rroswelltx

My DD (age 5) told me that some women had little boobies, and some had big boobies, but I had LONG boobie's..... Aint fat and gravity wonderful!!!!!!!

Liquids will go straight through the band and if you make high colorie choices like sweet tea and milkshakes you are not going to loose much weight.

Check this out, from the earlier post: Vertical Banded Gastroplasty (VBG) and Laparoscopic Adjustable Silicone Gastric Banding (LASGB or Lap-Band): Aetna considers open or laparoscopic vertical banded gastroplasty (VBG) or laparoscopic adjustable silicone gastric banding (LASGB, Lap-Band) medically necessary for members who meet the selection criteria for obesity surgery and who are at increased risk of adverse consequences of a RYGB due to the presence of any of the following comorbid medical conditions: Hepatic cirrhosis with elevated liver function tests; or Inflammatory bowel disease (Crohn's disease or ulcerative colitis); or Radiation enteritis; or Demonstrated complications from extensive adhesions involving the intestines from prior major abdominal surgery, multiple minor surgeries, or major trauma; or Poorly controlled systemic disease (American Society of Anesthesiology (ASA) Class IV) (see Appendix). I went to consult with my surgeon Friday, he said that him and about 15 other doctors have gone to Aetna's review board about the above requirements, and told them "They have their information backward, these 5 problems make the lap-band higher risk, Aetna is telling there patients you have to have one of these problems not to get RNY and you can have lap-band but the doctors are saying no way!!!!" My surgeon is AWESOME, he actually said I was the most well prepared, well researched, well documented patient he has had walk through his door in the last 2 years, and he would talk to the medical director of Aetna directly to try to get them to approve me........ I am so excited. Also I know if it's in God's WILL it will happen!!!!!!! You guys on this board had me so prepared and well researched, Thank You sooo much for all being here and sharing all the time. :hail:

I go for my appointment today with the surgeon. (Dr. Fox in Dallas). I have a ton of stuff to turn in for insurance approval. I have Aetna though and they prefer RNY.... Please send alot of positive thoughts and prayers my way, I need it. I am trying really hard just to put it in God's hands but I can't help being worried. Thanks, for listening.....

I was on Adipex a couple of years ago, there is also meridan, and a couple other's i don't remember the name. I have a problem with prescribed diet pills because they make me feel like I am crawling out of my skin, but thats' just me. Good luck!!!

I just don't get it, my insurance has this in their clinic policy: Vertical Banded Gastroplasty (VBG) and Laparoscopic Adjustable Silicone Gastric Banding (LASGB or Lap-Band): Aetna considers open or laparoscopic vertical banded gastroplasty (VBG) or laparoscopic adjustable silicone gastric banding (LASGB, Lap-Band) medically necessary for members who meet the selection criteria for obesity surgery and who are at increased risk of adverse consequences of a RYGB due to the presence of any of the following comorbid medical conditions: Hepatic cirrhosis with elevated liver function tests; or Inflammatory bowel disease (Crohn's disease or ulcerative colitis); or Radiation enteritis; or Demonstrated complications from extensive adhesions involving the intestines from prior major abdominal surgery, multiple minor surgeries, or major trauma; or Poorly controlled systemic disease (American Society of Anesthesiology (ASA) Class IV) (see Appendix). So in otherword you have to have one of these reasons NOT to have RNY before they will cover the band? Sounds crazy!!!

I don't have an update yet, I am going to try and find a dentist today. My dentist sold his practice apparently so I am without a dentist. I will let ya'kk know how it goes. My tooth is really starting to hurt bad, so I think that may be the culprit. Thanks everyone!!!

I know we have some nurses and medical people on here, so I have a question. My white blood count has been elevated for about 2 months now. The say the end of my high range is 11.0 and mine is 12.9. The doctors keep retaking my blood work but it's not going down, and they don't seem to concerned about it. I am concerned though because I remember last year when I had my hysterectomy my WBC was high because of a sinus infection (11.9) and they wouldn't do surgery till I got it down. Now with wanting the band, I don't want infection in my body. I haven't felt sick at all? :phanvan Any advice.... Thanks,

