insurance

Ceparano · November 22, 2005

Anyone out there waiting for 6 month approval from GHI in New York? How long after approval do they book your surgery? Do you know what the copay is?

Librasings · November 30, 2005

I had GHI and went to do some checking, The first doctor I saw told me GHI would deny the surgery and then I would have to wait for appeal.

My husband works for FDNY and we were able to change to Healthnet. They covered everything, including follow up for my lap band. Took me a year to decide, got banded on 10/25/05.

Have a six week post op on Dec 7. Think I have lost about 18 pounds. Inches coming off, weight is going slow. But, I really have no restriction, can eat anthing, so I am waiting to see what the doctor will tell me to do.

I haven't tried to overeat, but I was away for Thanksgiving, allowed myself to eat some regular food, had only 2 means a day. But, I noticed I felt very bloated and could not sit long. Also, I got sick the next day, so it works much better when you eat less and stay on the program.

It has been hard, the days are very long, I work from home. Today I had Protein shake for Breakfast at noon. 20 oz.

2:30 had some dark meat turkey sliced in small piece and dip in salsa.

My stomach makes lots of noises, I can't go far from the house, I drink my 64 ounces of Water, that keeps me running to the bathroom.

My body has adjusted to eating fewer calories, I know this is what happens to me. So I will take it slow and steady. If you are at my point, I would love to talk with someone. I knew going in that this was not the easy way out, and I would have to work hard to make this successful. So that is what I keep chanting to myself, I have the band, don't screw up.

I haven't really missed food, thought I would go through withdrawal, but I guess food is not my big problem, its filling up my time with other things.

Regards,

Barbara

Ceparano · November 30, 2005

Barbara,

Thanks for replying. I go for my second month appt. with the nutritionist and doctor handling the paper work for GHI next week. I guess I'll find out at that time whether or not I've been denied. At this point I have done all my testing and am just waiting for the six months to run out. This doctor is one of the leading doctors on Long Island doing this procedure, and is very familiar with the drill these insurance companies put you through. so I'd like to stick with him.

Did you have a waiting period after you changed insurance companies? Six months is long enough, I don't wanting to have to start the process all over again. I live on Long Island. Where are you?

Congratulations on your weight loss, you sound like your off to a great start, except for Thanksgiving :-) But I think that is just related to getting used to the band and realizing when you've had enough to eat. From what I've learned from this forum and different threads here, it is kind of trial and error.

I can not wait to be Banded. I am becoming more and more anxious from this lousey waiting period. It is almost an obsession for me. I am on this site every day reading everyones experience with the band so that I'll be prepared, but I don't know if this is helping or hurting me.

I hope all continues to go well with you. Keep in touch.

Roberta

Librasings · December 1, 2005

Hi Roberta

It was a long time for me as well. I visited the first doc office at Maimonodes in Brooklyn, I found out I would need psych and nutrition approval, so I went and got it. Then I found out that GHI would deny so I had the opportunity to change insurance. I made an appt with Dr. Kurian from Lenox Hill in Manhattan, she has an excellent reputation as one of the best surgeons. I went to see her in February, I was approved right away, my first emotions were to get really nervous, I knew I wasn't ready, and I did not know which surgery I should have. The doc's try to talk you into Bypass. They know this has the best chance of being successful. However, I watch the EMMI, patient education video for both the Lap Band and the Gastric Bypass, since they both give you a smaller stomach, I know much is up to me. I set a second date, then my husband had a gallbladder attack, I had Dr. Kurian remove his gallbladder, so I postponed, then I set a date third time for Aug, my mother in law had to get heart surgery both valves were leaking. So I had to postpone, by October 25, 2005 I was truley ready to get banded. I could not believe I actually did it when I woke up in recovery. This was a big commitment for me, and there was no turning back. I left the hospital the next day, not much discomfort, it hurts when you cough or sneeze. In a few days I was feeling so much more energetic. I went to see my interist after two weeks, I had lost 11 pounds and was taken off my blood pressure meds. When I went to my first post op, I was down 13 pounds, the weight is going slowly, but I am losing inches. I have to really get on my treadmill and walk and do my aerobics. My body seems to have adjusted to fewer calories. I am due back for my second post op on Dec 7th. Not sure if I will lose any more weight, maybe 3 pounds or 5. I am not sure how restriction feels. I can really eat anything, I think. I haven't had any bread, sticking to the stage II program. But, I get hungry about 5 times during the day. Today I had a Protein Drink, 20oz. at noon. 3 P.M. some turkey dark meat little pieces with some salsa. Drinking my 64 ounces of Water, so all afternoon I have been drinking. My husband gets home at 1o P.M. for dinner. I did not want food. I had a SF fudge for 40 cal. Sometimes I just don't want to eat. That's my problem, I rather graze as they call it instead of eat a meal. But, back to the restriction, I know if I was not working at home, and the days were not so long for me, I am really not that hungry. I have a support group http://CaringforElderlyFamilyMembers@groups.msn.com I am a passionate advocate for quality of life issues for seniors. I have promoted the group from a few members to now 200. It is truly special for me. I just started a website www.coalitionforseniorsafety.org. I have an e-book How To Start a Coalition for Senior Safety. If you have any interest in issues of aging or caring for and assisting aging parents please visit and join. Well, now its a week at a time, I try not to get on the scale anymore, I am able to see the big picture, whatever I lose over the course of the year is terrific. But, I learned a lot from the message boards, I just went to the dentist, now with the Lap Band I have to take antibiotic before the dentist. Sorry for going on, but this is a learning experience for me to. Please feel free to ask me any questions. You can email me at bbhcando@msn.com

Barbara

bandedredgirl · December 6, 2005

I didn't have to wait. New York has very good laws on medical necessity and external reviews. I had to get a lawyer, but I didn't need to wait the 6 months. I had enough to show I tried a ton of diets with my primary doctor. Good luck,

Librasings · December 6, 2005

Hello

My first fill is coming up.... can anyone tell me what to expect. Not afriad, just wonder how Dr. Kurian does it. I noticed a big long needle on my last visit. Will it take very long. I have restriction only if I try to eat as I did before the Lap Band. Then I get really bloated and have to walk around, I get pressure on my left side under my breast. Otherwise, I can drink 30 oz no problem, I can eat whatever, I have been really trying to stay on Stage 11 Program, but it is hard when you can eat and drink without any problem. I don't at this point need to eat real slow, especially Cereal and soft foods. So can't wait to get my fill and move down. Thanks Librasings.