adagray

Congrats on getting all of the pre-op stuff done! Really, 2 months is not bad compared to what I see others go through so you are doing great. I am just starting this journey myself. I'm in the process of getting all my past medical records right now. Then, I have an appt w/my PCP on Tuesday to discuss WLS and log in as my first visit for the supervised weight loss I will need to do for 6 months. The following Saturday, I am going to a seminar w/Scottsdale Bariatric Center. I'm not sure if this is the bariatric surgeon that my PCP will recommend, but its a well respected one so I figure it can't hurt to go and get more info ASAP.

This one is simple for me. I only have one big reason and that is to avoid all the health problems that have plagued my mom her whole entire life related to obesity. I just seem to be following in her path. We have the same build and I'm developing the same health issues in the same order as she did. The only thing down the road for me if I don't take the weight off is diabetes, pain, and lots and lots of meds. As she did, I have also tried all the diets. I have given it my all as I have seen her give it her all as well. I've always felt so terrible about her health and where she has ended up w/her weight issues even though she has tried so hard to take it off her ENTIRE LIFE! Well, just over one year ago she had lapband surgery and in just over a year has taken 95 pounds off. It gives me great hope to see her turn it around finally. It makes me feel like my fate is not sealed. What she did in her 60s, I can do when I'm 40. Awesome! BTW, through her experience, I know it is not easy and not something you do until its your last resort. I'm just so glad I'm able to do this sooner rather than later. I'm still not through the insurance hurdles, but I know I will find a way to get this sooner rather than later. :laugh:

I would highly recommend Weight Watchers. I have taken off 50 pounds twice on Weight Watchers. I've never taken off more than 30 on any other program. Weight Watchers has a great website w/an online forum like this that is VERY supportive and helpful and FREE! But, I think to give it a really good go, I think actually going to the meetings is key. If you go and don't like the first leader you get, then try another leader. There are some great WW leaders, but they aren't all great so you may have to try a few to find one that you click with. If this is you last and final go at trying a diet, though, I HIGHLY recommend going ahead to your doctor first and checking in w/your doctor monthly as if you were doing the 6-month supervised diet that is required by many insurances (if is is required by yours or if your insurance might ever change). The reason I say that is then if it doesn't work out, you can use that info in your medical file to get WLS approved more quickly (if you ever choose this). I hope you don't take this as discouraging, but I'm only recommending this because I wish I had done that on my last and final go on WW. Better to have it documented if you need it, than have to do another diet later that you don't really want or need. I wish you all the best!

Congrats to you! :tongue2:

As I've been looking into getting lapband, it occurs to me that I'd like to get my tubes tied at the same time. Anyone know if this is possible? And, if so, does it complicate the insurance? Like, what if my insurance covers the tubal, but not lapband... how does that work??? Any input/experience w/this would be helpful. BTW, I know I should tell my DH to just get a V already, but he is so doctor phobic. And, its not just about getting the V, but w/everything doctor related. So, I feel like my best chance of taking care of BC permanently is to just get my tubes tied when I get lapband.

By the way, I am going to talk to my doctor about doing two surgeries together to see if that will help (in case I get denied for lapband surgery). I want to get a tubal anyway (and that is completely covered by my insurance) so I am gonna see if its possible to do both surgeries at the same time so that I only have to pay out of pocket the fee for the lapband surgery itself (which I think is maybe only $5-$7k if the anasthesia, operating facility, etc. are already being paid for another surgery). In any case, whenever I get the lapband surgery, I want to get a tubal ligation at the same time. So, its not that I'm getting another surgery I don't want. I would just like to time them together and if it helps w/paying for lapband, that would be awesome. But, trying to do it this way is only my Plan B if my insurance won't cover the lapband. If I can get both surgeries approved and paid for then that is what would really be best. Anyway, I'm just mentioning this because a lot of ladies would like a tubal (after they are done having children), but figure it is not worth having surgery over so they have their DH get a vasectomy instead. But, if you could get it done at the same time as lapband and not have to go through a second recovery, then I think its a great option. Anyway, I am just in the very very beginning stages of seeing how I can work this through insurance. I am meeting my doctor on 1/6 and hoping she can give me some advice on this. I will update on here after I talk to her about it. In my case, I am worried my lapband won't be approved because my weight history goes up and down. Personally, I feel that is more evidence that this surgery could really help me and I'm going to try to write a strong letter about that when I submit to insurance. But, we shall see what they will actually approve.

Going back to your original question, I would be upfront w/your doctor and let them know that even though the lapband surgery may not be covered, you like them to try to get the other things covered if there is a way to link it to a different diagnosis code that would go through. A lot of doctors do this automatically, but it doesn't hurt to be upfront about it. For example, when I had been TTC for 6 months w/no success, I told my OBGYN that I wanted to move forward w/testing for infertility. Although my insurance would not cover testing until I had been TTC for 1 year, she was able to find other 'reasons' for the tests so that they would be paid for by my insurance. In the end, all the testing was paid for by insurance and even doses of clomid she was able to code as for something other than pregnancy. Don't ask me how! LOL The only thing she couldn't code otherwise was my DH's SA so we paid out of pocket for that. No biggie. I got PG within a month after that. :->

I noticed for one of my docs, the form said I might be charged for the copy service if you are asking the information to be released to yourself (as the patient), but its free to send directly to another doctor. I don't care, though. I want to see it for myself (as you recommended). Even if it costs me, then at least I have it for my own files and so if/when I'm turned down by my insurance, I have everything for the appeals process or to re-apply later.

I have just started seriously considering lapband surgery. So, I have checked my insurance (Aetna) and have found that I have coverage, I've reviewed their documents and meet the qualifications (BMI>35 + comorbidity). I don't mind doing the 3-6 month diet. Its a drop in the bucket compared to what I've already done before. The only sticking point I see is that my BMI has not been consistently over 35 for the past two years because I have dieted and then gained back. But, I can show 5+ years of going up and down and around 35 so I'm hoping that will suffice (probably will have to fight for it). The high BP has been persistent for 10+ years and not very well controlled w/medication so since Aetna only requires one comorbidity, it looks like I've got this one covered (plus recent diagnoses of high cholesterol). OK, so I made an appt w/my PCP to discuss weight and possible lapband surgery on 1/6. She is great and I trust will give me a great referal to a bariatric surgeon. I've done a little research myself and found one that is considered the best in my area so also scheduled to attend a seminar the same week (1/11). I'm just wondering if there is anything I can do in the meantime to start getting my info together. Specifically, since I'm worried that my weight/BMI history could be a problem, I'd like to start collecting that info. My former PCP and ob/gyn would have that info. Sooooo, do I ask that they send that to me or my new PCP or both? I would love to see it myself because I don't really recall what weights they will have. And, I'm also wondering that when we send weight history to Aetna, does my doctor then summarize the info that my other doctors have sent to her or does it have to come directly from those other doctors. If it goes to my new PCP first, is it OK to then have her only send the highest weight from each year? For example, I know at least two years out of the last five, I started out the year w/a BMI of 34 and ended w/a BMI of 36. I hate that I have to worry about just a few pounds here and there. Seems so silly in the whole scheme of things...

Thanks for offering to send me the letter. I have contacted two of my doctors now and haven't run into any problems w/the process so far. One of my docs, just had a form to fill out on his site. The other I just called and she said I could come in to fill out their form or fax in a signed request. So, looks like getting the info is pretty easy. And, I'm having it all sent to myself just so I know what it is and then we can just send the best weights to insurance. Who would've ever thought my 'best' weights would be the highest ones. Or, that I wish I could be just one inch shorter. LOL

Thanks! This is great advice. On the high bp, are they looking for you to take two medications at the same time or just have tried two medications without adequate results. I am actually on my 3rd medication for high bp and it is still not well controlled. I was on aldomet/methyldopa when TTC and PG because that's safe for pregnancy, but it only brought down my bp a little. My bp remained high, but not as high. Then, I tried aldomet which worked, but made me too tired all the time and made me gain weight. Now, I'm on lisiniprol (sp?), last visit to my doctor we doubled the dose because even though it brought my bp down, it was still high. But, what I haven't tried is two meds at the same time. Is this what aetna is looking for? I know some docs will prescribe a diuretic w/your bp med if the bp med alone is not working.

Thanks for your reply. I'm not sure why I am afraid to call my insurance. I just e-mailed them instead. They reply within 24 hours so I guess that will have to be fast enough. My insurance is through Aetna (Choice POS II) and I'm in Phoenix, Arizona. I was able to find some info on various bariatric groups around here and one of the groups said this: Aetna - covers the band and has worked well with surgeons and policy holders. There are some policies that do not cover the band. For Aetna HMO patients the HMO requires that you obtain a referral in order to see us in consultation.. For other insurance carriers, it specifically said they require a certain # years of history. So, since this wasn't mentioned for Aetna, maybe they don't require it here. Interesting that it varies from state to state and the rqmts are all over the place. Oh well, I should have more info tomorrow and then can start talking to my PCP for a referral. The sad thing is that if I'm denied, I know I'll EVENTUALLY qualify. I hate to sound so negative, but I've watched my mom deal w/her obesity her entire life and hasn't ever been able to successfully lose and keep off weight until after lapband surgery she had one year ago.

I'm just starting to look into possibly getting lapband surgery. I have a current BMI of 36 and have the comorbidity covered since I have had high BP my whole adult life. I also JUST got my first high cholesterol test. Looked at my insurance coverage and one comorbidity (oh what a lovely word?!) is all I need w/BMI of 35 so this should be covered. I have to do the medically supervised diet (Aetna), but that's OK. I don't mind spending some time thinking about this. My mom had this surgery a year ago and I know it is not easy. OK, so my question is that when they look at weight history, do you think it will hurt my chances of being approved because I have had periods where I lost up to 50 pounds. I can lose it, but the problem is that I'm always hungry and always end up gaining it back. So, my weight histories are something like this... 2003 - 206 lbs (weight before first pregnancy) 2004 - 190ish 2005 - 206 (weight before second pregnancy - I only know this because it freaks me out that I started both pregnancies at the exact same weight) 2006 - 190ish 2007 - 180ish 2008 - 215 My height is 5'5" so my BMI has pretty much been between 30-36 all these years so technically 'obese', but not consistently 35+. So, I guess my question is are they looking for 5+ years at 35+ or 5+ years being obese? I know, I know, I gotta check w/my own insurance on this, but just curious what others' experiences have been. Thanks!

Just want to say Hi and introduce myself. I'm starting to consider lapband surgery and this seems like a great place to learn more. Here's a little about myself... * I'm 39, 5'5", 220 pounds, had high blood pressure my entire adult life, just found out I have high cholesterol too now. I feel like diabetes is just around the corner and I'm bummed out. * My mom had the complete metabolic syndrome including diabetes. She got the lapband one year ago and has lost almost 100 pounds. I am sad that she struggled her whole life w/weight and didn't get this help until her 60s. * I've been on every diet under the sun. Last attempt was WW, lost about 45 pounds over two years. I lose soooooo slow. Then, fell off the wagon, and gained it all back last year. Arrrrrghghghghhghghghhghgh!!! * A couple months ago, I was diagnosed depressed/anxiety disorder and am now on Lexapro which is helping a lot w/that. BUT, I have no motivation to go on another 'diet'. I just feel like it will all eventually come back anyway and I hate being HUNGRY all the time. Maybe lapband is the answer for me too???? I just don't want to be hungry all the time and worried about my weight and health all the time. So, does lapband make you less hungry really??? I guess that is a stupid question. That is the whole point of it, right. :cursing:

Not yet, but I looked up info (I have Aetna) and looks like it should be covered. I probably still have to do a physician supervised weightloss program (3-6 months according to what I read). I'm OK w/that, though. I probably need a 'cooling off' period to make sure this is really what I want anyway.