KimberlyTrishelle 0 Posted January 4, 2011 Hello All! My name is Kimberly. I am 24 yrs young, married with no children, and currently a pre-Nursing student. I am 5'7, 354lbs with a BMI of 55.4. I started the lapband journey just over a year ago. I have Humana EPO, and they have been terrific. To qualify I had to have: Medical records with recorded weights for the past two years, (one a year was sufficient), Letter of Medical Necessity from my PCP, and 6 consecutive months of nutrition/exercise advise from my PCP (each month I went to the doc, she typed in something along the lines of "advised Kimberly she needed to lose weight, follow low-carb high Protein diet and exercsie 3x per week..yadda yadda yadda). I turned all of that into my insurance and received an approval less than a week later! (This was after my father, who is the primary insurance holder, forgot to renew me on his insurance last January..thus having to wait another 6 months until his open enrollment, then another 3 months for my insurance to become effective again, so this prolonged everything by 9 months :-/) But alls well that ends well, and now I am anxiously awaiting my surgery date. I am having it January 25th with Dr.Rehnke at the Palms of Pasadena Hospital in St.Pete, FL. I start the Optifast on January 11th, and really am NOT looking forward to it. What helps me is the fact that my mother had the surgery with the same doctor a few years ago, so she has a bunch of tricks that she has passed on to me. One of which is to buy a BUNCH of different flavored extracts, like banana, Coconut, Almond etc. to add to the shakes. I'm hoping that will help with the variety. I guess the main things I'm nervous about are: 1.) I have bad acid reflux when I don't eat. Will I have this while on Optifast? 2.) Anesthesia. I've never been under before, so I'm frightened of what my reaction will be. 3.) Just generally nervous about something unbeknownst happening to delay or prevent the surgery such as bad preop testing, complications in surgery, and various of other possible scenarios that have to come to mind. I want this so bad, I feel like I've been dreaming of it for a very long time, and now that my dream is being realized I'm afraid I will wake up! I look forward to continuing to post as I experience this new journey in my life and I look forward to reading all of your stories as well! Happy New Year! Share this post Link to post Share on other sites
TanyaOwens 0 Posted January 4, 2011 Great info in your post. I have a different insurance HMO United healthcare, do you know if all insurance companies require the six month report from PCP? Just wondering. I have an appt with my PCP next week to discuss my wanting the surgery. I am 38 and 280 and have been overweight my whole life Share this post Link to post Share on other sites
KimberlyTrishelle 0 Posted January 4, 2011 Great info in your post. I have a different insurance HMO United healthcare, do you know if all insurance companies require the six month report from PCP? Just wondering. I have an appt with my PCP next week to discuss my wanting the surgery. I am 38 and 280 and have been overweight my whole life Hello! Not all insurance requires the 6 months report. Some require 3 months, some don't require it at all. I suggest contacting your insurance provider ASAP. That way you know EXACTLY what you need when you discuss it with your doctor, AND if you do have to do some type of supervised diet with your PCP, then your appt next week can you be your first month. Normally if you do have to do the supervised diet plan, than a couple of sentences regarding exercise and nutrition added to the end of your notes when he sees you is sufficient. With my doctor it almost became a joke. I would go in for my appt, they would do all the normal things:weight, BP, temp. Then my doc would come in and say "What month is this?" "Number 3" I would reply. She would say as she wrote her notes "Ok, so you are here, you are overweight, you need to lose weight, you should eat fruits and veggies, lay off carbs, and hit the gym, anything else today? "Nope"-said me. Doc-"See you next month!" Yea. Seems pretty pointless...but definitely worth it in the long run. Good luck with your insurance! Share this post Link to post Share on other sites
Stephy5 33 Posted January 5, 2011 Welcome Kimberly! My mother had always told me don't look for something bad to happen. I have a hard time with that. But everything will be great. Sounds like everything is in order. I will be banded Jan. 19, So I am no help to you. But there are lots of great helpful people on here. Bubbles my insurance required at least 6 months. But thay could be in last two years. So being a big girl I have gone to my doctor a few times about my weight. Surgeon got my medical records, and my insurance accepted it. Good luck to you both. Your gonna do great! Share this post Link to post Share on other sites
BeverlyM 0 Posted January 12, 2011 Good luck Kimberly i started my Optifast this morning. It wasn't as bad as i thought but very thick. The taste was ok but wondering how in the world is this gonna satisfy me for two weeks. Thanks for your mom's tips Share this post Link to post Share on other sites