Maggie63

Hi Mary..Hi everyone- I think this is wonderful that we are getting a PA group together...I was banded a year ago and used to check the PA threads but we never had any chatter....that sure has changed!! Getting the lapband was the best thing I have ever done for myself...I was 192 this morning (2 LBS FROM GOAL..YEA). I will try to continue to lose after I get there. It has slowed down a bit but I am exercising and eating well so I know I will get there!! I am actually training to do a 1/2 marathan....could have NEVER done that almost 100 lbs ago : ) I am looking for a fill doctor in the Harrisburg area...any suggestions?? Good luck to all of you!!!

i say go for whatever you want. i recently had a breast reduction because mine were so saggy....when i sat down they touched my legs...ick!! i wish now i would have had a breast lift in stead of a reduction...i feel like they are too small now i am looking forward to the tummy tuck someday as well...you go girl...you look fabulous : )

this is funny. i am getting close to being a year out and my tummy never made noises until about a month ago....now, after every lunch...it just sings the afternoon away...it does not bother me but i find it interesting it just started out of the blue!!!

Health America denied my surgery in Dec (I did it anyway-self pay) I hired Walter and Kelley Linstrom from Obesity Law to assist in my final appreal (I appealed twice myself). Found out this week that HA will REIMBURSE me for all charges and cover me for fills, etc. My advice to those of you fighting for coverage is DO NOT GIVE UP (I almost did after my second appeal). The BEST thing I ever did was hire Walter and Kelley for my final. They were wonderful. You can reach them at: walter@obesitylaw.com or kelley@obesitylaw.com P: (619) 656-5251 F: (619) 656-5254 Best of Luck all. Contact me if you have any more detailed questions!!!

i had my surgery Dec of 2005...i have been thrilled with my doctors and very happy with how i have done so far (although i can't seem to get under 200...i have stalled for some reason...i know it is coming soon : ) i was self pay, fought my insurance company and won. i had to work with my doctors office to get reimbursed for all my appt...the surgery,etc. i also had to work seperately with the hospital, the anestigiologist, (thier billing deptments were great..very professional, good to work with...helped me in any way they could...) my surgeons billing office was another story. i called about a month back to see if they had submitted the final bill to the insurance company so that i could get paid. this insurance clerk went off on me. she said that she thought it was WRONG that i fought the insurance company...she said that i was making a lot more work for her office...and she did not appreciate it. when i tried to explain to her that this is a good thing...will probably bring in more business for her company (my insurance will now pay for federal employees to get lapband) ...she shut me down and said again that what i did was wrong and she did not appreciate it. now i was miffed and thought about calling the sugeon, then decided that i should just leave it be....this woman must not like what she does and took it out on me..... two days later my lawyers office (helped me win my appeal against insurance company) called me to say that she had just talked to the billing department about something else and the woman told HER that she thought what I was doing was wrong and they did not appreciate it. when the billing clerk went off on me, that is one thing..but when she starts talking about my insurance stuff with a third party...that to me is slander.... okay, now i am really mad...i wrote a letter to the surgeons office, they handed it off to the billing departement, and i got a letter from them with a very weak apology and saying that it really has been alot of work and they were frustrated...wait a minute...this is their JOB for goodness sake. well, although i love my doc i have decided to leave the office because i really think the whole situation should have been handled more professionally...... am i over reacting (i do not think i am). thanks for your input (sorry for the misspellings my checker is not working......)

welcome kat. go to LBT Forum Suggestions , Feedback and Questions...there is a thread that will walk you through it.....

Betsy Jane- I fought Health America and won...and you an too. More and more people are winning thier appeals. Health America is going to start covering lapband for federal employees because of all the appeals. If you want help feel free to PM me or go directly to the lawyers I used, Kelly and Walter Lindstrom (e-mail address is under my thread "We fought HA and won" I think the tide is turning here and before long Lap Band will be covered like Gastric.

thank you for your story. it is also amazing to me that some people do so well....while others struggle with either no weight loss...or like you, are unable to eat healthy. my only suggestion would be to get 2nd and 3rd opinions...call your buddies a Inamed and get them involved....keep searching till you find the answers. my thoughts and prayers are with you.

