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Question for CIGNA ("Open Access Plus")carriers
faithmd replied to kacee's topic in Insurance & Financing
I cannot speak to Cigna, but I have also not heard of anyone who was able to bypass any length of time requirement. Mine is 12 months MD supervised program. The important thing to remember is that they will be laying out a lot of money for this procedure and they want to know that you can follow a physician's advice and orders. The goal of the MD supervised weight loss is not to then say they won't pay for it if you are able to lose weight with the program, but to teach you good eating habits, etc. One other word of advice, if there is also a weight loss requirement with that 6 month program, you MUST lose it. My insurance company requires 5% loss of excess weight in addition to the 12 month program. I was sick over my 12 months and because of meds I was on, I gained quite a bit of weight. I was then able to lose about 20 lbs (of almost 30 that I had gained) before I applied, but I was denied because I didn't lose the original 5%. My insurance takes your starting weight at the beginning of the MD program and then you have to lost 5% of the excess of that. I have to make it to 335 and apply again. -
Just wanted to post about a few challenging days. I was away the last couple of weeks to someplace warm. I did pretty good while I was away and probably under ate, though I did have a few days where I had ice cream (tiny amount), but generally hit protein goals. It was HOT where I was, so I had a ton of extra liquids. I was exercising a lot, usually a few miles of walking, 3 - 5 miles of kayaking, swimming and just generally not standing still for any moment from 6am - 10pm. I didn't weigh in officially, but had noticeable weight loss (clothes stopped fitting during the trip). Anyway now to the venting part. I was so busy during the trip that it was pretty easy to stay on track. Coming back I was off track a due to the travel/ flight. The last couple days I'm back in the cold and doing less activity (wife is sick so I have the kids 24/7). I am STARVING. I've also eaten some carbs that I shouldn't and some nuts. Nothing crazy, but my calories are up 300 - 500 the last few days. I'm still hitting protein and fluid goals. I just can't figure out why I'm so hungry all of a sudden. Today I decided would be back on track so I removed foods I was struggling with (nuts and cheese-its) from the house and am focused on doing better. Hopefully I can get some exercise in today as well... Do you have similar stories? Ideas for getting back on track or curbing spikes in hunger?
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Wow!! You look great!!! That's a fabulous loss in just 4 months.
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Gastric Sleeve and chronic fatigue syndrome and/or chronic migraines
TammyDTM replied to DDSPICRN's topic in Gastric Sleeve Surgery Forums
Chronic migraines here. I was told that the weight loss may help lessen the frequency. Hope so! Will eliminate the need for some of the medications. I am so tired of all of the medications I have to take for this and that! How are you dealing with it? -
140 Lbs Lost 7 Months Post Op
Jessica9190 replied to Crystal1984's topic in POST-Operation Weight Loss Surgery Q&A
CONGRATULATIONS ON YOUR DAD'S weight loss. I'd be super proud too! Can I please ask What happened? Were there complications with VSG or was it unrelated? -
I've been stalking bariatric surgery forums and YouTube channels for about a year and a half. I finally decided this was right for me and have started the process. I've gotten my referral, gone to the seminar, and have my appt with the surgeon on the 16th. After about 4 different calls to Tricare, speaking with my pcm, her calling the medical directer, and what my surgeon's office is saying I decided to start a medically supervised weight loss attempt (again). They can't seem to agree on if I need to have a medically supervised weight loss attempt, the length it needs to be or the time that has passed since I've tried. So I give. I'm just going to cover my bases. Anyhoo... Awesome info on this forum and you all are extremely supportive! I love that!
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What's a PCP document? No. Sorry if that was confusing. In that sentence "PCP" is a noun and "document" is a verb. Have your PCP (preferred care provider), that's your regular doctor, start documenting any instances of rashes, chafing, or infection from the excess skin. That documentation can help make a case to your insurance company that skin removal is medically necessary if they even cover skin removal under any circumstances. You would want to contact your insurance company to see if skin removal is even an option. I know my insurance provider will not cover skin removal after weight loss surgery even if you can provide proper evidence of medical necessity. It says so very explicitly in my policy.
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I am officially obsessed! I've been reading stories on here and I want so badly to get my surgery approved!! I still have a long way to go. I need to lose 30 pounds and I'm down 9, which is good but I would like to see more, don't we all! I can't submit my papers until September 25th because that will be six months to the day I started my pre op weight loss diet required by my insurance. I've been reading stories on here about people who are scheduled in June and July and I can't help but to be so incredibly envious! I know this will be a process. I need to be ok with losing weight wether or not I get banded. I need to stop obsessing about the band itself and focus more on losing weight. THe more I lose now the more sucessful I will be! I was originally scheduled for surgery feb 5th but backed out a week before. I just didn't have that great of feeling about the doctor and I was also self pay. I found out that if I try to jump through some hoops my insurance might pay for it so I have to exhaust that before I put it on plastic. I know I'm doing this the right way but it's so hard to be patient! I've been looking into this since january and it won't be until October if everything is approved. It just seems so far away! sigh OH well... one step at a time. It's good for me to learn what it takes to do it right the first time. I so look forward to seeing the onderland again!
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Bernie, Believe me you have made the right decision. Yes, the lapband has a slow weight loss but it is better to lose it slowly than rapidly. Remember your spouse to be is marrying you who you are today so they wont care that you did not lose weight by the time you get married. Some folks tend to lose weight right after the surgery and others dont until after their first fill. Hang in there dont get the downs yet. You'll be OK.
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I never was an emoitional eater, I was a volume eater. I do get hungry and I do still want to eat, but it is different now. It is weird to explain, but eating is just not fun any more!! I can not eat much and really don't look forward to it like I used to. I do it to live now and not for entertainment. I am 4 months out on Monday and you really learn to adjust to the small portions and it really is o.k.! I make much better food choices now and don't eat crap. If I want something tho, I have it because I eat so little of anything, it really doesn't hurt my weight loss. Good luck to you! Kelly
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new girl on the block
strikeuptheband replied to anniegirl's topic in Tell Your Weight Loss Surgery Story
Welcome Anniegirl, I am also 56. Theres lots of fun folks here to talk to. Just jump into any conversation you find interesting. I think there is a thread for 50's here. Try looking on the home page, there should be a list of all threads and topics there. Good luck on your weight loss journey. -
new girl on the block
GratefulHeart replied to anniegirl's topic in Tell Your Weight Loss Surgery Story
I just had my 56th birthday this month (Oct 4) and was banded this month (Oct 20). So I think you have lots of company! Somehow it seems to me that when it comes to weight loss, we all speak the same language and understand each other without regard to one's age. We have all felt similar things and gone through similar experiences with the band, it seems. Perhaps those who post pictures are younger. :biggrin: I don't plan on posting anything until I have an "after" picture of some kind, then maybe.... But anyway, if age makes a difference in recovery time, or other issues, I haven't really seen it yet. So just jump in and feel welcome. We're all here in the same boat. Or would that be on the same band? :wink_smile: -
mandy congrats on your weight loss yes, everything with WLS and your new upcoming healthy, happy life is worth it keep that great feeling you have this second continued success
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Has anyone had any form of the DS surgery in Toronto, Canada?!
k95 posted a topic in Duodenal Switch Surgery Forum
Would love to hear your stories! I've had the sleeve done, but not much success with it (you can read my story which I posted here for a better understanding: http://www.bariatricpal.com/topic/360924-my-unsuccessful-sleeve/) After some long and intense research, I truly feel like the Loop DS is the tool which my body needs to get this weight loss going. I feel like the sleeve is an amazing tool but as we are all different I guess my body needed more than just the sleeve itself. Looking forward to any options/stories!! -
I remember asking probably 3 months ago (LOL) about shirts. I figured I would need smaller pants sooner than I would need smaller shirts. WRONG! I need both. Everything is hanging. I don't even want to spend much on clothes at thrift stores, but will if I have to. Would rather wait another month or two and then go shopping :lol0: I used two tricks this past week. Used clips at the office (not paper clips but those nifty fasteners??) to tighten my shirt in the back. Had to go to a memorial service and putting together an appropriate outfit with pants, etc that fit was a challenge. I did have to leave my jacket/blazer on which was fine. Today - some of my favorite TShirts are soooo loose and hanging! Did the teen trick of using a hair tie to do a "pony tail" in the back of my tshirt to pull it snugger around the waist. and then tucked it up under the bottom of the fabric. Yep - will need to keep my jacket on, but heck! This is a holiday weekend in Seattle which means it is cold and rainy!! :lol0: And I could take the coat off. The teenagers do! Anyone have any other ideas??
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I don't get banded until monday ( 10/1 ) but I wanted to know of anyone saw a difference in the body about 3 weeks after the surgery. my mom is getting remarried 3 weeks after my surgery and I am a bridesmaid in the wedding. I have already bought the dress for the wedding . I am kind of scared that it won't fit right or that I will have to get alterations done to it because of weight loss .
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Gallbladder problems post-op
ElfiePoo replied to gabsbags's topic in POST-Operation Weight Loss Surgery Q&A
Betsy, Is it the significant weight loss...or how fast you lose it? . -
Congrats on your weight loss so far! Awesome job! I know you're counting down the days! Good luck to you!
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Are you sure you want to do this?
Hop_Scotch replied to Everything's topic in General Weight Loss Surgery Discussions
Aside from telling her that it was none of her business...I may have said that WLS is a last resort option, and if I had have been able to lose weight and successfully maintained the weight loss without WLS I wouldn't be here. The nurse has no right to ask such questions, I would inform the hospital of the unprofessionalism of the nurse. She shouldn't be second guessing patients or their doctors. -
Hello! I had my gastric sleeve done on July 15 of this year and I AM NOT planning on waiting the 1-2 years to start trying again. We require fertility intervention to get pregnant (hoping not as much since I've lost 65lbs so far) but we've already started trying. My fertility doctor is one of the best in his field and has cleared me to move forward. I have one son luckily who took a year to conceive but I want more. Are there any newly thinner mommies that are moving forward with TTC dreams? Any luck so far, experiences, things that have helped?? I would love to create some connections here to support my weight loss and baby creation journeys.
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Improvement in Facial Hair After Surgery?
Debbiebydesign replied to Smilejoelle1's topic in The Gals' Room
Makes sense...losing weight can help PCOS, which can cause facial hair. -
Olivia is absolutely correct. Don't worry about weight loss right now~ this time is about healing your body! Water & protein are your best friends right now. 60 to 80 grams of protein a day is what you should shoot for. Walk each day, and take it easy and heal. Stay away from the scale!! The weight loss will come, once your body has recovered! Be proud of yourself for taking such a big step!! Hugs!
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Beth hang in there.. U will see the positive results soon enough. First of all you are in healing stage and i would say definatly focus on that right now. Weight loss probably wont be very successful until ur fills and get restriction although that is different for everyone. Just keep in mind you will be healthier you and while the scale isnt moving, you are becoming more healthy and more aware of the choices that you are putting into your body. Gl and stay motivated.
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HI TB07 Do I guess correctly based on the fact you are more comfy with kg than pounds that you are another Aussie- if thats the case double welcome ( I am in Adelaide south Australia) The amount of pain etc that people get post op and how quickly they recover varies tremendously and ther doesn't often seem to be much rhyme or reason why one person sails through and another struggles a bit- It will get better though, it s major surgery so even a week off work s not that bad really. the gas pain etc is usally the cultprit, for some people t causes irritation that s felt as shoulder/chest pain evn after the gas has been absorbed The post op diet I was given was pretty much like yours but you are right it varies a whole from surgeon to surgeon I was banded quite some time ago but have had a lot of other medical problems to deal with that kinda put a stop on weight loss- so I am a born again bandster and have gone from 175 kg(385pounds) to 150kg ( 330pounds) since November- still a long way to go but gettng there nice to meet you - i'm new to this board too but it does provide great support Karen
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I was sleeved 4 weeks ago tomorrow on 4/9. The whole process was really easy for me, almost no pain from surgery, no gas pain, no nausea, I was able to walk right away it was all pretty easy. The first 9 days I dropped weigh fast, I went down 24 pounds which was amazing and scary at the same time as I was afraid it was "too good" so to speak. Unfortunately that seems to be the case, since that initial weight loss I have only lost 2 pounds. I know its not all about the pounds and I know its common to stall......but is this common? I never meausred myself but I know my body has changed so that is positive but I have to say I am concerned. A little about my history. I have NEVER been thin, I have always carried extra weight and it has been a mystery. I eat very healthy with an occasional (maybe once month) splurge on some type of junk food like chicken fingers, pizza or chinese food, but again it is very occasional. Up until 3 years ago I was weighing in the 160's, this was eating right almost al the time and running about 5 miles 4-5 times a week. Then I got sick and since that time my health has continued to decline, I am not physically able to run at all and excercise has to be strictly supervised and approved and thats only when i'm well enough to attempt to excercise. Fast forward to surgery day I weighed 220 pounds......the only thing that kept me in the 160's was my vigorous excercise. The surgery was to help relieve the pressure on my joints and hopefully make me feel better and be able to be more active and less tired. Now here I am today, wondering if even with this surgery, will I not be able to lose weight. I am anal about getting my fluids and Protein in, I am walking every day and doing the bike at the gym I am feeling very discouraged.....if anyone has been in a similar place I would love to hear your feedback.
