kimmiev

Hey Guys~ This is Julies Sister in law .... here is a link to show the postion you will be in ... LAP-BAND: Surgery Technique In this picture , the table is set at a 30 degree angle so the Dr can stand in between your thighs... the bean bag can be used to keep the pt from slipping off the table and may not be used anymore. Good luck! It's all worth it!

:whoo:Hey Girls! I am 8 weeks pregnant! I had a sono last week and saw an actual baby, so now I am getting excited! I had my lapband surgery 12/21/06, and have lost 50 lbs so far! I have lost 4 lbs the past week thanks to morning sickness! woo hoo! :faint: Can't wait till the first trimester is over! Then I can relax a little. My due date is 5/9/08. Kim

After a second level appeal to Aetna HMO, I finally got approved last week and my lapband surgery is scheduled for 12/21/06!!! I am freaking out! Advice to anyone trying to get approved- don't give up! Keep appealing and getting letters from all of your Dr's untill your insurance co approves you! The insurance companies deny you thinking you will just give up- don't do it! I am so excited - and a little scared. Has anyone ever died from lapband surgery? I don't wanna be the first! I can't wait to start my new life! I have been overweight for 18 yrs. Any advice anyone has about the surgery would be totally appreciated! Happy Holidays !! Kim:clap2:

Hi Sam! Sounds like you should qualify based on your BMI. The main thing you need to verify with Aetna (or any insurance co) is that wt loss surgery is a covered benefit through your employer, also check the certificate of coverage to see what the qualifying steps are for the surgery if it is covered. Aetna made me have 6 months of supervised diet and exercise visits with my PCP (make sure you dr. notes that he discussed "behavior modification, diet plan, and exercise" on every visit! Mine didn't put behavior modification and I had to do a whole new 3 months in addition to the 6 I already did! Also- YOu can do only 3 months of dr supervised visits if it is pre surgery! I also had to have the usual- nutrition evaluation and Psych visit. Make sure your nutrition visit is about your diet before the surgery , not a lapband consult. ... Aetna got me on that too! Oy! Good luck at your visit! Let me know if you need anything at all! Kim

Hey Guys! Wow! Thanks for all the well wishes and replies! My surgery was a total breeze! I was back to work in 4 days! Haven't had any complications, and I have lost about 52 lbs so far! I think the wt just falls off no matter what you do the first 4 months, then you really need to follow the rules and exercise. I had been lazy in the exercise dept! Getting fills is major important too! If you can eat more than 1/2 cup of food within 20 minutes and not be totally full, it's time for a fill. I just found out that I am 8 wks pregnant! I am sure it's thanks to losing all that wt! I still have at least 100 lbs to lose, but I know I will get there! Good luck to everyone! It's the best thing I ever did! kim:whoo:

Dr Jayaseelan and Dr Fox are among the best! I have several friends who have been banded by both and had great things to say! I had to go to UTSW- Dr Provost's group... because of my insurance. The Dr's are awesome, but the office staff are not very helpful at all. I had to submit all of my own paperwork and my own appeals... I finally got approved and Dr. Daniel Scott is doing my band on 12/21. I know he is great because a friend of mine is a surgical nurse at Parkland Hospital and has actually assisted Dr. Scott on several occasions. If you want a great surgeon with great office staff, try Dr Fox or Dr Jay... Good Luck

Hello! This is my first post. I have been visiting this site for months in anticipation of having my lapband surgery. Aetna HMO denied my predetermination because at my 6 months worth of diet supervision visits with my PCP, he only wrote that we discussed diet and exercise. They also wanted the wording "behavior modification" in the records. The funny thing is that my actual policy (employer)covers the lapband surgery. So, now I am undergoing the 3 month multi=disciplinary diet and nutrition program offered by my surgeon to see if Aetna will be happy with what they do. It's good, they have me meet with the nutritionist every visit, and give me lots of tools and tips to lose weight. I guess my real question is- has anyone ever gotten approved by Aetna HMO in Texas (or anywhere) for the lapband? If so, what notes did you get? Any tips? I did the 6 mo of PCP supervised dieting, Psych eval, nutritionist visit, started exercising, and pretty much jumped through every hoop Aetna asked me to! My BMI is 52 and I have several co morbidities. I am starting to get discouraged and just want to give up. I am only 2 months away from maybe getting approved... Any tips or help is totally appreciated! Thanks! Kim

thanks for your replies. My employer actually does cover the bariatric surgery. So, at this point it is the insurance company requirements I need to satisfy now. They have told me by phone, that basically, they want my supervised diet to include progress notes that include what type of diet i was put on, what and how much exercise i did, and what behavior modifications were implemented. Behavior modification was the main thing that my PCP didn't mention in my records. Hopefully, The 3 month supervision I am going through will be enough for Aetna this time. Should be completed with that in November. Thanks to you all for your help!

I have Aetna Hmo and have jumped through every hoop and still got denied (I am appealing and going through another 3 months of supervised diet in addition to the 6 months i have already completed!) Aetna denied me because my PCP didn't write that we discussed "behavior modification" in my visit records. He did write diet, exercise, and what diet I was on and prescribed diet pills. I did everything and my policy/employer actually covers the lapband! I still got denied! I work for United Healthcare... I do know that they cover a lot easier than Aetna does. At Aetna, every case has to be reviewed by the Medical Director. At United Healthcare , it does not. Just call United Healthcare and verify that your employer plan does include coverage for bariatric surgery. Good luck!