Big Questions.....Thank You

[antetz 1]

Hi, i just called my insurance and they said im cover if i want to get a lap band. He said talk to my primary doctor and go on from there. My question is to u guys is how long of a process and doctor visit and which doctors i need to see before getting approved? Do u need to wait 5-6months to prepare or can u just go on and get the surgery. How long did it take for some of u for operation and did it really hurt that much? From the scale of 1-5 pain meter. How long is the healing process? Im male 32 yrs old 345lbs and i just found out i have diabites. i did try to hit the gym for the last 2 years but only lost 10lbs the most. I've been big for 22 years and its time.

[LilMissDiva Irene 3,282]

All that depends on your insurance. Mine is Blue Shield and I had to do many tests and 6 months supervised dietician appointments. It actually took me over a year from the time I inquired with my PCP to my surgery date.

Do not let that discourage you though. The dietician courses have proven extremely helpful. You need more than just the lap-band to make this work. You need knowledge of healthy foods and how to exercise properly. It’s all in the same game.

Best wishes and welcome!

[antetz 1]

wow. it take that long to get the job done. Well for the past 4months i've been eating healty. veggie, salmon and chicken breast. i walk 30mins a day on my threadmill. so i guess im getting there. lol! @LilMissDiva...how bad was the surgery? is it true u can go back to work the next day? Does this mean if i get a lapband i wont be able to drink liqour?

[AnastasiaBeaverhausen 0]

You need to check your policy for requirements. You maytbe covered for lap band procedure, but they almost always have additional requirements. Example - I am with Cigna and it is covered if it is deemed medically necessary. I had to do a 6 month physician supervised diet, provide 2 years of medical records showing my weight, get psychiatric clearance, meet with a nutritionist and provide a letter of medical necessity from my primary care physician. Cigna did not tell me this when I initially called-they only advised procedure was covered under my plan. I found all of this info out by reading my policy and meeting with the patient advocate at my surgeons office.

[antetz 1]

wow....i have anthem blue cross hmo. i guess there still alot of ?s to be ask to my primary doctor. All i know is they only take ppo insurance. Thats why its weird when i called this morning asking if my hmo is qualified. they said yes but need to talk to my doctors and my medical group.:smile:

[TinaM 0]

hi there-

they probably take hmo but they can't say that it must be a referral from your pcp.

My surgery is 12/15 and here is what I ahve learned on my journey.

My pcp put in the referral.

A week later I was scheduled for the seminar

attended the seminar,

met with WLS, Dr. Anwar his office knew all the requirements for Aetna HMO (6 months of monitored nutrition visits and 5 years of weight history)

Had 4 meetings with a nutrionist (not covered $95 a pop)

2 Shared medical appts ( covered and interesting pre and post op patients)

Met with pysch

4 days later DRs office called to informa me they were submitting the papaerwork to Aetna for approval.

6 days later approved for surgery

just completed a slew of tests today finally! Upper GI, Xray, blood tests, EKG, (paid all copays)

the entire journey once I decided to move forward took 8 months.

Good luck!:tongue2:

[antetz 1]

thank you so much for this info @ tinaM. so i guess it will take me that long to get this surgery done. so how was the surgery? did it reallly hurt that bad? if you can kindly give me some ingo about it. Thank You

[TinaM 0]

I'll let you know after my surgery - dec 15th :tongue2:

You can check some of the surgery day stories on the post op thread and also, I have found several online diaries on you tube.

[LilMissDiva Irene 3,282]

Ant, I took 3 weeks off from work. I was allowed 6 weeks from my surgeon but I felt really good after about 2 weeks. One thing I never advise anyone on is rushing this. This is a life changing procedure, and you have the rest of your life to get this right. Take your time and let things happen the right way.

Take as much time off from work as you can. Let your body rest and get adjusted. The post op diet is much harder when you are on the go all the time. The best thing to do is take this time for yourself and let your body heal.

The surgery is not bad at all in comparison to some others I’ve had. Those did take me 6-8 weeks to recover fully from. This one only took about 2. I had some bad bruising and port pain but that is very typical and did not have any complications.

Best wishes to you! Take care of yourself and let us know how you’re doing!

[Astrasmom 1]

Hi, i just called my insurance and they said im cover if i want to get a LAP-BAND®. He said talk to my primary doctor and go on from there. My question is to u guys is how long of a process and doctor visit and which doctors i need to see before getting approved? Do u need to wait 5-6months to prepare or can u just go on and get the surgery. How long did it take for some of u for operation and did it really hurt that much? From the scale of 1-5 pain meter. How long is the healing process? Im male 32 yrs old 345lbs and i just found out i have diabites. i did try to hit the gym for the last 2 years but only lost 10lbs the most. I've been big for 22 years and its time.

It took me 6 months from the time of the Initial consultation until my surgery. As everyone says it depends on your insurance. I had to go to the following.

6 nutritional visits

1 Gastric Doctor

1 Cardiologist

1 Psychological Evaluation

1 Pulmonary Doctor

And a letter of support and diet habits from my primary doctor.

The pain after the surgery wasn't that bad. I didn't use hardly any pain medication in the hospital. I used a few pain pills at home for maybe 2-3 days after surgery. I had my surgery on Friday and went back to work the following Tuesday. On a scale from 1-10 the pain to me was about a 5. You do have to walk though so that the gas that they pump into you during surgery comes out. If I had to do it all over again, DEFINATELY! I am very happy with the overall process and results so far.

[TSB 1]

Hi, i just called my insurance and they said im cover if i want to get a LAP-BAND®. He said talk to my primary doctor and go on from there. My question is to u guys is how long of a process and doctor visit and which doctors i need to see before getting approved? Do u need to wait 5-6months to prepare or can u just go on and get the surgery. How long did it take for some of u for operation and did it really hurt that much? From the scale of 1-5 pain meter. How long is the healing process? Im male 32 yrs old 345lbs and i just found out i have diabites. i did try to hit the gym for the last 2 years but only lost 10lbs the most. I've been big for 22 years and its time.

Time frames vary widely from ins co to ins co and surgeon to surgeon. I had to satisfy my surgeon's pre-op requirements before he would even submit my paperwork to the ins. co. for approval. My pcp referred me in Jan '09. My consult with the surgeon was in March '09 and I had my surgery in Aug '09.

[ParrotheadCathy 0]

I had surgery on Tuesday and went back to work on Friday. I firmly believe that a lot of it is in your head. Regardless of the surgery, I've seen it more than once in friends....they believe it's going to be bad and it is; they treat it like it's nothing more than a speed bump and it usually is just that. Yeah, complications happen here and there but for most, I firmly believe in mindset.

How long a process is it? I was self-pay and went from first consultation to surgery in just slightly more than a month. I had to have cardiac stress test, upper GI and chest x-ray, some bloodwork and a sleep study. Because I was self-pay, I didn't have to see the dietician or the psych. But your doctor will be the one to say what pre-op testing is needed. No reason to delay if there is nothing specific holding you back. Breathe in, breathe out .... move on!

[antetz 1]

Ant, I took 3 weeks off from work. I was allowed 6 weeks from my surgeon but I felt really good after about 2 weeks. One thing I never advise anyone on is rushing this. This is a life changing procedure, and you have the rest of your life to get this right. Take your time and let things happen the right way.

Take as much time off from work as you can. Let your body rest and get adjusted. The post op diet is much harder when you are on the go all the time. The best thing to do is take this time for yourself and let your body heal.

The surgery is not bad at all in comparison to some others I’ve had. Those did take me 6-8 weeks to recover fully from. This one only took about 2. I had some bad bruising and port pain but that is very typical and did not have any complications.

Best wishes to you! Take care of yourself and let us know how you’re doing!

Thank You!

[antetz 1]

just want to know if u guys still able to drink beer or any liqour?

[boskey60 0]

Antez, I also have Anthem Blue Cross and live in CA. I had surgery 5 1/2 weeks from the time I had my initial appointment with the surgeon I chose. I had to have a psych consult (my surgeon has one in his office) and I had to pay $175.00 of the $200.00 she charged. I also quickly made an appointment with my primary MD to get him to write a letter of support. I was quick to get my labs, chest x-ray, and EKG done so I would be ready once the apporoval came. It was approved surprisingly fast. I went in the hospiatl that morning and was out by 3:00. I had a prescription for 20 Darvocets (I'm allergic to Vicodin) and I took them all, but probably didn't need to. I went to work the next day, no heavy lifting for 4-6 weeks. The thing I was not prepared for, was after my 5th day post-op during which time I had no appetite and felt great, eating very little liquid and mush, I then had no restriction at all. The next five weeks I only lost 6 lbs and was anxious to get in and get a fill. I have had two fills now and still am not getting the restriction I think I should. I'm going to call tomorrow to see if I can come in earlier for a fill. My Dr. has you pay for each fill ($150.00), but they also bill the insurance. If the insurance pays, I'll get reimbursed. Get it done! I have only lost 20 pounds since 9/23/09, but that's 20 lbs! I can't wait to get my fill just right, so I can really lose weight a little faster.