Sharon1964

No problem! And remember this...

Okay, when you call your insurance company, ask them if there is a separate out-of-pocket max for bariatric surgery. If the person doesn't know, have them get a supervisor.

If your insurance company isn't any help, then talk to the staff at your surgeon's office. The surgery coordinator at my surgeon's office told me that I just have to go every single month (don't miss a month or you have to start the count over). She gave me a list of things to have my doctor document each visit (discuss weight, eating habits, exercise). She said my insurance company doesn't count the first visit with the surgeon as part of the six months visits, but some other insurances do.

I've never heard of an exception to out of pocket maxes. I think the lady was wrong. Maybe she was thinking of people whose insurance is out of network. My out of network max is double my in-network max. Call your insurance company and ask them to be sure, but if I were in your shoes, I would not worry.

Don't go for the "I'm full" feeling. Go for the "I'm not hungry" feeling.

@@losinghope15 I'm sorry your extended family hasn't been around for you. Have you asked them for help? I know some families figure if you need help, you'll ask. Have you reached out to the social service agencies that others have mentioned? In my area, churches give out boxes of food once per month (all different days). You don't have to provide proof of income or anything other than proof of residence, but your area may be different. I don't think I read how old your children are; if they are school age make sure you check on free/reduced price Breakfast and lunch at school. A lot of places have free lunch over the summer so the kids don't go hungry.

So I take it you didn't inform them when they hired you that you were having surgery and would need, say, two weeks off? Or that you had previous plans (don't have to say surgery) that would take you away for two weeks?? I can see how someone trying to get hired wouldn't want to volunteer this information. However, as a manager, it would not put us on good starting terms if it was withheld. When I interview someone, I always ask if there is anything that would keep them from starting right away, or any other plans that have already been made. It's usually much better to talk about these things up front.

Are you following your surgeon's plan? None of those foods are on my plan in the first few weeks.

Call the hospital and ask to speak to someone in "Risk Management". If they ask what it's regarding, tell them "EKG techs giving inappropriate medical advice." if it's not a hospital, call and ask to speak to the Medical Director.

You can have your sleeve re-stapled smaller. You can also convert from sleeve to duodenal switch.

Your surgeon and/or his nutritionist should give you an eating plan for after surgery, with suggestions and a list of what is allowed and what is not allowed. My surgeon may not allow caffeinated coffee, but yours may. It won't do you any good for me to tell you that you can or cannot have something, as we don't have the same surgeon. Mine may allow eggs; yours may not.

You may be right. All I know is it seems like in our area at least it's awfully hard to find a doctor if you have Covered California plans! I know this is from a while back... in our case (I work for a doctor), this was not true. We got letters from the insurance companies that said things like, "are you willing to accept the new products we are offering that will pay you 70% of what we would normally pay you?" A $50 office visit for $35? Our motto became "Just say no".

Keeping notes has helped several people get their surgery covered. In their cases, they were told on numerous occasions that gastric surgery was covered, but then it was denied as "not a covered benefit" when it came time to get the authorization. If you can show the insurance company that their mistakes caused you to go through the pre-op process, you have a very good chance of getting them to cover it, even if it's not covered on your plan. As you said, though, you do have to have active insurance on the day of your surgery in order for it to be covered.

What exactly are you worried about? You've talked to the insurance company, right? Document the date, time, name of the person you spoke to and what they said. If you haven't actually called them, then do that. Ask for all of their requirements for gastric surgery, and ask them if they cover roux-en-y, vertical sleeve gastrectomy, and lap band (so you know what your options are). Keep written details of every interaction with the insurance company.

I'm August 8. Don't forget there is an entire forum here just for August sleevers: http://www.bariatricpal.com/forum/1139-august-2015-sleevers/

This. In spades. YOUR doctor (not you specifically, amylynns, but "you" in the generic sense) has his/her reasons for their rules. My doctor may allow certain NSAIDS and disallow others. My doctor may allow it for VSG and not GB. Your doctor may say "never ever ever." So ask your doctor what his/her rules are, then ask for the reasoning behind them. If you don't agree with your doctor, look for peer-reviewed research on the subject, then show those to your doctor. See what he says.

THAT IS SO FREAKING AWESOME! You must be on cloud nine!!!

Ask your doctor about naproxyn sodium (aleve) or mefenamic acid (ponstel). When I was in my 20's (yeah, 30 years ago), those two drugs were the go-to for cramps, as they contain antiprostaglandins which help prevent uterine contractions or cramps. At the time, they were both prescription only; now aleve is over the counter. The naproxyn sodium worked great for me but didn't work at all for my roommate. She switched to ponstel and had great relief. If your doctor okays it, you do start taking it about 3 days before you expect your period, and then stop when the cramps stop.

Who knew my surgeon works on Saturdays?!?!?! I just got my approval letter and my surgeon is booked into August. If someone cancels, they'll call me to see if I can do it sooner. I'm hoping for July.

Call the customer service number on your card. PHCS (Private HealthCare Systems) was bought out by Multiplan years ago. They kept the name for some of their products.

You could try goal-setting. 1. Make a specific, measurable goal. "Eat no more than 1/4 cup of food at each of three meals and no more than 1/8 cup of food at each of two Snacks." 2. Set a time limit. "I will do this for one week." 3. Identify obstacles. "Eating out", "portion size", "lack of restriction in my tummy." 4. Identify ways to conquer the obstacles. "I will only order an appetizer, and I will ask for a to-go box with my order and I will portion it out before I take a bite." "I will wear super snug spanx to remind myself not to overeat." 5. Identify who you will be accountable to. "In one week, I will call my best friend and talk about my week." Read over your written list every morning and as often as you need to. You can do this, it's only for one week. Then when you are successful with that, do it for another week. Keep reminding yourself about your goals.

Oh my god, I've been approved. APPROVED! Sheeet just got real.

Yes it can get saggy. I remember back when the show "Extreme Makeover" was new. There was a woman who had lost a lot of weight and needed an all-over body lift. During the consultation, the surgeon commented on her labia needing a lift as well (which he did).

Wonderful!