kagead

My Dr. and nutritionist are also in the "No Soda. Ever." camp.

I loved my diet Dr. Pepper, but said goodbye to it in February. The most surprising thing is that my sweet cravings declined almost immediately.

I probably won't be banded until late May or early June, but I figured I'd have enough to deal with post op and having to cut out pop at the same time would probably push me over the edge. :thumbup:

DM

Katy, I had to do most of that too, but my supervised diet was only 3 months. The thing with BCBSIL is that you can't submit for approval until after all the other stuff is done so it is actually the last step in the process.

Good luck to you!!

It really depends on the insurance company. I have PHCS managed by PBA and it was six plus months for me to get the approval. I was required to have a 40+ BMI. I also had to get a psych eval, GI series, sleep study & ultrasound. My insurance also required six monthly visits with a nutritionist and the recommendation of my primary car physician.

My surgeon won't schedule the procedure until the insurance approval is in, so I am sitting here on pins and needles, watching my May surgery date slip away.

There is another thread for May bandsters you may want to check out as well. You can find it here:

http://www.lapbandtalk.com/f22474/looking-may-bandsters-110418/#post1447990

Good luck to everyone!!

kagead

You guys are giving me hope! I talked to the coordinator in my surgeon's office and she sent my file in TODAY. Finally! I plan on calling BCBS on Friday just to make sure everything has been received.

Good thing I am not a stress eater otherwise I'd be in big trouble...

kagead

I haven't been banded yet, but I do about 30 tradeshows a year and my feet tend to swell, so this is a concern for me, too.

I did talk to my surgeon about it and he said that I should double my Water intake (double!?!?!) when I am likely to experience swelling and he could prescribe a short course of a mild diuretic to help. He also suggested support/compression stockings.

I'm sure you'll get some great answers here from those with more experience, but I wanted you to know what I have learned. :cool:

Good luck!

kagead

I have insurance, but my policy has a 20% copay with surgery. I am self employed and have an individual policy so I was thrilled WLS was covered at all.

I expect my OOP costs to run about what yours do and know I'll have to set up a payment plan with the hospital.

DM

I have (or had, as the case may be) a terrible sweet tooth as well. I am thrilled to find that it has decreased TREMENDOUSLY and I'm not even banded yet.

In anticipation of my surgery, I stopped drinking diet soda in February and the difference in my sweet cravings was almost immediate.

I am also a big carb eater. I am not a vegetarian, but I don't eat beef or pork and tend to rely on carbs for quick, easy meals, especially Breakfast. When I stopped eating a muffin or a bagel for Breakfast, I found that my sweet cravings were MUCH less throughout the rest of the day.

I found I like the Muscle Milk Lite chocolate Protein drink and I save it for a time in the day that I really want something sweet. It is close enough to chocolate milk that it hits the spot. The Balance bars accomplish the same task for me.

Believe me, I know your pain, but I think you might find that some diet changes now will really help tame that sweet tooth and will set you up for better success after you are banded.

As is noted here time and time and time again, the band can only help how much and how fast you eat- what you CHOOSE to eat is still up to you.

Good luck!!

kagead

Congrats, but you might want to take this as a sign that you may have to be very persistent with them throughout the entire process.

Remember, you will rely on your surgeons office heavily post-op. Fills, overall well being checks and the like all need to be done there and if they are this difficult about an INFO session, you need to make sure you won't have trouble when you need a fill (or an unfill) or attention for any other issues.

If there are other surgeons you can look into (which may be easier for you since you are not dealing with insurance restrictions), I'd definitely check them out before deciding to go with this particular practice.

Good luck!

kagead

If you search these boards, you will find answers that are all over the place!!!

I am on an individual plan with BCBS of Illinois. When I called them to ask about approval time frame, they told me they usually get things done in 7-10 business days.

The insurance coordinator told me they are usually closer to 15-20 business days, sometimes as much as 25. And, she also confirmed the stories I have read here that note BCBS is notorious for denying on first submission. She said even if they deny, the tell them what is missing so they can get it through on the 2nd try.

