GoSetReady

My time is almost upon me. I'm scheduled to be banded on May 19th. I'm very nervous but excited too. If anyone else is scheduled around the same time I'd love to have a support group online. I'm going to take the dreaded full size photo today and measurements. One of the bloggers I read stated she wished she would have measured herself. So ... good luck to all. I'll share my experience next week. Add me as a friend.

I'm being banded May 19th at London's Princess Grace Hospital. I'm very excited yet nervous. My surgeon isn't requiring the pre-op diet so I'm interested in what you are consuming. Will this be the same liquid diet you'll consume after the surgery? I think I will be on clear liquids for 2 weeks post op, mushy x 1 week and than regular. I'd really love to have an example of a typical day of the clear liquids. Does anyone know of a site that lists foods approved for the lap band diet post op? My husband is in the US Air Force stationed in the UK. I think that they are a little more relaxed on the pre-op diet here. I'm a little concerned that I should be stocking up on food before hand but have no idea. I was told I would see the nutritionist before discharge. It seems to be go with the flow attitude over here. Hard for my type A personality. Anyway ... any help would be appreciated. On a side note: How do you get that ticker?

Annie - Congrats! I'll be a May bandster too. My surgery is set for the 19th. I just found out today. We were in Italy on vacay and I couldn't call to find out. I'm nervous too but so ready. You'll have to give me the low down on your pre/post-op experience. All advice is welcome. Congrats again.

Annie did you get approved?

Wondering if anyone else was required to submit to Tricare - History of 6 mos medically supervised diet/exercise and 5 year history of 100lbs over ideal weight by PCM before you can get a referral? Also, has anyone read that effective March 16, 2011 Tricare will now accept BMI vs. Met life ideal weight?

I believe on the Fed Register site they have a contact person. You might call her. I'm afraid I will be in the same boat as you. Stay with it. Are they aware of the change and that it was to go in affect on 3/16 not in the next couple of months? Good luck!

Thanks Dave! I'm Tricare Prime Remote Overseas. I don't think this is going to be an easy process. I'm kind of a pioneer in the UK. LOL

I've just made the appointment to see my Primary Care Dr to ask for a referral. So nervous to be taking this first step. Any pointers would be appreciated. I have my records since 2001. Thanks for the help.

Great news - he referred me without a hitch. Now just have to send the referral on to Tricare. Wish me luck. So excited.

That's great info. I hope he is supportive.

Thanks so much. Wish me luck. I'm so nervous.

Did you have to do the 6mos diet and 5 year history? Hope you hear from them soon.

We are stationed in the UK. Did you go through a military dr. for the referral or do you see a off base provider? Did you have to have 6mos supervised diet and 5 year history? We are at a remote location without a US military facility. This had made things more difficult. Thanks for any info you have. I hope you get your call today. Wishing you tons of luck.

I'm in the same situation you are in. I happen to be very short 5'1". With the Metlife table I do not meet requirements per current Tricare requirements if they went off BMI I'm at 37.4. Go figure. They are changing to BMI effective 3/16/2011 per conversation with Medical Director for Tricare Dr. Barry Cohen. He also told me they are going to start requiring documented history of weight loss attempts and history of obesity. He said the new policy should be on the Tricare site in a few months. For now you can go to the following website for the information. http://federalregister.gov/a/2011-3207 I'm planning on going to my PCP this week with the new BMI requirements before Tricare changes any other requirements on their site. Keep me informed of your progress. Interested in others success with the new BMI change.

Thanks for the response. I'm staying with it and hope to get a referral soon.

