Wheetsin

It's kind of ironic, but also the way the business works. Self-pays get "discounts" because they're paying out of pocket, that really aren't such great discounts in the bigger scheme of things. With my surgeon the total cost of surgery for self-pays is about $17,000. TO my insurance company, the total billed cost was about $48,000. Sounds like self-pays are getting a heck of a discount, eh? But that's where negotiated rates come in to play. The gross charges were about $48,000, but the network rate was about - oh, maybe $2,000. So while an insurance company may be billed some very large amount, their network discount is going to greatly cut what they actually pay out. Self-pays paid about $17,000, my insurance company paid about $2,000. For the exact same service. SO yeah, I'd believe about $56,000 in a heartbeat. Doesn't sound off kilter at all. But what your claim notifications, and you'll see that they won't actually pay out $56,000. Next to "charge" you'll have a column that says "agreed rate", "plan rate", "contract rate" - something like that. That's what the medical provider and insurance provider have agreed, between them, the services are worth.

I don't know what size pills you're taking, but one of my worst PBs to date was on a pill that had been quartered. It was originally about the size of a Tylenol, maybe a little larger. I didn't think it would be a problem, but knew instantly I was wrong. Since then I crushed everything. It's nasty, but better than going through another PB. I use spoonfulls of yogurt smoothie to help. Put the crushed pills on top, put the spoon toward the back of your throat and you can just kind of dump it. You still get some of the flavor, but that's what the rest of the smoothie is for.

My answers will be in blue. Our new insurance is going to kick in as of June 1, 2007 and this is when I'm going to start my journey of trying to get approved for the surgery. I don't even know if our insurance covers any of it but I am hopeful and I still want to get as much research as possible within me. We are going to have UHC so my guess some of it could be covered but who knows, I will find out in June once we get our cards, info packets, etc. etc. Anywho, here are my questions.... If you are enrolled, and just don't have active coverage yet, you should still be able to get a copy of the SPD. You should not have to wait. (I could be wrong about this, but that's what I think, anyway) 1) It's been a little over a year since I've had a pap smear. I'm going to go once our insurance kicks in and I'm going to let my doctor know that I haven't had a period in 7 months and that I am interested in having a weight loss surgery. I'm very sure it's due to my recent weight gain, do you think she would be willing to write a letter of recommendation to the insurance company that the reason for surgery is a health issue? First, your doctor will have to verify that your cessation of periods is due to weightloss. Your doctor won't write a letter of recommendation on your assumption that it is. General guidelines for insurance approval include history of obesity (5+ years) and BMI over 40 or over 35 with two or more comorbidities (doesn't sound like you have this). IF the periods were a result of weight gain, this might be one comorbidity, but honestly - I'm not sure. 2) How will I know what other procedures I need to get done before being considered for the surgery? Does the insurance company tell me this or the surgeon? Usually no other procedures are needed unless you have something that has to be medically corrected before the surgery can physically take place. There are general criteria that (usually) need to be met for insurane coverage. Common criteria include 6 months of medically supervised weightloss (6 months of being weighed in doesn't normally count, they require an additional 6 months of going specifically for Morbid Obesity - 278.01), psychologist approval, standard pre-op admissions (xray, labs, etc.). These vary by surgeon and insurance company. Your surgeon will probably have a set of criteria, as will your provider. 3)After that, do I just call up my surgeon (I'm wanting to go to Dr. Spivak in Houston, TX) and say "Hey! I'm interested in getting the lap band surgery!" and do they just guide me from there? Determine if you're covered by your insurance, or if you will be self pay. Dr. Spivak may or may not be an in network provider. If he isn't, you can either pay the difference or find someone who is. Once that decision is made, contact the surgeon's office. Most require you to attend an information seminar during which you're given the paperwork you need to begin the process. 4)Is it possible to lose weight w/ out fills or are they necessary? You can lost weight without fills, but you shouldn't count on it. The point of the band is to be restricted. Sometimes enough restriction is given by the band itself that fills aren't needed. 95%+ of the time this isn't the case. It's safe to assume you will need at least a few fills. ...Grr, that's all I can think of as of right now. I took a shower earlier and I swear that I had questions coming out of my ears! Anyway, thanks in advance for all of your help! 5) I know that some insurance companies require you to have a 6 month weight loss documentation. This is no problem for me considering I have joined Weight Watchers numerous times in the past. How do I get my information from them? I have long thrown away all of my weigh-in cards but I assume they also keep them on file? Weight Watchers is not medically supervised in and of itself. If it was something you and your doctor agreed on, and you were going to follow-up sessions with your doctor to monitor your progress. Weight Watchers weigh in cards are pretty much worthless as far as "medically supervised" goes. See above information.

