MacMadame

There are some support groups at the various hospitals. There is a monthly one at Mills-Peninsula in San Mateo and another at El Camino in Mountain View that I have the info for. Where exactly are you in SF?

I'm really curious because UHC seems to have a bunch of different policies rather than one policy. Because everyone on here seems to be told a different answer. I was told it would only be approved if I had a co-morbidity and WLS was considered a "cure" for it when I called on the phone. But I'm finding you can call insurance companies five different days and get five different answers so I really want something in *writing*! I'm going to have them send me a copy of the policy (not the plan summary) and see if I can get them to fax me their requirements. I'd feel better if I knew ahead of times what they were though. It makes it easier to judge if you are getting wrong info.

I still haven't done mine from 2006.

That picture reminds me of Mr. Mac. He is extremely overweight in his stomach area. He also has high cholesterol, asthma, allergies and, I suspect, sleep apnea (not that I can get him to agree to be tested for it). Yet his BMI is lower than mine! He's definitely not healthier than I am though and most people, when they look at him, think he's much heavier than I am. In fact, when I went to visit my next-door neighbor to talk about WLS (he's had GBS), he thought I was asking him *for* Mr. Mac and not myself. Some day we'll have a much better measure of health than BMI and everyone will look at the BMI chart and say "how quaint!". :huh2: In the meantime, they are better than the charts they replaced, but they still aren't the be-all and end-all of how to measure your health.

Another of my pet peeves... arbitrary enforcement or lack of enforcement of arbitrary rules and policies. I have been on MANY flights where people didn't fit in their seats but weren't made to buy an extra ticket. But every once in a while an airline employee decides to crack down just by some arbitrary eyeballing and we all turn a blind eye (when it isn't us) because we all have been impinged on at some time flying and secretly we think "yeah, someone's doing something about it!" But it's all for show and we still get stuffed into our tiny seats with inadequate leg room next to Mr. I Want Two Armrests. I no longer fly any more, if I can at all help it. In fact, I drove from CA to Kansas City two summers ago because it was easier and cheaper than flying, given some of the stuff I had to bring with me. That's what the airlines want you to believe. But have you looked at the salaries and bonus plans of their top executives? How come they don't cut those? No, it's always customer service that goes. Then they tell us that they *have* to do it that way, either for our own good or because we demand reasonable ticket prices. Well, I'm not buying it... If airlines want only thin people to fly, they are going about it exactly the right way. But if they want as many people to fly as possible, including the 60% of Americans who are overweight, then they need to rethink their policies. :huh2:

If WLS surgery is excluded for your particular policy, of course they aren't going to turn around and pay to have it in Mexico. They don't pay for it period, it's excluded. Beats me, but it's not a particularly special policy. I've been reading articles about people who got it done in Mexico and BCBS paid for it before I even 'met' snowbird here at LBT.com. It's not a big secret if anyone can read an article in the paper about it.

I was turned down for individual health insurance by Blue Shield (or was it Blue Cross?) of CA in few years ago. So was my husband. They accepted our (normal-weighted) children with no problem though. Luckily he found a job right after that and we both got insurance that way. That was one of the shocks that nudge me into considering WLS, in fact.

But the stewardess said it was THE LAW. She wouldn't lie, would she?

She looks so happy to have a lap band and be on LBT! :rolleyes2:

People don't understand statistics. When studies show that lap band patients lose an average of 42%, that doesn't mean everyone loses that amount. Some people don't lose ANY and some people get to goal weight. This is the way that it was explained to me in one of my statistics classes is: Say you know that the average height of people in a room is 5'5". How many people in the room are 5'5"? The answer is: you don't know. It could be most, it could be half, it could NONE. Statistics describe groups, not individuals. You are an individual and you will lose your individual amount. So how do you know how much you will lose? You don't really. But one of the goals of the pre-op appointments with the nutritionist and the shrink are to help you get an idea of how lap band surgery works and how your own tendencies will play into your success and failure. For example, are you an emotional eater? The band doesn't help with that. Do you have a sweet tooth? Many sweets are "band friendly". Is your problem mostly hunger or portion control? The band is designed to control your hunger and limit your portion sizes. Are you someone who sticks to a diet and doesn't cheat or are you a big cheater? If you are a big cheater, it's quite easy to cheat the band. Also, 42% is a lot better statistic than you get from a traditional diet. The success rate for people who get to goal and keep their weight off for at least 5 years (not even for life) is somewhere between 2 and 9 %. Lap band patients as a whole lose more weight and keep it off longer than those who go on a diet, even those who combine their diet with exercise. The way I look at it, why do something over and over again that has a very low chance of success? Maybe the lap band won't work for me, but I already know that dieting doesn't work. They say insanity is doing the same thing over and over and hoping for a different outcome each time. That makes getting a lap band the sane choice in my book.

But they don't mean by that that every person with a BMI of 24.9 is healthy and every person with a BMI of 25 is unhealthy. Let's set aside the questionable origins of the BMI charts for now. What exactly do those charts mean? They are *guidelines* based on *statistical averages*. Statistics described populations -- that is groups of people. Statistics are never predicative for an individual. You can't look at a chart and know for a fact who is unhealthy and who isn't. When I was a kid, the charts said I was overweight. My BMI (if they had such a thing back then) was between 20 and 23. That is considered healthy now. But in 1970 I was considered unhealthy by the charts in use at the time. The reality is that I was as healthy as I was. I didn't suddenly become more healthy the day the new charts were released. You can't take any of these measure so literally. We have some general ideas as to what makes people healthy and how to measure it but our measures are inexact. Weight is inexact. BMI is inexact. Blood pressure is inexact. Cholesterol is inexact. All of these numbers are clues as to our health, but they aren't exact. You can't tell if someone is healthy based on their numbers alone. It's not even true that someone with a BMI of 20 would be less healthy if their BMI was 26. It *might* be true. But it totally depends on the individual. If you want to say that people, in general, should strive for a BMI at or near the healthy range, I can buy that. If you say that in general a BMI of over 25 is less healthy than a lower BMI (as long as it's not so low as to be underweight), I can buy that. But when you say anyone with a BMI of over 24.9 is unhealthy, I can't buy that. Because it's not true and it's not what the medical community is saying and it's not what the BMI charts prove.

I always put up the armrests when I fly and am seated with family. No one has ever tried to stop me and I've seen lots of people do it. So I'm wondering about this "law" and somewhat doubtful that it actually exists.

I thought I was fat my entire life ... well from about 8 or 9 years old on. But I recently plugged my numbers from when I went on my first diet into a children's BMI calculator and they put me in the heathy range. Plus my next youngest sister was my size even though younger but she never got the fat label. Families can be weird the way they label people and the labels don't even have to match reality.

You probably should have done this beforehand rather than after the fact, but your surgeon and and the hospital often have negotiable rates. For example, it's very unlikely that the self-payers are getting billed for almost $60 for this surgery. In fact, that's the highest I've ever heard of. They will bill the insurance company for some outrageous rate in order to guarantee they get the amount they really want, which is often much less. Explain that because they are out-of-network that you are essentially not insured and see if they will cut you a deal.

I think you have to pick something you love to do even if it's not the best exercise. I spent the past 10 years ice dancing and it's not a big aerobic workout, but it was fun and I was willing to do it. At one point I was doing it 6-10 hours a week! That's way better than not doing anything. Which is what I'm dong right now. :smile2: I went to Curves for a while and I loved it. -I loved the hydraulic machines because I always worry with traditional ones that I'm using too much or too little weight. I can control the hydraulic ones so that I get the perfect amount of resistance. -I also loved that it was a bunch of unfit ladies and not a bunch of gym rats. -I loved that if I was doing the machine wrong, I'd get corrected right away. When I go to the gym I can *never* get the attention of the people who work there. They are either chatting up the hot chicks or hiding from the customers. I hate the hours and the location though. It wasn't convenient so I stopped going. We have a gym at work that is free and you can even hire a personal trainer as there are several who are contracted with the company. They have pilates and yoga classes, too, that are run by a combination of employees and a contractor. So I'm going to try that. First I need to have a week where I'm not out at doctor's appointments several times a week though!

You are also more susceptible to colds when you are dieting.

I don't agree that the stewardess can take care of the kicking kid. The stewardess can't do more than ask their parents to not let their kid kick the seat. But if the parents aren't going to stop their kids from kicking, they aren't going to do it. And if they are a certain type of person, they will just get mad at YOU for daring to criticize them, their little darling, and their parenting skills. Heck, some lady had a guy move out of his assigned seat and come jack off on her and the stewardess wouldn't do anything about, not even tell him to go back to his assigned seat. They aren't going to do much about annoying people unless it's really, really bad. Someone who keeps asking you questions so you can't sleep isn't bad enough. Airlines are one of the worst run businesses in the world, IMO, and making seats smaller then demanding people pay for two of them is just one example of how they don't keep the customer in mind.

