happygirl65

I have one too Tori's Tattle Tales Just started it a few days ago but it is very theraputic! I even told a few friends anf family about it so they can see the inner workings of my varying mind...I am SO DEEP and at times SO SHALLOW...I am an enigma but I suppose that's why the people who love me...love me the way they do. :rolleyes2:

Well, I don't know if NJ is the same as AZ but BCBS seems to have a LOT of information on their website...to be honest I found the simplest approach was to call the 800 number on teh back of my card...I exhausted myself searching every nook and cranny of the net to find a simple phone call was all I needed to know EXACTLY what was covered under my plan. :rolleyes2: They will also mail you a copy if you request it of the specific requirements. BUT my plan required : BMI of 40 or 35 with co-morbidities diagnosis of morbid obesity for 5 years Clinical documentation of diet attempts to lose weight in the last 2 years including self directed dieting, commercial programs, nutritional counseling or exercise programs Clinical documentation of for an active plan for active participation in pre-operative instruction program and post operative or follow up care plan in cluding preoperative nutritional counseling and must show ther is a plan in place for post-operative nutritional counseling as well pre-operative clinical assessment and documentation must reflect a significant motivation and understanding of the risks associated with intended surgery as well as understanding of the lifelong restricted eating habits that will follow Must be 18 yrs or older Individual has no treatable condition that may be responsible for the morbid obesity like endocrine or metobolic etc Individual has no significant liver, kidney or gastrointestinal disease Individual has no drug or alcohol abuse - must be abstinent for 12 months or more if there is a history of drug or alcohol abuse Individual has been evaluated by a licensed psychologist or psychiatrist documenting the absence of psychopathology the may limit the individuals ability to understand the procedure I would expect other states to pretty much be the same but you never know...also they have an access fee of $1000 which is out of pocket on top of your deductible,,,but your mileage may vary and you should call your company to find out...also SOME employers can specifically exclude bariatric surgery from their health plan so you will want to check on that as well. Good luck to you!!!

CHAPSTICK! I can't stress this enough! And lotion! I am not banded yet but have had several surgeries and my lips and skin always get SO DRY from the throat tube and lack of Water before and after surgery. GOOD LUCK! WE ARE ROOTING FOR YA!

Here is what my Dr.'s web site has to say about the psych eval: "When people come to us for weight loss surgery they ask about the pre operative psychological evaluation: why is that required? It is not a screening examination -- no psychologist or psychiatrist can tell the future, and see if you have what it takes to undergo the band. Nor is it like a cardiac clearance -- where we ask a cardiologist, on some patients with heart issues, to help us improve their heart's performance for the operation. We use the pre-operative psychological examination to make you aware of the tools out there to succeed. One of them is the psychological support. Our greatest support is in our groups that meet twice a month. Did you know that in the last year with the 20 support groups we had that Dr. Simpson was in 16 of them, and our nutritionist was in 18 of them? Some people find that things in their lives change, and their relationship with food changes, and they want to talk with a professional about it. The pre operative examination allows you to be introduced to someone, and know that these resources are available. One of our psychologists is a patient herself! " I found that to be most comforting. Mind you...all doctor's offices might not be the same...and a lot of insurance companies require very specific tests but I don't think they are allowed to disqualify you. It sounds to me like their purpose is to bring out your issues with food. Obviously some of them take the approach of making you feel like crap about it and doubt yourself...I am not a psycologist but maybe it's to test your resolve. It seems horrible to exploit our weakness in this way...maybe they are wanting to "sell" their therapy services. It sucks...but I don't think you should let it make you change your mind...only take careful consideration to finding a GOOD therapist you can trust if you find you still have issues with food....that's my two cents worth.

