ardelia

Crap. I just got home from my overnight sleep apnea testing. The kid who monitored me all night said I had no episodes. DAMMIT! With my current BMI (38-ish) and no comorbid conditions, there is no way that I can get banded and have my insurance cover it. I have a few options, I suppose, but self-pay is not one of them. The first option is to have my surgeon's office remeasure my height. Their measurement is a solid inch more than my PCP's. If I had the PCP's measurement, I'd be on my way to bandland. The next option is to gain weight to reach a BMI of 40. Cripes. Gaining weight to have a weight loss surgery just seems counter intuitive. Go on yet another f-ing diet only to fail once again is another way to go. Finally, I guess I could just give up and try to be happy as a heifer. I don't care for this option. I am supposed to call the surgeon today and let him know that I had my sleep study. I think that he wants to see me again after that....and if so, I will definitely ask for them to take my height again, during which time I will slouch as much as I can without being obvious. The most annoying parts of this? Firstly, I didn't even get a decent night of sleep. The ninnies kept me up two hours past my normal bedtime, so that messed me up. Then, that freakin' nasty crud that he put in my beautiful hair just vexed me. It was too gross. A little OT here, but I did learn that my Wen Cleansing Conditioner really does work!!! I had my doubts, but MAN, that stuff is awesome. Who needs shampoo anyway? NOT ME!! It got all of that nasty crud out of my hair just like that! Anyhoo....whatevah. I'll just sulk for a little while and then figure out my plan...

If I do get banded, only one person will know. In fact, I wouldn't even tell THAT person if I didn't need a ride home after surgery. He is thin - always has been - and he just doesn't understand being fat. NO ONE at work will be told. Why? Well, my supervisor actually revealed something that another co-worker had told her in confidence. "Oh, well, Jane Doe can't come to this meeting because her dad is dying in the hospital. Oh, but don't tell her that I told you because she told me this in confidence and wanted no one else to know." What an ethics-free, disgusting bitch she is. Jane Doe's secret is out and I feel like crap that so many of us now know. I do not trust that she would keep her fat mouth shut, so I'll just say I need time off for something medical. If she asks what specifically, I'll just ask her whether the HIPAA laws require me to tell her anything. (They don't, BTW.) That'll shut her miserable pie hole. Bitch. :scared2: ---Whoops! Sorry for that slightly OT rant, but I had to get that out....thinking of blowing the whistle on her for an ethics violation, but worried about retaliation...---

I'd stick to the facts. Forget about anything emotional. Don't embellish anything. BTW, if that is your real name, you may want to consider editing your post. I surely would not want my real name and all of my comorbidities out there!!!

I would recommend NOT using peroxide on your wounds. You can Google it and you'll find things like: it "has little ability to reduce bacteria in wounds and can actually inflame healthy skin cells that surround a cut or a scrape, increasing the amount of time wounds take to heal" and others. TMYK and all that....

Well, I had my consultation with the surgeon last week. He's very kind and his staff is also good. Unfortunately, I seem NOT to be fat enough for surgery. The height my PCP and surgeon took are a solid inch apart. DAMMIT. I should have asked the surgeon to do my height again - and I will when I go back. (if I go back, that is...) He told me that it would be unethical of him to do the surgery on me with a BMI below 40. (I think I came in at 38.6.) Without a comorbid condition, I am on my own unless I gain some weight. :smile: That said, he did think that I should see the pulmonologist because he thought I might have sleep apnea based on a few answers on the questionnaire. Happily, there was an appointment about 30 minutes later since the pulm had a cancellation. I saw the pulm (also very nice and took time with me) and he thinks that there is a 75% chance that I have sleep apnea. Um. Yay me? I have been scheduled for a sleep study. I do not sleep with any humans in my bed (just cats), so I don't know if I do snore or gasp for air. Obviously, I am conflicted and quite disappointed. Without a positive diagnosis of sleep apnea, I am out on my butt. If I do have it, then I could probably qualify under my insurance. (Though my credit scores are all over 800, I simply cannot afford private pay.) Oh, and it seems that my insurance is really good (the office lady said so) and covers everything but the nutritionist. I learned so very much on this site and through others' experiences and now it may all be for naught. It is just so disappointing. Of course, I ate a whole box of donuts when I got back from my consult. :scared2: I just had to vent a little since I do not have anyone I can tell about this.

Should I be concerned that I cannot find any reviews (well, found just one from when he was in NY) or much useful information about my potential surgeon? I met him at the seminar and I have an appointment with him tomorrow...but I wonder what y'all think about this. Feedback, please!

Yes, I think that it is odd that the insurance company won't tell me that big secret. No worries...my surgery consult is on Thursday, so I'll ask the office staff then.

