PSJ71

Hi All, Well, I went to my second seminar tonight with a new doctor and I have to say this new doc is wonderful! I know he's definitely the one I want to do my surgery, if I get to have it. Well, I had contact my insurance company in July to see if they cover everything. Of course they do. I have Blue Shield of CA. They also told me about covering the psych eval, nutritionist everything. However, the lady who handles insurance at this doctor's office told me that I would have to go on a 6-month supervised diet....My insurance never mentioned that and I have been trying to look up information on it and I don't see anything to that effect. I see they want a diet history. I have been heavy my whole life. I have tried many diets. Just this year I started WW in February and stopped in May and had lost 13 pounds. I have pictures of myself as a kid and as an adult showing how heavy I have always been!! I am so frustrated. I really don't want to have to go through this 6-month thing. I'm going to call my insurance myself in the morning and find out if they do require this. I can't find anything in the handbook about it for sure. Anyway, I had to vent and thank you for listening. :thumbup: Paulette

The lady at the doctor's office called my insurance today and found out I was right. I don't have to follow a 6-month supervised diet. I did find my weight watcher's card for this year just in case. But, I am tickled pink I don't have to prolong it with having to do that. :sad: So, for future reference if anyone else has Blue Shield of CA, they will not have to do a 6-month diet.

Ah ha, see. The lady I talked to with my insurance today told me sort of the same thing. She said maybe your doctor wants the 6-month diet done, and I said I don't think so? Because they said that YOU guys said I had to have a 6-month diet. So, she asked me if she could put me on hold and get clarification through the policy. She came back and said she saw nothing in the policy that requires a 6-month supervised diet. So....hmm.... could be the surgeon then? Well, I don't mind the extensive testing at all. I have often wondered if I have sleep apnea and may be this will shed some light on possible other issues I may have. I already know I have hypothyroidism and hypoglycemia and PCOS. But, there could be other things as well. Thank you for your response!! :omg_smile:

Whooohooo, I called the insurance company and talked to Medical Management and they said there is nothing in the policy that says I have to do a 6-month supervised diet!!!! Yipeeeeee :scared2: I am very, very happy. :omg_smile:

I am sure it's not the doctor. She said it was my insurance. So, I just got up, as I work third shift, I am going to make a quick phone call. Then, if they happen to say no, then I will call the lady and tell her. It could be that she deals with so many different kinds of insurance she may have just gotten confused. I will keep my fingers crossed. I really, really like this doc though. Thank you so much for your response :omg_smile:

Thank you both so much for your replies. I am going to check into it further and make sure. I will call them later on this morning and see if they can tell me. Thank you again,

OhGary, Good luck to you!!! I hope everything works out for you and remember....this is a wonderful board and it's always here for you no matter what your decision is. I know I have found it a tremendous help since finding it in July. I wish you the very best!!!

sorry, I kept saying lab band lol Meaning lap band. I do know to type. :biggrin:

OhGary, You would be surprised at how much WW really does help in some ways. I have tried it twice and for some reason, I have problems with staying on diet plans. Had I stayed focused and kept going to the meetings I think I might have managed to stick with it. But, I feel like I need a constant reminder with having the lab band, because for one thing, I HATE to throw up, I'd rather get a beating than to throw up. Secondly, I have actually eaten too much before and had PBing without the band..So needless to say I really feel the lab band will be a good choice for me, because I feel I have a constant reminder NOT to overeat and make bad food choices. But, since you have never dieted, I would highly recommend Weight Watchers. There is A LOT of support there and when you see people who have lost 25 pounds, 50 pounds plus, it really helps when they hand out those little prizes. Try it out and see.

Hey that's a great way to think about it, JB!! Wow!! I really never thought about it like that. My son is a first grader and when I pick him up, I think wow, If I put on this much weight I would hardly be able to walk. But, I never thought about it like that.

Congratulation!!! I am proud for you and I can't wait until I am posting the very same thing! :redface: Going to my second seminar with new doc tonight so hopefully by the end of the year :frown:

Jb, That was the BEST post. You are so right. I KNOW at 37 years old that this weight issue is to much for me. I did lose a significant amount of weight before I had my son only to gain it back plus a whole lot more! I can't wait for the day until I can get my band and start being healthy. I have a 7-year-old whom I adore so much. Even though I am fortunate not to have diabetes, I do have hypoglycemia and PCOS and can tell my joints are suffering a great deal by being this heavy. I am READY for this change. I just had to say that was a very motivating post. Thank you!

Hi Anne, Basically what they look for during a colonoscopy are any types of irregularities in your large intestinal tract, such as polyps, cancer, diverticulosis, ulcers, or if there is any bleeding in there. You are pretty much sedated for the procedure, and I have actually heard the worst part is the preparation you have to do before the procedure, but I am thankful we have such great procedures to detect things these days. However, I have never had to undergo one yet. Hope this helps! :thumbup:

I agree with RestlessMonkey. I want someone who has performed the surgery many times as well and has "seen it all." Yes, there are risks involved with any surgery and any surgeon, but I feel more comfortable going with someone who has the experience.

Hi all, Well, I am going to see another doctor, because something was just telling me something was not right about the doctor I was going to use. Anyway, I have to go this doc's seminar on Tuesday. MOst of the paperwork I will need is on his web site, including the some of the questionnaire for the psych eval. I looked over it and haven't printed it out, but I was alarmed at how much I fell into being depressed. I have wondered about this for a while, but I guess I didn't want to accept it. So, I am afraid if I do this, they will not operate on me if it shows I am depressed. So, if any of you can shed some light, I would be really grateful. I really want to get a lap band really, really badly and would hope this would not hinder it. Thanks bunches!

Thank you so much, Heather. You all are so wonderful. I love this site.

Thank you so much! Bless your heart. It's great to know you have it under control now. I don't feel suicidal, but I just feel sad and irritable and tired most of the time. I do have hypothyroidism and found out just this past February. I was also anemic. So after starting iron and the levothyroxine I started feeling a little better, but I have most of the classic symptoms of it. Wow, amazing what you get used to in some ways. I will answer the questionnaire honestly. I was not going to if it was going to affect having surgery or not. So... this makes me feel so much better.

Marie, Thank you so, so much for the information. I was so scared that it might have an effect on getting the surgery. When I saw some of the questions on there and I saw that I fit A LOT of it, I just didn't know if they go ahead with the surgeries. I just have to have a lap band, because I am just so tired of failing at weight loss attempts and this will be a constant reminder that I can no longer eat the way I have been for most of my life. I'm really excited to get it going. I hope I can have it done before Christmas. We will see how all goes. And thank you so much again for taking the time out to respond and ease my mind.

I have been meaning to ask this and then I forget! But, I have a 6-1/2-year-old son, which means if he gets sick....I get sick...And twice when he has gotten the stomch flu I have gotten it and I usually get it worse than anyone else. Once I had it so bad when I went to the ER I had purple splotches on my face and the veins in my eyeballs were busted. The ER doc looked at my husband and then at me and said, "who has been strangling you." I said, No one. I have been vomiting all night long and dry heaving. So, this is my MAJOR apprehension. I am terrified when I get banded I am going to end up with the stomach flu and end up with a slipped band, because I tell ya, when I get this stuff it's horrible!!!! Thank you

I have been thinking about some things about my insurance and my doctor. I have not gone to my doctor visit yet, but I do know my insurance does cover this type of surgery, but I still have to have an H and P, psych eval and nutrition evaluation. But, what bothers me is I talked to my insurance to find out if they cover the psych eval and the nutrition eval and they said they did. However, I am going to have to pay 200.00 for the psych eval and 200 for the nutrition consult, because apparently the doctors in the surgeons office does not take the insurance? Also, I am going to have to pay for my doctors preop diet supplements and and the postop stuff they want their patients to have. I guess what I am trying to get at here is about how much out-of-pocket money was everyone out for their surgeries? I do know it is going to cost 150 dollars for the preop diet stuff and 200 for the postop diet stuff. I don't even mind paying for this, but I can't figure out if my insurance will pay for the psych eval and nutrition, then why are they sending people to doctors who they have to pay that much up front? Even the insurance lady told me 200 was sort of high for those. What do you guys think? I really want to have this done as soon as possible, but with all the extra stuff I don't know when it will be. I was supposed to have gone to the history and physical appointment yesterday, but had to cancel because I couldn't do the evals next week.

Hi Emilie, Thank you very much for that info. I will call them Monday and find out if they will do this. I have a feeling though, that they will probably tell me that I will have to use their doctors, but it's worth a shot and I will definitely see what I can get done. Thank you again for that information

Hi All, I haven't been to the board in a couple of weeks because much has happened. On August 2nd my mom passed away and I'm still having a hard time with it. She has been ill for quite a while with COPD/Emphysema, but she was my best friend and I have no idea how I am going to get on without her. I am saddened because I wanted to have this done and to have lost a lot of weight before anything happened to her. I do have some good news I think, though. I am going in for my H&P consultation with the surgeon on the 22nd. I am supposed to go for the psych evaluation and the nutrition consultation on the 26th, but I don't know if I am going to be able to go to that one because I don't have the money up front to pay for that. I find myself getting the jitters here and there, but I know I have to do this to keep myself on track with any type of diet. I have also become a vegetarian and it's been 33 days since I have eaten any meat and don't miss it. I am worried I am not getting enough Protein though. Anyway, I'm sorry for rambling and I've missed you all. I'm just looking forward to getting everything done.

Hi! Yes, actually this is a normal process that happens when you do low carb and high Protein diets. When your body goes into ketosis this is released in the breath, thus the bad smell to the breath. This is good though! At least you know your body is burning the fat it needs. Having stinky breath is an unpleasant side effect though. You could try rinsing your mouth with Water frequently and see if keeping your mouth moist helps. Good luck to you!

Hi Angela, I do the very same thing. I have to wait about 2 weeks to find out if my insurance will approve me or not. We all get nervous about having to do something so drastic. Surgery is a very scary thing and then the thought of eating one way one day and then waking up the next and having to totally change everything. YES!!! It is very daunting. However, we all know, or at least I do, that I cannot do this alone anymore. Strangely, I have always been an advocate of diet and exercise getting you the results you want, because I lost a lot of weight in 2000 before getting pregnant and now I am over 100 pounds larger than I was then, BUT, if you have an addiction to food, such as I, then sometimes we need a little extra help. This IS okay. I think the hardest thing for me and what I am most anxious about is the fact that I will no longer be able to eat AND drink at the same time. I am the type of person who either has to have tea or Water when eating, and believe it or not this is what I am nervous about. :thumbup: I am so ready to make changes though and FINALLY be thin. I have NEVER been thin from the age of 6 up I have had a weight problem and was always told, "You are so pretty, imagine how you would look if you lost all your weight." And now, it's not even about being sexy or attractive anymore. It's knowing that after I do this, I will be around to see my 6-year-old grow up and know that he will never be ashamed of me for being the biggest mom or have to defend me if his friends say something about how big his mom is. And knowing that I will be healthy. lol sorry for getting off topic, but I guess I just wanted to say, you are perfectly normal for having these thoughts and for being nervous. Just remember there are so many that have had and will have this procedure and we are all here for one another. :crying: Good luck to you!

Congratulations on taking the plunge! I can't wait until I can get an actual surgery date. I am so ready to get this going. I think it's great you and your husband are doing this together. This will provide so much support for you both. Nothing like team work! My husband is very supportive. Keep us posted on how things go! :biggrin2: