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MommyTawnie

LAP-BAND Patients
  • Content Count

    35
  • Joined

  • Last visited

1 Follower

About MommyTawnie

  • Rank
    Advanced Member
  • Birthday 06/18/1984

About Me

  • Biography
    I am a stay at home mother of 2. I have a daughter that will be 4 this year, and a son that will be 3. I was never the overweight child/teen growing up, but after the pregnancy and 6 week preterm birth of my daughter the weight stayed.
  • Interests
    I love singing and reading.
  • Occupation
    SAHM
  • City
    Beaumont
  • State
    Texas
  • Zip Code
    77706
  1. Happy 29th Birthday MommyTawnie!

  2. I started my 3 months of charted dieting and exercising in June.. I have had my pych eval done, and just completed my 3 months charting with my doctor. I meet with the dietician on Monday and go from there to meet with a new surgeon. I am worried about the submiting part. Not because I have done what I was told, but because the new office informed me that my exercise was suppose to be charted by a professional.. My first question for the lady was "what do you mean a professional" then it turned to "isn't a doctor considered a professional" I mean come on I would rather exercise under the care of my doctor then a trainer at the gym. I feel they are going to take my health more serious then a trainer I pay to help me loose weight. I just worry that insurance isn't going to take the exercise regimin from my doctor and deny it bassed on the exercise part. Has this happened to anyone going through insurance? If so what is something I can do to insure my approval is granted? I started this long journey back in March, but had to put it to the back burner when health problems came up and surgery was needed.. But since June I have stuck with it and have done all that I can to insure nothing is missed. I went by what the surgeons office told me. My husband and I are switching insurance in January and we are not sure if the new insurance will cover WLS. So I wanted to do what I could to get it done this year. Are my worries for nothing?
  3. I was chating with my consultant lady the other day over the phone kind of touching base on where I am in my journey to surgery. I was explaining to her that I had to restart my 3 months due to a surgery that came out of no where and not being able to get to the gym. Going on to explain that even though I was unable to get to the gym I was able to loose 8lbs by myself from March-June with just the diet and exercise plan my doctor put me on for the 3 months charting. I was pretty dang proud of myself for loosing the 8lbs yes it may have taken 3 months to get that 8lbs off, but it was off wasn't it. Her next response hit me in the gut and made me a bit angry. She informed me that if I loose more then 4lbs a month insurance won't pay for my surgery, because they will feel I can do it on my own. Hello woman I just lost almost 3lbs a month so I am pretty sure I am safe of the 4lb mark. And anyways aren't we suppose to loose weight during the 3 month period just to show we are willing to stick it out and do it no matter what the amount of weight loss a month is? From June-July I only lost 2lbs. Starting to get back to the part of the diet that always shows up the brick wall. I just hope I can manage to loose atleast a pound between now and August. Has anyone of you been told this same thing? Is there truth behind it? :cool:
  4. MommyTawnie

    Desperately need lap band removed Erosion Insurance will not cover

    Sorry to hear of your lap band mishap. Many doctors will not touch a patiant that had surgery through another doctor. Did you change insurance during the 5 years of the band being place? If so you may end up having to pay out of pocket for the removal. Most insurance companies will not cover a procedure that they did not approve of in the first place. I have a friend that is trying to go through the process of insurance and lap band and they told her that she has to wait the full year before submitting for approval from insurance. She can always pay out of pocket, but they will not cover anything that happens after the band is placed. If she waits the year and has it place with insurance approval the cost of everything will be covered through insurance "fills, check up, etc" if however this is the same insurance you had when the band was placed call them and explain to them the situation, and ask them for the name of a surgeon they cover, and go from there. If it's causing that much trouble, and it has made it's way into your stomach it would be considered an emergancy situation. Call the origanal surgeon back and see what can be done through him/her..
  5. I have met with a weight loss surgeon back on the 1st of March. I was set and ready to use him, but the farther I get into the process the more I realize they are not helping me with any of it. I am doing it all myself and doctors are limited for in-network with Aetna. I have an appoinment on Monday with a surgeon for a different surgery, but have found out that he does the bariatric surgery as well. So now I am considering switching and going with him for this journey to a new healthier me. They have everyone in there office that is needed through each step. Plus they are ALL covered through my insurance. Am I making a better choice going with someone that is local? I feel I am for the simple reason if something happens during the first few months after the band is placed I won't have to make an emergancy trip to Houston 1 1/2 hours away. All of my fills can be here in town, and it makes for an easier journey. Am I wrong for wanting to switch doctors? Is it going to mess up anything with insurance? And what about the pysh eval I had done is that something I can have sent to the new doctor? I meet with the doctor on Monday like I said for a seperate surgery, but I will be asking him these questions as well. I want was easiest and best for me along the way. :tt1:
  6. sore after a workout but only if it was an intense one like the jillian michaels 30 day shred one. yeah i did know :D its amazing isnt it? also rearranging furniture burns up to 400 calories for doing it for an hour (said in the 400 Calorie Fix book awesome book that we just got)

     

    awh, thats awesome shes happy for your choice (: yeah i hope it stays that way for you too. i say if you think itll change some people then probably just tell them you eat healthier and exercise. they do indeed and it gives you energy :D

  7. ah, well thats good atleast. when i was really bad with the nausea at the begining, i never vomitted, just like dry heaving i think its called. so maybe its anxiety? cause when i meet someone new i get nauseous. hey, i think thats really good, i really want one of the still bikes. those are what i want to focus on the most too, and the thighs. im nervous about the loose skin too but the younger you are the less loose skin you'll have. it does work, just give it time and keep getting the fills, oh, im so nervous about those when i get insurance im getting my first one ahh. that could be why, kids can be a handfull haha i have two nieces and they are deffinitely a handfull. sometimes i get

  8. Anyway I finally let my mom know last night that I made my decision she was a little concerned about surgery, but happy that I was happy with my choice. I just hope it stays that way. The rest of the world will go on without knowing unless I feel differently after it's done. Keep the workouts up they work more then you realize.

  9. Thankfully enough it's just Nausea and with no vomiting. It really gets worse when I meet with another doctor. Always the thought of will I mess up and this doctor not reccomend the surgery. But so far I have been really complimented on my goals and everything I am doing for myself. I get a lot of workouts in during the week. Usually a mile on the treadmill, and 5 miles on the cycle. Then my rounds on the weights. I am really working on the midsection and the glutes. I do not want loose skin after loosing weight. Biggest fear after the band not working at all of course. I never got sore after a workout maybe because I chase after 2 little ones and am constantly cleaning house. Which by the way I was looking up on the internet did you know doing normal housework can burn up to 199 calories per hour. Sometimes more if it's a strainous job.

  10. (read the one under this first) close friend, im not sure if i want to tell anyone, i know my mom doesnt want me to but i might when i get to goal. i am hoping too (: thanks, haha thanks, i finally got the boost to get exercising again, had an intense workout yesturday with my brother's gf and i tried working out again today and it was hard cause im sore haha but i did 20 something mins today :D yeah i try to tell myself that everyday haha

  11. no problem. that stinks, maybe you can check those to see if they have pool excersing sessions. ah, maybe, it could be, i usually get nausea when im so worried, i get so worried it gets to the point where i get really nauseous and vommit but its sort of different for me now, when i get sick now, i get nauseous, and when i recently had a UTI it made me really sick but thing is i never get to the point where i vomit, thank god!. do you just get neausea or do you get nauseous and also vomit alot? is it a daily basis kind of thing for you? thats good, when you have something youre looking forward to, the days go by pretty fast. this month flew by and in the past years i always thought it went by soooo slow, thats why i always hated march lol. hmm i havent told anyone except family and one

  12. Thank You all for the replies you have left. I never try to bring myself down "only up in spirits" I catch myself all the time writing things down on notes and posting them throughout the house example "I will control my portions!!" or the "Goal of the day burn 500 calories" sometimes it's more, but the 500 I stick with is my goal everyday. I have lost 4 lbs from the date I weighed in with the weight loss surgeon, and I AM PROUD!! I will be happy no matter what the out come simply because I am doing this for a happy healthier ME!
  13. Thank You. We did have a YMCA but it closed down a few months ago. We have 3 very large 24 hour gyms around the area that I think kind of took over. I'm not sure what's causing the nausea I think it's more less nerves. Trying to get everything together and done right so they have no reason to deny the request for approval. I do know that I am excited for every day that passes. I finally broke down and told my sister that I had made my decission about the surgery. She was a little upset that I didn't tell her a couple of weeks ago, but she calmed down pretty quick when I explained to her that I wasn't really wanting to share it with anyone but hubby until it actually happened. I do hope you are able to get a fill soon. You are doing great with the weight you have lost, and I understand you wanting to get a fill to loose more. YOU WILL REACH YOUR GOAL!! LoL I tell myself that everyday.

  14. you dont have a YMCA around? thats good but also weird, do you do pilates? i hope it helps too, someone told me about it when i had nausea and it helped and it still does (: ohhh the pickles part yes, they do help, my doctor told me to try pickles and those also help, i think its because of the vinegar im not sure either. but thats weird it makes it worse, do you know whats causeing the nausea? maybe ask for a nausea med, im with ya on not beable to picture yourself 100 pounds light, i cant either. thats awesome, its more realistic, i wanna lose 60 more pounds, then all id have left to lose is 20-25 more ppunds, i lost all together so far is 35 pounds heh should deffinitely be more, but its so hard when you have no fill. ugh hopefully soon. sweet :D wish ya luck with that, and its right around the corner (:

  15. MommyTawnie

    < WEIGHT> Someone Pls Help Me

    My insurance says 100lbs over weight or a bmi of 40 or higher with no comorbidities. Or 35 or higher with comorbidities. If you are unsure what they are asking for call the insurance company and talk to a representative. They can explain it better to you, and don't be afraid to ask what they need from you. Through my insurance "Aetna" they require a bmi of 40 or higher with no comorbidities or 35 or higher with comorbidities. If you fall in the catagory then contact the surgeon you plan to use if you are approved and get a consult if they feel insurance would approve you then they will start you on your next step. For my I have 3 months of a charted diet/exercise program I have to complete with my doctor. I have to meet with the dietician and have a pysh eval done. I have met with my doctor to get started with the charting. I have had the pysh eval done. Now I am waiting on the dietician to call me to set up an appoinment. After I meet with her and I finish the next 3 months being charted. We will submit to insurance and hope to be approved with the first letter. Call your insurance 1st and find out what exactly they expect or need from you to get you started.. It never hurts to get a consult to see what they can do to help you find out more info. Best of Luck to you..

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