YngGram

I wish your husband was with you on this but men can be a fragial group. I am sill in the very early stages of getting this done. My blood pressure is high, BMI at 44, foot and kneen pain and I am tired of shopping for whatever looks only OK, rather than what I want or is in style. My husband of 31 years is not giving me much info on how he feels about it. I had breast cancer in 2002 and he had a very hard time with it. He was very supportive in that and I found out later how badly frightened he had been trough the process. I think that now his concerns are primarily about me being on the table again. I also think he is a little concerned about the "after effects." I am a very outgoing people person; however there is no doubt in my mind that he will do all the right things at the right time. Talk to him and talk to him and .... He loves you and if you love him as well the the love will take care of everything. Keep your head up. :rolleyes2:

Shop around that seems really high. I think the Realize Band has a support forum that you get access to after the surgery. And of course there are places like this. I have been to 3 seminars met with 1 doc, have an appointment on Mon. with the group I think I will use. The first two tried to push a 6 month structed weight program at me for about $400 telling me my insurance required it. NOT!!! It took a lot of emails and phone calls but I finally found out from TriCare that it was not a requirement from them. These two groups had program fees at $400 & $450. Nutrion eval at about $80, nutrion classes $200 for first and another $100 for the second. One even required you do Optifast for 2 weeks to the tune of $300. Neither of these surgical groups talked much about post care. Fills and any visits would be billed. So really shop around. Someone here told me about the guy I will see on Mon. they have no program fees and listed the insurance requirements for several companies in the packet they handed out at the seminar.:thumbup:

31 years experience tells me you were WRONG!!! He has the same right to like as you do to not like it. He is not pushing it on you, and the ti hing with your daughter could have happened to anyone. A son could have just as easily asked about the tampons he found under your sink when he was bored. You married a man not a priest, would you rather he check out the girls on stroll? Then there is the big thing of privacy, I want mine respected and I bet you do to. Got a dairy he hasn't read? I understand because I don't like porn either, so my husband will sometimes order something on TV and I get the befits. Now that you have breeched what I consider a trust issue; step up and tell him. Talk it out, let him know you were wrong, yes I said tell him that. Then let him know that if he must he should be very careful about it. Who knows, it might not have been his but the buddy that got a ride with him.

I had the reduction and lift but only on one, cancer got the other. Sensenation is fine, but....they grow back!!! Yep, it's been about 5 years and noticed last week that it is larger than the reconstructed one. A friend had told me hers grew back but I thought naaaaaaa. Well I was wrong. Since I am working on getting a lapband, I will deal with the girlz later.

Plans have changed AGAIN! Before this is over everyone will be convinced that I am a head case. Hope my eval proves otherwise, that is set for Thurs. After not liking the way things went with the staff at Fredericksburg office I went to the seminar for Bluepoint out of Potomac. Had issues with them as well. There they told me my insurance required that I do a six month structured weight management program, but my insurance would not cover it. When I tried to get an understanding of what was needed, they told me I could do it through them to the tune of about $300, this is added to the program fee of $425 and another $300 if I needed to do the Optifast for 2 weeks. I didn't want to drive that far, so I wanted to know what I could do here and still meet requirement. They didn't;t want to tell me about other options. I then pressed the insurance company and found out that they don't require this, the Dr. does. Insurance is looking at the BMI of 44, my high blood pressure and some other tings. So I am now set for an appointment in Richmond next Mon. Richmond Surgical Group doesn't charge a "program fee" or fees for nutritional class. They provided information at the seminar for the requirements of several insurance companies...mine is listed...no weight management program! I have my psych eval Thurs., my blood work will also be done that day. I recently had an EKG with my PCP as well as a chest X-Ray and in a few hours I will be taking a stress test. My PCP has my release form and is putting together the info surgeon requested. With any luck I could be doing my surgery some time in Dec.:laugh:

I could add to this a bunch of stuff along those lines but I will got to the place that has haunted me for years, THE GYM!!!! Last week I am in there struggling as a beginner, just trying to make it through the warm-up on the bike when behind me.. "Oh my God, I don't know what happened to me, I'm up to 98lbs." Of course she is on some machine next to another "skinny" working like they trying to get to God. This is the stuff that has keep me out of the gym, no matter what promises I have made to myself. I always managed to be there when the crazy people are there; sweating and panting and of course talking about how fat they are when I can take them and fold em into my gym bag!! I now live in a rual area with a new YMCA and it's not busy around 10 in the morning so I can usually avoid the "skinny crazies"!

Did anyone's Dr. require them to stop smoking in order to have surgery done?

I thought about this and when I finished the pack on last Sunday, I didn't buy more. It's really not that hard, when I have been ill or driving for hours with a non-smoker I don't smoke and am OK. I am a stress, and oh my hands have nothing to do smoker. I play pool league 5 nights a week and that will be hard to get used to. When my shots are off I reach for a smoke to clam my nerves!! :smile2: I went to another seminar on Monday and have first appointment on the Th, hopefully I will be able to say that I have already stopped smoking and by the time all the paperwork is processed I will be at least couple of months free:teeth_smile:

I just got this from the insurance coordinator at a surgeons office: The criteria requirements are as follows: 1. a 6 month structured weight loss program 2. Lab results from: Hpylori, TSH level 3. Pulmonary clearance 4. Cardiac clearance 5. Psychological evaluation 6. Nutritional evaluation My question finally was answered and I am very disappointed to know that I have so much time in front of me before I can hope for surgery.:smile:

Hi All:wink_smile: I choose to fight the no real answer game and below are the results. It Updates what I posted last week. Marla, I have communicated with the insurance company from the customer service, to Medical Management to the Policy Divison TMA West a Mr. Bob Bassey. I have been assured that TriCare DOES NOT REQUIRE A STRUCTURED WEIGHT LOSS PROGRAM! This seems to be from the surgeron, Ruth has given me some info that should meet the requirement, but I will not use your service for that. Once I am into my program I will follow up on the next steps for surgery with your office. I do wish you and the team had been more honest about who was making the requirement. Jardenia Their Response: Because of your (and other Tricare Standard patients)concerns about criteria requirements for Tricare Standard, I've called and spoken with our Healthnet representative. After a lengthy conversation she states there has been a re-review, and although they recommend the 6 month WL program, clearances etc. we(Dr. Halmi) are no longer required to make our patients comply. If they (Tricare Standard patients) so choose they may proceed as desired with the minimum of having a BMI of 40 with the knowledge that medical necessity is determined at the time the claim is review. We can schedule your surgery at any time, providing that you are willing to sign a waiver that states you are aware there is no pre-certification process and may/may not be responsible for your bill. At no time are we dishonest with our patients as that is certainly not good business practice. :biggrin: I LOVE TO WIN!!!!!

I had to get real into this and finally spoke with a man in the Policy Division of TriCare. He says that they don't require the 6 month thing! Now I know it's the surgeron who is trying to get me to shell out $300 to his office. I think I have found an office that doesn't have this and none of the "extras" for nutrienal classes or Opitfast for pre surgery at another 300.

I really need to talk to you. Can you call me at 775-5033 till 6 or 540 207-3098 after. I am having some issues and am about in tears!!!

No, they didn't and I called them again. I didn't like the way she talked to me so I researched and talked with another office in Potomas. I went to their seminar and I think I will go with them.

I am in the north region, where are you. I spoke with two surgeons offices and both told me the same. One was nice enough to pass it on to the insurance coordinator who emailed me the info that I pasted into my post.

GREAT JOB!!! Give her the sista snap and don't worry about how she feels about herself, stay strong. I am just about to start this, still calling surgeons, but you be out there when I need you. Jardenia

Am I the only nut stuck in VA trying to deal with a surgeons office that is telling me 6 months of supervised weight loss? I am at 240 5'2" I think the BMI is 43. Office says from that standpoint I'm good but need proof of the 6 months. I tried a program 23 years ago! Who keeps stuff that long? TriCare tells me it's not listed as a requirement but of course it is case by case. The surgeons nurse or whoever that called me today was very adimit about that requirement stating she deals with these people all the time and I just wasn't talking to the people she deals with.

Will Tri Care require you to have been a 6 month supervised weight loss program?

I went in for the required seminar, filled out and faxed back information pack as requested. Some of the test that will be required had been ordered by other doctors for some of the medical issues I was having. I had results sent to the surgeons office, I thought it might help smooth things, I also contacted my insurance as suggested. It's been over there weeks so I called and was told that the person who handled that was out and would call me. I still haven't heard anything. I expected some bumps along the way, but not before I could get started!! This is about my health and the delay in contact is making me nuts! Is this normal?:biggrin:

I had a surgery done at Georgetown and when I had a problem, and it was a big one. It was durning a hurrican late at night and only the "trainees" were working. Boy was it fun trying to get this kid to understand what was happening and for him to make calls and explain it to others. If I don't hear by the end of the week I will contact Richmond.

If they will do anything it will be done at MWH. I have had surgery in other places and if there is a problem there is a problem when you are home and it takes an hour to get to "your" doctor. There are just so many questions about this and I hate that I can't get them answered by someone who is trained!!

Hi All, Went to a seminar on Sat. and am beside myself to get started!!! I am looking at doing this in Fredericksburg, am Tricare insured. From the things I have read here this week I can't figure out if I should be optimistic or doubtful. I sent in the packet of info that Dr. gave out, I just can't figure out what the next step is. My PCP and Oncologist had requested some test for me last week that the Bariatric folks might request so.......I had results sent to their office also. I am ready to be doing something. I am 5'2' 240lbs. BMI 44 and have health issues. The foot pain keeps me popping pain pills. Any info you guys can give me on how this is supposed to unfold please do so. Thanks just for being here!!! Niterun

DON'T LET ANYONE STEAL YOUR JOY!!! I haven't even seen the Dr. yet but I know I am doing this for my health and I think you are too. Once you know how you are going to deal with your "husband" clear your mind and move on. Build your support group with real friends and those of us here. Let you doctor know, talk things out as needed and be strong. Stay in touch with us. Prayers and best wishes to you.