I don't like people typing like they are texting. It's not THAT many more letters to say your instead of u and you're instead of ur. Also, I also don't like it when people whine about people whining about poor communication skills. :biggrin: We're all going to make mistakes -- misspell an occasional word, leave out a word, type it's instead of its -- but some people clearly make NO effort. You don't have to be a master writer to hit the return key once in a while. Even if you don't do it in the "right" place, if you put in a return every couple of sentences, it will make your post 100% easier to understand. The same with capitalizing words like I and the first word in a sentence. Posting a message on a public board should be about communication, not about verbal regurgitation, and if you can't type something that people can understand without major effort, you need to improve your communication skills.

Ooh, good one. But I still disagree that a person with a 24.9 BMI is healthy but a person with a 25 BMI is not. Sorry, but you aren't going to convince me that as soon as you gain that extra pound or two, you stop being healthy. That's not how science or statistics works. The BMI charts are just guidelines and you can't take them so literally like that.

Why should I have to smell someone else's perfume that aggrevates my allergies? I paid as much for my seat as someone who doesn't have allergies. Why should I be miserable? Or how about a smelly person? A loud talker? That drunk guy who can't keep his hands to himself? How about that kid who keeps kicking the back of my seat or the family flying with a small baby who keep crying? The guy who sits down and immediately grabs BOTH armrests so that the person in the middle hasn't got any place to put their arms? Should they all have to pay more because all these people are annoying the crap out of the rest of us and even impinging on our space? At a time when the average American is getting wider, airlines have responded by making airline seats even smaller and closer together. Heck, I'm barely over 5 ft and my legs are too long for the average airline seat. I really feel for those are who are taller than average. Airlines have made fat people the scapegoat, but in reality charging a few people extra for a second seat isn't going to make or break their profit margin. Then, they institute the next cheap-ass policy to try to save a few more nickles and it turns off even more people so even less people fly so they make even less money. It's a vicious cycle and they can't seem to see how badly they run their business. P.S. I have flown next to normal weight people who still spill over into my seat. They do it because they sprawl in their seat and are rude jerks who don't care about anyone else but themselves. (These are usually the two armrest people too.) Should the airlines charge them more too? I'd actually be on board for that -- you can choose not to be rude, but obesity is a lot more complex than that.

They don't really fold it, as far as what I think of when I hear the word "fold". They kind of scoop it up and suture it in place on top of the band so the band is in a sort of tunnel formed by the stomach wall. (I've been watching lap band surgeries online. :biggrin: )

You need to get a copy of your insurance policy to find out the exact wording of the exclusion. Some people have policies that say WSL is excluded period and for those, you should only appeal if it's part of the process to get your company to hear your case. (I.E., if the appeals eventually go to the board at your company that approves exceptions). If your company doesn't do it that way, you need to use whatever method they do use to get your appeal to the right people. But some policies say WLS is excluded unless medically necessary and in those cases, you can appeal and make a better case for being medically necessary and it will work.

BCBS will pay for lap band surgery done in Mexico. My insurance company is Aetna and on their "Find a Doc" site, there is a special drop-down for Mexican doctors in the Vitalidad HMO plan. So... I think you are misinformed. P.S. It's "you're telling me", not "your telling me".

A while back someone posted the official clinical policy on bariatric surgery for Aetna. It looks like I won't be able to get this surgery with Aetna because my employer excludes it and I will have to switch to one of our United Heathcare policies. So I'd like to find the official policy for UHC. I haven't been able to find it on their web site though. I'm interested in what their policy is for approval and also what their requirements are. I meet the NIH guidelines... BMI over 40 plus 1 co-morbidity. But when I called our UHC hotline, they said they only approve if you are doing it to treat another disease and it wasn't clear if hypertension was one of the ones they allowed. It's hard to get info out of them since I'm not a member yet (plus every time you call these companies, you get a different answer). If I'm not getting approved with either one, I want to stick with Aetna as the policy I have with them suits my needs very well and the UHC policies we have are what are called "affinity" plans and I don't think will work as well for our family. But if switching means getting insurance to pay for it, then I'll switch.

That wasn't my experience. Airlines have a special bereavement rate that is lower than their normal full purchase rate, but it's still higher than the rate most people pay and to get it you have to jump through a lot of hoops -- some want you to bring a copy of the death certificate! Like I'm going to have that when I fly to my MIL's funeral. There is a bit difference between asking if you need a different seat and strong-arming you into paying for two seats. There is no *law* that says you have to pay for two seats. That's just an airline policy. Airlines are making it harder and less pleasant for more and more people to fly every day and then wonder why they can't make a profit. Companies that don't pay attention to the customer rarely last long. Many of these airlines would be long gone if they didn't get government bailouts and subsidies.