Thinjen- I am so sorry. You have been fighting for so long. How did your court date go? Let us know what happened. My thoughts and prayers are with you.

i did not tell, and am happy i did not. some people are just mean, and jealous, and would love to poo poo away my hard work by saying i took the easy way out....because of my weight loss some people assume i had gastric bypass and never let an oppurtunity go by to bring that up to see if i will admit to it. i just smile and continue on my merry way. when i reach my goal i may come out and tell my story. whenever i see a person that is obese and just hating life i want to run up to them and tell them my story.......

my doc said nothing about no soda...but i will ask him next time i see him...i have had a few diets with no pain or discomfort....why exactly is carbination bad for bandsters?

you are all so inspirational. i still have less than 20 lbs to go to have lost 100...i am hoping 2007 is the year for me : ) keep up the great work.

i am 11 lbs from personal goal...i will probably change to a new goal when i get there. getting this band has been the best thing i have ever done for myself...i could not be happier. i have reached a bit of a plateau..the only exercise i get is walking 3 miles 3 times a week...i have decided to join a gym to get some weight training in....the folks who say this is just a tool are right on....i still had to work very hard to continue my weight loss...joining the gym is just the next step in my journey.

Beth, welcome!! Wow, your weight loss is amazing. Are you happy with your lower body lift? I am thinking of getting one myself when I am done losing....how long were you unable to work for?

There is hope SherryW. I never thought I could win my appeal. It was not a pleasant process (insurance companies can be hateful sometimes....) but I feel so good that I did. If anyone needs help or wants to talk about the process, feel free to PM me.

Jordyn- I would be happy to share my appeal letters with you. PM me and I will be happy to send them along. Not sure about the exclusion problem. I would talk to either my lawyers (info in an earlier post) or New Days lawyer. They will give you advice whether it is even a possbilitity that you would win. I found out great news yesterday. I was the first (according to my lawyers) to win my lapband appeal against Health American. Many others have fought and won. Health American has changed it's policy for federal employees and will now cover lapband effective sometime in 2007....you have to fight to win!!!! Best of luck to all.

Hi all- Please update my numbers. I have been gone for quite a while. Things at work have been crazy! Where is photonut....didn't she start this thing? I hope all are doing well. Maggie63- H 285/ S 277/ J 235/ G 190/ C 209 (-76 lbs total)

i was denied because they called the lap band "experimental" after my third appeal they agreed that it was needed for me. i will try to get my stuff together and post it out here for all of you....remember..you have to fight to win!!!

I would just like to update my stats. I have been traveling for my job all summer and have had a computer that spent more time down than up...i hope to be out here more often come fall. Maggie63- H 285/ S 277/ J 235/ G 190/ C 214 (-71 lbs total) i do have some good news....my ins company denied me (health america) so i self paid. i filed an appeal (actually 3) and found out a few weeks back they reversed thier decision and they are going to reimburse me!! i hope this decision helps others trying to get approved. fighting it is difficult but worth the battle. joyce GA...congrats on how well you are doing...and everyone else too!! more later...i came home to a leak from my ceiling...i have a plumber here checking it out.

not sure what you mean by an exclusion...please explain.

sorry it has taken me so long to get back. my computer is down at home, i have not had time to get it rolling again. it cost 1500 to hire kelley and walter for your appeals (approxiately). it was worth every dime. talk to kelley first before you appeal. she will tell you realistically if you have a chance. since medicare is paying for lapband now, it makes your chances much much better. feel free to pm me if you want.

i am in...i am at 219 and REALLY want to get under 200 in the next month....i may not make it....but with this challange i could get close111

hi all-i have been gone for over quite a while...no excuse except my life got extremely busy. i am still plugging along with my weight loss...ninteen lbs to onederland...i can not wait!! my eating habits are still fairly good....i had a house full of people over memorial day....everyone noticed the way i ate.....like a normal person instead of eating every thing in site...i have come a long way. i promise to check in more often...how is everyone else doing? any challanges coming along?

i agree dawg...i am going to concentrate on weight loss, health, and building muscle and not so much on what the scale says....i just saw a neighbor my mine outside that i had not seen in about a year (he was in holland i think...) anyway, he did not even recognise me...he introduced himself like he did not know me....i must look a lot different...yippeee okay, i have been procastanating all day on my damn spreadsheet....now i can't even find it...

evertime i come to this thread i become so emotional....i read your stories and look at my own life stories.....how we got where we are today....it is no wonder we are still standing!!! but we are still standing and have long lives to live. saraintyler, joyceGA and others...i can not tell you what to do, but i believe the band can help you get where you need to be. i was an emotional eater big time!!!!! the band has stopped that for me, the bottom line is, if i try to eat too much, i get sick, so i stop. it is the first time in a decade that i feel like i have control over what i eat. it has literally saved my life!!!! best of luck to all of you...feel free to pm me if you have any particular questions or just need to talk : )