ShiraSimcha

I told my BFF I was thinking of this and her answer was the same...eat less, move more. I am just hoping my PCP goes for this. I think he will...he put me on xenical at my request last summer. He knows I want to lose and he knows my history of trying and gaining. I am waiting to hear back from Magee about whether or not they think I am eligible. I am not sure of their history with low BMIers. Anyway, I am sure it makes your husband worry. I think another of my friend's feels the same way. She needs to have it done more than me and won't even go there. She doesn't think I am "fat" enough but she is supportive. I don't have any advice for you...but good for you for doing something positive for yourself!!!

No, I haven't heard from them yet but they did say probably the start of this week so I am hoping today or tomorrow. :thumbup:

Groupie...go to the Highmark website. Dont sign in! Scroll to the bottom and on the very far right side there is a link that says "Medical Policies". Follow this and you'll come to a library of their medical policies. Put in "obesity" to search when you get to this library and you'll get the policy on banding. That will tell you EXACTLY what they require from you. That was where the very kind woman I spoke with sent me. I ALSO found out that I will possibly be able to have my "fat apron" or panniculus removed at some point and let me tell you...over the moon on that one!!!! I don't remember exactly if we discussed comorbidities or not. I did hear Dr. Eid was the best and I did request him :rolleyes2: While Dr. McCloskey didn't specifically mention asthma as one of the comorbidities, I think it is one as well as degenerative arthritis which I have in my spine. I also have heart issues which I forgot to put down on the checklist they gave me. I have an irregular heartbeat and my mom died at 40 of a massive heart attack. I would hope this would get me in. Good luck to you!!!! Shira

I also have a low BMI - 35.2 - although I admit, I gained some weight to get my BMI up past 35. I really want to have this done...it's very important to me and I feel it's a solution for me to stop the spiral of yo yo dieting. I also live near Pgh. I live in Jeannette so I am east. I went to Magees seminar on the 5th. I do have comorbidities - high cholestoral/trglycerides, asthma and arthritis so I think I probably will be approved. I called BCBS (same ins as you actually) and they said BMI over 35 and you're a go. I hope you'll stay in touch!

Hi!!! I went to the seminar at Magee last night. The woman who heads the program said that insurance doesn't cover Magee doing the nutritional classes...she said they will cover your pcp doing them. She also said once you start the classes you cannot gain ANY weight and in fact have to show either a steady no-loss or steady losses or you may not get approved. I wasn't sure if this was for Highmark or not. I talked to Highmark a few weeks ago and like you said, they seem pretty easy to deal with. I am on the cusp...35 BMI but I have comorbidities so I am hopeful. I have an appointment with my pcp on the 25th and just hope he agrees as well! Stay in touch!!!! I am also on the PA support thread in the Pgh section. Shira

Hi everyone! I just attended the seminar last night at Magee. I didn't feel hideously out of place...my BMI is 35.7 (if I drink a lot of water before I get weighed! ) and I have comorbidities - asthma, arthritis, possible metabolic syndrome, fatty liver, high cholestoral and triglycerides plus my mom died of a massive heart attack when she was 40. I am 45 now and I am sick of the back and forth of dieting. I lose, then I get bored or something happens and I gain it back and more. Everyone asks me how the band will be different since you STILL have to diet...I figure that yeah, but the weight loss is more consistent. I just am really worried about speaking to my PCP. I am worried he won't think the band is necessary. For those of you doing the Magee classes...how much do they cost? They said last night that insurance doesn't cover them. And what did you say to your PCP when you brought it up? I see him on the 25th.

I did tell one friend and she came back with "You don't need that! Let's do this together!" meaning losing weight on WW again. We've been doing it for the past 25 years and I am bigger than ever. My friend is 5'2" and nearly 300 lbs. She won't accept it. The problem for her is she has a friend who got banded at AGH in Pittsburgh and the surgery was a failure...no counseling, no nutritional support and she lost NOTHING. Her PCP wouldn't even treat her when the band slipped off. So my friend thinks its the most horrible thing. I broached it with another friend...what do you think about WLS? And she went off about how you have to move more and eat less. No duh but you know what? For me even an hour every day at the gym on the treadmill AND doing WW religiously....I gain. Obviously I need extreme measures right? I have had my gallbladder out but not many folks know so thats a GREAT excuse. I didn't even think of that! :smile2:

Wanna hear something sad? I KNOW I am on the cusp so I GAINED 5# just to be above 35! I have a family history of heart disease, high cholestoral and triglycerides, asthma and even when I exercise like a freak? The weight won't budge. I quit exercising I was so discouraged. I am not round and roly poly...I am solidly built and very active. I told my friend who is 5'2" and 275 and she went freaky on me. "Come on Shira, we can do this together!" She MEANT dieting. I don't want to diet anymore. I hate it. I want to just live my life and not have food be a ruling factor. I eat VERY heathily...and that's what I want to do. I don't want gimmicks anymore. I have been dieting for the last 30 YEARS! I told my Dad who has had GB and he was REALLY excited. He thinks it's the best thing since Wayne Newton!! He actually wants a revision TO the lapband since his GB has stopped working. He sent me an article from the Washington Post about it yesterday in fact. If my insurance won't pay (although I think that won't be an issue), he is offering to cover it. He really is a supporter. Now my BF? She dropped 50 lbs last year through diet and exercise. And I really applaud her. I am not sure if she'd be supportive of this or not and right now I haven't told her. Another friend I DID tell. And now she may be interested too. I guess it's just random. I go to the seminar on the 5th - this Wednesday!!!!! I am psyched. I am hoping my PCP won't object. I also learned what a panniculus is (look THAT one up) and found out I can get MINE removed. If so, I'd like to do them both together...I think that would so increase my self-confidence, my body image and my general health. I am really hopeful nothing FUBARs this.

I have a question...I understand Highmark will make me go through a 6-month pre-op diet. I started on xenical in September and it did NOTHING for me. Well, except for what xenical typically does which I couldn't deal with. Anyway, would this count as the start of my 6 month supervised diet? I saw my doctor in late August and couldn't get another appt until November! :smile: I plan to go to my seminar on Nov. 5 and am also afraid my PCP will not be as enthusiastic about this as I am. Does Magee do the pre-stuff and is it covered by Highmark? TIA!

I feel exactly the same way. I often want to call my BFF and ask her "what are your thoughts about WLS? But I have a feeling it's negative. My other friend has a coworker who was banded and who never lost a pound and I don't want to hear THAT either. I always swore I'd only do this if someone told me I needed to lose weight and would die tomorrow if I didn't. Now I just want to be able to get on with my life and not worry about dropping dead of a heart attack when I am 47. :smile:

Is it because of no vacation left that you have to use FMLA? How much vacation have you planned to take? I am wondering because we don't get much around here. Fortunately my job involves sitting at a desk and not doing much moving so I don't think I'll have to budget that much time away.

Best of luck to you TQUAD!!!

Best of luck to you TQUAD!!!

I am from Pittsburgh, PA. This is a great forum to discuss the kashrut aspects of this whole journey. I never thought about the whey and protein supps!!!

Is anyone going to the Nov. 5 session at Magee????

I am such a Disney freak. We're going in January. How did the band change your experience...especially dining. I am curious because I don't plan to stop going to Disney

Hi My name is Shira and I have a few questions. I am attending an info session at Magee in Pittsburgh on Nov 5. I am actually pretty confident this is a good decision for me. I am just BARELY at the 35 bmi mark and actually if I gain about 2# I'll be there solidly...oxymoronic huh? Anyway, I have tried all kinds of diets since I was in college (and I am now 45) - I just don't want to spend the rest of my life FAT. I want to be active and healthy. My mom died of a massive HA at 40 and I already have high cholestoral and asthma and an irregular heartbeat. I hope that makes me a good candidate! My questions are: 1. what is a rough timeline of this whole process from info seminar to end? 2. I want to keep this private...is that possible??? I don't want anyone but immediate family to really know. 3. What is anyone's success with Highmark approvals? What is their process? 4. Who is the best doctor at Magee for this??? 5. What is the "down" time? And of course anything else you can think of. Thank you SO much!!! Shira

Thanks TQUAD!

Where in PA? I am just BARELY 35 BMI and am 5'4" and weigh 200. I am worried I am too thin!!! :biggrin:

I am just BARELY at a 35 bmi...I could gain about 5# and be solidly there. Do they weigh you with clothes on? :biggrin: That's the thing that's got me a little apprehensive. I weigh about 205 with clothes. I am 5'4" so I no how have to lose 80 lbs. But 60 would work just fine!

Yes. I finally decided enough is enough. I obviously cannot do this alone so I need a tool to help and I think this will. I just wish the info session weren't so far away!!! It's Nov. 5. Of course that will put my surgery next summer so I guess that's good in it's own way. I'll have more vacation days then :Dancing_biggrin:

I live in Jeannette - close to the Penn Township side. So you're in Brownsville now? I have high cholestoral and arthritis, bursitis, etc. from my more active younger days, an irregular heartbeat and a very strong family history of heart attack. I hope that will be enough (doesn't that sound weird?) What did Highmark require of you? I have read about the supervised diet...do you do that with the hospital? That would sure be easier for me to do! :Dancing_biggrin:

I am glad the OP started this thread! I decided early on (and I am still pre-seminar) not to tell anyone but my husband. I am considering telling my best friend but still not sure. Definitely no one (and I mean NO one) at work...this kind of thing would become the office joke. My question to folks who didn't tell anyone, how did you explain your surgery and how long were you really "down" from it? I had my gallbladder taken out through lap surgery years ago and took a week off work for it. I was thinking about the same. I just hope I'll be eligible. I am at 35bmi but just barely. I do have to comorbidities though - arthritis in the spine, cholestoral meds, irregular heart beat meds and a strong family history of heart attacks. The last visit I had with my doctor in August he put me on xenical...but it really just didn't work. Alli did work for a while but would start and stop in spurts. I hope that will qualify me. I realize this is a BIG step but I really do want to improve my health and be young enough to enjoy it!!!

I am glad the OP started this thread! I decided early on (and I am still pre-seminar) not to tell anyone but my husband. I am considering telling my best friend but still not sure. Definitely no one (and I mean NO one) at work...this kind of thing would become the office joke. My question to folks who didn't tell anyone, how did you explain your surgery and how long were you really "down" from it? I had my gallbladder taken out through lap surgery years ago and took a week off work for it. I was thinking about the same. I just hope I'll be eligible. I am at 35bmi but just barely. I do have to comorbidities though - arthritis in the spine, cholestoral meds, irregular heart beat meds and a strong family history of heart attacks. The last visit I had with my doctor in August he put me on xenical...but it really just didn't work. Alli did work for a while but would start and stop in spurts. I hope that will qualify me. I realize this is a BIG step but I really do want to improve my health and be young enough to enjoy it!!!

Thanks for all the replies. I do understand that every situation is different. I am just at the start and was really curious what was involved. I think for me the privacy issue is really paramount. I work for a small non-profit and this would become the office joke...don't need that. Thanks again for the answers!