MiniBand

Well I survived. :lunch: I am doing pretty well considering everything. Actually today I am going to take a bus trip across to see a launch. I have been walking everyday to help get that gas out and sleeping in my lazyboy sofa. Not too bad really... just one TMI thing the liquid post op diet is wreaking havoc on my digestive system as it was before the surgery... ugh. Hoping imodium I started today will kick in. BUt overall... just the distention of my tummy and the betadine still on the skin where the tape is, itchy incisions, no complaints. I figured out since starting this journey I am now down 34 lbs. If you had asked me on Sunday and MOnday, I kept wishing they could just rip the darn thing out of me. I haven't told anyone at work or even my family except my husband. So hoping everyone is doing as well. I'll check back in. Sorry it took me so long but my computer crashed and I didn't find my password right away. Take care! M

Hey thought I would like join you all. I was just banded on Friday the 13th. So far so good. I started out around 37.5 BMI but have high lipids and diabetes and borderline blood pressure issues. Since pre-op I started out at 189 lbs or thereabout, highest was around 195 this past year. Although at one time in my life I was over 200 managed to keep away from that. Anyways, didn't think I would qualify for the surgery, got denied. Went through obesitylaw.com and then was approved but said my insurance changed 1st of the year... well to make that stupid story short... due to the ambiguity of the wording of my policy, obesitylaw.com got my denial reversed and hence I was able to be banded on Friday the 13th. During this time, I really thought I wasn't going to get it so I started taking the Optifast (got some from a friend) and doing boot camp on my own and whittled my weight down since Dec to 169. I lost 7 more lbs on pre-op to 162 and now 5 days after surgery down 7 more I am 155. My heighth is 4'11. Even more thrilling is the fact I went off my diabetic meds. Now if this darn liquid diet doesn't kill my colon, I'll be a happy camper. I am feeling fairly fine after my surgery. So that's my story. Hope to see you all later! M

Oh wow, what is the name brand of that scale, I am curious? Might have to get one of those.

I am cleared for takeoff... sooooo. fasten your seatbelts... (and now without an extension)

I am putting this out there because I am getting ready for pre-op and need to motivate myself: Going to audition and dreading dancing because I'll jiggle Thinking that they won't cast me because of my size Self doubt and Self conscious Sneaking food in the car so no one can watch me eat sticking myself with needles for diabetes meds My neck waddle People telling me I lost weight but I still look fat in the face... yes someone did say this to me recently and I have lost 20 lbs going into this. I just want people to say well nothing. Being depressed about going on a cruise because I am fat and not having choices for clothes. You all mentioned Lane Bryant, I like their clothes but not their prices. I won't miss Avenue or Torrid though... LOL

I was having the upset stomach thing... try increasing your fiber... well ok what I mean is call your Dr. and see if you can add benefiber to your pre-op diet or not. I start on Friday! I have to go get my optifast today. I was cleared yesterday.

I am also in SW Fl... more or less :frown: I am gonna be banded on March 13.

Ditto for me! How coincidental. I think we also have a group discussion going on in the groups section. I am in, I am in!!!! WOO HOO!

Yes I went to them after the first denial. They were very helpful for me, and I was able to get mine covered through a program so I didn't have to pay. Let me say this is not a quick process and you won't always like the answers you get back. In the end what happened was my denial was reversed however then the insurance co. said no longer covered as of the first of the year. Obesitylaw through persistence and getting in touch with the right people was able to find out that this was not the case. I would have given up on my own. In fact at times I was resigned that it wasn't going to happen. Not only did they help me but the specialist with my insurance was looking at other denials based on the wording in the insurance coverage so it is possible that my victory helped others. I can only say, if not for Obesitylaw.com this would not have happened for me. I am scheduled for the middle of March for my surgery. Best of luck in your journey! M

Yes absolutely have every Dr. you visit document a positive endorsement. Another thing keep a log yourself of your food intake, your exercise and symptoms that go along with your co-morbities.

I think my surgery date is going to be in March. I have to find out from my lead when it would be best. I have been waiting for this for a really long time. I hope I get to be a March Melter! M

Honestly we couldn't say what the odds are. Some people go through without any problems and others like me get denied. It's really hard to say. Also it is going to depend on what is in your company's plan, so even if someone had the same insurance plan it may differ. I have not seen a lot of posts about Highmark. I used to have them and for many things, my plan was covered more than the BCBS I have now. I chock that up to my employer though. My best advice is think of every question about the surgery and the lapband that you have and write them down. *My* suggestions: Document everything and advise people on how to document your visits. Your PCP needs to be detailed in that you cover things like your weight, your behavior modifications, your exercise, your diet, etc. Those things need to be in every visit you make. You need to keep some kind of a journal yourself. I started using fitday. Get letters of support from people like trainers, therapists, every Dr. who has looked at you. Any written back up you can get helps. I didn't realize how poorly my documentation was until I was denied, and now I am waiting for the appeal letter to go out any day from obesitylaw.com. We'll see what happens. Since you are starting out, read everything you can, write your questions down, start making behavior modifications, and journal. Good luck. Also you can try and see what others have gone through with your insurance by typing in Highmark to the search box.

You really need to see what the requirements are. You are right on the BMI requirement point (with no co-morbs) so if you actually put some jeans and coins in your pocket when you get weighed it might help. Call them up and see if there's specific details they can give you. M

Check out the resources like how to write the letter, etc. at obesitylaw.com They have some ideas for the best chance at getting your surgery approved. The Library of The Obesity Law & Advocacy Center Take care! M

This article is worth a look to help you get the approval the first time: http://www.obesitylaw.com/images/content/pdfs/Maximizing_Article.pdf What I had to do was fill out this really long packet of info and then go to the Dr. and have them weigh me. Unfortunately most PCP aren't clued in about what to put for notes for this kind of surgery. I was supposed to go for 6 months. Well then I was denied. I wish I had read the article above. You may not have all these requirements but your Dr. office once they get the packet may be able to help more. Hopefully someone with the same kind of ins. will chime in. I have PPO but I thought I would at least reply with that article. Good luck! M

I am in the appeal phase of my journey as my insurance denied me the first time. I am waiting for assistance from Obesitylaw and so I won't know for another week or two when my appeal goes in. Once I potentially have an approval, I am wondering how long is it before I can have surgery? I know I will be going to do the 2 week liver shrink... so that's two weeks, but I thought perhaps I had to have other tests before I can schedule the surgery. How long from approval to table did it take you?

Thanks everyone! I did tell them I figured the middle of Jan because the letter won't go out until Nov 30 and gosh knows how long ins. can drag the decision for the approval. I also have been planning my life around this. I have been putting off things thinking I'll be prepping or having the surgery for months now... I decided to try out for singing in a show and I got a big part and so the show is going to be done in the middle of Jan. I mean I could potentially be approved sooner, etc. I just am so tired of putting my life on hold and missing out on fabulous opportunities. A month to be in the show isn't going to hurt me. I guess my way of thinking is I have been waiting on the surgery... now the surgery can wait on me. :thumbup: :thumbup:

Hi Welcome. I am just in the waiting stage of my process for the insurance and whether I have overturned my denial. I wish you all the best in your journey.

There's several things you can do. You can call for a more detailed reason, why you were denied. Sometimes they aren't specific enough why you were denied. I didn't get much information when I was denied. Basically they wanted MORE information. They said I didn't prove this is medically necessary for me to have this surgery. I contacted obesity law and hoped they could help me. I gave them a lot more information too. I am waiting for my appeal letter now. Good luck. Your doctor's office may know how to help you best. My Dr.'s office wants nothing to do with the appeal process so I was lost. You best bet is to rethink what you submitted in the first place. Did you have meal plans, exercise logs, gym membership receipts, did your Dr. document your behavior changes and your weight. These are very important. M

I am all ears for the protein drink as well. Welcome to the website. I haven't been banded yet but I am hoping to very soon get my request appealed. I don't know the answer to your question but I hope someone will be more clued in than me. I just wanted to say hi and welcome. Lots of really nice people here.

I just went in them. They have changed since the last time I went in there. It was highly customizable the last time I went in which was about 3 weeks ago. I went on vacation and just getting back into the swing of things but the rooms work... definitely different than they were before.

Congrats. It is good to see some people getting approved. I am waiting for my appeal from Obestiylaw.com to go in. You'll probably start the pre-op diet soon.

If there's an emergency it might be helpful to have this information. Maybe get another Dr. to ask like your PCP or something. OR here's another thing, get copies of your office visits, it should have the information in there.

I am just waiting for approval but at first I was really upset about all this stuff (waiting and waiting at the mercy of the "morons") and then I got denied. I decided not fret about it and just keep making positive life changes. This is working. I am exercising more and watching what I eat and to be honest I am feeling better than I ever have. Once I let go, it all seemed to kind of make sense. I do know what it is like to want to something so badly and it not happen. It nearly drove me mad. Don't do this to yourself. Keep making positive changes. Remember the band is a tool, and right now you have other tools to work with. I am going through the appeal process and I am not obsessing too much about that and things are falling into place for me. Just keep as much faith as you can and hopefully you'll have some peace. Hugs, M

I was also denied but I am trying to get help with my appeal through an advocacy program I read about on here. Obesitylaw.com So far they are looking at my stuff. I was denied because I didn't show enough proof of multidisciplinary approach. I tried but my Dr. notes are not very descriptive and the behavior modification was done with a registered dietitiandiabetes educator that is available to us at work. I am hoping that it will be before the end of the year! Everyone keep their chin up ok!!!!