:help: Ok I go to the doctor on the the 20th to get the insurance stuff turned in. Some of you know my story about trying to get approved last year and what the barix clinic drama was. Ok so I digress. I know that I can possibly be denied again this year with my new insurance which is Aetna. They are going to want me to go on a doctor supervised diet, which I am actually on right now to get a head start. My question is this, I know I can loose weight on a 1200 calorie diet, but I am unable to maintain that indefinetly, and it comes right back plus. If I loose weight on this diet and my BMI drops below 40 won't the insurance company then say, well if you can loose weight on your own you don't need surgery? Isn't it a double edged sword. Or do I do the diet but not really and not loose weight. I don't want to do the dang yo/yo stuff anymore. Any thoughts? :faint:

I went to my doctor yesterday, I guess I was wrong she is concerned about it. Before she sends me to a blood doctor she asked me to get my teeth checked out, I have had a tooth bothering me and I have gingivitis pretty bad. She thinks it's possible the infection is coming from that. I hope thats all it is, I have had so many health issues the last few years I don't know how much more I can stand.

Ok I visited my PCP today, and she updated my Letter of medical necessity, she signed my (so far) 2months of doctor supervised diet, I also have my phyc eval letter, my medical nec. letter from podiatrist, my medical clearance from cardiologist, and diet history. And I nice little 2 page letter from ME. Pray that it be enough for Aetna to approve. Thanks for listening....

I am so happy for you!!!!:clap2: You fought the good fight, and WON I only pray that my battle will turn out like yours. Let us know when you have a surgery date!!!!!

Ok I'm confused, hasn't anyone been required to go on a doctor supervised diet for insurance approval??? No one is responding to how they handled it, I'm feeling very unloved here:confused: Please some encouragement from my favorite board!!!

Mandy, I will be praying for her. What is her name, I will put her on my prayer list at church also. I want you to know that God is still in the miracle business, and some times he uses people or physicians to help him. But remember that God is the greatest physician!!! There are always reasons for why things happen, and God has a plan! Please look to Him for the answer, you na dyour DD are His children and He loves ya'll! I will be praying. Regina

Ok so I will start my journey of 2006 still unbanded, but in heavy pursuit!! Here is the amazing thing, I didn't gain during the holiday's, instead I actually lost 5 pounds. Whahoo! I am starting my workout routine today, and am going to try to eat as much as possible like a bandster till I get approved. Drink, drink, drink that water. I know my insurance now (Aetna PPO) requires 3-6 months of doctor supervised diet. I worked with my doctor last month on the letter of medical necessity. I wonder if there is a way for me to write all my diets on my own for the past , hmmm forever and get the doc to sign it?? Naw she probably won't but hey it's a thought. I am going to have the surgeon go ahead and turn in all my stuff I have already to insurance and let them turn me down (if they do) why I am working on my doctor supervised stuff. I have doctor supervised stuff from 2002 but I know that will be too long ago. But I have had my physicological eval done, my nutritional eval done, and a letter of medical necessity from my PCP, cardiologist, & foot doctor, my BMI is 42, so what the hey why not send it all in. Thanks for listening guys and have a great new year!!!!

Carrie, I am on zoloft, I haven't had any problems. I was on ;exapro and wellbutrin, and it made me soooo tired I couldn't function no matter when I took it. So far the zoloft has been better. But as I read in an earlier post if the situation your in is always bad no pill is gonna fix it. I think that is my problem most of the time, but God is working on my DH so I have hope for the future. And pray to join the banded in 2006.....Merry Christmas ya'll.....

Hi everyone. I hope every one is geared up and ready for the Christmas holiday. I'm just ready to be off work. I wanted to pose a question to all of you that are already banded. Based off your expierence to date, and how you feel, and what you know/read etc. Do you think you will stay banded the rest off your life? I mean I know you would want to be, but since this surgery is relatively in the "new" stage (meaning not more than 10 years) Do you think it's plausible. I am just curious to hear your responses.Thanks.....

There is a post on the support page, someone who was banded in July and just found out she is pregnant. Might want to look at that.

Hmmm, I hadn't heard that fact about 10 years, did your Dr. tell you that it can last up to 10 years, or is that what INamed says. I haven't found any stats on that. Thanks for the info...

1. What does your handle mean? * my 1st intial and my last name, I live in TX2. What book are you currently reading, or did you last read? * Been a long time since I read one, I mostly just read the bible doing my buble studies. I did just purchase "The 5 languages of Love"3. What do you do for a living? * Crystal Reports developer4. For what in your life are you most grateful?* #1 God, my DH, and my precious 5 years old daughter5. What's one thing about you that you think would surprise other people?* I write poetry, very good actually but I don't do it very often.6. One word to describe yourself? *Independant7. One word others use to describe you? *probably cocky8. Would you rather play a game with someone better or worse at it than you? * Doesn't matter-I just love playing games !9. Favorite movie? Favorite show?Not sure I have a favorite movie, show would be grey's anatomy, house, biggest loser, survivor, big brother, I know I watch to much TV thats why I am FAT!!!LOL10. Something unusual about yourself? I was VERY wild in my youth!!!

Sunta,I recently had issues with the barix clinic, you can read my post from last week. http://www.lapbandtalk.com/showthread.php?t=12692titles "I'm SO angry!" on the support forum. Do NOT let them get to you. They are salespeople, as you see in my post they can be very underhanded. I just Thank God he saved me from going there for the LB, they might be good at GB, but they are not at the LB. Find a good reputible (sp?) doctor and don't freak out, thats what they are wanting you to do.

I'm sorry ya'll this may be rather long winded, but I am so angry! I have been looking at this surgery for over 1 year and when I finally decided to do it in Sept. I was working with a Dr. Fox. They didn't kow if I would have time to get it pushed through my insurance by the end of the year, and since my insurance was going to change to a harder insurance (Aenta) Jan1 2006. So I kinda gave up till next year. Well one day on line I did a BMI calc through the barix Clinic web site. I filled out a form for information on their clinic. They called me, and talked to me at length. I told them the situation with my insurance and they said they believe we can get it pushed through, so I decided to give it a shot. So I had my consultation with the surgion the end of Sept. He KNEW very well that the lap-band was the ONLY surgery I would be interested in. He told me that the Barix clinic had only recently started doing the lap-band several months ago, and I would be a good candidate for it. I explained to him about my insurance situation and he said that would do everything the could do to have it done by year-end. OK so at that time I got excited, I got letter of medical nec. from my PCP, I got the physic eval, I got letter from cardiologist, foot doctor, nutritional eval and all the required stuff. It was turned into insurance last week. I have talked to the patient counselor at the barix clinic on the phone just about every day asking questions, and talking about it getting done before the end of the Year!!! I talked to the insurance company yesterday and they said they would have an answer by end-of day TODAY!!! OK here is the kicker. Last night a nurse called me from the barix clinic because I had some questions about what size band etc. that they use. I was told by her, that they are scheduling their FIRST lapband surgeries for the first week in Jan. I explained to her that wasn't possible that the Dr. and everyone knew I had to have it done my end of year, and she said. Well I don't know why they would have told you that, we have NEVER done a lap-band surgery here, this will be the first one, and the doctor has completed his training but has to have an Inamed rep and another surgerion here to supervise his first ONE!!!! I was floored, they had never told me he hadn't done the surgery before, in fact led me to believe the opposite. She said well he has done thousands of the RNY and GB so this is a peice of cake for him. I told her then I would not be having surgery there, because after Dec., my insurance would change and #2, I didn't want to be the FIRST patient of someone who has never done it. So in closing, I may get my insurance approval today, but it was all for nothing!!! My hopes and dreams are dashed, and I am livid. I hope I explained this well enough, but I was so decieved by this clinic it is UNREAL! Thanks for letting me vent!

WOW she sounds like my Hubby!!!! OMG!

Thank you all for your words of encouragement. I did speak to the Dr. directly on friday. He apologized. He said they did intentionaly miss lead me, but thought it would work out by year end. I asked him why it was never stated that HE had never done the surgery before and he really wouldn't give me an answer. I vented on him, and told him I had spent a great deal of money on evals, administration fee's for letters etc. He just apologized. As far as the insurance I knew it would be a long shot anyway, I mean if an insurance company could drag it out for just 2 weeks, they can keep from forking out alot of money. They are such rackets anyway. I made the decision when I started this journey that it was all in God's hands, and if He made it happen it was meant to be, and if He shut the door it just wasn't my time. So I will try again next year, and turn in over to God again. I don't want anything that doesn't have God's hand in it, because if it's only for me, based off what I want, then I'm sure I would pay the price later. Love this board and all my new support friends. Have a great Christmas everyone, and always remember Jesus is the reason for the season!!!

Congrats, and Hope you will feel better soon. P.s. I hope one day I can find my belly button. Good thing I never got it peirced it would be lost!!! OMG do I still have one?!?!