celticdreamer

Carrie, I feel very bad for you and have a couple of pieces of advice. 1) Don't pay your surgeon's office program fees until you have an understanding of exactly what you are getting for your money. You have a right to know what you are purchasing. The fact that they made you pay $105 for a visit the insurance covered seems a little sketchy to me. Is this surgeon reputable? Please make sure you do plenty of research before you invest your money and your health in this office. 2) If CIGNA continues to deny you, get an attorney. In the long run, it'd be a lot cheaper than footing the entire surgery bill on your own. I'd suggest appealing on your own at least once more, though. I used to work for Cigna, but had nothing to do with claims or pre-approvals. I left there when I found a job with better insurance. Don't give up without a fight. They have ridiculous prerequisites for weight loss surgery, then end up denying anyway. Make sure you meet all the requirements then FIGHT FIGHT FIGHT. Don't let people walk all over you - whether it's Cigna or your surgeon's office. Take care, Theresa

Appeal, appeal, appeal! Also, provide them with MORE copies of what you already sent them. Call to confirm they received the documents if you fax them. If all else fails, contact your state's insurance commissioner. How they could pay the surgeon but not the facility is beyond me. Reminds me of when my brother's triplets were born. The insurance company paid the medical bills for the two girls but refused to pay for the boy. As ridiculous as that was, it just took a lot of fighting to get the insurance company to do the OBVIOUSLY right thing.

This is slightly off topic, but I live in Connecticut and wasn't impressed with the medical care my 71-year-old mother received here. My brother lives in Texas and recommended she go there and get a 2nd opinion at Scott & White. She did and we were all impressed with the quality of the care there as well as the doctors' genuine concern to help. If I were in Texas, Scott & White would definitely be my first choice for WLS.

Well, I think I can offer some insight into your kickboxing question. When I met with the therapist at my surgeon's office, he asked me if I have considered what I'd do for exercise after surgery. I said I wasn't sure, but that I have a 4th degree black belt in karate, and I hadn't attended class in a long, LONG time. He highly recommended I get back into it. So, I'm assuming that kickboxing would be fine, since karate is no problem.

The port on the Realize band is flatter. When you lose all your weight, it'll be less detectable beneath your skin.

Good luck, Brandy! I called my insurance today and was told that they don't require pre-authorization. I then called the surgeon's office to tell them this, and they said it does require pre-authorization. Sheesh. I guess I just need to be a little bit patient.

You can get Cigna's position on bariatric surgery right from cigna.com. Read it carefully. If they say they'll cover people with BMI over 40 and yours is 40.1, I recommend you fight tooth & nail to get them to stick it. I used to work for Cigna. Left there for better insurance. Good luck to you!

I'm using Dr. Valin in New Haven, CT. I am currently awaiting insurance approval. Dr. Valin's office said he has done more lap bands than any other surgeon in CT. I'm surprise that I don't see more posts here from his patients. Would love to read more reviews. I'm encouraged, though, because every review I've read is positive.

Congratulations!!! I have searched for your posts because you have the same insurance that I have, Empire BCBS. It's very heartening to see that they approved you because I'm waiting for approval, too. I'm so happy for you. What a great way to start your 30's! Woohooo! -Theresa

Hi everyone, Has anyone here been required to do the Protein-Sparing Modified Fast diet by their nutritionist? This diet consists of the simply 9oz of meat per day, divided equally in 3 oz portions. One portion is consumed in each of 3 distinct meals. They are able to test whether you've been successful on this diet by checking for ketones in the urine. I have been on the diet since Monday and every single minute is a struggle. I am so damned hungry I want to cry. This is a very trying time for me. I am determined to do it, though. The sole purpose for this diet, though, is to prove to the office that a patient can follow instructions and has the willpower to stick with the food requirements after surgery. I'm starving so much that I'm shaking and I am also mentally foggy. This is a problem since I work in IT and need to be very focused. Here's my question though: Is the diet following surgery this torturous? Will I be starving after surgery? Am I setting myself up to feel this miserable for the rest of my life? I've been reading that people can eat pretty much anything once they've healed, only in very small portions. Do you who have had the lap band done honestly feel satisfied after eating? These are all important questions and I'm turning to you, the experts, who have had the surgery and live with the band daily. I really want this to be a positive experience and I would appreicate any feedback at all. Thank you, Theresa

You know, the idea of being thin is so foreign to me. I think that I'm about to open a whole new world for myself. :puke:

Happy Monday Everyone! I have to remember to visit the CT local thread more often. I had my 2nd visit with the nutritionist and the therapist on Saturday. I passed the psych eval and got the green light from the nutritionist. Next this is submittal to the insurance and I am concerned about how that'll work out. It's Empire BCBS. On April 23, I have to attend a class that the nutritionist & therapist give together on what to expect pre-op, at the time of surgery, and post-op. A surgery date isn't far off once I get the insurance approval. Woot! My surgeon is Dr. Valin at St. Raphael's in New Haven. His office says he's done more of these surgeries than any other surgeon in the state, so I am very confident that things will be fine. I live in Waterbury, but decided it's worth the extra travel. I guess that's my update for now! Good luck everyone! :thumbup: -Theresa

OMG, most of my friends in my adult years have also been overweight. I found my comfort zone with them. Not surprisingly, those friendships did not last. "Hey, you like to eat, too" is just not enough glue to keep a friendship together. Don't be nervous about having the surgery. I haven't had mine yet. However, I'm looking forward to trying new things after I've lost some weight - things I wouldn't or couldn't have tried at the weight I am now. I think this will give me an opportunity to make friends with whom I have more in common than eating habits. Be brave, do this for you! You don't need to worry about them. The ones who are truly your friends will remain. And I think it's awful that they excluded you from going out simply because you were treating your body right. You deserve a whole lot better than that. Congratulations for so clearly seeing what's happening. I think we will both be very surprised with the unexpected positive changes that occur in our lives when we have lost some weight. -Theresa

OK, so I'm doing this protein-sparing modified fast diet, which is required by my nutritionist prior to surgery. This is not the pre-surgery diet, but a way to prove to them that I can follow a food plan. I am allowed only 9oz of meat daily. So, I was struggling through it, barely making it. Today, there was a presentation by the CEO of my company held at the local Marriott. I didn't know attendance was mandatory until this morning. I got there and they were serving a full Breakfast. I was so damned upset, watching 200 people eat while I drank Water. I am starving. Literally, STARVING. I couldn't handle this. Five hours later, I still feel like crying. This diet has been the most traumatic food-related experience of my life. I am so stressed. The only positive thing here is that there is a light at the end of the tunnel. Today is my last day and I see my nutritionist tomorrow. After that, I will be going out for lunch. I will NEVER EVER do this diet again. I keep thinking Weight Watchers is a much better option. I just can't wait to get the band. Six weeks after surgery, I think I will be eating real food. I am SO sick of MEAT, for now. I'd give my left arm for a salad or piece of fruit. -Theresa

Yep, now I get to play the insurance waiting game. I have at least one significant co-morbidity and that's sleep apnea. Granted, it's mild, but at least I have already been diagnosed with it and have a cpap. I think this will work in my favor. I don't know how long it'll take to get insurance approval, but I heard that Empire BCBS is generally pretty quick.

As much as I hate what I had to go through last week, I have to say that the dietitian did ask me if I were diabetic before giving me the diet. Honestly, I felt really bad all week and I'm still not back to myself. Yes, I lost 13 lbs but at what cost? I was dizzy after walking up two flights of stairs yesterday (totally not normal for me) and it's only a little better today. I think my body is rebelling.

Actually, I'm in Connecticut. My company has offices everywhere, including NYC. :thumbup:

Wow, you're brilliant. I'm gonna save that for the next person who decides to torture me for 5 days! hehe

OK, here's the scoop you all have been waiting for: I went to the nutritionist today and definitely passed the ketosis test, and I lost 13 lbs this week alone. When I questioned the purpose of a diet this drastic (not to mention horrific, insane, etc - feel free to add your own adjectives please), I was told it's how they weed out those who can comply with those who cannot. It's simply based on ketosis. Hell, I could have literally eaten half a cow and been in ketosis. I still don't understand why I had to starve all week. I asked her whether the food restrictions pre-op and post-op would be so severe. She said no. The pre-op diet is 7 days on a 1000 cal diet. I know I can handle that. The post-op diet is the usual liquids, progressing to full liquids, to mushies, and finally to real food. She said that the diet I was on this past week would be the worst of it. I also saw the therapist who did the psych eval. He said I passed. The next step now is to submit it all to the insurance (Empire BCBS) and wait for approval. The only other requirement is attendance at a class that the nutritionist and therapist give regarding what to expect before, during and after surgery. It's getting closer. This doesn't feel like it's miles away anymore. Oh, and I immediately went and got a vanilla shake when I left the therapist, and then had dinner tonight with my Mom at TGI Fridays. hehe You know, I thought I'd be so thrilled to get that first bite of food, but it wasn't anything special. That surprised me! Anyway, that's the update. No more starvation for me. I'd rather be fat the rest of my life than live through last week again. Thanks everyone for all the support. You all are incredibly awesome!!! -Theresa

Hi again everyone! You all are so darned supportive. I am very very happy that I found this site. No, I don't have a surgery date set yet. I am still a bit nervous about insurance approval. I used to work for Cigna but left there because I heard bad things about them regarding weight loss surgery. I now have Empire BCBS and I'm reading good things about them, so hopefully it'll all work out. My BMI is 49, or at least was until I went on this diet on Monday. I'm sure it's lower now! Well, I'm off to get ready to go to my nutritionist. This ought to be an interesting visit. Will definitely post when I get home! -Theresa

OMG this is the most hilarious thing I have heard all week. Thank you! I needed the laugh and badly. Survivor would be an improvement. Can't they at least eat natural fruits & veggies found in the wilderness? Truth is, I *am* a survivor for getting through this diet for 5 hellish days. I'm asking a lot of tough questions when I see my nutritionist tomorrow. Thanks for the advice.

Hi everyone, I'm from CT, too. :smile: I had my initial consultation with Dr. Valin's office about 3 weeks ago. I have had my first appointments with the nutritionist and therapist, as well. I have my 2nd appointment with the nutritionist and therapist tomorrow. The nutritionist has me on a pretty severe diet this week. It's been a struggle, but I have less than 24 hours more on it. I haven't read anything here about experiences with Dr. Valin's office. Anyone have any comments? -Theresa

You all are an interested combination of helpful and hilarious! And, thanks, but I'm gonna pass on the offer to snort meat out of my nose. lol Someone commented today that my face is looking thinner. It was nice to hear, but it doesn't really come near making up for five days of starvation! The difficulty of this particular diet has me sort of ambivalent about things. I guess that'll pass once I EAT tomorrow! :smile:

I can eat 9oz of meat and that is all. It has to be divided into 3 oz portions over 3 distinct meals. I can also drink non-caloric beverages.

I understand where you're coming from. I really do. I, too, enjoy food more than I ought to. I'm guessing most people on this forum do. I think seeing a therapist would help you tremendously. I'm doing the same thing right now. I want to be the cool person on the outside that I know I am on the inside and I know that I need to conquer my emotional eating before having my surgery. When anyone has an addiction, no matter to what, overcoming it is a serious challenge but it can be done. And YOU can do it! I'll keep you in my prayers. You have a lot of living to do. I hope you can find a way to do the things you want to do while still eating some of the foods you really enjoy. Good luck to you!