Hello from Ohio

[Boadicea 0]

Hello all,

I'm in SE Ohio and it seems a whirlwind already. Providence, really as a coworker started telling me about her lap band last week. Because I considered a RNY 3 years ago I didn't need to do all the mental work to return to thinking about a surgical option. I'd left off with the RNY because it felt wrong to scramble my insides quite THAT much. I have an appointment on 2/8, will have a psych eval before then and possibly in hand for my appointment. I've confirmed my insurance will cover this and possibly not require a 6 month diet supervised by physician. (Anthem BCBS) They told me today that if I show up with all paperwork ready to go, they can submit to insurance for approval the following week, another 1-2 weeks to know if I'm approved ... and if I am, another 2-3 weeks for surgery. To me, that seems a whirlwind and a sum total of 6-8 weeks.

I've tried everything except prescription meds for weight loss and nothing is a long term solution. I get to thinking I've "changed my lifestyle" and get tripped up and return straight away to bad habits.

I'm also already in therapy -- and discussed it with my therapist today. I'm free about why I'm in therapy, too. I'm a midwife and had a pretty bad birthing experience about 6 mos ago and just started down the path of talking it out with someone about 5 weeks ago. To be able to talk to someone about how I feel regarding the emotional baggage of excess weight is also nice. She apparently also specializes in body image therapy -- so that's going to totally rock. I really like her. She is also helping me get the psych eval ahead of time.

I do have some questions for anyone on Anthem BC/BS -- have you been required to do the diet for 6 mos supervised by a physician at all? Was it because BMI was below 40? I'm really worried I will be denied for this reason and I have concerns about my insurance changing before that 6 mos would be up. My BMI is at 46.

I'm doing a lot of reading on this board/site and sometimes it's reassuring and other times it worries me. I feel this is the right path, though. As I told my therapist today, I want to kayak with the Orcas...ride horses with my daughters ... try hanggliding...maybe learn to surf...learn to play soccer and take my kids camping (without getting eaten by bears, of course!) I'd be outdoors all the time if I could, but right now, I'm physically unable. I feel as though -- here I am -- 36 -- and I'm still waiting for my "life, my happy life" to start, even though I've done a tremendous number of things already and am happy otherwise.

Thanks for reading so far!

Boadicea

[michelle9003 0]

I am from dayton, and i have capital blue cross/blue shield and i was required for 6months non suporvised diet, co morbilty diagnosis, because my bmi was 39. i was denied at first but i have sleep apnea and i provided jenny craig for 6 months. so now i'm approved and my date is feb 5th. good luck stay on them and find a good office who will work with your ins company when or if you get any negative feedback. good luck.

[lmpersons 0]

I have the same insurance and was banded last year. They did not require me to diet, I just had to say that I tried and it didn't work. I was a borderline BMI. What you need to discuss with your doctor, are what they call "co-morbidities". For me it was joint pain, fatigue, and the inability to lose on my own. BCBS did not question any of it. Your doctor's office will know what language to use.

Get ready to get your life back!!

[Jazzywoman 0]

Wow! Welcome!

I have Anthem Blue/PPO and it was so quick and easy to get approved. I have high blood pressure and high cholesterol, and my bmi was 40. No questions, quick approval - within 2 weeks!

Welcome to the journey!

[Boadicea 0]

Well, I was approved on 2/26/08 after my paperwork was lost. My surgery date is 3/12 and I start my preop diet tomorrow. I did an EKG, chest x-ray and blood work today. Everything is rather ... ready. Rather fast, really. I was approved within hours once my paperwork was located.

I have my last meeting with my doctor next Friday and then it's off to be done the following Wednesday. I'm a bit shellshocked.

--B

[kathyotto 0]

I just started the process with my first meeting (physical). My BMI is 38.6 and they couldn’t give me any clue if they thought my insurance would cover the procedure. I did call and e-mail capital blue, but they only read what was on my plan either a 40-50 BMI or 35 with co-morbidities and a 3 month pre-op program is required. I have been dieting for 28 years, but never successful. I am on meds for my cholesterol. The pre-op program will cost me $415 and I won't even know if I am approved until right before surgery. Any suggestions? What was your BMI? You had no other proven "co-morbidities"?

Should I go on with the pre-op program and hope that the procedure will be covered?

[ParrotheadCathy 0]

Are you absolutely sure you don't have another comorbity? Obviously, your PCP has done some bloodwork since you know you have elevated cholesterol so not likely that you have Type 2 Diabetes.

What I would do before I spent $415 is make an appointment with my PCP. Ask him to do the hBA1c blood test which is an average blood glucose level for approximately 90 days...and if it's elevated you are either "pre-diabetic" or Type 2.

Also many overweight people suffer from sleep apnea which is considered a comorbidity. If you PCP refers you for a sleep study and it comes back positive, then you have your second co-morbidity AND you've done the sleep study which is almost 100% going to be a pre-op test you'd need anyway.

[kathyotto 0]

At my first appointment they suggested I go for the sleep study for apnea. I did have blood work done over the summer through my PCP, including the fasting diabetes blood test. The diabetes test came back high, so they sent me for another, which came back normal.

We will see how the sleep apnea test comes back. I do snore loud, but that doesn't mean I have sleep apnea. I am going to keep my fingers crossed that it comes back positive.

[ParrotheadCathy 0]

Almost everybody who has sleep apnea snores like crazy. I'd get that test out of the way and then spend the money for the pre-op program. Just to be safe on the money.

I've never wished anybody to have a medical problem, but I guess here's hoping your sleep study comes back positive.

[kathyotto 0]

Thanks, I am going to make that appointment very soon. Wow, I just noticed you lost 78lbs. That is great!! I've never lost more than 35lb. on a "diet". I am keeping my fingers crossed that everything goes through!

[ParrotheadCathy 0]

Thanks for the congrats! But something I'm actually MORE proud of is this...I made it through the holidays, all the parties, big meals and food in the kitchen at work all the time without gaining. Mind you, on January 1 I hadn't lost an ounce since mid-November BUT I DIDN'T GAIN. And I'm as happy with not gaining during the most difficult time of year as I am about losing. Now, I'm back to a regular eating program, drinking all my Water and weight is starting to drop again....a pound so far this month. Yeah, I wish it was more, but I'll take that!

[Just-Ice 1]

I too have the same insurance. I live in Northern Kentucky (probably not too very far from you!) and my insurance approved me on the first go. I had an initial bmi of 39. I also have fibromyalgia and pcos (the pcos has shoved me into diabeties.) I did not have to do a supervised diet. I think they approved everything right away since I have had the same insurance for 11 years and they have ALL my medical records.

Hope this helps!

** Please excuse my spelling, I'm several days post-off and haven't found my spelling gene yet.

[kathyotto 0]

Thanks for the info. I have been with capital blue for 17 years, but I don't think they will take that into consideration. I think my only chance is sleep apnea. I have to make my appointment for the sleep study.

Good luck...it looks like you are off to a great start!

[Liftingchic 0]

Well, I was approved on 2/26/08 after my paperwork was lost. My surgery date is 3/12 and I start my preop diet tomorrow. I did an EKG, chest x-ray and blood work today. Everything is rather ... ready. Rather fast, really. I was approved within hours once my paperwork was located.

I have my last meeting with my doctor next Friday and then it's off to be done the following Wednesday. I'm a bit shellshocked.

--B

Hiya! My date is Mar 12 too! We will have to keep in touch

I am orginally from WV right across the river from Marietta, OH

Nice to meet ya..

LC

[kathyotto 0]

I finally got the results from my sleep apnea test and I have mild sleep apnea, so I'm not sure if that is good enough. My PCP is doing another round of blood work on me and said I would be a good candidate for lapband...eventually I will have comorbity. He said he would write a letter for me if I need one. I think I am going to start the process and keep my fingers crossed.