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I'm 34 weighing in at 252 lbs. I've struggled with my weight my entire life. I've finally had enough, the day I could no longer strap into my favorite roller coaster was the day I started looking into weight loss surgery. I've decided on the gastric sleeve and am currently waiting to schedule my sleep study and attend the mandatory seminar for qualifications for my insurance. This is an amazing place to read information and I'm grateful to you all!!! Sent from my SAMSUNG-SM-G925A using the BariatricPal App
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CIGNA Coverage Policy - Effective 10/9/2018
Walter Lindstrom posted a topic in Insurance & Financing
This may have been discussed before but for anyone covered by CIGNA or one of its affiliated companies, they have abandoned their prior formal requirement of a specific duration (e.g. 3 months) in favor of this language: • A statement from a physician/physician’s assistant/nurse practitioner/registered dietician (i.e., other than the requesting surgeon) that the individual has failed previous attempts to achieve and maintain weight loss by medical management. This is the old language: • Medical management including evidence of active participation within the last 12 months in a weight-management program that is supervised either by a physician/physician’s assistant/nurse practitioner or a registered dietician for a minimum of three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly documentation of ALL of the following components: weight current dietary program physical activity (e.g., exercise program) Programs such as Weight Watchers®, Jenny Craig® and Optifast® are acceptable alternatives if done in conjunction with the supervision of a physician/physician’s assistant/nurse practitioner or registered dietician and detailed documentation of participation is available for review. However, physician-supervised programs consisting exclusively of pharmacological management are not sufficient to meet this requirement. Anyone covered by CIGNA now and going through a mandatory weight loss program under the old medical policy should request their surgeon/bariatric program to submit their request for approval NOW and not wait to finish the supervised diet. You might get some push-back from crusty bariatric practices or surgeons, but hopefully they will help you. The new policy is more favorable to patients, and because it is the medical policy in effect for anyone having surgery after October 9th, we take the position this is the operative medical policy - NOT the policy at a patient's "starting point". Call us at 1-877-992-7732 if you have questions about this or are in need of any information about what you need to do if you have been denied by your insurer - whether it is CIGNA or any other payer. Good luck to all! CIGNA medical policy effective October 9 2018.pdf -
Oh, Lisa, I know EXACTLY how you feel. I felt that way only one week ago today!! Let's see, what words of wisdom can I impart? Just this: in the very short term the thing to think about is that you're having surgery, and you have to recover from that. That's plenty to keep you busy all by itself. Don't worry about the band, or your reaction to it, or if you're going to lose weight with it (for heaven's sake!). Good luck, girlie. You'll sail through!!!
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What do you guys think about this? Now you can have a bmi of 30 and qualify for the lap band. I have been reading so many stories and so glad I decided to get the band. Surgery in 8 days!! See link of interesting insight on the new fda approval. Do you think insurance companies will bite on this? http://articles.nydailynews.com/2011-02-18/entertainment/28631190_1_lap-band-weight-loss-surgery-band-slippage-adjustable-gastric-band
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You are doing fine. One thing I learned is weight loss is 95% food intake. It toook me 5 months to get my energy back. I am now at 10 months 130 lbs down and started training for a 1/2 marathon in April. Last week I ran a 15 K. Give your self time. As my mentor says do most of the stuff , most of the time and you will lose most of the weight. You wont regret this ride.
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I was sleeved on Jan 20th and I'm down 30 lbs. On most days I'll use every calorie that MFP has to offer for that day. Occasionally I'll eat about 800 a day but no matter what I get in my Protein, Water and Vitamins. Having said that, I average a weight loss of about 3 pounds a week. My question is... Will we still loose if we eat the allotted MFP calories per day/per weight?
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I wish I was where you two are! You are fine and the weight loss will be slow but your doing great! I however am 6 months out and weigh exactly what I weighed 1 month out:( I have had 3 fills and I have to eat slow, I do get stuck daily if I don't chew slow enough and I can go almost 5 hrs with no hunger and still just plateau. I have increased my Water and my exercise inches lost I do see but that scale isnt changing. Keep up the good job ladies! Your not in Bandster Hell
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105 down, 11months out
janetsjourneytoslim commented on BandsterMom's gallery image in Member Photo Gallery
I don't see anywhere what weight you were before the surgery and the large pants, what size were you wearing before? I think you have done an awesome job! You look wonderful and are a very pretty stay at home mom of four. I had four too and had to work, God Bless you! I am proud for you. -
Whats sodium got to do with weight gain?
Sabredy12 posted a topic in POST-Operation Weight Loss Surgery Q&A
Really curious about this as I've seen it mentioned on a few of the weight gain forums!! Everytime someone mentions a weight gain someone says watch ur sodium intake! Can someone explain why?? As after weeks do water and protein I love a bit of salt on my scrambled egg :( -
The marks on my stoamch are healing and have some bumps.
Mellzbellz21 replied to sprinkle715's topic in POST-Operation Weight Loss Surgery Q&A
My scars are still a little raised up and purple, had surgery the end of Feb. At first they were kind of puckered in, but with my weight loss they're now even with the rest of my stomach. My port site never really bothers me, but sometimes I get sharp pains on the other side, my doctor said it is just the muscles still healing because they had to do very deep stitches on that side. Totally normal at this point. -
Did anyone notice if their water retention/weight gain intensified after getting the sleeve as well? I have been sticking to the diet and making sure to keep my fluid intake up...but it seems that I'm retaining water worse than I had before. It may also go hand in hand with the intensified period, bleh.
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Band To Sleeve. Is It All It's Cracked Up To Be?
Gilly replied to kate33's topic in Gastric Sleeve Surgery Forums
I had my Realize band surgery June 2009. Dr Rodriguez did my revision at Star Medica on 4/27/12. I had a wonderful experience with Dr Rod and his staff. I am just a month out so I haven't been really adventurous yet. However, whatever I eat, it sits comfortably in my stomach, not my throat! I haven't yet slimed or thrown up. So far, I haven't had any acid reflux issues. I didn't really notice but I was eating a lot of soft foods, Soups and sliders with the band. If I had a lunch or dinner date, I would have to scope out the menu in advance just to make sure there was something that I could eat that I wouldn't get stuck on. With the sleeve, it's not an issue. I am adding in veggies and salads back into my diet. Although, I haven't tried any fruits yet. But my goal is to focus on getting to my goal weight before I start adding in more fruits. -
Hi everyone! My name is P.J.. I live in yakima, wa and I was banded 5 yrs ago by Dr. Sanchez in MX. I was almost to goal and re gained my weight. Now to this day I am 10 pounds over what I was going in for my banding. I didnt know that over time I would need a fill. I thought once you get filled you'r good to go. I guess nothing is that easy. I was not given much info on bands ether. So instead of sitting on the couch and not caring about myself I have desided to do something to is good for me. That would be to get a fill. I am sooooo freaked out about needles but I am gonna put on my big girl pants and deal with it! :frown: I am a mom of 5 kids. 3 or my bio kids and 2 are my bonus kids from my husband, kevin. They are 2 boys ( 13 yrs & 12yrs) 3 girls ( 13yrs, 11yrs and 9yrs) 3 of our kids are special needs, so we have our hands full. I guess thats it. I would love meeting you all and learning as much as I can and hope to build some friendships as well.
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Weighing options
Heathermarie0407 replied to edmontongirl's topic in PRE-Operation Weight Loss Surgery Q&A
Of course you can do it yourself. But there is no shame in getting help either. You said you gained a lot after your husbands death, just wondering if you have sought advice from a mental health professional? You may have some depression that could benefit from medicine. If you feel that weight loss surgery something that will help you get healthy then do it! You must do your own research to decide that you can make the lifestyle changes that you have to make with lap band. Are you ok with eating very small portions, possibly not being able to eat certain foods, becoming more active. When you think about the worst case, can you deal with those also? Some people dont lose very much weight, have complications. Good luck in whatever you decide! Take care of yourself -
It is hard. And it's SUPER hard when you compare--it's also human. When I was in WLM, I was losing SO SLOWLY in comparison to everyone else around me. And the last 20lbs took as much time to lose as all the other initial weight. I think a 120lb loss is phenomenal so please give yourself proppahs for an amazing journey well done!! I also understand having a laser focus and being wigged out when the scale is up rather than down! Please stick around and post a lot here so you can get involved and we can all work to support each other. Especially during the crazy craving holiday season! Also, please go fill out your profile so we can see where you started, how old you are, when your surgery was, what kind of surgery, how tall you are, and even a ticker in your signature! Do you plan, weigh and measure your food? What is your daily food intake look like. Are you drinking any alcohol or caloric beverages, eating protein bars, having a lot of protein drinks? Hang in there! It IS hard!!!
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I should have started writing this before I got the surgery done, but oh well. Things are going well with the band. I am finally at a good fill level. I am already at 4.2 cc in a 4.0 band. They are going to check my levels next month at my next appt. I have lost around 55 lbs or so, my scale is always off compared to the doc's office. I feel pretty good, but have been losing very slowly. I have stepped up my exercise and joined the Y last week. I do the Body for Life program. Yes, it is hard but is is also very rewarding. I love the results I get from it. I don't take a bunch of supplements, just drink my own protein drinks, etc... It is frustrating when you spend exorbitant amounts of money, and it is just as hard as dieting in my opinion. I am however, very happy that I got the band. I know I won't gain the weight back because I can go in for fills when I need them, or start seeing the pounds come back on.
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Are you making your protein and fluid goals? Both are extremely important to keeping the weight dropping off.
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Hello, everyone! I hope 2016 has been treating you well thus far! I am here tonight to request your experiences/advice with my current situation. A quick overview of where I'm at in the process: tomorrow I have an ultrasound of my gallbladder and liver. The 13th I have my EGD and a follow up appointment with my surgeon on the 20th. I completed my 6 month attempted weight loss in December, so my file should be ready to submit by the end of this month or early in February. With that being said...here's my problem: Since June, I have treated this surgery as if I have already been given the thumbs up by insurance. I have spent countless hours researching every aspect of this surgery. This site has been a God send. I simply want to be as prepared as possible. But as I approach the end of this [ridiculously] long process, I've become more aware of the possibility of denial. I meet all requirements, but I am also fully aware of insurance and how difficult they can be (yes this surgery is in my plan). And now my nerves are through the roof. I've spent 7 months preparing for something that may never take place. I know that I shouldn't get myself worked up over something that hasn't happened. But my biggest concern is how I will react *IF* insurance denies me. I know I can appeal and resubmit. But I've read plenty of stories of patients who did that and we're still denied. So, I basically feel as if I've prepared for the best case scenerio without any consideration for the worst. I'm hoping that any of you can offer some advice to help me relax as this chapter comes to a close. Did you experience this same anxiety? How did you handle it? Were you denied on your first attempt? How was the appeal process for you? I have faith that what is meant to be, will be. But I can't bare to think about the disappointment I will endure, should this not go through. Thank you in advance!
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It's story time!
