Tobeornottobe

I started my 2 weeks of liquids today. I am not really hungry as more of it is head hunger than anything. I do have a headache. I believe it is from no caffeine.

I have a very supportive husband. He is doing the shakes with me. He said he doesn't want me to have to go through this alone. (He doesn't need to lose weight). It's very sweet.

I am starting to doubt the surgery. I think it's because it's hard and I am scared. I am just going to take it one day at a time I am upset I let myself get here. I know it's just all in my head and this is what I have fought for for the last 6 months.

Did anyone else feel this way? As I write this I am crying. So many emotions. I had to write them down. This site has been good and this the. sometimes it freaks me out. Any advice or support would be greatly appreciated.

I totally understand how you feel. I'm scheduled for surgery next week. I too have been having second thoughts. However, we've come this far so hang in there and know you are not alone in this journey and the way you feel is completely normal.

Good luck.

Is your insurance through your job? All insurance companies offer bariatric surgery, however, its not considered a medical necessity so employers can opt out. If your insurance is through your employer, the other plans offered may have the same exclusion with BCBS and United Healthcare.

Greetings ! My name is Amanda. I am inquiring about WLS however, my insurance company (Cigna) has an exclusion to Bariatric Surgery. With this being sad I am pretty sure that they won't cover it even with medical letters and such? (right or wrong?) please correct me. So my next questions are should I change insurance companies? I see that some have BCBSTX or United Health Care and it's covered with of course evaluations and such. Would my best bet be to get an individual plan with the coverage or to try to save up as much as possible in the next year or so to do self pay? I've been researching for the past few months about weight loss surgeries and I feel it would be the best bet for me. I meet with a surgeon for a general consult on Dec 4th. Maybe he will be able to give insight? I don't want to get discouraged but the entire medical insurance in Texas is blowing my mind. Any good feedback would be great. Thanks for reading.


-Amanda

I don't have any timeline to offer but have you called them yourself? Sometimes you can get answers before the doctor's office.

Casseroles travel really well. I sometimes wait until I get to my destination to pop things into the oven (this is a great option if you can do it). Shepard's pie travels well as do parsnip mash. Spinach and artichoke dip can be served warn or cold. It reheats easily in a microwave. Buffalo chicken dip also travels well and is easy to reheat in a microwave.

Hope this helps.

There are many ways to take traditional recipes and make them healthier.

http://natashaskitchen.com/2014/01/31/skinny-spinach-and-artichoke-dip-recipe/

http://www.myrecipes.com/recipe/mashed-potato-casserole (omit the bread crumbs and sub sweet potatoes)

http://www.myrecipes.com/recipe/tex-mex-hash-brown-casserole

http://www.myrecipes.com/recipe/smoky-three-bean-bake

http://www.myrecipes.com/recipe/black-bean-chicken-chilaquiles

http://www.myrecipes.com/recipe/zucchini-eggplant-lasagna

http://www.myrecipes.com/recipe/wild-mushroom-lentil-cottage-pie

Anyway, hope it helps.

Shepard's pie

Curried Parsnip Mash

Wow so many people on December 8th. Good luck all.

You should check this out really well, since your husband is still covered his insurance, his insurance would be primary and your insurance would be secondary. The general rule of thumb is they go by what the primary insurance covers. You should look into this before your husband starts the process.

I have Cigna. My paperwork was submitted on a Tuesday and got approval on Thursday. If you were submitted on this past Tuesday, you probably won't get anything back until next week since Thursday and Friday (today) are days off.

HTH

Just wanted to add Naked Pea Protein 27 grams of Protein. I bought it from Amazon 5 pounds (76 servings) for about $54. The great thing is since it has no sweeteners it can be used in sweet and savory dishes.

The pea protein I used before was awfully expensive.

Please note the act reads: 12 weeks of leave in 12 months. Not that you have to work for a company for 12 months before you are entitled

• Twelve workweeks of leave in a 12-month period for:

• the birth of a child and to care for the newborn child within one year of birth;
• the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
• to care for the employee’s spouse, child, or parent who has a serious health condition;
• a serious health condition that makes the employee unable to perform the essential functions of his or her job;
• any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or

• Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember’s spouse, son, daughter, parent, or next of kin (military caregiver leave).

http://www.dol.gov/whd/fmla/

The practice I use recommends chewable vitamins (bariatric advantage), since after the surgery swallowing pills can be a challenge.

Is COBRA available? Can you buy your own insurance on the healthcare exchange or through a broker? You do have options. Good luck.

LOL it does seem a bit strange. You will be approved and it will all go swimmingly!

I am a very private person. I have told exactly one person about my WLS. Today I received an email from my surgeons office detailing future support group dates/times and about 500 names and email addresses (just a guess, too many to count) were cc'd in the receiving field. I am shocked and I feel violated. What would you do?

This is a violation of HIPAA. It may have been done mistakenly so I would contact the doctor's office and inform them.

I, like you, am a very private person and this probably wouldn't sit well with me either.

I've just started my Weight Watchers diet supervised by my PCP. I know that every plan is different but I'm wondering what experiences people have had with CIGNA; I have a few questions:

We are changing our insurance carrier and my CIGNA coverage doesn't actually begin until Jan. 1; the plan requires A 3 month supervised diet, will I have to start over on January 1? I will if I need to but hoping it counts now since the policy is a 3 month diet within a 12 month period.

