Waiting...........

[HollyBerry 0]

Hi everyone!!.

My name is Holly. I'm 43 ( will be 44 on New Years Day) I notified my insurance company ( PCIP California) that I wanted lap band surgury. I then contacted my dr. that I wanted this. I told him what the insurance company said and gave him the info. That was Nov.12 of this year. I am still waiting. My dr emailed me and said he is still trying to figure stuff out and that their requirement is that I get in a surgical group ( huh???) and he is still waiting to hear from them where to send me. I have PCO ( polycystic ovaries) and insulin resistance. I have 4 children, their ages are 12, 10, 2 1/2, and 18 months. I have struggled most of my life with weight. When I was 18 I got up to 200lbs for the first time. I went on a crash diet where I basically would not eat for 2 to 3 days at a time and became very obsessed. I dropped 60 lbs in 4 months. I also gained gallstones! lol. I gained it back, of course. I married for 20 years and got divorced, had two children 22 months apart and reached 270 lbs. I went on a diet of low carbs and dropped 80 lbs! I then reunited with my high school sweetheart and we got married and pregnat with our first of 2 together. After the last pregnancy, my weight just went back up. I had got down to 197 but am up to 230 again. I tried Atkins this year. I lost 23 lbs right away. I messed up and then got back on it and never did do good. I was going to gym 4 days a week, doing atkins, had a trainor show me what ot do and the scale was still not budging. I ended up unhealthy from this diet. My Vitamin D is so low that it is not on the range scale. I also have high LDL. This is all since Arkins. I just hope the insurance answers soon so my new chapter can begin!

[Maddysgram 6,159]

Hi Holly, welcome to the forum! You've come to the right place to learn about LBS . You will find knowledge, support &inspiration here too. So stick around and ask questions.

I think when your Dr says" looking for surgical practice", he is talking about a Bariatric Center, who handles everything for insurance company. They also give free seminars to learn about the LB. You might even post here giving what city you live in and someone might be able to help find a place. You def want a good surgical team behind you and help you succeed on your journey.

Your story pretty much sounds like the rest of us, yoyo dieting until metabolism is shot. I have always been successful taking weight off, but keeping it off is another matter. I'm pleased with my surgery so far. Its not a quick fix. The LB is just a tool and at first takes a lot of work learning to eat slower, chew more and make healthier choices.

I wish you the best on your journey!

[taijos 17]

Hi Holly,

Congrats, you are doing the right thing, but remain patient. In my case, my insurance company does have me enrolled in a medical provider group who is the liaison between my doctor and the insurance company. They are the ones that actually authorize the surgery. I would suggest that you contact your insurance company and inquire about the procedure yourself. Your doctor has several other patients and it may take him time to respond to letters, calls and emails returned by your insurance company.

Another thing, there are many many evaluations and tests that you probably have to take that will help the doctor paint a better picture of you in order to justify your need for the surgery. In my case, it actually took a few months to complete all the tests. Tests/evaluations that I had included: psychological test, nutrition consultation, several lab work visits, and gall bladder ultrasound even before I was referred to a specialist who was the weight loss surgeon. My surgeon isn't a part of a larger bariatric center, so you may not be referred to one of those. It is actually whomever your insurance company approves (preferred provider) and ultimately whomever your doctor has a relationship with and is comfortable sending his/her patients.

Hang in there it will work out I am sure. You have a couple of other weight related health concerns that the insurance companies look for in authorizing surgery. In addition, you have a history of trying to lose weight over the years. My doctor and I had to really work together because although I am obese, I don't have any other medical conditions. We did finally realize that I have arthritis in my knees, which was the factor that put my referral request over the top. I completed all the preliminary tests/evaluations and within a month or so, I was referred to surgery. Hang in there!