pennreporter

Trish, I'm a Trisha also. I'm in Tobyhanna and on Geisinger. I didn't have a problem getting initial coverage but really had to fight to get surgery approved because I'm on the borderline of what they require. My PMP was extremely supportive and I even had to gain a little weight and go through a sleep study to get diagnozed with sleep apnea. That was the clincher. But I had gained weight from when I initially got covered by Geisinger. Are you saying they declined to even let you subscribe to insurance, period? I didn't have a problem with that even though I have high BP and high cholesterol and thyroid issues but all were under control with meds. In Pennsylvania it sucks. Have you tried for state-assistance coverage because they do cover the surgery. Several people at my meetings at Geisinger were getting it that way, especially if you're unemployed. Good luck from a fellow Poconos person!! Trisha

what a great support team you have going!! My daughter had hers done 2/08 (85 lbs, now a size 8 and going for PS.) So she's my support and at least I've seen the ups and downs (many more ups than downs). Good for you guys!! Trisha

I'm having band on June 1, but my daughter had hers last year and is going for first PS June 4, lower body lift, breat reduction and fat implants into but. The arms and back fat/skin and a small implant will be next year. Very nervous about her being on an operating table for 8 hours but the doctor is a very well known and reputable doctor so I just have to trust that everything will be okay. Good luck to you. The arms might be the only thing I will do and may be able to do the one where the incision is actually in the armpit instead of down the arm. Again, congrats and speedy healing Trisha

Mine does the 5-incision procedure. My daughter's was the five also. Trisha

I haven't been banded yet, but my daughter has. She had the gas problem pretty significantly for quite awhile. She still does but not as bad, although still has episodes if she overdoes herself. She finally got a script for it, which has helped tremendously but she forgets to take it. Also at nightime, she has to be very careful about not eating even remotely close to going to bed or she can't sleep. The food hasn't had a chance to digest from the pouch and makes it hard for her to breath. She also has started buying raw milk which is loaded with nutrients and that has seemed to help her also. She just has like a cup of it a day. But clearly something you're eating in the middle of the day is causing problems if it's at the same time every day...maybe a lighter lunch. Good luck Trisha

Welcome. I'm also from PA, the Poconos, and being banded June 1 at Geisinger-Danville. Good luck on your journey. Trisha

List keeps growing. Congratulations and good luck to all!!! Trisha

do you have to have a passport these days to go to Mexico? Where in Mexico are you having surgery? Trisha

I agree with Parrothead, you need to find "exactly" what your insurance company requirements are to qualify. In your denials, they should have told you why were denied. They are required by law to inform you. I find it hard to understand with your BMI and diabetes and blood pressure that you don't meet the requirements, but insurance companies will do anything they can sometimes to deny claims. is your Primary Care Physician supportive? Some insurance companies have a six-month plan which include group sessions, psyche eval, a certain percent weight loss. So you can't begin to move forward until you know what requirements are and why they denied. Have you appealed to your medical state board. You can always go over your insurance company and go to the state board, especially if they won't give you a reason for denial. Then last resort, hire an attorney that handles medical appeals. Good luck Trisha

it's hard to tell someone else financially what they should do. Not sure how much your surgery is costing you, but there is such a wide variety of doctors charging different rates. Here in PA surgery can be in the high 20ks. In Texas by an extremely reputable surgeon, 13.5k. I am a believer in creating your own future and new possibilities. Like the one poster said, even though employers are not supposed to discriminate, let's be real. With this market, if you have two candidates equally qualified, you know as well as anyone they will probably pick someone who may not be morbidly obese. True the surgery isn't going to make you thin overnight but it's a new beginning and will create new possibilities. But my first step would be looking at the cost of the surgery and start comparing. Dr. Spivak in Houston didn't require a gazillion months to qualify. My daughter was denied by her insurance and no amount of appeals was going to give her any comorbidities, which is what they required on top of at least 40 BMI. She clearly couldn't afford 27k in NYC and did her research and found Spivak. My surgery luckily is being covered but if it wasn't I would be heading south. Not so sure I would head to Mexico but there are some extremely qualified surgeons down there now. Don't give up until you explore everything. Good luck and look at the employment situation and surgery as a new adventure and to your surprise there may be something wonderful that comes from all of this. Trisha

Three Cats, didn't mean to discourage you at all. But if it means taking a month, do your research, maybe go to a support group which I'm sure they're in your area, if for nothing else but to make an informed decision. I'm at 70-80 lbs but my daughter has done it already. So I really have great support and a great source of knowlege because she really did a lost research before doing hers. There's a book by Mohammed Ali's daughter who has had the band. I think it's called Fighting Weight. It's a pretty informative book, written by her with her surgeons. I have no doubts about this being the right thing for me, but that's not to say I'm not nervous, but mainly just about the first few weeks after surgery, after that I have no fears. any questions that you have you, no doubt, can find them here. My hospital had a support group for bariatric patients. Unfortunately, it was mostly bypass patients, which have different issues to deal with but not one of them regretted going through their procedure. You'll know when and if it's right for you and when you're ready to commit to the life change. But with my daughter, we still go out and eat, went to Olive Garden for Mother's Day, but only ordered and appetizer and an entree, and brought enough back home for another meal. She's a cheap date these dates. lol. So good luck on making your decision!! Trisha

thanks Susan. 60 lbs in less than a year is wonderful. My daughter's loss was 80 in 14 months. So it all sounds like a healthy pace. I can hardly wait. When I first got my surgery date, I was like eating everything I could. That has now worn off. Now I'm looking forward to starting the liquid diet because i know that's my real countdown to THE day. My daughter and I were going to do the band at the same time, but she has struggled her whole life with weight issues antd I really wanted it to be her time and for her to enjoy the support and attention she has gotten. She so deserved to enjoy her weight loss and it has been life-changing for her, nothing short of a transformation physically and mentally. And at least now I have the knowledge she has from having gone through it. Very glad to see an over 50 group on here!! Trisha

Thank you so much for your response, Doctor, although I don't know that it has alleviated any of my nervousness for her. I will convey all of this to her, so that at least she has questions to ask. I know that she would have conveyed the fact that she lives in NYC. So let me ask you another question...she's paying 27k for all three procedures in Houston. She had several consultations in Houston and they were all within that ballpark. Would that be that much difference than if she got her surgery in NYC? Her best friend lives in Houston, so she does travel there somewhat frequently but it sounds like she may not be aware of the follow-up that she will need. Thank you again so much Trisha

I'm being "Realized" June 1! My surgeon is just now switching over to the Realize...so much so, he hasn't attended the Realize training seminar that's required by the FDA when physicians/hospitals begin to use a new product. So as a result the chief of surgery for the bariatric department will be also in the operating room. Nothing like feeling like a guinea pig...lol. But it's an excellent hospital and the do hundreds of bypasses, just not as many bands. But I have to trust my doctor when he says that placing a band is relatively easy as compared to doing the bypasses. So assuming I don't come out with the band around my neck instead of my stomach (which could keep me from eating also), then all will be good...lol:thumbup: Trisha in da Poconos

I haven't had mine yet (June 1), but my daughter has. She flew to Houston on Sunday night, went to the doctor's little video-thing, had surgery on Tuesday, flew back to NYC on Friday and worked Saturday. But I will say it's something you have to really want to do because it is a life-changing relationship with food. But if all you're worried about is the first week, well, in my way of thinking ...what's one week versus the rest of your life. But I've had 7 months to prepare because of the program my ins. co. requires and 15 months of watching/listening to my daughter's post-op progress. So if it's moving all too fast for you, then that's a decision you have to make. Maybe you haven't gotten all the answers to all the questions you might have. Good luck on your decision. by the way, whereabouts are you in PA? Trisha

Nah, not so interested in the boy-toy...lol...that is unless he's also a carpenter/plumber/electrician...then any age would be fine. lol I have no doubt that my weight loss will not be the same as my daughter's but, like I said, different goals. From some of the complications that I read about on here, as long as mine are as minimal as hers have been, I will also be happy and I think she's been on the aggressive side with her fills, but she had a plan/goal and has stuck to it pretty good...although I'm sure the boy-toy has helped her :tt2: It also helps having someone close that's also had it. I have someone a phone call away to ask. But I think being single may also help in the sense I don't have to cook food for anyone else. The dogs don't count. Although starting next week when I start liquid pre-op, they are so not getting roasted chicken with their dog food for awhile. :biggrin: thanks all and a very happy mother's day to all trisha

Hello, Dayna. I'm also from PA, the Poconos. Congrats on your surgery date. I'm scheduled for June 1. So one more week before i start liquid diet. Good luck Trisha

I'm not banded yet (June 1), but my daughter is. She clearly doesn't go every month. She's at about 14 months. After the initial fill, she's had maybe three fills. One was too tight and she had to go back in after a few days and have some taken out. But she's been at this level for about six months. For her, it's just as needed, but never has it been monthly. She's getting close to goal, so then she will loosen it somewhat but not all the way. good luck Trisha

June Jewels? Jewel: a person or thing that is treasured, esteemed, or indispensable Juneberries Jumping Junipers Trisha

So sorry also, but I'm sooo not surprised. I'm kind of in a remote area and I have no doubt that the group leader at my local WW group would be the same way. But the good thing about WW is you don't have to go to a meeting group just to follow and count points. There are so many programs out there these days that will do the same thing. I had a program for my Palm that tracked points and now on the iphone there's numerous. But you can get that reaction from many non-WW people. I haven't been banded yet (June 1), but my daughter has, but I've stopped telling some people I know because of their reaction. Even my previous primary care phy's reaction was "just count calories." DUH!! Silly me for not ever having tried that approach. So not to worry. Some of my greatest successes have been on WW, and also my biggest weight gains after I stopped following WW. Trisha

Dr. Schulman, my daughter who is almost 18 months post-lapband surgery, is having her first PS (lower body lift, breast reduction, fat injections in butt) next month. She lives in NYC but is going to Dr. LoMonaco down in Houston (Big Medicine TV doc). She's planning on being there until right after her 10-day checkup with the doctor. But she's allowed three weeks before she goes back to work. She's a haircolorist in the city and is on her feet all day. I know she's going to try to go back on a reduced scheduled at first. What is the realisitc time before someone goes back to work? She uses her arms a lot, so will this be an issue for the breast reduction? I noticed on your website it says that there are dains inserted (which she didn't mention to me). How long do the drains stay in? The doctor is also sending her home with a morphone pump. How many days of meds will she get from the pump? i appreciate any answers you provide. I can't accompany her down to Texas as I'm having my band surgery two days before she leaves. I wish she was doing it in NYC, but I think the cost is considerably less down south and banks aren't doing many medical loans these days. (plus one of her clients works on the set of Big Medicine and I think she was hoping to maybe have an "in" for the show but I don't think it got picked up again, which wouldn't have made it free but greatly discounted.) Also...hate to rattle on..other than a physician's CV and reading their own site about their accomplishments, are there any watchdog websites to really check on your prospective physican? I'm somewhat nervous with her going to a "TV doc," although his credentials look great. Trisha

I second everything the previous poster wrote. The first place is your insurance company. My insurance is an HMO with its own hospitals/doctors. So they had their own bariatric department, and my only choice was to go through their program. But when you go through what your ins. co does/does not cover it should be very specific. If not, call them and request what their requirements are as far as BMI/comorbidities. Mine was at least a 40 BMI for I think a five year period and history of failed weight loss. If between 35-40 you had to have other medical issues. But my primary doctor was wonderful. I had one previous to him that when I mentioned it, he pooh-poohed the idea and gave me the whole watching-your-calorie speech. My program was also a six-month program, which actually is more like 8 months. So I would start your process now because assuming you would meet ins. co's requirements, sometimes it takes time to get into doctors, etc. I would be very specific when asking ins. co if they cover surgery for your age, because if they don't, that may be your deciding point. Some doctors, if they know your plan won't cover it, won't even start you on the journey. But I will give you this bit of info. My daughter had hers done Feb 08. She's 37. She struggled from the age of 5 with weight issues. If your family is supportive of you doing this, it's wonderful. In hindsight, had this procedure been around when she was 17-18, I would have consented in a heart beat. It has been life changing for her and I know first-hand the heartache that teenagers go through with the weight because I've lived through it with her. Best of luck and please keep us updated on how it goes with your insurance company. Trisha in da Poconos

I initially was kind of in the same boat. 39 BMI, had high blood pressure, high choles., thyroid, arthritis, you name it. But my insurance required under a 40 BMI, that you had to have either diabetes or sleep apnea, which I knew I didn't have diabetes but wasn't sure about the apnea. My primary care dr. was fabulous and very supportive, sent me for a sleep study and, lo and behold, had sleep apnea. Now everyone around wasn't surprised. Guess I was the only one not disturbed by snoring...lol. But still had to jump through all the hoops for the six-month program. And even gained weight to make sure I still fell within the weight guidelines because I knew that part of six-month plan was to lose 10 percent and had to be careful not to drop below the required weight. My daughter was also refused for having no comorbidities. She flew from NYC to Houston to Dr. Spivak who is one of the original 14-member team that introduced lap-band to the US...pretty much as long as you're a 35 BMI, he will do it. I would think it wouldn't matter as far as complications after the fact as to whether insurance will cover. it's then a medical problem and they should still cover, but there are plenty of attorneys out there that do nothing but litigate insurance company denials. So I wouldn't worry about that. Dr. Spivak in Houston last year was 13,500 but my daughter did all of her follow-up/fills in NYC. Good luck Trisha

My doctor/program required also to lose 10 percent of your total body weight in order to get the final approval. It's a total of six months to go through the whole program before they "approve" you to go through to insurance approval and the surgeon. I drug my heels until my sixth-month appt. I had lost a few but had myself convinced that they really didn't mean it...lol. Well, they did. Go for 6th appt when I should have been given my green light. She sent me home with a month to lose the additional 9-12 lbs. That was my wake-up call. I hate going to the gym. So I bought a stationary bike. Rode it twice a day for 20 minutes at a pretty decent speed. Kept my calorie intake to 1,000 but the biking was burning off 300-400 of that. I was back at the doctor's in two weeks. Plus the day before I got hold of some of my daughter's Water pills, but like another poster wrote there are foods that will have the same effect. So it can be done, but if your program requires you to lose weight don't take the chance I did of believing they're not really serious. My daughter's doctor did not require the 2-week liquid diet and didn't require the weight lost beforehand, but she also paid cash for her surgery. some of this is driven by insurance companies. Good luck. You can do it. Trisha