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Showing results for 'weight gain'.
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Letter To Appeals Dept At Insurance Company
nikkiluv replied to nikkiluv's topic in Insurance & Financing
Thanks for all the help!! I am anxiously awaiting to go to the first seminar. My insurance company recently implimented some new guidelines that do not have a "criteria"" to meet. Its all case by case now. When I called the insurance company they told me that they just put this in place within the last 2 months. I am unsure if they require a personal letter but if they do I will be sure to take all of this advice and add it. The addition of how this will benefit my life, prevent future obesity related diseases and should be used as a tool are all very powerful things to include. I was wondering if I should also include that my husband has only been on the job for 6 years and we have a long time with this policy should be included. I assume if they are aware that it would make them benefit in the long run by not having to pay for other obesity related issues it would sway them. I also feel like because my BMI is only 39 that gaining the 8-10 pounds to make it a 40 BMI would not be beneficial.I am hoping not to have to fight it. Thanks again! -
Letter To Appeals Dept At Insurance Company
Sojourner replied to nikkiluv's topic in Insurance & Financing
I was not denied approval for the surgery, however the insurance specialist who reviewed my medical records prior to submitting to my insurance company told me I needed to write a letter to be included with the rest of my records. The letter was necessary to explain the reason why there was no weight recorded for me for nearly 1 out of the 3 years of records sent in. I drafted a short letter, explaining why this crucial number was missing, and was approved with the first letter submitted by my doctor. My BMI was also 39. Any weight related co-morbidity, especially one which requires you to take prescription medication will be in your favor. It's not just your current medical issues that are usually considered, my doctor also included the mention of my very high probability of developing Type 2 diabetes in the very near future (like within the 6 month window of having to complete the 6 month supervised diet). I hope that you don't have your request denied, but be proactive to state your case to the insurance company if you need to... Good luck! Please post on the outcome. -
Bmi Timing For Use In Coverage Determination
lovealways replied to Raven21's topic in Insurance & Financing
It's hard to determine, because I'm not really sure anyone knows the answer to this. In terms of the supervised diet and losing weight...it's kinda "damned if you do, yet damned if you don't". I would say don't fall below a BMI of 40 for sure...just to be careful -
Unlike most people, I did zero research. My lung doctor told me you are getting this surgery and made the appointment for me to go to a meeting about all the WLS. The band is the best thing I ever did for me. I started the journey, October, 2011 and started watching my intake, March, 2012 at 268. My surgery was July 30, 2012 and I was 240 that day. I am now around 190-192 and have had 3 fills for a total of 1.5 cc. I have lost 60% of my BMI and the doctor is thrilled with that number. I want to lose more, don't really know how much. I planned on this taking 1 1/2-2 years to get to my new weight. The way I lost the 28 pounds before the band was having shakes for breakfast and giving up all breakfasts. I still have them every morning and enjoy them. I don't eat eggs so this really works for me. I go to the support groups every month at the hospital and love them. My husband goes with me for support and he has learned a lot, also. I hope I have helped you. Just ask any and all questions, there is no such thing as a dumb question. Arlene
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I have a consultation appointment in a few weeks and have done a ton of research on the band. I'm curious how much/how fast you lose weight on the band? I'm not interested in doing any of the other surgeries, removing stomach etc, but those seem to have a faster weight loss. Thanks!
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It all depends on YOU!! If you follow the guidelines given to you by your surgeon. A pre-op diet helps get you into the groove of eating less. Exercise will help to not only lose but get stronger.Everyone is different, and it's sooooooooo True. As far as I'm concerned any WLS can be Successful if you want it enough. and ANY weight loss is a GOOD thing if you get healthier Their is allot of good advise here on LBT. SO make a note of all your questions that you want to ask before going for the consult, It's allot of information to take in at once. Write down the answers as well. Ask the doctor how many patients he had banded, what is the success rate of those patients, what is the average weight loss for his patients. What are the complication rates, and what complications If any has he seen. Ask if he finds a hiatial hernia will he fix it while he places the band. ( I had one that I was unaware of prior to the band) He will probably tell you also about the tests that will be needed prior to be banding, endoscopy, Phys. eval, stress test, sleep apnea, Ask what pre-op diet they recommend, ideas for protein drinks, meal plans etc. He will probably tell you that you can discuss all of this with the nutritionist, but that may be a separate fee? Ask if he is going to be available to discuss problems if any arise some offices always instruct pt's to "just go to the ER" When in fact most ER's don't know how to handle band problems. I could probably think of more things ...but you will find answers here if you just put it in the search it's full of information from allot of good people.
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I chose to go a nutritionist for 6 meetings, rather than go to my pcp. I was weighed at the meetings and given knowledge of good and bad fats, carbs, etc. I think they ( the ins co ) go by what you weighed at the onset; not what you've lost. We all can lose weight...but keeping it off... Hence the surgery tool for help losing and keeping it off.
