and there were two people having a really loud conversation in the background so I couldn’t hear what she was saying. Also, she put me on hold 3 or 4 times. I was really aggravated, but whatever. Maybe they take all the information on the phone so you don’t have to fill out a bunch of paperwork when you get there. After that, she put the phone down to go get my info off the printer. While she was gone, I had to listen to the inane jabbering of the two people in the background. Then she came back and said she had to enter all of my information again. I asked her if her computer had locked up or something and she said no, she just has to enter the info twice. Twice! Are you kidding me? That's got to me the most inefficient thing I've ever heard of. It made no sense. But I sat there and listened to her tap away on her keyboard. She wasn't a very good typist, LOL After all this, she was *finally* able to schedule the appointment. That part of the call took 15 seconds. Then she said that she was going to mail me a packet of information and I’d have to fill everything out and bring it with me to my appointment, and by the way, I’d have to be there 45 minutes ahead of time. Huh? I already told them everything but my parent's wedding anniversary and apparantly I was going to have to fill out a bunch of other stuff in that packet. And we hadn't even gotten to the phone interview. Why then, would I need to be there 45 minutes early? What else could they possibly need from me before I can see the surgeon? Taking my weight and height and calculating my BMI does not take 45 minutes. Was there a urine test? A drug test? An essay assignment? Good grief. Maybe I was just in an irritable mood, but I just did not understand why I had to go through all of this just for an initial consultation to learn about their program and eligibility requirements. The receptionist said goodbye and I stopped her and asked about the phone interview. I could almost see the question mark in her thought bubble. She had no idea what I was talking about. So I said goodbye and hung up. Anyway, I don’t have a good feeling in my gut about Cedars. Maybe it's because I have a background in process improvement and I'm being hypercritical. Also - if you believe in star signs - I'm a Virgo and virgos tend to be that way. Nevertheless, a gut feeling is a gut feeling. I'm probably going to cancel that appointment. I guess I thought a big famous place like Cedars-Sinai would be first class all the way. Then again, I suspect people like Sharon Osbourne receive an entirely different class of treatment. When she shows up, they probably exchange air kisses and then they hand her a latte, LOL.

Here's the question: could I be rejected for the surgery because I’m “socially disadvantaged?” In reading up on the eligibility criteria from a few different places, I kept coming across something about how part of the accept/reject decision is based on the victim…er…”patient’s” support system. I don’t have a support system. Nobody. Nada. Oh solo mio, etc. I Rarely speak to my family. My few friends live on the opposite coast. My HMO is really being a pain in the butt, so I have decided I’m going to do whatever I have to do to get approved by my PPO. Does anyone know if this “support system” thing is make or break? Because while I’m not to thrilled about lying, I’m fully prepared to tell the doctor I’ve got a loving boyfriend, I live with my four siblings and we all get along perfectly, and my parents live across the street. Has anyone had to deal with this?

Are GB patients more likely than LB patients to gain the weight back? From the comments, it seems like that is the case. Why is that? Both groups have a tiny little stomach area that can hold food. I thought it would have pretty much the same effect. And what's this "window" thing I keep hearing about GBers and losing weight?

Thanks so much everyone. It helps to know what others had to do. :-)And I definitely feel less alone in this. I hate having to explain to a doctor I’ve never seen before why I’m friendless and alone. It’s not that I’m some weirdo or people phobic, it’s that I moved here three years ago, and was too embarrassed by my weight to get out there and meet people. I know I am an extreme case and there are plenty of fat people who go out there and live life to the fullest. But there are also plenty of people like me and people (doctors and such) who have never been obese just don’t get it. Alexandra: I have 3 tier health insurance with healthnet, so I can choose to do HMO with them, PPO with doctors in their network, or I can do my own thing. Cindy – do you live in L.A.? LOL

If you were self-pay in the US, how much did you pay out of pocket and how long was the wait between the first evaluation and the actual procedure? Oh, and a third question – does that same doctor do your fills? Thx SJ

I know a lot of people have had the procedure done in Mexico because they were denied by their health insurer here, or because they had to self-pay and it’s significantly less expensive down there. Forgive me if the answer is here and I just haven’t found it, but do you have to go through a process to be eligible for the procedure in Mexico? What is involved? I’ve been skimming some of the information here and it seems like you just tell them you want it, they give you a physical, and then they just schedule the surgery. Is there more to it? I’m researching this as an option as I am a borderline case and may be denied by healthnet. Also, I live in Los Angeles and Mexico is just a hop skip and a jump away, so I’d be able to go back for fills. For people who don’t go back, how do you find someone else to do the fills? I don’t think my insurer would cover fills for a procedure they didn’t cover…? Thanks SJ

That's so great for you guys. I'm glad you've been able to do it together and support one another. :-)

Just curious. This is one of the requirements for UCLA's bariatric program. If you had to have the documentation, what did it consist of? Is it just a letter, or is there more to it? And does the diet have to last for a certain length of time? SJ

I’m taking your advice. I made a list of all the things I need to dig out of various corners of my closets to add to my application. Between that and writing out my diet history, it really knocked me for a loop. I mean, I know I’ve been trying to lose weight for a long time now, but to look at the list of all the crap I bought – the books and the equipment and the memberships and on and on – and all of the times I didn’t succeed is a little mind-blowing. I never really thought of myself as a yo-yo dieter, but there it is, in black and white. It makes me even more anxious to get banded because I can clearly see just how much time, my thoughts, my energy and my money – how much of my LIFE has gone into my weight. I can only imagine what I might have accomplished if only I’d been able to channel all that energy into something else

I don't know anything about the place, but you might have better luck in the doctors and hospitals forum.