k_podski

Hi all, I cannot find any info on this site of anyone dealing with Harvard Pilgrim for this surgery, more specifically a band to sleeve revision.. My surgeon has approved me for this revision and said he is willing to help me fight to get it. I am no stranger to this site as I followed it over from lapbandtalk.com when I saw how many people were getting revisions and having beter success. The hunger with the band is killing me, and the constant fill/ unfill process is getting old. I am over the extremes of starving or sliming.. And always feeling hungry.. My doc feels as though the sleeve would be a better choice to address the hunger issues. I have lost 50lbs with the band since 3/19/08 (246lbs-195) and have maintained, which is considered average- but the surgeon thinks I could stand to lose another 50-60lbs.. At 5' 3.5", my personal goal is another 50, anything extra would be a bonus! Supposedly Harvard Pilgrim is one of the top insurance carriers now adays, and have always been great to deal with, and quick with descisions. The doc wants me back in 2 months to see what progress he's made with HP and for me to see the nutritionist every 2 weeks until then and get a print out from my gym of my visit dates to show a paper trail to help my case. He feels as though the sleeve will be the new band and that the band is already phasing out due to complications and lack of success. He also feels that now there is 5 year research out on the sleeve that more insurance company's will cover the surgery. As of now HarvardPilgrim.com states that it does not cover the sleeve, however when I called to inquire if I could get around it they suggested my surgeon call with more info and codes.. Any ideas or experiences with Harvard Pilgrim? Thanks in advance for any input, Kerri:)

This what is covered as of 10/2008: • Bariatric surgeries, including gastric stapling, vertical banded gastroplasty, gastric lap banding for obesity, biliopancreatic diversion with duodenal switch, and gastric bypass surgeries with required prior authorization from Harvard Pilgrim.

Yes Elisabeth, that was really helpful! I guess I hadn't given my BMI much thought.. It is now 35. I am 197lbs and 5'3". Could this compromise the possibility of a revision?? I would like to lose another 60lbs or so. As for my surgeon and nutritionist, yah.. You got the idea lol I should have known better at the beginning when my surgeon asked me which surgery he did on me and whenhe had done it, when I was there for my final consult pre op. Then for my second fill he asked me if I had a fill yet and how much I had in my band. Yikes! What was I thinking:( Thanks again for your reply, I really appreciate it!! ~Kerri

I am having SOME issues that I've been dealing with mostly all along. My GERD is back as I suspected it would be. When my doc was in there he said my hiatal hernia "wasn't that bad" so he did not fix it. I was without reflux for almost a year, then in January it started up again. My reflux now makes me nauseous so I am on meds for both now. The nausea med makes me want to sleep all day. I have also had a sore port since day one. I had a revision in Nov last year, and it continues to bother. There is a dull ache all the time, although when I sit, stand, or bend, forget it, it feels like it's getting ripped out. When I went to my doc for this he asked "does it hurt when you touch it?" I said yes, to which he replied "then don't touch it and you will be fine..." Thanks. 'Preciate that. I also am hungry ALLLLLL the time. I've been working with my nutritionist every two weeks for god knows how long now. I'm sick of being hungry. I've been hungry all my life. That's why I'm fat. No it's not head hunger, no it's not poor food choices, no I'm not an emotional eater.. I'm effing hungry, can't you just hear me out??? I'm sick of cramming in 75 grams of Protein a day to prove to them it's not lack of protein. "Add another 5g-10g in, you should feel better then." Ugh. I spoke with the nurse from the bariatric center who also has a band. She suggested I look into the VSG originally because of a possible hunger hormone issue. She is getting a VSG in July. When I brought this up to my Doc he pretty much laughed in my face. I think that he thinks I'm not doing the right things. Granted I don't exercise as much as I should, but I do damn good, and am a different person than I was a year ago. I wish they could follow me around for a week to see what I go through:( So yah, sorry to let loose, I kind of needed to get that out. lol I guess I'm confused about pre op and post op stuff if Mexico is chosen for surgery too. Will I need to do post op here in the US with my current doc? Because EEEEK, I don't think that will work out well.. And how does the pre op stuff work? Is it all done once you get there?? Thanks again for your time and responses! Kerri

So I have been in contact with my insurance, Harvard Pilgrim. As I suspected, they currently do not cover VSG. However.. The woman that I spoke with said that between her and I (?!) she believed it was in the process of being a covered surgery as long as it's medically neccesary, well documented history, blah, blah, blah.. But she wasn't sure about a revision?? Is it possible for her to know this info?? And if the insurance company covers the surgery why is a revision considered a different procedure? I have thought a little about financing the surgery myself and heading to Mexico.. I'm not so sure I could afford what the payments might look like? Does anyone know what a finance plan looks like through Dr. A's office? I know they offer through a few different companys, but I'm curious if it's even worth looking into? Generally anything like that through an office offers an extremely high APR and outrageous payments. If I do a personal loan I'm sure it would be a high APR as well.. Maybe I should wait on Harvard Pilgrim and see what happens??? Even if they did end up covering the surgery, I wouldn't know where to start in the US with a surgeon as I'm sure that no one in Maine does VSG... (Although I believe there is someone in Boston?) So yah, a whole lot of questions here. Hopefully you guys can understand my thought process here, I'm working on negative sleep and lots of coffee today:) Thanks in advance for your responses! Kerri:)

aJoneen.........................+1 75 pounds lost! Bandana....................... 0 92 lbs lost BrandNewLisa............0 80pounds LOST forever!!! evelas5000...................0 50 pounds Lost Desdemona...................0 Fenton...........................0 100 POUNDS LOST !! HarleyGirl....................0 85 pounds LOST! Hopeinapril................. .0 55 pounds lost! Kpodski......................... -4 Lynnt1215.....................0 NurseNiki......................0 Nycm00........................0 OUCH Potatie............................0 132 POUNDS LOST!! Scrappy_Friend........-3 160 POUNDS LOST!!!! SpecialK........................0 102 GONE forever! Sugarbean....................0 117 POUNDS LOST !!! Sharona.........................0 stellabella......................0 75 POUNDS LOST! Tess415..........................0 Thin2bme....................0 100 POUNDS LOST !! WestCoastMom............0 Wishin4...........................0 78pounds gone!! Back to onederland again! Down 13lbs of the 18 I gained while quitting smoking!

So... I have been lurking here on the VSG thread now for a while. You guys have posted so much useful information, and have definately struck some curiosity in me! I was banded just over a year ago, and have a love hate relationship with my band. I have had several fills and unfills trying to get to the right spot for me. I think I am about there now, although I am still hungry. As I always have been. I am at the point where I mostly eat mushy types of foods. Not many types of normal foods agree to go down. In the morning I am usually so tight I can't eat. Breakfast is usually coffee, which sometimes, even that gets stuck. By mid morning I can usually eat breakfast very carefully. I am currently working closely with the nutritionist from the bariatric center where I had my surgery. I feel like there is no happy medium for my restriction. Either I am loose, starving, and can eat a cow, or I am tight, starving, and can barely drink. Either way I am HUNGRY. All the time. I have done so well with keeping on track, logging food, and making good choices. I admit I slack on "exercise" but I am a fairly active person, always go go go, out and about. I feel stuck in a rut. I think I need something other than the band... I may have the option of getting the sleeve if I look more into the financing, but I am still unsure about the process. I also question my insurance. I have been told several times that Harvard Pilgrim is one of the quickest and easiest companies to work with. As of last October they said they do not cover VSG. Is it possible to challenge them? Or bring info to their attention? Also I'm curious with the VSG if things get "stuck". I've read posts about still having to chew chew chew.. I am so over being stuck and spending hours in pain, in the bathroom, waiting for things to come up or go down! I guess that's enough for now, sorry about writing a book on here! I've been curious for a long time, and just finally got the nerve to ask some of my many questions. Thanks in advance for your time and knowledge, Kerri

Very interesting! I will definately have to try this.. I have never heard of it.. My doc suggested doing this after banding to help the gas move from the shoulders.. I wish I would've know this when I was ohhhh soo stuck last night on a banana. Ugh! I was up until 1:30 waiting for that sucker to come up or go down! Thanks for the info:)

aJoneen........................0 75 pounds LOST! Bandana....................... 0 92 lbs lost BrandNewLisa............0 80pounds LOST forever!!! evelas5000...................0 50 pounds Lost Desdemona...................0 Fenton...........................0 100 POUNDS LOST !! HarleyGirl..................0 85 pounds LOST! Hopeinapril................. 0 50 pounds lost! Kpodski........................- 4 Lynnt1215.................0 NurseNiki...................0 Nycm00.......................0 Potatie..........................0 100 POUNDS LOST!! Scrappy_Friend......0 150 POUNDS LOST!!!! SpecialK.....................-5 97 lbs and closing in on 100! Sugarbean..................-2 112 POUNDS LOST !!! Sharona.......................0 stellabella...................0 HALFWAY TO GOAL! Tess415......................0 Thin2bme................. 0 100 POUNDS LOST !! WestCoastMom........0 Wishin4......................0 73 pounds gone!! After gaining a pound on vaca, then coming home to gain 3 more, THEN, eluding the scale, I decided to get my butt back in gear. 2lbs to go to be under 200 again!! Have a great week all! :smile2:

Congrats Teri!!!

aJoneen.......................075 pounds LOST! Bandana......................-2 92 lbs lost BrandNewLisa..........0 75 pounds LOST forever!!! evelas5000................-2 Desdemona.................0 Fenton.........................0 100 POUNDS LOST !! HarleyGirl..................-2 80 pounds LOST! Hopeinapril................0 Lynn1215.....................0 NurseNiki...................0 Nycm00.......................0 Potatie.........................0 100 POUNDS LOST!! Scrappy_Friend..... 0 150 POUNDS LOST!!!! SpecialK......................0 Sugarbean..................0 100 POUNDS LOST !! Sharona......................0 stellabella............... 0 HALFWAY TO GOAL! Tess415......................0 Thin2bme............... 0 WestCoastMom........0 Wishin4......................0 Kpodski............-1 BRATZ98363.......0 Only down one, but I'll take it. I will be on vacation for the next 2 Fridays.. I hope I can come back and post a few more lbs down?? I'm at 200 again, 8lbs to go to be back at my "pre-quitting smoking" weight.. It will feel good to be in the 100's again for sure!!

I too have had an issue with sweets. Since getting back on track a few weeks ago I started buying sugar free sweets again. Russell Stover makes small bags of sugar free chocolates that taste like the real thing, no after taste or fake sugar taste. They have all kinds to choose from. I have a hard time eating 1 so I keep them in the freezer. I know that I crave sweets after supper, so while I'm preparing supper I take 1 or 2 out of the freezer to thaw for my sweet tooth after I eat. They are IMPOSSIBLE to eat frozen so I only eat the 2 and am satisfied, and also know that if I want more, too bad, they're frozen. I also keep them at work in the staff freezer:) Also I found sugar free tapioca cups. I put a little cool whip free on top, and yum! It's enough for me. Also I do the same with SF jell cups. Just a few ideas, hope it helps someone out...:tt2:

Lynn, this post made me sad:( I am so sorry that you are struggling.. What an icky feeling. I am and have been struggling as well. In 3 months I have put on 18lbs.. I had a fill about 2 weeks ago and have lost about 9lbs of the 18, but still feel horrible about myself for getting so out of sorts. It is so hard to see the wonderful success of others and know I could be there... I'm not sure what I can say to help you feel better about your situation, but know that you are not alone! You have done a wonderful job, keep up the good work! This journey is definately full of bumps, and you WILL get over yours, just give yourself time:)

Wow! You give me hope!:thumbup: I also cannot stand the thought of exercise. I have been fooling myself for a year now having money deducted weekly for my gym pass. I have gone once. I have such a hard time getting motivated.. But when I do, the weight usually melts off. I just need to do it. You go girl! And thanks for sharing.. You can do this!! :)Kerri p.s. best of luck with your surgery, and have a wonderful birthday!

I hope it's not an issue that I am posting late.. I have been unable to login from my computer to post my Friday numbers.:thumbup: aJoneen.......................-2 75 pounds LOST! Bandana.........................0 BrandNewLisa............0 75 pounds LOST forever!!! evelas5000..................0 Desdemona..................0 Fenton........................-1 100 POUNDS LOST !! HarleyGirl................ -6 80 pounds LOST! Hopeinapril................0 Lynn1215.....................0 NurseNiki...................0 Nycm00.......................0 Potatie.........................0 100 POUNDS LOST!! Scrappy_Friend.....-1 150 POUNDS LOST!!!! SpecialK......................0 Sugarbean..................0 100 POUNDS LOST !! Sharona......................0 stellabella...............-.4 HALFWAY TO GOAL! Tess415......................0 Thin2bme...............+ .2 WestCoastMom........0 Wishin4......................0 Kpodski............-4 BRATZ98363.......0

aJoneen.......................-1 75 pounds LOST! BrandNewLisa............0 evelas5000.................-.5 Desdemona..................0 Fenton........................-3 100 POUNDS LOST !! HarleyGirl.................. -3 75 pounds LOST! Hopeinapril................0 Lynn1215.....................0 NurseNiki...................0 Nycm00.......................0 Potatie.........................0 100 POUNDS LOST!! Scrappy_Friend......-3 150 POUNDS LOST!!!! SpecialK......................0 Sugarbean..................0 100 POUNDS LOST !! Sharona......................0 stellabella...............-3.4 HALFWAY TO GOAL! Tess415......................0 Thin2bme................- 2 WestCoastMom........0 Wishin4......................0 Kpodski............-5 Wowwwww everyone!! Nice work and congrats on all of the milestones!! Keep up the good work:)

Hi Carole, and congrats on your 70lb loss!! My name is Kerri and I was banded in Maine on March 19, 2008. I have lost about 50- ish lbs, and I too am finding things wayy harder. I would like to lose another 50-60lbs and seem to have lost my ambition along the way.. I am really frustrated with myself. I used to be on here all the time, but since I've been struggling I've kept to myself. I need to do something different.. So here I am!

Hi there, just found you this thread.. Here's the link: Mental Health and Lapband Life - Lap Band Surgery and Lap Band Discussion Forum I knew it was on here somewhere.. Hope it helps! Best of luck to you~ Kerri

Yah, I am still at good restriction. Although i have the same issue as you, some days I can eat more than others, and once in a while my band has to remind me- "slow down, smaller bites idiot!" lol Otherwise things are the same. I know 4lbs will go fast, but my motivation factor right now is 0.. For some reason? You would think that since I am proud of not smoking that I would be excited to hit the gym and try out the new lungs? Noooooooo uh:(Not to mention I set my Daytona goal to help me get motivated- not a chance! I think that mentally I gave myself the option to gain weight while quitting just so I could cheat. I def have my "fatty habits" lurking:( I know I can do this, it's just a matter of when.. Anyhoooooo, enough complaining- time to do some chores before work! TGIF! :)Kerri

p.s.s. lol how's restriction????

Hey girl! Congrats to the half way mark!! What a good feeling, huh?! I had no idea how long it had been since I got on here- almost a month! I get online usually daily for my myspace, but that's been about it. I was thinking of you last night and wondering how you were doing- Sorry for not being better with staying in contact- the story of my life lol. I have finally kicked the nasty habit of smoking- for good! Today is day 24. I am so excited! The DH quit as well, and we are feeling better than ever, I'm so glad it's working this time! The down fall is that I've gained 4lbs.. Ugh! I knew I would gain a little, but 4lbs seems like so much to me. I am hoping that some of the nicotine cravings go away sooner than later so i can stop stuffing my face so often! Then I can focus on getting back on track for Daytona:) Oh yah, I just got a new bike too! I got a 01 Honda Shadow:) It's not the Harley I've always wanted, but it's beautiful, and a perfect beginners bike:) My hubby got it for me last week, I can't wait to feel comfortable on it and be able to ride to work:) By the time that happens, it'll probably be winter lol.. Well, I must be getting off to work. Congrats again on the halfway mark- you go girl! Chat soon~ Kerri p.s. do you have a myspace? if so, my link to my everyday page (lol) is: MySpace.com - www.myspace.com/22733778. I get on there daily:) I also have a lapband one as well, but I think you knew that...:regular_smile:

Hey girl, long time no chat lol How is everything since the fill? Are you feeling restriction? It's crazy that 2cc was too much?! Maybe you'll be at your sweet spot with this second fill?? I am definitely at mine. Once in a while my band reminds me not to eat so fast, or to stay away from potatoes lol.. I just can't eat them.. ah well, life goes on. I don't need the starch anyway:) I tried to write back a few days ago on Monday (??) and hit something and it erased all I had written, I gave up I had to leave for job #2 and had no time to write again. I get so frustrated with this site sometimes.. You would think that you could hit the "back button" and your message would be there, but noooooo. Ugh. Enough complaining!My dh and I have decided to go on our first ever vaca to Daytona Bike Week at the end of Feb... I am super excited as I have never really been anywhere, or on a real vaca. We have some friends that are driving down, (2 other couples) and another couple is flying. We are going to drive down with the 2 other couples, and we are all hauling our bikes in a trailer. I have a fear of flying! This sounded like the best opportunity:) I have a goal of losing 43lbs by then. I sooo need to step it up! I will be at 100lbs total loss and 150lbs... My goal.. I know I can do it! I have 5 months.. I know if I hit the gym and watch what I'm eating I will do it no problemo:) I'm on a mission! Well, sorry to blab so much! I need to get ready for work. Hope all is well with you!! Chat soon, :)Kerri

So the weekend was fabulous. OOB was a blast, then we came home and went to a friends cookout on Saturday, then yesterday we went on a wonderful bike ride trough the mountains on a scholarship ride for a friend of ours who was killed on his motorcycle a year ago. It was a wonderful turn out. What a a full weekend! It's hard to get back to reality.. Congrats on losing 7lbs in 4 days! Holy crap, you are a woman on a serious mission:) Well, sorry to cut this short, I have a half an hour in between jobs, and I really need some lunch! Hope all is well, and happy monday.. Ughh lol :thumbup: ~Kerri

I was at Mt.Washington on Monday?! lol..... We got there around 12:15 on bikes, there was 19 of us in all.. Our friend proposed to his girlfriend at the top. I didn't go up, I got scared so most everyone payed $26 a piece and rode up in the vans to the top. They obviously wouldn't let anyone ride their bikes up:) I heard it was amazing tough. The lady at the front desk told us that it was 100% visibility, and that only happens once a year. They all tried to talk me into it but I backed out and stayed with 4 other at the bottom. Too funny you went too! Things are still the same here. I'm not eating the best, and keep catching myself falling into old habits. grrrr I am headed out to OOB tomorrow afternoon for my anniversary (which was technically yesterday, but I worked 19 hours ugghh) We have a few friends going too, so it should be fun. I can't wait to get out of town. I sooo need this! Glad to hear from you, I have been wondering how things were going for you. Chat soon:) ~Kerri

Hey Sarah, Hope you guys had a good time camping! Did the weather hold up? I have only been once this summer, which is disappointing, but I just haven't had the time. Next weekend DH and I are going to OOB with a few friends for our anniversary for an overnight. It will be fun- I soooooooo need to get away! Work has been insane. Over the last few weeks we have had 3 staff out. And we have no per diem staff, so it has made for crazy hours for the rest of us. Not to mention that we are now staffing a client 2:1, and we had to cover that ourselves as well. Our team leader resigned on Monday. lol. Imagine that?! Last week I put in 67.5 hours at that job alone, 20 at my home health job, and 8 hours of classes. I though it was over until Monday I got the call that I had to be in at 1:30pm. I didn't get home until 7:30 last night. Ugh. I am overtired and keep getting these awful headaches. My doc thinks it's tension headaches... I think they're work headaches lol I haven't had time to prepare meals at home to bring to work so I've been eating crappy too. This morning I was 193.6 gahhhhhhh!!!! I just can't win! Now is my time to start anew. I've always seen fall as a time to start over for some reason. It's usually when I get my butt in gear, get to the gym, and focus on what I need to be doing. So I'm on a mission. I wish you were closer so we could meet up at the gym! I need a buddy to keep me on track . Sorry I am soooo rambling.. too much coffee! Congrats on staying at the same weight. It is hard to do when you are needing a fill. 10 weeks is a long time to wait, but it seems like you're on the right track. September is almost here, and you'll be in for a fill before you know it! Things have been great since my unfill. I occasionally feel things going down a little harder than usual, but I know it's my fault and what I did wrong. I still feel like I can eat too much though. I think I'm at proper restriction besides the portions. Do you know if it's normal to be eating 1- 1.5c (sometimes more) of food still? It jut seems that it takes a lot to feel satisfied. Anyhoo, I'm going to get some laundry and supper going so I can have a normal meal at work tonight:) I hope things are good with you! Keep up the good work:) ~Kerri