I'm wondering if anyone else is having to complete the following checklist from their PCM with Tricare Prime? I'm actually Tricare overseas Prime Remote. I just spent the entire AM on the phone trying to explain that this is not the requirements per the Tricare Manual Chapter 4 Section 13.2. After I couldn't get a clear explanation on how they came up with this checklist through International SOS (3rd party used by Tricare Prime overseas for referrals) I spoke with the regional Tricare office in Germany. I was informed they came up with this checklist so "not just anyone" could get the surgery. I was then informed I could just go to the PCM and have them submit a letter addressing my Hx of attempts, comorbid Dx and etc. But was informed approval was on a case by case basis and if denied could appeal. (Duh Rolling eyes) So aggravated that the requirements are not the same across the board for Tricare Prime. I'm 5'1 and approx 198lbs with sleep apnea. I'm aware that b/c I'm not 100lbs overweight according to Metlife charts I will be denied although my BMI is and has been above 35 with the comorbidity for >5 years. I have tried every diet known to man as I'm sure you all did too. I loose the weight but it never stays off. We have been overseas now for 6 years but I don't have the documentation they are requesting in my medical record b/c we are remote (not at a MTF) and these diets are not covered by Tricare therefore paid for out of pocket. I also recently read in the Fed Recorder that the requirements will change from the Metlife Chart to BMI on 3-16-2011. Anyone else aware of this and have spoken with Tricare in regards to the change. Right now I'm afraid that I've stirred the pot too much and will be denied just for demanding where they came up with this checklist. If anyone has a better contact through Tricare I'd love the name and number. Any advice is appreciated. Wish me luck. I plan on seeing a PCM on the 16th of March and keeping my fingers crossed. Step 1: Patient Review (All items must be checked by the PCM and applicable to the patient) Documented morbid obesity for 5 years. Meets definition; body weight is 100 pounds over ideal weight for height and bone structure, according to the most current Metropolitan Life Table, and such weight is in association with severe medical conditions known to have higher mortality rates in association with morbid obesity; or, the body weight is 200% or more of ideal weight for height and bone structure. List any co-morbid conditions: ________________________________________________________________________________ DEROS date at least 12 months from the anticipated surgical date. Date of DEROS: _____________ Participation in a documented nutrition/exercise program for a cumulative total of 6 months with documented ability to lose 10- 15 lbs within the last two years. (Patient‘s inability to comply with a diet and exercise regimen prior to surgery indicates poor compliance and an increased risk of adverse outcomes) Comprehensive evaluation and review of significant medical or psychiatric history by their Primary Care Manager (PCM), surgeon or mental health professional/counselor indicating good candidacy, readiness for bariatric surgery, and confirmation of positive family support system. Education regarding the need for lifelong follow up. The patient has been advised that TRICARE policy does not cover breast lifts, thigh and arm reduction, and that a panniculectomy must be deemed medically necessary to be covered by TRICARE. Step 2: Post-operative Management Primary Care Manager must acknowledge capability to provide appropriate post operative medical management to include: (all items must be checked in order to be considered for approval): Dietary Counseling Mental Health assessment or referral Laboratory assessment plan for possible nutritional deficiency _________________________________ __________________________

I just spent the morning on the phone with International SOS. They approve all our referrals for Tricare overseas. They told me it is done on a case by case basis. I've spoken to Tricare in Germany and was informed that they set these conditions for overseas dependents so "not just anyone" can get the surgery. I just left a message with a Dr. Barry Choen (sp) in VA. Just wondering how the tricare manual can state one thing and a region can require more? It should be the same across the board. So frustrating. Here's the form we are required to have our PCM fill out here. Step 1: Patient Review (All items must be checked by the PCM and applicable to the patient) Documented morbid obesity for 5 years. Meets definition; body weight is 100 pounds over ideal weight for height and bone structure, according to the most current Metropolitan Life Table, and such weight is in association with severe medical conditions known to have higher mortality rates in association with morbid obesity; or, the body weight is 200% or more of ideal weight for height and bone structure. List any co-morbid conditions: ________________________________________________________________________________ DEROS date at least 12 months from the anticipated surgical date. Date of DEROS: _____________ Participation in a documented nutrition/exercise program for a cumulative total of 6 months with documented ability to lose 10- 15 lbs within the last two years. (Patient‘s inability to comply with a diet and exercise regimen prior to surgery indicates poor compliance and an increased risk of adverse outcomes) Comprehensive evaluation and review of significant medical or psychiatric history by their Primary Care Manager (PCM), surgeon or mental health professional/counselor indicating good candidacy, readiness for bariatric surgery, and confirmation of positive family support system. Education regarding the need for lifelong follow up. The patient has been advised that TRICARE policy does not cover breast lifts, thigh and arm reduction, and that a panniculectomy must be deemed medically necessary to be covered by TRICARE. Step 2: Post-operative Management Primary Care Manager must acknowledge capability to provide appropriate post operative medical management to include: (all items must be checked in order to be considered for approval): Dietary Counseling Mental Health assessment or referral Laboratory assessment plan for possible nutritional deficiency _________________________________ __________________________