Do I need to submit anything to begin with so they know my plans or do I just have my PCP and surgeon submit everything when I'm done and ready for surgery?

What do I need to submit of my diet? Do they want every day of documentation as proof? Will they just take my PCP records of visits, weight, program, & exercise?

Thanks for your help!

You can start now. I started the process with United Healthcare and hubby and I both changed jobs and our health insurance changed to Cigna. My timeframe changed from 6 months to 3 months. So instead of having surgery in Feb/March of next year, I'm going in on December 9th.

When we moved to Cigna, I called Cigna and got them to email me the criteria and verified benefits, co-pays, etc.

As far as nutrition, WW and Jenny Craig are acceptable as long as you are supervised by a medical doctor. Cigna does not require a day to day accounting of what your diet. The nutrition component is mostly to know you are equipped with the information to make you successful after the surgery. Monthly weigh-ins are also required. I visited my doctor's office once a month to be weighed. My surgeon has nutritionists in his practice so I used them for documentation. Please note: Cigna requires 90 days of documented nutrition information, not 89 but 90. I did 4 nutrition visits to be safe.

These are the Cigna requirements:

Medical management including evidence of active participation within the last 12 months in a weightmanagement

program that is supervised either by a physician or a registered dietician for a minimum of

three consecutive months ((i.e., ≥ 89 days). The weight-management program must include monthly

documentation of ALL of the following components:

weight

current dietary program

physical activity (e.g., exercise program)

Programs such as Weight Watchers®

, Jenny Craig® and Optifast® are acceptable alternatives if done in

conjunction with the supervision of a physician or registered dietician and detailed documentation of

participation is available for review. However, physician-supervised programs consisting exclusively of

pharmacological management are not sufficient to meet this requirement.

• A thorough multidisciplinary evaluation within the previous six months which includes ALL of the

following:

an evaluation by a bariatric surgeon recommending surgical treatment, including a description of the

proposed procedure(s) and all of the associated Current Procedural Terminology (CPT) codes

a separate medical evaluation from a physician other than the requesting surgeon that includes a

recommendation for bariatric surgery

unequivocal clearance for bariatric surgery by a mental health provider

a nutritional evaluation by a physician or registered dietician

Here is a link to the current Cigna policy:

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

Hope this helps and good luck!

@@Tobeornottobe - Hi All, I wanted to say that I was approved for surgery. The peer to peer review did come through.Thank God. I learned on Thursday. I faxed over some additional information that I thought would help. I don't know if that did the trick but 1/2 hour later, they called and said it was approved.

@@Solmar Brilliant!! I am so happy for you!

I make a weekly menu. Use the menu to shop for ingredients (what veggies do we need, meat etc.). We generally cook 6 out of 7 days.

Can anyone give reviews on Dr. Halmi? I dont have a surgery date yet, will be at the beginning of the new year. (waiting now for over 2 years for a surgery date..... dumb insurance company). I'm so beyond excited to finally be getting closer! Any advice is welcome here

I will be sleeved by Dr. Halmi next month. I know several people who have had surgery with him and they rave about him. I will be having my surgery at Fair Oaks.

Also, what do you look for in a vegan supplement? Do you prefer pea powder? Hemp Protein? All-natural flavorings? And do you find it easy to get these powders at your local supermarket, or do you go online? Thanks for your answers!

It's important for me to be able to read what's in it and low is sugar. My preferences are pea Protein and brown rice. I like the mix in Plant fusion which includes quinoa, amaranth and pea protein. I'm not a fan of hemp as it gives me stomach issues. I prefer the flavoring be natural but that's not always possible in powders.

I usually order my protein via the internet, Jet.com, Amazon.com or directly from the manufacturers site. Protein is available at local stores, Target, Harris Teeter, Giant, GNC, Vitamin Shoppe but I find the pricing to be higher than online.

Thanks for the responses! We've received quite a bit of interest in when and soy free items in our BariatricPal Store.

How about vegan Protein bars and other vegan Protein foods?

Clif Builder Bars (20g) are vegan and available at most grocery stores. I also like Barre bars but they have limited availability and only 10 grams of protein, great in a pinch but a but expensive. I love chia bars but they are low in protein.

Honestly those are the only ones I use.

@@Tobeornottobe - yes, they are going to do a peer to peer review. I also called the insurance company to appeal and was told that the surgeon can appeal. It is scheduled for tomorrow. I am gonna turn on candles and pray (Catholic) for this to go through. I hate to have to touch my husbands 401K and use our retirement fund for this surgery but I've invested so much time, effort, gone to visits, psych, heart, lung, endoscopy, to let it all go to waste. On top of it. I am already paying the remaining balances that all these visits and tests have incurred. Please send me good vibes, I need all I can get.

@@Solmar, sending positive vibes that all goes well with the peer to peer. Honestly, sometimes, the peer to peer does the trick. It maybe a small unanswered question the insurance company needs answered. This will all work out and you'll be ready to go in no time.

Are they going to do a peer to peer review? There is still hope. Don't give up.

Let's do. That would be great!

I'm having mine on December 9th.

It depends on the plan. If you are paying for insurance out of pocket, look at plans that offer bariatric coverage as part of the plan. Not all do.

Speak with a broker or check healthcare.gov.