Niecey

I'm getting banded 9/16. Thank you for your story. I understand your thoughts because you forget how much the band is doing for you. I read titles that say "life without the band" and I can't even read them because it scares me too much. The only reason I read yours was because it said Please read! I'm glad I did. In college I actually got my weight down to 150 lbs, by the time I got married 180, lost a baby 210, had another healthy baby 240, second baby 270, unhappy with life and myself I think I reached 300 but I wouldn't get on the scale. I just knew that the 28 pants I was wearing was getting too tight and I started freaking out because I didn't know where I would find clothes after that. I did Atkins and got down to 225. I felt great, a diet I could eat as much meat, eggs and cheese and I ate a lot and still lost weight. Then we went on a cruise and I was going to reward myself and eat everything I wanted and go back to dieting a week later. I don't know where the time went but all of a sudden I woke up and I was 275 again. I have played this yoyo all my life. I am so glad I read your story. I will be very careful with my band and have respect for it because I am so tired of living this life. thank you. Niecey

My doctor says its very important to do this because it makes it safer on you during surgery. Shrunken liver, less chance of damaging it. I am on day 6 (OMG I have MADE it 6 days) of a 2 week preop. The first 2 days I thought I was going to strangle someone, but it gets easier. It's also a way of mentally preparing for the first few days after surgery. Those are especially important because that is when the lapband seats it's self on your stomach so you don't have slippage problems later. Also I don't know if this is true but I tell myself if I don't shrink my stomach down as much as possible then how can they get the lapband on real snug so I don't feel hungry afterwards? I have a protein shake in the morning, one at lunch and a lean cuisine or smart one at dinner, with unlimited SF popsicles, SF jello and lots of broth to distract me. So far I have lost 8 pounds so that is motivating too. My doc says if you just feel like you are going to die a day or 2 before the surgery make sure it's low fat and low cal. yesterday I ate a tiny salad (just lettuce) with a bit of watered down dressing. Very low cal and no fat. The crunch made me feel like I was eating something. I hope that helps, hang in there. Niecey

How's the pre-op diets going? I thought I was going to punch someone the first 2 days. My nerves were getting the best of me and I was obsessing about food. 3rd day was much better especially seeing 5 pounds come off in 2 days. I'm starting to notice the difference between just wanting to eat and actually being hungry. One of the girls I work with is so sweet she is doing the diet pre-op diet with me. Niecey

I have 130 pounds to lose and I am doing the lapband. Gastric seems so much more invasive. Someone at work had the gastric bypass and he really has a lot of problems with gas odors. Both of my sister-in-laws have had the lapband and do not have those problems at all. One of them has lost almost 200 lbs and they both are doing great. Hope that helps. niecey

My date is still Sept 16 and my goal weight to lose is 127 lbs.

I'll be getting banded on Sept 16th. I figure I'm not going to lie. Everyone will ask how I did it so I'll be honest. I figure it this way I know I'm fat they know I'm fat so if there is something out there that can help me loose weight, I'm taking it. If someone has something negative to say...shame on them. All I want to do is have a longer, happier, healthier life. Who can say anything bad about that!!! Niecey

I'm 42, married 16 years with 2 beautiful girls (13 & 11). I can't wait to be able to help my girls with eating healthy and exercising with them so they do not have the same problems I had at their age. I had to laugh at the boat thing. Last time I tried to pull myself on to a boat after snorkeling was on our honeymoon. It was one of those rope ladders and I couldn't get up the damn thing. All the gentlemen on the boat ran over to one side to help me and in the process the dang boat almost tipped over. How's that for embarassing. I'll be happy for things like sitting down without my pants rolling down, talking and walking at the same time, being able to wear a skirt without worrying about keeping my legs together, just a few of the simple things skinny people take for granted. LOL Niecey

I wanted to have surgery on a Thursday to return to work the next Monday but with they way their scheduled worked my surgery is Sept 16 (Tuesday) so I just plan on taking the rest of the week. I think that should be good. I wonder...I had a hiatal hernia (sp??) when I was 16 and have just lived with it. I wonder if the doc will fix it if he sees it. Hmmm...I'll have to ask him that. Denise

Just got my date yesterday....September 16th!!! It took ONE year to get approved. Sept 2nd I start a 2 week preop diet. I'm scared. 2 protein shakes and a frozen meal. I can't remember ever eating that little, except when I was in college doing a fast with my roommate. LOL Niecey

I will tell you I sent that letter when I was denied but I don't know exactly what got me the approval. Apparently the first time my PCP sent in the info the exact diet that I was following was not included, so I also included a week's worth of the diet I was doing for 6 months which was an 1800 calorie diet. They worded the denial "based on information submitted this has been determined as not medically necessary." Maybe if I have included that the first time I would have been approved. They also did the 30 day thing with me too. They said not all the info was there and so the lapband doc resubmitted the same info. What that did was give them another 30 days. It wasn't until my DH's HR person actually spoke with the rep that I got a real answer of what was missing. They may have still denied me until the diabetes came into play. I don't know what did it but if you are determined and willing to take spend the time it will happen. Good luck and keep in touch. niecey

Here is my letter: "To Whom It May Concern: I am requesting a “fast” appeal or an “expedited review of my appeal”. In September of 2007, Dr. Morton and my PCP submitted a request for approval for Bariatric surgery. I have been denied and since that time my borderline diabetes has turned into full blown diabetes. I have currently been perscribed Metformin 1000 mg twice per day. My doctor and I feel this procedure is medically necessary. Enclosed is another letter from my PCP and the diet I have been following since September of 2007. My father died from diabetes with many complications including having both legs cut off and his fingers decaying. I do not want to live that life. Quoted from the American Diabetes Association: “Weight-loss surgery helps reduce the seriousness of all four of the diseases studied. Diabetes completely disappeared in 76.8% of the patients and was resolved or improved in 86%.” Enlight of the fact I have just become diabetic, this surgery would help me get off of medication and reduce, if not eliminate, the possibility of dying from diabetes. I do not know why an insurance company would deny a patient a chance to live a full and healthy life. Please reconsider this decision." My doctor's letter was also included. In the process of this I also found the step-by-step procedures for BCBS. I saved it in a word document. Is there a way for me to send you an attachment? I'll try to PM it to you. Denise

I have been approved YEAHHH!!! Niecey

Well it's August 16th and guess what??? My approval letter came today in the mail from BCBS of NJ. OMG I cannot believe it. I am 2 weeks shy of it taking ONE year to get approved. A few things helped...one was having my DH's HR department staying on the insurance company and the other thing is when I sent the appeal letter I had then found out I was diabetic and my PCP started me on medication. I think the 2 things together made it happen. So I will hopefully get a date on Monday when I fax the letter to Dr. Morton's office. I am so incredible happy. Good Luck to everyone having to go through this. It was very discouraging at times. Niecey

Thank you for the prays. Since I wrote that I have been denied for "missing paperwork", it took a while to get that out of them. They said they need the exact diet I was on. I just found out Monday that I am now a diabetic and on Metformin. It's making me feel really sick. I have now asked for a "fast" decision appeal with the diet and new info of being a diabetic. I pray they approve me because I want to get off the medicine as quickly as possible. Thanx again. Niecey

Jersey Boy, My doc wrote I have been unsuccessfully trying with her for the last 6 years and what diets I have been on. Did you have any other problems besides being overweight, like high blood pressure or diabetes? Good luck. Niecey

I started this last year, end of August. Amy in Dr Morton's said they would require a 6 month diet so I could start that to save time. Sept 2007 was my first 6 month visit. I didn't get a letter from BCBS til Nov 2007 so I was well underway. I turned it all in, end of March they said something was missing. Middle of April they finally received something. I did not get a denial until July 3, 2008. So 10 months to get denied and that was only because the HR department got involved. I have gone to my PCP again to get a letter to appeal and ask for a "fast" appeal decision. Doc told me insurance companies are denying unless you have comorbidities. I am borderline diabetic but that doesn't count I'm told. I'm still going to fight it. I'll let you know how it goes. Niecey

I am glad for you. Good luck. My DH's HR person has now got involved and now they are saying I need 12 months of "supervised" weight loss program with emphasis on the last 6 months. 12 months was never mentioned until now. I go back to my PCP tomorrow so they can write another letter appealing this. This is just crazy. Neicey

MEM123, Did you get anywhere with your appeal? Finally after 4 MONTHS I have been DENIED. Can you believe it took that long to get an answer on whether or not I was even approved? And that was after my 6 month diet. I am starting the appeal process now. I found on their website a 19 page appeal process that goes to Level 5 and then it's Federal Court. I cannot believe insurance companies decide whether or not we can get help or not. I am so frustrated I could scream. Niecey

