former_vbg

Yeah, horseshows can be good and bad. There is often lots of bad food for choices with various vendors and junk food is easier to bring to these events. The hard work does help, but I'm going to have to make a specific effort to have good choices for myself at the show. Congrats on getting back on track!!

Update: I'm trying to increase my cardio work outs which seems to really make a difference. Just trying to find time to fit everything in in a day can be a challenge. I can do this though. SN..................... Starting Wt........Current.......Goal.......Lbs to Goal FormerVBG...........218lb................211lb.........185lb..........26lbs

Just got back from a 1 day local open show and aside from the fact that I really like horseshows, I know that I WILL loose weight because of how much work we have to do in getting ready, showing and getting packed up to come home. I lost 2# today, now maybe 1# might be Water weight, but I don't care. I love stepping on the scale and seeing it drop. Keep your eyes focused on that new suit for the show season next year! I have been to 3 local shows since my guy has been home from the trainers to get him some ring time. It's cheaper than when I get to the A shows, will be at the American Royal in 2 weeks. I look at those tiny wastes in those tiny show clothes and just think how easy they must have it to be able to stay so thin year after year. I don't care to get quite that thin, but it would be nice to have a nicely defined waste so people don't notice the "fat girl" riding as much as the horse and rider as a package.

You are not alone. I gained 2# this week, and since lost it just in the last couple of days, but it is very frustrating when this happens. I start going into this mode of "well, I screwed up so what's having this or that" kind of thinking. I was at the bank the other day and they had a bowl of bit size chocolate candy bars and of course there were my favorites in there. I was standing there waiting for things to finish up and those candy bars just kept screaming at me. Yes, I took 2 of them and ate them. I felt really guilty afterwards, but got back on track. I don't keep any of that stuff in the house and do my best to avoid it any other time. Try to remember your goal of getting back in the show ring. I am attending my first bigger show in a couple of weeks and although I'm not where I would like to be going back, but I'm down 58# and within 15# of where I was at showing last year, so I'm just going to go for it and hope to loose a few more before the show. Thank GOD for Spanx!!! Hang in there, you can do it!!

You are right to be upset about their "administrative fee". Most Dr.'s call it a program fee. To be honest, all it is is a way for the docs to collect more $ for their time. They are allowed to charge it because they will say it covers all kinds of STUPID JUNK that they aren't allowed to bill the insurance company. By contract, they are required to bill the insurance company for any charges they know they are contracted to perform. So, they come up with silly things like support groups, access to their NUT, processing insurance, etc, etc... I had to pay $325. I did it under protest but felt I had know choice. There is a Dr. out in southern CA that charges a $2,000 program fee. It's INSANE!!! It should be illegal IMO.

SN..................... Starting Wt........Current.......Goal.......Lbs to Goal FormerVBG...........218lb................218lb.........185lb..........33lbs

Don't forget- her employer may have excluded certain aspects of the traditional coverage provided and that won't be known unless she goes through her HR/ Benefits Dpt to be sure she is getting the most accurate information.

I would encourage you to contact your HR Rep and ask them if you can speak with the person in your company who is the contact for your insurance administration. You don't have to give them specific details, but explain to them that you are trying to make the best decision for you and/or your family but need more information that what has been provided in the booklets specific to coverages/ exclusions. You are right, each plan is going to vary- especially because employers can elect to add/ exclude things for the very same policy which is why everyone has a unique group ID#/ policy#. I know what you are going through because while they do give you a nice overall view of the benefits, it's the fine print that can really be a problem for some people. Seriously, contact your HR rep and ask them for who you can talk to- maybe they can provide you with a contact at those other insurance companies. I wish you luck!

I personally find it very unprofessional for a Dr. to require the use of their own protein shakes. My Dr. has his staff push his "products" pretty hard, including vitamins and I declined. They are WAY overpriced and just another marketing gimmic for them to make more $. You can find the same stuff way cheaper on your own- just follow the guidelines that they give you like usually they want you to have whey protein in the drinks. I know several people who have loaded up on stuff from their Dr.'s office only to get home and hate the flavors and they were not returnable. Go to a healthfood store and get the single packets so you can try different ones before you start buying large quantities.

The very first thing I would do is call your insurance company to see if what that insurance coordinator says is correct- that sounds a bit odd to be to require that length of time for a high BMI. Second, I don't know of a single insurance company that will allow you (the insured) to submit for pre-approval of any surgery. Someone who works "in the biz" can surely correct me, but I had thought about that myself when i had some issues with inept ins. coordinators and was told I couldn't do it- only the Dr.'s office could submit it. Third, if you find out from your ins. company that your husband IS within the guidelines, ask them if their policy bulletin is posted online and then I would PROMPTLY fax or email that to the ins. coordinator at your Dr.'s office and explain to her that she was MISINFORMED on your insurance guidelines. You have to be your own advocate - or in this case since you are helping your DH, then you must help him be his own advocate and not let others determine your future or his. I had to switch surgeon's just 2 wks before being scheduled for surgery w/the first surgeon- already had the pre-approval without doing the supervised diet because I met my ins. policies requirements for having a Revision under the clause of complications. When I switched surgeons, the IDIOT insurance coordinator kept telling me that even though I already had a pre-approval I would still have to do the 6 mth supervised diet. She literally argued with me and I told her she was wrong. She finally caved and made the request to switch the approvals over but told me they would still deny me on those grounds. HA!!!! She was wrong and she had to eat her words. She wouldn't return my calls after all that was said and done. I didn't care, she kept saying, "I've been doing this for 10 years, I think I know how to do my job.". Yeah... whuuuutttt evvvvvaaaaa.... So, at the end of the day, don't take the final word from ANYONE unless it's from the result of you making the contact with the final decision makers whether it be your ins. company, etc.

Well, a couple of things as I read your post. First, I would call your insurance company and ask them point blank. Be sure to document date/time of call/ who you talked to, etc. Start a file and be diligent about keeping it up. Second, as I read what you listed- if you have more than a BMI of 40, you don't have to have any co-morbidities- BUT, I do see that they do require documented proof through medical records that you have tried other ways to loose weight. This is not uncommon and why you typically see most people have to go through the 6 mth supervised diet. I think you should be ok if you have a BMI > 40. Just call your ins. company and ask them to clarify their policy on this coverage. I hope this helps.

Glad you had a good experience at Forest Park. I had quite the opposite, as several others I know who have gone there. They don't respond to the call buttons, the nurses don't follow OSHA care practices in their practices, and VERY lacking in their knowledge of what people who have had WLS needs really are. I had asked for a trapeze bar because I was having a tough time getting in and out of bed and the nurse says, just reach up and pull yourself up. I'm like WTF.... are you an idiot? The in-house docs don't read the charts before they walk in the room to cover for your surgeon.... They are not equipped (currently) to handle any real life emergency situations. They would have to try to stabilize you and transport you to an ACTUAL hospital for further care. I could go on and on.... You couldn't pay me enough money to go back there.

Wow, how boring to not be passionate about ANYTHING in life. I can't even imagine not having some sort of interests about something. Good luck to you!

LOL, oh, I have a ways to go- but thank you. BTW, I LOVE your quote in your tag line- LOVE IT!!!

