Just getting started in So Cal

[Nooshie 0]

Hi Everyone. I'm in So Cal and just starting my journey. Went to see my PCP about med problems, (weight, arthritis in the knees, swelling in my feet) and I asked her about lapband surgery, which she said was a good option. I had gone to an informational seminar a few weeks prior. Anyways, I've got Aetna HMO which doesn't cover lap band, but my doctor said that she could write a letter to the insurance company for me. About a week later, I got a referral to go see Dr. Quilici in Burbank.

My consult is on Monday, January 19. I really really want this to happen. I'm just in limbo right now because I'm not sure if my insurance will cover it (but I'm hoping they will because they did approve the consult). Have any of you had a similar situation with HMO?

So I'm really happy to be here. I've learned so much just by reading your posts. I've struggled with my weight for my entire life. I need to deal with this once and for all.

Nooshie

[serenity55 15]

Hi Nooshie,

Welcome to lap band talk. I have been going through the motions with my HMO for the past nine months, and was finally approved a couple of days ago. I was involuntarily switched from one medical group to another, and that was a big part of the problem.

It sounds like you're on the right track, though, if you got a referral to see Dr. Quilici; who, by the way, will be my surgeon.

I'm sorry I don't have an answer about the changing of insurance companies, and I'm truly sorry to hear about your husband being laid off. I hope things work out all right, and someone more knowledgeable than I comes along with answers for you.

Please keep us posted on how things are going.

[Nooshie 0]

Hi Debbi,

Thanks so much for responding. Keep me posted on how it goes with you. I don't see too many on here who are patients of Dr. Quilici. I've never met him...but will on Monday.

I read the post from another member about the insurance and her husband getting laid off...but t'wasn't me....

Good luck to you!

Nooshie

[serenity55 15]

Nooshie, I don't think there are many here who have Dr. Quilici as their surgeon, but there are some. He has support groups the first and third Wednesday of every month--well, I should say members of his staff facilitate them. I found them to be very nice, and maybe they will have some idea about what can be done.

I hope everything goes well at your consultation, and maybe we'll meet at the support group meetings.

Look forward to hearing how everything goes for you, and thank you for the good luck wish.

[Nooshie 0]

I had an appointment with the Gastroenterologist today (for other issues). A new doctor for me, so he doesn't know anything about me. When we were finished with the appointment, I asked what he thought about the lapband, because, I told him, I was considering it. (okay, so here I am all excited about being banded...seeing a doctor on 1/19..etc.) and the Gastrodoc says, "Why don't you get a bypass done? I haven't heard of a lot of success with the lapband...and I don't think you'd lose much weight...maybe 20-30 pounds. If I were you, I'd have a bypass. I have quite a few patients that have had great success with bypass surgery" (!!!) I mean, we were having an honest conversation, so it's not like I took his comment to be anything but that, but it made me start thinking...I mean, i haven't considered bypass surgery because it's so invasive. on the otherhand, I truly do have the metabolism of a tube of toothpaste...what if I have the lapband and I truly don't lose. You know what I'm mean? I guess I'll have to research, and discuss with the surgeon on monday during the initial consult. Oh, and I know the lapband is just a "tool" and it's up to me...but y'know, i've done lots of restrictive diets in the past...what makes this different (is it because the restriction is truly physical and not left up to willpower).

[serenity55 15]

The things that helped me make a decision to go for the lap band are, 1. It's minimally invasive.

2. there are fewer risks with lap band.

3. Though bypass patients do lose weight more quickly at the beginning, it all equals out to the same in the long run. 4. There can be malabsorption issues, as other side effects.

5. The band is simply placed around the top portion of the stomach and nothing else is rearranged.

Of course, this is just my opinion, and there are lots of people who have success with bypass, so, as you say, you will have to do lots of research and decide what is right for you. But don't let anyone, doctor or layperson, try to sway you.

Good luck.

Edited January 15, 2009 by serenity55

[Nooshie 0]

hi! i've been thinking about it as well. I have determined that bypass is just too risky for me. i'm not comfortable with it. and seeing all the success with lapband here on the site, it's much more encouraging. i'm getting excited about my meeting with the doctor, and nervous/anxious as well. I really want it all to work out...with the doctor, with the insurance...with the whole thing.

keep in touch and let me know how it's all going for you. like you said, maybe we'll meet at the support group meetings!

all the best!

[Nooshie 0]

Went to my appointment on Monday at Dr. Quilici's office. First had a consult with another patient-to-be with the nutritionist, Julie, who went over both bypass and lapband surgeries, showed us the quantities of food we'd be able to consume after surgery, went over the rules, etc.

Then we had a short consult with the patient liaison, Rosalie, who has lost 135 pounds with bypass. She was a huge help with questions regarding insurance and timelines. I have Aetna HMO. I found out that my insurance will cover the surgery but I will have to go through a 6 month supervised weight loss program with my primary care physician and a dietician/nutritionist. ::shrug:: y'know, I'm kind of bummed that I have to wait, but on the other hand, it's not like they're denying me so I'm feeling blessed. Oh, also found out that everyone has to go through a psyche evaluation.

After that meeting had BP and BMI and weight done. :::thumbup::: my BMI IS 45!!!! That's pretty scary when you think about it. :biggrin: Needless to say, it was pretty sobering and I'm trying to take things seriously since i've gotten home.

Met with Dr. McVay after that. She does the fills. She was very kind and not-rushed which I really really appreciated. She took the history and physical and answered any questions. Told me about support group meetings the 1st and 3rd wednesdays. Then, for about 2 minutes met Dr. Quilici. He, also, was very nice, but by then, I had discussed and found out everything I needed to ask.

Sooooo....I've made my appointment with my PCP to start my 6 month course. Called Aetna to make sure they were all cool with it. They said yes. The nutritionist will be contacted by my PCP. So if all goes well, I'm thinking surgery sometime around August?? We'll see. But I've started the journey to a new me.

[lil miss scare all 0]

I am a patient of Dr. Quilici's. I am having my surgery in a few weeks on Feb.19. you might find that you have to keep on top of his office staff to keep things moving. Would you believe they never even told me i was approved? I found out when i received a letter in the mail from Aetna saying my surgery was approved. lol. It was a huge shock, because according to Dr.Quilici's office, they hadnt even submitted my information to the insurance yet. sigh.. lol.. You kinda need to keep close tabs on them =/ but other than that, Ive found the Dr. himself to be very nice. He did try to push me toward the gastric, but I am still going with the Lap Band.

[Nooshie 0]

Hey Lil Miss, Thanks for letting me know about keeping on top of things. Feb 19 is just around the corner for you (eeps!)... how exciting and scary , no? Do you have Aetna HMO or PPO? And did you have to go through the six-month supervised weight loss thing? Have you gone to any of the support group meetings? I hope you don't mind all the questions. Keep in touch and let me know how it all goes!

Good luck to you. - Noosh

[lil miss scare all 0]

no . i dont mind the questions. keep em comin. =]

I have Aetna Global PPO . and NO, they surprisingly didnt make me do the 6 month diet, which I was happy about. Made for a nice surprise approval =]

Yes. I have gone to a couple support group meetings. I didnt really want to and thought it would be " lame", but I actually like it. Its really insprirational. You should go! Maybe if you would like to go sometime, I could meet you there and we can go together. I never have anyone to go with =/ Anyways. Let me know if you have any other questions or whatever. I'll be here.

[Nooshie 0]

Ah, that's the difference. I have HMO, so I have to do the six-month thing. It's okay though...I'll get there soon. :::shrug::: Let me know a couple days before the next meeting. I can meet up with you. I live in Sunland. You? I'm curious about the meetings. I've heard there are a lot more bypass people than lap banders.

[lil miss scare all 0]

Yep. There were more bypass people at that meeting in LA.. know why?? cuz Dr. Quilici favors bypass. even Rosalie kept pushing the bypass as well. I think its humorous how they say its " up to you . its your decision" , yet they obviously are pushing one over the other. lol I live further away than you do. I live in Claremont / Upland . They have a really good lap-band meeting out here where theres about 25 ppl or so and theyre ALL lap banders.

[Nooshie 0]

Yeah, I had heard that. So when I went in and was talking to Dr. McVay, I told her right out, "I've heard that Dr. Quilici pushes bypass." She laughed and said, "We don't "push" anything, though he does suggest." Then she continued on saying that there were studies done that showed bypass patients lose 90-100% of their excess weight but banders were 70-80%. But, she did say that the success is entirely up to the patient. And that if lapband felt right for me, then that's what I should have. I thought she was pretty nice. I did get the bypass push "vibe" from Rosalie though.

[lil miss scare all 0]

i kinda hate that though, cuz it makes me second guess my decision. I would like to think that i have enough self control to be successful with the lap band. . . but what if I dont? what if im still fat a year from now, wishing I had gotten the bypass ? ...........sigh........... Dr. Quilici told me to just " get the bypass, then I dont have to wonder that " . Just go with the more drastic one, to be safe. but,, i dunno. . My mother in law got lap band in Nov.06 and I watched her lose about 120 pounds over the course of a year. This is a woman with no self control . She still chain smokes and drinks diet coke non-stop. I have no idea how she ever got cleared for surgery. lol.. but anyways. I figure if SHE can do it, I can certainly do it. I did have the self control to stay on Atkins for an entire year in 2004 and lose about 55 pounds , only to gain it all back as soon i stopped doing Atkins.. =/ that was really discouraging. Anyways. what do you think? think i should just stick with the lap band?