Search the Community

I have Anthem BC/BS PPO also. My coverage will not pay for any fills or aftercare, either. Luckily, my Dr. gives the first year of fills for free. After that I'm on my own. It just depends on what plan your employer bought into. Sounds like your employer bought into the same plan mine did. :smile:

Anthem BC/BS paid for the surgery but they are not paying for any of the post-surgery visits; not for fills, checkups, anything. When I call they just say they are not a covered benefit - WHAT? Anyone have the same issues? What did you do?:smile:

I have had some second thoughts and fears. I am worried cause I have to pay out of pocket and what if I fail at this like I did other programs.. I also was watching some things on you tube on lapbands and there was a Dr.R something on there cutting down the lapband. Got me pretty scared... But then I sat here and thought more about it looked up some more research and am as ready as ever to do it I have 6 days of protein shakes to go... Holy poop.. It is coming fast and I can do it.. My family doc has a cheering section at his office for me.. It feels good.. Not many people have WLS up here in BC cause it mostly self pay except for the very few who are approved for the GBS... So anyways we can do this... I am here if you ever wanna talk..

steve - i am VERY new to this process as well. i actually just signed up for this website today. but what i did FIRST was consult my insurance company about the requirements/criteria from them. i then worked from there. my insurance company requires u to be a BMI of 40 or above OR a 35 BMI with a comorbid condition, under a doctor supervised weight loss management program for 6 months, and doctor's documentation proving i've been at a BMI of 40 for atleast 3 years. So, once I got that information, I researched weight loss doctors. I am going to my first appt tomorrow, and that is when i'll let him know I'm interested in the Lap Band surgery. I've also gathered all the information from BC/BS to take to my doctor as well. then, i called the doctor i want to do my lapband and scheduled a seminar with them. presently, that's all i have done- but that's what i did to start my process. keep us updated!

I feel your pain. I had hoped that I'd be one of those that could stop taking all my diabetes meds the day after surgery and never look back...haha...no such luck. All I can tell you is to keep doing what you're doing and as you lose weight, I'm betting your BS will improve. I stopped taking my meds (2000mg of metformin and 2 doses of glimiperide per day) 2 days after surgery, and my BS stayed pretty low for about 10 days, but then it starting going up again. Now, I am 3 weeks post-op and am taking 500mg of metformin a day and that is keeping me in the 85 to 125 range. I am also trying to eat low carbs, and am not having anything sugary. What does your doctor say about it? Hang in there - I'm sure it will improve as you continue to lose. Good luck!

I have been 100% approved with all the tests for a sleeve procedure. Now I have to decide when to have the operation done. I am always coming up with some excuse to put it off but I am calling BS on myself and want to proceed. I do have an important family function coming up (my mothers 101st birthday party) with family flying in from all over the U.S. I can have the procedure approx. 4 weeks prior to the party or put it off until after the function. My question is, for the average person, what am I to expect after 4 weeks? Can I function enough to enjoy the party and be social or am I going to be grumpy, uncomfortable and not 100% of myself? I want to enjoy myself and interact with my family or should I put it off until after the party. I will not have a problem with the food portion of the function, I just want to be enough of myself to enjoy.

It started about 3 years ago, My sister, then, a 21 year old young woman was living her life normally when she was overtaken by a horrible pain in her abdomen, followed by throwing up and not even being able to keep water down for days we decided it's time to take her to the emergency room, the doctors wrote it off as a stomach virus and said it would pass. Months go by without a trace of another "attack" when again same scenario, back to the E.R- again told it was a stomach virus, not one doctor did a test, MRI, CAT anything.. this happened more times than I can really count in the years to follow, when finally she had the worse "attack" ever which lasted for weeks, no one had a clue what was going on "could this really be a virus?" It got to the point where, her face had sunken in at her cheek bones, she looked sick, I thought I was going to lose my sister and I was terrified. After the last episode we met with our family doctor yet once again, he sat and brainstormed with us for what seemed like forever, then finally he thought "it's a long shot but let's check your pancreas" – A long shot because not only was she a 22 year old otherwise healthy young woman, but she wasn't an alcoholic. He performed the necessary testing and made the astounding discoveries, not only were her triglycerides at alarming numbers, (normal triglycerides levels should be 130 or under) hers were at 5000, but my sister, my best friend, was suffering from pancreatitis (inflammation of the pancreas) causing the "attacks "of dehydration, excruciatingly painful episodes and constant vomiting. Now you can imagine how angry we were with the hospitals and previous doctors that not one of them thought to check her levels, not one of them cared enough to get to the bottom of why my sister was withering away slowly and in such pain. Once we knew this info we thought "ok, give her some medication and let her get back to her life" They experimented on her as if she was the poster child for narcotic exploration, she tried it all from high doses of Niacin, Omega 3 fats (which spiked her triglycerides even more) to Trilipix, Nothing helped, Now it was starting to become an issue of just when her body was going to give up the fight because she was tired, fed up and sick and tired of feeling sick and tired. I had been researching the Lap-Band®®® procedure for myself and brought it to her attention, "Well it's known for helping with diabetes.. maybe it will help with this too". She searched for a surgeon right away, we didn't need any surgeon, what we needed was someone experienced and had a "clue" about this monster inside her. She came across Dr. George Fielding at NYU Langone Medical Center, when reading his bio we thought maybe this is the guy to help, we hoped that finally our prayers would be answered and within the month had an appointment to meet with him. Now let me get into why I wrote this, This isn't one of those writings of mumbo jumbo or blah blah hear my story blah.. No, this is for you, the reader to understand the extent of the situation before any action was taken, and for you all to know that without Dr. Fielding, my best friend would not be here with me today. During the consult he was what some would call brutally honest, but coming from all the flakey sugar coating doctors we came from, this brutality was utterly refreshing. He told her that while the band would help lower her triglycerides, at her severity, it wouldn't have made much of a difference and she was a ticking time bomb. So here we thought "back to square one" When Dr. Fielding mentioned there was another option called the Biliopancreatic Diversion where he would by-pass the pancreas so that she would only be using a small percentage of it, It was a dangerous procedure but considering that by the time she'd be 30 we were looking at heart attacks, strokes or even worse, this was our best bet. I must mention that both my sister and I have medical backgrounds, both went to medical institutes and both have an above "average" knowledge of medical terminology and physiology but this, was foreign to us. We had no idea what it would entail, was it going to work? So the researching data started. This was it! Why hasn't anyone thought of this before? Why didn't any of the doctors we saw in the past even mention the option? The answer, we shall never know but one did, and for that, and I speak for my entire family, are eternally grateful. Dr. Fielding performed the procedure within 2 months of her initial consult, The procedure itself took less than 2 hours and here I am writing this over 2 months later and she is doing fantastic. Her triglycerides are down to numbers I am even to scared to mention because they are so good and she is finally able to eat normally, just live. Without him, I don't know what Id be writing about today, but chances are, nothing good. I'd like to express my gratitude, my appreciation to him and his staff for letting me keep my sister, We could never express it accurately or enough but, know, that he saved my sister's life and I can never repay him for the gift of a normal life he gave her. Thank You so much for everything, we are forever grateful from the bottom of our hearts. -Jasmine (scheduled for the band with Dr. Fielding 6/14)

I was sleeved on the same day, and I had this issue during week 2. My dr recommended 3 meals a day, but I chose to add a snack and upped my water intake. That seemed to help bc I dropped a few more lbs. I also exercise everyday. And maybe increasing your protein to 60g would be good for you too. And during that time, I literally had to put a sign on the door to the room my scale is in saying "leave the scale alone!" Lol

OMG!! I can have watermelon?????!!!! I am 8 days post op. Are you sure! Bc I'm heading to the store right now if I can! Lol

You were just like me! But keep reading, there is light at the end of the tunnel!!!! Im sorry to here your frustration. We all have had our ups and downs for sure. I think my situation was pretty similar to yours. It took me forever to finally feel restriction and by the time I did, I had lost all the good habits I had practiced right when I got my surgery. The day of my 7th fill when I finally felt it, it was like a truck hit me! I was like "wait a second i don't like this!" But then I reminded myself that this was what I had prepared for but unfortunately because it took so long I forgot. As far as being too tight. I think you sound ok. If you can get down solid Protein like fish then you should be fine, chicken can be iffy, most of the time if its tender it goes down but sometimes it doesn't. Now as far as your weight loss, I will tell you what worked for me... As far as food goes, you sound like your on par with that. I try to keep mine around 1000 calories a day, and even if your not quite full, stop after 20 or so minutes and let it catch up. So great job with that! But as CRAZY as this sounds, even with a 1000 calories a day, you won't lose weight unless you get in 30 mins of light cardio a day because of that stupid thing we call metabolism. I chewed my doctor out 30 days after I was in green zone bc i hadn't lost a pound. I told him I'm only consuming 1000 calories a day! I should be losing, what is 30 mins on the treadmill really gonna do! Well out of desperation, I finally pulled my old bike out and started doing what he said. EURIKA! It finally all came together! The weight started coming off, and all i did was walk every night for 30 minutes!. I can tell bc the weeks i do it 5 to 6 times, I lose 2 to 5 lbs, but the weeks i get "busy" and only do it 2 or 3 times, i don't lose any . You don't want to really "work out" for hours at the gym though bc you might get burned out and not want to exercise the next day. Keep it light and consistent. The nurse told me that under a "normal diet" 30 mins of walking or whatever might not make that much of a difference because it doesn't burn that much calories but we aren't really doing it to burn more calories ... all the 30 mins of movement is designed to do is to keep your metabolism from going into shock. You need to get your heart rate up for a good 30 mins and it works wonders! To this day, I have never stepped foot in the gym. I get on my bike and turn on food network "haha". Anyways I don't make up reasons for not doing it anymore... my husband and children know that every night at 8:30pm leave me alone for 30 minutes. Moral of the story... 30 mins light cardio, as many nights as you can! If you do it 5 to 6 times a week no more, no less, you will be down 100lbs before you no it! Good luck girl!

Gm. I think one of the hardest steps is admitting we need help n then seeking it when we can't help ourselves. Ik that u can do this, keep praying or start praying, bc as you know, as the bible says, we can do all things through Christ Jesus who gives us strength:). So by all means we will gladly encourage you, while God strengthens you! Keep us u2d!

I know every doctor has his /her own protocol about what we WLS patients can/cannot have, but I have never seen/read/heard that coffee is on the "forbidden" list. Very interesting..... I have no words of wisdom or advice, bc I would be like you.... In a haze. I was in a haze and had headaches when I first gave up sugar and flour. Thank God that only lasted for two weeks. Maybe with time things will get better..... I sure hope so!

There is a big group on here from Vancouver, BC area on the Canadian group link that you can find scrolling down the main page!! They are very helpful and supportive.

that sounds like the guidelines of Kaiser through feds... it sucks but I didnt get approved because it was not two years and I didnt have 2 comorbidities... issurances are evil

So, I was sleeved on august 13th 2012... I lost 20 lbs pre op, and 14lbs the first week post op. I have stuck to this new way of eating. I've completely changed my eating habits. I have yet to get in my full amount of water, or protein, but I think if I focused more on that, I may be able to.. It doesn't really cross my mind much that I am thirsty, or need to drink, drink, drink lol. I still get that hungry feeling, but there are times when it takes me hours to feel it. There are other times where I feel hungry an hour or two after eating. I am on soft/regular foods, and have been eating things like chicken, cottage cheese, scrambled egg substitute, lowfat string cheese, Greek yogurt, etc. after my first week, I hit a stall.. which I've read is normal bc you're body is adjusting. This lasted 2-3 weeks, until the other day when I noticed I was down another 2-3 lbs, and then another .5-1lb. I can take more than a "SIP" of water, I have had a popsicle with sugar, (I use sugar substitute now) nothing I've ate has made me sick, or throw up. I have not had ANY problems... is this normal? I know everyone's experience is different, and although I was a little worried if I was actually sleeved... I know I have to be bc I eat much less, I have lost weight (first week) I'm just wondering if im doing something wrong? has anyone else had an experience like this? any tips? :/

so i pushed off starting th C25K. i dont know why. i tried it last thursday and i made it through but it was hard. i just didnt want to do it this week. i did however do kickboxing yesterday which was fun. i am just so tired of looking at myself in the mirror. im at another plateau and i cant wait for my fill on monday. money is still an issue here with me and i hate constantly complaining about it but i am tired of losing things i worked so hard for. and to make matter worse, i dropped my google phone in the toilet here at work yesterday and now it is not working at all. oh well they turned off the service right now anyways. tony found out that he can do work for th county which does pay good money but he needs money for insurance, bonding, corporation fee, and tax id numbers which total 1600.00. i dont where we are going to get that kind of money. hell i dont know where we are going to get money for groceries. and as always i make too much to get any help. i think that this stress level is really getting to me and my weightloss. i find myself unable to sleep and wanting to eat in the middle of the night. my 5 year old is driving me nuts bc he continues to get into things that he isnt suppose to and he is soo stubborn. but i love him. he starts kindergarten this august and im so proud of him and his test results. he is 1 point away from being gifted but i know that as long as he is challenged that he will do fine. i am going to try to do a tae bo workout video in the morning before work so if i cant run i still have some sort of workout in the day. well until next time.

I HAVE BC-BS OF KENTUCKY, I HOPE, AND IT BETTER GO THROUGH:heh: LISA W

four ducklings wow! Most surgeons who are accredited have awesome stats. Complications can always happen of course but obesity can kill you too. So can driving a car...or crossing a street.. . I guess surgery just puts it in our faces because it's new territory for many of us, you sign your life away on forms and everyone tells you horrible stories! I've had general anesthesia anniversary if times and many procedures and a couple if surgeries. It's always a bit scary but I do remind myself if what I started out saying... obesity comorbidities are deadly, and life activities can kill you too so that might help you too I did ask my surgeon how many patients he has lost on the table and it was zero in many years and a small handful from drastic complications like pulmonary embolism often bc people feel symptoms and don't seem medical attention until it's too late! They do a lot to prevent clots, infection, etc these days...

I had a TERRIBLE TIME. I ended up on Zofran and Reglan and nexium. Then they warned me off the reglan and increased my nexium. It took a while. Make sure you eat bc if you don’t the acid is worse and makes nausea worse I think. Good ick to you it’s really hard for some people in the first couple months after. It DOES improve! It’s just so individualized.

You're fixing to hit a stall, if you haven't already. I can't say this emphatically as everyone is different, but this is my hunch. I hope I'm wrong, bc it sucks prayers for your success

I keep posting pics bc I'm so proud ! I figure this is a great way to share my progress- I'm one month out the 4th of March and I'm down 45lbs including the 2 week pre-op diet! [ATTACH]9959[/ATTACH] [ATTACH]9960[/ATTACH]

Hi everyone, I was banded Aug 11th. I initially was loosing weight the first week or so. I am now down 18 pounds since surgery. I havent been loosing weight in quite a while. I am concerned bc I am now at 6.5 cc in a 10cc band. I am able to eat quite a bit more than the 2 oz. at a setting that I've read our pouch will hold. Are there others out there besides me that had to have more than 6.5 oz. to feel good restriction. I have never gotten sick and I dont know what the term sliming means. I'm just a bit disappointed in the weight loss not happening quicker and not feeling the restiction I keep reading about. What do you think?

There is a couple in my group and they think it's their hour to talk about them only, their relationship, their kids, everything. They can get down right rude by interrupting people all the time. However they haven't been there the last two months. I have to say they have been the best two months Bc everyone gets a chance to share, ask questions, and so on.

hi and good luck, I am also interested in your journey thru the insurance jungle, bcbs fed myself, wondering the ins and outs., good luck and love to hear your story along the way. cindy