Bertha / Abkin in Morristown NJ

[Sonia 0]

Sonia,

What insurance do you have? Any weight loss attempts should be listed on your application. Not only ww or Jenny Craig. Have you ever taken diet pills to lose weight? I did and I named every one I ever took. How about the gym? That's an attempt too. Slim Fast anyone? Dexatrim? any of those over the counter medications for weight loss. Put your thinking cap on and as you think of them write them down. Any assistance, I can provide please don't hesitate to contact me as it is ALL still very fresh in my head.

Sorry for the long thread. I guess I got a little carried away

Hi,

I have Blue Cross/Blue Shield POS (point of service). I have no clue whether WLS is approved, I belive so. I remember looking in the book they gave me when I was researching WLS before, and it was included, but not sure if Lap Band would be. Dr. Abkin and Bertha are both in my plan, which means if my PCP would give me a referral it would all be covered. TO me that would be too good to be true, but who knows.

I would appreciate any information you may have. I plan on calling my PCP tomorrow to make an appt. I gotta be honest, I had been avoiding going to her because no matter what was wrong with me she would put me on the scale, then proceed to lecture me about my weight. I hated going to her. I do know, however, that she is pro WLS, specifically RNY, because she mentioned that surgery many times at a time when I would never consider it. Now I am hoping she is open to Lap Band. I don't see why not, but I don't take anything for granted.

THanks again, Newbandster and Alexandra, for responding. I am part of many lap band groups, but this is the first one where I have been able to get local precise information.

Thanks!!

Sonia

[Alexandra 55]

Hi Sonia,

First, I can tell you that in general Horizon BCBS is very band-friendly. Of course, if your company is a large company and has a non-standard plan, that decision is in other hands. Is yours a large-group plan? How many people work for your firm?

If you have a POS then you definitely do need a referral. And, as I said, you'll need the physical no matter what. But it's not your PCP's job to decide whether you're a good candidate for surgery or what surgery to recommend. All of that lies in the hands of the surgeon. All you need your PCP to do is write the referral to a surgeon based on your diagnosis of morbid obesity and Dr.s Abkin, Bertha, et al will take it from there.

I think you're in very good shape for insurance coverage, based on the information you've shared here. Your BMI is in the 45 range, so you don't have to show any co-morbidities to be diagnosed with MO. (A BMI of 40 is the benchmark.) In other words, simply being at the weight you are is reason enough to investigate surgical treatment.

Don't let your PCP try to push you toward the RNY. It's premature to make that decision, tell her, and that's why you want to talk with a surgeon.

BTW, do you have the handout from Abkin/Bertha's office? You'll want to have that before you see your PCP for the physical, so your doc will know what tests to order. You get that handout at their intro meeting, which I can't remember if you said you've attended or not. (Sorry--mommy brain.) Good luck!!

[Sonia 0]

BTW, do you have the handout from Abkin/Bertha's office? You'll want to have that before you see your PCP for the physical, so your doc will know what tests to order. You get that handout at their intro meeting, which I can't remember if you said you've attended or not. (Sorry--mommy brain.) Good luck!!

No, I haven't gone to their intro meeting. I think they are having one this week, from what I remember seeing on their website. Is the meeting open to anyone (i.e. can my husband come along as well?) I know it will probably take a couple of weeks to get an appt with my PCP, hopefully I can see her during holiday recess. If I attend the intro meeting at least I will have info to give her.

I am a teacher, so my insurance coverage is through the district. From what I remember when I signed up, the did cover WLS, as stated in the book they gave to everyone.

Thanks for responding so quickly yet again. I am getting psyched. Do you know I acutally had a dream last night that I had the surgery and everything went ok? I know I am obsessing about it, but it was reassuring nevertheless. Weird huh?

Sonia

[Alexandra 55]

Sonia, you are in like Flynn. With the state coverage you're in fantastic position. No worries there! And yes, spouses are welcome at the intro meeting, absolutely.

I believe in dreams. You're on your way!! :D

[Sonia 0]

Sonia, you are in like Flynn. With the state coverage you're in fantastic position. No worries there! And yes, spouses are welcome at the intro meeting, absolutely.

I believe in dreams. You're on your way!! :D

I jsut RSVPed online to attend the new patient seminar. It is on 12/15. My hubby will come with me. Hopefully we will get more information and see if this is something we can do.

Thanks. I gotta get off this computer today. Been reading all about the lap band all day. My eyes are crossing!! LOL

Sonia

[Newbandster 0]

Sonia,

This is great. I work for a school district as well and I have the same insurance. You should be okay. Don't put it off too long though. I have heard talk of the insurance companies threatening to stop paying for the surgery. That's why I ran with it. I can't say I'm 100% glad I did yet, because I am still in the full liquid phase and it is EXTREMELY tough to get through but I know I will and once I get through it I'm 100% sure I'll be pleased.

[Newbandster 0]

Alex, Please keep me posted on that January meeting. I am a patient of Abkin and Bertha but I live all the way in South Jersey. I do work in North Jersey though so maybe it will be a night that I can come. I'm not quite back to myself yet. I'm still extremely sore in my stomach area where the stiches are on the left side. I'm assuming that is where the port is. I still can't bend down to tye my shoes yet. I think the toughest part of this is keeping my stomach from growling so much. It keeps me up at night and I still can't sleep comfortable as it is because of the soreness. I actually tried a little bit of pudding today and it wasn't bad. In some of the books that I received on the post op diet before the surgery. They said that you can have pudding in Phase II of the diet. I don't know. I just try to keep the edge off and it's extremely tough. Any suggestions? I can't wait unitl next week when I can go to mushies. I think I will be so much more satisfied. I find this support group so very helpful.

[Sonia 0]

Sonia,

This is great. I work for a school district as well and I have the same insurance. You should be okay. Don't put it off too long though. I have heard talk of the insurance companies threatening to stop paying for the surgery. That's why I ran with it. I can't say I'm 100% glad I did yet, because I am still in the full liquid phase and it is EXTREMELY tough to get through but I know I will and once I get through it I'm 100% sure I'll be pleased.

That does give me hope. You had the surgery a week ago? Are you back at work yet? Are you in the classroom or a support person?

From all the success stories I have been reading, I am confident that you will be 100% pleased. You already went through with the surgery. TO me that is the biggest thing. I am abolsutely petrified of the whole surgery thing. I really have nto had any major surgery in my life. I was put under a few times, once for dental surgery and 3 other times for various reasons, but never for major surgery. When I was younger my parents did all the worrying. Of course, now that I am older and know the risks I am going crazy with them. I had just gotta stop watching ER. LOL

Anyway, did you feel the same pre-surgery? I mean, I can picture myself going into hysterics right before the surgery. How did you deal with it, if you did? I know if I could just blink my eyes and have the band inside me I would do it in a heartbeat. It is the actual surgery that has me holding back.

Sorry for the long post. It is just something that weighs heavily on me and I feel I can share with you guys since you can definitely relate. Thanks for listening.

Sonia

[ShrinkingViolet 1]

I had Dr. Bertha and was banded Nov. 23. I first saw him a year and a half ago, but my insurance--which was CIGNA--denied the surgery. Then my husband's employer switched to BC/BS--Empire. I was 5'7" and 285 pounds, with high blood pressure and borderline diabetic. So I resubmitted this Nov.

The only "evidence" I had of being on a weight loss program were my Weight Watchers meeting booklets from way back, logging my progress. My family doctor was very helpful with his letter, and mentioned "prescribing Weight Watchers, Atkins Diet, and Meridia, all with no success." While he did tell me to try Weight Watchers (didn't help much) and then a lowfat version of Atkins (I lost 50 pounds and gained it back) and prescribed Meridia, which I took for one day because it made me sick, the diets weren't really "medically supervised." But BC/BS did not request any medical records to substantiate this. They just accepted my doctor's letter that he had prescribed these things.

I also had my father write a letter detailing our family history of high blood pressure, heart disease and diabetes and expressing his personal concern for my health. I read that someone else did something like this and figured a personal touch couldn't hurt.

The BC/BS nurse called me less than an hour after Dr. Bertha's office faxed my request, and she said "It was a very easy decision to approve you" and was extremely nice. So I think you'll have good luck, particularly if you have a co-morbidity.

Newband, hi!

I agree the liquid phase was very hard to survive (my last day is today). I haven't "cheated" exactly, but I've had some liquids that have a tiny bit of soft solids in them.

