aculberg

Hi everyone! I had my surgery on the 16th as well. Just got home a little while ago, had to spend one nt in the hospital because they had to fix a hiatal hernia as well as placing the band. When I woke up from surgery, it felt like an elephant was sitting on my chest! A couple shots of morphine took care of that. But now that I'm home, my neck and shoulders are killing me, I guess from the gas pains. I've been up walking and that helps a little, but sitting and lying down hurt way too much. I've been using a hot pad on my shoulders and that helps too. If anyone has any other suggestions, that would be great. Also, my stomach is growling and going crazy, but I'm not really hungry, isnt that weird?! Good luck to us all and a speedy recovery...

Sunny - Definately appeal it! You have all of the qualifications, just fight them. So far, I havent seen anyone get denied on their appeal! Its just gonna take a little longer, but you'll be way more prepared. Go for it!!

I'm so happy for you! When is your pre-op appt? I start my clear liquid pre-op diet next Tuesday, and I'm trying to get ready for that, and I've been stocking up on things for the all liquid phase after the surgery. I've even been cooking huge meals and freezing them for my family for afterwards, I think theyre gonna hate me! lol At least for the first month or so!

Yay!! Woo-Hoo!! I just knew that they would approve you...see it pays to fight the system!! Congrats, now you can relax and focus on the next phase, getting ready for the surgery. Thats the stage that I'm at. I'm scheduled for Sept 16. Welcome to the September Samurai's!!

Yay! I'm sure you'll get approved now. Best of luck, keep us updated.:thumbdown:

RestlessMonkey, How did your surgery go? Congrats on finally getting banded!!

Question for you guys, Does Tricare cover fills? I am approved for the surgery, but cant find anywhere that says they actually cover fills?! Thanks!!

So, tell us about the surgery, and what its like after...I Need Info!!

That's funny! I saw this saying once somewhere "Never Trust a Skinny Cook"!! I thought it was soo great...because I am a great cook, and thats going to be one of my biggest challenges with the band. But there's another one too that I heard..."Nothing tastes as Good as being Skinny Feels"!! lol

It sounds like some of the reps at Tricare are just being petty b/c I was about 5-7 lbs under the 100lbs according to the "metlife scale" and mine was approved, so like I said before, I think its whose desk your package lands on, and how picky they are! I do have a question though, how many that appeal still get denied? I cant find many so I'm just wondering.

Hi there! I am scheduled to be banded on Sept 16th, and am also looking for tips and suggestions for the pre-op diet. I have my pre-op appt on Aug 27, so I will find out for sure what kind of diet I have, but I believe its a week of clear liquids with up to 4 protein shakes a day! I am trying to get prepared for this, and have NO idea how I'm going to do it, but I AM going to do it! So, any suggestions would be great, esp for the clear liquids...soups, etc.

Maggies - I think I will have a week of Clear liquids pre-op, but I will find out more at my pre-op appt this Wed!! I am gearing up for that anyways, and trying to find all the clear liquids that I can, lol. Good luck!

The process is actually pretty easy, but can be soo complicated at the same time! 1. Get the referral from your pcm to see a surgeon. 2. See the surgeon for an initial consult, he or she will weigh you and have you start all the process for your insurance, and order any tests that they will need. Tricare only requires that you be over 100 lbs according to the MetLife Ins table, and have at least one co-morbidity, like diabetes, hypertension, sleep apnea, and at least one other one, I cant remember! 3. Like you said, you'll need to see the dietician, have a psych consult, which Tricare will pay for IF you see a participating provider, have a surgical physical and bloodwork, and that can all be done on base. 4. Once you get all that done, your surgeon's office will submit the whole package on to Tricare. In my opinion, its all a matter of who's desk your info lands on, and how picky they are, as to whether you get approved or not! My best advice to you on this subject is, keep on top of the docs, keep copies of EVERYTHING, including your medical records, and make sure the surgeons office knows everything so they can submit it with your package. The more info the better! And stay on top of them! lol If you have any more questions, feel free to ask, I'll help any way I can! Best of luck.

No, Tricare doesnt require the 6 month diet...but alot of ins companies do! Good luck!

You GO Girl!! Dont let them get you down! Try the rolled up coin bit, I didnt think of that one... How soon can you resubmit it? Does Tricare make you wait any certain amount of time? How long has it been since you first weighed in? I cant believe they are being so petty about 6 lbs!!

JWRN - I am soo sorry about that! Are you going to appeal it? I definately would, tell them they got your height wrong, lol. That should help! Seriously, keep on fighting...you deserve this!

Ummm, the only problem with that is...my surgeon did kinda a mini physical and actually checked my ankles (for edema) and my stomach (for scar tissue and adhesions), so I'm not saying *not* to do it, just beware! That would be totally bad if you got caught!!

I totally agree with JWRN - be prepared, go armed, and DONT take NO for an answer. It helps if your PCM is a civilian, in my experience, military docs are just mean. Probably not all, but mine were. lol You just have to stick up for yourself and tell them this is what you want!

Congrats! Isnt it such a wonderful feeling??? And a really fast approval!

I just found out that I am approved, and I too, was quite worried about it b/c I was on the borderline of the 100lbs, but I did have hypertension, and some other co-morbids that Tricare doesnt recognize. Mine kept saying "pending approval" for over a week, so I called them and turns out they needed more info, that I then faxed to the surgeons office, which they submitted back to Tricare and viola, I'm approved! So, stay on top of your paperwork, and keep up with what the surgeon's office is doing and also Tricare, dont be afraid to call and see whats up!

Michelle - I love it! I actually laughed till I cried about the boat/snorkeling comment!! I completely understand that one! I'm Amie, 33, married to my husband Bret for 15 yrs, he's active duty Air Force and were stationed in UT. We have 3 beautiful children, a 13 yr old daughter (yikes!), a 11 yr old daughter, and a 4 yr old little boy. I am a cosmetologist, and am soo looking forward to being able to work without my feet and ankles killing me, and fitting in with all of the stylish people in this industry, having more energy for my hubby and kids, and just fitting in...everywhere, in clothes, and mostly in life. My birthday is in Sept, so this is the greatest present of all, a new ME. I feel like I'm being re-born. Sounds corny, but I'm sure you all will understand. Yay for us!! :biggrin2:

That is so great, what a wonderful guy! What do you have to do for your pre-op diet? I think my surgeon mentioned a week of clear liquids and up to 3 protein shakes a day for me, but I guess I will find out the specifics at my pre-op appt which I am yet to make. Please let me know how it goes, and any suggestions along the way. You got a really early surgery date, thats great! I think mine will be in Sept. Congrats!

I know! Thats how I was, I think I was making myself sick about it. But I truly do think its whose hands your package ends up in at the insurance office, that makes all the difference. The woman I spoke to was so nice, she was genuinely happy for me, and was so pleased to give me the good news that I had been approved! I guess the only thing that got my mind off of the waiting was that I could appeal the decision, and was getting prepared to do that and not waste any time!

I, too, just went from "pending" to Approved!! Yay! I didnt think mine would make it either b/c I'm a little shy of the "magic" 100 lbs...but I too had alot of comorbidities, and I guess that helped. I was really getting worried b/c I've been seeing alot of denied's on here as well. I was actually getting all my appeal paperwork ready! But now I'm so relieved...and hopefully my surgery will be sometime in Sept (a great birthday present...a new ME!!) What will we Sept surgeries be calling ourselves?? Congrats to all the approvals and good luck to all the pendings!!

Hi everyone! I just found out today that I am approved!! Yay! I was getting really worried because it kept saying "pending" and then Tricare needed more info, so my docs office faxed it in and the lady from Triwest actually called me today to tell me it had been approved!! She was so nice and said that I would have to stay overnite ( I'm also having a hernia repaired ) and that they would call me to check after surgery! So, from the time the doc's office submitted to Tricare, its been 10 days. Since I started this whole process, about 2 1/2 months.