ocbreeze4u

My surgery is this Thursday, I have not had mine yet. My surgeon does not require a pre op diet and Aetna only required a 6 month attempt in the last two years with a doctor. I did lose about 25 lbs on a doctor supervised diet but that was it. Unlike most on here, I am not nervous at all about my surgery and I am quite excited about it. I am fully aware that this journey will not be easy and it is not a "fix-all" but it is a wonderful tool to help me get my health back. I will let you know how my surgery goes sometime this weekend and I hope you can join me soon :confused_smile:

Contact Customer Care line and they will tell you who does the surgeries in your area. Kaiser really does not let you choose and they centralize everyone into one location in your area. Did you try going to www.kp.org? There you can view the available services and doctors in your area and find more information about the bariatric program. My close friend, and she is also a nurse for Kaiser, is using them for her Lap Band and it is a long process. She first had to get some lab work done and an EKG before her doctor would even refer her. While she was waiting on that she did attend the seminar for bariatric surgery with Kaiser, you can attend that without a referral it think and there you will be able to get all the information you need. After all she told me it sounds like she will not be able to have her surgery until next spring with all the classes she needs to attend and the waiting list. I also have Aetna and I went that route for my surgery instead of Kaiser. Good luck, start with the seminar at Kaiser first and write down all of your questions to ask when you are there. Keep me posted please.

I have two insurances, Aetna PPO and Kaiser through my husband and with Kaiser you always have to go through your Primary Care Physician first (except Dermatology and OB/GYN) and get a referral and there is no getting around it. Strap on your seatbelt and be patient because it is a long ride with them.

Jill, ask if Dr. Naim can do your surgery (he is with Top Surgeons) he does it out of West Hills where the Bariatric Surgery Center is and you can view his very impressive resume at Los Angeles LA Weight Loss Bariatric Center Dr. H. Joseph Naim M.D., F.A.C.S. He comes across as a bit snobbish but he really is not, it is how is disposition is preceived. He is actually a very kind person and truly one of the top lap band surgeons in So. Cal...again, read his resume. I am sorry that you are having such great difficulty with them. Their main office is the Bevery Hills office and there you can talk with Andrea or Ara and tell them I told you to call. Explain your apprehensions and I promise they will take care of the situation and make it right.

Alliemorris73....that is so funny I almost fell off my chair! Fruit flavored feet, yuck! I ordered the Orange-Pineapple-Banana flavor via BodyBuilder.com and hopefully I will like it.

I am online shopping for Isopure and I was wondering which ones are the best flavors and which ones to avoid....tell me your favorites???

Am I correct to say that you are with Top Surgeons? I have Dr. Naim and I have had other surgeries done at their West Hills office and they are awesome! It is worth the drive as I drive from Corona to their Beverly Hills office for all of my appointments then West Hills for surgery. I had my septoplasty and rhinoplasty (nose job) done there.

I'm up for Vegas, I can drive there in under 4 hours!

I fell off the list for July 17th, how can I be added again?

Welcome, I too am from California and there are some great doctors out here. Good luck :cool:

There are some ethical red flags here...you were already in the program and now they are charging you a $300 fee that they "just started this week"? You entered their program on a specific date under the terms at that time, they cannot come back later and charge you another fee that was not disclosed at the time of admission to the program. I would talk with the office manager and put your grievance in writing and if they are a preferred provider with your insurance then also contact your insurance and file a complaint as well for the charge. Let the office know that you will be contacting the State Insurance Commission as well as the State Medical Licensing to report it.

UCLA is great, I did my clinical for my practitioners there. I do not know much about their Gastric Program but do remembe that it is a teaching University Medical so they will probably have you do through many meetings and appointments but maybe they can work around it since you are so far away. BTW, who is your insurance carrier?

Where are you having your surgery? Wow, the 9th is soooooo close. I am having my pre-op on the 10th and surgery on the 11th. I originally went to Dr. Naim/Dr. Omidi's office in Beverly Hills for a Lap Band seminar and while fighting with my insurance company with two appeals I had a MAJOR nose reconstruction done with Dr. Omidi. As you can see by my photo, it was quite a large nose...now it is small and in proportion with my face...lol! They are very kind there and I am sorry you could not join me. I am sure you found a great surgeon as there are so many here in Southern California, it is very hard to choose.

Hello July! My name is Dawn (age 39) and I live in Southern California with my wonderful husband and three daughters ages 3, 6, and 11. I am a stay at home mom but used to be a Nurse Practitioner until a few years ago, when my youngest starts kindergarten then I will return to work a few days a week. I was alway thin (stayed between 125 and 132) most of my adult life until my second child came along, now I am 222 lbs and I am disappointed in myself but I am about to change that. My surgery is scheduled for July 17th and I am very excited...not nervous at all. I guess when you hit rock bottom and come to accept that you are fat and need help then you grasp at one true hope and go with it. I know this is best for me and I cannot wait for the wild ride! My inspiration is to eventually be able to... 1. Do my own French Pedicure again 2. Be able to shave "down there" without feeling like Helen Keller 3. To play competitive softball again and actually be able to hold my own I hope you all become Losers...of many pound and we are all here together in this so be kind.

