cat lady

Just wondering if too much protein can be bad for the kidneys. Has anyone had any problems with all the protein consumed after the surgery.

Hi all: I finally got approved after being denied. I had my date for last summer and then BCBS of NC denied me. I put together a strong appeal and just got approved. I just have to repeat my cardio clearance and pulmonary clearance. I don't think it should be a problem So now instead of being 62 and getting the band I am 63. I hope I am making the right choice. I do have a concern with all the protein we are supposed to have after the surgery. I know it can affect the kidneys to consume too much protein. I will ask my dr. about this. Good Luck to all of the baby boomers. I am planning on getting this done in July. Will keep you posted.

Definately appeal.....I got denied by BCBS and won my appeal. It is discouraging after you did all they asked. I was denied bcause they said my high blood pressure was not considered a co-morbidity. I had my three doctors write letters to support my appeal. I attached documents showing how my HBP could be helped by this surgery. I was so glad to be approved. Planning to do this in July when I have vacation time. Good Luck with your appeal.....I'm sure you will be successful. Don't give up.

Amazing weight loss Knaroz....wow. Jenn -- great for you too. Thanks for your helpful hints on swallowing the pills. Will try to choose wisely when I need to purchase them.

Thank you all for your honest replys. I think one week should be okay......hope I can do as well as all of you. Congratulations on your weight loss. It is really inspiring to see that this lapband really works for most people. Hope it does for me too. I am not a youngster any more and need this done for my health issues. Praying for no complications. Thank you all.

I take pills every day and also PM products to sleep at night. Are you able to swallow the pills. I know some cannot be broken because of the time release effect of the meds. Do you take a daily vitamin in pill form?

Just wanted to know approx how long it takes to drive back to work at an office job. I'm figuring about a week. Is this estimate correct. I hear some people up and about in a couple of days while others need more time. Just wondering.

Bobbi: Great pictures....you look teriffic. I hope to be getting the band in July and hope I can do as well as you did so far. cat lady

I am planning to have the surgery in July.....just got approved and waiting for vacation time to do this. I have only told my husband and daughter. Will tell my immediate family members but that is it. I also do not want to explain and justify my reasons and I have thought long and hard about this procedure. My boss is a health nut.....exercises in the office every day and always tells me I have to lose weight or it will shorten my lifespan. I know this is true but don't want to hear it from him. He is in great shape in his 80's so I do not want to tell him. He will tell me just to exercise and cut down on what I eat and he will think this is not necessary. I know it is! I have lost and regained the same weight many times. I am still deciding what I will tell him. I need a week off of work. The gallbladder story sounds good.....only I'm afraid if I do need the gallbladder out in the future, what will I say then. I was thinking saying Hiatial Hernia repair or Appendix removal....but the same would apply if God forbid I need this type of surgery. Am I worrying too much about what to tell this exercise buff?????? Maybe I should just get the flu for a week....lol

Hi Toni: I also have a BMI of 35-36 depending on the day. I have some co-morbidities but the first time my ins denied me last summer. They said my high blood pressure was under control and therefore not considered a co-morbidity. I appealed it once last summer and was denied again. Then I got some assistance with a Level 2 appeal and they approved me last week. Hoping to get this done in July. Now that it is a reality.....I'm getting nervous. I have to repeat some testing b'cause its over a year since I did my cardiac clearance and pul. clearance. Can't believe its approved. Keep after the ins company if you get denied.......but I hope you get approved on the first go-around.

Just found out I was approved and so glad b'cause it was a fight with the insurance co. to get it. It took me a year & a half for this whole process. Now they are asking for another Stress Test for cardiac clearance.....since the original one was done 2 years ago. Also need another Pul. clearance. I am concerned about the Stress test b'cause the last time I took it I really had a hard time finishing it....especially when they make it go fast and inclined. My legs really hurt at that point and they finally stopped it after about six minutes. They said everything was fine at that time. Just working myself up b'cause its not my favorite thing to do.....since I never really run at that pace. Has anyone else had a tough time with this test. Wondering if I should ask for a "resting" stress test? Has anyone had that done? Any replys would be appreciated.

Thanks girls for your support and congratulations on your wonderful success with the band. Cocobean you have done teriffic in three years and kept it off for so long. This is something I have never been able to do. I am now about 225 and hope to get to 170 with the band. Hope all goes well for me with no complications. What have you heard about erosion with the band. This is something I am concerned about and will address with my Dr. Amanda you also are doing great for such a short time with the band. Can't still believe I'm approved after a year and a half. Persistance pays off in the long run. I only hope I can be this persistant with the band. cat lady

Hi all: thanks for your support with my appeal to BCBS. I took some time and put together an extensive appeal with letters from my Drs stating that I have HBP for 20 years which is not always under control, back pain, knee pain, etc. They finally approved me after a Level 2 appeal. I'm happy about this but now scared at the thought of getting banded.......am I insane. Its been 1 1/2 years since I began this process and really kind of thought it wasn't going to happen. Now I must get my head back in the game and get prepared to do this. I'm seeing the surgeon again on tuesday.....since I have not spoken to him in over a year. I have new questions now that this is a reality. thanks again for your support CAT Lady

After being denied by BCBS of NC I appealed twice and was finally approved. Please do not get discouraged if you are not approved on the first go-round. It is possible to change the insurance company's decision. I received some online help and gave some detailed information about myself and had my Drs write letters supporting me. So happy I continued for the second appeal......I was actually so discouraged after the second denial I was about to throw in the towel. Now I am approved -- horray! Going to see my surgeon on tuesday since it has been a long time since I've talked to him. Want to update him on my fears and concerns. Good Luck to all waiting for approval.

Great Job Cynthia -- Your words are very encouraging to me. I am waiting to be approved by my insurance co. I am at 225 lbs my highest weight ever and don't like myself this way. Its so great to hear you had a good year with the band. I am concerned about complications. Hope I get approved and in a year can speak like you. Would love to get down to 168 lbs. Keep up the good work. Chris

Has anyone after being denied had any success with a grievance against BCBS. I really want to do the surgery but they have denied me b'cause my blood pressure is under control with 2 meds.

Thanks girls for your honest support. I don't know what the cost would be from my dr. and if it includes after care and fills which is also important. Also what if there are any complications??? Does the insurance then pick up the fee? These are the reasons I am hesitant about getting it done without the insurance coverage. My doc did call them to try to convince them I would be a good candidate but they refused to approve it. Don't want to come back and try again after I've gained alot of weight and have a BMI of 40 which they then would consider. Seems counter productive to my goal of better health and losing weight. cat:mad:

Okay so after 7 months of all the testing required and out of pocket monies....I officially got denied by BCBS. they are saying my BMI is too low at 35.5 for this surgery. I do have high blood pressure and back issues...but they said that the HBP is under control with pills therefore not considered a co morbidity. They are now saying my BMI would have to be 40 or above to get approved. I appealed and got the same denial. My surgeon, Dr. Geiss felt I was a good candidate for this and he even called the ins. medical director without success. Why is it that my HBP is not considered a comorbidity when I hear everyone else on this site is considered for approval. I cannot afford to pay for this surgery so I guess I am finished. I am disappointed to say the least. I am trying to rationalize this by saying maybe this is God's way of telling me not to do this. I must try to do this on my own...AGAIN. I had my date of august 19th so I decided to go on the liquid diet anyway and try to lose on my own. I have to try to exercise and do this for myself. I only wonder why they let me do all the testing and doctors, etc. just to deny me. They knew my BMI and HBP stats from the beginning. It was a waste of time and money also for the ins company. I think they should send it for approval to the ins company earlier...Not after you have your surgery date. Sorry for rambling on but I am discouraged. cat lady:confused::party::smile2::thumbup: Good Luck to all !

Hi all: My BMI is at 35 and I have high blood pressure. My doc thought I was a good candidate for this surgery. Did all the tests, saw all the drs required by my ins...even got a date in Aug for surgery then BCBS said my BMI is not high enough and they do not consider Hi Blood Pressure a comorbidity??? My Dr. called in support of doing the surgery but BCBS denied it. After seven months of preparing for this I am disheartened. I did send an appeal letter to them but don't have too much faith in it.cat lady

Having a similar problem here. On Wednesday BCBS told me everything looked fine for approval. Sent them the weight for 2008 that they requested. On Thurs. got a call that I was denied bcause the weitht was too low in 2008. I then submitted three other weights for 2008, since I have constantly tried to lose the weight without success....my weight varied from month to month. I don't know why after the 6 month diet that I followed they are going back 2 years to my old weight. I am now at my highest weight ever. So disgusted that after 7 months of following all their rules this happened. My surgeon is calling them for a "peer to peer" discussion to try to reverse the denial. I have my date and everything. Not happy at all. cat lady:thumbdown:

Don't want to discourage anyone but after 8 months of doing all the required testing my file was complete. MY surgeons office sent it to BCBS and I was told this am that it was denied bcause of low BMI. I weigh 220 and am 5'6 with high blood pressure. I can't believe they denied me. Yesterday they said it was ready to be approved....but after getting my weight chart from 2008 (when I weighed 205) they denied me. Tomorrow my surgeon, Dr. Geiss in NY will personally call BCBS and have a "peer to peer" discussion with the supervisor to see if he can change their minds. Hoping for the best. Discouraged to say the least. cat lady

Not so lucky here. Yesterday heard from ins and they said they only needed my pcp to send them my weight from 2008 and everything else looked okay. I went to pcp last night and faxed them the weight report from 2008. Got a call this a.m. from nurse at BCBS and she said it was denied bcause my weight in 2008 (2 years ago) made my BMI too low. I told her I have been trying to lose the weight for many years and have been up and down on the scale. Currently I am at my highest weight ever 220 lbs. She said my surgeon can make a call to the insurance supervisor called a "peer to peer" call and try to reverse the decision. I already have my surgery date....went for all necessary tests....even went to hospital for meeting with nurse who will be in operating room. Why did they make me do all of this if my BMI was too low? I do have comorbidities also, high blood pressure, low back pain, knee problems, etc. Not too happy tonight. cat lady:mad: