Jmone

Not sure if this is good news or not , but I know I have gained some weight I was not sure how much . In the begining of this I was at 200 lbs ... but I went to my PCP in January so I called to see what I weighed in at and he told me at 205.5 that gives me a BMI of 40.1 . Now that was last month , maybe I gained another pound or two so at my current weight I am over a BMI of 40. I tried calling the DR's office and see if they will appeal with my new weight ...Wish me luck .

I just received a call from the Dr's office to say that I was denied . She told me they denied me due to my BMI is 39.6 and no cor-morbidities .. Mild sleep apnea is not enough and they do not consider PCOS . She said she has to give it to the DR and see if he wants to appeal . Is that my choice or his ? Also my PCP had me on Phentermine for over a year now and since I had to be on the PREV PAC (H PYLORI) I stopped taking the Phentermine and I have gained 7 lbs in 2 months . If I am not on these pills I will just gain .. I am so upset , What should be my next step... Weight currently is 203 at 5ft . I am so upset I cant think straight ... Not sure what to do now

Exact wording word for word is : Obesity Surgery limited to gastric bypass as long as the following conditions are met and it goes on to say the conditions then it says : " Gastric banding/ Lap band surgery is not covered" My secondary AETNA does cover banding , it is just harder to get coverage from HMO than POS II... I am hoping to get approved soon by either

I am so upset , not to mention hurt . I did my 3 month diet plan with Aetna Pos II( I also have Aetna HMO as my secondary), and my surgeon scheduled me for 3/30/09.. I do have sleep Apnea and BMI is 39.9. With Aetna POS II you need to have a BMI of 40 or more for two years or 35-39 for two years with a co-morbidity. I was perfect . I was originally at a BMI of 42.4 with efforts I was able to drop some punds and have been at my current weight for months . I also have PCOS so it is just that much harder for me to lose. I requested a copy of what my employer covers and it states that they only cover gastric that banding is not covered at all. I am so upset and hurt . My only hope is through my secondary but that is much harder for me as they require severe sleep apnea and 40 plus BMI . I feel like my dreams were shot down right before my eyes ... Has anyone else experienced this . If so ...Please help me get through this .

Hi all March Melters ... I have a surgery date of March 30th. I am hoping it stays as I have not yet received clearence from the gastronologist. My test results show H pylori and signs of Malt Lymphoma (a rare stomach cancer) needless to say I am on the prev-pac .Per the gatronologist , I have to get another EGD on 3/03 and depending on results which I wont know until 3/19 he will let me know if I have clearence or not .. Wish me luck guys !!!! Per my Bariatric MD , We will stay on schedule and wait for results ...

I just searched Malt Lymphoma today as I just received results from my EGD test . I am already in my last month and was due for lap-band surgery on 3/30. Results show I have H.Pylori and as many others I have to be on the 14 day prev-pac.Total of 112 pills. But I found it strange that the DR wanted to post-pone my surgery (as I saw on lap band talk that many who were disgnosed with H.pylori continued with their surgery.) He then mentioned signs of Malt Lymphoma showing on my results. I was ignorants to all these words he threw at me and decided to log down the words I did not understand much about and look them p on the net when I got home. Well Malt Lymphoma is a cancer mainly caused by H. pylori. I am sure I am in the early stages and hopefully with the prev-pac it will go into remission . But I am upset about post-poning the Lap-band.... I am not sure what to think or do at this point as I see many here disgnosed with H.pylori but no mention of Malt Lymphoma .

Right , and DR's comments on the study report is for the sleep apnea to be treated with a CPAP machine . I have a call into the Dr's office so they can explain further , thanks for your response

Hi everyone , Before making the decision for Lap-Band surgery my BMI was 42.6. I then went on the weight loss pill phentermine for a year and lost approx 20 pounds with 4 days of hour long cardio/kickboxingand have been on a pleteau so my DR and I decided maybe lap band is the way to go . I have been on the Aetna 3 month plan and I started on Nov'08 , When I met with the surgeon he gave me a surgery date of 3/30/09. My BMI is 39.6 so as required with Aetna I need a co-morbidity ... Needless to say I do not have high blood pressure nor diabetes etc.. I do have PCOS but I am aware that does not qualify me for much . I just received my results from the sleep study and it shows I have a mild case of sleep apnea. Now my question is would a mild case of sleep apnea be enough to get an approal from Aetna ? Does anyone know ??

I have been on Phentermine for over a year now and like you stated , It just did not make me hungry . I used it in conjuction with weight watchers and lost approx 20 lbs and stopped losing for 6 months . I was also going 3 times a week to kickboxing class. I hit that plateau and could not lose anymore with the phentermine and that is why my DR suggested lap band. I also was diagnosed with PCOS and it can be due to that , the reason I have not lost anymore . Good luck and it does work for some

I like you have Aetna and worry if they approve me as my BMI is only 39.4... I also have not told no one but my husband and mother . Mother said she will support me no matter what and hubby is not thrilled as he says my weight does not bother him , but it bothers me . I get my support from here and from myself . Keep your head up you always have us !!

Thank you for your answer , At my intial visit they gave me a date of 3/30/09 for my surgery , I am getting banded at Mountainside Hospital in Glen Ridge NJ by Dr Karl Strom. I also have to get an ultrasound for my gall bladder as my PCP thinks I had a gall bladder attack , but I want to get these other appointments out of the way and then I will go for the ultrasound .

Mine is Monday 12/8/08 and I am not sure what to expect ? Can anyone shed some light ?

Hi I just joined LBT , I just started my process for lapband. I am a little worried for my BMI is only 39.4 and that has me right at the mark. Any one also go through this 11/19/08 seminar 11/26/08 met surgeon 1st dr visit 12/2/08 went through psychological and passed 12/8/08 appointment with pulmonary dr 12/10/08 cardiology appointment 12/12/08 gastroenterology appointment 12/16/08 first nutrional class I hope I am well on my way and wont be let down