New Here and so many questions!

[spoiltmom 44]

I'm a 30 year old mom of 3. I weigh 220 and I'm 5 foot 5. I have hypothyroidism, mild sleep apnea, high blood pressure and knee problems. I've been overweight since I was 18. On my SIL's advice I called my insurance company today and they told me that I qualify for Lap Band by their standards. She said my BMI is 36- She said it only has to be 35 with one qualifying condition. I'm currently at 100% for the rest of this year so I'm thinking about calling and scheduling a surgeon appt next week.

How does this all work? I have United Health Care. My cousin also has United Healthcare and she checked into it and was scheduled and approved for surgery within 2 weeks. That seemed fast to me. I will be using the same surgeon she used.

So what all does the process involve? I have tried Weight Watchers in the past and I got down to 176 and gained it all back. I've weighed at least 190 since I was 21.

I'm at 100% b/c I had a baby in March. He was born 3 weeks early b/c my blood pressure was too high. I'm now done having children. I had my tubes tied last week and I'm now ready to get this weight off for good.

[JustAskinThx 0]

Hi there! I will try to help. I got my band on April 22 and had my first fill on Monday.

Your first step is to go to at least two seminars. That's my personal advice, because I did see differences in the way the two doctors I met handled their patients. One of the two doctors had a $4000 "program fee" which was not covered by insurance, and, alas, although he did seem to have quite an IMPRESSIVE program with in-house dietician, exercise consultant, insurance specialist, and pharmacist, I settled on the doctor who outsources the dietician and exercise consultant and didn't charge a "program fee." I am glad I did. My surgery went VERY well, the insurance specialist got me approved without a lot of hassle, and I actually managed to join the gym on my own! (gasp!) As to the pharmacist, my local Publix pharmacist helped me with a pill splitter but I haven't had any trouble with my time-release meds so far.

OK, so, go to the seminars and ask questions. Meet the doctors afterwards. Don't discount the way the doctor treats you and makes you feel. Meet the people who work with him or her--they should be very understanding and treat you with respect.

Next step is to find out about the insurance issues. Usually at the seminar you will meet the person who handles the insurance for the dr. Some insurance companies have requirements before surgery, such as a 6-month doctor-supervised diet. However, from what I understand it is very standard to require a potential lapband patient to see a dietician for a consultation and to see a psychologist for a psych eval. Don't be scared, the dietician consult dealt with recommendations for pre and post-op diets, lots of info sharing, and advice about the surgery and reinforcing good habits. The psych eval sounds very intimidating but the main questions the psychologist had for me were about my family support, about my history of depression (I brought that up, not him...) about whether I have begun to really consider the changes I need to make, and a few questions to find out whether I have an eating disorder like anorexia or binge eating. The psychologist was very helpful and friendly and nonthreatening and the consult was even covered by my insurance with a $20 "specialist copay." The surgeon's office will tell you names of the dieticians and psychologists they work with frequently. I used one of their recommended psychologists, but I could've used anyone I chose. I went with that one because he was experienced in dealing with weight loss patients and his interview wasn't like inventing the wheel for him.

OK, so, once that stuff is done, the insurance specialist will submit it. Sometimes the insurance company wants something else--in my case, they asked me to undergo a thyroid test just to be sure my overweight was not due to something that could be "fixed" less drastically than through surgery. I had a BMI of 35 with really nasty and persistent blood pressure, GERD (yay! off the medicine since the day of the surgery!) and asthma. These comorbidities made it a go with the insurance company.

THEN you see the surgeon (at least, I did) and you start your preoperative diet. Different surgeons do different things, but your preop diet will include at least some time right before the surgery of Clear liquids ONLY. My surgeon required four solid days of Clear Liquids only. A friend who went to the Program Surgeon got to have two meals a day of clear liquids then one low-fat low-carb meal, with only one full day of clear liquids the day before the surgery. So, they vary. But this is very important, because the diet is designed to shrink your liver before the surgery--if the liver is not reduced before the surgery it can interfere with the surgery. For me, honestly, the clear liquid was by far the toughest part.

Meanwhile, you can also start going to support group meetings. These are for people BEFORE or after surgery. You meet people who can help you a lot.

I hope this helped. I tried to keep it fairly general but I'm sure different doctors do things differently. I did research my surgeon pretty carefully and he has a good history.

Good luck!

[spoiltmom 44]

Thanks! I have an appt on Tuesday to meet with the Bariatric coordinator at the surgeon's office. She said I will fill out paperwork and she will verify my insurance benefits and then we will discuss how the whole process works.

Now how does this work? If my insurance requires me to do a supervised diet plan first then what happens? What I mean is I've done diets in the past and yes I can lose weight But I can't get anywhere close to a healthy weight or goal weight and it always comes right back. Since my BMI is only 36 if I lose any weight at all then I won't qualify anymore right? Or am I not understanding?

[Tori1983 0]

I Have United Health Care too. I went and saw Dr.Kim May 15th aprroved for sugery last week, liquid diet June 8th and Surgery June 29th. So, In just over a month I am getting everything done.

I too am at 100%! My son has some issues and we usually have our max out of pocket/deductable met by march-april. So, I am paying nothing out of pocket except for my diet and post op meds. All fills and unfills are covered 100%

I made the appt. They submited my paper work to the insurance and that week I heard back with my scheduled date.

Good luck to you.

[spoiltmom 44]

I Have United Health Care too. I went and saw Dr.Kim May 15th aprroved for sugery last week, liquid diet June 8th and Surgery June 29th. So, In just over a month I am getting everything done.

I too am at 100%! My son has some issues and we usually have our max out of pocket/deductable met by march-april. So, I am paying nothing out of pocket except for my diet and post op meds. All fills and unfills are covered 100%

I made the appt. They submited my paper work to the insurance and that week I heard back with my scheduled date.

Good luck to you.

Wow! Congratulations!

Maybe I'll be just as lucky. I'd love to get it done before the end of this year that way it won't cost me anything.