Lindypie

Hi again, Chocolate snaps..in California, we have insurance codes..Look up New York Health and safety codes online to see what you have under the heading of reconstructive surgery. Also check to see what your state insurance codes says about coverage for these surgeries as well. If you have a chance go online and type in cpt and icd codes and their definitions..these are universal codes. Go on the web under WLS and find some examples of letters of denial if you are denied coverage. These may be a guide to help you with examples that pertain to you, for you to write a letter of appeals. Hope this helps! Keep in touch Linda

Hi Chocolate Snaps, Love your name....I actually went in for a follow up for something else. I also told him about my recurring headache, neck and lower back pain. When he tapped my neck and back he said that I was wincing. He gave me a referral to a PS. The surgeon took lots of photos and measurements of my breasts and also of my tummy. I was approved in just 10 days! He and I were shocked that they would cover all. So please document all with photos and also in your case I would call and/or see your primary DR with complaints of your pains and of rashes under your skin...including your breasts...also get prescriptions for anti-fungals. I hope for your success! Linda

Hello everyone, Haven't checked in for a while. Just wanted to say to please document everything...don't be shy to communicate with your primary physcian. I am two years out highest weight 231lbs. down to 165lbs. I have been at this weight for about a year and a half. last May of this year 2009. I had a breast reduction with lift and a tummy tuck. YES my insurance company [Health hmo] covered ALL of it. No out of pocket fees. I DOCUMENTED EVERYTHING rashes blisters etc. I had my doctor document everything in person and arranged to phone in to his nurse anything related to my discomfort and put it in my file. Although you may think as I do that I have not lost as much as I wanted too,My dr. said that everyoe settles sometimes at the weight our bodies are set at. Do not give up...Please research on the web about how to appeal if you get denied. Happily I did not have to but I was ready for rumbling with my insurance co. if I had to. Please be your own advocate,You have not worked this hard only to be half done with your accomplishments! Good luck to you all and fight to be healthy!

Hi, thank you, I am really nervous about the surgery, but I hope it will relieve me from my migraines,back and neck pains! You may think that you are slow in losing weight but you are already a success! You have been brave enough to do something about changing your health and prolong your life! Slow and steady wins the race! Good luck to you and all the rest of us! Linda

Hi, I just posted on another thread. Yes, my TT and breast reduction w/lift has been approved by my insurance company. My plastic surgeon and office personnel are just as surprised as I am! I am scheduled for April 2009.

Hi Patsy, and everyone, I haven't posted for a while. I am also at a plateau. I was banded on Sept 18 2007. I have lost about 60lbs. I have been at this weight for 7 months! I was also begining to droop in my tummy and breasts,etc. for the last 7 months also. The silver lining is that my pcp,thinks that maybe this is where my body has settled to be. Because of the pain and migraines I have been enduring, my doctor sent me to a plastic surgeon. As to my surprise, my plastic surgeon submitted paperwork for a TT and Breast reduction. I was approved! One of the criteria was that my weight has been stable for at least 6 mths. Although I would have liked to have lost more , The pre-banded symptoms have been eliminated. I am grateful! I hope that anyone out there who is going through plateaus... give yourselves a well deserved break. There is always a reason for everything. Keep positive! Keep having faith. Maybe we have to accept what our bodies are telling us. Good luck to us all! Linda

hello everyone, I was just wondering if anyone with hmo healthnet has had approval for a panniculectomy? thank you! Linda

Hi, Just checking in..I have lost 55lbs since my highest weight. Everyone seems to be doing great!

Hi, well, I been complying, with the rules! My problem now is that I have had a migraine headache the day after my last appointment. It lasted 3 days! around 8-9 o'clock I also get tummy aches!...but I am doing the baby spoonfuls that my dr. demands. This can't be good. I do not think that my eating 1/2c. per meal puts me in the hog section! I thought the fills for my lapband would not be so hard to get! I forgot to mention that my surgeon said, at last weigh -in, that he is glad that I had not gained more than 1 pound, because he would have me go see a shrink!

Hi Joe, How much are you eating per meal...I am only supposed to have 5-8 baby spoons per meal plus two shakes a day. I usually have -1/3c to 1/2c per meal. I also don't need my cpap. I exercise 3-6 days a week..and am still recovering from a brokrn L ankle

Hi, I DON'T KNOW WHY HE IS SO TIGHT WITH FILLS! It drives me nuts he says that I am having head hunger! 2cc.in a 10cc band after 7 months does not seem alot to me either. He does not have an associate to do the fills. He also talks so fast that he barely lets me ask any questions! I thought that the patient would know when it time for a fill. I have been working really hard! My first fill was at 5 mths out! So I know how to eat! I am so sad and disappointed! I am constantly made to feel like I am an annoyance to my dr. Thanks for your response! Linda

You two look fabulous! you are both sooooooooo pretty! Keep up the good job!

Hi everyone, Haven't checked in for awhile. I went in today...gained one pound ! My surgeon says no fill for me today! Last month he was in a bad mood and scolded me for coming in two weeks before I was due to come in. But his nurse asked him..and said That I probably needed a fill. This month I was under a lot of stress :wink2: and did not do as well as I should. I feel so discouraged....I am down 47lbs since being banded on Sept 18 2007. Has anyone had a slip? I am so scared !!!!!!!!!!! I don't want to gain any weight. He still only wants me to have around 5-6 baby spoons of food per meal. I sometimes have a 1/2 c per meal. He scolded me and said he would not give me a fill today...I have had 3 fills totaling 2cc. in a 10cc. band. That does not sound like it is enough. Please share your story with me. I need your support! Thank you for letting me vent! Love to you all, Linda

Hi everyone, Put me down for 41lbs...banded Sept. 18,2007

First of all I would like to thank you all for being here for me and for one another! I finally had a chance to voice my concerns to my Surgeon and office staff. I told them how I felt about their treatment of me, my perspective, of course, and told them how their lack of concern had made me feel. I told them that I had recieved more answers to my questions, on this forum than I had recieved from their office! I also got my first fill [1cc.] after 5 mths out instead of the 6 months that my dr. wanted me to wait for. I just now recieved my second fill[.5cc.] I am doing fine! I no longer get the stink eye from the office people1 In fact this last appointment my husband sitting in the waiting room, overheard one the the office managers tell a patient not to give up on the process of being approved for surgery. She said one of our most persistent patients { she named me} just walked into the exam. rooms. She did not give up ...she is six months out and has lost over 35lbs so far! I was surprised to hear this! I am greatful to have had all of your support! I no longer feel like a victim of my dr. office staff! We seem to have a better understanding. I thank you all for your great advice...I am truly grateful! Linda :cursing:

Hi everybody, Today was my first fill! thanks to all for your advice. According to my surgeon, I wasn't due for my first fill till next month. I am five months out and started to slow down on weight loss ( only 3 pounds) since December. I told my Dr. that I was hungry with only 1/3c of food three times a day, so, I increased the amount to 1/2c., I dropped 2lbs. this month. My Dr. also said that he does not know how many baby spoon bites are in each 1/3c. or so ...but if it's more than 3-6 baby spoonfuls it would be too much! Just wondering .....do any of you eat this amount? Is it reasonable to think that 3-6 baby spoons of food 3x aday plus two protein drinks is what you guys are doing? I don't want to mess up! Don't forget this is my first fill. I thank you so much. any advice or feedback would be appreciated! Linda :confused2:

Hi, hope for a full and speedy recovery! It is a pleasure to hear about your weight loss success.....May god bless you! Linda

Hi everyone, Could someone add me to the update list? I was banded 9-18-2007...I have lost 38lbs. so far. I have one 1cc. fill. You guys are doing awesome!

:cheers2: Hi guys...36lbs since sept 18,2007

I am sooooooooooooo!!! happy for you! You are an inspiration to us all! :thumbup::thumbup::crying::thumbup:

Hi again, Well, it is the only doctor that is closest to me. I am sure If I research I may very well find one...I also have a secondaryinsurance, which I thought of when I read your response. It is tricare but I haven't used it much. I am lucky to find this forum and all of you! You all have shed a lot of light on many questions and issues I have. Thank you! Linda :thumbup:

Hi, I feel I could cry!!!!!!!!! I chose this surgeon because he was the only only one covered by my insurance. I had to leave my provider of 15 yrs and switch to this provider to get approval from my insurance. I am not hungry if I eat 1/2c of food, which after 2 wks ago increases my intake fom 1/3! I told him if this what my daughter ate JUST after gastric bypass, and reminded him that I was a lapband without a fill. He told me that to eat 1-3 bites put down the baby spoon, wait about two minutes AND IF I WAS STILL HUNGRY go ahead and finish the other two bites! can I just say ....I now DREAD going in to see my dr. The nutritionist says That I must drink the 64 oz. of water...i said that 48oz. was my limit so far. I thought this might was away my nutrients from the little food I take in. Her reply to me was "I have patients that drink over 100 0z." Am I wrong to feel dejected? Do any of you have this time of regime? I am starting to feel like a big complainer...and I am getting depressed! Any advice? Linda

Hi, I found that when you go home from surgery make real sure that you use a heating blanket...wrap it around your shoulders and back! This helps dispell the gas, which is trying to escape. I personally had it gone the next day! Also walking around as suggested before works great. Hope this works for you all! Linda

Hello bandsters, Just wondering...I too have been reading posts, I just joined yesterday. I am 4 mths post-op. I have not had my first fill yet, I have lost 32lbs. I am concerned about what amount to eat. I try to stick to 1/3-1/2 cup of food per meal,protein usually. On my last visit to my surgeon, last month he told me that I should only have 3-5 baby spoons of food per meal. honestly, I sometimes feel hungry after that amount. I also feel dizzy sometimes with wierd vision blurriness. My dr. says that he wants to wait three more months which will be May or 6 months out for fill. I don't know if I'm eating too much or not. from what I have been reading I don't think I am. Has anyone else been dizzy....or have any insight to my overfeeding my piehole etc. my Dr.'s nurse says that I need a fill and despite my weight loss thus far, they have patients who have lost alot more than me...in the same amount of time. It made me feel bad about my slovenly self :party: lol...Thank to you all for being a sounding board! Linda