James Marusek replied to sassyfrass23's topic in POST-Operation Weight Loss Surgery Q&A
Put blinders on. I ran into a lot of problems along the way with my insurance. They did very unusual things. I went through a 6 month medically monitored weight loss program. They paid for my doctor visit for the first month but not the second month. When I asked them why they didn't pay, they said weight loss is not covered by my plan. They paid for the 3rd month visit but not the 4th. I contacted my insurance and they said they made a mistake but not to worry, they would not ask me to repay them. They paid for the 5th visit but not the 6th. I just put blinders on and charged ahead. I figured this was just some game the insurance companies played to make sure I was really committed to this process. If you encounter roadblocks, just keep trying to go forward, until they give in. -
So Upset With Myself
Humming Bird replied to lgm217's topic in POST-Operation Weight Loss Surgery Q&A
Welcome to "Bandster Hell". You will have to "diet" during this stage. If your doc is one who does many tiny fills, this may last a long time. If s/he does a couple of larger fills, you will find the green zone quick and the weight just may melt off pretty quick. Hang in there. You are still well on your way to skinnyville! -
So Upset With Myself
phatkatblue replied to lgm217's topic in POST-Operation Weight Loss Surgery Q&A
I was banded on 2-15 and am also waiting for my first fill (come on Friday)! Don't be mad at yourself this is the early stages of our journey and it will get better...I too have a sweet tooth and have found a nice little protein shake that tastes like strawberry quick when I'm feeling weak...I have also been taking in more fluids to tame that head hunger and stepping up the exercise...the weight loss will happen:) -
Yes bandster hell is very real. For me this was will power diet for 6 months! My best recommendation to you would be to buy a digital food scale. Measure out your Protein (my doctor says 3 0z). Eat low fat/calories veggies until full. Also everytime you go to eat something ask yourself "Would I eat this in front of my doctor"? If not don't eat it. Am I an all or nothing dieter? Not anymore. I try to live by the 95/5% rule. Live super healthy 95% of the time and the other 5% you can have some fun. The first couple months after surgery however I think you need to be very dedicated and eat healthy all the time. Also, are you exercising? If not find something you can force yourself to do for 30 days. After 30 days you will see weight loss and feel motivated to keep going. I highly recommend lap swimming (preferrably with Water proof MP3 player) or water aerobics. Great for those of us with joint problems.
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ok...now I'm concerned...what is the usual procedure when you are revising to the sleeve...I too have a lapband that needs to be removed.....I guess I need to ask now....I know the reason why I haven't gained anymore weight is because my band is still filled (even though I have only lost a few pounds with it in 7 years)
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Hi! While I have yet to lose a big amount of weight, I am starting to go through my closet and get rid of some clothes. Today's offering is a size 22 cropped khaki pants from Fashion Bug. Tags still attached (bought them and they were a little big but never actually got to wear them!!) They are 98% cotton, 2% spandex, nice and soft. According to the tag, they are straight through the thigh and knee, mid-calf length, sits below natural waist. I'd be happy to send them to someone that can use them. I think I also have a matching white pair that I've worn once, washed on delicate, then hung to dry...then realized that even though they were a little big, it was too much of a pain to Iron them, so they've sat in the closet!!! If you like these khaki ones and also want the white ones, I'll send both! They're not like leggings, they are actually somewhat dressy-looking. Send me an email if you're interested. kittyforet@yahoo.com thanks!
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having trouble finding someone like me
BlueTattoo replied to becca4uf's topic in PRE-Operation Weight Loss Surgery Q&A
Hun you are singing the same toon as i am. I wasn't always this way but it's been hell trying to get it off!. I've got a 2 year old and a 3 year old. I like you, gained 100lbs with first pregancy , and 20 with my second. 3 months after i had my daughter i was preggers again... My body wasn't able to "bounce back" like most peoples do. I'm still waiting on word from my doc atm. I dont think i'll hear from him til march. But who's your main insurance. Different people with different insruances have to go through different things. I myself have BCBSOK, -BlueChoice, i called ahead of my doctor and spoke with them before i even made my doctors appointment. They said i would be approved i just had to find a doctor in the area that was in the network with my insurance... i was like a yo yo through school due to being on ritlin during the school year and then being taken off of it during the summer. I would lose weight in the school year and then gain it when i was off . I was never "super skinny" but i had a lil meat in all the right places. Least that 's what i like to think but ever since i got married my ex husband used to say you are losing too much weight, i want more weight on u.... Secretly i think he was trying to trap me so that no one else would want me but that's a whole different story and now i'm getting sidetracked LOL. In other post below you will find great information about the procedures, doctors, hospitals and insurances. We're all here for you and good luck hun! *hugs*