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Can not stop losing weight ! hit my goal and than some
VSGAnn2014 replied to Scottyd1264's topic in POST-Operation Weight Loss Surgery Q&A
I simply mean that sleeve surgery works to restrict severely the volume of food you can eat. That's why many people lose weight "effortlessly" for at least six months, sometimes losing 100 pounds or more during that time. Your profile looks like you wanted to lose only 35 pounds. You have boarded a train that takes a long time to slow down. Eating high fat, high carb food would help to slow it faster. Your surgeon may have better ideas. -
Today, I did awesomely well with my eating, I made it to 1,086 calories, and got all of my protein in through just eating, no gross shakes. That amount will off set once I get in my cardio/weights before bed. I logged in my meals for today in a food journal and I looked at the list and got scared...scared of regaining weight. All of my choices were healthy and I don't understand why I'm nervous and on the verge of tears(it could be the period hormones acting up this month) My greatest fear is failing this journey. I can't understand why I feel this way, I've done well so far I just have this picture in my mind(and on my phone) of how fat my face looked and how tired I was of dealing with being like that.....just thinking about going back to that state, makes me panic. Some months are better than others, but this month, 9 days before my period starts, I feel like a weepy mess...I don't like PMS....I just feel really sad right now.
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Did exercising cause you weight gain?
music1618 replied to russianpenny's topic in Fitness & Exercise
Exercising and getting in proper nutrition can be a task. I weight train, run, and play soccer 3-4 nights a week. I only worry about my protein intake. With this much activity calories are a mute point to me. I have reached goal weight and now working on adding muscle. Keep in mind every gram of protein is 4 calories. So I aim for 100 grams of protein - and right off the bat I am at 400 calories. Play around with your protein and calorie goals. The more active you are the more protein you need. -
I am 6 months out, so as the others said, I can't speak for the weight gain in the long term, but as with any weight loss surgery, there is still a lot of work involved with exercise and making good choices. You could easily put the weight back on, I'm sure, if you don't stick to a high Protein low carb diet. At this point, I still can't eat more than a 1/2 cup of food at a time and I was told by a year I would be able to eat a cup, so the stomach stretches but that is not anywhere near the capacity I had before surgery! As for the Vitamin deficiency, I take a Multivitamin and vit d with Calcium once a day and my labs have been perfect every two months since I had the surgery.
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Slower than expected Weight Loss in the beginning
rumpole6 posted a topic in Weight Loss Surgery Success Stories
I am very early days, two weeks post-op as of today and I am not seeing the results I expected. I was really hopeful because i lost 14 lbs on the preop diet, but week one I lost 3.5 lbs and week 2 I lost 2.5 lbs for a total of 6t lbs post-op. With the 14 pre-op Its a total of 20 over three weeks so I am not sure what I am complaining about but I expected more since calories are so low. I am tempted to chalk this up to age, or unrealistic expectations, but my surgeon told me way back when that I might lose 30 lbs in the first month, and that doesn't seem possible now unless I include the preop weight loss and even then it might not be possible. I've gone back to work and the increased activity of that may help accelerate the weightloss, I hope. I would love to hear how others our age (58 at surgery) did in the very early days. Best Regards, Barry -
Can not stop losing weight ! hit my goal and than some
theladyslipper replied to Scottyd1264's topic in POST-Operation Weight Loss Surgery Q&A
My mother had this problem--she was sleeved a year & a half ago and lost around 150 lbs in the first year. She has a hard time eating a lot at a time w/ acid reflux. She's since gained 10-12 lbs, but is around 5'8 and 140. She kind of got scared that if she were to get sick, she'd lose more. Never thought that losing too much could be a problem until I watched her go through it. Good luck increasing calories! -
Can not stop losing weight ! hit my goal and than some
Scottyd1264 posted a topic in POST-Operation Weight Loss Surgery Q&A
I had revision surgery from the band, and now I cannot stop losing.... Really not a good thing. -
I will post in the "before & After" thread when I have had my hair and make -up done. I am going to the theatre on Friday night with DH (hence the hair make up and fancy pants), I will get the boy-child to take some photos, that pic was just for me to "see" what the suit looked like on. Now I am blushing! Thank you! The 0cc fill is just so I stop losing. At this stage, I am a pretty strict vegetarian, and the majority of my favoured foods are very bulky, and by nature low fat and calorie. Add to that the running and other exercise. I am at a point where I don,t want to lose any more weight. I weigh on a good day 49kg / 107lbs, and that is the low end of a healthy weight for my height. We tried taking the fill out 0.5cc at a time, but I was still losing, so it all came out, and at this stage, I appear to be maintaining. I must say, I do feel all special now, having been "called out" like this!! Thank you!