Click on the thread below, this is Aetna's Gastric guidelines for surgery. Trust me, I went through two appeals and they do not deviate from this list. Again, I went to a Dr. office that prescribed pills and tracked my weight (documented) and when it came time for me to apply for my lap band he also wrote a letter that I received nutritional counseling and exercise guidelines and it worked. My denial was due to a completely separate issue and I had it over turned. Click here Obesity Surgery

I have Aetna PPO Choice and I noticed that most doctors that are actually in the network do not show up in Aetna's Directory. Have you called Aetna and asked them for a bariatric surgeon in your area? If they do not have one within a reasonable distance they have what is called rual service providers where they will pay for an out of network surgeon at an in network price. They also will reimburse you for medical related travel expenses if you need to go far for treatment. Call them and ask. As for the weight loss pills. Aetna requires 6 months of a Doctor supervised diet within the last two years. I was going to a weight loss clinic for over a year that was pills, herbal suppliments etc. and a doctor oversaw the clinic so it counted. Just be sure that you get copies of your patient log that shows you weight loss history and they will take it along with a statement from the doctor that you were educated on better eating habits and exercise...that is all they need. Aetna can take less than a week to approve however, mine took 6 month due to two appeals but I won last month and my surgery is this month so good luck and contact me if you need any further assistance. I know Aetna inside and out.

I learned that if I have two windows open online that this happens to me, I do not know why...it just does. When you are on this site, close any other sites you may have open (do not minimze, close them).

I am an Orange County Transplant now living in South Corona. I lived in Riverside in the late 80's while I attended college at UCRiverside. Where are you in Riverside?

If your insurance is requiring the 6 month weight loss then if you go below their guidelines for BMI then you will not qualify for the Lapband. The 6 month diet is not to prepar for surgery but to prove that you are not able to persistantly maintain a healthy weight. That is why I had to go through 6 months with two appeals with Aetna. During my diet my BMI dropped to 34.8 (1 lbs below) for only 5 days and they tried to disqualify me for that. In the end I prevailed due to it was only .20 that I went below and not a full point. Just be careful and only lose a "few pounds", do not go below their guidelines.

I need to laugh about the chocolate cake, I was at costco last weekend and passed by the cheesecake...we all know how great Costco Cheesecake is...lol. I ALMOST bought it but I am really watching my cholesterol for two years now and that would have caused me a triple bypass! Jackie, thank you for the kind words and you will be a good support system for your husband as you look fantastic!

OK, so I have Aetna and I have Dr. Naim with Top Surgeons, Inc and neither require a pre-diet, I just cannot eat within 12 hours of my surgery. I am curious if any of your are just eating what you want from now until your surgery date or are you waiting until that Last Supper...you know...the one where you starve yourself all day and then gorge yourself on your favorite food or restaurant? My thought was me and my husband (he can eat what ever he wants and NEVER gain a pound) would go to my favorite sushi place and eat until it hurts and I am going to have one of every sushimi on the menu and drink soda all evening...lol! I will never be able to do that again so why not and I have actually lost 16 lbs. since February while waiting for my insurance appeals to go through so I have a few to spare for one evening of hedonism:thumbup:

OMG Grace! You have lost over 100 lbs in one year!!! That is my goal...I have 97 lbs to lose and I was hoping it would take a year and half but with hard work maybe I can do it in one:biggrin:

Yes, I go two very unkind private message accusing me of influencing others not to be motivated and others will want to not stick to their pre-op diets. I was called "inconsiderate" and "...not being part of the community..." some of us have doctors that want them to use a diet before their surgery and other surgeons do not require it...mine does not want me to go on one...sorry it that offends some. It is just a celebration/kick off to what is about to be a wild ride. It has also been something that my husband and I have done for years. About once every three months we leave the kids behind for the evening and go to our favorite restaurant for sushi. We sit at the sushi bar and eat, drink and talk for over 3 hours. We can still do that however I will be very limited to WHAT I can eat (yellow fin tuna and salmon are soft and mushy enough and I am sure two will fill me up) and HOW MUCH so I will no longer eat over 7 varieties over a 3 hour period. It is a social thing that we have done since we started dating 10 years ago and we also do this with friends. It is more of a sentimental event that we enjoy and it will never be as I know it again, very different from here on. I know many are doing it here as some poster do not have a pre op diet as well, I just wanted to know what they were doing but if this is going to upset others then I withdraw my question.

I have not been eating terrible at all, have gone from 338 to 222 lbs since the last week in February (15 weeks) and I have always eaten healthy, my problem is I eat very late in the evening and I eat very large portions at that time. As for the sushi thing, most of the people that I know can no longer do sushi with the band, they say it gets stuck due to texture and moisture and it cannot be chewed well. Keep in mind that I eat real sushi, not the rolls...no rice with it...just uncooked fish with some fresh ginger and wasabi. It is my celebration night and my final time that I will be able to do this and I see nothing wrong with it, especially if it is just one night out of 180 days that I have been eating right since I had my wls seminar. It is my reward for doing so well and my kick off to a new life after sugery. Sorry if I have upset some as I got some very unkind emails...wow people, relax!

I too had two appeals and won my case in late June, my surgery is July 17th. May I ask their reasons for initially denying you?