justmee

Hello, I am new to this forum so bear with me. :cursing: I am Tricare Prime (TriWest), assigned to an MTF. Does anyone know what steps need to be accomplished to get approval for Lapband? I am at a BMI of 40. I have talked about this several times w/my PCM prior to it being a covered procedure. Once I found out it was covered I talked to her on the phone and she put in some referrals. I can't into an actual appointment w/ PCM until the end of the month. I have referrals in place and appointments with right now: Nutrition Psychiatry General Surgery and I am registered for 2 "Therapeutic Lifestyle Change" classes But my referral to Case Management was denied as "more information needed". So my question is: For those who have been Prime, assigned to a MTF, looking to be banded at an MTF......what steps did you have to take? What was your experience? Does the General Surg make the decision? Does it not bode well that my referral to Case Management was denied? (PCM is trying to find out what more is needed) Thanks in advance....:drool:

Right now I am drinking the Nectar Chocolate Truffle with a tiny bit of SF Coffee Mate and a splash of SF caramel syrup and it tastes like a Milky Way bar to me. It is yummy!

I want to tie my shoes on the top, not the side. I want to build a sandcastle with my kids and not tell them "no, not right now" because I don't want to be embarrassed trying to get back up from the sand. I want to buy clothes because they are cute, not because they hide me I want to hug my husband and be able to melt into him, not just feel like I am smooshing my tummy into him

I am drinking the cappuccino flavor Nectar right now with a splash of S/F caramel syrup and it is yummy! By far my favorite of any of the "coffee" ones I have tried so far.

The steps I have had to take so far: I had to get approval for a case manager. She will be the one helping to co-ordinate all my other appointments. I meet face-to-face with her on the 18th. I have had to register for 4 "Therapeutic Lifestyle Change" classes. (Note that is up from the 2 classes I was originally told) I have to see a nutritionist every 3-4 weeks to monitor my progress on a low-calorie/high Protein diet. I have to attend monthly bariatric surgery support group meetings. I was started on my "pre-op" Vitamin and beginning Protein shake regimen. (40g of protein in supplement form every day) This will continue for approximatly 6 months. It can go faster depending on when the caseworker and nutritionist think I am ready to move on. I was also warned that they have kept others in this "limbo" for over a year. I am also going to have to meet with the psychiatrist at my MTF and undergo a couple personality tests. I meet with the surgeon on the 25th to discuss the surgery and weather I am a good choice for Lap-Band or if traditional by-pass is the better choice. (If they won't do the Lap-band, I am really not sure where to go from here because I don't like the idea of a bypass.) So this is where I am sitting with what needs to be done for Tricare Prime to be banded at a MTF. I can't help but wonder if each MTF comes up with it's own hoops that we must jump through. Anyone else banded/going to be banded at a MTF? What was your experience?:confused2:

I am slowly working my way through the many hoops needed by Tricare Prime to be banded at a MTF. Today is my appointment with the nutritionist. What can I expect? I have had to keep a weeks worth of food records on Mypyramidtracker.com. After doing that I see that I eat on average 1700 calories a day. When I go in there will the nutritionist do a "Duh...no wonder you're fat!" (not in that form of wording of course:biggrin:) and want me to be on a lower calorie plan before she will give her okay? I know no one can predict what any particular nutritionist will do in any specific situation, but has that happened to anyone else? I have my appointments for "Therapeutic Lifestyle Change" classes next week, the appointment with the surgeon on the 25th (yes or no appointment :huh2:) and then the final hurdle of psychiatry on the 31st. On my way to Bandland........I hope:thumbup:

I have been approved to see the surgeon: Dr. Sebesta, at my MTF. I have also been approved for Nutrition and Psychiatry. I have already done my sleep study. However my case management referral was denied pending more information (???). What steps have others had to take? Anyone else seeing D. Sebesta? Thanks:thumbup: