Jump to content
×
Are you looking for the BariatricPal Store? Go now!

I am new to this...this is my first post



Recommended Posts

Hi everyone, I am new at this and not sure how it all works, but am hoping to find some others that are in the same place as I am, or have been through it already and can offer me some hope and help.

I have been on the road to physical and emotional health for over 20 years...between diets, healthy eating, and lots of inner healing from counseling I have tried it all and have had little success. I am tired, weary and feeling quite hopeless to say the least.

I went to a eating disorder program for 30 days 3 years ago, and have maintained a 60 lb weight loss, until about 3 months ago. Since then I have gained 10 back and see no end in sight. The 60 lbs was slow at coming off, and I still have over 100 to lose...help!!!

My counselor approached this with me recently and I just called my insurance company to find out that my employer put an exclusion on this type of surgery.

What do I do? Is it possible to appeal and get approval, and if so, does my employer have to get involved?

Thank you for listening and I look forward to any information that might help.

Cherylseekinghope :smile:

Share this post


Link to post
Share on other sites

In Texas, if we didn't purchase the coverage for WLS (speaking for the employer) then you aren't covered.

I am not unlike you, but I am much heavier. Since the surgery locally cost about 15K, we discussed it and decided my health was totally worth the cost of a small car, and we'd finance the surgery ourselves.

Once we had decided that, we found out our insurance (tricare) had changed and now covered it.

So I know how you feel. My doc told me in early July that unless I took action in the next 3 months I'd be diabetic. I was glad to hear him say lap band because I'd wanted one since they came out.

Since that 7/3 date it's been a whirlwind, but a great ride. I'm down 32 pounds from the post op diet and looking forward to eating normally for the first time in my life (because let's face it, being able to eat 4 pork chops, mashed potatoes and gravy at one meal isn't normal, at least not for a 5'5" sedentary female)

Like you I tried therapy and weight loss programs aplenty. I truly deeply know this is my solution.

I say research the band (I did, for years!) and probe how you feel about it. If you decide it is the right thing for you...well, you're worth the price of a Kia, don't you think?

Share this post


Link to post
Share on other sites

A lot of us have tried every diet out there and lost and gained and lost and gained. I was pre-diabetic and would be diabetic soon had I not taken some steps. Im self pay.

There are lots of doctors in Dallas TX that are in the under $10K and under $11K price that I know of. You can go over the border, like I did to Juarez, but Im not sure how much you save in the long run, since you will still need to pay for fills locally, cost too much to go to Mexico every time I need a fill. My first fill was a waste of $200.

I dont feel like I overeat, I think my biggest problem is eating the wrong foods, I love to snack and nibble, so Im still not sure the lapband will work for me. So far its all been will power with no help from the band. My fill doctor only works every other Sat in alternating locations and had a wedding, then I have a cruise, so my 2nd fill wouldnt even be until Sept 27th.

Lapbands are not overnight answers, thats for sure. My thoughts are it might or might not really help me lose, since I wasnt eating large meals before, but it might help me keep it off, I can get a really tight fill Im hoping if I start to regain the weight like I always do when I cant stand not eating candy and popcorn and Snacks, the band will make it hard to eat these foods if I feel full. Thats my hope anyway. Im not sure lapband is the answer for everyone, but it might be your answer, but its still just a tool and dieting is hard work.

when I get to my sweet spot, hopefully, I will be saying wowie, this really does work. When some post say this could take up to 6 fills to get there (at $200 a pop and Im driving 5 hours to get to where I can get this price).

Share this post


Link to post
Share on other sites

At my seminar, they told us if you snack a lot, the lap band isn't for you. I did snack at night after supper but am not a day time grazer; I don't eat at school, work, in car etc. I figured I could handle the night stuff with some behavioral therapy I learned from 10 months of that.

I say go to several seminars (they are free) and get info for yourself.

And flowers i grew up in El Paso. You couldn't hold a gun to my head and make me get any medical care in Juarez! Thank goodness your surgery went ok!

Share this post


Link to post
Share on other sites

A mother and her adult son also were picked up at the airport, the mom was a U.S. doctor and had researched our surgeon and said he had a great track record. Yes, the surgery went fine, but some of the details could be a little better. The reason I only got a teensy fill was because I didnt have anything in writing with my band size on it and the fill doctor thought I might be confused (I knew) so she gave me a fill for a 4 cc band instead of a 10 cc band. Ever since then Iv been trying to get a operating report and they act like they dont know what Im talking about. They did email a signed letter saying I have a 10 cc Realize band I can bring to my next fill. I also think maybe the fill doctor could have told me I needed something before I went to save me all that driving and $200.

Thats why Im saying you wouldnt save as much as you think with a doctor in Mexico. the $10K surgeons here include a year of fills and after care. There is a closer fill doctor for $250, who charges U.S. bandsters $150, but its $250 if you were banded in Mexico. stuff like that evens out the price somewhat, but I knew that going in.

I knew that being a all day snacker and never sat down and had a regular meal most days the lap band was iffy, but I think other WLS's were too radical and tired of gaining and losing this darn weight. I also know some bandsters who get so tight on purpose they cant eat solid food, not sure I want to go that far, but if I start regaining, its a back up plan. I was walking and exercizing real well, and then got some kind of bad heat rash and cant go out in the heat and walk.

I am determined to lose the weight, whatever it takes in the long run and keep it off this time. I lost over 80 lbs on nutrisystem and was down below 155 in 2007 and put it all back on, I could kick myself.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 1 reply
      1. stevieoriole

        Am feeling this right now. My surgery date is 4/1. Sign the consent tomorrow. I feel like I overloaded myself with too much info, too many opinions. Got to the point where I was wondering if I should do this. Then I thought of my reasons for taking this step and that settled my nerves. Still get moments of doubt but am striving forward. Am just going to follow my book from the surgeon. Joined this because I was told by my dietician that I should do this for support

    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×