Beader

Hi Everyone, It's been a few weeks since I've been on and there are so many new bandsters! Still working on getting approved but I was wondering, if anyone has United Health Care, do you need to have a repeat of a sleep apnea test if you had it done two years ago. I have severe sleep apnea and have been using a cpap machine since then. Any info would be appreciated.

Gotta OMW no not for 5 yrs that's just plain ass stupid... Have you though about going to mexico... Yep to have to gain 20 lbs for a short time - yes I could do it too :eek: Indigogirl, Sorry I misunderstood. The fact that my insurance co. requires a FIVE- year history of BMI 40 to me is crazy especially if you have so many other co-morbidities and I've had them since I hit the 200 mark. I don't care if you have a BMI of 30! Well, all I can do is try and Phyllster is helping me tweak my letter. She's a huge help. No I haven't considered Mexico. I really am on a tight leash financially so that's out but thanks for the suggestion. I love this site and I think all you helpful people willing to spend your time helping everyone else are great.

Indigogirl, I thought of that but I don't really want to be even heavier for another 5 years? I want the Lap Band now, of course. My insurance co requires 5 years of BMI 40. If I just had to do it to get accepted now, I'd do it in a heartbeat and have fun doing it! :biggrin2: thanks for the suggestion! You all are so great. thank you all for your suggestions and input. I love it and welcome any comments on my dilemma.

Phyllser, I didn't submit my first letter yet because I wanted to include my doctors recommendation with it also. Do you know if the insurance co. will ask him to send his records of all the diet attempts I've tried in previous years? I ask that because I never discussed it at length with him until he told me about Lap Band Surgery. I just told him all the things I've tried. Probably through the years we discussed it in passing but not enough for him to make a note of it. My worst problem is improper documentation. My lap band office told me about the appeal but they would do that only once they submit their information and I'm denied. They told me they weren't allowed to send just the 5 year weight loss history without completing all the other requirements (nutritionist etc). Like I said before, I refuse to pay for all that if they aren't going to approve me because of my lower BMI history. Do you think I have a chance on my own getting an approval of just this step? Not sure if you read my other messages. I really don't want to get my hopes up if I don't have a chance at all. I'm so sad about this as it is. I would be willing to share the letter I wrote with you since your experienced. My email address is jejme@sbcglobal.net. If you email me I'll send the letter over to you. It's too long for this site. If not, I appreciate your input.

Gotta whats your bmi - I thought that 40 bmi with out co-mobities was usually approved.. I really can't help on the appealing to the insurance issue cuz my bmi was 42 with high blood pressure and sleep apena - so I was approved right away (but again 42 was morbidity obese) Have you ck'd out the insurance thread - I think you will find help there on appealing to your insurance Good luck.. Indigo girl, My 5 year history BMI that's documented is 32,34,36,37 and 39.5. I know under 35 is not acceptable no matter what but my history shows I have consistantly gained weight every year, even if I lost, I have ALWAYS gained back that and more. At the seminar they showed me at 40 BMI but I got sick right before my appointment (3 straight days of relentless diarrhea) and I was down 10 lbs. but gained back most but not all of it within a week 1/2. Yes I did check out the insurance thread but haven't seen any circumstances similar to mine.:thumbup: thanks for the suggestions.

Joann, thanks for the advice. I'm sorry I forgot to mention that paying for it myself is not an option, wish it were. My lap band group, Dr. Ehrlick, is wonderful and they would go above and beyond to get me covered but they said the insurance company won't approve. They said to submit the letter myself because they are not allowed to do it without all the other required letters. The thing is that I don't want to pay $150 for the nutritionist and $115 for the mental health analysis if I'm not going to get approved because my weight loss history didn't show I was "morbidly" obese. I also don't show I've been on a supervised dietitions diet for six months. I do have documentation from weight watchers that I've been to them for 6 months ending in February 08,however, I'm not sure if that's good enough either. I'll see what happens when I send the letter. I'll send my doctors recommendation too. I wonder if anyone knows of anyone that has been approved without this kind of documentation. Thanks

Hi Everyone, I haven't been on this site for a while because I was rejected before I even got started. I'm so devastated. I received my 5 year weight loss history from my doctor and I was obese for two years and severely obese for three years. I didn't realize you had to be "morbidly" obese in order to get approved. I think this is totally unfair since I have all the same health issues all the morbidly obese people do. I have severe sleep apnea, awful pain in my knees, ankles and feet, I'm on meds for acid reflux, I have 0 self esteem which causes stress, anxiety, and depression, I can only do about 10 minutes of housework at a time due to severe lower back pain, and a fatty liver. I've been on every diet known to man which is why my history isn't accurate. One minute I'm 225, a few months later I'm 190 but then I'm right back up there in another few months from that. Being shot down right from the get go has left me so depressed and hopeless. Well, I sat down and wrote my insurance co (United Health Care) a two page letter and poured my heart out. I think I gave them some pretty good arguments and I'm praying whoever reads it has a heart. Have any of you had a similar case? I started out so excited and hopeful, I even started sampling protein drinks and practiced chewing the right way to prepare for post op. I'm broken hearted and hopeless. thanks for listening.

FLALMT, I've been sick for the last week but I wanted to thank you for your explaination. It was helpful, still makes me nervous but I like to know everything. I'm still not well so it's hard to think right now. I look forward to hearing about your progress.

Hi CTGhostHunter!, I'm also going with Dr. Ehrlich but haven't had my first appointment yet (July 10). It seems like a year from now...I'm too anxious. Can you tell me a little bit about what you've gone through with him up to now? (when your up to it) I hope all is going well with you. Keep us posted on your progress.

Hi Sil, I couldn't help noticing you live in Wby CT. I live in Beacon Falls, CT. Hey, we're neighbors! Never found anyone on these threads that close. What insurance company do you have? I'm wondering if I'll have to go to those classes. My BMI is 40 and I have acid reflux, sleep apnea and maybe high cholesterol. I'm hoping I can bypass the classes. I've been to several weight loss centers but nothing in the past 6 months that was ever documented. Tomorrow I'll be checking with my insurance company to see exactly what I have to do. Have you heard of Dr. Ehrlick out of St. Vincents Medical Center in Bridgeport? That's who I'm going with. My PCP recommended him highly. I also went to his seminar in May. Well, just wanted to say hi and if you want to contact me by email, feel free. jejme@sbcglobal.net Hope your time goes by fast.

You really are an inspiration to all of us and I hope someone can say that about me someday. I haven't even been to my first consultation yet but I have decided to do this. My BMI is 40, I have acid reflux and severe sleep apnea and maybe high cholesterol so I think I will be approved. My insurance company will cover 100% :sad_smile: so there should be no stopping me. One thing I have to ask you and anyone else that cares to answer...Can you describe what PB is? I read somewhere else that is stands for "productive burp" but I need to know what that is exactly. Will I be coughing up gross stuff in a restaurant or having dinner at a friends house? Is it possible to be discrete about it or will I be totally embarrassed? And do I need to carry a barf bag with me all the time? I'm terrified about this. Does it feel like you're choking? It would not stop me but I like to know everything about what I'm getting into and don't like surprises. BTW, I think it's great how people write in about their setbacks and still say it's the best thing they've ever done for themselves. Keep up the good work:thumbup:

Hi, I have my first consultation appointment on July 10th and can't wait for my surgery. I've only told my best friend and my mother in law because I will need rides here and there. After listening to all of you, I think I agree with not telling everyone. I was going to because I couldn't figure out how to eat only a few tablespoons of something without someone making a comment. I come from families on both sides who are not heavy but there is SUCH an emphasis on food. Then I received a suggestion on one of the other threads that I liked. Fill your plate (not overly filled) and just eat a little of it. This way no one will notice a large dish with near nothing on it. Also I will start doing it even before my surgery and just tell people I'm trying to cut down. Then when the time comes I'm hoping they won't ask anymore. If I have to do liquids two weeks before the surgery, I'm not sure how to handle that! I'm doing a cleanse??? haha Good luck everyone and if you think of something else, let me know!

