bigbeauty78

My insurance does not cover sleep apnea unless you have more than 5 episodes per hour, and will not consider covering the surgery unless a cpap has been prescribed. My sleep dr. said that 5 and below is considered normal. It does not matter which stage of sleep the apnea occurs in. Good luck

I have the band and I have had it 5 years ... I HATE it! I still feel hungry and I don't get a full feeling I get a stuck feeling!
I have had port replaced and I had to have band replaced too! I never lost more than 25-30 pounds. And after reading band to sleeve revisions on this site and all. Their problems I am having my band removed and checking into the sleeve myself. If had to do again I would have done sleeve to begin with. Plus consider the cost long term ... The band requires office visiting and fills every 4-6 WEEKS until goal is met IF it gets met and that cool take over a year. Very expensive! It adds up!
Sleeve after your post op you will follow up every 6 months I believe.
Get another opinion ... It may be you are too small for surgery

Honestly, I hate to say it....most people are just ignorant and uneducated about bariatric surgery in general. And it is easier for them to eye roll and make judgments than it is for them to educate themselves.
I say good for you! I am glad you are taking this big step to regain your life. I did it 8 weeks ago and it is the BEST decision I have ever made for myself. I have lost 32 pounds in 8 weeks and feel AWESOME! No complications, no nauseau, very little discomfort pain when healing. I am really doing super and you will too!
If you and your partner have made the decision for you to do this for your life then who cares what everyone else thinks and I wouldn't bother telling people if they are going to be negative about it. I hate that it has been this way for you, but I assure you once the weight sheds off they will all be extremely curious to what your secret is!
Good Luck to you and keep your chin held high....I leave you with these two quotes from Dr. Seuss:
"You're on your own and you know what you know - you are the one who will decide where to go!"
"Be who you are and say what you feel because those who mind don't matter and those who matter don't mind!"
That Dr. Seuss knows what he's talking about it....

Sorry to break it to you, but my clinic said if there's an exclusion, then it's not going to happen through your insurance. Good luck

I just had to have a statement from my Dr. that I had made previous attempts at weight loss and they failed. She typed up a statement showing dates I had come in to see her and that I had tried diet pills, phentermine, and was unsuccessful. I have BC/BS TX. It was a simple, brief statement.

As far as I have been informed if you are diagnosed with sleep apnea it IS a co morbidity I don't believe there has to be a certain type or level as long as you have been diagnosed...I could be incorrect but that is the impression I am under by my insurance and dr.

I don't have Aetna, I have Highmark BC/BS. Mine was submitted on Monday of this week, and I just got my approval today - Thursday.
Good luck!!! My fingers are crossed for you!

It seems weird to me that you are the paying customer, but have to kiss up to these people and try to convince them to allow you to make a personal medical decision. If you and your physician agree you need it, then I would have a real problem with someone trying to play games with me. I had a 40 minute session and that was it. If you aren't a danger to yourself or others, then how can they force you into therapy? Being a little nutty or dysfunctional is my right as an American:). If it were me, I am way too assertive to just simper around and try to talk them into it. I would go right to my primary care doctor (who knows me, was in agreement with me pursuing WLS, and manages my total health). I would tell him what was going on, say that I think this therapist is full of crap, and get him to call her himself. I can't imagine most therapists are going to tell a physician that has an ongoing relationship with you that, after one meeting, they are going to delay a medically necessary procedure. My PCP would put a stop to it. Unless of course I did have an eating disorder or that therapist could convince him I was a danger to myself. You need some back up here. Talk to your doctor that knows you and get their help. The surgeon is great, but he just does his thing. He can't really help, because, for all he knows, you really are a nut job who will binge and kill yourself 3 weeks later.
Good luck and don't be afraid to stand up for yourself. She's not God and she's not your mother.

That's great your getting the help to get things moving as they should be and unhindered. Let us know when you get your surgery date.

Thanks.. I'll try doing that today!!

Im doing the happy dance! My ARNP is supporting me 100% and will write a medical necessary letter. My sleep AP test showed rem sleep AP. He didn't issue me a cpap machine. He did imply on his letter I lose weight and sleep on my side. Wondering if this is going to affect my co-morbid with Bmi of 36.

The psychologist that my surgeon uses doesn't accept my insurance (annoying). So I called my insurance company and they found me someone who does Bariatric surgery evaluations. He was basically evaluating if I understood what I was getting into, if I could manage the post op dietary requirements, and if I was doing this for myself and not to please someone else.
He didn't insist on more counseling, but I am leaving the option open. So far I am doing okay, but if I feel the need to talk to someone, I will go back.
Good luck on your journey. It's going to be amazing!

If anyone feels your pain it is I. Something similar happened to me. I tried the seek counseling as a condition for surgery approval. Nope didn't work. When I went to see the psychologist I was referred to she told me that getting therapy is not something I can check off my list so I can get surgery. Guess she had me pegged, lol. Lucky for me she won't be my therapist. I'm being handed off to someone else that hasn't got her license yet. It could be a good thing. After a few sessions with her where I let her know each time how much talking is helping me, I'll ask if she can speak with the psychiatrist that did my psych evaluation. Let him know how far I've come and I'm doing well. Being that I'm just a name he won't remember and the therapist I worked with for wks knows me better he should be more willing to go ahead and approve me. If he doesn't I will call his supervisor n demand a reevaluation from a psychologist/psychiatrist who doesn't have a bias against WLS. I guess some psychologists/doctors/counselors are determined patients get counseling for any perceived issue. It's ridiculous and shouldn't prevent or delay surgery because of it. A life without problems doesn't exist. Good luck with your therapy.

LifetimeLoser is right. You really can't hide anything in a physical evaluation. I the only reason I could see the need for a PT eval is to get an exercise program to prepare for surgery and the post op exercises. I doubt there is anything that would hinder your pre-op process. Anything they find should be helpful to you.

i've never heard of that. Although, just like a psych eval I would just be honest. It may be a set back now, but will help you be successful post op. As far as a physical evaluation, I don't think there is much you can hide...not like you can hide your thoughts. :0)

Mine said basically the same. Suffer from depression and anxiety, wanted me to see herself or someone else. Only difference is that I was already medicated. Had my sleeve 3 1/2 mos ago. Mainly in the psy exam (unless you get a whacko) they are looking for people with extreme mental illness who may self harm with the procedure.

To be honest that doesnt sound so great, but if it makes you feel better my therapist was as clear as mud. We didnt hit it off, she was super thin and weird, and I found her irritating. She repeatedly asked me why I ate and I told her it was because I really enjoyed food and it was one of the only I things I do for me. Finally I told her I didnt really want to get into whatever deep problem she thought she saw inside of me, I just wanted the surgery because I could lose weight but I always went back to poor eating habits and regained it so tell me the magic words to get the crap over with. After two appointments (and copays) she was suddenly confident that I was sufficiently cured but told me I could only get her clearance if I didnt gain anymore weight. I managed not to, and so never had to see her again. Is there a way you can assert a personality conflict and start over with a new one?

You are not doomed. So many people need a bit of help via medication and counseling. I started psych counseling with my pre-surgical eval. I never quit going. I go twice a month and believe that is why I am so successful. Just because you need a little "mental" help - should not disqualify you for surgery. I would recommend getting a second eval done if you are not comfortable with what that person gave you. Not all the "professionals" get it right every time. Good luck.

Thank you for your concerns and replies. I've taken it to heart. I'm still searching for another DR.

Thank you for your concerns and replies. I've taken it to heart. I'm still searching for another DR.

Thank you for your concerns and replies. I've taken it to heart. I'm still searching for another DR.

Thank you for your concerns and replies. I've taken it to heart. I'm still searching for another DR.

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I had a consult with a surgeon and he's trying to talk me into the band. Given my bmi is only 36, He thinks I will loose a great amount of weight and become malnourished. I believe there are other reason for his push on the band. Like follow ups and the fills, means more . I over heard him through the wall, to the room next to mine, trying to push the band on another patient. Should I give the band a try first then have revision later if it fails?? So stressed over this!
I have had the band for five years and for about the first 2 1/2 it worked great. I am finishing my final process to have a revision to the sleeve. Because my complications with the band are becoming so unbearable! I am actually on an all starch diet due to gastritis which I have NEVER had in my life. Now with these last few weeks constant diarrhea and dry heaves are horrible and make u feel dizzy!
Honestly I would choose the sleeve first if I knew what I know now. Aftercare is set up for any and everything required. You don't even come in till you feel you need it.
Why put yourself through two surgeries the sleeve was the newest option When I got my band five years ago
Chat With me privately if you want to keep talking about it

Please go to another doctor! There has to be someone you can go too!!