Cocoabean

I saw on a TV show about the band that it can be a good choice for someone who is at risk for cancer because you "can" un-fill it if you need more nutrition. So, it did not sound like it has to be unfilled, but can be if you need more nutrition than your band currently allows.

Denise

Hi Denise -

I was wondering if it was possible that you could send me a copy of the information that you submitted regarding the National Institute of Health. I haven't been denied or accepted yet. I am still going back and forth with my PC to get the "proper" referral letter :confused2:. But I would like to be prepared in case they do hand down a denial.

I would greatly appreciate it.

Thanks so much in advance.

Becky

Hi Becky,

The lack of a 6 month program is the only reason my insurance company quoted for my denial.

Here is the link to the NIH Opinion:

The National Institutes of Health (NIH) Consensus Development Program: Gastrointestinal Surgery for Severe Obesity

If you can see a copy of Weight Loss Surgery for Dummies, it has several ideas for an appeals letter. This is what I used as the basis for my appeal. I used my own info of course, but it was effective. I pretty much plagerized the part about the NIH in their example letter.

I said something along the lines that the NIH 1991 consensus on obesity surgery does not mention a 6 months physician supervised diet program as a requirement for obesity surgery. I went on to cover my co-morbidities and made copies of diary entries from previous diet attempts and also previous Weight Watchers attendance information.

I stated that will all of my previous attempts, one more is unlikely to produce sustainable results.

Good luck! I hope you do not need to file an appeal, but it is good to be thinking about what you will write if needed.

I sent it to my insurance company and my primary care doctor.

Denise

It is such a personal decision whether or not to tell, and who to tell or not..

I have decided to be very open. So far, I haven't encountered any negativity. Unless you consider the reaction of normal weight people not understanding why I made the decision I did because I "am not that big." I explain that it has been a life-long battle and I was pre-diabetic, had high-blood pressure, and a family history of heart disease. That usually gets a nod of semi-understanding.

That is my decision...

I have someone at work who had gastric bypass. She is a huge support to me. Although the surgeries are very different, she is a great cheerleader.

Denise

Thanks Gwen, the doc said that "many" of his patients lose weight during the post-op phase.

Today, at long last, I am down 2 lbs. From when I began the pre-op diet on 2-1-08, that is 10 lbs. total at 4 lbs. since surgery two weeks ago. I am pleased with that! Apparently it took my body a while to get the flick after surgery. :w00t:

Eventhough I have no fill, I am still eating less, thus I feel I "should" lose weight. But my brain knows that they body doesn't always do what we think it should.

But, for today I am very pleased!

Now, if I can just get rid of this back-ache....

Denise

Hi Wendy,

Glad you are losing so well now!

I had what I call an "explosive decompression" of my bowels yesterday and today. I was on the pot for a while.

I am pretty sure I am down now, but tomorrow is my "weigh-in and measure" day at home. I am trying not to weigh myself every day...well, OK, Friday was my first day not getting on the scale first thing in the morning.

I'll post my findings tomorrow.

Denise

I drink the K20 Water, it is good, I think. I like it much better than the propel Vitamin Water. I know it is a different type of drink, but it goes down well and increases the Protein count.

To those with gas issues, it does get better, I am 2 weeks post-op today...much better!

I, too, get the uneasy have-to-burp feeling. Moving around helps me with this and will sometimes work up a nice burp.

I have just started having back pain just below my bra line. Heating pad helps. But I am wondering, is it because of the surgery scrambling my insides or my horrible posture due to discomfort? I try to stand and sit up straight....

Now, I just wish I could get to sleep (not surgery related!)

Denise

My experience with Blue Shield is very similar to Sophie's. I was denied consultation due to lack of 6 month program. Submitted Weight Watchers booklet and a few other diary entries of other attempts I had and got approval without the 6 month requirement. After that, did the testing and psych thing. Submitted pre-auth mid December, approved mid January, banded mid February.

Denise

My denial for consult was due to the fact that I had not done a 6 month physician supervised diet. I appealed with weight watchers records, diary entries from other attempts I had done and also that the National Institutes of Health does not state that a 6 month plan is necessary for a good outcome from WLS.

I won the appeal and did not do a 6 month plan. Although it took nearly that long to get all the paperwork in order!

Denise

I started with a BMI of 38, had surgery with BMI of 36. When I went on the pre-op diet, I told the doc if I lose too much weight, I won't qualify any longer. He grinned and said we'd put rocks in my pockets for the weigh in!

I have had several people tell me I am not heavy enough for this surgery. I say when I started the process I was 220 with high blood pressure, pre-diabetes, knee and foot pain. That usually shuts them up or I hear, "wow, you hide it well." My weight is all over my body, so maybe I do look "thinner" than I am, but when I see me in pictures with other people I am almost always the largest one in the picture.

But then, what is someone who is not your best friend going to say..."Oh good for you, you are soooo big!" or "It's about time!" ?? :rolleyes2:

I have been fortunate, those closest to me know my struggles and have been nothing but supportive.

I have chosen to be very open about the procedure I had done. Thus, I guess I can expect some unexpected responses.

I was initially denied for my consultation with the surgeon, I appealed it and won. After that, it was just checking the boxes: psych eval, check up, blood work, gall bladder ultrasound, yada yada (psych eval letter took 2 months to get out of the office).

The surgeon's office submitted my pre-authorization in the middle of December and in mid-January I got approval. The insurance company can take 30 days to respond to the request.

My PCP said most insurance he deals with will deny first requests for consult but will usually approve upon appeal.

I think I went to my surgeon's information seminar in June 2007, I had my surgery Feb. 15, 2008.