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I looked up the fax from my BCBS Mich provider & they say," a 12 mth period of weight loss that can be WW or Jenny Craig etc but it must be documented by a medically supervised weigh- in with a physician" I thiink you really need to find your employers specific outline of coverage. It seems every employer maybe different. Bottom line seems to be a pcp must sign off every month.
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I used my weight watchers for my Dr. supervised diet. I simply had my PCP write a letter stating that she recomends WW, langth of time on WW, weight loss and regain. Then I asked WW to e-mail me all of my on line daily food records and sent them all in. Was approved in a heart beat. United Health Care. Caresa!
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WW irritates the bejebbers out of me! I e-mailed them yesterday to try to get my lifetime membership number so I could get some records (I can't find my membership books) and they were like "We cannot provide these kinds of records for you, you will have to show your physician a cancelled check or your membership book" and gave me info on how to obtain a new lifetime membership number - in other words, how to rejoin. I always had trouble sticking to their plan because I simply cannot eat fruit and I was told that it was required. And the people who own the franchise here are soooo self-righteous they make me want to scream . I did much better on ediets, but I still gained all but 5 lbs of it back. That's still better than WW, where I always gained it all back and then some :faint:
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A lot of people understand just may not still be hanging around here when it gets to that point of removal etc... Those that do well don't always want to hear negatives and don't want to "jinx" their band situation. For those of us that don't do well or have complications it can be very frustrating because we want that same result. It doesn't mean we don't work as hard our bodies are just different. I just never was able to lose the weight and ended up gaining back what I lost before the surgery. It's hard to pin point exactly why but possibly with all my issues I just needed the malabsorption that other procedures have. I ended up being too tight and vomited too much and ended up with acid reflux which a lot of people get and even without any saline in the band was still having issues. So it was removed. I waited about six months before deciding to revise to another surgery, the RNY. My daughter had RNY a few months after I received my lap band and I've been with her through all the ups and downs but in the long run she's been successful. I got the lap band in 8/07, was put in the hospital for chest pains in 9/08 (acid reflux) and had it removed 10/08. The removal was covered by insurance and I'm in the waiting stages of approval for the revision to RNY 6/09. As far as I know it should be covered and am crossing my fingers and toes! Good luck to you Nancy.
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:sad:Help!!!! Well I found out why I was hungry all the time I went for a fill yesterday after not having one for over a year and the Dr said ooops we have a problem you have esophageal dilation and I will have to remove fluid so it will hopefully undialate. He said to go on a liquid and soft foods diet. He mentioned I may have to have the band removed I went thru heck with the insurance co to get this band I don't want to have it removed I am very scared has anyone ever had this happen and after removing fluid from the band did the pouch go back to normal size? I am going back to see him in 3 weeks. And if you had to have the band removed and replaced with something else will the insurance pay my company has stopped paying for weight loss surgery since last year on our insurance???? I am very worried!!! Any Help Please!
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Yea, just healing because your body is kinda in shock, it all evens out after about 6 weeks. Also remember 1-2lbs a WEEK is normal. I know all the liquid diet weight is exciting, but it doesn't continue like that. Sounds like you are doing everything right though!
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Thanks! I know I am doing well. I am just have a scale obsession and am on it every morning. I got on the last 3 days at the same weight and couldn't understand why it hasn't drop even a ounce But I am okay!! I know I have to kick up the water intake and maybe a few more calories. I start walking this week so that should help also!!
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Sorry, one more BCBS of IL ? regarding weight watchers
kewlshort1 replied to shawna_s's topic in Insurance & Financing
I have Humana, not BCBS, but my policy specifically excluded Weight Watchers (and some other similar programs) because they were not "physician-directed". I would guess you would have to verify it with your specific plan to make sure they don't have a similar wording. -
Your first fill probably won't have much effect, other than making you a little sore for a day or so. Some people don't feel any effect. I didn't, but my band was filled and then emptied because I had a 38 lb weight loss so a fill wasn't necessary. You need to relax a little, this isn't that bad. A fill will probably give a little restriction for a few days, then you'll be right back where you were. If your weight loss is enough, a good surgeon may choose not to give you a fill until you either stop losing or begin to have hunger you can't control.
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Hi everyone, I need some suggestions/advice, etc. I am having a very early appointment with my surgeon tomorrow (not being banded until April 10th) and intend to use his time to ask questions about my upcoming surgery such as: Realize vs. Lap Band (APS, APL) Incisions (how many? where? where will they be after weight loss and TT?) Port Placement (higher? lower? I'm looking ahead to TT and waistband comfort) Fills (how soon?) If you had it to do over again, what would you ask? What would you want different? (or would you?) What did I leave out? Thank you! ~Carol :thumbdown:
