Alexandra

Vamaid, as you see your question is a common one. I've even heard doctors' staffs express exasperation over this particular hurdle imposed by insurance carriers. But I don't think it's at all unreasonable and actually think more carriers should use it. If your BMI is 51, you should have been talking to your doctor already about how to get a grip on your weight. Not to sound harsh, but obviously you are aware there is a problem and that you need medical assistance. You wouldn't be here otherwise. Going to your PCP to get help is a crucial start. That's what the insurance carriers want to see--that you are trying sincerely to get control over your weight and that bariatric surgery is not your FIRST step. Every medical authority agrees surgery should be the LAST resort in the treatment of obesity, so there needs to be some evidence of previous attempts. 6 months is not a long time. Call your PCP tomorrow and make an appointment for a physical and a serious look at your weight issues. Make sure the diagnosis of morbid obesity is in your file (the diagnosis code is 278.01). Get a diet from your doctor (they probably have a printout all ready for their patients who ask for one) and talk about an exercise plan. Then visit once a month to report your weight and talk about whatever other issues may have arisen. It's really important that your doctor's notes show your serious interest in taking control of the problem--not necessarily that the diet is working, but that YOU are working. That will let your doctor say without hesitation that you are a good candidate for surgery and will be a success. Make a list of all the diets you've tried in the past, and if you can remember note the results. (My diet history went as far back as Weight Watchers at age 8 and diet camp at age 10.) These notes all support your medical claim of being qualified for bariatric surgery, and your current doctor's records will be the cap on this file. During this time you might also want to research surgeons, visit their seminars, get whatever pre-op tests you might need out of the way, and so on. The time will pass before you know it, and you really don't have to worry about dieting yourself out of qualifying for the surgery. But you will never qualify if you don't start this process with your PCP. So call!

Hi Kim, Welcome to LBT and into the light!! :D

Liquids for 24 hours, no restrictions after that. Just take it easy!

I hope someone will post the "news" here for those of us who are TiVo-deprived! I'm VERY curious to hear how the band is presented on the View. Oh, and yes, it's on ABC.

Eating just the topping off a pizza is a tried-and-true bandster solution to the limited pizza-place menus. But I have to say it's not as appealing without the crust; SO loaded with fat and oil and nothing to sop it up. I was very cautious about trying pizza after banding, but when I did it was absolutely amazing to see how little it took to fill me up. Like Chinese food, it's no longer one of my favorite foods, because quantity was in part why I liked it. It was cheap, "balanced," and easy to overdo. Now it just doesn't seem like a good choice, and you may find your tastes changing in a similar way over time, Paul. Once in a while a bite goes down wonderfully well, but it's not my choice for a meal.

NSAID: non-steroidal anti-inflammatory drug. This is the class of drugs to which ibuprofen (Motrin, Advil, etc.) and naproxen sodium (Aleve and others) belong. Lots of antibiotics can also increase the risk of stomach problems, but antibiotics are much less likely to be taken long-term than painkillers, and so less frequently warned against than the over-the-counter stuff. I know some docs say it's OK to take NSAIDS once in a while, if you have some pain that won't respond to Tylenol. However, a lot of people use them frequently for back pain, menstrual cramps, or arthritis. It's that kind of frequent or chronic use that is the most likely to lead to stomach problems. I'm just steering clear and sticking with Tylenol when I need it.

Mandy, you may have your best chance with an independent reviewer. My fingers are crossed for you! That's how I won my battle with Aetna. Through all of Aetna's internal appeals the people doing the deciding were Aetna employees so the outcome was a foregone conclusion. It wasn't until a third party got involved that I got the right result. Good luck!!!

There is no one cause of erosion; obviously if we knew that it could be prevented it in all cases. The medications that we are told to avoid are those that rob the stomach of its naturally occurring protective substances (I'm not up on exactly what those are). It seems to me that such weakened stomach tissue can react by ulcerating internally OR externally at the band site. Whatever the exact mechanism, I know I'M never taking any NSAIDS again.

Is the patient going to be Starr Jones? (Or whatever her name is?) She's lost a lot of weight and as far as I can tell has been cagey about how she did/is doing it. Wouldn't surprise me if she came out of the bandster closet on the show.

All these "I'm discouraged" threads are even discouraging me! Let's hear from people who are now doing well with their bands but who may have had a hard time of it at some point. Did you have a really hard time sticking to liquids? Did you think you could out-eat a football player when your appetite returned? Did you feel like a total failure when you had one, two, three fills and still couldn't feel a difference? Let's hear from you if any of the above scenarios sounds familiar but NOW you're rockin' and rollin' along with decent restriction and good weight loss. Let's hear how temporary the "problems" are and how you look back on them now. For me, I can't really say I ever had any of those "I'm a failure" moments. I mean, I experienced all of the above phenomena--I'm human and a normal bandster--but my mind-set simply didn't see any of those as failures. I ALWAYS looked at the band as a long-term process rather than an event after which everything would be peaches and cream, so having things happen in slow motion is exactly what I expected. It's what I wanted, why I chose the band in the first place. But I know a lot of people have different expectations, so I thought it would be helpful to hear from folks who have come through those short-term disappointments and frustrations and seen the light on the other side. So, share!

Hi Shelley, One reason a fill "wears off" is that we lose weight and the tissues of and around the stomach get smaller. We have to remember that the band and stomach are a system, and restriction is not solely dependent on the amount of Fluid in the band at any given time. Restriction can come and go with changes in our bodies, so IMO it's always a good idea to let at least a couple of weeks go by after a fill or after thinking about getting one--the situation may change again!

I've had that same problem for several days and from more than one computer. There must be some big problem with the board.

There isn't any food I can't handle, but some pieces are just too large. My guideline is knowing that if I can't reduce whatever it is to paste in my mouth, I just take it out. So I can eat steak, but any gristly parts get left on the plate. I have no problem eating bread, but it only takes a couple of bites to make me very full so there's just no point.

You know, this syndrome never goes away, and it's what we have to be really on guard against. Last night I had a second chicken thigh, even though I knew perfectly well that I wasn't hungry, didn't need it, and it might lead to heartburn (which it did). So why did I eat it? Ahhhh, the $64,000 question. Sigh. Some days you beat the bear, some days the bear beats you. The good news is that it was only two chicken thighs, not FOUR, and I only had a small amount of the rice it was served with. It helps to put it into perspective like that, knowing that what is "too much" now is nowhere near the amount it used to be. And that's what it's all about.

NRS1, you can't enlarge your pouch by drinking. If you take in too much Fluid at one time it will just come back up, and you'll know it. Drink! PBs are to be avoided as much as possible, becuase their can lead to irritation and cycle of swelling and further negative effects. Once you have one, it's a very good idea to stay on liquids for at least 24 hours to let the tissues rest. Your appetite returning is a sign that you're healing up, not that your band is not working. Once you're on solid foods and know whether you have any real restriction, then you can talk to your doctor about a fill if you need one. But you're still healing and I'd suggest sticking to soft foods for another week or so. Where were you banded? Did your doctor's post-op instructions cover any of this?

Kristen, your concerns are totally understandable. It's certainly a learning curve and learning how to eat less is not easy. But it's what's needed to lose weight! I'm almost two years out and don't hesitate at all to go out for dinner. Unless I want to have lots of leftovers, though, I order off the appetizer menu. Some restaurants offer a half-portion but that's usually a total ripoff so I don't do that. And then of course there are the foods that go down easy, and if nothing on the appetizer menu seems appealing I'll go for fish or something really soft. So there are adjustments to be made indeed but they're not the sort of thing that make you feel like a spectator on the sides. They're the kind that lead to a better life!

Whether you start out with the surgeon or not, if you're hoping for insurance to cover it then at some point you're going to have to see your primary care doctor. I think it's a VERY good idea to start with your PCP and make sure you get the diagnosis of "morbid obesity" in your record. A history of discussing your weight with your primary care doc goes a long way with your insurance carrier. If you're paying cash or have a very liberal insurer, then you can go right to the surgeon. Otherwise an initial visit to a PCP is likely to be the best way to start.

T'm so sorry for your loss. What a terrible way to arrive home.

You weren't denied, you just got a flip answer from some customer service rep who probably didn't know what you were talking about. You have read the fine print. If your doctor believes you to be medically qualified for bariatric surgery (ANY kind of weight-loss surgery has the same medical qualification guidelines), then you should have your doctor go about the process of submitting a request for precertification. No one can answer you definitively until YOUR medical case is made--unless there is an exclusion on your policy, which you already know there is not. You might try calling again and asking if you can be sent a copy of the medical criteria for bariatric surgery. Don't ask if it's covered, just what they are.

Sandie, I think you're in good shape. Once you're approved for one kind of surgery, if the carrier doesn't exclude a different treatment for the same condition you'll very likely be approved for that one as well. And we know United doesn't exclude the band, so your approval should be quick. It's a good idea to call again, there's no reason it should take so long. And yes, you should have it in plenty of time for a July surgery date. Let us know how it goes!!

That six-month supervised "diet" period is really to make sure you are on board with a regimen and ready/willing to keep followup appointments with your doctor. You'd be surprised how many people find it too big a burden and give up on the whole idea of WLS! It's not really about losing weight--you can follow your doctor's instructions to the T and you'll probably only lose 20 lbs at the most. Would that be enough to keep you from qualifying? If so, maybe you're one of the borderline people that carriers are trying to screen out. While that may sound callous, look at it from their point of view--they can't simply absorb the costs for every single person who decides they want bariatric surgery. Then need to put some screening procedures in place to be sure they're paying only for the people who are a) really in need of the treatment, and who will use it to their best advantage and be successful. You're on your way, and 6 months will go by before you know it. Good luck!!

Sharona, you should call your carrier directly and ask them if what your doctor is doing is appropriate. He should, of COURSE, be able to give you a referral based simply on his judgment that you need to see a specialist. If he's unwilling ro let you explore this avenue then you should see a different PCP. And I have heard that Blue Cross of CA is now covering the band, though I don't know if it applies to both the PPO and the HMO plans. You should ask them about that when you call as well. Good luck!

Bigmom, it's a learning curve and you're learning. No one ever said this was going to be a bed of roses. But it will get better as your behaviors change to accept the reality of restriction, and you'll be losing weight!! Hope you're feeling better today. Take it slow!!

Ugh! What a terrible time to get sick! Good luck for a quick recovery, and take it easy!!

There isn't any specific period that one must wait after a fill. Some doctors will add more Fluid as soon as a week later or maybe even earlier if the patient really has no restriction. In MY opinion, waiting at least a couple of weeks is advisable. Unless he gave you a really tiny amount, it's always possible the fill will make itself felt after some time has gone by. But you and he should talk about whether waiting is necessary.