Alexandra

Matt, doctors are people too, with just as many biases, hangups, and personal experience stories as anyone else. Unless your personal doctor knows that YOU PERSONALLY have some health condition, an extreme eating or behavioral disorder, or simply will not be able to live with the modifications the band forces us to make, I can't imagine any medically sound reason to recommend against the band. Do you have any specific medical conditions that would contraindicate banding? If so, your doctor may be right. But if you're severely obese and NEED a tool to help you (force you) to eat less, the band is a safe and sane way to do it. Complications do happen, but when they do they're relatively minor and easily repaired. I'd be very interested to hear why your doctor thinks it's not a good idea.

This has happened to me almost every time. It's a common phenomenon, which I think just shows how much our minds are involved in our health: have you ever called the doctor with symptoms only to have them clear up before your appointment? That's what this is, only in reverse. Keep your appointment, and just be honest with the doctor. Your restriction has been mostly absent, and if they do the fill under fluoro the chances that you'll get filled too tightly are pretty small. But do stay on liquids and soft foods for a couple of days or so after the fill so you can tell how your body is going to react.

You go for it and we're pulling for you. Lots of people are afraid to try because they're afraid to get turned down, but the fact is you'll never know if you don't try. Claims are never determined before the fact, and no carrier will ever say they are definite about something. It's all about the specific request and how it is submitted. But it sounds like you got good information and are on your way. Fingers crossed!!

Have a great time!!

This is EXACTLY what I faced when I was seeking approval. The fact is that it is within the carrier's rights to decide whether a certain procedure will be covered treatment for a given condition. The decision is not based on your having an HMO; it's a broad determination across all their medical plans that covered procedure A is the "preferred" procedure as treatment for covered condition X. All other procedures for the condition are just not on their preferred list. If they (and by "they" I mean the medical policies department at Pacificare) receive a request for this procedure and deny it, you MUST be told why they are denying it. They have no obligation, however, to fill you in beforehand about why something is not on their preferred list. (That's so they can't be accused of making your medical decisions for you--yeah, right.) They aren't deciding which procedure you can have--they're only deciding which they will pay for, and while we know that in practical terms that is the same thing, it's legally not the same at all. Carriers are not required to accept all new procedures or drugs as covered as soon as they're approved by the FDA. They want to see a body of experience first, and that means most carriers watch carefully to see how some new procedure works in the real world. I've seen banding be accepted slowly across the insurance universe, but some are still clinging to the "experimental" label even four years after FDA approval. This is why I was initially rejected, and what I managed to overturn on external appeal. So don't give up!! You will never know the precise reason until your doctor submits a request for precertification. You may even be approved! So give it a whirl, and let us know how it comes out. If you need to appeal we can help you with that when the time comes. Good luck!!

Kat, you need to speak with someone at Pacificare who is familiar with YOUR policy. Your employer may have carved out some benefits, but it's unlikely that the band is carved out specifically. More likely, your employer may have excluded all treatment for obesity/morbid obesity. If that's the case, you're probably up against a big problem. IF, however, you are looking at Pacificare's OWN rules regarding RNY vs. band, you'll have lots of grounds for appeal if you're denied the first time. First of all, qualifying medically for bariatric surgery is the same no matter which surgery you may be having. If you're medically eligible for RNY, you're medically eligible for banding. (Do you know what your BMI is? If it's 40 or more, bariatric surgery is medically indicated. If it's less than 40, then you will need to show related medical conditions to support your request.) So qualifying medically is step 1. IF the carrier (Pacificare) approves one procedure over the other--as many still do--you can appeal that depending on what their denial says. If it's a pro-forma denial because the band is "experimental" you argue against that in one way. If they say one is medically preferable, you argue that in another way. You just have to wait to see what their objection actually is before you argue with them.

You know, this was definitely one of the things that attracted me to the band as well. But the reality may be a bit different. I'm more than two years out and while I'm not gaining weight, the weight loss has virtually stopped and "just getting another fill" would not be the answer for me. This is not to say that I can't lose more weight if I want--my band is still working to restrict my intake and control my appetite--but it's definitely more about my behavior than anything else at this point. It seems that many people start to experience negative symptoms due to long-term restriction--reflux, dysfunctional esophagus, enlarged pouch--and while none of these are life-threatening like bypass complications can be, they can sabotage weight control or even lead to other health issues or band loss if we're not careful. What I think the REALLY good news is about the band is that if these symptoms occur, the band can be adjusted to relieve them. The fact that the band can be loosened, I think, is just as important to my long-term success (which is what matters most to me) as the fact that it can be tightened. If there are complications with the bypass, quite often additional surgery is indicated and in some cases it's major surgery with only mixed success. To pair that risk with the fact that once the effectiveness of the surgery has worn off there is NOTHING to be done, seemed, well, nuts. So for me it came down to safety, both in the short- and long-term. I'm in my early 40s and expect to live another 40 years--who knows what might happen in that time? Facing the rest of my life with a compromised system for absorbing nutrition seemed extremely foolhardy when a safer, saner alternative was available. Losing weight fast was not my main goal--losing weight permanently was (and remains).