Thanks for all the candid replies. I guess one of the things I need to work on is the idea of absolutes...all or nothing...it's that kind of thinking that lets me go off the deep end instead of having one little treat in moderation.:eek: In the end I will still be me...still be human...still make mistakes, but if the band can help me (as it seems to have helped you all) not have the cravings and take some of the focus of my life OFF of food that would be absolute bliss. It is hard when you have to be so diligent about every single calorie that it takes control of your entire life. That is where I am at now...so I guess the question I have to ask myself is do I want to live this way forever...weight loss or not, just obsessing about everything I eat all the time, watching the clock, starving myself if it's not "time to eat" again yet and just being basically miserable about it? NO, I don't, and whats more I don't want to pass that affliction on to my kids who WILL learn from me no matter what I do. They will learn far more by my example than by my words. I deserve better...and so does my family! I LOVE the support here on LBT. Thanks for listening and caring...time I start caring as much about myself as I do about everyone else! :rolleyes2:

Wow...you are so right! I wouldn't question it if it wasn't something that I am pursuing on my own. :thumbup: It is funny that I was so sure about my decision until it started to become more real and I have financing all lined out and just waiting on the docs to get all the info to my surgeons office. I just have to keep my eye on the prize and not let the self doubt creep in and sabotage me like it has so many times before.

Good point... I think the fear of a foreign object in my body is what is holding me back...the what if's but I do have to remind myself that there is no certainties in anything. All we can do is the best we can with what we've got right?

I am pre-op but my doc office says let them go flat and only drink them that way, after that you may be able to give them up (I am trying it now to get ready and would rather drink tea!)

The out of pocket will depend on your insurance but there is a 1200 program fee and only 500 is refundable if you back out. But you don't have to pay that fee until the Bariatric coordinator gets all the paperwork together and makes sure you meet the other criteria for your insurance. You can't get approval from insurance though without the psych test and nutrition counseling though so you are taking a small gamble but she explained to me that they are really good at getting everything together and knowing whether your insurance is going to approve before they move forward with that step. She said you usually pay it when you come in for the psych and nutrition consults. So be prepared for that. It does seem steep but it pays for the psych tests, nutrition counseling, after care, support groups etc. I personally am working the 1200 into the financing for my other out of pocket costs for my deductibles and cost sharing etc that my insurance wont pay. So they will work with you on that. Everyone in the office was very nice and pleasant. I think you will like it. Dr. Simpson is quite confident which is very comforting. DO bring in a list of questions because I got so overwhelmed with the entire process and all the other info they were giving me that I couldn't think of my questions when it came time to ask them. Good Luck!

Well I had my consult today, now I just have to wait for my doctors to send records to the surgeon's office so we can get the rest of these requirements going and out of the way. Looks like it wont take too long. crossing my fingers anyway:thumbup:

High cholesterol, depression and hypothyroid all can be co-morbidities as well as high blood pressure, stress incontenence and some other things...each insurance co has their own requirements...just call your insurance company and ask or find the book that spells out your coverage and you will find it...I was amazed at my consult though at how much the Dr.s staff knows about getting things approved...they are pretty good at it. I bet all will be well if you consult with a surgeon.

You definitely have to find a way to deal with the stress...but you should realize that just RECOGNIZING that you have that trigger is the first step toward changing it. RIGHT ON! WAY TO GO! Now, the next time he pisses you off (and it will happen cuz face it...married people make each other mad at time...that's life) you will go for the kitchen as an impulse and then you will stop and say....wait...there are other ways to deal with this... I dream of throwing a roll of TP at his head and saying..."clean up your crappy attitude" I never do it...but thinking about it makes me laugh anyway.

Try reading some blogs, that really helped me...these are people who have been where I am, have gotten banded and then had major success. Like anything else in life, it's not success only and there are people who find ways to make it not work, and there are some people who just don't like it but the vast majority it seems do lose weight and use it as the wonderful tool it is. I am scared too but am getting excited about getting it done because I honestly believe it to be the first time that I am truly going to succeed because the drastic physical change will force me to make permanent changes. I am on a journey already to finally put myself first in my life and that is what I am doing. Part of me feels terribly selfish to pay all this money but it's about time that I took care of myself for a change...I figure the family will have to adjust but in a short time I will be able to take better care of them and for longer because I will be healthy and I will be able to teach my kids how to grow up KNOWING how to be healthy so they don't have to wade through the train wreck of contradictory information out there. I think we will look back and say..."I should have done it sooner, it's the best thing I have ever done for myself."

Well I had my consultation today. I really liked Dr S. He is ver confident which I found comforting and he explained things very well and put my mind at ease. Hoping the paperwork and insurance part goes and smoothly as today went. :thumbup:

Thanks so much for the encouraging words. :eek: I think it is amazing and awesome that you have accomplished so much! I have an incredible amount of support and I believe you are right about the mental thing. I can't wait to see how well it works for me. I know it will because the last year and a half has been about changing my life for the better, taking control and finding myself. I am putting me first for the first time in my life and it feels really good. I know I deserve it and that I am worth the effort. :thumbup: Your story is one more confirmation that I am doing the right thing for myself and that real change is possible. I am happier than I have been in a long time. :tt2:

Hi! I am going to be having my surgery done in Phx which is 2 hrs from me. I was wondering if there is anything you would have planned for or wish you knew to plan for? Right now I am thinking, plan to stay the weekend in Phoenix if possible incase there are any early complications.. Pack for a hospital stay just incase I need it Anything else?

Any type of permanent change is stressful. :mad2: Let's face it, many of us have used food to deal with life's issues, or used it to Celebrate...or both...it has been a central part of our lives for a long time. That is something that has to change if we want something different for our futures, and now that you have the band it will. Once you get past your recovery period you will find ways to enjoy higher quality foods in lesser quantities, each much slower, savor each morsel more. I have heard many people say they enjoy food even more because they are not obsessing about it they can just enjoy the small amount they do eat and be done with it. It is very important to remember also that ansesthesia will often effect you in an emotional way...I have had 4 surgeries in my lifetime and it does it to me everytime. Just try and talk to yourself nicely when you feel low, telling yourself that this will pass, healing is hard and stressful and you have to allow yourself to feel that. Grieve for your loss if you need to as well. It's ok. It will be ok, and one day, like so many others you will look back and say...yes it was hard but it's the best thing I have ever done for myself. We are not super beings. We don't have to go through it all alone. We need support and love from others and from ourselves. We are regular people doing something extraordinary for ourselves. It will eventually be worth all the pain you have gone through. I am pre-op myself but I have had the fears that I will go through all of this and it may not work but I have to remember that I got to the point of wanting surgery because I am truly ready to take control of every aspect of my life and as long as I start treating myself with the love and respect I give to everyone else I will not fail myself. Just remember why you are doing this and that YOU ARE WORTH the effort, the discomfort and the changes it will take to master your own destiny. Say it outloud to yourself if you need to. YOU ARE AWESOME! YOU CAN DO THIS!!!! :frown:

Good luck to you!

That is so AWESOME! And encouraging. THanks for sharing that. Most people say thy like him...I have read some negative comments about his mannerisms but in the end what is most important to me is that he knows what he is doing and I have heard nothing but great things from anyone who had him do the surgery...along with the support. Pipedoc...did you use the after care support of his team? If so/not what was the most helpful to you?

I am meeting Dr S for the first time on Monday. I am really excited to get the process started. I have thought about it for years and have done what I feel is everything else I can do to lose on my own. I feel comfortable that this is my best option for longterm success. It is really easy to start second guessing myself though. I just hope that everything goes smoothly with all the paperwork and insurance. That can sometime throw a monkey wrench into things. I am trying to see the positives in every part of each step of the process. Waiting just gives me that much more time to exercise and plan and prepare. WOO HOO!

Well I was all set to start fretting over whether I could get the surgery done this year since I have already met 750 toward my 2600 deductible but now I am thinking...either way, next year would just give me almost an entire year of having my deductible already met...and that ain't too shabby.

The doctor I am going to in Phx charges a $1200 program fee and it was explained to me that it is for all of the support and things you need afterwards to succeed in your weight loss goals. It includes email access to the doctor anytime and also a bunch of books and supplies to start you off with. It does seem steep but it seems there are lots of docs that do charge a program fee of some kind, what is covered in that fee varies widely though.