Big Questions.....Thank You

[antetz 1]

It strictly depends on your insurance company/group policy. I had BCBS of Louisiana, but it depended on the requirements my employer placed on it that determined the hoops I had to jump through, which were very few. I had to have 5 year weight history which was obtained through various medical charts and a BMI of 40 or higher with co-morbidities. They also asked for previous weight loss attempts, but I didn't have to have verification of it. I attended a seminar at the end of May in '08 but didn't even call the surgeon's office for a consult until June 23, I was approved June 26, did all my pre-op and had surgery on July 14th. It took a total of 3 weeks from the phone call to my surgery.

As far as time off of work, I would suggest at least a week, if you can. It depends on the demands of your job. I am a teacher, and I had my during summer break. You aren't going to feel like going to work when you are on the liquid post-op diet. You don't have much energy and you really need some rest. If you have a job that is physically demanding, you may need 3 weeks off or a "return to work with restrictions". I was told not to lift anything over 15 lbs for 3 weeks.

Problems that went away:

-had sleep apnea(undiagnosed, but would wake up GASPING for air); this is gone

-GERD, gone

-joint pain, gone

Well said! thank you!

[tessierose 0]

Antez, I have BCBS Anthem too. I have done the seminar, a support group and met with my surgeon. He wrote the letter to show medical necessity. I called the insurance company on Friday and they haven't gotten the Dr.'s letter yet, but I asked what the requirements were. She said that the requirements were your BMI and co-morbidities. I don't know for sure, but my fingers are crossed. My surgeon said he thinks I'll be approved within the week. I'll let you know how it goes. I figure, either way, the time will pass and I can be proactive or just keep packing the pounds on. I'm trying to be proactive!

[antetz 1]

Antez, I have BCBS Anthem too. I have done the seminar, a support group and met with my surgeon. He wrote the letter to show medical necessity. I called the insurance company on Friday and they haven't gotten the Dr.'s letter yet, but I asked what the requirements were. She said that the requirements were your BMI and co-morbidities. I don't know for sure, but my fingers are crossed. My surgeon said he thinks I'll be approved within the week. I'll let you know how it goes. I figure, either way, the time will pass and I can be proactive or just keep packing the pounds on. I'm trying to be proactive!

Does your primary doctor refer you to a surgeon?

[tessierose 0]

My insurance allows me to self refer, so after I went to the seminar, I called the surgeon and scheduled my visit. The seminar is a prerequisite of the surgeon, but not necessarily the insurance company. Good luck.

Tessie

[ready4nume 1]

i went to a seminar and submitted my ins info them the night of the semimar... they took my info and called me a few wks later and said that my ins. does cover the procedure. there are several steps that the ins. requires so our first step was the consultation which we held with the dr. office last friday. so now we are required to attend a once a month appt with them to consist of sleep study, nutritional sessions, psych evals. and then after the 4 appt (4months) dr's staff will submit all the info to the ins for approval...they said our ins is good at aprproval if the steps are followed and that after submission it only takes them about 3-4 days to approve it and then we can schedule the procedure.

again every ins. is different but this is how ours works. so i hope this info helps. FUTURE BANDER hopefully my band date is MARCH 2010

[jenrobbar951 0]

I have a Blue Shield PPO Plan in the state of California. It took less than 6 months for me to be approved and do all the requirements for the surgery. But that also includes a month delay from the Psychologist and the month wait between getting my surgery date and having the surgery.

The surgery wasnt too bad. I felt pretty good immediately after surgery. Infact, I was out of bed and walking around just a few hours after surgery. I was feeling so good that I only needed the assistance of a nurse for the first few times I had to use the restroom. All the other times I unplugged my IV and did it myself. I even stopped taking pain medicine within three hours of being out of surgery.

Now, the pain didnt start until two days after surgery. And boy, it hurt like hell! It wasnt pain from the actual surgery, it was the darn gas. It collected in one of my shoulders and I couldnt move my shoulder, sit down or lay down without being in excrutiating pain. Infact, I had to sit up in a chair to sleep, with my feet resting on another chair. This lasted for nearly two weeks, despite walking. Walking is supposed to help prevent the gas from collecting. I ended up using all of my pain medication, but not refilling once it was gone.

