NanaRenan

Do the doctors who did your banding not do fills? I'm not sure about OA meetings. I had a negative experience years ago that left a bad taste in my mouth -- pardon the pun! But I'm happy to chat online any time!

My policy with Aetna required a '90-day' program as part of the criteria for submission. The surgeons's office allowed me to do my monthly weigh-ins at my GP's. But they sent it in with only 3 dates" March 19, April 20th and May 2nd....the girl assured me that it would be fine since it was three calendar months. It wasn't. Aetna kicked it back on appeal. Good thing I also went in on May 22nd!! So, June 19th, they sent in an amended appeal with the updated facts. I'm like a cat on a hot tin roof!!! The NOT KNOWING is excrutiating! But in all honesty, getting denied relieved some of the pressure!!! I'd been dreading that for so long that it felt good to get it overwith!

I'm still on the outside looking in -- in appeals process with insurer -- but I'd love to be a part of a group. I'm in Pearland near Beltway 8.

I'm just so skeptical that they're ever going to approve me -- I'm flat out sabotaging my 90 day supervised diet!!! And I know its because if I do it and lose a little, I'll get my hopes way up. By shooting myself in the foot, I can't get let down and lower than I already am. I'm SO tired of how this all plays with me head!

Right -- I have a sister who's 11 years older than I am. I've watched the onset of her diabetes and the resulting neuropathy. Three years ago she had a double bypass at 52 and is STILL trying to get on disability. Now she has cellulitis on both legs and is undergoing treatment for that. My mother had had diabetes for many years before it was diagnosed. (The woman NEVER went to the doctor!) And died from strokes. I hope if the lap-banding procedure can help me lose about 100-150 lbs I can avoid some or all of those nightmares.

Wow, Mary Sue!! I tho't I was bad -- I have a fairly steady addiction to the 44 oz. Diet vanilla Cokes from Sonic. It's bad enough that ALL of my family members have reloadable Sonic cards and cell phones and they know better than to come home without checking to see if I need one. But I can sip on one of those things for hours and hours. It actually hampers my attempts at weight loss tho' -- because if I have a Route 44, I don't eat and my metabolism never gets 'turned on'.

I have Aetna POS and my doctor's office also says a three month program is what is required. I begin that on Monday. So far, I've done the sleep Study and the Psyche Eval as well as blood work and had an endoscopy. 5 years ago I tried and was denied -- since then I've developed diabetes, GERD, high cholesterol and a heart condition -- seems to me like it would've been cheaper for them to have approved my surgery back then!

Glad to know I'm not alone. My MIL was a real doll -- seriously, we had very little problems in the 25.5 years I was blessed to be her DIL. BUT, the times we DID have problems, was when I did something she DIDN'T do....like have four children (to her 3) or be a stay-at-home-mom (she said she always "had" to work). Of course when she saw that I was going to have four in spite of what she said -- she loved her as much as all her other grandkids. And when she saw that my children wouldn't starve and my husband wouldn't drop dead from exhaustion if I didn't work outside the home, she eventually got over that, too. We call it the "Dove and Degree Delimma". Expressing confidence in a product or procedure rattles the cages of those who are grappling with similar issues. If I come on here and rave on and on about how great my Degree Deodarant is -- that it is THE best -- and that everyone should be using it. Those of you who use Arrid or Secret or whatever start to get a little defensive. If I brag on my Buick, Chevy owners get bristly. It's the same thing with losing weight. Maybe the MIL in the first post is afraid you'll rub her face in her own weight problem if you succeed. Not that you would, but in her pain with her obesity, even the slightest remark can be misinterrpreted as critical.

I think you answered your own question here. She doesn't want to watch you do what she's herself can't......lose the weight that imprisons her. It's the "crab bucket" effect. Something petty and carnal in our human nature seethes when we see someone else succeeding. So we want to tear down their success and bring them back to our level. It happens when one of the single gals in the group gets married to a great guy. All the gals who think they'll never find a guy hate her and all the ones divorced (or still married to) a jerk are jealous. It happens when someone from an impoverished family gets an education and a good job. It happens when one of the gang quits smoking or quits drinking. And it happens when someone loses a tremendous amount of weight. 17 years ago I dieted down from a size 22 to a size 10. My fat friends and relatives were mean to me -- told me I looked sickly and would ask about my health. This is what's going on here....the accusations of "dishonesty" and the anger are just a ruse to cover up her fear that you will succeed in doing what she KNOWS she needs to do for herself.

Today hubby says, "No, open enrollment was in November." Grrrrr.... He was the one, WHO, on Oct. 22nd said, "No biggie, if we can't get you approved with Aetna by Feb, we'll just change insurances." He's back-pedaling trying to say that "I" misunderstood. Does he REALLY think I would misunderstand about something so important?

I have YET to speak with Melissa. BUT, today I find out that Spiegel is no longer accepting Aetna..... GRRRREEEAAAATT!!! Now that I've got proof that meets their criteria. SOoooo, I call Spivak's office to find out that he won't operate on anyone who DOES meet Aetna's "criteria". It seems the "criteria" for lapbanding is a list of reasons why you wouldn't be a good candidate for gastic bypass.....and according to Spivak, those same reasons mean you also wouldn't be a good candidate for lapbanding. So NOW what.....? Should I just give up...? Are there any other good LapBand surgeons in Houston?

Insurance enrollment starts Feb. 1 I'd like to know what company seems to have the best track record for approving lapbanding.

What happened that constitutes fraud?

The more I read about Dr. Spiegel the more concerned I am. Maybe I should check out others. First rattle out of the bag, when I made the appointment for the seminar/consult I was told they would call me back to confirm. They didn't, I called the morning of (early on Saturday) to make sure, before I drove all the way over there, that I was on the list. I was -- but no one had ever called. I was very pleased with the ladies talking before and after the seminar and his presentation during was excellent. The "consult" could only be described as a 'drive-by'. LOL He told me what I already knew...that I needed banding and should qualify. And the ladies told me what I feared, that Aetna is a big, ugly witch to get it past. :ermm As we left, my husband and I were told that a "case worker" would be assigned my file, would contact the insurance company and talk to me within the week. Three weeks later I called and was chastised that it was MY responsibility to contact the insurance company and prove to them that I met the criteria myself. Now I was aggravated at those ladies in the seminar who made it seem like the office staffers were pit-bulls on the ins. co. and would really go to the mat for us. About three days later someone left a message telling me that Aetna had denied me. That's all. :tired Okay, so I called, faxed and faxed again and yesterday received surgical recordes detailing adhesion surgery I had years ago -- one of Aetna's "conditions" for surgery. It's time to get back in the fight. But with all the things I'm reading along with what I've already experienced, I'm really thinking I should seek out someone else. Opinions? Comments? Advise?

Hey, I "was" that "little" little sister sitting at the table til bed time. And all through childhood and adolescence I was picked on for being skinny. Because my mother and sister had been obese since childhood, I tho't I'd escaped that genetic "curse". My sister was thrilled several years ago to realize I was finally as big as she is. But, 11 years older than me, a diabetic who recently had a double by-pass.....I DON'T want to follow in her footsteps! Thanks for the post, Trying2live....I've recently come to realize that I still need to work on my portion control....making healthier meals is good. But that's not the end of it. I think I need smaller plates.

I found this thread when I did a search on "adhesions". How exactly do they determine if a person has adhesions without actually doing surgery to see...? Does prior surgery for adhesions (like 14 years ago) suffice to qualify one now? I have Aetna and ran into their wall of requirements. I called the hospital where I had surgery in 1992 and had my records sent to me, they clearly state that multiple adhesions were lysed during that surgery. I'm faxing it to my doctor's office tomorrow. I hope to hear something soon. Insurance enrollment is in February!! Any insurance companies that are pushovers at approving lapband...?

Thanks for the replies. I'll call them tomorrow. I did send a fax to a hospital where I had surgery a few years ago...I'm hoping details in the report will help facilitate the insurance approving it. I guess I'm getting antsy and emotional. (I just had a good cry because the recycling people took the basket my newspapers were in!) LOL My daughter is expecting a baby in late Spring and I want to be able to go attend to her...but in my current condition, I wouldn't be much use. I'd like to get the surgery ASAP -- even a 20 lb. weight loss would be very beneficial at this point.

A ? for those of you who used Dr. Speigel... How long from your first visit (seminar, whatever) until you heard from them...? I attended their seminar and had a brief one-on-one on October 22. My husband and I both left with the impression that I would get a call from my case worker that week, but I still haven't heard anything. Should I call them? I'm anxious to get the process moving along. If my insurance isn't going to cooperate, I need to know so we can switch when open-enrollment comes around in February. Thanks in advance, Nana

I actually quit lurking and registered just so I could reply to this thread. I'm at the very beginning of the investigative process, so I'm learning a lot, but wanted to share something that works for me. I buy spring Water in the 16 oz bottles, by the cases. I have baskets or cubbies all over the house and disperse a case as soon as I get home. There are bottles EVERYWHERE. By the computer Under every end table and night stand On the magazine stand next to the toidy At my work table On top of the dryer Basically anywhere in the house that I MIGHT be standing or sitting when the first flicker of hunger or thirst hits me. I grab a bottle and toss off 1/3 to 1/2. Then leave the bottle sitting there. My family knows to hold on to their's, only mom can leave recapped bottles "out". I used to struggle and fight to get down 1 to 2 bottles of water per day. After I started doing this, I can effortlessly empty 3 or 4 without even thinking about it. Have a good day. I'm off to my first Lap Band Seminar and 1-on-1. Renan