This argument really doesn't make sense to me. If you have a cornstalk with some kind of corn nub on it, "conception" has already occured. You don't have a nub of corn and then wait for it to be conceived. That's like having a fetus in your uterus, and waiting to become pregnant, or being pregnant but still waiting to conceive. A corn "nub" is not an ear of corn, it's a nub. If you leave it there it might become an ear of corn. If you remove it, it won't. A lot of things have to occur between "nub" and "ear", including a lot of developmental stages. A fetus is no different.

Hi 396Power, since I see you're back, I thought you may have missed this:

food - turkey pepperoni. I microwave it on paper towels until the grease cooks out, then blot to ensure they're as dry as they're going to get. They're nice and very crunch. I don't like chips, and try to avoid other crunhy foods, so these satisfy my cravings and they're perfect scoops for cottage cheese or garden vegetable cream cheese. Very low in fat and calories, and very high in Protein. Domestic - aside from the obvious (lightbulbs, toilet, etc.) - I have a few of them. More to come later with a little more thought, I'm sure. TIVO. It's so nice to watch something hen I have the time, without commercials, and to record it in advance using the digital guide. I'd still be here without it, but it makes life that much more convenient. Magic Bullet. I use it every day. Stretchflex...Strongflex... forget their name, but the stretchy trashbags that don't rip. My Sonicare toothbrush

Hi Funny! Things are going well - how are things for you? I still stand by my earlier - not really an idea, not really a claim, perhaps notion that better education needs to be provided. I know it's hard to educate objectively, but women need to know what their options are, what the known long term consequences are for each, etc. I also think there should be madatory psychology sessions. And I don't mean counseling, I mean with clinical psychologists who have been specifically trained in the particular area. I agree completely that people are often lead down one path. And while I agree that ultimately individuals are responsible for their own decisions, I also believe that the decision-making process needs to be theirs. To draw another parallel to the lap-band, I've had probably 50 people come to me in some form or another because they were banded and immediately regretted their decision, even though they were sure it was right for them going into it. For the most part, they're seeking help finding a way to come to terms with their decision, or tips to make life more livable. In most cases, these people were not educated about what they were doing. They heard of the lap-band, decided it was for them, and were banded a few days later. Or were just ignorant about what it really looked like (the "you don't even know enough to know what you don't know" syndrome). It's too bad, because the information is out there, it just didn't get and wasn't found by these people. Who's fault is that? It's easy to point fingers. As I've said in an earlier post, yes - people have the responsibility to educate themselves. Programs SHOULD have a responsibility to make sure their patients understand what's happening, but they don't -- but if you think about it, taking steps to educate your patients will only benefit you. Should we look to schools? Should we look to society on a more macro scale? Who carries the expense? Who carries the responsibility? I dunno. I just think that a lot of the problem lays in education - o rlack thereof.

Ugh, forgive my typos, I really miss the ability to edit!

So... my cousin is getting married in about a month. I know beyond a doubt that had this news come to me before my band, my first response would have been, "I'm going to look like an idiot because I will never find anything nice in my size." My reaction this time - "Oh, a perfect opportunity to wear that new sundress I just bought!" Guys, it's SOOOO liberating. In soooo many ways. I can go into a store (ok, so probably not Black House/White Market or Banana Republic) and pretty much know there's something there I can wear. Why is that such a big deal? Because for nearly 8 years, there was no way I was going to find something that fit unless I was at a "supersize" store like Avenue, Catherine's, LB (and even there for a while there stuff didn't fit me). I so cannot wait to have that be true for any store. BTW< I had a nice little ego bump this weekend. Went to Dress Barn, grabbed a 20 and a 22, tried on the 20, and it hung on me. Grabbed a 16 (the smallest size they had on their women's side) and it was loose. Now, I'm not a 16. I fall consistency between 18 and 20 for tops (except for Target, damn them, with the occasional 14/16 at places like Avenue or LB). And I'm 20 - 22 for bottoms. But don't think for a second I was tempted to buy that dress jusut because it was a 16.

Sounds like you're talking about me. I have very, very little interest in food any more. It's quite liberating. I do still enjoy some things, but for the most part, it's something I do because I have to. I've literally had to add calendar pop-ups to my work schedule for "go eat" -- and it's not uncommon that I go until 4 or 5 without feeling the slightest bit hungry. It was confusing to me in the beginning... I'm supposed to eat this many calories and get this many grams of these things, but I'm not hungry, and I'm not supposed to eat unless I'm hungry... but you'll find your groove.

The only problem I noticed while fat that I didn't have while thin was the sweat in the skin folds. My pannus hung, and the fold between it and my abdomen was a problem area for me. Even with daily and sometimes twice daily washing, I would sweat there - and I'm not a sweater. But the skin there is in constant friction, a very warm place, and once it got moist there was no way for it to dry out. AFAIK it never got to the point where other people could smell it, but if I lifted the pannus up, there was no doubting whether or not it had been sweaty. BTW, if anyone else has that problem, I fixed it by swiping my deodorant under my stomach. Not only did it take care of any odor, it also lubricated the skin (I use Dove, which is silkier than other brands) and I stopped getting the friction rashes. I still have a pannus, though it's greatly deflated and reduced in size, but I still do the deodorant thing every morning after my shower. I just feel better for having done it. I probably don't need to do it anymore, but it doesn't hurt me, and hey - better safe than sorry.

Jachut, I've been trying $$$ conditioning shampoos/conditioners, and all they're doing is leaving my hair feeling weighted down (IMO, it doesn't really look any different, it's just the feel) and my hair now takes about twice as long to dry as it used to. There's no difference in texture at all. Well - the hair is soft, but it's so frizzy you can't really tell. The protein makes sense, esp. since that's what we're dealing with anyway. I think I will give that a try. I have a general fondness for Redken products. Are you still happy with the results you've gotten from your haircare program?

Interior design/decorating is kind of my thing. And by "thing", I don't mean I'm good at it - I just mean I think I'm OK (prefixed by an "ehhhhhh..." - whiny ehhhh, not Canadian eh?), and most of that impression is generated by the massive amounts of money I've sunk into it. I guess one could call that "justification." Although I will say that while I'm never completely happy with the way something in my house looks (let's nevermind that I'm a major perfectionist), I do get lots of compliments and people asking me to come give them advice (that's where the cynic in me comes out - they're just being nice). So I can whip out a side table arrangement like no one's business. You'd think I could move some stems around in a vase, but it just doesn't happen. I do wrap a mean package. I'm sort of the holiday icon in my family, I'm known for my copious use of tape. Fold the paper over, tape it. Fold the other side over, fold it under itself (so you get a folded edge vs. a cut edge), tape it. Fold the top flap down, tape it. Fold the botton flap up, tape it. (Alternately, fold the side in and top it on top and bottom, then repeat with other side). I use 17 pieces of tape on the average present. I wonder how much that adds to my ecological footprint?

Yup. If you can get away from it, just leave. If you can't (and there are times where you can't), say something. Like I said - IMO - there is no "just be nice" when it comes to smelling someone else. I've also said something when it's repeated. Where I worked about 5 years ago, the guy on the other side of the cube from me would fart all the time. At his cube. The bathroom was literally 10 steps away, but he wouldn't walk it, he would just sit there and fart - out loud. And it wasn't a medical condition, he just didn't care. At least per his account. And it would piss me off when I would be on a conference call, and then out of nowhere get a whiff of something that would - very literally - make me start gagging.