My wounds are still healing. One of them got infected a little bit, but is healing just fine. I had surgery on October 27th and had lost 29 pounds in just about a month. I gained back about 7 pounds over the Thanksgiving holiday (I discovered that since I dont have a fill, that I can eat just about anything and not have a problem.....ooopsy!). I weighed myself this morning, and I am back at having lost 29 pounds. Yay! My first fill is on December 17th and I can hardly weight to have restriction again, to minimize what I can eat and how much. I have been paying closer attention to eating smaller portions and drinking more Water.< /p>

My surgeon said no alcohol and no soda, unless it is flat. However, the whole idea behind a soda is the carbonation. It tastes horrible otherwise. I havent had a soda since October 20th!

This is a personal decision. Not everyone will have the same results. What may work for me, may not for another, and whatever may work for someone else, may not for me. Yes, the recovery is a little painful, but in the end, you forget about the pain and become excited about the results you are getting.

Go to a seminar and check it out a bit more. Best of luck!!!!:thumbup:

[antetz 1]

Hello everyone! i just have one more question. Im goin to my primarcy doctor tommorow and im gonna tell him about my decision to get banded. i just want to know what kind of doctor or surgeon should i tell him to refer me to. Is there a certain dr for this or is that the endocrinologist? My dr. is old so im just wondering he might now know what lapband is..lol

[jenrobbar951 0]

The type of surgeon who does the lapband and gastric bypass is called a BARIATRIC (bear-ee-ack-tric) SURGEON. Just be sure that the one that he refers you too is covered by your insurance. Mine tried to refer me to a specific surgeon and I think it was because he gets a cut for referring patients.....lol. Best of luck!

[antetz 1]

The type of surgeon who does the LAP-BAND® and gastric bypass is called a BARIATRIC (bear-ee-ack-tric) SURGEON. Just be sure that the one that he refers you too is covered by your insurance. Mine tried to refer me to a specific surgeon and I think it was because he gets a cut for referring patients.....lol. Best of luck!

Thanks Alot for the info. i will surely tell him about my coveraged. So after u got refered to a bariatric surgeon is he the one whos gonna guide u to the psyc and seminar and all those good stuff?

[crzytchr 3]

Thanks Alot for the info. i will surely tell him about my coveraged. So after u got refered to a bariatric surgeon is he the one whos gonna guide u to the psyc and seminar and all those good stuff?

Yes, probably. They usually have someone they will refer you to. Mine set up all the preop testing and my psyc eval was an online questionnaire. It was around 150 questions and it was a lot of the same type of questions worded differently.

[jenrobbar951 0]

Thanks Alot for the info. i will surely tell him about my coveraged. So after u got refered to a bariatric surgeon is he the one whos gonna guide u to the psyc and seminar and all those good stuff?

My Bariatric Surgeon required that I attend one of his seminars in order to get my surgery date. This probably isnt a requirement of all surgeons. But the seminar is usually set up by the surgeon, as is the nutrition evaluation and the upper GI tests. The only thing I had to set up on my own was the Psych Eval. Oddly enough, everyone else I have talked to on here, had to take a survery or spend an hour or so answering questions. Some had to go back for a second or third visit. My Psych Eval consisted of asking why I wanted the surgery, what my goal was REALISTICALLY, and a quick discussion of my family psychiatric history. Done in 15 minutes. It isnt like that normally.

My surgeon also set up a time and date for me to register by. His office did most of the work. All I had to do was come up with the money and show up. I have my first fill on December 17th and I am really nervous about it, but cant wait to have restriction again. Right now I am in a position where I can eat just about anything, as long as I chew really well....and I dont like it. LOL. Finally lost my 6 pounds that I gained over Thanksgiving week. Down 30 pounds......only 100 or so to go! :rolleyes2:

[mznita 0]

@antetz.

Tell you dr. to refer you to a Bariatric Surgeon and once you talk to him, they will let you know about the other tests and procedures.

[antetz 1]

Ok went to my doctor last thursday and he refer me to a surgeon. when i call to make an appointment the assistant told me that the sergeon is not in my medical group. They told me to wait mybe 2months coz they said they are trying to get on board with my med group. So hat i did was called anthem blue cross CA hmo and they told me that i need to talk to my medical group and find a sergeon who is in the network. If there isn't any they told me to tell them to look outside the network. I guess this is how it work if you only have an HMO insurance. I will call my med group monday and let them know. Blue Cross CA said that they will cover the surgery as long as my primarcy dr. gets me a sergeon and my med group cooperate with them.:thumbup:

[antetz 1]

damm...my primary doctor is so oldschool! I dont even know if he know what lapband is! I made my medical group look for a sergeon!

[antetz 1]

damn my medical group! they still havent done anything!!!! They still looking for a surgeon!