Wanting to eat until we're stuffed is something we can all relate to. And in fact, it really is one of the hardest things to internalize after banding--that being "stuffed" is not possible anymore and there is a whole new way to feel full and satisfied. But it's by no means impossible, and after a while it's really liberating! Head hunger does go away, finally, because behavior modification does work. It's a tried-and-true method for changing addictions and phobias. When you discover often enough that you just CAN'T eat until you're stuffed, eventually the desire goes away. The same effect simply cannot be achieved, physically, and your subconscious eventually will get with that program. It works! Just not overnight. And there are some frustrating times along the road. But I wouldn't change a thing, it's been a major blessing in my life.

I'm a Jersey girl, and hey Fran, we have doctors in common!! Have we met? Glo, we're all here for you. Where are you having surgery?

Hi Patty! Glad you found us!

Hunger suppression is one of the ways the band helps us control our intake; physical restriction is another. I know that recently when I had a total unfill, I noticed the lessened restriction immediately. However, it took several days (a week?) for me to be aware of another change, that I was definitely hungry sooner after eating than I had been while my band was full. The early days of banding are the hardest, because for most of us hunger is more in our brain than in our stomachs. And it takes TIME for the band to work its magic on our brains. Before banding, I'd just get a whiff of some good smell and the thought "I'm hungry" would pop up even if I'd just eaten. NOW, though, I can actually have a rumbling stomach sometimes and I can still not really want to eat. That tells me that it's not only a physical effect that the band has on my stomach; it's really put a damper on the impulse mechanism that always governed my behavior in the past. But this didn't happen overnight, and maybe not everyone has the same experience. I'm more than two years out and only really became aware of it recently.

Becky, what a marvelous post and I'm so glad you decided to share it here. You're a strong and honest woman and that's more important than any number on a scale. You make me proud to be a bandster. Congratulations on your amazing success, and all the successes yet to come!

"That area" is the theater district, and I can tell there are about a MILLION choices there. If you need me to, I can get recommendations from friends who work in Times Square. (I haven't been there in quite a while, and I'm sure everything has changed. If not, I'd suggest Ollie's for Chinese, a great restaurant with lots of room.)

Babs has great advice. I've been eating protein bars for breakfast since very early on. They dissolve to nothing in the mouth, and are packed with protein enough to keep me full until lunch time. Good luck!

You do not need to start protein drinks now, or ever until surgery unless your doctor wants you on some pre-op regimen. Just follow your doc's instructions--you may have a pre-op diet to follow but it's not universal by any means.

Carolyn, to fight the "not medically necessary" determination your doctor will have to get involved. That's a case that only a medical person can make. It's possible that your file simply didn't include enough evidence (like a sleep study or something?) or that you are indeed borderline and that's the hangup. Try talking to your doctor and asking him to get specific details from the carrier about why it's not being accepted as medically necessary. He should have a provider-relations phone number he can call where he can speak with medical staff. You will likely not be able to get access to the same people and the customer-service reps you can speak with don't know jack. Good luck!!

Well the good news is that *I* don't think it's tragic, so there's nothing to worry about. Being able to view oneself as sexy may be wonderful and powerful, but only if one thinks sexiness conveys those things. I'm thinking that I just have a different definition in my mind, because I definitely feel wonderful and powerful most of the time (when I keep up with exercising, anyway). And I have a very happy relationship with my husband, full of love and affection. I'm not frigid, if that's what you're thinking. Maybe I'm full of hangups, although I feel level-headed enough. Hell, I have NO problems allowing for what others may find arousing--it's not like I disapprove or anything. Maybe I was just born without enough estrogen or something, but my point is that it's not necessarily a bad thing to not feel that "sexy" is some goal to be reached. And maybe it's all semantics, because I'm definitely for self-appreciation in all its forms. The very word "sexy" sounds like some objective benchmark imposed on us from society, and that just makes me bristle. Editing to add that I am sorry I jumped in here, because I really don't want to start a debate. But I'll leave my comments in case they resonate with anyone else. 'Nuff said.

Speaking of faces, I thought this was an interesting before-and-after. The one on the left was taken in 2001, and the one on the right a couple of weeks ago. Even I think I look younger now!

Wet blanket here: I have never in my life felt "sexy" and I don't now. I do think, and have thought for most of my life, that I'm reasonably attractive, and now that my face shape actually shows through I can see that I'm even pretty. I love my new collarbones and think my proportions from top of head to shoulders are just about perfect. But "sexy"? Nope. I know that's my frame of mind more than anything else, and it's just always been that way. I'll come right out and say that I don't mind it, either. I'm only putting this out there for the other people who may be reading this and feeling somehow inadequate if they don't have "sexiness" on the list of things they're missing in their lives. Just because someone else says it's an attribute to be desired doesn't necessarily make it so. Maybe it's just a language thing and we really are trying to talk about the same thing. But to me, one's degree of "sexiness" does not correlate to one's worth, and it especially does not indicate one's lovability.

Sally, I've never had gall bladder problems, but I've heard many people say that the removal of their gall bladders helped them immensely with a whole range of health issues. I'm with everyone who says to have that taken care of and just leave the band empty but in place for the time being. There is nothing wrong with your band, remember? So why remove it? It's part of your body now and removing it might itself lead to more problems. Gall bladder surgery might go a very long way toward improving your health, so do that first and see. My thoughts are with you with crossed fingers that your gall bladder is the culprit, and your band stays with you for many years to come. Congratulations on losing 140 lbs!!!

Amy, Amy, Amy! If you have learned nothing else about banding, please try to believe this: it does not happen overnight. And that's GOOD!!! You didn't gain weight overnight and you don't want to lose it that way. The band has not yet started teaching you new ways to eat, new ways to think about "enough" and new ways to relate to food. So how can it be working to help you lose weight? The time to decide whether you've made the wrong decision is not now, before you've even started to explore this decision. Check this thread in six months; I have a pretty good guess your thinking may have changed a little.

That sounds like A LOT to commit to, Lisa! How about just the no more soda and No more booze parts, to start? The others might be easier once you've started with numbers 1 and 2, but give yourself a short break if you can't do them ALL at once. Good luck!!

I had nothing but good news at my appointment today, I'm happy to say!! For those who have been following my saga, and whoever else may care, the word from the doctor is that my band is in great position, my esophagus still works, and my pouch is not enlarged to any great degree. Whew!! :banana :banana I wasn't really worried about a slip, but it's very unnerving to have a doctor tell you that's what your symptoms indicate. Since my recent unfill resolved my symptoms so completely, it seemed very unlikely that anything real was wrong. But still, having the doctor see immediately on the fluoro that everything was cool was SO reassuring, I almost wept. Dr. Bertha told me today that when "all" my fill was removed recently and only .8 cc came out, it very likely wasn't actually ALL my fill. Measuring the amount of fill just isn't an exact science, he said, and it's almost impossible to be precise about totals. Then he put an additional 1.1 in, leaving me with -- well, I don't know how much total but with what felt like a bit more restriction than I had going in. And that's what counts. So it seems that all my problems were likely my own fault, and I probably should have done a three-weeks-of-liquid regimen when I first started having symptoms. That's what I'll do the next time, if there ever is a next time. For now, I'm happy to have a clean bill of health for my band and a good level of restriction, and I promise I'll be a good little bandster-camper from here on out. (I PROMISE!) :D

It's not easy, I won't pretend it is. But after you get restriction you WILL find yourself thinking about food in a different way. It used to be all about quantity for me, and that's really all that those bulky comfort foods (bread, Pasta, potatoes, rice) are good for. Once you reach a good level of restriction, you will find that only a couple of bites of such things will put you out of commission for that meal. And THAT is a sobering reality that makes it very easy to winnow them out of your diet. This will not happen overnight...for weeks or months after surgery you WILL be able to eat these things, although likely only in lesser amounts than you've been used to. So don't worry that you have to go cold turkey from all your favorite foods. But there will come a point, after your second, third, or whatever adjustment, when you won't WANT to eat your old standbys anymore. And that's the beauty of the band...by the time it happens, you'll be totally ready for it.

I've been wondering this myself. Guess the corporate sponsor pulled the plug...