All that said, my stuff should be submitted any day and the insurance coordinator at the surgeons office said BCBS has been running "pretty quick" lately and she was hoping for a 10 day time frame.

Good luck to you!

kagead

I am self employed and have an individual policy through Blue Cross Blue Shield of IL. I am waiting for approval and have not had a straight answer about coverage for fills. O

ne agent told me "everything post op is covered, including maintenance", another told me "it is treated like a Dr. visit" and I'll just have to pay my office visit copay and another said fills "are not covered at all."

Once I have my approval in hand, I'll push the issue further.

Sorry I couldn't be more help.

kagead

Glad to hear everything went relatively well for you Ms. Rhonda. Keep us updated on your progress!!

I am so happy for all of you who have surgery dates. I'm still in limbo over here and hopeful I'll be posting my own very soon!

kagead

I'm so glad you told them!!!

Sorry to bring a morbid tone into the conversation, but there are other considerations to telling or not telling parents about surgery in this particular case.

The OP is young and engaged, not married. If G-d forbid a million times something horrible happened, who would have a say about her treatment or care if she could not? Her parents or her fiancee? In many states her fiancee would have no rights at all. Also, how would her fiancee deal with telling her parents she went for surgery without telling them?

Like I said, I know this is morbid but my family has a long history of health issues and hospitalizations. After learning a very hard lesson, we all have living wills and powers of attorney so our wishes are clear in case of an emergency. Most young people do NOT have these provisions and they should be taken into account.

FWIW, I am single with no children. My mom will make any decisions for me should it come to that. The hospital already has copies of those documents on file for me in anticipation of my surgery.

Again, I sincerely apologize for bringing things "down", but this is something I feel strongly about.

kagead

I want to emphasize something that was touched on in another response- be NICE. Really, really nice. Smile while you are talking because the person on the other end of the line can hear that.

Phone customer service (in any industry) is a very rough job and it is easy to get "snippy" when the caller is less than friendly.

Be direct. Tell them your file has been submitted by your Dr.s office and you want to see where you are in the approval process. Make sure you are sent to the correct department.

If you don't get much of an answer after all that and you have someone sympathetic sounding on the line, tell him or her you are really anxious for the approval and ask 1. When should I call back to check again and 2. Is it ok if I ask to speak with you again or is there someone else who handles this?

Good luck. I'll be in your shoes shortly!!

kagead

I'm not sure how close you are with them, but I agree 100% with others that said you should tell them.

When you do it, you can make it clear that you are not asking their permission, or even seeking their approval, but rather you, with the full support of your fiancee, have made an important decision about your life and you want to share that with them.

Good luck!!!

kagead

I got my surgery day today!! I will be banded 5-10-10!! So excited!!!

Congrats!! So excited for you!

kagead

Ms. Rhonda- you just have to put your foot down and offer up a polite, but very firm, "No, thank you." It doesn't really require any more explanation other than that, and you don't owe them one. You have to set the limits and stick to them and the only behavior you can control is your own.

Why give anyone this power to upset you? You are obviously intelligent and brave (you are getting banded!) and shouldn't feel bad about any decisions you are making.

If you want to try and make them see the light, so to speak, you can try and say something along the lines of, "I'm working hard on living a healthier lifestyle and while that brownie looks delicious, it isn't on my menu plan for today."

Stay strong!!! You can do it!!!

kagead

Mine will be outpatient, and I'll be having a hiatal hernia repair at the same time.

I will be at a huge hospital in downtown Chicago which is only about 10 minutes from where I live.

My mom had hers done at the same hospital with the same surgical team I will be using, but she stayed overnight for 2 reasons:

1. She had a clot risk and they wanted to keep an eye on her and

2. She lives about an hour from the hospital and wasn't keen about being so far away. There are tons of other hospitals near her, but that wasn't much of a comfort.

kagead

I love her and it has been amazing to see her progress. She is an inspiration.

Her Ruby-isms are hilarious!

My only complaint is that when her voice gets "singsongy" it is like fingernails on a chalkboard to me. Sometimes I have to mute the TV and watch the closed captioning! :smile2:

The Australia episode was great.

kagead

I am just starting my 3 month diet before I am banded. I have been dreaming about how it will feel when I get to my goal weight. One of the things I hate about being big is the heat! I sweat all the dang time. Its actually embarrasing sometimes bc everyone else is comfortable and I am sweating.

For those of you who have lost weight, do you feel cooler?

I'm glad you brought this up! I also sweat very heavily, mostly on my head, face and neck. It took me MONTHS to convince my personal trainer I wasn't about to pass out! :thumbup:

I am pre-band and I did ask my PCP about this. She said there is a good chance the sweating thing is genetic and completely non- weight related. That, along with the news from my surgeon that my high blood pressure is likely genetic and won't improve much with weight loss were two big bummers.

I'm secretly hoping they are BOTH wrong!!! Looking forward to hearing responses from others.

kagead

May 14th!!!

Congrats!!! So exciting!!!

I have BCBSIL (not Anthem, though) and hope everything will be submitted to insurance next week.

According to the 4 different people I have spoken with at BCBS, they usually approve in 5-7 business days. According to the insurance coordinator at the surgeon's office, it is really more like 3-4 weeks on average and yes, they do like to deny 1st submissions so I am bracing myself for that.

Everything else is done, so I don't even have other tests and things to keep me occupied while I wait. On pins and needles over here...

kagead

Congrats Ms. Rhonda!!! I'm so excited for you! You can be our fearless leader as you'll be a couple steps ahead of the rest of us.

kagead

So glad to see this group is growing and really hope I'll get a May surgery date! :frown:

Quick update: Spoke with the insurance coordinator at the surgeon's office yesterday and she did a quick review with me, but was giving me more general guidelines rather than the detailed info I was looking for regarding my individual situation.

She told me that they use an outside service to do the letter of medical necessity and that is why it can take up to two weeks to receive. Hope mine will be here by this time next week.

She did ask me to have my PCP fax over a couple things but other than that, she said there isn't much we can do until she actually makes the submission. She did reiterate that with BCBSIL, it is a total crapshoot. People she thought would never get approved go through without a hitch the first time and those who have every i dotted and t crossed have to jump through more hoops. Despite this, it seems they have always managed to secure an approval, even if it takes 2 or 3 tries.

Last but not least, she said that if I were approved today, I'd be looking at a late April surgery date. I am hoping that if I get approved in the next two weeks, I'll be on track for mid or late May.

Hope everyone else is doing well during this crunch time!

kagead

First off, you all are doing great! Congrats to everyone on your successes!!

Thanks for this topic. I was talking with a friend of mine over the weekend about this very issue. I haven't been banded yet, but I am already anticipating the "sizing down" thing will be a mental struggle for me. I have lost 10lbs, 20lbs etc. previously, but never enough to go down a clothing size.

I am pretty "compact" for lack of a better term. I am 5' 3", 230 lbs. and am wearing a 16 in dress pants, and a 16 or an 18 in jeans depending on the style. I am much bigger on top thanks to the "girls." I know I will need to drop a significant amount before I get to buy some new things.

If you can, please keep us posted and let us know when you have to give in and do some shopping! I bet it will be here before you know it!

Best of luck to everyone-

kagead

Ms. Rhonda, I'm right there with you on the waiting for insurance game.

I had my final nutritionist appointment on Tuesday and while I was there, I mentioned that I was disappointed because I had slipped through the scheduling cracks and wasn't meeting with the surgeon until April 14. (was supposed to be Mar. 31 but was pushed back by the surgeons office.)

Due to my work situation and the lifting restriction post op, I have a very narrow window in which this surgery can happen. If I don't get it done in May or June, I'll have to wait until NOVEMBER.

Luckily, the nutritionist took pity on me and manged to squeeze me in with the surgeon the very next day. I met with him on Wednesday, he said I am good to go and now all we have to do is wait on the insurance company. He told me to plan for late May or early June.

Keeping my fingers crossed this last little bit goes smoothly!

kagead