OK All you bandsters out there...I need your help!

[tanderson 3]

Dear bandsters,

I am about ready to submit all my information to my insurance (Cigna) company for approval. I have a few questions.

First, I have 7 consecutive months of documented doctor's visits for weight loss, psychiatric eval, nutritionist eval (will go back for last visit in 2 weeks) and blood work. Did I cover everything?

Second, in your opinion what are my chances of getting approved? I am 42, 5'7'', weigh 265, have chronic low back pain, fatty liver disease, elevated cholesterol, occasional leg and ankle swelling, occasional high blood pressure, occasional chest pain, difficulty sleeping, and chronic depression.

Third, I would like to know what a typical day in the life of a bandster feels like. Could someone let me know how much you eat, what you eat, when you eat, how you eat, and how quicly you feel full since you've had the surgery? I am very curious.

Any other information or words of wisdom would be really great as well.

Thanks,

Trudie:)

[faithmd 14]

I haven't been banded yet so I can't answer the last questions, but if you use the search function there are quite a few great threads about these topics, and some are quite recent. I mention this because I'm sure you will get a few responses to this thread, but there is a ton more info on this board, I just don't want you to miss any of it.

Welcome!

And about your insurance question, no one can answer that for certain except CIGNA. DO you have a contact person you've been working with there? I'd call her/him and ask. If you don't have someone you are talking to, then ask for someone. Do you have a 3 month, 6 month or 12 month MD supervised weight loss requirement? You're fine if you have a 3 or 6 month, but you'll have issues if it's 12 months. Will your surgeon require you to see a cardiologist (you mention chest pain) or a pulmonologist (you mention difficulty sleeping, perhaps a sleep apnea eval will be necessary)? If so, it may take a bit longer to get things scheduled with the surgeon.

It sounds like you are certainly on the right track, your BMI is above 40 (which is what most insurance companies require) and if it wasn't you still have at least two comorbidities so as long as you were above 35 you should be good. I wish you all the best!

[Kat817 19]

H i Trudie,

Welcome to LBT! It sounds like you are as prepared as you can get at this point in time with insurance. Did you call prior to find out what their requirements were?

A day in the life of a bandster....after you go through your healing, it is surprisingly similar to life before banding!!!

I am 11 months out from surgery this month. I have had 2 fills/adjustments, and feel like I am at a good place in regards to restriction. I eat most foods without issue, and am not hungry, so it is working for me where I am at.

Today, for Breakfast I ate about 1/2 a container of Dannon Low Fat yogurt with about 1/3 of a cup of granola stirred in. I helped my DD box some things up in her house, and we each had a cappucino, since it was chilly in the house. For lunch, I had a chicken strip, and a strip of fried zucchini, with ranch dressing. Not a real healthy day for me by any stretch of the imagination---we are waiting for pizza for dinner!!! I will actually eat part of a salad, and maybe a piece of pizza, but probably only 1/2 of one.

If I had been home at lunch I usually eat some tuna salad, or some deli meat and cheese rolls. For dinner I try to eat some sort of Protein, and veggies. But the fact is, we have all been working on the house today, so we are being too lazy to cook!! Same as I would have done preband. EXCEPT at lunch, I would have ordered an entire meal, and eaten it as well as the 2 items I ate off of the appetizer tray---and tonight, I would have eaten several slices of pizza, and breadsticks! And would have spent the day washing everything down with Diet Dr Pepper! I can no longer eat anywhere near the proportions I did!!!! I now eat in the neighborhood of a cup of food, and I am full. I don't feel real hunger anymore....it went away with my 2nd fill. I get kind of an empty feeling, but nothing like the gnawing "I need food and I need it NOW" kind of hunger I used to have. As for how I eat---I eat slowly, small bites, that I chew into oblivian!!! But that becomes habit for the most part over time. I still have flashbacks where I think I can pop a piece of popcorn chicken in my mouth, chew twice and swallow---and then I hurt!!! It does not want to pass through the band if it isn't chewed well! I can dine out with my DH or with friends and we all eat and chat, and when we are all done, we finish at about the same time, but I have taken small bites, chewed well, set my fork down, visited, laughed, taken another small bite....and come the end of the meal we are all done about the same time, the only difference is I need a doggy bag, because I have about 3/4 of my meal left. No one pays me any more attention to how I eat, than I pay to them!

I love my band, it has given me a control over the raging, starving food monster who lived within me! Most days I do not eat as I am today---but the fact that I can eat this way today, and get right back on track tomorrow, without feeling the loss of control is wonderful! I chose the band so I could live as normal of a life as possible. I told my Dr. I wanted to be able to eat a piece of cake with my grandbabies on their birthdays, I just no longer wanted to inhale 2-3 pieces! I do that now---I could likely lose faster if I followed a good diet plan---but this is how I plan to live the remainder of my life, and I did not want to give up todays fun, and family for tomorrows....we never know if we will get a tomorrow. I had had enough of diets---and this has been the perfect answer for me!

I wish you luck on your insurance submission! If you have any other questions or concerns please let us know---maybe we can help!

Please look around---get to know us---we look forward to getting to know you!

Kat

[ralheit 1]

My insurance required a sleep study. Sleep apnea is one of the co-morbidities that help in getting approval.

[tanderson 3]

To all of you who replied....THANKS so much for your help. Especially you Kat817!! I was still on the fence trying to make up my mind for sure, but after your description, I know this IS the right choice for me....again THANKS!!

Trudie

[Kat817 19]

Trudie--I hope it works out as well for you as it has for me. If you have any questions or concerns feel free to ask away or shoot me a PM.

Glad to have helped!

Kat

[Wheetsin 714]

No idea on your approval. I don't even like to pretend to make a guess.

Third, I would like to know what a typical day in the life of a bandster feels like. Could someone let me know how much you eat, what you eat, when you eat, how you eat, and how quicly you feel full since you've had the surgery? I am very curious.

Honestly, it's like a typical day in the life of a non-bandster, only you get full faster, may have some pain to contend with, and might not have certain things that some surgeons outlaw, e.g. carbonated drinks.

I eat twice a day. I know I should eat more frequently than that, but I just have no appetite. Here's what I ate today:

lunch - two bites of a tuna salad blend, and about 4 oz of a salad bar mix consisting of tofu, chicken breast, bleu cheese, sesame sticks, egg, and cottage cheese topped with a small amount of balsamic vinaigrette.

dinner - went to Chili's and ordered the chicken fajita quesadillas, substitute mashed potatoes for the rice. Skipped the Beans. Ate about three bites of mashed potato and two pieces of the quesadilla (which equals about half of a small tortilla... the soft taco size).

[Tired_Old_Man 1]

Your BMI is over 41. A BMI over 40 gives you a much better chance at approval.

Good luck and welcome to LBT.

[rtgirl77 0]

I chose the band so I could live as normal of a life as possible. I told my Dr. I wanted to be able to eat a piece of cake with my grandbabies on their birthdays, I just no longer wanted to inhale 2-3 pieces! I do that now---I could likely lose faster if I followed a good diet plan---but this is how I plan to live the remainder of my life, and I did not want to give up todays fun, and family for tomorrows....we never know if we will get a tomorrow. I had had enough of diets---

I couldn't agree more. Its taken me 18 months of struggling with my band to have this understanding. I finally started back into therapy and this is the main thing that we've worked on. Its living in the middle and eating when you are hungry and not eating when you aren't. Its also about enjoying the things in life you enjoy and still maintaining control. Its awesome that you have this ability now and it seems like you are truly pleased with your decisions.

[Mvpo8961 1]

Don't stop your montly check in until you know for absolute that you have been approved (approval letter in hand).

That way if they come back and say you need such and such you won't have a gap in "physician managed weightloss program".

It would be a shame to have to start completely over for one missed monthly visit. This almost happened to me.

M