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Hi all! I have a question about the Cigna 6mo diet requirement. I had been seen by my PCP June 2003 - December 2008 and was prescribed diet pill - Adipex - each visit with the exception of 9mos during my last pregnancy (8/06-4/07) I stopped going to my PCP 12/08 due to the fact that he had been prescribing me excessive pain meds as well. I entered treatment for opiate addiction & started seeing an addiction specialist in a clinic at that time & then switched to his private practice around April. We have been discussing weight loss programs on most visits, however not 6 consecutive. My BMI has been well over 40 for atleast 3-4 years. I read on the website that Cigna requirements state specific regarding the 6mo diet as: "Failure of medical management including evidence of active participation within the last two years in a weight-management program that is supervised either by a physician or a registered dietician for a minimum of six months without significant gaps. The weight-management program must include monthly documentation of ALL of the following components: weight current dietary program physical activity (e.g., exercise program) " I am wondering if they hold true to that requirement - 6months consecutive within the last 2 years OR will they make me do 6months consecutive right up until surgery consult? Any advice or input would be greatly appreciated. Thank you much! Kara
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Thank you for sharing your story. I am so sorry for your loss.
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The Fear of the Unknown
Suzannesh replied to Suzannesh's topic in PRE-Operation Weight Loss Surgery Q&A
I think I am doing just what Rule # 12 says. 12. Recommendations or reviews of surgeons, hospitals, products, or services are welcome if based on the reviewer's personal experience. The reviewer must have no financial interest in the subject being reviewed. Violations will result in the posts being removed and a possible permanent ban of membership. "I can’t speak about any of the other doctors because Dr. Aceves is the only person I have had experience with." The post I made before this one DID NOT mention Dr. Aceves at all. So sorry this bothers you, I would suggest that maybe you might not want to read any of my posts. I also wish you great success in your weight loss journey like I do for many other people. Enough said. Suzanne -
I am so very sorry for your loss! When you lose a pet it feels like you lost a member of your family. I am glad to hear you are going right back after goals. You should be so proud of yourself. It is also always very encouraging when someone says something so kind to you when you need it most. My thoughts and prayers are with you! Stay strong!
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Amazing results at one month!! Continued success on your journey!! BTW.. great tracking...I also track monthly, (weight, inches loss and a dated picture, to document my sleeve journey and one day make a video). I will wait initially until 10/8 my 6 week checkup.
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<a href="http://www.TickerFactory.com/weight-loss/w1RSyt9/"> <img border="0" src="http://tickers.TickerFactory.com/ezt/t/w1RSyt9/weight.png"></a> I am trying to post my tickerfactory am nothing everyone has one but me HOW DO YOU POST THE TICKETFACTORY?
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i want to be banded but have alot of ?s
tonya66 replied to jenna_renee2003's topic in Tell Your Weight Loss Surgery Story
*is there a health insurance company that covers the lap band most of the time? I have UHC Choice Plus and was approved in about 2 1/2 weeks. You have to make sure your employer doesn't have an exclusion on weight loss surgery, many do. It is up to your employer whether they choose to allow the WLS. So you should call your insurnace and ask if they cover CPT code 43770. UHC required a BMI of 40 or above, no exceptions. So make sure you ask your insurance what criteria is needed to be approved, and then get the name and badge number, ext. etc of the person you talked to for future reference. It may or may not be needed. * is it safe to have it done in Mexico? I've heard a lot of good experiences, but I've also heard some bad. So do your research on the doctor, not just Mexico in general. * if i choose to pay with out insurance what is a round about cost? My doctors charge is about $15,000 - $20,0000. -
Surgery after c-section/breastfeeding.
Motherof2in2013 posted a topic in PRE-Operation Weight Loss Surgery Q&A
I have been planning on getting the lap-band for a couple of years. I was in pre-op when they told me to go home I was pregnant. That was in July of 2012. I had a c-section March of 2012. Waited to heal, savings was drained so had to start over again. I started a weight loss plan about 4 months ago, lost weight and bam I got pregnant again. My baby is due in December, and I'm hoping to have the surgery in January 2014. My first question is how soon after a c-section(I'll be having another one) can I get the surgery and question two is, can I have the surgery while i'm breastfeeding? Thanks in advance! -
Anyone do a pre preop diet?
KarenElaine replied to rbmk14's topic in PRE-Operation Weight Loss Surgery Q&A
I'm pre-op. My insurance co (Tri-Care) requires a period of time to learn healthy eating and weight loss prior to surgery. Prior to seeing the nutritionist I had given up soda which was huge for me. My surgeon gets in my face and says, you are fat because you are addicted to food. I was warned before I got in there with him (I had my big girl panties on thank goodness). Also helped that he spoke from experience--he and his complete staff are banded. The surgeon staright off said get down to 30 carbs a day. Once I looked at food lables I was shocked. Several weeks later I saw the nutritionist--now I don't eat rice, pasta, potatoes. I'm gluten free, so I already don't eat bread. So, 30 carbs...totally doable! You really need this "pre" pre-op time to learn a new way of eating and that eating is truly overrated. We've been eating all our lives, some of us longer than others. I really wanted to jump in and get that surgery pronto quick. I know now, that had I done that, it would have been disasterous. We have to really learn, understand and come to grips with how we got here first. -
I met my surgeon about 1 week out of scheduled surgery for a last minute prep-op checkout. I was informed about 6 weeks prior what was required of me as how much of a weight loss percent I was required to lose prior to the scheduled surgeon visit. We talked about how I will feel and what to do with pain(I had very little) discomfort(in my case). Just a last minute eye to eye checkout. Best wishes and Keep the Faith.
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I am soooo confused. Since the fill I had in early October I have felt that I was at my "sweet spot". I was supposed to return for a doc visit just for a check up in early November but, since I didn't think I needed a fill (and since my doc moved to Beverly Hills the parking is RIDICULOUSLY expensive and impossible to find on the street - yuck), I opted not to return for a while. Well, now I can't decide if I need a fill or not. My weight loss is pretty slow but steady and in the right direction -- down. Lately though, I have been feeling hungry -- like right now -- AND, I know longer feel as tight in the morning and at lunch as I did a month or so ago. I had scheduled and appointment for December 3rd but cancelled it because I am afraid that if I get even a small fill I won't be able to swallow my breakfast (a protrein drink). My daily regimen has been pretty satisfying and filling for the last couple of months (breakfast = protein drink, lunch = Lean Cuisine, dinner = protein[meat, poultry, fish], starch, and veggie. But, of late I am getting hungry during the day AND I am able to eat more at dinner. I am sorry if my post is a bit confusing, but I am confused myself. Do I need a fill or not? Should I just stick to my current food plan and eventually the hunger will go away or what? Any and all advice would be helpful. Thanks.
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Sleeve to bypass revision
SamRoss2021 replied to tracyintennessee's topic in POST-Operation Weight Loss Surgery Q&A
How are y’all doing with the weight loss? I have my revision on November 2nd. -
I hate you diabetes
DELETE THIS ACCOUNT! replied to Omfgmelly's topic in PRE-Operation Weight Loss Surgery Q&A
Wow I'm so incredibly sorry. Be careful with your liquids between now and Friday. I'd stay away from juice or anything sugary. Can I ask how high your sugar is running and how low do you need it to be to safely have surgery? I really, really hope this works for you because I am guessing the band and weight loss would help you so much. -
This may not seem like a big deal to many; but, I'm so very excited!!! I have not been under 200lbs in over 20 years. Always, hovering between 233-227. I can't believe that I'm actually wearing a size 14 pants @ 199lbs - currently I'm averaging a 2 pound loss each week and my goal now is to reach 180 by Christmas.
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Has anybody switched insurance just before surgery?
monarchcat posted a topic in Insurance & Financing
Hi, I'm new here and I should probably head over to the intro section first, but I hope you'll bear with me! I am scheduled for a seminar on Sept 26 and am looking forward to starting the process toward a band. I have cigna insurance currently, so I know there is a 6 month supervised diet required before approval. At the moment my BMI is 40.6, which just makes it for the insurance requirement. My husband will probably be losing health insurance in March (his company is going through bankruptcy and his job will be ending) and we will be switching insurance (either he'll start with a new company or we'll pay out of pocket for health insurance - no cobra available). In either case it more than likely won't be cigna at that point and that will be right around when my 6 months will end and I'll be trying to get approval and a surgery date. I understand that to submit to insurance they take the weight you are at at the beginning of the process (taken on the day with all the appointments I believe?). Does anything get submitted to insurance at that time or is it only submitted when all the criteria are met (i.e. the 6 month supervised diet)? If it's not submitted until AFTER the 6 months then I should be ok with waiting til I've switched insurance companies and submitting to whatever new company we are with, correct? I will be sure that if it's in our control we choose one that covers lap band, of course! However, if i have to submit a weight at the time we switch insurance, by BMI will almost certainly be below 40 as the program I am attending (Lahey in Massachusetts) requires a loss of 10% of excess weight before surgery. I have no comorbid conditions presently that would allow for an approval with a BMI under 40 (damn! LOL) Has anyone had a situation where their insurance changed part way through the process, and especially BEFORE surgery? Does it even matter what I have now, or does it only matter what I will have when it comes time to surgery time? I'm sure this has happened to some, as in this day and age, people are changing jobs (or unfortunately losing jobs) all too often. Thanks for any input! I just trying to understand the whole lap band process and am glad to have found these boards! You guys seem like a supportive, happy group and there is so much great info here! -
Is this a normal weight loss in the begining? I am going on my third week and really don't know what to expect. I feel like I can eat more then my 2 ounces but don't want to push it, my concern is that I can't get my fill until 4 more weeks. Do doctors usually make you wait 6 weeks before a fill? Eryn
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My doctor won't do it for 6 weeks. I'm hoping to go back and get it done over Easter weekend but not sure how busy it is in Mexico at that time. I had my surgery on Feb 20th and I've lost 22 lbs but man I'm starting to get hungryyyyyyyyyyyyyy. I ate things yesterday that I know I shouldn't have and I'll try to not do it again but I'm so hungry. Good Luck and continued success with your journey... Congrats on your 25 lb loss....hope you keep it off and continue losing more before your fill. Linda
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Gaining weight :(
Wanna-Be-Healthy replied to ebssss's topic in POST-Operation Weight Loss Surgery Q&A
Congratulations on your baby!! I agree. And I also agree with Carolinagirl that "to gain you must take in more calories than you burn off. WLS or not" so it seems that you are consuming more than you are burning. All that said, I'm not sure you should really be focused on too much weight loss when breastfeeding but that is a personal choice. Good luck mamasita! -
I had surgery on 4/8/10 and am down 60 lbs so far. I'm back to working out again, although not yet at the level I was 15 years ago, but getting there. I can carry my 60 lb daughter around, almost as much as she'd like me too even. Never in my wildest dreams did I imagine I would lose this much weight in 3 months! I am really happy about it! The trainer I have at the Y has told me that because I've lost the weight so quickly, it will come back quickly, even though I have the lap band and even if I keep working out. My Dr. has told me that once I reach my goal weight, I can eat a bit more than I do now (1/2 cup instead of 1/4 cup at a meal) and maintain my loss. Has anyone lost weight quickly and started to gain it back, even if they keep exercising and eat about 1/2 cup of food every meal?
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http://commonhealth.wbur.org/2015/05/why-diets-dont-work “Studies show that willpower, the thing we all blame ourselves for not having enough of, is in many ways a mythical quality and certainly not something that can be relied upon for weight loss.” 'Turns out, a good bit of Mann’s plan calls for external changes, like using smaller plates and taking smaller portions, a la Brian Wansink’s Mindless Eating. ' I read this with a smug look on my face..
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Getting cold feet! Surgery date July 24th
Jean McMillan replied to skb123's topic in PRE-Operation Weight Loss Surgery Q&A
Who's the "everyone" trying to talk you out of weight loss surgery? Have any of them actually had weight loss surgery? Have any of them lost 255, 175, or even 100 lbs by any method? And if they lost that weight "on their own", without weight loss surgery, how long have they maintained their weight loss? I think it's wonderful that you've lost 175 lbs on your own, and losing another 80 lbs is a worthwhile goal, but if you've been stalled for a year, I'm not sure the on-your-own approach is going to take care of that last 80 lbs any time soon. On the other hand, you do need to be realistic about what adjustable gastric band surgery will do for you. It's not going to turn the weight loss switch back on for you. When properly adjusted, the band will provide you with early and prolonged satiety, but good food choices, portion control, dealing with emotional eating urges, and exercising will go on being your own responsibility. I won't try to persuade you to go ahead with surgery or give up the idea forever. I hope that losing 175 lbs has already given you many health benefits, and I would hate for you to consider yourself a failure if you don't lose the additional 80 lbs. Good luck! -
Getting cold feet! Surgery date July 24th
catlover602 replied to skb123's topic in PRE-Operation Weight Loss Surgery Q&A
I was having second thoughts too about having the surgery. I was scheduled for surgery on the 25th of this month and I cancelled it. I plan on working on myself for the next 6 months and reading up more on the Lap Band. I have no regrets on my decision. I know some people will be upset with me for not going through with it, but oh well. I want to make sure this procedure is going to be right for me. I know it is not going to be a quick fix; it is not going to help me stop eating. It is a tool that is going to help me feel satisfied. I am still going to have to watch what I eat and count calories. Even with the lap band I am not guaranteed weight loss… Don't feel rushed into making a decision. You can always reschedule your surgery. That is how I came to my final decision. Good Luck. Your weight loss has inspired me!! -
I am sorry for your loss I can not image to lose a child. I am glad you are getting back on track! You go girl!!
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crazy question....
bella71 replied to dontgoggilme's topic in POST-Operation Weight Loss Surgery Q&A
During my mushies phase, I was lucky to have enough room for the proteins (which you need to eat first) and veggies to have room for rice and pasta. Plus, simple, refined carbs are not conducive to weight loss. Maybe whole wheat pasta or brown rice instead? -
Hey, that's the day before me! I started a thread for Sept '08 sleevesters in the 2008 section. Come join me. :thumbup: As for weight loss, I am below my original goal and here is how I did it: -religiously track everything I put in my mouth. Then, whenever weight loss slows down or cravings come back, I check it over to see where I can improve -drink a lot of Water - at least 64 oz of Fluid, most of it water, a day, but 80-100 oz, if I can -exercise 4-5x a week for 30 min. at first and then upped it every time my weight loss slowed down. -held myself to under 800 calories, 70-90 g of Protein, under 40 g of carbs, under 30 g of fat for the first 6 months; after that, I gradually upped my protein and eventually my carbs but I was trying to slow down my weight loss at this point I think tracking, high protein, and exercise were really the keys though.
