Stormie

I finally got the answer I was looking for from Aetna regarding the exercise requirements for the 3 Month Multidisiplanary Program. I emailed Aetna last night and here is the answer: Thank you for using the Aetna Navigator website to contact Aetna Member Services. Clinical Policy Bulletin #0157 states the exercise program must be physician-supervised and must be documented in your medical records every visit. You can exercise at a gym, although your physician is required to supervise you participation. If you have questions, you can reach Member Services by logging on to www.aetnanavigator.com and select "Contact Us." You may also call the toll-free number on your member ID card. Sincerely, Internet Response Team Aetna Thought this might be helpful for anyone who had the same question.

Thanks so much for taking the time to explain the exercise regimen. It makes sense. I made several calls to Aetna today for clarification and was referred to the Information Line on the back of my insurance card. I spoke with a registered nurse who could not be specific either but between the two of us, we concluded that it is about making the effort and getting it documented by a "qualified professional" who would be the Nutritionist as you say or perhaps your PCP. In any event, I joined Curves tonight and had my first workout. Must admit it is pretty simple and fast and I will make the effort to go 3 times per week. This will be documented each time I go so I will have something to include in my package to send to Aetna. I made appts for Upper GI and Cardiologist appts and finally my next two Nutritionists appointments today. The woman who handles insurance at my doctor's office wasn't real positive about getting approval the first time out. I hate that. I am a glass half full person and will hope for the best. I am sure all of you went through similar feelings as I am. It's mentally exhausting. My feelings are up and down. I think every roadblock furthers my resolve to get this done. Thanks again to you and all for the really valuable and important information you all share.

Hi Bandsters, I am interested in learning what I can about Dr. T and experience with Faulkner Hospital. I have met with Dr. T and Phyllis, the Nutritionist and am hoping to speak with Susan tomorrow regarding setting up my appointments and getting further direction on the upcoming process. If you had Dr T, were you pleased with bedside manner, attentiveness, pre and post op support? Did Faulkner meet your expectations? Anything I can learn will help me quell some of my anxiety. I am excited about getting banded but I am apprehensive. This is a big step. THX:unsure:

Hi Lil Miss, Sounds like you opted for the 3 month Aetna plan. Did you begin dieting right after meeting with the dietician? What did you do for the exercise piece? The 3 month plan requires an exercise regimen and I am not clear on what that means. Would a Curves program suffice? Are there any other details you can share? I had my consultation with my surgeon and meeting with the dietician last week and have an appointment for psyche eval on Tuesday. I would love to do this in 3 or 4 months as you have. I am so excited to finally find a solution that will help me keep off the weight I lose. Good luck to you and thanks for sharing your experience with Aetna. I agree, feedback has been 50/50.

Thank you SunnyRachel, for both your words of encouragement and for taking the time to welcome me through the door! I can see that you made the right decision and applaud your commitment to success. I will pay your kindness forward once my story unfolds. Warm regards to you.

Hello! I am new to this forum. I have decided that I can’t win this weight battle on my own. I need help as I am convinced that I am doing great harm to my health. A few months ago, I knew nothing about banding. I’d heard about gastric bypass but I never really thought of myself as “that overweight” (by the way, I am) and focused on being a failed dieter. I gave up dieting. I only gained the weight back after killing myself to lose it. No more WW, Nutrisystem, Atkins, South Beach, and so on. I’d lose weight with a great deal of effort and gain it back the minute I felt a modicum of success. I learned that I was pre-diabetic about three years ago. Blood fasting sugars about 120 each day. Pre-diabetic – well heck..that’s not so bad. I mean, I am not truly diabetic I told myself. Of course today, that number has jumped to 182 some days. But still under 200! I am not REALLY diabetic! Right? Wrong! I was seeing the gastro doc because I have developed “fatty liver disease”. Isn’t that a pretty name for a disease? Hey folks, I have fatty liver disease (but remember, I am not diabetic, only pre-diabetic!). So now let’s count my co-morbidities – pre-diabetes (just had my Metformin dose increased to 4 tabs), high cholesterol, high blood pressure (just doubled that dose) and fatty liver (my daily martini has changed to an occasional glass of wine but I haven’t stopped eating like a Viking. (no offense to any Vikings out there). What a mess I’ve become. And every visit to the doctors – PCP or specialist, ends with “if you could just lose 10 lbs…” Incidentally, my BMI is 41 and I am 5’7. I wear a 20 to 22 and 1X to 2X. I am a big girl and have been for most of my 58 years though never as big as I am right now. My husband loves me no matter what size I happen to be thank goodness but I know that he wants me to live a long time and that he is worried I will not. My gastro doc mentioned that if by the next time I saw him, I did not lose some weight, I should consider surgery. I think that was the dose of reality I have been waiting for since hearing I was “pre-diabetic” a couple of years ago. This time the words were not as softened as the word “pre” softened diabetes. It was just out there. You are obese and are unable to lose weight and you will die if you don’t change things. After feeling totally shocked that he recognized that I could not fight this battle without help, I began to research my options and found myself here on this website lurking every evening and reading all of your thoughts, prayers, concerns, and successes. When I read between the lines of what you all write however, I see HOPE. You all share hope that things will be better and can be better with a little help. I’d reached the point that there was no hope anymore but now, thanks to you and my gastro doctor, I can see that even at my age, there can be a future without obesity. So, I have taken control of my health and have decided to be banded. I attended the Weight Loss Information Session at Brigham’s and Women’s in early Dec. I scheduled my consultation with Dr Ali Tavakkolizadeh for Jan 21 along with the Nutritionist that day. I have an appt with Dr. Cynthia Worth end of Jan for my weight management behavioral evaluation. I have called Aetna and learned that I am covered for 80% and that there is a 3 month and a 6 month program. I am not sure yet what the difference is between the two programs but most certainly would prefer the 3 month one. I saw my PCP last week and asked for my medical records. All of these appointments were scheduled within one day with little effort. I take it as a sign that success is in my future. Thanks for reading my story. If anyone has experience with Dr Tav, Dr Worth or Faulkner Hospital which is where Dr Tav does this surgery, please write. My thoughts are with all of you fighting this fight.