Onnie67

I agree, check with a different doctor.

Make sure you list ALL your co-morbities.. anything you have...it helps. My doctor put down mild hypertention, GERD, back and joint pain, restless sleep, planter fasica, heavy periods...anything and everything...

I am in the final stages for approval. 2 others in our local had their paperwork turned in and they were approved with in 2 weeks... I am hoping it is the same for me!!!

i sent you a private message...

I am in IL...i have never heard this...what i have heard is it depends on your insurance... where are you having your surgery done at??

my best friend is looking into the sleeve too. However, she is 150 pounds over weight. I have the same issues as you do with with the gag reflux. My surgeon has assured me that if i eat slowly, chew well, and don't drink with my meals, I should be fine. Also, something to consider is sleeving is permanate. If you have problems of issues then what??? And you can vomit just as easily with the sleeve as without (according to surgeon) and you also can have issues with dumping syndrome though it is not supposed to be as common as it is with regular bipass. Most insurance companies do not cover it since it is still "new" i think i was told it has only been out for about 5 years on the mass market. :rolleyes2:

I know my best friend has looked into both bypass and banding. The best thing with banding is that you keep your insides the same. And once you do bypass, you are done. It can not be reversed. She and her doctor decided to try lap banding first, and if it is not successful, then she can look into bypass. Also, he stressed...that with banding you have to exercise. It is a TOOL...bypass, the weight will come off no matter if you sit on your duff or if you exercise....just some food for thought!

I am in the same boat as you...my insurance does not require 6 months of supervised diet either. I started the process on 3/17 with the seminar. I called and scheduled my next required appoinment with the nurse (first one was 2 weeks after seminar) and we went over my insurance requirements. It took her another couple of days to "type out my plan" with the names and phone numbers of the doctors and such that I had to see to get clearance and the approval. I called right away for the pysch appointment and it was 30 days out. Nutrition was 25 days out. Cardio was 21 days out. My pulmonogist (sp?) got me in right away to give me clearance..so I thought!! but he wanted to do a sleep study first, that was scheduled 30 days fromt he date I called. My pcp did my first appointment to "talk" about what I wanted, what I thought, and what was expected. I have a follow up appointment next week with him for my physical and history (required by surgeon and insurance) so I am almost 5 weeks into process and I have only gotten my cardio clearance at this point. I am figuring that by the end of May, I should have my paperwork submitted to insurance for approval. It is not a fast process and I believe it should not be. I have been practicing living like a "bander" by eating Protein first, then veggies, then healthy carbs. I am also doing the small bites 20-2-20-2 process (chew 20x...put fork down for 2 seconds...then next bite...chew 20x...you get it) and not drinking 30 minuets before meal or 60 minuets after...that is reallyyyyyy hard...start working on that if you have not yet....and no soda. That sucks, it is hard...but being fat is worse. Hope this gives you a bit of insight as to what I have to do...not by any means saying you will have the same experience!

wanda, actually, my doctor said NO it does not delay your surgery. But, when you are coming out of surgery, they will mask and watch you incase you stop breathing. I am not a doctor, but this is the answer I got from both my docs... Hugs!!

i read a lot of posts in this group, i read the good, the bad, and the ugly. I think that was important in making a decission...

is it maybe that your husband does not know or understand the lap band system? I have had friends who were negative until i explained to them in more detail how it works and more importantly WHY i wanted it...not because I believe it is a cure all, or that this will fix my issues, but rather it is a tool that will help me to become a more healthly person. i am not looking for a certain number or size, but rather a "feeling" a feeling of feeling GOOD...not having pain, being able to walk away from food and feel ok about it...not worrying about the future...maybe if you can express why you want the surgery with your hubby you can have a conversation and get the ball moving!! Good Luck!!!

Part of the reason they don't usually set a date (my understanding only) is that they need to wait for approval from insurance. Most insurance companies need you to complete EVERYTHING before they will consider or review your file. I am still in process myself, and I have a few more appointments to go yet, but it is ok. I know that in the long run I am doing things to help my approval. Also, you don't mention, but I was curious, have you started thinking and working like a bander? I have been working on not drinking before/after meal, no soda, small bites..protein first...chew chew chew...working on getting my exercise plan into place...that really helps me to keep positive... :huh2:

I was wondering (I am not yet banded) why no carbonation and no gum. I have not met with the nutritionist so I am not sure about the whys yet.. Also, what other things have you been told to avoid. The reason I am asking is so that I can start working on training myself not to eat or drink what I am not supposed to kwim? I will start weaning myself off soda next week Monday. I have been buying crystal lite and cases of water to help that. I am a gum chewer...so I will work on that this week... Any other suggestions????

I have had my first pysc visit done today. It was interesting. Lots of questions, then quizes, and I have another appointment on 4/21 to go over the results of what they find, and discuss what to include in my plan!!! I am soo excited. I really was nervous about the entire thing because I did not know what to expect...the Dr. had left the room, and I was with her "student" and he was so nice! Felt very very comfortable talking with him. Tomorrow is cardio....wahoooo we are getting there!!! :thumbup:

WOW that is expensive. I had my pysc appointment today, and it was $50 and the next one will also be $50. I had to take a bunch of tests (t/f and scale of 1-5 things) and they will "score" them and my next appointment we will discuss the results....and I am also in IL... :frown:

my husband is also in the union (elevator) and we have BC/BS IL who manages our plan. WE DO NOT follow the BC/BS IL guide lines either...what I was told by my benifits office was to call our pre-cert number and speak directly to the nurse and ask what the requirements are for WLS (weight loss surgery) which I did...VERY VERY different than the BC/BSIL requirements. So I would suggest going that route first. You can also ask your benifit department what surgeons are allowed, what the copay if any is (I have none), and any other questions you might have. Once you find a surgeon, they should have some one that will work with you on your benifits...BUT be aware that they may look at your card and ASSUME you have to follow BC/BSIL guide lines. I actually wrote down my guidelines, the name of the nurse that gave them to me including his/her extention, and the phone number...i had to request that the benifit nurse from the surgeons office call while I was there. She was very suprised to learn that I was correct and revised my plan for the surgeon... Hope that helps you some!!! Feel free to private message me if you have any questions...

are you kidding me??? YOU LOOK WONDERFUL!!! Do it now!!!!!!!

OH YES!! that would be awesome!!

Wow!!! Congratulations To You!!!!! That Is Awesome News!

I am having the sugery done in Kankakee. Dr. Ian Soriano is doing the surgery. I am still in the "appointment" stages so I don't have a surgery date yet!! :huh2:

Hi Becky!! I am in IL too...near Kankakee. I don't have my banding date yet, still going through the process... :wink_smile: Good luck to you!

For me, even though BC/BS manages our plan, my DH union (NEIB) says what we need. Fortunately, I don't have to do the 6 months of supervised dieting... :wink_smile: Tonya

Ok, having talked to my insurance (NEIB-managed by bcbs and medical cost management) I have found out that though BCBS IL is a pain in the butt to deal with, our union has the final say about the go ahead... so far I have leared that my requirements are as follows: 1. height, weight, bmi (easy enough) (done) 2. TSH levels (again easy) (done) 3. physical and history 4. cardio and pulmonary clearance 5. 5 years of diet information 6. pyscologist 7. comorbidity My concerns are what comorbiities are considered... I have GERD, planters fascia, fatigue, menorrhagia, and had my gallbladder removed. I am going for a sleep study to rule in/out sleep apena. my BMI is 39.66 (5'5" 238lbs) My tsh levels were normal I also have a family history of diabetes. My family doctor is doing my physical and history on 4/8 and he needs to include my weight gain for the past 5 years, medications, and other health factors... Is there anything else you guys know of that will help the approval along?? Thanks!!

Well duhhhh I never would have thought about the pouch stretching out or the gum getting stuck. I am so glad that I found this board...I will be working on breaking my gum and soda habits NOW instead of next week... thanks so much for the info!!!!!!!!!

Is there a pyscologist you can talk to or a therapist? Many insurance companies will cover it. I would also look into a local support group. I am not banded yet, but I have approval through my insurance to meet with the therapist 2x monthly and also found a local support group. :puke: