bklyn1984

You know what? It's time to take care of you and move on from him. Erase his numbers from your cell and home phones and ignore him completely. I think this creep gets some sort of pleasure out of watching you get upset. He loves to keep you miserable and enough is enough. I do not know you but from what I read in this post you are above him in every way. Do not let him ruin all of the hard work you have already put into this journey. Let her have him I say. I have been having the same conversation with my sister he's not worth it. Keep yourself busy go for a walk, go to the gym if you belong to one or a night out with the girls. If you do catch up with him and he gives you these false promises just tell him you know what I am busy right now why don't you go and talk to your new girlfriend I have a life to live and it does not include you and your problems. Have a nice life! Do not go to his level by texting or calling him either because really who is it hurting not him? Sure he may get pissed but what will you get out of it other than more misery. I'm sorry for being forward but it's a sore spot right now since my sister is going through something similar. Stay strong you will be fine really! I find nothing wrong with coming here and talking about it I found that there are very nice people here.

My DH is very supportive and my cheerleader right now. I told some of my friends and got mixed reactions but none so bad that I am afraid of losing their friendship over it. The friends that are not so sure about it I do not bring it up in conversation anymore and we're fine. I then told some of my immediate family who I knew would be very supportive even if they did not agree with my choice. They handled it exactly the way I knew that they would. Now when I go over to their house they call before I come to see what I can eat. They will go to Trader's Joe's (favorite place) and buy food which I can eat right now on my pre-op weight loss. My Grandmother is 86 years old wanted to be educated about it before she would agree :biggrin: So I explained the whole process to her in a way she would understand it and yes I got her approval (I hope the insurance is this easy). Her only concern was the surgery like everyone elses family no one likes to see anyone go through it. I will not tell my dad and mom since they will not understand and will give me nothing but grief and anxiety over it and it's not what I need in my life right now. I do not know if I will ever tell them but they will be happy to see that I lost weight and that I am happy and healthy. That's more important to me.

Here's what my benefits says I have BCBS FED Standard Option: Gastric restrictive procedures, gastric malabsorptive procedures, and combination restrictive and malabsorptive procedures to treat morbid obesity – a condition in which an individual has a Body Mass Index (BMI) of 40 or more, or an individual with a BMI of 35 or more with co-morbidities who has failed conservative treatment; eligible members must be age 18 or over. Benefits are also available for diagnostic studies and a psychological examination performed prior to the procedure to determine if the patient is a candidate for the procedure. While it does not mention anything about the length of documentation my surgeon took six months worth so I would check with your surgeon's office. I have a surgical coordinator who is very familiar with their requirements so I am sure your surgeon's office should be too. I would explain the situation and tell them about what you have now and what you are considering and go from there. I used to have NALC and they were an absolute nightmare. I am so glad we switched during the last open enrollment. Everything that I have done already has been paid for minus my responsibility. I was told that they I would pay out 10% after they pay out 90% for the procedure with no co-pay. The 10% is not based on what your surgeon charges. It is based on what BC pays out. The same pay out for anesthesia and $100.00 per night in the hospital. Here's the link to the site choose one option at a time to see the difference it's for this year: New Members Index

I had read on one of the boards that surgeons from the United States actually went over to Mexico to be trained for lap band surgery. I googled this and found a Dr. Ortiz from Mexico who actually trains United States surgeons here in the United States. I am not recommending him or anyone from Mexico because I would be lying if I said I knew about their qualifications. Below are links that I found so that you can read up on it. I am fortunate to have insurance that will pay for the surgery. I would probably consider going there myself if I was self pay. From what these sites say this surgeon is one of a small group of surgeons that done more WLS surgeries than United State surgeons and if this is true than here's your proof about the experience level. Lap-Band For Life - The New Lap-Band Book by Dr. Ariel Ortiz Lap Band Surgery in Mexico - Dr. Ariel Ortiz at the Obesity Control Center I cannot begin to imagine how you feel but I wish you all the best with this. You should be number one in your life right now I know I am. I did not decide to have WLS for anyone but myself. Just make sure like everyone here has said you do all the research necessary.

Exactly and that's what I meant by not only people who choose lap band gain weight back. That was the point not why they gained it back. You implied that the only people who will gain their weight back are people with lap bands and you're misinformed. My sister's friend and Carnie who both had gastric gained weight back. They will only lose the weight they gained back if they get back control and Carnie has. She has lost 40lbs of her gained weight and looks great and should be applauded. Now my sister's friend well that's too long of a story for here.

Did you see the recent episode with Rose? Not only the Psychologist is denying her the insurance, and the surgeons are too. Rose needs help before she can have surgery. In my opinion she will be unsuccessful and it's sad she has so many things going on including a severe shopping addiction. Why is that important? Well for one thing her insurance requires up front money and she's saying she has no money but part of what the psychologist finds at home when calls for help is astounding. She has $2000.00 worth of handbags crammed into her daughter's dresser because she was hoping to hide it from her husband and she had no other place. I wish that I knew when they will air this episode again so you can see that's there's more to the story. I was told when I went for my visit that it was not her job to deny me but to make sure I am mentally ready for WLS and afterwards. We all know that this decision was not an easy one to make. I went into this visit with the attitude I had when I decided to have WLS. I am doing this for me and my health and no one else. I am more than 100% committed to this. I have a strong support system and no one will stop me from achieving my goals but me.

This was such a great response. I totally agree. I went to two seminars for three different surgeons (two of the surgeons are in the same hospital) before choosing the surgeon I was most comfortable with doing my surgery. I also did a ton of research on all options before I made my choice for lap band. This is not an easy decision to make. It's what is best for you and only you. You should be number one in this choice. Good Luck :mad2:

I agree that it's what's best for each individual. If you were trying to say that you can only gain weight back with the lap band then I will disagree with you on that one. My sister's friend had gastric and went back to her habits and gained most of her weight back. Here's an article on Carnie Wilson and her challenges OK! Magazine - First for Celebrity News - Carnie Wilson's Weight Struggle If you know that you can gain weight back with either one then I apologize for the above.

ROFLMAO!! :smilielol5:It was gross but so friggin funny I got over it very quick. Yep Karma is a bi*ch and I love it!

My support group is run by a behavioral therapist who fully supports WLS 100%. She does not side with one or the other she believes it's what is best for each individual. Ironically enough my group has a very high percentage of lap band group members. A member tried to talk me into RNY and I told her personally it's not for me and not to take it personally. I told her thanks but I would not judge her so do not do the same to me. She does not talk to me anymore but that's okay I am not there to make friends. If I do I will count that as a blessing. I am in no rush I plan on living a very long healthy life.

This is BS! :biggrin: The hospital should be fighting this not you. I would personally go to the coordinators office and not deal with this on the phone. Go over everything with them. They receive other letters from the insurance company that you never see so they know exactly what additional information the insurance company is looking for i.e. surgical reports. I would also consult an attorney about this too and contact the state health insurance here's a link I found for you Health Care Services - Health Insurance - State of California I would report this situation to them. They need to be your advocate for this. It's a breach of the contract the insurance company has with your hospital and other providers they are not paying. This is intimidation and harrassment from the insurance company. They are not getting what they want from the hospital or anyone else they asked for information so why not go after you. They know that you will not accept this lying down and that you will make sure they get what they are looking for. Also, make sure that you contact everyone that you could possibly get a bill from notifying them upfront what's going on. Their billing coordinators should be able to work with you and not send you to collections. Note the date, time, and who you spoke to and what the outcome was i.e. they will make note in their computers. We did that at the doctors office I worked at so we would know why the patients bills were outstanding and at the same time our office would continually contact the insurance company to get the matter resolved. You should not have to do this alone I know that you will be doing most of the leg work to get this resolved but also make them work for their money too. Do not make any payments or payment arrangements to anyone just yet. You should only pay the patient's responsibility portion of it and nothing more.

Do not even get me started about the sleep study and I needed pulmonary clearance because I am a chronic asthmatic and my surgeon wanted to make sure that my pulmonary doctor was on board with this surgery. When I went to make the appointment for my pulmonary doctor the staff would not make the appointment with him and insisted that I see the sleep doctor who did my sleep study in 2006 which was negative for sleep apnea. I had it out with this doctor when she told me I had to have another one ($$$$ is the main objective here not my health in my opinion). Then she tells me well why did you make an appointment with me? I told her it was her staff not me I did not want to see her in the first place. Her staff insisted on it because of the type of surgery. She defended them. Bottom line was that she would not clear me for the surgery unless I had one and the surgeon's office told me that if she wrote that they would insist on it. So this weekend I had one with no machines just the crap wires. Which I am sure will show that I am negative again for sleep apnea. Fortunately, I had a 6 month follow-up with my pulmonary doctor this Wednesday so I am going to insist he take over for her and provide my clearance. He knows me better than anyone when it comes to my asthma. I am not going to see that other doctor again. Now here's my question for you what is considered nutrition? Do they require a number of months? Do they require that the documents be no older than a certain year? I have 9 months worth of documents from a doctor but it's older than 5 years. I have 3 months worth of documents from a nutritionist monitored program that is from 4 years ago. I have some documents from my primary but I hardly had any reason to visit him I am normally a well person. Jenny Craig also wrote a letter stating what my starting and ending weight and the time frame which is also from some years ago. I am currently in my second month of monitored diet with a nutritionist who reports my progress to my surgeon. It's so confusing and my anxiety level is through the roof. I just want this done already. I also have written letters from other doctors in support of this surgery so hopefully they will accept this too. My BMI is > than 40 so in my opinion based on how I read the benefit handbook is I just need psych part which I have already. But my surgeon told me that I had to have primary, cardiac, pulmonary, psych, and nutrition. I am losing on my own I was not told I had to lose weight. It's wrong that they hold us to any of it if since it is not clearly specified in the handbook. Because when I called to find out if they will pay and what I had to do since it was not clear they told me they follow the handbook. Thanks for the feedback I truly appreciate it :biggrin2: Here's my e-mail - lh215bk@gmail.com

I have learned that you can say goodbye and good riddance to family members who live to hurt others. I have siblings that are like your sister and what I have done is to just go on with my life. Your sister's probably jealous of you and your life the one that she wants and has yet to find it. She need's help and probably medication too. If anyone listens to her garbage then you are better off without them too. Stay strong! Do not let miserable people bring you down to their level it’s a very lonely place to be and that’s why they want you there. Misery loves company.

That's great! Keep us up to date! I bet his expression will look something like this when you tell him.

Oh trust me if I am denied they will know who I am real quick. See I live in NJ but I am from Brooklyn, NY and there's a saying "You can take the girl out of Brooklyn but you can never take the Brooklyn out of the girl" :teeth_smile: I hope that you get your surgery date real soon. I just got back from my sleep study. Sleep?! Yeah right! But it's over. This is the only thing left. I just need the pulmonary doctor to write the final clearance and then they are sending my package to the insurance for approval. My husband works for the government. He does not think that there's going to be any problems. But he's also up for a fight if necessary. He's a great support system and will do anything for me.

Good for you!! Don't let her get to you. You should not have to lose your surgeon because of an employee who's out to prove something. I worked for surgeons and I will tell you if one their employees did that they would have been let go. One for patient treatment and two because she's actually taking money away from the practice if you chose to go somewhere else. I bet he rips her a good one once he finds out the latest because I know he has not been updated. Also, if you do not already have one I would obtain a copy of all of your documents. Since what has been mentioned here before. If they deny you because of missing documents you will have a copy to send to them without having to deal with that woman.

Thank you for this information :wink2: I too have BCBS FEP Standard Option and I am in the final process with testing so hopefully by the end of this month my file will be submitted for approval. This is the worst part of it for me. All of the testing is nothing compared to the anxiety you feel when it comes to insurance. Did you call the 800# on the back of your card when you called to let them know hey I am still here and I am not going anywhere? I thank everyone here for providing all of this information. It encourages me to keep going. If they deny me for whatever reason even though the employee benefit guide states something totally different than what they are making me do I will fight it. I wish you all the best in your upcoming surgery. You will do great your a fighter!

Thanks from my husband (was reading this along with me) and myself. We both thought that you had to stay behind your pacer. So tomorrow I will go and find this dog. Thanks also for the link on Jillian Michaels. Okay we should all get set to pre-order this one since it will be a popular one. If anyone finds out a release date or where to pre-order one please post it. I will do the same. I have watched her before so I will not be surprised if her game kicks butt big time :biggrin2:

Whoa I did not know that :crying: That's so cool! :thumbup: Thanks for sharing I have connected to the internet via the Wii and it's amazing to see the internet on a LCD TV.

Thanks for that Allison :thumbup: During the winter I love to make soups and if I buy them already bought I really watch the salt because it says light does not mean they lightened up on the salt it's sometimes more than soups that are not light. We'll see what happens. Once I have the surgery maybe I can add more tomato paste to my vegetable soup to make it more stew like.

You have BCBS Federal if I remember correctly. Do you mind sharing why you were not approved? Also, which one do you have? Basic or Standard. I am going through this process with the same insurance and I read the same thing you did. I am concerned I will be denied too when it's submitted. Thanks :thumbup:

I love my Wii and my Wii Fit! :thumbup: I play tennis on the Wii and with the Wii Fit I run. I always wanted to try running on a tread mill at the gym but not in front of everyone which obviously was impossible. The Wii Fit gives me my private time with running. I ran with the remote in my pocket. You do not run on the board. I am just learning about what the Wii Fit has to offer so I have not tried everything yet. You can also earn Fit Credits that unlock additional exercises and activities. I want to try the hula hoop next. My husband tried the step and it was hysterical because it tells you when you are out of place. It tells you to follow the Miis and not the feet. My Mii is so funny looking. While I was running my husband's Mii appeared next to me running what an incentive to continue running. I was also able to create a password so my nosey husband would not see my information.

OMG! You can eat soup after being banded? I was told to stay away from it once I have had the surgery and can eat solid food. I was told that the liquid from the soup makes it go through the band quicker. If I want soup I was told to make it more stew like. Did you feel full after eating the soup? Kathy, It may sound weird but I put sliced skinless apples in water and leave it in the fridge until its cold. I use sweet apples not like granny smith. Right now I am using gala and in the fall when I can find them I use honey crisp which is the best apple I have ever tasted. It's expensive but so worth it when they are in season. Also, just a suggestion if you do drink caffeine and go to Starbucks for the Iced Tea which is very good I agree. I would choose the green tea instead of the black tea since black tea has more caffeine in it.

I go to my support group at least twice a month which is required since I am not approved yet and it's the same thing there. What annoys the RNY members the most is that there's like 10 of them there and more than 30 lap band members. They call themselves the outsiders. I just listen to what they have to say and ignore the negativity of it all. I am not there to judge anyone. It's fortunate that my support group has a lot of lap band members. I was told by three doctors that they would not support me if I chose RNY. They felt the slower the better and they see the lap band as good tool to help us lose weight. One of them said it was like a "Jump Start" for me and that he felt I was ready to take this on. They also mentioned that they were not satisfied with all of the post operative effects RNY has on patients both mentally and physically. But that's just there opinion other doctors would not agree with this. I guess it goes back to their own experiences with other patients. I do not know I chose not to ask them. I researched all options in every place I can think of and I am 100% positive that I have made the best choice for me and that's what it's all about it's what's best for each person.

I have not had the surgery yet and I am constantly reading stories like this. I know it's offensive but like everyone else has said if they spoke about the positive results of having WLS then everyone would go this way if they could and not go to Jenny Craig, WW, Nutri System, etc.... My husband said that this not in any way the easy way out. He told to keep on going and it will all work out in the end. It's all up to me I am doing this for no one but me and like everyone else here I am working my a** off just to get approved. So I will continue to ignore what is being said and keep on going to achieve my goal of a healthy long life Even with all of the money Oprah has her weight continues to go up and down. The latest is that she's got a "Thyroid" problem. She has all available resources at the tip of her fingers and yet she still continues to gain weight. Maybe it's more of those trips and other dining excursions she has had with her BFF Gayle that made her weight go up :thumbup: Whatever it is she has no right to judge WLS so negatively without thoroughly researching it first.