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Waiting for Approval



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This is my first post here, although I have been a lurker for several months now (didn't want to jinx myself by posting too early:paranoid.) I am hoping to be a January bandster also, and I am currently waiting for approval. It is very nerve wracking to wait and just keep hoping to hear something positive.

So, here's hoping we all have very Happy Holidays and approvals soon. ;) ~Amy

AMY.....WELCOME!!! We are honored this is your first post....and we look forward to many more to come!

You should tell us what your journey was like once you decided to pursue the band.....

You have great taste in tickers. Hope you are approved soon too. It would be a great holiday present!

LOL

StLouisGal......I should have known by your thread name but I didn't want to assume anything....

And to think of it...you haven't told me about your journey neither once you decided to pursue the band...What hoops did you have to jump thru?

I have bcbs il hmo so my referral is being reviewed by the director. I'm hoping all the t's and I's are crossed. I had to do 12 months surervised diet before they would approve anything, just finished that on Dec 12th. I'm keeping my fingers crossed.

We will be sending positive vibes your way as well for approval..~~~~

:nervous

In the meantime we shall all be nervous wrecks together!!!!:clap2::nervous

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Thanks for the welcome, StLouisgal. My journey started in July 07. I stepped on the scale and it said 286lbs. and I nearly burst into tears. When I told my hubby, I did burst into tears. About a week after that my hubby sat down with me to talk about the Lap-Band. He did internet research and even called the two places in MT that do Lap-Band surgery to get info from them. I had my initial consult with the surgeon and the nutrition class and pysch eval. on Sept. 5. I had a sleep study on Sept. 11 and was diagnosed with significant sleep apnea. Then i did the 3 month pre-surgical program of working with a dietician, an exercise therapist, and behavior modification that the insurance requires. (It is frustrating that my insurance requires a BMI of 40 AND TWO co-morbidities, mine is 44+:faint: and I have reflux, apnea, and knee and ankle pain with every step). So I finished up that program Dec 10. My surgeon's office had faxed some of my file in on Dec. 3, then another fax on the 7th. Then they got two more pieces of info from my physical therapist and counselor but I don't know if they have faxed that in. I called them this morning and the office is checking into that. I also called insurance and she told me it is still in review... I should hear early next week... but since that is Christmas, I don't expect any word until late next week. My surgery is scheduled tentatively for Jan 21.

I am really nervous, and trying really hard to stay on the program I put in place for the last 3 months, and I really just want to get an approval now!

Venting over now. :ohwell: ~Amy

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Amy,

I am so glad your husband is so supportive. I have not told my husband. He knows I am having surgery and will be there surgery day, and afterwards for help/care. But he does not know what procedure I am having or anything else.

He is smart...I think he kind of knows what it is but is probably not sure.....

I am just ashamed to let him know I have let myself be the weight that I am. Plus he does not have a clue to what I actually weight...many people quote me at 60 lbs less than what I actually am....I guess I have mastered the dress to hide it well :rolleyes:

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I had my first appointment today. The dietician and the surgeon feel that I should not have any problems, however another dietician was quiet pessimistic. My BMI is 39.7, with 99 pounds to lose. I do not have hypertension or diabetes, but my cholesterol is a little high, but not considered dangerous. I have joint problems though (2 knee surgeries on left knee and back issues). I was psyched until the last lady saw me. I work at the hospital that does the surgery, so maybe that will help. I'm in Virginia & I have Anthem BC/BS Choicecare/Blueview. I really, really want this badly!!!! My knee is starting to bother me again and I'm tired of being a load. Also, I can't stand having "hidden areas", if you know what I mean!!! Any words of wisdom, encouragement, advise would be most encouraging while I wait!!!!

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I started researching this about four years ago but at that time my insurance didn't cover anything but bypass and I didn't want that and my primary doctor refused to even let me consider that,:rolleyes: so I kind of decided I was just meant to be fat. I tried WW again, about 40 pounds lost :)and gained back about 60. :mad:Tried Atkins, lost about 70 pounds, :)gained back all 70.:) Again decided I was just going to be fat, got rid of all my small clothes, except this one green suit that I love but is a size 18.:( Oh well,

My epifiany was when I went to an amusment park with my neices and nephew and had to get an electric cart to keep up.:embarassed: I decided that I didn't want to have to ride around in a wheelchair to keep up with my grandchildren if I ever am blessed with any.

I started researching again. The band was now available and a possiblity with my inusrance. I ran across this site, and did more research, clicked every link and read, read, read, Finally in September I went to see my primary care provider and asked what she thought. She thought it was a good idea and said she would support me any way she could. :whoo:I started researching surgeons in this area. Found one, got information, signed up for a seminar, etc. only to find out that they don't accept my insurance. :cry Back to the drawing board. I found another surgeon, requested information, etc. filled out preliminary paperwork, saw pcp again to get letter of medical necessity, made appointment for the psychological evaluation (a month out from where I was then:cry) and waited. Got the Psych eval, passed, waited while surgeons office evaluated paperwork to decide if I was a good candidate. They submitted the paperwork to the insurance about a month after I submitted it to them. :D Now I am waiting on the insurance. My Doc doesn't even see you until after insurance approval. Once the insurance is approved I have to meet with dietitian, exercise therapist, preop testing, and a consult with surgeon. :clap2::clap2::clap2:

I guess I haven't had to jump through all that many hoops yet but I hate waiting. Fortunately my PCP was able to document several diet attempts and a long history of obesity. I guess there are advantages to sticking with the same primary care provider for 20 years plus. :eyebrows:

So that is my tale of woe. We are going to make it.

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I had my first appointment today. The dietician and the surgeon feel that I should not have any problems, however another dietician was quiet pessimistic. My BMI is 39.7, with 99 pounds to lose. I do not have hypertension or diabetes, but my cholesterol is a little high, but not considered dangerous. I have joint problems though (2 knee surgeries on left knee and back issues). I was psyched until the last lady saw me. I work at the hospital that does the surgery, so maybe that will help. I'm in Virginia & I have Anthem BC/BS Choicecare/Blueview. I really, really want this badly!!!! My knee is starting to bother me again and I'm tired of being a load. Also, I can't stand having "hidden areas", if you know what I mean!!! Any words of wisdom, encouragement, advise would be most encouraging while I wait!!!!

Ohmy! don't be discouraged....

the day I went in for my preop testing...one of the techs that took my blood-oxygen or gas whatever it is...asked me straight out...that lately most bypass patients seem to get smaller and smaller...and if I had tried to diet and exercise that I don't look like I should be having any procedure....

HELLO!!! WHO ASKED YOU!

I remained calm thought.....and answered her that is why I have postponed it and half my life on hold...but not any more... according to 3 MD's agree this is the best decision for me...

She didn't say anything else...but it made me so mad....

but what helped me was the phlembotogist(screwed up spelling it) actually was very supportive, and told me that if I follow instructions and I ever go back for labwork...she probably won't recognize me because it has happened to her with others....

yipeeeee!!! and that I will go from good looking to killer....whoooooo!!!!

take that!!!!

so don't give up we are here for support....

huggssssss

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I started researching this about four years ago but at that time my insurance didn't cover anything but bypass and I didn't want that and my primary doctor refused to even let me consider that,:rolleyes: so I kind of decided I was just meant to be fat. I tried WW again, about 40 pounds lost :)and gained back about 60. :mad:Tried Atkins, lost about 70 pounds, :)gained back all 70.:) Again decided I was just going to be fat, got rid of all my small clothes, except this one green suit that I love but is a size 18.:( Oh well,

My epifiany was when I went to an amusment park with my neices and nephew and had to get an electric cart to keep up.:embarassed: I decided that I didn't want to have to ride around in a wheelchair to keep up with my grandchildren if I ever am blessed with any.

I started researching again. The band was now available and a possiblity with my inusrance. I ran across this site, and did more research, clicked every link and read, read, read, Finally in September I went to see my primary care provider and asked what she thought. She thought it was a good idea and said she would support me any way she could. :whoo:I started researching surgeons in this area. Found one, got information, signed up for a seminar, etc. only to find out that they don't accept my insurance. :cry Back to the drawing board. I found another surgeon, requested information, etc. filled out preliminary paperwork, saw pcp again to get letter of medical necessity, made appointment for the psychological evaluation (a month out from where I was then:cry) and waited. Got the Psych eval, passed, waited while surgeons office evaluated paperwork to decide if I was a good candidate. They submitted the paperwork to the insurance about a month after I submitted it to them. :D Now I am waiting on the insurance. My Doc doesn't even see you until after insurance approval. Once the insurance is approved I have to meet with dietitian, exercise therapist, preop testing, and a consult with surgeon. :clap2::clap2::clap2:

I guess I haven't had to jump through all that many hoops yet but I hate waiting. Fortunately my PCP was able to document several diet attempts and a long history of obesity. I guess there are advantages to sticking with the same primary care provider for 20 years plus. :eyebrows:

So that is my tale of woe. We are going to make it.

Your story sounds similar to mine...i will post it later on today...

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I had my first appointment today. The dietician and the surgeon feel that I should not have any problems, however another dietician was quiet pessimistic. My BMI is 39.7, with 99 pounds to lose. Any words of wisdom, encouragement, advise would be most encouraging while I wait!!!!

Why would one of the dietitians be pessimistic? What is there to be pessimistic about? It seems like you are a reasonable candidate for surgery. Is that dietitian specifically for bariatric patients or just a regular dietitian?

I know how you feel about waiting and just wanted to do it already. It's a long process sometimes, but I definitely think it's going to be worth it in the end. I have had my Jan 9 surgery date since August. 5 months is a long time! But guess what? Time flew and now I'm less than 3 weeks away and I am so happy I had these few months to read up on the lapband and do more research. I feel much more prepared than if I were to have done it a month after my consultation.

Think of the time you will have to wait as a period to get yourself more educated about this life altering surgery. Since August, I come almost daily to Lapbandtalk(LBT) and just read as much as I can. I realized how much I didn't know about the band. I suppose "Patience is a virtue". Though I've also heard people say, "Patience is a virtue.......that I don't have"! I try to stick with the original saying! Everything will come in its time!

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I called my insurance again this morning. the gal I talked to today said it was still under review and that could take 30 days. :angry I feel like I am just supposed to put my life on hold until they decide to get their act together. :faint: I don't want to tell my family that I am having the surgery until I am sure I am because in my mind it will be just another thing I didn't follow through with in their eyes. :rolleyes

I wish they would get their stories straight. The last gal on Wednesday told me 72 hours. I think this one just wanted to get rid of me. :bored

I may call back this afternoon to see if I can get a third opinion. :decision:

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02 I have a 1 st. appointment with the surgeon January 11 let's hope he pencils me in. I have BC/BS (Anthems). Bless the Coordinators I have had to make use of them quite often . When calling for appointments I have never gotten a human just a recorded message that says (Please allow 24 to 48 hours for our office to respond) which they did not do 15. I have had to have the Coordinator to call the office on their secret hot line (*lol*) in order to talk to someone. I too would love to start my New Year off with all this taken care of. All this hurry up and wait really takes a toll on a body, even one the size of mine09

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:welcome:Hi Chaca,

at least we have each other here....

gotta be short today the girls are fighting again....

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I called my insurance company this morning and found out that I was approved on December 21. :whoo::whoo::whoo:Now for the bad news. I have to leave this fantastic January thread because my pre-op class won't be until Jan 30 and surgery 2-6 weeks after that. And I so wanted to be a January Jewel or New Years

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StLouisGal,

Perhaps we can make you an honorary member!!!

CONGRATULATIONS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Do I not recall you calling on the 21st and them saying still under review...ha...!!!

can't believe a word they say!!!!

or maybe it wasn't in their system yet....hehe...regardless....

again....CONGRATS...YOU DID IT!~!!!!

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Yeah, I called on the 21 and they told me it might be 30 days before I was approved. Go figure!

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