MommyTawnie
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Everything posted by MommyTawnie
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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?
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Were you ever told to not loose more then 4 pounds?
MommyTawnie posted a topic in PRE-Operation Weight Loss Surgery Q&A
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: -
Desperately need lap band removed Erosion Insurance will not cover
MommyTawnie commented on amburlie123's blog entry in Blog 89948
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.. -
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:
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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.
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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.
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Just a thought and then I will go..
MommyTawnie posted a topic in PRE-Operation Weight Loss Surgery Q&A
I was sitting here thinking to myself last night "I don't remember what I looked like when I was (skinny)" I have searched and searched through pictures and cannot find a single one of me prebaby/preweight gain. I was a little over weight when I got pregnant "145-160 depending on the day or the week at 5'3" The one picture I can find has me hiding my size with an over large coat. So then the panic started to kick in. If I don't like the road I am on now what makes me think I am going to enjoy the new journey? And then it hit me I'm not doing this so I can be skinny. I am doing this for my health, and for my children. I want to watch them grow up. I want to enjoy life more. I want to feel free to swing on the swings with them, and run and chase them. I want to be happy and HEALTHY. Never mind what I will look like after I loose weight. As long as my health is better I will take what I can get. If by some crazy reason the band doesn't work for me I can live life knowing I tried. My name is Tayna I stand 5'3" tall and I weigh in at 248 my bmi is 43.3. I have to beautiful active children and I hope to one day be able to stand outside and play with them, and know that I have no limits. Sorry all just my thought of the day. -
Just a thought and then I will go..
MommyTawnie replied to MommyTawnie's topic in PRE-Operation Weight Loss Surgery Q&A
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! -
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.
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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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well we only have an in ground pool, and it is still way to cold to even consider swimming. I work out on a daily basis usually an hour a day sometimes 2 hours. It seems to help the pain for a little while and then it comes back once my body has stopped moving. I will try the minty items for the nausea and hope it works for me. I know during pregnancy the only thing that worked was pickles. Don't ask my why it's weird I know but that's what helped. Now they make the nausea worse. I am looking forward to a healthier me. I just can't picture myself 100 lbs lighter. Well my first goal is 75 lbs then I will reset each goal as I reach it, and make new milestones along the way. I meet with the dietician next week. So so excited I can't wait to get to June..
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Any August 2010 Bandsters?
MommyTawnie replied to kimclow's topic in PRE-Operation Weight Loss Surgery Q&A
Are you self pay or will you be going through insurance? If you are self pay then I suppose it could be that easy, but insurance no way. There are diets and things you have to complete before insurance will even consider approving the surgery. Like I said before with my insurance it takes 3 months of charted dieting and exercise along with a dietician and a pysh evaluation before they send in for approval through the insurance. With out these things being completed I will not get approved. I would contact the office again and start asking more questions. Did they set you up with a case worker? The office I am going through assigned me a case worker the day I went in for my consult. She is the one that is helping me along the way with appoinments and insurance. Best of Luck to you!:cursing: -
Any August 2010 Bandsters?
MommyTawnie replied to kimclow's topic in PRE-Operation Weight Loss Surgery Q&A
Well I'm not quiet sure when the surgery would be, but I do know it's looking like maybe July/August my insurance requires a 3 months charted diet program before even considering approval. I am in month 1 month 3 will be June then request for approval cross my fingers it goes smoothly. Everyone I have seen or talked to that has the same insurance "Aetna" has said theirs was approved with the first letter. I am hoping for the same we are aiming for July to be a the surgery month, but it could be August. Best of Luck to all on the journey to a happier healthier you..:scared2: -
Well my thoughts and prayers are with you through your journey. Everyone I have talked to that has had Aetna as there insurance said it went quickly and got approved within 10 days. I am hoping I have the same luck. My only thought and concern through it all is the health problems I am having presurgery. I have a cyst on my spine that causes unbelievable pain down my right leg and in the lower back. I have issue with strained ligaments in my lower stomach. It's become a very big issue. I have already been in the hospital over the pain and the serverity of the nausea. I want a healthier me for myself and my children..
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Thank You I am hoping to have mine done this July like I said I am in month 1 of a 3 month process for the insurance. I finish in June so from June to July it gives me a month to appeal I can wait however long I need to I would just prefer to get it done asap. Congrats on yours how much are you down?
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i am really embarrassed by this picture, but i had to put it up to show that i am over weight..i weigh 233, my height is 5'1", thats considered morbidly obese!! =(
MommyTawnie commented on Erin18's gallery image in Member Photo Gallery
Hope the banding is coming along for you. I am 5'3 and I weigh in at 248 which is a bmi of 43.3 so I know where you are coming from. Hopefully I will be banded sometime in July "fingers crossed" -
Making the steps to get approved through Aetna!!
MommyTawnie posted a topic in LAP-BAND Surgery Forums
Well after seeing pictures of me at our family Christmas this past year. I realized I was larger then I thought I was hitting the scales at a big fat 255. I was never "fat" as a child, and never really had weight issues as a teen "other then the normal pick on your self" I was a fit and active 140 lbs at the age of 20. Then I became pregnant with my daughter and boom the weight started adding up. I realize you gain weight during pregnancy, but I gained a total of 95 lbs in 8 months. My prengnacy was a high risk pregnancy and I was on bedrest pretty much the first 5 months. After her birth I started back with daily walks, and workouts at home. But it was doing nothing for me. The weight had made the decision to stick around. Then the excuses started well she's only 3 months it can take up to a year to loose baby weight. Then 9 months hit and I told my husband the same thing. After new years 07 we started a hard core low carb diet loosing 28 lbs in the first month. I was thrilled the weight was coming off so quickly. Then I became pregnant with our son. After his birth and 30 lbs later I was right back where I started 240lbs. It was devestating to know I worked so hard to get what weight I could off just to have it come back. Don't get me wrong I was thrilled to have our son, but the weight why couldn't it just fade away? I tried everydiet out there to the point of drinking the Apple Cider Vinager "Nasty Nasty Nast" nothing was working. Finally I decided I wasn't that big, and I would be ok. Besides I just had a baby a few months before I was fine. Then he turned 1 and the weight was still there. I realized I had to try to get it off. I started diet pills and working out, but it just wasn't going away. This past Christmas when I seen a real picture of me from my daughter's point of view I realized I have to change my life. I have to loose this weight, and if diets aren't going to work for me then I have to move to the next step. Going through our plan coverage I realized "AETNA COVERS WEIGHT LOSS SURGERY" I called Aetna that day just to confirm what I had just read, and ask what the first step was for the surgery. The lady "her name was Carol" gave me the name and number of a weight loss surgeon in my area that took my insurance, and that I could go through them to figure out my next steps. As soon as I hung up I was making the next call setting up my appointment for a consultation. I went in on March 1st and met with Dr. Felix Spiegel he explaned to me what would happen during in surgery, and the diet to follow after the surgery. They set me up with a case worker to get the insurance verified, and get me on my way. 2 days later she called to tell me insurance will cover the surgery, but I have to follow the steps to get it approved. step 1. 3 months of a charted diet/exercise program through my pcp step 2. meet with a dietician step 3. meet with a pyschologist for the pysch eval. I meet with my doctor on the 9th to start charting my weight. I joined a gym 4 weeks ago. I meet with the pyschcologist on the 10th and the dietician the following week. I am excited about the journey ahead. I look forward to the day when I can run and play with my children without getting out of breath. I can't wait to walk into a room and no longer feel like I am the fatiest person around, or looking for someone fatter then me so I can feel better about the way I look. Aetna has been wonderful helping me find doctors that take the insurance. I can't wait for June to get here so we can send off our request for approval. Please keep me in your thoughts as I go through this and I will post as I find out what's next..:smile2: -
Congrats to you. I sure hope it's that quick with me. I am still in month 1 though so maybe by July. Fingers crossed.. :frown:
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Will I qualify for lap band?
MommyTawnie replied to Mili85's topic in PRE-Operation Weight Loss Surgery Q&A
I am in the first month of my insurances coverage process. I have Aetna and with our insurance they require you to have atleast a 2 year history of being obese along with a bmi of 40 or higher with no comorbidity. Or 35 or higher with comorbidities. Along with this I have to have a 3 month charted weight and diet plan with my doctors office. I have to meet with a pyschologist "I have already done" and meet with a dietician "doing so next week". The best thing I can offer you is telling you to contact your insurance company and see what your plan covers and what steps you need to take to get approved. Go ahead and meet with the doctor his office will help with the insurance part and seeing what you need to do if you want to do it all through them. Don't be afraid to call your insurance company and ask questions. I did everything and set everything up myself before I ever met with the surgeon. I wanted to speed things up as much as I could on my end. Best of Luck to you as of now with your hight and weight you are at the required bmi with no comorbidities. -
ten thousand questions????????????
MommyTawnie commented on princesslaurie1's blog entry in Blog 61819
I am 4 months away from having surgery "if the insurance approves 1st time" and I to have had the fear of missing food, but you know my doctor told me that with the lap band you want to continue on with your normal foods that you eat everyday. You just won't be able to eat as much. Spread it out over 5-6 smaller meals throughout the day and go from there. Pizza will be a no no, but treating yourself to 1 slice once in a blue moon will give you the satifaction you are wanting. I know that I have to make changes and sacrifice the joy of the good tasting food, but I am willing and prepared. I will continue with a normal diet "chicken, fish, vegies, etc." I started dieting and joined a gym a month ago I have managed to loose 4 lbs on my own in 1 month. Not much but atleast I am working towards a happy healthier me. It's going to take a lot to get into the mindset of Portions and snacking. Snacks are allowed, but only healthy nutritional snacks that limit you calorie intake. Don't fear the loss of food look at it as a step to a new life. Food is what got you to the place you are at, and will continue to hold you back unless you make the choice to move past the want for food.. -
I have been open about this subject from the day I made the decision to look into it and do my research. But after meeting with the doctor on the 1st I decided that I wanted to keep the official decision to myself "my husband knows of course". Yes my family knows that I was looking into it, but they do not know that I have officially decided to take that journey. I know they would be supportive of my decision, but I want this to be about me, and me alone. I live far away from my parents, and have not gotten to see them in over a year. I want them to see me as a happy person again the way things are looking now the surgery will be somewhere in July or August. We have a family event at the end of August, and yes I will more then likely tell everyone at that time that I had made my decision and was past the surgery. I don't need to hear an opinion from everyone. I want them to know this was me and only me that made this choice.
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From the album: "09" and "10"
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From the album: "09" and "10"
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I'm not much of a camera person. I have very few photo's, but will share them with you. I plan to post pics leading up to my surgery, and the progress I make. Surgery as of right now is looking to be in July 10
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At my heaviest "255 lbs" This is what made me realize I have to change my life.
MommyTawnie posted a gallery image in Member Photo Gallery
From the album: "09" and "10"