It is funny though, I thought the surgery would be the end of my "quest" and that I'd kick back after that and move on...but now--two weeks post-op, I cannot wait for my fills to speed up the process! I realize it is a life-long program and that this time, I will succeed at becoming healthy!

Denise

I was banded on 2/25 and feel pretty good today. Have been on clear liquids for 2 days and that went well. Haven't had any hunger yet. Today I start on full liquids and am a little scared. I feel like I'm alone in this, my Doc's info is real general, and the nutritionst who came to see me in the hospital was all of 10 years old(thats what she looked like!) and didn't know much. She said I would never again be able to eat a salad, yet I hear some of you talk about salads...is she wrong and just uneducated? The lack of help is whats making me scared. You guys out there will have to be my help.

Hi Sue,

I was banded on 2/15. I have received conflicting information from the Hospital-who runs its own bariatric program, my surgeon, and his nurse practitioner.

My docs written info says 2 weeks of clear liquids then 2-4 weeks of full liquids.

I chose to mostly disregard the hospital's program, as my doctor borrows their facilities. His NP is much more conservative than my surgeon is. I was banded on a Friday (two weeks ago tomorrow), my doc said clear liquids until Monday. Monday morning I had oatmeal (yummy!). His nurse called later that morning, it sounded like she wanted to keep me on clear liquids until I told her I had switched already.

When I saw the doc at 1 week, the nurse still wanted me on runny stuff. I told the doc I had eaten some well cooked peas and spinach and that they went down well and stayed down.

The doc then cleared me to eat real food that is easy to chew. No corn, rice, or doughy breads.

So, I have somewhere around 5 sets of instructions, all different. I keep asking my husband if I heard the doc right that I can eat "real" foods. I am eating soft stuff like oatmeal, cream of wheat, non-strained cream Soups, mashed potatoes, cooked veggies, and small portions of easy to eat meats like fish filets. I also include a Protein shake to bump up the Protein levels.

So far, I've had no nausea and everything had gone down well. I also haven't lost any weight since coming off clear liquids :thumbup: But, I caught a cold right after surgery and haven't been able to walk much yet.

Take care,

Denise

Thanks BJR and Andrea--hanging in is about all we can do, eh?

My cough is nearly gone, yippee!!

I am looking forward to starting on fills to get the hunger under control. I have been very hungry today, I guess I am healing from the surgery. But I still have a month before my 1st fill.

I know it is worth it in the long run, and I need to focus on that, as you said Andrea. This is a long-term solution, after all!

Denise

I have a slow thyorid. Will that make it hard to loss even with the band?

I'm on meds for it.

Jill, if you are on meds, then your thyroid level should be normal, if it isn't, then you need the meds adjusted.

I had my thyroid radiated due to an overactive non-cancerous tumor and am now on replacement meds. I have been everything from high to low as my disease and treatment progressed. Through it all I could easily gain weight and had to struggle to lose. Now I get checked yearly and my levels are normal.

If you think your levels are low, ask your doc to check them. There is no need to go around with low thyroid levels for long periods.

Denise

Hey Carol,

I was banded on Feb 15 as well!!

Denise

Thanks Andrea, I know all you said to be true, but it is nice to hear it from someone else!

After having gone through this surgery, I think I should be down 50 lbs by now! (Well, my brain knows that to not be ture, but you know what I mean!).

And I know I need to get off the scale! I did finally get out for a walk at the mall today--and got myself a dress one size smaller than I am now. It felt good after fighting the respiratory infection post-op to get out!

Denise

Hi all,

I am one week post-op. Surgery went very well. I am eating soft foods. Here's the thing..I have not lost any weight since being released from the hospital the evening of my procedure, 2-15-2008.

While in the hospital, I caught an upper respiratory infection and got a yeast infection from the IV antibiotics. Done with yeast medicine now and still have just a bit of a cough left.

Anyone else not lose anything immediately post-op?

I am hoping it is the infection causing imbalances in my Fluid retention, I am certainly eating less than I was pre-op, except for the two week supervised fast right before surgery.

HELP! Need some advice/cheering-up.

Denise

Thanks brandda and candle!

Candle: enjoy your trip and vacation! I am going on a cruise in 2 weeks. Have been told I cannot gain weight before surgery...and I go on a cruise...how silly am I?

I scheduled an appt with the nutritionist a week after, hopefully that will keep me sane on the trip.

Denise

Hi Everyone, Thank you for the responses. I will, of course, ask my surgeon. Just looking for a few personal experiences.

I appreciate it!!

Denise

Hi all,

I am pre-op still working on requirments before a surgery date can be set.

My question is, barring any complications, how long post-op before you can do something like visit an amusement park (no wild rides)? Hubby wants to plan a Disneyland trip, so we'll do Space Mountain and Matterhorn, but that is about as wild as it gets.

Is 6 or 8 weeks enough?

Thanks Everyone!

Denise

Thanks Claramae--I got my gallbladder ultrasound scheduled today. So, not much left to do but go to appointments and fight for the insurance coverage!!

And read, read, read here to get a good idea of what to expect!!

Denise

Thanks to all for the nice welcome, I'll be updating as things go!!

Denise :clap2:

Hi all,

Just want to say hello! I am in the San Diego area and applying for LapBand surgery.

I am 43 years old, married, female, BMI 36.

I am sure I'll have tons of ???.

So far I have had my consultation, EKG, Female exams, and bloodwork. I have my psych consult scheduled, getting ultrasound scheduled. Then it is getting approval for surgery.

I was able to appeal the 6 month supervised diet required by my HMO medical group. Went directly to my insurance carrier and won the appeal.

Happy to be here and look forward to getting to know you!!

Denise :eek: