Shauna80

So I talked to my ins company yesterday, to find out the specifics on my requirements. I have been gaining weight for 6 years, but I found out that I have to have a BMI of 35% or more for 3 years. I am not sure if I have. I went from 140 to 218 in 6 years, and 3 years ago I was 196. I have not been below 196, but I am not sure if my BMI was 35% at that weight. Did anyone else have this problem?

The lap band has only been around for 5-6 years in the US. They have been doing it in other countries for over 10 years. There is not enough data to give long term effects if there is any. Especially here in the US, since its only been approved for 5-6 years. I would try and find someone on here from another country who has had it longer than someone in the US.

I started gaining weight 6-7 years ago due to PCOS. I was 140, muscular, healthy and loving life...and its become harder and harder for me to remember those days...Now I'm 28 and 215 and literally have tried EVERYTHING like everyone else to lose weight, and all I've done is gain! I am in the process of getting approval for banding, but I find myself laying in bed thinking "why is this time going to be any different than every other time I've tried to lose weight." So I am finding myself feeling really sad and down, and I am hoping to get some encouragement, and some hope. I just feel really alone....

I am researching getting the lap band, and I currently work in the ER at a local hospital...I have seen patients come in with serious problems with the band and gastric bypasses. I am curious what serious complications have happened to you or people you know? How often do these complications occur? I really want this, but I know there are risks with every kind of surgery, and when something foreign is put into your body. I'm just trying to look at all avenues. I am really afraid of going through this and fighting the same struggles I'm going through now. Thanks

Thank you so much for answering! You are the first person I've talked to that is my same boat. Did you workout, or how did you lose so fast? I am also giving myself 1 year to lose 80+ pounds....I am hoping to get pregnant next year, and thats my motivation! Good luck with you journey, and congrats on your success.:wink_smile: Shauna

I know how frustrated you are. I haven't been banded yet, but your struggles are what I've been going through these past years. Your initial weight loss is expected from what I hear, but the fact that your going to the gym, and working as hard as your are is helping in a lot more ways than weight loss. But on the other hand...whats probably happening is when you work out with cardio and weights, your body is building muscle and burning fat. I bet if you take your measurements, you will see a reduction in inches. The one thing you have to remember, is you have to fuel your body properly with the 40-30-30% of carbs to fats to Protein every meal 4 times a day. If you dont fuel your body your body will store and you will not lose. You will also hit plateaus and will need to change up your routine every 4-6 weeks. Also check with you DR. you may need more restriction. Hope this helps Shauna

I'm not too sure. This may be something or a stipulation that BCBS Illinois has. Things are so different state to state. I have BCBS/GA and I dont have to do a diet, and they cover 100% as long as its medically necessary and I meet the requirements. I do know that if you dont follow the guidelines, they may not cover you. So that may explain why people dont have the surgery because they missed a few months and didnt follow the guidelines. I hope you get approved, and I would recommend calling the insurance company, and talking to them. they may be able to explain things based on your coverage. Sorry I couldnt be more help.

Hey Iwalktheline, That is very true. Even though BCBS doesn't require you to have a supervised 6 month diet before surgery, the group provider ( your employer) states they are requiring it, so BCBS is following your employers guidelines. BCBS is just the insurance provider, and your employer sets the parameters for what is going to be covered and their stipulations for the coverage. I hope this helps.

I agree with Luluc....I think you should go to the wedding, then find another surgeon that is willing to do the surgery earlier than a year. Your health is more important, so I would start calling now to see if there is another surgeon your comfortable with. Good Luck!

I've seen people come in with there stomachs swollen shut from a small stomach bug...they were in the hospital for 3-4 days because of dehydration. I recently saw a woman with a perforated bowel from a gastric bypass...they nicked her bowel during the resection. I've seem bands slip off, and patients being in pain. There is a lot that can go wrong, but I've also been hearing that this is not suppose to be forever...my doc tells me otherwise. Thank you for all your posts...it great to hear the good and bad!:eek:

Hello Sndtee, Congrats on the weight loss! This is a great place if you have any questions. I am not banded yet, but I am so excited to have it done, and experience what everyone is talking about! Good luck on your journey!

I'm just getting started, and I hope to be able to have surgery in September. I plan on making my appts as soon as possible...and getting everything done ASAP...I was wondering how long it's taken on avg to get their approval? My doc told me it can take 3-6months...Way too long for me to wait!

I have thought of this very question...I am a woman, and next summer when I'm wearing a 2 piece people will see the scars....I plan on keeping this hush hush as well, so I have been thinking of what to say....You can always use the excuse they're from exploratory surgery done, or caused by and accident of some sort...These are people who you are not close with, so who cares what they think....tell them anything to satisfy there nosy needs.

The decision to do this is yours to make, but you have a lot on your plate with moving. You have other options to getting the lap band that are a lot cheaper. Have you looked at going to Mexico? The cost is only about $8k, and there is Dr. Ortiz who is Tijuana MX who was one of the pioneers in the lap band procedure, and has done over 8k of them. I too have PCOS and you sound like me... .I weight 215 and am 5'4...I do have one child, but my doctor told me that I have to wait 10 months to a year to have another baby...I dont know why they told you 2... I have about 85 pounds to lose and the doctor thinks I should have it off within 10 months at the latest. I know personally that this is my last option, and without it I will have long term health problems within 5 years. If money is the problem, look at going somewhere else that is cheaper. My doctor only charges $14,500, and he is one of the best in Atlanta. You and your hubby should sit down and prioritize whats important to you....we also have a lot of financial things we are working out, but this is my health we are talking about, and me being around for a long time healthy means more to the both of us. Good luck, and if you need anything else please contact me anytime. :biggrin:

I was wondering if anyone has had surgery in Mexico with Dr. Ortiz in Tijuana, and used their insurance. How does the insurance work with fills back in the states? Are they covered? thank for any info

I have a question about eating properly and the correct amounts of food to fuel your body to intense workouts. I know if I dont have a balanced meal of carbs to Proteins to fat before my workout I hit lactic thrush, or my glycogen bottoms out and I get severely sick and light headed. When you have the lap band, you can't eat enough food before a workout so your fueled properly, how do you get around this? I used to compete in fitness competitions and I plan on doing my 1st on in 6 years next year...I am scared that I won't be able to eat properly or enough food to sustain my workouts. Any advise?? Thanks

I know its a huge life change...thats what I am looking forward to! I haven't been overweight my whole life, just the last 6 years. Its been due to having PCOS and insulin resistance, but I didn't know I had it for the first 4 years....and have spent the last 2 years doing everything! I am ready to have my old self back. I have the reverse image of a bigger person. I think I'm smaller than what I am. My self image doesn't match my body image. I know what my body can look like muscular, fit and in great shape...I plan to be there sooner than later! thanks for the advise. I just hope it doesnt take that long.

Girl, I am feeling the same way you do! I have only 80-85 pounds, but I am not fully comfortable telling people about my decision to do this. I feel this is a personal thing, and its really no one elses business! I may feel different when I have it done, but at this point only a handful of people know about this. I am not sure if I am going to be able to hide it, but I will only tell the people I am comfortable telling....I will let the others whisper and envy:thumbup:

I have a question for you....Is your stomach hard, with pain at times? I am asking this because normally your stomach is not going to be "pregnancy hard" unless you have some sort of fibroid, or something else going on. If your muscular that is one thing, but I am not sure what you mean by "real real hard". I do agree with the comment before mine, about genetics, age and how much weight you have to lose. Good luck!

From what I understand is that almost all BCBS requirements are pretty much the same with the gastric surgeries...I have a BMI of 37% and I have 2 co-morbidity issues and I was approved...but the other requirements are >40% BMI or 100 pounds overweight, but you can't have weight gain due to a metabolic condition. When i talked to them, and the doctors, they told me if you have a BMI of over 35% and no other issues besides being overweight, then its not medically necessary to get any gastric surgery. But if your BMI is higher than 35% you probably have something else going on. I would get a full health screen by your PCP and you may find tryglyceride problems, blood pressure, cholesterol....It can't hurt. Good Luck!

I too have clinically high blood pressure, weight gain, and Insulin Resistance. My main reason for doing this is because I had post partum Congesitve Heart Failure at 25. I was in 1% of pregnancies this happens to,and I run huge risk of have heart problem later in life,and with my next pregnancy....but next time it may not correct itself. My heart is fine and normal now, but in may be permenant damage next time if I get pregnant and have all this extra weight. I am ready for a change, and ready to feel normal again!

Hello, I am getting banded in about a month...I am in a full time program for school, and I go 4 days a week, and only have 3 months left and CAN NOT miss any school. I scheduled my procedure on a Wednesday, so that way I only miss one school day. I plan to go back that following Monday. I do sit for about 2 hours at a time, with a 5 min break in the middle, but my day at school is only 5 hours with an hour lunch. Do you think giving myself 4 full days of rest will be enough for me to return to school? If I do, what kind of pain will I experience, if any? Thanks

Thank you for all your information! I have had a laparoscopy before for endometriosis and PCOS so the gas thing I am well aware of...I was painful and sucked! I think I will be okay, but I was curious on what other people did and the outcome. So thank you for your advise!:thumbup: