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Yes, UHC requires the 6 month program. Your surgeon's staff is probably making the same stupid mistake mine did, almost costing me my surgery. They call the ins. co. for a verbal verification of the requirements and get stupid answers from ill-informed people at the phone banks, rather than taking the time to read the official UHC Statement of Medical Policy in their files. Below is the link to UHC's Statement of Medical Policy on Bariatric Surgery which gives their requirements for surgery. I received it from a UHC employee during my appeal. Note the bullet points near the bottom of page 3, but read the policy so you get the big picture. My ins. administrator relied on a verbal check of UHC's requirements with some clerk at their 800 number, instead of reading the document in her file, and didn't tell me about the 6 month requirement when I started the program. Upon completion of my class work, they submitted my request for surgery. I was approved by the contract manager for UHC and then 2 days later, UHC revoked the approval when they reviewed the file. I went ballistic and ultimately involved the medical directors at UHC and the contract manager as well as the COO of the hospital that owns the bariatric center and a lawyer. It took 45 days, but I finally won my appeal with records of a past 6 month program years ago. You might not be so lucky if it happened again. Be sure you get very clear written instructions as to what is required for that 6 month program to avoid the problems I had. Keep very complete notes of all conversations, including names, phone nos. and dates. Send me a PM if you need more help. https://www.unitedhe...ric_Surgery.pdf

I went straight to a bariatric surgeon and didn't involve my Primary Care doctor until I needed a letter from him for my appeal. If you don't have to involve him, then don't, it's easier that way. Otherwise, ask for the referral and be prepared to stand your ground and defend your decision. Best of luck to you!

I, too, did not go to my regular doctor first. I went to my Bariatric surgeon's newcomer meeting to find out more. I also researched the procedure and the surgeon. My insurance company required my regular physician to sign off on it. He just answered the required questions and signed off. I don't think there was a question that said "are you for or against the surgery". They were generic questions about my health.

Ooohh - I can't wait to see my hip bones. The are getting closer, so hopefully just a matter of time. Nicole - I haven't had any fills yet. I had my 8 week checkup a couple of weeks ago and felt no need for it. BUT, I did forget to ask if he did a fill at surgery, so I have no clue if there is anything in it or not at this point. I will say that I'm full after about 1/2 a cup of food and will generally stay satisfied for about 3-4 hours. I do also drink 4 oz of Optisource Bariatric High Protein drink between meals, so that helps to keep me satisfied as well. However, it does seem just within the last couple of days, I'm not as satisfied as I was. I may go in the week after next, to see about a small fill. We are going hunting this week and I don't want to be out, a few hundred miles from my Dr or a hospital after my first fill. Kind of paranoid about it.

I'm feeling really discouraged. Just had my first appointment with the surgeon. This is at a bariatric center of excellence that is known as the top place to go in my area. After years of being discriminated against by the medical community (hand pain??? Lose weight!) I went to this appointment feeling excited that, if nothing else, I was going to be treated as a human being. I was ushered into an office and this man said, "I'm going to review your history." I said, politely, "And you are???" He looked affronted and said he was the doctor. I didn't know I was seeing the doctor at this point! Anyway, in the hour he spent with me this man did not show me one shred of warmth. He told me that for as long as I've been overweight and my current BMI I should never expect to get under 200 pounds. He said I take more insulin than any of his other patients and should not expect my diabetes to resolve. He said that since my joints are bad I shouldn't expect to lose much. I said I swim regularly, and he said, "I'm not talking about laying in the sun by the pool." From there, I was taken into a room where another person gave me a clinically delivered speech about the process and the cost. I went from there to an appt with my endocronologist, and I was in tears as I told her what had happened. She said that she's had patients taking 3x the insulin I am who have done very well after the surgery. Honestly, I felt like I was doomed to failure at the start. It's got me doubting everything, and has sent me into a tailspin. I have to decide whether I want to proceed with this clinic. He's not the only doctor there. The clinic has a really ecxellent reputation, but none of the employees were warm or very friendly. (Although I haven't met the dietician, etc.) I'm someone who gets along very well with people, so I know it wasn't me. Do you think I should trust the process and focus on the medical aspects rather than the interpersonal stuff, or do you think I should look elsewhere? I'm still reeling from this. Feeling like a piece of meat.

Now that I am "approved" for surgery and this is becoming a reality, I figured NOW is the time to post my story so far. I am 49, 5'7 and 235 at my highest weight. (Can't believe I actually wrote that down for public consumption!) That made me a BMI of 36.8. I had considered weight loss surgery off and on throughout the years of yo-yo dieting. My last good weight loss was about 30 pounds back in 2009 and I was lighter then. So that means I have put on about 40 pounds in four years. (Less than a pound a month, not too bad, right??!! Ha!) I have some lung problems, high blood pressure (if you would only lose weight, you wouldn't have to take these pills anymore....) and hypothyroidism. Too much for someone my age I decided and started considering the lap-band. I am a nurse and considered that to be "least invasive" and "easiest" to have done surgically. On November 28, 2012, I signed the hubby and I up for an informational seminar. While hubby wasn't interested (I'm hoping to change that), I listened to the doctor present the band, sleeve and RNY options. To his credit, he didn't try to sway anyone to any one procedure, but I had changed my thinking from lap-band to sleeve. I submitted my "insurance verification" form and left. In lateDecember/early January, I was contacted by the doctor's office and told that my insurance (CIGNA) did provide WLS benefits. I had started a post-holiday "kind of" diet about mid-January with Weight Watchers. I saw my surgeon for the first time on January 28, 2013. We discussed all the usual things and agreed that the sleeve was a good procedure for me. My only beef with the process was that the coordinator told me "All your insurance needs is the evaluation and 3 months of diet history. Just print out Weight Watchers and it will be ok." More on that in a minute.... From there, I had: EGD (endoscopy) on 2-4 and found to have a small hiatal hernia. Psych eval and nutrition eval on 2-13. In the mean time, I had researched CIGNA's bariatric policy and found out that I needed a lot more than "Just 3 months of Weight Watcher history." Rather than chance it, I went and got clearance from my PMD and met with a nutritionist for 3 months of a supervised diet. (2-20, 3-16 and 4-20...boy am I glad I started that "kind of diet" back in January!) Am now at 222 (fluctuating pounds.) My coordinator submitted my packet on about May 10th with a comment of "everything looks great...should be no problem." On May 17th, I was notified of denial...based on two points. My physician had failed to state that he BOTH recommended me for the surgery AND cleared me (he only recommended me....despite the fact I had asked him to do both.) The nutritionist did a summary report that detailed all three visits, with all of the components required, but CIGNA wanted it in three separate notes. At least it wasnt because of medical criteria! So...my coordinator got all that together and on May 21st, she submitted again, stating it could take up to 90 days, but probably not that long. The waiting is the hardest part!!! Well, today I got the news I was waiting for...APPROVED! It took 7 business days for the appeal. Now we are in fast-forward mode: 6-10: Pre-op meeting with surgeon to sign consents, etc... 6-15: Start of pre-op diet! (Not looking forward to it....) 6-17: Pre-op lab/x-ray work at hospital 6-25: Surgery I travel for my work (I am a healthcare consultant) and will be out of town three weeks between now and then, so it will fly by! I am so excited. I think now that it's a reality, my husband is concerned. I got the "If it makes you happy, it makes me happy" but I am not convinced. I know he is supportive of my decisions, but probably a bit insecure at the same time. food has always been a big part of our life and I have been slowly withdrawing from that over the last few months. Thanks for listening! I am so darn excited I just needed to share it with someone. I have told very few people. I will update after the surgery.

Hi jgandg. A couple of comments; I've had several patients not lose weight for a while then "get it" and somehow they begin to understand how to use the band to lose weight and their weight comes off. It's very important to follow the eating principles that make the band work best. If you do this, then you will notice the decrease in hunger. Unfortunately, gastric banding doesn't work the same for everyone. All bariatric surgeons know this and we can't explain why (even though we have a lot of theories). But one thing is for sure, following the general guidelines, often provided by your surgeon, is absolutely necessary for long-term success.

I have not heard the term...but for those of you were were wondering...this is what I found. And after reading it... I need it. LOL Mermaid Lift procedure is designed to achieve the following: 1. Accentuate the waistline to create a more feminine flare at the hips. 2. Flatten the abdomen to improve its contour and definition. 3. Lift the pubic area to create a more smooth youthful transition to the lower abdomen. 4. Redefine the belly button to compliment the bottleneck waistline. 5. Lift and restore shape and volume to the buttock and lateral thighs. 6. Cinch and redirect the skin to reduce /or eliminate the appearance of cellulite in these areas The design of most lower body lifts often does not address each of these crucial aspects, leaving many patients disappointed with their results. Over the last ten years, working with over 2500 post-Bariatric patients, we have developed the Mermaid Lift procedure--inspired by the feminine curves of these mythical creatures which are emulated both in art and fashion, to enhance and accentuate the female body. The key to this surgery is properly placed tension. Just as in any graceful, well-constructed wedding dress, the lines smooth out wrinkles, lift key areas, augment curves and give an overall pleasing shape. We begin centrally by making sure to lift the pubic area smoothly without leaving any unsightly mound while flattening the upper abdomen, without any need for a vertical scar. The incision is then carried out to the sides along a bikini cut, lifting and curving the thighs. We always tighten the midline abdominal muscles since this helps lower the scar further and brings in the waist, allowing us to have the thighs flare out naturally from an hour-glass shaped abdomen. The incision is then carried to the back along an imaginary bikini line and the buttocks lifted and augmented with fat from the lower back creating a pleasing curve. The total effect is similar to that achieved with so-called Mermaid-cut dresses and perfectly addresses all the key points that concern most massive weight loss patients. Another very important aspect to achieving the optimum shape is that we pre-operatively size every patient for a compression garment customized to her figure. By choosing the right size and shape of garment before the surgery and placing it directly on the patient in the operating room we are able to better control tension and allow the newly placed tissues to conform to their ideal positions. This also allows easier mobility for the patients and they are encouraged to begin walking the same evening after their surgeries. Proper preparation before surgery is also crucial. Patients’ weights need to have stabilized and their nutritional status must be optimized. In addition, any anemia must be addressed pre-operatively. We are often able to combine tummy tucks or the Mermaid Lift procedure with hernia repair or gallbladder surgery by the Bariatric surgeon at the same time, saving the patient recovery and expenses. Because of the extent of the surgery, we are cautious about doing a great deal of additional surgery. On select patients we will also do breast or arm lifts or augmentation along with a Mermaid Lift procedure. For most patients, a day or two in the hospital is sufficient, but depending on whether other procedures are done simultaneously we sometimes keep our patients longer. Recovery is usually about three weeks, but varies a great deal. Insurance coverage for at least a portion of these procedures has improved dramatically over the last few years and this often takes a great deal of the financial pressure off of patients allowing them to recover with a little more peace of mind. Plastic surgery is often the “icing on the cake” of the Bariatric experience. Once a patient has lost the weight and is feeling good, she feels complete when her newly restored inner harmony is matched by a newly harmonious outer appearance. The Mermaid Lift procedure transforms these patients’ figures and helps them radiate their new inner happiness outwards.

http://www.mybrandnewlife.org/patient-stories-and-support/bariatric-dietitians-guide-to-successful-weight-loss/

Yes told my trainer though I don't tell everyone. Basically I do a need to know basis. But trainers at my gym take continuing education and learn about bariatric surgery, working with people who are obese or have asthma etc. so it is good for them to know.

Surgery was on 12/15. It went smoothly. I came home the next day in a lot of pain. I ran out of meds. I have a large bruise on my stomach with a knot on it. It concerned me enough to go see my surgeon. He assured me it was normal and re-uped my pain meds. He's apparently proud of my progress in meeting my Fluid and Protein goals. I also got a little card that lets me eat off the children's menu. I'm a card carrying bariatric now! So, overall, I'm good. But it's a little bumpy.

I still take Bariatric Advantage citrate caramel chews to the day, six a day. Last week I bought them in 500 mg rather then 250 mg size which translates to taking 3 a day instead of 6 a day. The price per bag is also the same so now I feel like I am getting 2 for 1 on the calcium citrate and that makes me happy. Each bag is about $12 when i purchase it through the WLS Center or 22 dollars when i buy it online through Amazon. Staying healthy with all the supplements really adds up. I do not take any iron in isolation, but there is some in my optimen multivitamin and green drink. Not 100% RDA though, but something small like 20 %. Should I be aware of iron as a man?

I do know that it will take us three years to lose the amount of weight that a bypass patient will lose in one year, so if you were to have lap band, you would have to have patience. Being 60, I felt that this (band) surgery was less invasive for my older body but at 38, this is probably going to be totally your decision. What I would do is talk to my surgeon / Bariatric Center about the risks and rewards of each. With either surgery, you certainly are taking the right step to a longer healthier life with a lot more quality to it! Congratulations!

I was banded on 8/2010 by Dr Lusco at Sts Mary’s and Elizabeth Hospital in Louisville KY. Dr. Lusco, his office staff and the Bariatric Center at Sts. Mary’s and Elizabeth Hospital has provided me with one of the best medical experiences of my life. Their professionalism and obvious level of knowledge about all aspects of the LapBand process gave me the comfort level I needed to go forward with the LapBand operation. Somebody else in this thread stated that they are “Awesome” and that “They Rock”, I have to say that I 100% agree.

Hi Everyone, Just wondering if anyone has been to Parkview Bariatric Center in Fort Wayne IN ? My first consultation appointment is set for June 19th and I'm trying to do a little background if possible. Thanks

I decided to look into bariatric surgery a couple of years ago. I was always thin, until I hit about 40. Then I started to gain every year. I have Rheumatoid arthritis so my mobility is impacted,had a hysterectomy, arthritis meds can cause weight gain, etc, excuses, blah, blah, blah! But, I just turned 55; I have legal guardianship of my 10 yr old grandson who has some neurological issues. I am the only stability that kid has ever had and I decided that I needed to do something to make sure I was around for him for awhile yet. I also want to be able to do things with him. I didn't want him to someday be embarrassed when some kid asked him who was the fat, old lady. I'm 23 days out. I'm doing well. Surgery weight was 200, and I will go for my 1month post op in a few days. I think I'm gonna be a slow loser seeing as my BMI was a little lower to start with. But, that's okay. Like I said, I'm 55 and the skin doesn't bounce back like it used to. I just want to be able to go for bike rides, go swimming, etc. with my boy BEFORE he gets "too cool".

Hello all! I'm just starting my research into the lap band procedure and am attending a seminar at the end of the month. I will be 33 in July and have 3 children under 3. I have struggled with weight all of my life and am at my highest weight now (I'm guessing 260 but haven't been on a scale in 5 months since I gave birth to my daughter). Anyway, our insurance says "Not Applicable" under bariatric surgery. But there are some things listed as "Not covered." Does anyone have any experience with this or know if it's possible to get it covered when the insurance says "N/A" under coverage? I'm afraid to get my hopes up.

I am unsure why at your height and weight it is considered elective... Did you have a sleep study? If you turn out to have sleep apnea, which you might, it should not be considered elective. The other issue is if your insurance pays for any weight loss surgery, elective or not. Good luck. Most bariatric surgeon know how to work with insurance companies, if it is not elective it might make a difference

So with surgery near I'm kinda freaking out about paying for things. How much did u guys spend on medication and shots..and as far as paying for the surgery..how much were u asked to put down? (My bariatric center does payments) any advice would be greatly appreciated.

I was on Dexilent next, took it faithfully, felt results were good, was faithful up into my bariatric surgery time. Afterward what should rear it's ugly head but omeprazole. Oh no no, I told them THAT doesn't work for me. Their excuse: you can open those capsules and pour it on food or stir into applesauce. Moot point on the capsule opening, I was willing to cut the Dexilent capsules open if that was the rationale.Why not give me something that works instead of that stuff. But they insisted and I finally bent,to their will. 2 weeks in I stated THERE IS SOMETHING WRONG, and at first I was poo!pooed, You're swollen, give yourself time to heal, you're imagining things, my favorite We Are The Bariatric Weight Team, We Know What Is Best For Your Body, yeah Your Degree- My Body! Finally, I suspect, to shut me up they scheduled me an endoscopy, an EGJ, because of course, a bypassers duodenum is never easily visualized again, only the jejunem can be, the price RNY pays. And who was right? ME ME ME! I have lived in this body many years, give me a little credit please! And in addition to the stricture I thought I hand who should be there except 5 new nasty little ulcers 2 in the pouch near the stomal openings and 3 more on the back wall of the,jejunem, all grown with daily dosing of omeprazol. I have had scoping 12th October, 26th October, 9th November and another 23 November, just don' t have designated time yet. And,last time Dr Noria stated the ulceration is worse, I cannot longer be in the presence of an active smoker, indeed not even someone who has tobacco residue on their clothing, I am not yet bleeding or ready to perforated but who knows? Of the precipitating risks? Ischemia from the operation, Roux limb tension, dehydration, difficult to move past when Precious Pouch accepts no more than 3 ounces of anything without active rebellion. And after 10+ weeks it is emotionally wearying, so I have gone back to mini-cup therapy every 15 minutes, manage to get medications, vitamins, minerals in , thing,i may be living on them instead of effective calories. And since I am still on a limited Stage 2 diet it is difficult to be dietarily indisecreet. I have been on Zofran 3 times daily, now have added Carafate every 6 hours around the clock. James I would like to receive some,joy by now! I am dropping weight like an anorexic sailor, I'm tired, dizzy if I exercise very much. Clothes much looser, some people have noticed my weight loss, the average person can't be bothered to care. And I keep on keeping on and yearn for a change.😙😉😳😜

I have Aetna and was approved. When my case was submitted, my BMI was exactly 40. I had none of Aetna's listed comorbidities (diabetes, sleep apnea, high blood pressure, etc). Nor did my weight history indicate a BMI of 40+ for two years. (It was 40 one year and 38 another.) I do, however, have sever osteoarthritis/degenerative joint disease in my knees because of years of being overweight. My orthopedist wrote me a letter of medical necessity for surgery. Additionally, I wrote a personal narrative and had it included in my file that was submitted to Aetna. My narrative/letter detailed my lifelong struggle with weight from my earliest memory at age 5. It chronicled every diet I'd ever been on, including my first Weight Watchers meeting at age 8, and Fen-Phen/Redux at age 16. When the Aetna nurse called me, she said, "I read your letter and wanted to tell you myself that you're approved." I was told by the bariatric coordinator at my surgeon's office that approval really comes down to whoever is reviewing your case. Luckily, I tugged on that nurse's heart strings. My story was a compelling one that outlined my family history and my plea to not be another broken branch on that tree.

Bariatric advantage shakes aren't too bad. I love the Iced Latte!! Also try Syntax Nectar. Really like the lemonaid. Hope it helps, Ms Tink

Hi, well I was sleeved in Tijuana, Mexico in late August, 2015 by Dr. Maytorena. I was picked up from my San Diego Hotel and was able to meet everyone being sleeved that day. There was 3 of us and I think it was great as we each had something to offer the other in way on info, support, etc. 2 of us traveled on our own and the third person had a relative that had the surgery less than 10 months prior and was down 200 pounds! All of our surgery's went fine. We went to a recovery house that was nice and we each had our own room with personal A/C control by remote. I just wanted to write this quick note as I think it is helpful to others. I don't plan to update as I'm not a computer person. I'm six weeks out and down about 32 pounds. my BMI was 40 at time of surgery and I'm very happy with results. I have taken it easy and followed the diet that most sleeve doctors recommend. I have also attended two bariatric group meetings that I found hosted by hosptials in my town. My surgery took place at a surgery center. I was the first to have my surgery that day and liked that as I'm in the medical field. All in all just wanted to put this info out there for anyone looking at Dr. Maytorena. I didn't want to put anything online till I spoke with the other 2 people and things are going will for them. Wishing everyone a great success with what ever than plan in life. Dr. Maytorena's August 2015 patient.

Hearburn/reflux is a very well-documented side effect of sleeve surgery, whether you are having a revision from lap band or this is a first bariatric procedure. If you have a hiatal hernia, see if your surgeon can repair it during your sleeve surgery. This is a very common cause of GERD and having it repaired can make a huge difference. I had occasional GERD prior to my sleeve surgery, my surgeon fixed it during my sleeve surgery and no GERD since. Many sleevers take a PPI such as omeprazole or Protonix for several months after surgery -- talk to your surgeon about this. If you already have GERD and it is not caused by a hernia or some other repairable deformity, then gastric bypass may be something you want to consider. Sleeve surgeries can cause or worsen GERD but bypass cures it something like 98% of the time.

I have seen Jessica in the past. She is the sweetest! Looking fwd to meeting w/ her again. I'm wondering if she takes a different approach for the bariatric patients than just traditional diet for high BP/ pre- diabetic.