Faithmd - if I do say so myself, the cake was awesome. And I don't even like it that much (cake in general, and in particular pineapple upside down cake). I had a piece, and a piece the next day, with the pineapple removed. It's very dense, moist and buttery. I can shoot you the recipe if you want. Gadget - I'm a cynic but honestly, I don't care if the story is true or not. I wonder why the person would be there if they were so upset by what they're doing. I don't know the story, and I'm certainly not asking -- but it reads as though the storyteller were "forced" into being there, in which case there's a whole lot more to the story (and perhaps the discussion) than whether abortions are right/wrong.

What do you mean by "undone"? Do you mean it "flipping" or pulling away from the abdominal wall? Or are you talking about something closer to assembly failure, where the port becomes detached from the tubing, for example? You're recently banded, you should expect to have your port area be sore for a while. It was about 3 - 4 weeks before the "twinges" and "pulls" stopped for me. 4 days post-op, I personally wouldn't be alarmed if the site of an incision felt like it stretched. It *is* stretching... the skin is stretching and hitting on the staples/glue/stitches/whatever, your muscles are doing the same. But of course, general advisory, if you're concerned -- do call your surgeon.

Oh, I'd posted to you too, Krystal (and lost it as well). How tall are you? We were almost the same starting weight, and have almost the same goal weights.

The sig restriction is actually a good thing. It keeps viewers from having to bypass too much space. Think of some of the sigs we've seen where you have to literally scroll the page just to get past it. :girl_hug: If you want to keep the info you have currently, try deleting out some of the blank lines. I *think* an empty line still counts as a line, since it's looking at "space" lines and not "content" lines (that's my non-techie explanation). Or try consolidating multiple lines of text on one line, perhaps with a ~ or / or * to delineate.

I had a big long response to this typed out and lost it when the site went down, so you just get the short version. Don't ALWAYS assume that you're just the butt of someone's joke. Even at my highest of about 380, I was still sincerely hit on. Even by guys that didn't make me vomit. :girl_hug: How you carry yourself can overcome a lot of how you look. I was always told, "You don't act like a fat person" or "You don't walk like a fat person." What does that mean? I wasn't sure, so I asked. And here are some of the things I was told that made me "stand out". I hold my head up, and I make eye contact with people. I don't submit and look away or go out of my way to walk around people. I don't move like a fat person. I had to probe a little more on this one, and was told that often, someone as heavy as I was walked like a little more of their self esteem is dripping out with each step, and I never had that look, I always looked extrar=orindarily confident and sure of myself. I would say hi to people, hold doors for them, etc. I never put myself on the outskirts of social situations (because I'm a deeply expressed introvert I would try to avoid them alltogether, but when that didn't work, I was never the wallflower). Anyway - that's how it was described to me by other people, so take it for what it's worth. Remember that it's at least 80% attitude. Don't let yourself get beaten down. And in the meantime, start thinking about how you're going to make the mental change from "butt of someone's joke" to "attractive woman". I was out with a girlfriend this weekend and two guys were following us around, staring at us, smiling, etc. Of course in the back of my head was, "they're laughing at me." I commented on this to my friend and she was like, "What?? Whatever. You're a cute, tall redhead. OF COURSE guys are going to smile at you!" And it was kind of like an a-ha. Yeah, I'm still fat, but I had no problems attracting men at this size on the way up, so why not on the way down? to me, I'm still the fat girl trying to cram myself into a size 32 or 34, but I'm not that person to anyone else.

I was not much of a sweater before, so I can't say "yes" -- but I can say that I am definitely colder. I expected I would be, hell - I've lost a LOT of insulation!

1) Is anyone having success with the band restrictions only, meaning no real excercise regime. I have time to walk a couple of times a day, but no time to go to a gym. I had some success up front without exercise, but this has become much less. Lately if I don't exercise, I don't lose - no ifs, ands, or buts. The gyn isn't the only thing that's exercise. Walking counts, and it's better if you can do it at a brisk pace or incline. 2) How soon did you go back to work? Do you think you could have gone back to work sooner? To a desk job? I had surgery on Wednesday and went back to work Monday. I did work from home Monday - Tuesday, only because my staples hit right where all of my pants fell on my abdomen. I could have gone back to work Monday if it weren't for the clothes issue, but since I can work from home I did. 3) Has anyone regreted this surgery? How many reversals are you aware of? I'm sure someone somewhere has regretted it, but I can't speak for them. I can only say that I have not. There have been some removals (is that what you mean by reversals?)... I personally know of one person who had a removal and one person who should have a removal but isn't going to. If you look here under life after lap-band, I think it is, you will find more stories.

I should add (because I can't just edit and tack it on) - the tensioner really does work to keep the ring upright, too. My fingers are tapered and comparatively thin, so I usually end up with my rings on backwards and constantly have to fidget with them to keep them upright. Especially with my wedding band - it has a large stone, and two heavy channel set bands. It likes to sit sideways, and jabs DH if he holds my hand. :girl_hug: I never even thought of using one of those things to keep the ring upright, but that has been an added bonus -- it really works!

I have a large wedding ring (I like thick bands so it's three separate rings soldered together) and a small anniversary ring. But I haven't gotten them sized yet because gold can only take so many sizings... trying to just go with one or two. Both of them will freely fall off if I shake my hands around. The other day at a self-checkout one fell off and went under the register. Damn skippy I made them get some burly guys and move the whole cabinet. Anyway - for the wedding band, I had them put a "sizer" inside. That's what she called it but I'm not sure that's the real name. It's kind of like a spring loaded tensioner. It's great at taking up the slack. For the smaller ring (a regular 3 stone anniversary ring) I just bought a companion band, plain gold, in the size that fit and I wear it above the one with the stones. Since it fits, and the other one can't fit over it, it keeps it nicely in place. Just found this link for you. It explains the tensioner thing I was talking about. There are a few other options here too.

I am not the best money saving shopper, it's one of my addictions and I enjoy indulging in it, but here are a few things I did to get more wear out of the sizes. Summer - skirts. Esp. elastic waist or drawstring. If you have a problem with your legs rubbing together, just wear a pair of spandex shorts underneath. Sure, they aren't flattering, but who cares - no one will see them. Or even thin tight cotton shorts, like workout shorts. Or use (can't remember the brand) the powder lotion. Goes on just like a regular lotion, but when it dries, it makes your skin silky like powder, and stays on. That will help "lubricate" and keep the friction away. Last summer I pretty much lived in an assortment of 5 skirts, 6 shirts, and a pile of camis in different colors. Get basic pieces that are interchangeable. Oh, and a pair of denim capris and a pair of khaki capris. Because I was wearing camis underneath, I could buy the shirts a size or two smaller than I needed, and wear them open, then a size down I would button the mid chest button and wear it open (think one tie cardigans), then wear it buttoned. Knit gauchos also helped a LOT, because one they're too big, you can just roll the waistband once and they fit just fine all over again. But they're only good for one roll, anything more and they'll go up your butt! :girl_hug: Winter - this winter I also lived on a few basics. A good pair of jeans. I don't buy cheap jeans because... well, that's one area where you get what you pay for. Invest in a good pair of jeans, even just one per size that you're in, and just wear them all the time. Good ones can take the washings. Jeans paired with a blazer (I bought several in corduroy (beige, rust orange, dark brown, etc.) a few in velvet, and one denim) and the infamous cami. I buy the camis at LB and they're under $20. Buy the one that's snug. Since you're wearing it under something it doesn't matter, and you'll get two or three sizes out of it. And they're stretchy so they'll hold their shape, even after you wear them snug. Anyway, pairing the different blazers with the different camis and a different necklace gave me a TON of outfits from maybe 10 or 12 basic pieces. A few pairs of heeled pant boots and I was set. Find other bandsters. There are a few girls I traded clothes with and that REALLY helped. And a girlfriend of mine had RNY and saved some of her clothes for me. Your styles probably won't be exact, but if you're only wearing it for a few weeks (which is what, one or two wearings? Maybe three?) then who cares. I need to meet back up with them b/c I've gone down a few more sizes since our last trade. If you go to a support group, ask there -- the one thing you can be certain of is that everyone else there is going to change a size eventually.

I'm in MO, NW part - close to KS. Banded in KS. In fact we looked at a house in Prairie Village yesterday... still debating the hop to the other state though, not completely sure it's the right move. :girl_hug: