SaucyBandster

Have you been to a Lapband seminar yet? Typically there is a bariatric coordinator and it's their daily routine of working with insurance companies and knowing the in's and out's and pitfalls, etc... I would recommend attending one of if you already have a surgeon in mind, they usually have mandatory consults or seminars they hold which are very helpful. They definitely got the ball rolling for me. I am going on my 3rd (3 out of 3) supervised monthly weigh in's with my PCP and had my psyche eval last week. One more Dr's appt and I am then submitted to insurance. From there, once approved, the surgeons office will schedule my surgery date and guide me on my EKG, Chest X-Ray and Labwork appts.

Good Luck!

I posted awhile back and wanted to update.

I have now completed 2 out of 3 monthly weigh in's with my PCP and then she will submit a recommendation.

I sent my surgeons office 2 yrs of previous Dr's visits where my weight was documented.

I just had my psyche eval and he gave me the green light.

My last Dr's weigh in 3 of 3 is Jan 6th ( I can't wait!) and then they will submit everything to insurance.

I have Independence BCBS. I was told this is what is standard... they didn't send it initially or anything. I hope I wasn't jumping thru hoops for nothing and could have been approved back in October or something?

Anyways, I am really crossing my fingers that once I am submitted in early Jan that insurance will approve and approve quickly. It amazes me to read how others on BCBS get instant approvals. Any idea why there are so many variables??

Hi Everyone,

I need to schedule my psych eval next and was curious if people could tell me what to expect?

If I say something wrong, can they not recommend me for surgery?

I am so apprehensive about this next appt so any words of wisdom are appreciated.

I am so nervous about hair loss! I lose a LOT of hair daily as it is. I have Lupus and Rheumatoid Arthritis, and I have lost hair by the handful since I was a teenager. That being said, I have extremely thick hair that was to my waist until I cut it short about 2 years ago. When I wash my hair, I pull a fist full of hair from the drain when I'm done. At any given time, I can run my hand through my hair and pull out at least a few strands, often more. I don't know how I haven't gone bald! The thought of something else potentially causing Hair loss freaks me a bit. When I started on immunosuppressants, I was really worried because a side effect was hair loss. I think it may have gotten a small bit worse (maybe?) since then, but not significantly. I am hoping that by chance I will have a similar response after surgery. Fingers crossed!!

I am nervous about the hair loss potential as well and am glad to read all of these responses.

Quick question regarding Lupus. I didn't think you could have the lapband if you had Lupus? My mom really wanted to get the lapband and has it and her Dr said no. I would love to hear how you are doing and if you had any issues with getting approved if you don't mind? Thanks!!

Surgery went good, I'm still here at hospital, I've been walking and eating Jello, broth, juice, pain where the port is and shoulder pain...all in all I think I did good, didn't have panic attack or anything,I'm so proud of myself.....

And now I'm ready to go!!!

That is wonderful!! I so wish I was you right now! I am still in my Dr's visits and have two months to go. Get some rest and feel well!!

I posted this on another thread and thought I would post here as well incase someone has interest...

Frittata recipe for anyone interested...

Ingredients:

Buy one large container of Egg Whites

One package of baby spinach (you can switch out any veggies but this is my fave)

Pam Spray

Goat cheese (you can also add low fat mozarella)

Italian seasonings (or any spices you enjoy)

I buy one package of Jimmy Dean low fat Turkey Sausage crumbles. (You can also switch this out with turkey bacon, vegetarian fake sausage crumbles, etc)

Preheat oven to 350 degrees

Take one large frying fan with a METAL handle (NOT PLASTIC as this will go in the oven)

Spray with pam pretty heavily so that the fritatta pops right out at the end

Pour the bag of turkey crumbles in the pan (or your meat of choice) and warm up

Then I add the whole bag of spinach which cooks down and softens up very well and sneaks in a good amount of veggies - (this is where you can also sneak in other veggies if you want - Asparagus tips, red peppers, etc)

Then on Medium to Medium-High heat (you don't want this to burn the bottle) add the carton of egg whites which will cover the large pan. You may not have to use the whole container. It all depends on how large you want your fritatta and how big your pan is. It doesn't rise so you can eye this.

