sarcasticwriter

I had what I called my food Farewell Tour. I ate a lot of stuff I didn't think I would be able to eat after surgery - both food types, and foods in combinations that probably won't be allowed or are really only satisfying in large bites. Case in point: Rubio's Baja Original Fish Taco is one of my top five all-time favorite foods. Fried fish, yogurt sauce, cabbage, thick corn tortilla, and I add a salsa verde and lime. It's the nature of the thing that you have to open your mouth wide and take a big bite to get all the different components in one tasting. And it isn't the same thing if even one ingredient is missing. Will I be able to enjoy my RBOFT again? Highly unlikely; if I even allow myself to have fried fish and corn tortilla, I might not be able to tolerate salsa and I certainly won't be able to take a huge bite and get all the flavors at once. So as my date approached, I had RBOFTs until I was literally sick of them and didn't want to eat any more. Then I had an extra couple, so I was really completely good and sick and the idea of having one was almost nauseating. For now, at least, I don't particularly want to have one. So as part of a mourning process, and to (potentially) get yourself sick of your favorite foods and ready for your diet? I say go for it!

Are you an independent contractor renting the space, or an actual employee? Do you work full-time? How many employees work for your company? If you're a full-time employee, and your company has enough employees to qualify, you'll be protected by the Family Medical Leave Act, as long as your health issue is documented by your doctor. You can research if you qualify for FMLA here: http://www.dol.gov/whd/fmla/ . However, you'll have to tell the truth that during your vacation you had a medial procedure (you don't have to tell her what it is) and that you had complications from it. And you'll potentially have to fill out some FMLA paperwork for her. Tell her ASAP. She's probably going to be deeply annoyed that she only has a couple of days notice, but if you qualify for FMLA protection, she legally *can't* fire you.

The N.E.W. Program in Newport Beach requires that you buy their Bariatric Advantage package with shakes, Protein Bars, Vitamins, etc. for both your pre and post surgical diets, but I HATED HATED HATED the Bariatric Advantage shakes. I managed to go about five days with them on my pre-op diet before I called my NUT and begged her to let me switch to Premiere Nutrition, a brand I'd tried and loved. Thank god she let me switch! Premiere Nutrition comes premixed in tetra packs. 11 Fluid ounces, 30 grams of Protein, 1 sugar. You can get them at costco (exclusively, I think?) for something like $25 for 18. They're in a red and white box. Buy chocolate only; the vanilla is naaaaaassty! Also, they should be served as cold as possible, but not frozen (obviously). Good luck!

Hi everybody!<br /><br />I hate people who jump on to message boards and ask questions they could suss out for themselves with some research, but I'm desperate!<br /><br />This is our annual chance to change our health plans at work. I'm in Seattle, currently on the Group Health H.M.O. which, needless to say, does not cover bariatric surgery of any kind under any circumstance.<br /><br />However, there are two Blue Shield PPO plans listed, a "high" and "low" one depending on the amount of coverage you want to receive. The brochures I got at work don't have any detailed information about exclusions and limitations, though. Just cost.<br /><br />After doing my research on doctors, I've decided that I want to go to Dr. Quebbermann in Newport, CA, because he seems to be the leading US bariatric surgeon and because my family is in O.C. and it will be easier for them to care for me there than have them come to me in Seattle.<br /><br />So here are my questions:<br /><br />1. Do PPOs let you travel to doctors "in-network" but out of state? Dr. Quebbermann has Blue Shield listed as an insurer on his website, but I know there are hundreds of plans within Blue Shield, all of which have exclusions attached.<br /><br />2. If I stick with my H.M.O. and pay cash for the surgery, will my H.M.O. be invalidated? Will it cover me if I have a complication? I've seen horror stories here about month-long stays in the ICU. I can pull together enough money for the surgery, but not six figures for a month-long hospital stay and extra corrective surgeries.<br /><br />I've called both the P.P.O. and H.M.O, but they've been cagey about giving me clear answers. They obviously want to keep people confused and off-balance as to minimize claims. Any info that anybody might have would be incredibly helpful!

Well, I did another round of calling, this time with some more specific questions and information, and the BCBS rep said bariatric surgery is covered now! I asked him to triple-check that he was looking at my company's specific plan, and he said that he absolutely was. I asked him to make sure the New Program is in-network, even for an out-of-state patient, and he said that was cool, too. He even read me a huge long list of requirements (six month diet program, consult with dietician, consult with psych, etc.) that the insurance company requires to approve the surgery. I don't think he'd have that if they don't cover the surgery. He wouldn't send any of it in writing, though. Then I called the New Program offices, and Paula (who was very sweet and incredibly informative) pretty much told me all the same things the BCBS rep told me. So it seems like this is going to be a go, unless the insurance rep got it wrong and my company does have a specific bariatric exclusion. I'm staying skeptical that I got my miracle answers over the phone, but it gives me a direction for what insurance to pick during open enrollment, that's for sure! Spending an extra $600 in premiums this year to potentially save $18,000 is a gamble I'm willing to take! Thanks to everybody for the tips and advice. When I had some more specific questions to ask, and knew how to ask them, I really got the answers I needed. Thanks to all!

I got a reply back from my HR person that basically amounted to, "All I know is that our PPO program is Blue Shield of Washington, under the umbrella of Blue Shield of California. Call the 800-number provided for more information." It's a bummer, because I really wanted to have any information in writing! <br /><br /><br />

HI Janea! Thanks so much for your offer to help out! My HR person gave me the basic BCBS toll-free number to call. I tried Monday morning, but after being on hold forever I gave up. I'm calling back today (Tuesday) to get more information, hopefully it'll be less busy after the weekend. I think our name is Blue Shield of Washington State, but the HR person said we're under the umbrella of Blue Shield of California. Kinda confusing. I will certainly get back to you with more information! Thanks so much! <br /><br /><br />

Hi MeMeMEEE! My HR person did confirm that we're under the Blue Shield of California umbrella. She didn't know much else and referred me to the basic customer service number for BSBC. She didn't give me the group policy number or anything, but I presume that they'll be able to look it up. I was kind of hoping I'd be able to avoid doing this over the phone, because I'd like to have proof of coverage (if there is any) in writing. But what can you do? Unfortunately, the H.M.O. is an entirely different program unaffiliated with BCBS. I actually like my H.M.O., so that's a bummer. Thanks for the tip about having the insurance for two years, by the way. That's vital info! <br /><br /><br />

Thanks VBG! I contacted my HR rep, but she didn't have access to any of the contracts or anything. She suggested that I call the customer service number for our insurance company. Hmm. I did find out that our PPO plan, Blue Shield of Washington is apparently under an umbrella of Blue Shield of California, which theoretically would give me access to Dr. Quebbermann, if the PPO covers bariatric stuff. I waited on hold *forever* Monday morning, but I'm going to call back today. Thanks for the info! I didn't know that employers could modify the policy to exclude specific things! <br /><br /><br />

Hi Veda! I guess by now you'll have attended the information session. May I ask what kind of impression you had of the staff? I've heard nothing but good things, but more information is always better than less! Also, if it's not too personal, may I ask if they quoted you a self-pay price, and if so, how much it was for? They don't seem to want to quote any prices without first subjecting you to a big pitch. But I'm already sold on the surgery, so don't really care about the sales pitch. I just want to know how much it's going to be, period. I understand if that's too personal a question, and please forgive me if it is. <br /><br /><br />

Hi there everybody! Just wanted to say hello and that I'm joining the board. I signed up with the LapBandTalk board last year, but I'm starting to lean toward the sleeve, instead. I'll be around a lot! - Christina