Mr. Green

I had sinus surgery several years ago and during my first follow-up appointment at the doctors office, the doc informed me how the whole OR felt sorry for me because I woke up crying my eyes out. Guess I did this right when they wake you up in OR before going to recovery. Great, grown man cried his eyes out for no reason and the doc remembered it 3 days later!!!!

Never heard of the PREP study. I am having surgery in at Magee and I can relate to all the work you are doing. One thing I can admit is that I am not going into this without a ton of information. If it is out there, I have read or researched it to the fullest. I am like you, going to quit it now than suffer later (pop, caffeine, etc.). Need to make a change so things are not so rough later.

The band is a tool that will require you to eat right and exercise. The insurance wants to see that you are changing your lifestyle for the better by losing some weight and changing your habbits. My group told me this can be around 1-2 lbs. a month, but must be a loss with no gain.

I am in Magee's program also and on month #4. I am taking it one step at a time since I have a scheduled appointment with the Doc. at the end of this month. I had a slight gain which may set me back a bit, but I am looking to lose that weight and more.

In most cases from what I read is that the insurace company wants to see a loss over the 6 months that you are supervised by a doc. or surgical group. I would not give them anything else unless necessay. Insurance groups look for any reason to deny anything anyway they can. With a BMI of 39 do you qualify or have other conditions that qualify you? The insurace company will most likely from my research look at your starting BMI and weight and if you had continuing losses over the 6 months.

Well, you need to check the requirements of the insurance. I have UPMC and they require a 6 month diet, fitness, etc. with no gain. If your insurance requires it, then it needs to be done to show you can change your lifestyle with the band and eat correctly and exercise. All of this has to be documented by a doctor or the surgical group. It is tough I know, but the 6 months do go by fast and if you need to show a loss, it usually is only a few pounds a month that is documented. You are going to change your lifestyle if you get the band so no better time to start than the 6 or 8 months before you get it.

Can't comment on the requirements of the insurance plans, but try the insurance web sites and see if you can find the plan. Most insurance companies will have the policies on the site. If not, give them a call.

Not only are these fourms a good tool, but pick up a book or 2 pertaining to the subject. If you think you have done some research, I suggest going back and doing some more. I am 3 months into my 6 month insurance diet and exercise program and I am still learning a ton of stuff.

Everything I have researched has said they are a NO NO. Too many problems caused by the intake and no one can ever say, I will just have one. One leads to two, two to three and so on. This is why I love my insurance stating I need the 6 month diet and exercise monitoring. No better time to start reducing and then quitting.

One thing that is a common theme when reading about the band is, get rid of the soda, diet and regular. Caffeine issue aside, pop is real no no. If you are that devoted to having it, the band and bypass may not be for you. I am in the process of giving it up on my 6 month diet. Might as well do it now than later.

They measure your weight and height with shoes off only during your first visit.

Go to your insurance web site, they should have the policy somewhere that you can download. If not, have your insurance company send you a copy of the policy or e-mail it to you. I did this so I know exactly what is needed for the surgery and to qualify. This way, you have it in front of you at all times. Most insurance companies seem to require the 6 month diet and exercise and your doctors group may be able to help you with this or give you the information that your PCP needs to track on a monthly basis.

I think it really depends on the insurance. My insurance requires a 6 month diet, exercise, and lifestyle instruction and progress. The group that I am working with provides classes for a fee that help with all of this so you meet the criteria. They basically say that you should lose around 1-2 lbs per month, but you need to document your eating and exercise habits and you go to monthly weigh-ins. I think this also helps post op so you are not in shock with your eating habits (the bad ones) and helps transistion you to the band life. I really see this as a plus because it appears to me that changing your bad habits now helps ease you into your new life.

Also having my surgery at Magee. Here is what I can tell you so far. -The seminar is not that informative and when I say that you can pretty much educate yourself with this message board, books, and other sources of information, but you have to go. -You will fill out a form at the seminar with a breif medical history, height, weight, which surgery you want, etc. -They will contact you in a few days to let you know if you qualify. This is not a for sure thing for surgery. -If you qualify and most insurace companies require a 6 month diet and lifestyle change program, they will offer you to go though there program for around $400.00 dollars or do it with your PCP. -Not that I am pushing one over the other, but there program seems more in tune with what you need for insurance coverage (40 bmi or higher without other medical issues, lifestyle change, etc.). Appears to me that they are doing everything in there program so nothing is left out for the insurance company to deny you. -You attend your first class and they give you the schedule for the remaining 5 months that you have to attend if you go with Magee's program. You get weighed in at each class, keep a food and exercise journal, etc. -I think you can see the Doctor after 3 classes I beleive and the Nut. after 4. From there I beleive they schedule the surgery so IMO it looks like a 7-8 month process before surgery, maybe longer, I don't know. All the doctors seem good and the head of the department is one of the first to really get into the Lap Band. You can pick a doctor or they will give you one. Just FYI, you are in the group with gastric bypass paitents also so it is a diverse crowd. Let me know if you have any other questions, I am just starting out and attended one class so far, 5 more to go.

I have never been tested, but I did snore. Found out that due to my allergies, my nose was full of nasal polyps and I had a deviated septum. Went in for surgery 2 years ago to have them fixed and snore much much less. My wife is a health care professional and she claims to have stayed away for about 2.5 hours one night observing me?? She said I never stopped breating, but who knows, maybe a sleep study is in my future??

The group that I am working with has a $395 fee if you want to join there program. This includes monthly seminars, weigh ins, etc. Basically, all the stuff you need for insurance to get approved. You can avoid the fee and go to your PCP, but I think going with the group can give you that edge. They coach you on all kinds of stuff and give you a ton of info.

You have to make the choice!!! If you can do it with diet and exercise and keep it off, then that is great. Others like me have tried for years, and I am not lying about this when I say I have tried them all and had some moderate success, but gained it all back. Everyone is different and as you will find out, this works for some and not others.

After attending an info session I came out much more educated about the all the stuff that needs done before you even get a surgery date. The nice thing about the group that I am going with is that they know what is required for your insurance carrier and I am sure most groups know this.

Have you insurance company put that in writing. Also, have them send you a copy of the policy which all companies should have one.

Just curious, have you increased any clothing size and have you ever measured your muscles?? Way back in the day I know sever people who put on about 15 lbs of muscle from working out hard. If you have not been gaining in waist size for example, but your arms and legs have increased in size, you could be putting on muscle weight.

Hello all, I found this site and joined now that I am serious looking into getting the band. Little about myself: I am 6'4" 354 lbs at the age of 33. I guess you can say I hide my weight well since I am so tall and some would look at me and say I don't need it. But for the last 5 years I have tried every diet (WW, Atkins, South Beach, went to a NUT, etc.) I had the most success with the South Beach and lost about 12 lbs. in the first phase, but really stalled after that. The big issues is keeping it off for good which is the issue and my heaviest weight was 371 lbs. I need to change for not only me, but my daughter and wife who I love so much that I fear leaving them way too early in life. Size and the complications that go with it run in my fathers side of the family and I witnessed his father pass away because he refused to do anything about it. It scares me that my Dad is settling in to his fathers old ways. I want to make the change and I think the band is the best options for me after doing tons of research and I attend a conference in a few days for the surgical group that I am interested in having this done with. Well, I am on the path to a better me. Talk to you all soon with many questions and will keep you updated on my status.:rolleyes2:

Thought I would give a quick shout out and let ya all know that I attended a seminar for where I want to have the surgery and met the Doc. Filled out a quick form that will be reviewed by the good doctor to see if I qualify to enter into there program. If so, will start my 6 month observation/classes, etc. for insurance reasons. Hope to hear something in a day or two.

One thing I found helpful was going to my insurance carrier website and downloading and printing the entire WLS policy. A little confusing in some parts, but it gave a good picture of what was covered and requirments.

Hello All!!! My insurance requires the 6 month diet that is regulated through a doctor (my PCP). My question is how do you avoid losing too much that you don't qualify in the end. The diet thing I have done several time and lost, its keeping it off is the issue. Beside keeping my pockets full of silver dollars when I weight in, how did this work for you???:redface: