ParrotheadCathy

Well, I think I would call my insurance carrier and ask the following: 1. Does my policy cover weight loss surgery, specifically the lap band? Note, if there is a "written exclusion" in your policy against weight loss surgery, there is no avenue of appeal. IF YES: 2. Ask for their exact requirements for approval. 3. Ask how long the approval process takes. 4. Ask what pre-op testing they require, if any. Most would be at the discretion of your surgeon. 5. Make sure the surgeon you want to use is on the approved list for your policy. 6. Ask if there are specific surgical centers/hospitals you must use for the procedure. 7. Ask specifically what your out-of-pocket costs would be (deductible, co-pays, etc.). When you have these answers, you will know what to do. Good Luck.

Instead of eating more at mealtime, try eating the prescribed amount. Then, if/when you get hungry in less than three hours, eat a small PROTEIN snack...a boiled egg, an ounce of low fat cheese, a little cottage cheese, an ounce of lunchmeat or anything similar (protein and 100 calories or less). That should hold you over comfortably and not compromise your overall eating/weight loss.

Your port is attached to muscle on your left side (for most people, on the left side). It is either stitched in place for the Lap Band AP or attached with metal crimps (Realize Band). That has to heal/recover just like the rest of you. A little time with a heating pad, some Tylenol and you should be feeling it much less.

This is something you have to discuss with your surgeon and/or his staff. There are several possible causes, but only a doctor can sort through that. I know you're frustrated and, of course, concerned that something else will interfere with your weight loss but you cannot continue with the circumstances you're experiencing. True acid reflux can erode your esophagus and over the long term can even lead to esophageal cancer. True acid reflux should be treated with a drug that decreases acid production, such as a proton pump inhibitor like Aciphex or Nexium...but, again, only your doctor can prescribe medications. I suggest you make an appointment ASAP and clear up your questions and concerns so that you can move forward! Good luck and keep us posted!

And remember one other thing. The exclusion of weight loss surgeries of any kind is actually more likely the election of your employer. Each employer negotiates with the insurance company about what is covered versus what isn't and they try to provide as much as they can for as little $$ as possible. Group insurance is expensive to provide, after all. Another employer with your same insurance company may have included WLS. It's an option that can be written in or out. You can't really compare Lap Band to a pap smear ($15,00 or so versus a lab test that costs maybe $25 is no comparison). An individual policy would likely be expensive but perhaps you could find a second policy that would cover. Back in the days of the "straight 80% policies" I had a supplemental insurance policy that paid the difference on a hospital room between semi-private and private, the 20% on surgeons fees and anesthesiologists, etc.; paid me regardless of what my primary policy covered on mammograms, pap smears and some other testing. You'd have to talk to an independent insurance agent since if your employer offered any supplemental insurance you'd already know about it. Cost? Well, I can't even hazard what that might be for private pay....probably MUCH more than what you want or can pay comfortably.

For me, if the steak is closer to rare than medium, it's usually fine. salad? Well, that's a whole different thing. I can eat salad from this burrito place I like .... their lettuce is all shredded because they use it in tacos and stuff. Already cut like that, I can chew it well and have no problems whatsoever. But a torn lettuce like you would make a salad at home or get at a restaurant? Well, that's pretty much asking to get stuck. One little piece that doesn't get broken up well enough and that's all it takes. So, yeah, I feel your disappointment. I am at my sweet spot, losing a pound per week, every week. If the only salad I get is my chicken salad from the burrito place, that's okay.

My observations: 1. Are you eating at least 60 grams of Protein per day? 2. You should be drinking at least 64 oz of Water a day. 3. You may need to up your exercise to 2 or 3 miles per day. 4. Lastly, and probably most difficult, if you haven't found a doctor you can work with do it now. You may be too full. Or you may just need the accountability! 5. You likely need the assistance of the dietician to work out a strong meal plan.

ToriBug....the best and most reliable information -- and quicker to get than waiting for a phone call from your doctor -- is to go see your pharmacist. The pharmacist can tell you quickly what meds cannot be cut into pieces with a pill cutter or crushed, AND can tell you what meds are available in liquid form or in smaller pills that can be taken at one time to equal the correct dose. For instance, if you can't swallow a 500 mg metformin tablet, you may be able to take 2 or 3 of smaller dose by taking them one at a time. Mellliecat, Metformin 500 mg is bigger than a Tylenol as I remember ... what a joy to forget! My band has enabled me to get off ALL my medications. Delacruz, talk to your doc or pharmacist. Some medications, if crushed or even cut into pieces, lose their effectiveness or, worse, absorb all at once instead of extended release.

Even if you did overeat volume-wise, which is debatable, one event will not stretch your pouch. Relax. I would not have been able to eat the bread, but since you obviously can, I would have ditched half the bread to lose some of the carbs.

There is the potential for every employer's policy to be different from the others. It happened to me....my BCBS of GA doesn't cover weight loss surgery or care at all; my best friend's BCBS of GA policy does. Sucks!

I too was self-pay. My initial consultation was 1/2/09 (I never went to a seminar as my doc offered the option of individual consultations). My surgery was 2/10/09. I had to do EKG and stress test, chest xray, upper GI, and sleep study.

It is not all that uncommon in this country that doctors fees paid by an uninsured patient have very little to do with what is billed to an insurance company. There is some"allowable standard" and doctors charge as close to that as they can to maximize what they actually get paid. I paid for my banding out of pocket since my insurance did not cover it. $15,000. And I am absolutely sure if they had billed my insurance company it would have been MUCH more. Why do I say that? They tried to bill my insurance for my first fill visit...$469. It was, of course, denied because I have no coverage for weight loss surgery or follow-up. What will have to pay for a fill visit after the first year (which was included in the $15,000)? $125. Look at Explanations of Benefits that you've received on other claims. There is often a "discount" applied. And the EOB usually states specifically what you are responsible for so that a doctor cannot come back to you for that larger amount!

NLawlor, you're in bandster hell. It's a rotten time. You have pretty much no restriction from just the band, you're healed, you're feeling pretty normal .... and you can eat a lot of food. And you're scared. Let me assure you, as others have, that it gets better. Your first fill isn't going to put you in the green zone, but it's going to start you in that direction. How much fill it takes varies from person to person. As an example, 5.8ccs is perfect for me; 6.8ccs is "close" for my best friend. What worked best for me until I hit the green zone was to not count calories but to make sure I got at least 60 grams of Protein per day and eat three meals a day. Breakfast, I often had a Protein shake but now have a soft boiled egg and a littel greek yogurt. My other meals were (and usually still are) 3 oz of lean protein. a vegetable serving, and a serving of whole grain carb (about 15 grams or so of carbs). I was told that the goal was to be able to go at least 4 hours between meals before I got hungry and that until I reached that point I should have a protein snack to hold me over. Something like a boiled egg, an ounce of low fat cheese or some low fat cottage cheese. That got me to where I am now. I still have that snack before I leave work at 5:30 because that's already 5 hours since my lunch and another hour and a half before I even get home to be able to cook dinner. It's a comfortable habit now. I can eyeball protein servings, don't worry too much about getting the vegetable serving to an exact size, and I know what carbs I can have and how much. And with 80 pounds down, I am now losing about a pound a week. Bear in mind that how much you have to lose has a lot of control over when the weight loss slows down. AND, I'll tell you I had a spell a while back where if it were not for my band, I would have gone back to my old habits and gained it all back. But that little bit of plastic and silicone stopped me short. You eat too much, your stomach hurts. Don't want to do that again, LOL. So if you work your band, it will work for you faithfully.

MrsBerggren, I do think you are a tad too tight. At 6ccs, I got stuck at least once every meal, was uncomfortable when I did eat successfully. I had just .2cc removed -- yeah, just two tenths of a cc -- and magically, the problems stopped. I needed to lose a total of 134 pounds and I've lost 80 so far. It's not as fast as it used to be BUT it's about a pound a week and I'm happy with that. Remember that 1 to 2 pounds per week is the goal of the surgery and a healthy rate of weight loss. As for enjoying the food you eat, that's a head thing AND a selection thing. I read a post elsewhere on here just in the past couple of days where a man said that he eats only the things he truly enjoys. In other words, if he could have a hamburger steak or sashimi (which he says he loves), then he would have the sashimi. He suggested aiming for those quality dishes that offer a great taste and/or texture. I'm not gonna say "why even mourn a french fry" but I'm gonna say think about the foods you truly, absolutely love and don't want to not have. Then plan how to have them. If you have to have a smaller portion of something you adore versus a larger portion of something that's "just something to eat", then you see my answer. If you get really stuck, it can irritate where your esophagus joins your stomach and at the stoma. If you're really uncomfortable after a bad stuck episode, have liquids for the rest of the day. That hasn't been a necessity since the little bitty unfill I had a few weeks ago. If I get stuck now, if I hold my arms up over my head and sit up straight, it moves. Your band isn't there to punish you. It's to help you. I still eat a slice of cake at the monthly office birthday party. But it's about 6 bites instead of a huge chunk of cake. I'm okay with that. A GB patient might not be able to eat that bit of cake without an unpleasant reaction. I have a friend who had GB and she has had nothing but problems from Day 1. If it were reversible, she'd go tomorrow. She hates where she is now. Yeah, she's lost 15 pounds but she's living with problems that can't be fixed. You have some problems but they are things that can be adjusted away. So, go to the doc's office, talk about the stuck episodes and how you often find you can't eat the amount of food you SHOULD be able to eat and ask for a slight unfill. If that doesn't get you there, get another slight unfill. Don't go drastic. A little change can make a huge difference in your daily life. And, let us know that it's better!!

I don't eat bacon in strips .... just doesn't break down enough with chewing to go down easily. I do cook it really crisp to crush to go in recipes though. Bread. Wholel grains have a different texture than white bread. White bread turns into a doughy ball when I eat it and gets stuck every single time. But whole grains (pumpernickel is my favorite bread anyway) do better for me. Toasted is even better!

The counselor got it right.....each of us is different. I had surgery on Tuesday and went back to my desk job on Friday. For most, a week is plenty of time.

Well, not something I'm interested in doing BUT I would imagine it would be close to the cost of banding, minus the cost of the band itself, which isn't terribly expensive. Surgery center, surgeon's fees, anesthesiologist, drugs for anesthesia, other medical supplies like sponges, sutures, etc. are going to cost about the same as putting your band in.

I was told that when I reached the green zone, I would comfortably be able to go 4 or 5 hours between meals. I was never told to eat only a certain amount of food. What I was told was to eat 3 oz of Protein, a serving of vegetables and a serving of whole grain carbs (a serving is 15 grams of carbs). When I was still working toward the green zone, I was told that if I got hungry in less than 3 hours to snack on PROTEIN ONLY....a boiled egg, an ounce of low fat cheese or some low fat cottage cheese (all around 70 calories). Now, at 5.8ccs, I am in the green zone and have been there for a while. Having lost 80 pounds already, I now lose consistently at the rate of about a pound a week. Don't compare your 7ccs to my 5.8ccs ... we are all different. My best friend is at 6.8ccs and hasn't made up her mind if she's really "there" or not.

I have a card that my surgeon's office gave me. My cellphone has "I.C.E." in it .... "In case of emergency" which I have been told is often checked for in the ER if the patient is unconcious. It has my daughter's cellphone number, and she is fully aware of my band and my doctor's name as well.

Here's what I was told to do. Eat a meal of 3 oz of Protein, a vegetable serving and a serving of whole grain carb (that's 15 grams). I was told that if I got hungry in less than 4 hours to eat a snack of PROTEIN ONLY....a little low fat cottage cheese, a boiled egg or an ounce of low fat cheese are what I usually choose. Once you are in the green zone, you will likely not get hungry in less than four hours .... that is a goal. I was told that if I knew I had to go as long as 6 or even 7 hours between meals (which does happen to me between lunch and dinner fairly often since I have a fairly long commute home and I don't leave work until 5:30), then have that small protein snack...to keep me from eating whatever I pick up when I get into the kitchen.

Heather, it's all anatomy. Some stomachs are bulkier than others. And the green zone is different from one person to the next. I'm at 5.8 and this is the green zone for me. My best friend is at 6.8 and is still thinking she needs another fill. Just keep reminding yourself that we are all unique and just because at 4.8 you didn't feel what you thought restriction should feel like doesn't mean you didn't have any. You just aren't "there" yet.

Some of the psych. consults include a T/F or Y/N set of standard questions, too. Bascially, what they are looking for is that you do not have unreasonable expectations about the surgery. I mean, there are plenty of people who seek the surgery who haven't done their homework and who somehow expect this to work like Samantha's nose or a magic wand. Those people need to be weeded out, so to speak or referred for more review. Anxiety and depression are rampant in our society...and how many of us obese people have been treated for depression???? I wouldn't even hazard a guess, LOL. No, those would not rule you out.

If you're really questioning the "no carbonation" rule, do this. Open a bottle of beer or soda. Take a condom and stretch it over the top so that it completely covers the top of the bottle with no "leaks" and walk away from it. Come back in a little while and you will have a condom balloon...inflated by the carbonation. That's what it does in your pouch/stomach and it can be quite painful. Bread? Yeah, I eat bread. IF it's toasted. Or crackers (I love Kelloggs Special K Crackers!). Pasta? No way. Every time I've tried, I get stuck. So not worth it.