On Medium heat, let is cook for a few minutes. You will notice the whole thing cooking except the top. At this point is where I put in goat cheese crumbles which end up melting with the turkey sausage and spinach and then I sprinkle Italian seasons all over it

Put it into the oven for about 8 mins which will cook the top up and melt the goat cheese

Once you see it's finished, pull out of oven and flip onto plate. You can then use another plate to flip it back over to see the pretty side. Cut into pie slices.

You can then rewarm each slice for about 45 seconds thru the week.

It's a super easy, super quick Breakfast and it's such a great flavor and way to sneak in veggies and Protein and being very low fat. It also helps with less waste of throwing food away because you can sneak in different veggies. The one above just happens to be my fave flavors. You can alternate different meats and cheeses and veggies and have a million different variations.

This ends cooking with Lisa LOL

Frittata recipe for anyone interested...

Ingredients:

Buy one large container of Egg Whites

One package of baby spinach (you can switch out any veggies but this is my fave)

Pam Spray

Goat cheese (you can also add low fat mozarella)

Italian seasonings (or any spices you enjoy)

I buy one package of Jimmy Dean low fat Turkey Sausage crumbles. (You can also switch this out with turkey bacon, vegetarian fake sausage crumbles, etc)

Preheat oven to 350 degrees

Take one large frying fan with a METAL handle (NOT PLASTIC as this will go in the oven)

Spray with pam pretty heavily so that the fritatta pops right out at the end

Pour the bag of turkey crumbles in the pan (or your meat of choice) and warm up

Then I add the whole bag of spinach which cooks down and softens up very well and sneaks in a good amount of veggies - (this is where you can also sneak in other veggies if you want - Asparagus tips, red peppers, etc)

Then on Medium to Medium-High heat (you don't want this to burn the bottle) add the carton of egg whites which will cover the large pan. You may not have to use the whole container. It all depends on how large you want your fritatta and how big your pan is. It doesn't rise so you can eye this.

On Medium heat, let is cook for a few minutes. You will notice the whole thing cooking except the top. At this point is where I put in goat cheese crumbles which end up melting with the turkey sausage and spinach and then I sprinkle Italian seasons all over it

Put it into the oven for about 8 mins which will cook the top up and melt the goat cheese

Once you see it's finished, pull out of oven and flip onto plate. You can then use another plate to flip it back over to see the pretty side. Cut into pie slices.

You can then rewarm each slice for about 45 seconds thru the week.

It's a super easy, super quick breakfast and it's such a great flavor and way to sneak in veggies and Protein and being very low fat. It also helps with less waste of throwing food away because you can sneak in different veggies. The one above just happens to be my fave flavors. You can alternate different meats and cheeses and veggies and have a million different variations.

This ends cooking with Lisa LOL

My surgeon is putting me 2 weeks of Opti Fast. He explained it was necessary for a few reasons.

He said it does shrink the liver and going in, he wants to in and out of surgery as quick as possible. He said the less a patient is on anesthesia, the better the healing and outcome and chance of anything negative occuring.

As much as I am DREADING a 2 week liquid fast, I will use it to lose weight and get a headstart and go in with a clean slate. I am also a bit fortunate that the 2 week fast will come right after New Years. So I am sure by then, I will be ready to start the new year fresh and get rid of all the holiday food gluttony!!

I met with the dietician last week, and she wanted me to start eating like I would after the surgery. I started today. She wanted to me to try Greek yogurt with some granola for Breakfast, and some fruit. I HATE yogurt. She recommended the Greek yogurt and granola to give it more texture. I took about three bites until I started gagging. I am having a hard time thinking of something else I can eat for Breakfast. I know eggs are a good one, but I have an extremely hectic morning, so I need something fast. Any suggestions???

Another easy thing to do is make your breakfast only once a week. I make an eggwhite frittatta and sneak in all sorts of veggies, some goat cheese, turkey crumbles and spices. Then I cut it up into pie slices for the week. I heat a slice up each day for like 45 seconds. You can make it on Sundays for the week.

If you need exact directions on how to make a frittata, let me know and I will write it out step by step. One pan, easy cleanup and SOOOO Yum!!

The taste is incredible and it's super low fat, extremely tasty and very filling.

So tomorrow i am going for the general information meeting at the hospital.This is required before they will schedule a consult with you.I am so excited to be taking the first steps in this journey but cant help but feel a little anxious to get everything going. So my question for all you that have been banded usually how long does it take to get an appointment after the general info meeting if you were required to attend one?

Thanks!

I am in the beginning of my journey as well and it is frustrating to play the waiting game and wanting to get the ball rolling quickly.

When I called my surgeon, they booked for me my orientation and the surgeons appt at the same time so my appts were already set up.

I went in for my orientation on October 26th and then I met my surgeon and started all of it on Nov 3rd.

Now for my insurance requirements, I need to see a primary care Dr who will put me on a "diet" and will notate and recommend for 3 months. So my first appt with that Dr is on Nov 14th and when I am there I will set up the next 2.

Then I will set up appts for my psych eval and hopefully that will be in. If everything goes as plans, I will have everything submitted in Jan and have a surgery date in Jan or Feb. I wish it was NOW!!!

Good luck to you!!

Read this and felt so bad for people who live there who are in the process of trying to change their lives for GOOD.

Anyone read or hear about it?

http://www.inquisitr.com/156812/weight-loss-surgery-no-longer-covered-in-georgia/

When I attended my orientation, the bariatric coordinator explained that we would have to choose between the two and we pick them. The Dr uses both and it's up to the patient. I have been running searches but to no avail.

When they passed both around the room, the differences that stood out to me were the way the band inflates. The Lap Band has sectioned pieces on the ring and the Realize has one continuous band (non perforated) if that makes any sense.

My question is - Did others have options between the two? Are there pros and cons to each? Are they the same in results?

Any help is appreciated! Thanks!

No. I do not have asthma.

My pulmonary eval/testing was excellent!

It is asthma like symptoms people get when working out / running in aerobic conditions.

Especially happens when cold, but can happen to anyone at anytime when doing aerobic workouts such as running, etc.

I have asthma and it always gave me a roadblock when exercising. I would always use the inhaler once I had symptoms until my Dr told me to do the same thing. It is absolutely night and day. I used to have to stop midway thru Zumba and thought I had a truck on my chest. Now, I take 2 puffs before and can do the whole hour fine.

It's such a difference. For those with it and those with the induced "like" symptoms.

Great post!

So sorry to hear all of the issues you are having. I think the best thing you are doing is going to a rheumotologist. My mom has lupus and Fibromyalgia. Sounds like some, not all, of her symptoms. I am 37 and have dealt with some pain and she wants me to get checked. I think weight has a lot to do with my pain (back aches, etc) but I may still get checked.

While she has pain, she has learned pain management and with her meds, she leads a very normal life. I know she has issues sometimes but you would never know it. She is a trooper. I wish you luck on finding out what is going on and by going so young so you can get a handle on whatever it is.

I went to my orientation today. I met with the bariatric head of the hospital. The hospital has performed over 7,000 lapbands and are a center of excellence.

With that said, the lady was banded 7 yrs ago. Her husband and son are both banded as well. And on top of it, she runs hundreds of support groups so has a LOT of experience.

Today she mentioned she orders a shot of vodka and then a glass of Water. Then she mixes her crystal light into the Water and add's the shot. She also said she DOES have carbonated bevvies. Not often and she said it much slower because you have to let the bubbles go down. But she said every once in awhile she craves a diet orange soda or a beer.

So with all of her experience, I trust her in not giving out bad info as she keeps pretty up to the minute. Anyways, champagne may be tough to drink and may not be your regular go to, but I am sure a few sips here and there will be ok just like having a martini every so often.