Well I finally got my answer. I was denied!! "Office notes documenting supervised weight loss were requested but not provided. Criteria for medical necessity has not been met." If you say you didn't get the documents you needed then how can you determine it's not medically necessary??? I have all the paperwork the insurance received 3 times (so they could prolong it 30 days each time) and it's all here. I could just cry. I am so ready to get this surgery. Both of my sister-in-laws got the surgery and they look great. Everyday I'm doing the treadmill, trying to watch what I eat and nothing, no results unless I almost starve myself and then I'm so hungry. So now I am going to appeal it. I did find a 19 page long document on the Blue Cross/Blue Shield website on appealing, greivances, etc. It actually goes up to Level 5 and after that you go to Federal Court. Wow, do I have a long road ahead of me? I am not going to give up. Insurance companies should not be deciding the fate of our life. If my doctor says it's medical neccesary and would provent my start of diabetes then I should be able to get this procedure. They did not deny me from having a tubal ligation and that had nothing to do with helping my health in the long run. I know I could just get it and pay out of pocket but we also need a new car. I don't want to put my family in $30K+ debt. Wish me luck!! Neicey

I wrote this in another post but wanted to copy it incase anyone has anything they can suggest I do... I have not posted in a while too because my insurance is dragging their feet. I have BCBS of New Jersey. My whole process started in Sept of 2007. I did my 6 month diet and I'm borderline diabetic. Everything was processed in March then in April they came back and said they needed more info about the 6 month diet. Everytime they ask for something they say it's another 30 business days. So by the end of May they said it was still being reviewed. I asked why it was taking so long and called every other day. They said they would have to send an email and that response would take another 10 business days. I asked for a 48 hour expedided review and still no response. My DH talked to his HR person who sent an email asking what the hold up was and that this was the 2nd time they did this and they needed them to get on it. Dr. Morton's office, Amy, has been wonderful about calling everyday. Amy now has an actual person she can talk to, Jennifer, a part time nurse that works for BC/BS of New Jersey, and this lady has asked for additional info showing I have dieted for years and what diets I have been on. Amy explained that this was not in the original request but the letter from my doctor in Sept of 2007 already stated all the diets I had been on and I have had my PCP for the past 7 years. Jennifer asked that it be resubmitted, which Amy did and that was a week ago. Now BCBS of New Jersey is not returning of her calls. How can insurance companies get away with this? I have not even been denied so I can appeal it. My guess is they have no reason to deny me so all they can do is string me along hoping I go away. Meanwhile I know that I am getting closer to needing to be on insulin. My dad died from diabetes. I don't want to start that process. Isn't it a known fact that the lap band helps get rid of diabetes? Wouldn't someone at BCBS of New Jersey realize that in the long run the lap band will be cheaper on them? Sorry to rant but this seems so wrong that they can get away with this. Thanx for listening. Denise

I have not posted in a while too because my insurance is dragging their feet. I have BCBS of New Jersey. My whole process started in Sept of 2007. I did my 6 month diet and I'm borderline diabetic. Everything was processed in March then in April they came back and said they needed more info about the 6 month diet. Everytime they ask for something they say it's another 30 business days. So by the end of May they said it was still being reviewed. I asked why it was taking so long and called every other day. They said they would have to send an email and that response would take another 10 business days. I asked for a 48 hour expedided review and still no response. My DH talked to his HR person who sent an email asking what the hold up was and that this was the 2nd time they did this and they needed them to get on it. Dr. Morton's office, Amy, has been wonderful about calling everyday. Amy now has an actual person she can talk to and this lady has asked for additional info showing I have dieted for years and what diets I have been on. Amy explained that this was not in the original request but the letter from my doctor in Sept of 2007 already stated all the diets I had been on and I have had my primary doctor for the past 7 years. She was asked that it be resubmitted, which she did and that was a week ago. Now BCBS of New Jersey is not returning her calls. How can insurance companies get away with this? I have not even been denied so I can appeal it. My guess is they have no reason to deny me so all they can do is string it along hoping I go away. Meanwhile I know that I am getting closer to needing to be on insulin. My dad died from diabetes. I don't want to start that process. Isn't it a known fact that the lap band helps get rid of diabetes? Wouldn't someone at BCBS of New Jersey realize that in the long run the lap band will be cheaper on them? Sorry to rant but this seems so wrong that they can get away with this. Thanx for listening. Denise

Amy called today. My insurance will still take 6-8 weeks for the final decision. How frustrating. So hopefully I will know by the end of April. She said if I get approval they immediately set a surgery date and I come in and find out what all I need to do. One thing being a 2 week pre-op diet of 2 protein drinks and 1 frozen meal. What is a frozen meal? I'm scared to death because I cannot imagine only eating 2 drinks and a snack per day. If I could do that I wouldn't be fat to begin with. Oh well I will just have to pysch myself up.

Brock good luck with everything. Let me know if Dr. Morton has you do a liquid diet before you have surgery or anything else he has you do. Baboo when is the support group held? Denise

What support groups are out there in Nashville?

did Dr. Morton have you to go on a diet before surgery? If so what and what type of diet after surgery? denise