With regard to asking what the hoops are to be jumped through, I can tell you my experience today. I called my insurance company (Keystone Health Plan East) to ask a lot of questions. I found out that LAP-BAND surgery is covered as an inpatient procedure "based on medical need" and that the patient "must meet all criteria." Of course, I asked what those criteria are, but she told me that she is not permitted to give out that information. She also refused to tell me what the insurance code is - not that having it would do me any good. She did tell me that there "are 7 to 10 things" that make up the criteria and that my doctor's office (surgeon) would be able to tell me what they are based on my insurance. I also found out the following: My co-pay would be only $250 (the inpatient co-pay). All pre-op testing is covered, as would be any procedures afterward that would be medically necessary (e.g. band slippage repair, defective port having to be replaced). The nutritionist is not covered, per my company's specifications. All of the paperwork would be submitted to the pre-certification department and that their decision would be mailed to me in 7 to 10 business days. After approval, I could schedule the surgery based on my surgeon's availability. So...YMMV, but this was my experience. The woman I spoke to was extremely helpful and very patient with my numerous questions. We were on the phone for a good 25 minutes. Oh, one more thing...When I asked about bariatric surgery, she specifically asked, "What are you considering? LAP-BAND?" I guess they must be getting a lot of folks asking about it? She did not mention the sleeve or GB.

My favoring of the LAP-BAND has a lot to do with my brother-in-law. He had gastric bypass a little over 90 days ago. He has had no complications (happily), but he has lost 100 pounds already! :confused: I cannot imagine losing that much weight so quickly! I plan to tell only one person about my WLS (if I can actually get it, that is). If I lost 100 pounds soooo quickly, I'd almost HAVE to tell people. (I mean, I know not really...but there would be A LOT of questions about my sudden, extreme weight loss. I know I'd be cornered about it and I am NOT pleasant when cornered.) With LAP-BAND, though, since the weight loss will be more gradual, I can just use the ol' "diet and exercise" reason when asked about my weight loss. It is no one's business, and I think that hiding my LAP-BAND surgery would be far easier than hiding gastric bypass.

Lower chance of issues with malnutrition Adjustable & removable, unlike GB Better paced weight loss (lower chance of saggy skin) No dumping syndrome Faster recovery time Lower mortality rate post-surgery Fewer complications post-surgery I am sure that there are many more, but my brain is a little slow today...I know that there are many more, though. Best of luck to you!!! Keep us posted on your progress.

I found the contraindications on the lap-band page and it does not specifically mention APS; however, it does mention autoimmune connective tissue disorders as contraindicated with the lap-band. I'd ask a surgeon or even call the toll-free number and ask someone at Allergan. The LAP-BAND® System is not right for you if: You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn’s disease. You have severe heart or lung disease, or any other disease that makes you a poor candidate for any surgery. You have a problem that could cause bleeding in the esophagus or stomach. That might include esophageal or gastric varices (dilated veins). It might also be something such as congenital or acquired intestinal telangiectasia (dilation of a small blood vessel). You have portal hypertension. Your esophagus, stomach, or intestine is not normal (congenital or acquired). For instance, you might have a narrowed opening. You have/experienced an intraoperative gastric injury, such as a gastric perforation at or near the location of the intended band placement. You have cirrhosis. You have chronic pancreatitis. You are addicted to alcohol or drugs. You have an infection anywhere in your body, or one that could contaminate the surgical area. You are on chronic, long-term steroid treatment. You might be allergic to materials in the device. You cannot tolerate pain from an implanted device. You or someone in your family has an autoimmune connective tissue disease, such as systemic lupus erythematosus or scleroderma. The same is true if you have symptoms of one of these diseases.

I haven't scheduled surgery yet...but I am a (compulsive) planner and I like to be prepared. I certainly am hoping that my life will change after surgery. Many around here (lapbandtalk.com, I mean) seem to have great success after their surgeries.

This is kind of an odd question, but I fear that I have found myself in the unfortunate position of not having someone to drive me home following surgery or to watch me to make sure nothing weird happens. My friend was supposed to do it, but a severe falling out now excludes this as a possibility. The question is: would a private duty nurse be permitted to bring me home after surgery and stay with me the first day or so after or must it be someone who is my family/friend? I really don't have anyone else to help with this because my circle of friends has significantly diminished since I have packed on so much weight. Actually, the circle is non-existent. (If you refuse every single request to go out with friends, eventually they stop asking.) No, there is no family member to help - both parents are dead. Please don't think I am here for a pity party. This question is quite serious and I am hoping that someone here can help.

Please stop smoking before AND AFTER your surgery!! Nicotine constricts your blood vessels and with a reduced blood supply, your incisions will take much longer to heal, if they do at all. Long story short, my sister had a breast reduction and she refused to quit smoking (not sure why the doc even DID the surgery...). The end results? She had 7 surgeries over the next three years and she had to have her areolas tattooed in. Her breasts just look scary. It is simply not worth it.

I would not feel guilty about this, but I do not really have many close friends that I would tell about this. I plan only to tell one person and he is sworn to silence. If I didn't need someone to drive me home after surgery, quite frankly, I'd not tell anyone! It is no one's business but mine.

I realized after the poll had already posted that I did not include "other" or "none of the above" in it. :thumbup: Sorry about that! If someone knows how I can add it, I'd be happy to!!

Not that this is my sole motivation, but this is a biggie for me... I want to be able to fit into a pair of buttery soft black leather pants that were tight on me even when I was at my "thinnest" adult weight around 2002. If I can get myself into those, I will be happier than a clam. :drool: Oh, yeah, I also have a fairly sizable wardrobe of custom-made corsets (including a leather one) that I hope to be able to fit into, if not completely have to discard...and then I'll start with a complete new wardrobe of them!! Is this shallow? Yeah, maybe a little, but I need all the motivation that I can possibly get. I am less than two weeks from my first surgery consult and I am getting excited for that...Let's just hope all goes well. :thumbup:

I see that everyone who gets banded needs a psych eval. Can someone who has had one enlighten the rest of us? The more details, the better. ( I am not particularly interested in the insurance/financial aspects, but more of the actual psych exam itself.) (I go for my surgery consult on July 15th and I am getting nervous ...trying to kill time here before that, so please help!!)

Yes. No spicy food. That may very well kill me. :scared2: If no spicy food is my biggest problem, though, then SIGN ME UP!

Hello from the suburbs of Philly!! Where are you having your procedure done? What doctor? I cannot seem to find people from this general area who have gone through this.

A little of the ol' Google and I found this regarding erosion and alcohol....See number four. http://arturorodriguezmd.com/lap-band-erosion

If you read the product information of the LAP-BAND System, you will see that one of the contraindications is if you have alcohol or drug addiction. I don't know the OP, so I don't know whether there is an addiction issue; however, if there is, the physician must be told about it so that s/he can help the OP make the best decision. It really is critical that you tell your doctor everything. Omission of anything is not fair to YOURSELF. Don't you want the best possible outcome for YOU? I surely want the best possible outcome for you. :scared2:

I have never been diagnosed with any sort of mental issue. Only the other day was I told that I have a food addiction. Frankly, I have no interest in trying to game the system just to get myself a band. That would be irresponsible and STUPID. The docs have to know everything about their patients and not being honest with them JUST so that I can get a band is moronic and I will not do it. If someone does have some kind of mental issue that they try to hide, and then they get the surgery, there could be major problems. If you are a food addict, for example, but you hide that fact from your doctor, it is a mistake. The band will not change one's behavior, though it seems some people here don't care about that issue. They are single-sighted: MUST GET BANDED NO MATTER WHAT. If the docs decide that banding is not for me (for whatever reason), then I have to live with that. Trust me, I do not WANT to get the band unless I really have no other option. I'll give the meds a go and see how I do.

Yep! And that is why I still look around here...if bupropion does not work in combination with the thyroid meds, this might end up being a great option for me. :thumbup:

Right. I went to see my primary care doc to get a referral to the surgeon so that my insurance would cover that visit. Before know what happened, he has scolded me for not having taken my thyroid meds and he thinks that surgery is a bad idea. If I can't change my eating habits, then the surgery won't work. Yeah, I get that. He also said that any decent surgeon would refuse to operate on me till my thyroid is under control. I get that, too. Then he said that he wants me to read about bupropion, which I did ravenously. It is used for many things, but an off-label usage is for people with eating disorders (not anorexia or bulimia, though) - like me, apparently. He tells me that he thinks (based on what I have told him over all my visits) that I have a food obsession and (now get this) that my overeating IS NOT MY FAULT. WHAT? I can see the food obsession thing since I do have some other compulsive behaviors like counting things or thoughts cycling though my head incessantly. My fatness is not my fault?! I cannot tell you how that felt to hear. I mean, when I try to explain to my best friend (never been fat in his life) that I just cannot control myself, he doesn't get it. I feel like a weight has been lifted off my shoulders. I am about in tears. These are good tears. I am going to get myself back on the thyroid medication and start the bupropion and see how that goes. If it works, then I can avoid having an invasive procedure. If not, then I can always come back to the surgical option. I am not going anywhere, though...I want to continue to learn more so that I feel comfortable in case I have to go the surgery route. So...I have canceled my consult with the surgeon. (Though, interestingly, his office called me a few hours later - apparently they had not listened to my message yet - to tell me that the surgeon had to cancel my appointment. How funny!) I am, however, going to go to the learning session at Phoenixville Hospital on Thursday...should be interesting.