Well, I'm probably not as good as many on here about tracking my foods, etc. I do focus heavily on my carb content and nothing on calories. For Breakfast, sometimes all I have time for is a string cheese and a few crackers. I try to cook a scrambled egg mixed with a little cheese and onion. I'm also pretty non-traditional in terms of what I eat for what meals. As a single person and no kids, I don't feel compelled to eat breakfast items for breakfast, lunch for lunch, etc. Sometimes I will cook up a little sausage mixed with cheese for dinner, or green Beans sauteed in butter and melted cheese. I also had a garden this year and am eating butternut squash that I broil in the oven and cook with butter- YUMMY! I have an occasional carrot but have had LOTS of muskmelon lately. For lunch, sometimes I bring some cooked white fish and a cup of sugar free Jello, or some cooked chicken. I also have mostly been drinking more Water than before surgery as well as crystal lite. I was drinking a zero calorie fruity drink from Walmart but after posting about carbonation drinks, decided to back off on that awhile to see if that would help break my stall and I don't know if that helped but it seemed after a few days I was dropping weight again so I am going to stay off that awhile. Oh and I bring pepperoni slices to work to snack on, they are zero carbs. The other thing that I think is a huge help is that I have a small horse farm and I am the only one to do all the work around here which includes a fair amount of mowing, weed eating, moving hay and all the other things that go along with taking care of acreage and a home. I have been wearing a podometer and I average between 8,000 to 10,000 steps per day. I'm not sure if this helps give a good picture of what I'm doing- but that is basically what I'm doing. Basically, I just focus on keeping my carbs to under 20 per day. I should also add that I have an occasional salad, but choose pretty much only Protein things to add to it and instead of light salad dressings, I choose regular because the carb content is lower- but even then I can usually only eat enough salad for about 2 or 3 TBLSPNS worth.

I also had the same pain, but mine happened about 2wks out and lasted for close to a week. When I called the Dr.'s office they said that it was likely referred pain, meaning that the actual source of the pain was someplace else, but that is where my body is showing it. It was severe in that anytime I coughed, laughed and moved in certain ways it was excruciating. It should go away within a week or so.

I'm so excited to be down 51# in just a few days from my 2 month surgiversary!! I did have a couple of weeks where I barely lost anything at all and then just like someone pulled the drain from the bath Water my weight loss kicked up with a burst! I'm already fitting into clothes I haven't been in for awhile. I still have a ways to go, but this sleeve is just incredible!

That's interesting. So, that makes me wonder even more. If they "NEEDED" the $83,000 when they got paid $51,000, how is they could "afford" to accept TENS of THOUSANDS less by self-payers. The staff used to process the insurance claims are not paid tens of thousands per patient. I'm not disagreeing with you, but it just makes the situation even more glaring to me.

Congratulations!!! I have done the calculations on what it would take to move me into that category too and that seems so far away right now. If only I was taller. LOL

A drain is dependent on the patient also. I was having a revision and although it was laproscopic, he placed the drain in to help detect if there was any infection going on.

Update: SN........................Starting Wt........Current.......Goal.......Lbs to Goal former_vbg................271.................222.............190............32

Yes. My post stated that Forest Park BILLED Aetna for more than $83,000 and were paid the $51,746.

Interesting information on the government kickbacks. On my claims, Aetna paid my surgeon within 10 days of them submitting a bill. Most of the claims (not just for this surgery), they usually pay within 10 to 15 days. But, I'm sure that may not be the case for everyone, like you stated in yours.

I wasn't given a choice, they just booked me. Being out of state, I'm not sure I would have known how to choose one place over the other. I just think its important for people to speak up when there are issues. I did google Forest Park, but could find nothing about the place except for references to the hospital being built, the developers and Doctors being owners, etc. I'm glad you had a good experience, but I also know others who had a similar experience as me. Many will not speak up though which is too bad.

Yep, I completely agree. All along the whole process everyone kept referring to Forest Park as a hospital and you can imagine when I got there realizing it was no more than a brand new office building with rooms equipped to do surgery- needless to say I became FREAKED OUT. I asked one of the nurses the day before I had surgery when I was there for some pre-op bloodwork what would happen if someone had a true emergency. She pointed to this mobile cardiac unit on wheels and said we can handle emergencies. I was like OMG, what have I gotten myself into. But, what was I to do. I had traveled several hundred miles to do this, gone through all the insurance hoops, had arranged time off work.... When I was laying in the room waiting for my turn, I had a bit of a meltdown hoping I hadn't made a big mistake. The pictures on their website are VERY misleading in my opinion.