Maggi makes a good Hot & Sour Soup mix. It's 35 calories per cup and has tiny little bits of mushy mushroom and tofu. I heat it to boiling and stir in one egg (like egg drop soup). It is pretty satisfying.

Also, for my Protein I put whey Pro Protein powder in a blender/smoothie maker with 1 cup milk and 1 cup crushed ice (and Splenda). It's thicker and more pleasant to eat and helps me get in extra Water. The ice crunching makes me feel like I'm "eating" instead of drinking.

I also have a really good recipe for a fairly smooth tortilla Soup if you're interested. I ate that for two days straight. I also pureed clam chowder. I ate a few Yoplait Whips, the pina colada flavor. (I tried sugarless yogurt but it was icky). I also went out with my family twice and ordered egg drop soup once and cream of potato soup another time.

So far, I'm down 13 pounds, although I went up one pound last night, which must be Water retention because I definitely didn't eat anything differently or consume enough calories to gain a pound.

I think some of the initial two week weight loss comes from emptying our digestive system of foods, in particular carbs, which hold water. One cup of water weighs 2/3 pound. So I think when people start mushies and gain a little or don't lose weight at first, it's because of the increased food matter inside their bodies and not real weight gain.

Anyway, good luck to you Sonia and nice to meet some fellow New Jerseyeans.

[Alexandra 55]

Sonia, I too was very apprehensive about the surgery. And I'll tell you, surgery is no picnic. But as surgeries go this is pretty easy, especially since at Morristown it doesn't involve a night in the hospital (which I think is the worst place to heal and rest).

General anaesthesia was the worst part for me. It took a good three-four days before I felt it was completely out of my system. And with two little kids at home that was a real challenge. But after surgery on Wednesday I was back at work on the following Monday with only a little soreness to speak of.

Before surgery I comforted myself by thinking of all the people who have surgery for various things on a daily basis. Even though general anaesthesia was a new experience for me, people go through multiple surgeries when they're in an accident or have a serious health problem. Major negative reactions to anaesthesia are quite rare when we take into account how many people are put under every single day of the year. What if you needed a joint replacement or a heart valve operation? I think it's just the "elective" nature of this procedure that has us worrying so much.

[ShrinkingViolet 1]

I have been under general anesthesia many many times (at least 7). I always seem to have a hard time "rousing" myself afterwards and I don't push it anymore. Once it wears off, I am usually fine and start getting up and everything; I recall after having my gallbladder out, they really pushed me to get up and walk around before I felt ready. They did not do that at Morristown at all. They were pretty patient about it, which was great.

Also, I asked the anesthesiologist if it made any difference in post-anesthesiology recovery whether you were given a sedating drug before hand to "calm you down" and she said yes, that the effects of that drug can linger, making you a little more tired. So I asked not to have it. It's something they give you if you're anxious before anesthesia, but I really didn't feel anxious and if I did, it was only going to be another 15 minutes before I was out.

The best part about anesthesia is when you are just waking up and they give you these incredibly toasty soft blankets. I want one of those blanket warmers for my house!

[Sonia 0]

Sonia, I too was very apprehensive about the surgery. And I'll tell you, surgery is no picnic. But as surgeries go this is pretty easy, especially since at Morristown it doesn't involve a night in the hospital (which I think is the worst place to heal and rest).

General anaesthesia was the worst part for me. It took a good three-four days before I felt it was completely out of my system. And with two little kids at home that was a real challenge. But after surgery on Wednesday I was back at work on the following Monday with only a little soreness to speak of.

Before surgery I comforted myself by thinking of all the people who have surgery for various things on a daily basis. Even though general anaesthesia was a new experience for me, people go through multiple surgeries when they're in an accident or have a serious health problem. Major negative reactions to anaesthesia are quite rare when we take into account how many people are put under every single day of the year. What if you needed a joint replacement or a heart valve operation? I think it's just the "elective" nature of this procedure that has us worrying so much.

You're right, I know you are. I guess I will feel a bit better about it if/when I get it done. And it being elective surgery is also a factor. I mean, I don't need this surgery as a dire emergency at this point. The only thing wrong with me, besides the obvious MO, is my high blood pressure. I am afraid that I will have it, and then people will say afterward "well, she wanted to get better, but what a shame that she had to die this way". and some other melodramatic scene playing in my head. I mean, I am a person that goes to "the apprehensive patient" because I am so afriad of dentists (pathetic I know). Of everything to do with this surgery, I am jsut afraid of that, to the point of ridiculous probably, but it is there jsut the same.

I did speak (via email) to deborah and am attending the new patient seminar next wednesday. It is at the Old Mill Inn. Have you (or anyone else) attended it there? What can I expect?

THanks!

Sonia

[Sonia 0]

I have been under general anesthesia many many times (at least 7). I always seem to have a hard time "rousing" myself afterwards and I don't push it anymore. Once it wears off, I am usually fine and start getting up and everything; I recall after having my gallbladder out, they really pushed me to get up and walk around before I felt ready. They did not do that at Morristown at all. They were pretty patient about it, which was great.

Also, I asked the anesthesiologist if it made any difference in post-anesthesiology recovery whether you were given a sedating drug before hand to "calm you down" and she said yes, that the effects of that drug can linger, making you a little more tired. So I asked not to have it. It's something they give you if you're anxious before anesthesia, but I really didn't feel anxious and if I did, it was only going to be another 15 minutes before I was out.

The best part about anesthesia is when you are just waking up and they give you these incredibly toasty soft blankets. I want one of those blanket warmers for my house!

I can use one of those blankets right now...my hoem office has no heat!!

Did your surgery take about an hour? How long are you actually under, if you know? It's funny, but I think we all take being put under for granted. I mean, my mother today had a colonoscopy done, and she was put under. No stress on her part whatsoever. And my grandmother was put under to have her gall bladder removed - at age 91!! SO I think I am going a little crazy here.

Thanks!!

Sonia

[Alexandra 55]

I did speak (via email) to deborah and am attending the new patient seminar next wednesday. It is at the Old Mill Inn. Have you (or anyone else) attended it there? What can I expect?

I attended that meeting in October, actually, to speak as a banded person. They have about 100-150 people or even more in the room, and most of them are interested in RNY. But basically it's an introduction to the different kinds of bariatric surgery this practice does, what the medical criteria are, the risks/benefits of surgery, etc., etc.

I'd be very surprised if people actually *learn* anything new about surgery during the planned part of the evening--I think the vast majority of people attending have already done a bit of research and know what they're looking for. But then there's the Q & A and that's when it gets interesting. The doctors attend and you'll get a look at them if not meet them personally, and they take questions from the audience so you get to hear them speak as well. All in all it's a great introduction to the practice, and you might even be able to make your appointment that night.

[Newbandster 0]

Hey Sonia,

I have been put under so many times, I can't even count them. It's always something to think about, but never anything to worry about. I don't know what your relationship is with God but I just put it in his hands. After all it is he who has the final say. I just asked him to keep me safe. You see, prior to approval, I prayed and I said to myself if it is God's will, I will be approved. So when I got the call that I was approved I knew I would be okay, because it was God's will. Don't get me wrong, the thought of it still frightened me quite a bit. But I reminding myself that GOD has the final say in everything. I did get the sedative prior to being put under because I had quite a bit of aniexty. I can't say that I remember even being wheeled into the OR but when I woke up I thanked God and I still thank him every day. Keep the faith and keep talking to your GOD and you will be fine.

Shrinking Violet and Alex

Hey guys, I posted this on another thread but I like to send it to you guys as well since we all have the same doctor.

I went for my first post op appointment today. I lost about 10 pounds thus far. I was both shocked and estatic when the doctor told me that I could move on to the MUSHIE phase. I thought I was supposed to be on full liquids for two weeks. Anyway while I was in the waiting room I was reading on the articles on the wall about a patient who had been banded and it said that when she went for her 1 week checkout, Dr. Abkin told her she could advance to mushies. Maybe the books that I got from the nutrionist are outdated. I don't know but everything I read said I couldn't advance until 2 weeks, but I asked the Doc again was he sure and he said "yes". So I came home and my mom made me what taste like the best homemade mashed potatoes I ever had. I couldn't eat very many of them, but I was able to eat some. I do find that after a while I'm hungry again. Is that normal?