JayTee562

Let's see... 1. My brother died at 43 with heart attack 2. My dad had by pass at 38 and eventually died in a car wreck when his pacemaker/defib went off 3. Grandmother heart attack 4. Uncle H died of a heart attack 5. Uncle A died heart attack 6. Uncle W died of a heart attack at 80 after about 20 surgeries 7. Uncle E died of a heart attack young 50's (All the above on my dad's side) 8. I have 2 stints, put in when I was 42 9. HBP 10. Tired of furniture creaking when I sit and stand

I'll start by saying I'm preBand so I'm not speaking form program experience. I never really cared o much for whiskey but after living in Kentucky for almost 3 years I've learned to enjoy bourbon. When we go out one person stays sober and I'm usually the one. A bartender friend got me started on Bourbon on the Rocks (good stuff) and I can spend a few hours nursing it don't get buzzed but still enjoy a drink with everyone.

I was just on the phone with the hospital that I'd get my procedure done at to schedule my evaluations and they said that they are having trouble getting inpatient approval for the procedure from UHC. Outpatient no problem but they keep everyone over night so all of their bands are inpatient. They are in negations with UHC to resolve it. Has anyone had such an issue? J.T.

This is vry encouraging I'm switching form Aetna to UHC and my coordinator from the surgeons office taalked like it may go quick with UHC. I didn't take much stock in what she said but now it sounds promising....thanks

WOW you all are encouraging my insurance changes on 1/1/09 to UHC and I've been concerned about their requirements and coverage. My Dr's office said it maybe very easy after I switch but I've been holding off on a lot of my out of pocket expenses.... Thanks again.....

I'm being switched from Aetna to United Health Care I to can't check anything till 1/1 so I don't know it it will get better or not...we are not suppose to lose any coverage my surgons office said that UHC might be easier then Aetna. I'm still on 6 mo weight loss and I'm holding off on any out of pocket expenses till the swtch. Good luck to anyone else who's switching....

I put my DH on my paperwork as contact and person alowed to receive and pass information for me. We don't rally announce it but openly discuss each other to people in our lives. We say DH and I blah..blah..blah.... Most people figure it out pretty quickly the Dr's and staff will know my other half and I are without us announcing it.

Congratulations and good luck....ahhhh to be in 38 jeans.....

I haven't been on the board for a while but remember you and others mentioning hitting a wall. Glad to hear the your gettig past it and happy with your loss...... I'm still preband and doing the monitored weight loss exercise but my heart isn't really into it...my insurance changes next week and I hope once I see their requirements I'll get excited again.... Good luck and wish you all continued weight loss....

How did everything go?

If it's seminar and consultation at the same time it took that long when I was there. About 8 of us were there some of us took someone with us some didn't. They looked over our paperwork and asked for anything that was missing. Then we got called in individually photographed, weighed, the person asked a few questions then we were free to go till the seminar. Dr. Shina did the seminar and then we went each ahd about a 5 minute consult with him. He asked me a couple questions looked at my legs for Water retention and looked over my meds gave me status of which I'd need chagned befroe surgery and I was on my way...4 hours later. If you are not seminar and consult on the same day then it may not be as long.

He's very frank and up front. Are you going through the seminar and consult thing they do? That's how my first appointment was when they say give it 4 hours they mean it. We arrived at 9am and I walked out a little before 1pm. If you google his name there a site with reviews Good Luck

I can't find it right now but somone on here said it's Dr Mark Shina and then one time I saw his name on their site. His office in in Jeffersonville and he also comes to Suburban. The day I was looking at their site they said that surgery can be done at a hospital on that side of the river. Dr. Shina is who I'm seeing, I liked him on initial consult and will be sticking with him if I have the surgery. I'm going through Norton and have to pay $300 when I go to Norton Bariatrics neat thing about Dr Shina is he did the consultation before I had to pay the money he's I think he's the only Dr. at Norton that does that. My PCP Refered me to him.

Well I was correct talked to my coordinator today and she needs 6 months of weight with my PCP. Of course I stupidly didn't make an appointment with him in October so I started with weigh-in 1 of my six months......... I should have used what everyone on here has said and made an appointment last month..I'd be two months closer. All is really still up in the air because of our insurance change on 1/1 and we can't access the new company (United Healthcare) yet so I don't konw what they will want hopefully not much different than Aetna.

I don't have HMO but was told by my coordinator said they just needed documentation that I've been over weight for the last two years. I asked if I needed documentation that I saw my PCP for the last six months for my weight she said no just documented that I was over weight 6 times and two years of records. I was suprised and will see in a couple month if that's correct.

Mellygirl.... Went to my second seminar today and it was totally different than the first. About 10 people we were weighed and photographed and talked with a tech/nurse then Dr. Shina spoke a lot about Pulminary Embolism (sp). Then discussed the procedures a little bit and then opened for questions. After that we each saw the Dr. for a few minutes individually it took 4 hours.

Link to AETNA => Obesity Surgery Member must meet either criterion 1 (physician-supervised nutrition and exercise program) or criterion 2 (multidisciplinary surgical preparatory regimen): Physician-supervised nutrition and exercise program: Member has participated in physician-supervised nutrition and exercise program (including dietician consultation, low calorie diet, increased physical activity, and behavioral modification), documented in the medical record at each visit. This physician-supervised nutrition and exercise program must meet all of the following criteria: Nutrition and exercise program must be supervised and monitored by a physician working in cooperation with dieticians and/or nutritionists; and Nutrition and exercise program(s) must be for a cumulative total of 6 months or longer in duration and occur within 2 years prior to surgery, with participation in one program of at least three consecutive months. (Precertification may be made prior to completion of nutrition and exercise program as long as a cumulative of six months participation in nutrition and exercise program(s) will be completed prior to the date of surgery.); and Member's participation in a physician-supervised nutrition and exercise program must be documented in the medical record by an attending physician who supervised the member's participation. The nutrition and exercise program may be administered as part of the surgical preparative regimen, and participation in the nutrition and exercise program may be supervised by the surgeon who will perform the surgery or by some other physician. Note: A physician's summary letter is not sufficient documentation. Documentation should include medical records of physician's contemporaneous assessment of patient's progress throughout the course of the nutrition and exercise program. For members who participate in a physician-administered nutrition and exercise program (e.g., MediFast, OptiFast), program records documenting the member's participation and progress may substitute for physician medical records; or [*]Multidisciplinary surgical preparatory regimen: Proximate to the time of surgery, member must participate in organized multidisciplinary surgical preparatory regimen of at least three months duration meeting all of the following criteria, in order to improve surgical outcomes, reduce the potential for surgical complications, and establish the member's ability to comply with post-operative medical care and dietary restrictions: Consultation with a dietician or nutritionist; and Reduced-calorie diet program supervised by dietician or nutritionist; and Exercise regimen (unless contraindicated) to improve pulmonary reserve prior to surgery, supervised by exercise therapist or other qualified professional; and Behavior modification program supervised by qualified professional; and Documentation in the medical record of the member's participation in the multidisciplinary surgical preparatory regimen at each visit. (A physician's summary letter, without evidence of contemporaneous oversight, is not sufficient documentation. Documentation should include medical records of the physician's initial assessment of the member, and the physician's assessment of the member's progress at the completion of the multidisciplinary surgical preparatory regimen.)

Jeremy looks like many of your questions have been answered if you haven't found it yet there is a area for local support groups... in the forum you will see one for USA and under that link there is an area for each state I bet somewhere in the CA link you will find info on that center.

I haven't had either yet but decided when I do to get the Lapband because it leaves everything intact. There is a section on here for other types of weight loss surgery and they have a Gastric Bypass area you may look/ask around in there. I have a family friend who recently had Gastric Bypass and she seems to be happy with it. When I went for my first seminar they discused all type of surgery even those not done anymore and the history of most. Good Luck with whatever you choose....:crying:

I have proof from my PCP since Aug or Sep of 2006 when I saw him recently I realized that I hadn't seen him for almost a year to date since 2007, but I do have 2 years with him of my BMI being over 40 and I have high blood pressure, sleep apena, high cholestrol, two stints..I think I have plenyt of issues associated with my weight. As I said earlier I'm thinking my timing is off due to my company changing from Aetna to UHC at the start of 2009. Well see the surgeon on 10/28 and will take it from there they are the ones used to dealing with the insurance companies..I hope

I'm wondering if it's even worth putting in, our insurance changes from Aetna to United Health Care on 1/1/09..... I'm thinking they will just put me off till after they aren't our carrier any longer. Our company does have it's own dedicated perauthorization at Aetna so it may go smooth. I see my surgeon on 10/28 it will be a tight window. TMBOWE - The Aetna website says there are two options for the prepreation 6 month monitored diet or a 3 month plan where you have to have psych eval, nutrition...etc did you have those options or did they tell you 3 month monitored diet?

My PCP refered me to Dr. Shina and apparently he does things differeently than the rest. His office is who told me I had to attend the second seminar when I went to the first seminar they said that covered all Dr's but when I told them i was refered to Dr Shina they siad he does things differently you see him before yousee the Baratric Group. I haven't had any evaluations yet except my PCP saying that it was my best medical option.

ElectricBear I understand how it can sometimes seem like that :tt2: I'm fairly new on the board but it seems like there is a lot of support on here. I'm lucky that my other half, mom and the coworkers that know are very supportive. I've been through other stages of my life where I felt like you... Hang in there you'll find the support. What stage are you at in the process.

I understand what your feeling my company is changing my insurance on 1/1/09 and I'm concerned that the current company will either put me off till after then or if I get started on the road to approval but don't get my surgery till after 1/1 that the new company will start the process over. Ii know it will be a long road but I'd rather get the surgery part over with.

I haven't attended the second one yet but I will on 10/28. I wish I knew..... I attended a seminar at Norton Suburban that Dr. Geller gave. I talked to Dr. Shina's office (also part of Norton Suburban) they said that I had to go to a second seminar. So to answer your question I'm attending the second one because my PCP refered me to Dr. Shina and his office said that I had to attend a daytime seminar as well as the night time one. One good thing I guess is that I see the surgon the same day.