seanmama

Thanks ladies! Makes me feel better. I have my 2 week appt with Dr Cribins today. So we shall see. By the way- does anyone drink coffee? Or is this a total no-no?

Okay, I am almost 2 weeks post surgical and have started on mushies. I am getting REALLY hungry though. Like most new bandees I have little restriction at this point, but please give me reasurance that this will get better once I have a fill. I also notice that I am hungrier/can consume more in the evening. This also seems quite common for many bandees, right? Okay- dare I say it- there does not seem to be a huge difference for me.:phanvan :cry

Hello Bright, I just reread your initial letter where you were saying that you felt like the only banded person in the world! Well, just thought I would share what drove me over the edge and prompted me to seriously look at my life and weight.... Last year my hubby and I went to Europe- England, Germany, Austria, Italy for a very long awaited vacation. It was nice, but the most stressful thing for me was being excruciatingly aware of my size- nobody came near me sizewise! I felt (and per my husband truly was) like the hugest person for miles around. And then to add insult, my uncle in England told me I was way too fat and needed to do something about it!!! Was it my imagination or are there just not all that many obese persons around Europe? No wonder you feel so alone! I am rather lucky as I am a nurse and the lap band is done here at my hospital commonly. So I get to see lots of bandees and a couple of my friends have one also. By the way, you are really nice looking- your adventures in trying to get your pic posted cracked me up! I am worthless as far as anything but the basics goes! So I doubt I will ever get my pic posted!

Thanks ladies! I actually bought that whey Protein yesterday but have not tried it yet. Are you just putting a glop of pb in when you blend it? Sue, thanks for the explanation on the shoulder pain- thank heavens it goes away.

I transitioned to full liqiuds yesterday and tolerated it just fine. I was having a sharp pain in my left shoulder area and thought it was gas, well later I was reading the book "Living a lighter Lifestyle" and found a paragraph stating that one will experience this left shoulder pain if one stretches the pouch too much too soon after surgery. Has anyone else had this? Also I could really use some advice on Protein Shakes. The dietician told me I needed 60g of Protein a day- well I would love to find one that is high in protein and low in volume. I feel amazingly fine today! I think it made a difference drinking something a little more nutritious than gatorade and bouillion!

Hi guys, Everything went perfectly. I am home and now a proud bandee! I am too slow a typer to give a blow by blow account and it would be boring anyway. The only thing that I do want to mention is how important walking and doing the breathing exercises were for me. I swear my lungs felt like they had been squinched when I woke up. And walking and deep breathing made me feel way better. I slept most of the day of surgery and then got up yesterday, had a shower walked laps around the floor- it was kinda fun. Also important was to remember to take small sips frequently of whatever I was drinking. Interesting is that I have yet to feel hungry. The sorest part is the site where dr placed my port. My kiddos were very interested in mom's tummy with 5 little square tapes on it. Now I need to go to GNC to buy Protein shakes.

Okay...the countdown is happening! I am having my band placed at 0930am Teusday. I must confess I am having big time last supper syndrome!

Hello all, Yesterday I did my preop stuff- Okay, I got thru the barium swallow for the upper GI! Gag!!! What a gross bussiness. Actually it wasn't too bad except for not being allowed to burp! My anatomy is fine other than a rather scary looking hiatal hernia!?! Today is my preop appt with the surgeon. Hope it goes well- I have lost a bit of weight thanks to stress and prozac! Now the thing that is bothering me... dreams, really weird dreams. I recon I must be a little more nervous about surgery than I had thought. I have also developed two huge fever blisters on my lip- always a sign of intense stress for me! Boy! Do I need to relax or what!

It took me about 4 1/2 months all told- the initial request from the dr was denied, then I wrote an appeal which was approved. The whole thing has taken since July 31st (first appt.with dr )- my surgery is scheduled for Dec 9th. UHC did rather expect me to jump thru hoops. Also I kept being given the wrong info regarding my appeal- each time I called I was told the appeal was denied- then finally recd a letter of approval! Keep after them. Be sure to look at your benefits handbook if you file an appeal- the address should be in the handbook. Make sure you mail it with a tracking receipt- that way you have proof of exactly when they recd your letter.

There are good examples on bandstersinurance group on yahoo.com. Is there any way that you could change ins next year? Does your employer have other choices? (just a thought- sorry if that sounded defeatist!!) Ther are also lawers who will appeal for you.

Another thing- go and get a copy of the letter/s that the surgeon's office wrote to UHC. Note what details were and were not in the letters. Carefully read the denial letters from UHC. Try to determine exactly why you are being denied. Then address this in your appeal. It is better to take ownership here! CONVINCE them that you MUST have this procedure. The lady at the drs office is just doing her job- she does not have the conviction that you have. Good luck.

Hello everyone, A quick update. I am scheduled for my band on 12/9! So far I have done the sleep study- what a weird experience!! In the morning I asked the tec if I had obliged with some good snores-LOL- and she said yes, and I had even stopped breathing a few times! What a pleasure to have someone appreciate my nightly noises! I now have the psych eval on 11/25 ahead of me. UHC kindly approved 2 follow up counciling sessions, mmmm, will I need those? My preop stuff is on 12/2 , then, the presurg appt with my Dr is on 12/3. Apparently he will provide me with a guide book- has anyone else had this? I am also trying to practice chewing my food as long as possible- only problem is I find myself kinda swallowing parts of the "bite" during chewing. Does that make sense?

Okay, my surgery date is December 9th!!!! I have to have a sleep study first- my dr insists- and a psych eval. Luckily they have set up a date before these two things are completed. Probably because we are in a time crunch. I am still completely taken aback. I was so sure that I was going to be denied that I have actually lost 12lb since my first visit to the surgeon at the end of July! Thanks for everyone's kind words and support when I was so despondent AND now for being so excited for me! Seanmama PS I know this may sound silly- but can any of you bandsters tell me if you can feel your band? Is there any sensation at all? I have to get back on track with reading up about it as I had kinda turned my focus away as I was convinced I would never be approved.

Hello All, I have been approved by UHC- they approved based on my appeal! What a scene! I was told by 2 customer service people that my appeal was denied then was told by a third person that the decision had not yet been made. Then yesterday I received the letter in the mail saying it is covered! What a muddle! Now for the frantic dash to get the band before the end of this year- due to changes in my insurance coverage next year, I need to get it done soon. I feel kinda scared actually. Seanmama

Which insurance did you have? And what type of info were they asking for? I have found the people answering the info line at the insurance company(UHC) unhelpful, unfriendly and ignorant. I asked to speak to the nurse reviewer on my case and was told that it was not within my rights to speak to her! Best of luck to you, I hope you don't have to go thru what I am experiencing.

Thanks for the kind words. As soon as I get the letter in the mail I will let you know their reason. Maybe someone will have advice or opinion. Marsha, my initial request was denied because I am not within the defintion of morbidly obese and my comorbidities apparently do not qualify me.( BMI 38- arthritis, GERD, brderline high blood pressure, high triglicerides) Whatever. I am very despondent. Seanmama.

Hi all, After being very patient I just found out that United Healthcare denied me again. I had filed a comprehensive appeal, but they still are not wanting to preapprove. I am curious to see what the letter is going to say. I am going to file a second appeal and request a specialist review- the surgeon suggested this. I am confused as I know that many bandsters have had success with appeals, and I thought I would too. This is most upsetting. Seanmama

Sue, Your comments are well taken and yes it is rather eye opening to view it like this. I am somewhat focused on preventing the regain of wt as, just like so many others I am unable for whatever reason to keep wt off once it is "lost". I believe that with the assistance of the band it will be possible. If I am wrong, please, tell me, anyone.....

Thankyou guys- I am encouraged. I have found some excellent examples of appeal letters on the web and will adjust and edit one to fit me:D . the reason I chose the doc I have is because he practises at my hospital and I know him well. I trust him explicitly, it is just that I have found his staff to be unhelpful. They have told me that because of the new HIPPA regulations they can't help with the appeal- not even suggestions. Oh well, I will give it my best shot- on my own. On a lighter note- remember I am the postie who'''s husand blabbed to my father in law about my intent to have surgery? Well of course he had to be kept updated, so yesterday DH apparently told him that since I was denied, i won't (yeah, right) be having the wls. SOOOO, in his wisdom he asked Jeff to share with me his life long WEIGHT LOSS SECRET.....SLOW DOWN WHEN YOU CHEW!!! don't you love it!:banana

Thanks to all for taking the time to reply to me. I feel like i need to respond- esp to Sue. Yes, I am fully aware that wls is not a magic bullet and that it still takes PLENTY of effort and dedication. However, truth be told, I would be perfectly happy to lose 50-80lb. AND KEEP IT OFF!!!!.......with the HELP of the band. Over the course of the last 20 years I have lost and regained probably 10 times that amount. Believe me, I may have "only around 100lb" to lose, but that is as much of a mountain to me as it is for say someone who has 150, or 200lb to lose. I can EASILY get to that point (I am not even presently at my highest weight)- in fact it has taken a huge effort NOT to gain way more than I alredy have. I plan to gather up my med records and send proof of diagnosis with my appeal. And I plan on having a sleep study done for the possible sleep apnea. Your suggestion to get their definition for "significant comorbidities" is excellent. As far as the legal option- I may go there if my first appeal is denied- hopefully it won't be.

Thankyou Larry and Alexandra, According to my denial letter, " the enrollee does not meet the definition of morbid obesity, lacking significant comorbidities". I have diagnosed arthritis and GERD, painful joints, snore at night to the point that my husband has slept in our study since my third pregnancy 5 years ago(!!!!) and am hovering at the uppermost limit of normal BP. My sugar is normal- thank the lord- at least for now! The list goes on and on. Alexandra, I have to think maybe the dr's letter was not very persuasive. Do you think I should try another Dr here in the Dallas area? I don't know of any others that do lap banding. Or should I try to convince my primary care MD? As for my BMI, it is 38. I am 5'4 (that is about as short as I can hunch up ) and weigh 222lb give or take 5lb depending on the time of month.

Thank goodness I looked on this page! You guys are so helpful. Annette I am going to Yahoo right now! I too have been denied - by United health care. Seanmama

Hello everyone, I have waited for a couple of days to post as I have been overwhelmed with hopelessness and anger. I recd my denial letter from United Healthcare in the mail on Thursday evening. Of course this came as a shock as I was completely pursuaded that uhc would pay- I am a nurse and we do lots of bariatric surgery at my hospital- frequently pts that are around my weight with the same insurance. So of course, that, combined with most everyone conveying the attitude of " oh you have uhc, no problem, lucky you"- had me in a fools paradise. I never doubted for a second that it would be covered. The reason is that my plan only covers "wls for the morbidly obese" and although I am severely obese, with 100lb + to lose and at least 3 comorbidities, they are sticking to the rules. Can some one please help? I know I am not the only one who has been here. I feel so hopeless and frustrated. I have already tried to contact all the drs I have seen in the past 10 years or so to get my medical records, so that I can offer proof of comorbidity. Unfortunately I have only done 2 medically supervised wt loss attempts and don't even know if one of those companies (LINDORA wt Loss clinic, Glendale/Pasadena, Ca ???) still exists. And as for pursuading my husband to go for the Mexico option.....That was met with contempt and a flat NO! His advice was- go on the exercise bike every day and you will lose 2 lb a month. can y'all imagine how that made me feel? That would only take me 50 months right, lets see, thats about 4 years. Boy I can see my resolve lasting that long. LOL. Thanks for allowing me to vent! :think :cry

Gosh! Thanks to y'all for replying to my thread. It makes me feel much better to know that we all can help each other. Freebutterfly- your situation sounds so stressfull- sorry! I will shoot a little prayer heavenward for you. What an awful bunch of people. You show em how gorgeous you are going to get! My husband asked me how much this surgery would cost if we paid cash- I estimated around $18 000- he was STUNNED! I added that in Mexico I could have it done for around $7000 and he said No, not there. We will see how adamant he is if my insurance denies me- then I will show him this website and all the great info. I bet he will change his mind!

Thankyou Alexandra! I appreciate your insight. My DH and I did have a long chat later in the evening and I explained that his insensitivity really hurt me. He explained that he was just seeking reassurance from his dad that all would be well and that nothing terrible will happen to me. I think I had thought that he was telling his dad that I was going to have wls- and now at last I would become "normal". You see, although we seldome see my FIL, he sees us on videos we send and I have gained ALOT of wt since our wedding 13 yrs ago. I know that this is an intense embarrassment for my DH, so it makes me over sensitive, almost irrational. Anyhow, thanks again for your kind words.