Gotta say, this is funny. I'm retired from AT&T (actually SNET in 96. Do you have a BMI of 40 or over? Mine is 40 and maybe that's why I might not need everything else. Not sure but I will check tomorrow. I do agree that a 6 month diet is good to get me prep'd to get use to my new lifestyle but I really don't want to wait. I'm so impatient! :ohmy:

Hi I'm a newbie to this thread and I just happened to notice your comment on a protein powder. I too would like to find a good one but I rather check it out first than buy a large amount and hate it. I ordered samples packets on www.unjury.com for about $1.75 each the other day. They even have chicken soup flavor. I can let you know what my opinion of them is but everyone has their own taste. I thought I'd start taking it even before my surgery as I really need more protein in my diet anyway. Good Luck finding a good one. Let us know. :ohmy:

Gottaluvme, I am only 2 weeks post op. I only had to do a 2 day liquid diet pre op and that last night as I was eating my 'Pizza Hut Meat Lovers Pan pizza' and diet coke (before I started the preop liquid diet) I started to really have doubts if I could do this. But it's not been as difficult as I thought. I sortta have your thinking, I've come this far and to 'blow it' would be really stupid. Plus I was self pay and to have paid that much money and then not do it kindda freaks me out a little too. So far I've not been very hungry and am amazed at how little I eat. I'm sure as I heal and the swelling goes down I'm going to struggle a little bit more as I can tell already my 4 oz portions are getting consumed much easier but so far so good. I get solids on Thurs. DH has told me to pick where I want to go for my first meal. I'm a little scared as I don't want something bad to happen in a restaurant like something getting stuck. But I'm thinking if I do something like crab legs at Red Lobster I might be okay, as long as I tell them not to bring those biscuits! Good luck to you! When are you being banded? Hi Long2bThin... I just looked for your message so I could read it again. The only thing I can say is that I was have a "senior" moment! lol It's very clear.

I have United Healthcare. Oh my, I think I might have some time to wait. I'm going to cry. On my first call to the insurance company, they told me several things I had to have documented in order to get approved. I forgot that they said I had to have 6 months of a weight loss program documented, at least that's what I thought. I'll have to call them tomorrow to check it out for sure. If I have to wait 6 month I'm afraid I'll get super discouraged and change my mind. My LB office said not to worry about anything. Told them I have paps every year and always get weighed so it's not a problem to show 5 years of being overweight. They said there's a lot of ways to get around the other things so we'll see. I appreciate you mentioning this. I'll get right on it and do what I have to do. I'm praying I can get through this without waiting. Thanks for the advice.

:ohmy: Guess I misunderstood you! Sounds like you're doing great. I envie you and all the others that have already been approved by your insurance companies. Mine said I will be covered 100% on everything when and if I'm approved. IF!!!!! Can't bare the thought of a denial. The more I read on these threads the more I know it's something I've got to get done. It's so comforting to talk to people who've been there, done that. It's a blessing! Oh yeah, you already know that

Long2bthin,I haven't even had my counsultation yet! I see my doctor July 10th which by the way seems like a year away. I just can't wait to get my preliminary stuff done so I can get my date. Once you make up your mind, it's torchure to wait isn't it? Did you actually eat Pizza only after two weeks??? That sounds dangerous. How much did you eat? You must have had to chew at least 35 times to get that down! Guess you haven't had your first fill yet. My insurance company requires two weeks of fasting which sounds crazy but if that is correct, I'm doing it. I don't want to blow this. I've already started practicing chewing and making better choices, sometimes successful, sometimes not but I've got to get the mindset rightl. I was reading in one of the threads, something that I will be trying if I ever do venture out, and that is to order from the appetizer menu instead of getting a whole dinner and tell the waitress to serve it at the same time as the meal. With the amount of chewing you have to do, seems like you would both finish at the same time. I think I'll be too afraid to go to a restaurant for a while. The thought of caughing up part of my meal in front of people terrifies me. Thanks for the input and don't forget...make those good choices :redface:

Indigo, thanks so much for that great message and taking so much time to do it. It was great! I've read so much in the past week and I know you are absolutely right about everything you said. I get it...it's all up to me. Sometimes that kind of worries me because I've been unsuccessful with sticking to a lifetime change in the past. Head hunger is a BIG problem for me as well, but I want to be possitive. I'm thinking that if I can go through the fasting, the liquids the first couple weeks, and ALL the rest, I can't be stupid enought to blow it after that and I don't want to! This is something I not only want but desperately need. I know I need help and I think the LB is it. I believe that once I start feeling a little better, I'll have the energy to start exercising again. I was doing the Leslie Sansone 30 min Walk cd's every day for the longest time and then bought the 45 minute one which incorporates weights (havent' done that one yet). It's low impact but you can really work up a sweat. The 30 minute cd is a good home tape but I think the other with the weights is better. My point is that at one point in my life I did well and had energy to exercise and I felt good and stuck to it for a long time. I'm praying I can do it again but I might need a lot of encouragement and support. You and the others I know are great for that. Do you believe this...that you can eat everything as long as you eat in moderation? I'm not trying to make up my own rules but realistically, I think that sounds doable for me. I've tried WW myself and I also agree that it's the most sensible program around and I know you can eat just about everything but only in very small amounts. I also understand that with the LB I will be eating way smaller portions so I have to make sure those portions are as nutritious as possible. Well, I know I can do the exercise, I just hope I can have the willpower to make the right choices for a lifetime. I think I can do it with help and encouragement. Thanks again for all your input! Talk about writing a book!!

Just checked with my insurance company today and they pay 100% including all the testing and any post operations and as long as they are medically necessary, they cover them :rolleyes2:. I'm so excited. There shouldn't be anything in the way now but still haven't had my first dr apmt. Every day I get more and more sure this is what I need. All I have to do is go shopping and try on clothes. Hey, has anyone ever joined a new thread and no one answers their messages? :confused2:

Hi Everyone, I'm a newbie and just found this great thread. I'm 56 and still researching the band but no matter what negative things I read, I still feel lead to do this. I've been reading that a lot of people are not loosing weight or weight loss is very slow. That scares me with all that you have to go through before, during and after surgery. What I don't get is that people who are over 200lbs. (like myself) are that weight because we overeat. When I get banded, I'm assuming my food intake will change DRASTICALLY so how could weight loss be slow? I'm concerned about this because I really believe the old saying "you are what you eat". I got the way I am because I eat the wrong things PLUS I eat too much AND at the wrong times. The band will really limit the amount of food I eat no matter what I eat or when so why won't the weight loss be, not easy, but easier? I need help in working all these things out in my mind before I make a decision and my insurance company has a lot to do with my decision too. I will be devastated if they won't cover it. You all are experienced and so helpful. I welcome all your comments. Thanks in advance for your advice, encouragement, and support. :confused_smile:

Thanks so much for ALL the details!! It was nice of you to take the time. I've already been trying to chew properly. I actually have to concentrate on NOT swallowing so soon. I don't drink diet soda much but I loooooooooooooooooooove coffee and that will be a tough one. I will start slowing down when I get my date and be totally off by that day. You'll have to let us know about the Pre-Op Testing too.

Hello Delane, Welcome to this great site! I do believe Annabelle in that you will be totally excited as the time gets closer and closer. Once I make my decision, I will want to just get it done and get on with my new life. I can't wait to get my date. Sounds like I've already made my decision but I still need more info from my insurance company. Keep us posted on your progress.

Thanks Annabelle! So you DO understand. Well, you'll have to let me know how you manage eating with your family when the time comes and if your filling the plate but only eating a little works without anyone noticing. lol I just got nervous when you said I should be scheduled for surgery soon. I was thinking it would be a couple months. I'm a whimp! It might take that long though because my consultation appointment is for July 10th. I had to wait a whole month just to get that! Maybe I need that much time to decide but as of right now, I'm on the positive side. I need more info also from someone who has actually had it done and is a year or so in. Can you or anyone else share what tests they've gone through before the surgery date and what you have to do until then? Did anyone have to have a test that had to do with their asophagus? I was reading other things about that somewhere. One more thing...how do you paste the ticker info on here??? I did mine on the Ticker Factory site but couldn't get it to copy on this. Thanks!

Hello! I'm new to this thread and I've only gotten as far as the seminar. My first appointment is July 10th and I can't wait. I'm still researching, reading, reading. I think it's good to read all different threads but some are just about complaining. I'm not into that and yes it is scary to read so many negative stories. When it's just one after the other, I just bow out and check out another thread. This one is great. Already I've been calmed also by some comments. I've also gone to WW years ago and 5-6 times since the 80's but always gain back more than I lost. I am a healthy food eater, not a frequent binger but I eat often and not just when I'm hungry. I feel, like someone said, that you HAVE to loose with the band. I can't imagine not with the amount of food you'll be able to eat and that feels good. Good luck to all of you and keep us posted on all your progress. Email me if you want at jejme@sbcglobal.net