peatie

Yesterday my Dr said Aetna didn't ask for weight history as a requirement, but all their other patients w/Aetna were required to provide a 5 yr history. I ended up gathering all my own medical records (ran around to the various places and got copies for myself) and gave my Dr the copies that indicated weights from 2007 on. I'm sure it's adequate but until I see their big 'approval' stamp i'm cautiously optimistic. :thumbup1:

I have that same page and combed it. This is all i can find: presence of severe obesity that has persisted for at least the last 2 years (24 months) and in the 'background' section, this: Requirement that Obesity be Longstanding (Present for 2 or More Years): Obesity surgery is not indicated for persons with transient increases in weight (Collazo-Clavell, 1999). According to the Guidelines of the American Association of Clinical Endocrinologists and the American College of Endocrinology (1998), “Surgical treatment of obesity may be considered only in carefully selected patients [where] … obesity has been present for at least 5 years.” So...... ???? History, yea or nea? Doug, how many years did your Dr say?

I hear ya! We're having the holidays at our place this year so i'll get to hang out watching everyone feast! But it's only food... not like i don't know what it tastes like.

Where exactly does it state Aetna wants a weight history?? I have my copy of Bariatric Surgery criteria and I don't see ANYTHING which asks for weight history. Can someone shed light on this? I'm only hearing about this requirement on the forums, not in my paperwork. thanks!

Hey! When do you plan to have yours done? I told everyone in my Dr's office I want to be penciled in for the 8th NOW. LOL I think they're taken back by how 'prepared' I am with this.. And it's all this board reading I do!

Hmmm. To be honest, it sounds like a lot of 'fudging', if you know what i mean?? We're pretty similar. I'm 5'1 and my BMI is 36, but I was actually diagnosed w/sleep apnea via a sleep study (and I would have SWORN up and down I DID NOT have SA, so you never know!!!). I am able to fulfill all criteria as required by Aetna, but i'm still nervous they'll deny me. If you don't have any comorbidities or weight history over a 40 BMI consistently, I'm not sure they'll go for it. My advice...have the actual sleep study done. It should be covered by insurance (mine was). You just NEVER know what might be the outcome!! And if you ARE diagnosed w/SA, you definitely qualify with less than a 40 BMI so it's worth a try! Good Luck!!

i think it depends on your plan. My deductible is $650 and then a max of $1500 thereafter..so no more than $2150 total. I have however already met my $650 and already paid several hundred toward the $1500, so (crossing fingers) hopefully when i get the sleeve done this Dec, my out of pocket will be close to $1000. But again, that's MY Aetna plan. It all depends on what your deductible and yearly Max amount is. If you have issues with your out of pocket, there are some finance companies that you could work out a plan with. Good Luck! april

Hmm...i always thot the hernia was in those who got the band to sleeve revision. Crud. Now i gotta do some reading up on that too. :thumbup: Thanks for the heads up..

Welcome! I am sorta new too and just had my first consult last week. It's exciting isn't it?

Hi, I'm planning to be sleeved in December and glad you asked this. I had no idea on the gallstones so you better believe i'm off to do my research now. good luck to you...we're on the same timeline.

Proteins are the building blocks that our body needs to regenerate new cells and help us heal. Without it, our body feeds off our muscles rather than fat and in the long run, you have now lost muscle which is what BURNS the fat. That's why, it's almost more important to do weight lifting/training after having the surgery rather than just walking.. your body will naturally lose muscle thru the weight loss, so building it/keeping what you have is imperative to long term weight loss success. and it all can't happen without getting in your daily Protein. crazy stuff.

I have a BMI that barely makes 35 and had to 'pad' myself at my initial consult to be sure i weighed enough. I'm short (5'1) so any amount of weight looks worse on someone like me. I'm tired of being on the yo-yo train as well. My Dr said as long as you eat your recommended grams of Protein, your hair loss should be minimal. But i guess like anything, it does depend on each individual. Good luck on your journey!

If you have a Costco nearby, the Premiere chocolate RTD protein drink has 30g protein in 11oz. It has only 5g carbs and 1g sugar.

I'm a lightweight now... I drink one beer and I have googly eyes. lol :confused1:

OMG! Are you my sister in disguise? LMAO!!! This is my fave too!!! And I would always order Jack shots for my friends and they'd HATE me b/c it would knock them on their butts for the evening! :confused1:

Thanks! I didn't want to give up happy hour w/the girls for good. lol I can handle one drink very slowly... well, maybe. HAHA

I'm not a big drinker (maybe one beer/mo)...after VSG, are you able to drink any type of alcohol again? And i mean like 6mos down the road kind of deal? Thanks!

I hit my deductible this year too which is why i want to have my by year's end. ugh... hate the waiting game. Good luck to you!

I'm sorry to hear they dropped the ball in picking you up. I'd feel exactly the same way too! It sounds like you're moving along as expected tho and I wish you a quick healing to make up for a lousy start. :thumbup1:

OMG! I used to LOVE looking at all the plush organs..and was even considering getting my dad the intestine one when he had to get a colostomy! LOL Plush Organs : I Heart Guts, Love Your Insides

Thanks everyone! I sat my husband down and spoke w/him last night. I was so scared and i think it made him nervous because he thought something was seriously WRONG with me. It went way better than expected. He is not too concerned about the surgery per se as much as I thought he would be. He almost looked as though he wanted to cry, and i think it was out of sadness that i was feeling I had to 'go this route.' He understood everything and said he's more than willing to go to the dr appts, etc.. whatever i needed. He was so supportive and made me feel more loved than ever... esp since i have put up a wall since gaining all this weight. He said he wants me to be 'me again' which is what I SOOO want. I always felt that after i gained all this weight (I was 115 on our wedding day) that he got the short end of the stick. Thanks to everyone for your support here! I feel so much better being able to open up here and with my husband now about this that I can 'move forward' with confidence! :thumbup:

I can relate to your interest. I want them to tape my surgery so i can watch it when i'm healed. If they video the stomach after it's removed, i'd be content with seeing it that way. It's customary in certain cultures to keep some body parts, and when i had my kids, my OB asked if I needed to take home the placenta as she would 'mysteriously' make it disappear if that was the case (and no i didn't need it, but did inspect it myself first). I'm a student nurse who wants to work in the OR, so naturally I am fascinated by this stuff too. lol

Hi mini-me! Lightweight. hehe. only in a weight loss forum, huh? LOL I'm in Vancouver so have been looking both here and in Portland. I am leaning toward Legacy in Portland (Dr Halpin). Yes, i'm looking for my 2nd life. I'm tired of waiting around for the 'when I lose weight...' stories. I'm not getting any younger as they say.. Crossing fingers I can move rather quickly in this Quest.. I'm on a time-frame w/school and don't want to wait too long for it to be done. i hate waiting! haha

LOL! I know i'll need to put some tape on his mouth so i can explain everything out first before he starts spouting off stuff. haha

Aetna. So i'm gearing up for hoop jumping. lol