The few problems you have and your family history may be a big help. I'm glad you found a doctor and staff that you are comfortable with, that's very important. I love my doctors and their entire staff are wonderful.. One tip, your doctor can answer all your questions the best but the one thing our doctors can't answer (unless they are a patients themselves) is what it's like to have a band on a daily basis, what swallowing, getting stuck, feeling full ect really feel like with a band. My doctor talked to me about this, she actually asked me to please explain all of it to her in full detail, she admitted to me that she can get frustrated not being able to truely answer certain things because they just cannot be answered unless you've experienced it. So for every question you ask your doc, you ask us here on this site too, you'll be amazed with the things you will learn. Good luck with everything! I got my fingers crossed for you!

Funny you mentioned this! I haven't even met the Dr. yet. I meet him early November. Today was my orientation at the Dr's office which is at the medical building at the hospital that I will have the surgery (if approved).

So the lady I met today is the head of Bariatric education at the hospital and holds the orientations. Ironically she was banded 7 yrs ago and 146 pounds lighter. Also, her husband and son have also been banded. She provided a wealth of info.

With today and this site, it just has put me in a really good spot mentally. I am going to call the office tomorrow and see what my insurance requires.

I was told I may need a 3 month supervised diet. With the holidays and stress and hosting them, I am not ready for surgery until early next year anyway. This would be perfect timing as come January, my life will be slow. Perfect NYE resolution right?

Thanks so much for the thoughts and writing me. It helps me wrap my head around it all in a better space if that makes sense. It was like the lightbulb came on once I joined here.

"Medically necessary" is basically a co-morbidity. The insurance companies are looking for a medical REASON as to why you need WLS, morbid obesity or a high BMI are not always enough of a reason for them. Some examples of medically necessary diagnosis' or co-morbidities are sleep Apnea, PCOS, Diabetes, High Blood Pressure, and other cardiac or pulmonary conditions. They want proof that your weight is a threat to your health. Which is stupid because obviously weight is a threat to ones health! But if you do not have any other co-morbidities as of yet, they could deny you for this.

Do you know for certain that you do not have sleep apnea? I didn't think I did because I didn't have any of the common symptoms, but it turned out that I did have mild sleep apnea after taking a sleep study (which was a requirement for me). My family history of diabetes, high blood pressure and my PCOS and Sleep Apnea helped with my insurance approval. They also wanted PROOF that I had been overweight for at least 2 years, the only thing they recongnized as actual proof were my medical records from my OBGYN. My weight history from Weight Watchers meant nothing. Also, I didn't need to be referred from my PCP, I went straight to finding a surgeon and was still approved after my medical history was submitted to insurance.

To insurance companies if it's not on paper (medical records), it didn't happen or it just doesn't exist. So not really having much of a medical history might be a problem. I don't know what your insurance requires (they're all different) but be prepared for anything, things can get quite messy. But hopefully things will go smoothly for you. Good Luck!

Thanks for your note on this. Actually no I do not know for sure but I assume because I have never seemed to have issues. My family history includes major heart disease on both sides, lupus, HBP, Diabetes, etc so I am trying to prevent any of those.

I do however have more severe asthma when I am heavier. My back is always in pain and makes it tougher to exercise even tho I enjoy doing so. So I am hoping we can go that route with the high BMI.

I went today for the orientation and am totally ready after all the questions and answers and the help they gave me. I felt very comfortable with the staff and the relationship with the hospital which has an incredible amount of bariatric surgeries each year. So at least I am able to wrap my head around it more. Next up is the Dr's appt. On that date, I will find out what my insurance actually covers. Crossing my fingers!

Check with:

Carillon Surgery Center

St. Petersberg, FL

Outpatient

Fully Accredited

They're a Center of Excellence and can virtually be guaranteed to give superior service

That is where Dr. Jessee is I think. Do you know anything about Palms of Pasadena by chance and what their rating is or where I can find that info?

Forgot to mention that someone from Dr. Jessee"s office called me two days in a row after surgery to check on me! That made me feel like they really did care

Thanks Dawn! Good luck on everything and I will continue to see how your journey goes I am going to my orientation tomorrow at Dr. Rehnke's ofc. I hope I meet him tomorrow. If I have any reservations or don't feel comfortable, I may make an appt with Dr. Jessee. I am relunctant to push it back again and have to start with the appts when all have been set. Tomorrow will be interesting!!

I would almost guess that to be true. I never checked any other doctor. I had heard nothing but great things about mine so I went with her right off the top.

Now my SIL is going to a dr in Riverview (i think) and she said he does not charge that fee.

There are a few Dr's in Tampa that are free. However it's just not very convenient for me to go back and forth.

Question about your Dr. - I have heard wonderful things about her as well. How was her bedside manner and her aftercare?

Have you had any issues since banding?

What hospital did you have it performed at? I so wish I had someone local to talk to. I attend orientation tomorrow so I hope I can find a "buddy" of sorts.

I had to pay the $1,000 fee as well...and mine was worded just about the same way yours was

Dawn, After reading all of these posts today, and the recommendations of calling around, I ironically called your Dr as well. They stated it was 1k as well.

So I was curious if the $1k is the norm around St. Petersburg because there are a few Dr's charging it???!! Maybe they figure that since one is charging, they can all charge it?

IS THE $1,000 YOUR CO-PAY?

No - not my co-pay. It's the standard Dr fee for this particular surgeon. I guess to cover seminars and orientations? I have no idea, that is why I was curious if others had to pay a fee or not.

Hi Chill,

Your primary doctor will give the insurance a note if you ask stating you need the surgery for your health.

As far as insurance, you either have it covered or not. You will know when the Dr Office calls in the codes for the procedure. They might accept WW but will still put you on a restricted diet. Not sure how long but again if you gave the Office your insurace information, they will tell you at the oreintation if you are approved. Actually you can call your insurance company and give them the code. The code for Lapband is CPT 43770 Keep me posted and good luck

Thanks for the note! My insurance company tells me the Lap Band is covered if medically necessary. So not sure what medicall necessary really means to an insurance company.

Tomorrow morning is my orientation and I will bring all of my paperwork and insurance info. My Dr's appt is on Nov 2nd so I am crossing my fingers for the green light. I will definitely keep you posted and would love to hear how you are doing.

Nervous for this step but very excited! Thanks for the friend add as well

Have you gotten a breakdown of exactly what that $1000 fee is FOR? And $2-300 for Optifast... I would be ok with that if it was optional, but I wouldn't be to thrilled about being FORCED to go on one specific brand of pre-op diet.

This is the email I received:

The program fee is $1,000.00, which is non-refundable and is a mandatory part of our program (this fee is not covered by your insurance plan). On the initial visit with the Dr., $200.00 of this fee will be due. This can be paid with cash or credit card. The remainder of this fee ($800.00) will be due and payable at your pre-operative appointment in the form of a cashier’s check or money order.

Your regular co-pay for a specialist will be due both at your first visit with the doctor, as well as on your pre-operative visit. Post operatively, 90 days after surgery, we will begin billing out your visits to the insurance company, and your specialist co-pay will be due at each of those visits as well.

There will be an additional out –of –pocket expense pre-operatively for the 2 week supply of Optifast Nutritional supplement. This diet is mandatory before surgery, and the cost will be $230.00. We accept cash and credit cards for this. No checks please.

I am curious if this is the norm and wanted to gauge what others had to pay.

I am meeting with a surgeon and their fees are $1000 plus a $2-300 Optifast diet. Seems steep.

I was thinking of going to another surgeon but he has a nice track record from others I have searched and he is the only surgeon on the West Coast of FL that does only once incicion (in the belly button) so easier healing and less cutting. (Personally after having surgery from an ectopic pregnancy and losing my left ovary, etc and having 4 surgical cuts to heal, this was a PLUS).

Also, his office is close to me so will be easier for follow up care, etc.

So with all of that said, is $1k normal or do most surgeons not charge? TIA