Search the Community

Two weeks ago I called my new insurance company to make sure VSG was covered - before I ever went to the informational meeting about any type of bariatric surgery, before I got my hopes up, before ANYTHING. I went to the meeting, got excited, got down and got funky with the idea of VSG. I filled out the forms, I made the appointment for my first visit with the surgeon. My first visit was today. I got weighed in, measured, and then the assistant asked what type of surgery I was interested in. I told her VSG. *crickets* "Oh honey," she said. "Aetna doesn't cover VSG." But they DO, I argued. They SAID SO when I CALLED THEM. They wouldn't lie to ME, would they? "Way-ul, we'll just play like they're gonna cover it for today. You give 'em another call again tomorrow and let me know, and we'll see what happens." Fur will FLY, Ladies and Gentlemen, if I have been lied to. FUR WILL FLY.

See, that's the thing. I go to a therapist, I can get medical clearance from my doctor and bariatric surgeon but the 6mos thing?!?I don't have that much time because my insurance is about to change. I am hoping that recommendation letters stressing the need for the surgery can do the trick. So let's say I do wait 6 mos and go to a nutritionist and all this other stuff..am I supposed to fail on purpose, so I can have the surgery!! With each passing moment, I am further and further away from having this procedure. Guess I'll just be fat, depress and lonely for the rest of my life.

Hi All, I just got my “welcome to the bariatric dept” letter and a denial letter on the same day. The denial said I don’t have a history of failed diets. My GP noted my failures specifically in my chart though. I’ve done so many diets, and Weight Watchers more times than I can count. I remember being on WW in my teens. My first prescription diet was early elementary school for G-d sake! Now I have to jump through appeal hoops. I have Kaiser (Oregon) via Medicare (I’m disabled). Any tips and encouragement is welcome!

Hey allycatt98, Yes, my friend went through a coordinator named Cathy. My friend will not recommend her surgeon to anyone now. She saw everything I received as a patient from A Lighter Me and recommends them and Dr Ortiz to her friends. By the way, the owner of the hospital is an Internist named Dr Sammy Tepperman. He does not do the surgeries himself. But when he has a patient that needs it, he refers them to Dr Ortiz out of all the drs that perform bariatric surgery there. Dr Ortiz operated on one of Dr Teppermans's patients while I was there. I learned a lot while there about things other surgeons have done to rip patients off. I met the patients. That is why I'm thankful for Dr Ortiz and his group. $250/nt for a nurse at the hotel seems unnecessary. I stayed in the hotel 2 nights after 2 nights in the hospital. I definitely did not need a nurse. I changed my own bandages that were provided by A Lighter Me. They gave me bandages, tape, pain meds with directions written in them (non narcotic, Toradol) which I didn't need because I had no pain, antibiotics with directions and a bottle of mylanta to take prior to abx. They were in a goodie bag of items for hospital stay. My driver also took me to a pharmacy where I purchased a supply of Omeprezole that I need to take for a few months. I bought 4 months worth for $60. Much cheaper than Prilosec OTC in Walmart. The lack of follow through my friend experienced would only be related to the split in that Dr Lopez left A Lighter Me, where they actually take care of their patients. He now contracts with a different group.

So who is buying the soda? Stop buying it. You are playing head games with yourself. This happens. Get back on the horse. One meal at a time, cut the carbs out. It's not that you fell off the wagon, it's that you get back on the wagon. Go get some sugar free popsicles or something to replace the binge sweets. You can do this one meal at a time. After 3 days the cravings will subside once you stop ingesting all those carbs. Add some good fats like avocado, coconut oil to help you feel sarisfied. Up your protein to 100grams. Get your bariatric materials out and reread them. Journal. Journal your food. Journal your gratitude.

I'm really grateful for the info that you've all generously posted here. It's helped me mentally prepare in so many ways. Now I'm at a crossroads of my own. I'm totally comfortable making my own decisions, but a little feedback from others in the same situation doesn't hurt either. Synopsis: I live in FL and have UHC insurance with the Bariatric Resource Program. Within a two hour radius, there are only three approved hospitals. I finally decided on a hospital and surgeon only to find out they want a ridiculous non-refundable $600 "Program Fee," in addition to me having a MOOP of $6000. So total estimated costs are at $6600. The alternative path would be venturing to Mexico for either Drs. Lopez or Osuna at Specialized Bariatrics -- estimated costs $4200 - $5000 (surgery, flights and incidentals). Yes, there are flight costs and no follow-up, but considering my initial FL doc choice was over two hours away, I doubt I would necessarily return to him for complications. But if I opt for a Florida doc, I wouldn't be alone. There is a chance that I would be alone going to Mexico. So what are your thoughts? Would you opt for Mexico for a savings of $1600 - $2000 dollars?

Thanks Nola, That is a good point. The doc I chose in Florida is considered the "grandfather" bariatric surgery here. He was the first in the state to perform the sleeve using the Spider technique. I think he's performed over 12,000 surgeries in addition to being a bypass patient himself. So he's definitely qualified, but that doesn't mean that he's the only one that can perform the surgery safely. Ally

I did keto a while back and had the keto flu for about a week. The bariatric diet and keto are actually the same except bariatric diet wants your fats 50 or less per day and keto wants HEALTHY fats higher. I did the bariatric diet for 2 1/2 months and my body hated it. I would stall over and over. I decided to switch to keto again and I haven't had a stall in the month I've been doing it and have steadily lost. No keto flu this time, tho. But it's normal and goes away. I keep my calories between 1000-1150 per day (I work out and need the extras so my body doesn't think it's starving and hold on to everything). I keep my carbs between 25-35 per day. My protein stays around 75-85 per day. My fats are usually around 70-80. And I'm completely sugarfree or very low sugar (such as certain fruits or veggies). I work out for 45 minutes per day, and I generally take in around 75-90oz of fluids (depending on the type of workout I did that day).

Good morning! So my surgery date is 3/28/19 and I started my 2 week liquid diet yesterday. I was diagnosed with Type II Diabetes last year in June before I started pursuing bariatric surgery and this diagnosis actually pushed me to go through with it so I decided to not go on insulin since this surgery has such a high rate of success in putting diabetes into remission. I'm getting nervous though since my fasting glucose result just came back and it was really high, 170 to be exact, and I'm worried my surgery might be delayed because of this?

Even though we aren't supposed to snack I found these awesome crunchy krinkles. If you are like me and like to have something that crunches you should try these. They are found on bariatric kitchen.com. I also bought pancake batter. High Protein and ok on the carbs. The krinkles have 13g per serving size (can't tell u serving size since I cut it off...oops). They are really yummy.

Don't give up...appeal, appeal and appeal. When you call them make sure to ask for the bariatric coverage in writing. Some times over the phone they will just say "oh we don't cover that". It happened to me and sure enough it was covered as long as certain criteria is met.

Hi! I had LapBand sugery in 2010 at the age of 51. I had prior health issues such as SIJ arthritis, & back surgery (2008). Before my LapBand surgery, I took myself off my presciption anti-inflammatory as directed. I lost around 30 lbs. in 4 months while going to the gym & walking on the treadmill at least 4 x per week. When my anti-inflammatory med finally left my system, my knees started KILLING me! I went to a Osteo surgeon who tried shots; found a torn miniscus and worn joints, but who didn't want to do sugery. Well, of course my weight loss journey not only stalled, I gained most of the weight back. I could barely go up & down my stairs at home, it was so bad. I got back on my presciption anti-inflammatory and am doing much better. I contacted my Bariatric surgeon and had a consult wih him yesterday. Heres the deal, I want the LapBand out so I can take stronger meds than acetametaphine for my pain. He and I are now talking LapSleeve. Has anyone else out there gone from a LapBand to a Sleeve? If so, are you happy you did? My doc did a flueroscopy and it looks like I have a hernia ; he said my band looks "flat". I'm praying my insurance will cover this re-do. I was self-pay for the band but no way I can pay for a removal & sleeve. Thanks to anyone who can respond to my question of LapBand to Sleeve.

Ok I think he’s part of Chi Franciscan’s internal bariatric program. Again I have nothing but good things to say about everyone I dealt with from testing to surgery to recovery. [emoji4]

I think the bariatric doctor your primary sent you to can go suck it! You might want to check into another bariatric doctor that may be in group, or even consider going to a different doctor altogether if you don't find one you like through your pcp. If you found one you like, you can always petition your insurance agency to get him or her approved. I was self pay so I didn't have to go through the the whole insurance run around. I absolutely love my surgeon and my trust in him made both my surgery and aftercare fairly easy. Bottom line, find a surgeon you feel comfortable with, and the entire process will go much more smoothly.

I can understand that, if the country's health care system is gov't based. It doesn't mean I have to like it. They are not turning out their own citizens, but denying immigration. I am a Benefits Adminstrator for my company and see our premiums jump 10% or more with every renewal, because we are forced, through our premiums to subsidize un-insured people (both citizens and non-citizens) who either can't or won't pay their medical expenses. If the couple agree to not use the gov't medical system and pay for the expenses themselves, New Zealand should let them in.

Protein drinks can be powder or ready paid. They need to be whey protein isolate. I am a little confused by everyone taking childrens chewables or gummies as I have been instructed to take only those formulated for bariatric patients (brands I use are Bariatric Advantage and Celebrate). The only things I can take that aren't are after 1 month I can take calcium citrate (citrical is one brand) and my B-12 as long as it is sub-lingual. I am 2 weeks out tomorrow and taking my vitamins since day 5. Drinking my fluids takes all day long and I am scared to start food - will I be able to get my fluids in?? I'm so full with just fluids!

When did you start your 6 month plan and when did it all get submitted to insurance? Insurance has denied me because they say there isn't 6 months of a documented weight loss plan. I went to my PCP in October of last year. She weighed me and we talked about diet/exercise along with getting my referral to a bariatric center in our area. I started going to them in November and have not missed a month. So, March should have been month 6, correct? I'm not sure if they just aren't counting the PCP one or if they count their months differently (October-November, November-December, December-January, January-February, February-March would only be 5?). If anyone has had this situation and had it resolved, I would love to hear from you! Although I will know the answer in a few days I can't help but ask!

i started 2 years ago at 425. Through a successful bariatric program at my hospital and one of the top surgeons I am currently at my goal and maintaining at 220 pounds. My journey was one for ME.

Oh, another thing - any good surgeon will have a whole pre-op team... Mine included the bariatric GP, exercise physiologist, dietician and psychiatrist. And the care doesn't stop there - they are available to me when ever I need. Like I said, I am in a remote location so I have all their mobile numbers and can call if needed. They are there at my disposal, and for you who struggles with emotional eating, then the psychologist may really be of help to you. Also, with the pre-op liquid diet - I almost cried when I found out I had to do it. Not cos I am worried about sticking to it, but because I HATE Optifast, which is what my surgeon wants me to use, it has made me vomit before when I tried it to lose weight previously. But after talking to the dietician, she gave me some great tips to get through it and the psychologist really put it into perspective - its only for two weeks and then I never have to do it again! My surgeon has also had me on a strict "three meals a day while sitting at a table, 10,000 steps a day, minimal alcohol program" (not diet - I am still allowed to eat what I please, he is just trying to get me to learn to listen to my body - when it is full etc) and it has been a real eye opener for me. Especially as I was a massive drinker before, it wouldnt be unusual for me to put away more than a bottle of scotch in a session! If you really want it, you'll be able to do it. And if you choose a good surgeon and support team, you'll have all the support you need. Good luck.

Okay so my curiousity got the better of me and I emailed his office. I fully expected a member of his staff to answer that email as opposed to him and was delighted to see that he responded directly. I can tell from his email that he was a bit on the defense as he may have thought that I was saying he didn't know anything. So I've since emailed him back with an apology if he misunderstood my intention in the question... What I asked: "in my consult I believe he told me that they do not need to use sutures when doing the Midband. Can you please tell me if I am recalling this correctly? The reason I ask is with futher research and talking to other Lapband patients (not of his) they informed me that their surgeons were rather adament about using sutures to hold the Band in place. I know not doing sutures is a fairly new practice for him. Could you please tell me why again that he does not do these. And are having sutures an option if this is something that I felt strongly about?" His response: "You heard correctly. With the MIDband, according to the manufacturer, and Dr. Frerer, who personally has placed over 5000 bands (1000 Swedish Bands, 1500 Lapbands, the rest MIDbands), anterior plication stitches are NOT necessary. Therefore, I do not place these stitches when I place these bands. They don't seem to do any good, at least not with the design of the MIDband. Dr. Patrick Yau, perhaps the most experienced Canadian bariatric lapband surgeon (Toronto) also places MIDbands, although he is trained in Inamed bands, Swedish bands and MIDbands. There are six adjustable gastric band companies whose products are available for us to place in Canada. If I place a Swedish band (used in Europe and around the world for years, just approved in the USA Sept 28th, will be marketed this January on TV etc), then I will place anterior plication stitches, per the manufacturer's recommendation. I am trained to place lapbands, but I need to be proctored for two cases before I can place these on my own. I have chosen not to pursue this at this time, as I see no advantage of this band over the Swedish band or the MIDband. Remember, virtually all of the USA patients have lapBANDs®. Their products are different than the ones that I use. Not better, not worse, just different . until a few months ago, USA surgeons could ONLY use one product. how could they possibly comment effectively on another band that they have no experience with? Further, most USA surgeons have only done the lapband since 2001, and not the 1990s like the Europeon surgeons. To answer the latter part of your question. I prefer placing the MIDband at present, and if that is the band we go with, then I will NOT place any plication sutures. If we place a Swedish band, then, per the manufacturer's instructions, we will place anterior plication stitches. That is the choice. The price is the same with both of these. I am comfortable placing both of these. I think that the weight loss will be the same with both of these. The MIDband people suggest that there may be less complications with their band, and that it is softer (it feels softer, with no rigid parts) and that their patients report that the band is more comfortable. How can they say this? In France, bands are covered as part of their 'MSP'. Some patients with failed bands from other companies may have had a MIDband placed later, and reported on the differences. I am impressed by how easily it is to place. I was most impressed by the technical skills of Dr. Frerer. If he thought stitching was necessary and useful, he would do it. " There you have it. I am comfortable with his response and with him as a surgeon in general and will continue my persuit of the band in his capable hands. (sorry for the bad formatting, I was just copy pasting from my email)

That is ridiculous! My psych eval was very thorough and detailed! It only cost me 50 of $150! You need another doctor in my opinion! Oxford Bariatric is awesome!

Good afternoon, I went in at 6:45 yesterday for my surgery. I was back to my room at 11. Found out I was the only patient on the bariatric floor until 3 when I was moved to a private room on the surgical floor. Super nice corner room that had windows on both side to enjoy the mountain view. I was out of bed by that point and walking the halls. My blood sugars went up, but are coming down now and insulin was reduced to 3 units. No other meds. I am sore, but not overly so. My Dr said it went extremely well. They didn't do the upper GI x-ray today because of the snowstorm. He wasn't worried because I am drinking the three one ounce cups each hour. So I will have that on Tuesday for my post op. So glad its over. Now I get back on with the business of relearning and living life. See you on the other boards! Nell

So I was hoping we could do this here. I need extra help. Maybe we could low carb it togethor? Since I am just starting this fresh I was hoping noone would mind me starting a new thread for it at my home VV. The other thread on the main forum is so large and intimidating. Anyone want to do this with me? recipes? Ideas? I am supposed to be eating this way anyway so I thought I could renew my commitment (or actually make one) to low carb lifestyle now. Protein first, Veggies if room, and hopefully no carbs. :puke:

I got banded on April 21st and today was the first day where I actually could tell that I'm getting better. It still hurts when I get out of bed and even when I stand up after sitting for awhile. I too have bruising by one of my incision but I think that is where they gave me the blood thinner, it also happens to be the biggest incision and where I believe my port is. There is quite a bulge as well so my stomach appears alittle lopsided so I guess maybe its normal. I wouldn't worry unless the incision is red and pussy but if you want piece of mind theres no harm in calling the Dr's office and talking to the bariatric nurse there thats what they're there for.

Hi everyone, First off, I would like to apologize for the length of this post, but I'm at the end of my rope here and SO upset!! Second, if anyone has ever been through something like this please feel free to add your input. Like a lot of you I've never been so motivated and excited in my life for my upcoming surgery. My husband's employer has CIGNA insurance. They have never covered bariatric surgery until what I thought was this year. In prior years they had our plan documents on their website so you were able to see the specifics of what was covered and what was excluded. We had many changes this year but for some reason they have never put this detailed information up on either the employee website or the CIGNA website this year. Needless to say, I contacted CIGNA for this information on more than one occasion. FINALLY, I received information in the mail with very detailed information saying that weight loss surgery WAS covered. Imagine my happiness!! I even contacted CIGNA via phone to verify this and it was confirmed as covered. I started all of my paperwork and submitted it to my doctor's office. The doctor's office ALSO contacted CIGNA and they were given an approval of coverage for the surgery and a reference code for the call. The requirements were for 3 months of doctor supervised weight management along with the usual psychological evaluation, high BMI, sleep apnea (check), diabetes (check), high blood pressure (check), etc. Therefore, my journey began and I stuck to the program like crazy. I went in this past Monday for my final doctor's visit and they submitted my paperwork to CIGNA. My claim was immediately denied by CIGNA saying that weight loss surgery is not a covered benefit. If you could only see the look of despair on my face. The doctor's office informed CIGNA that my surgery is scheduled for June 23rd and that I have done absolutely everything required. CIGNA told the doctor's office that they have given the case to their supervisor and that my doctor's office would have to submit an appeal (IN WRITING, which will only slow down matters). My husband also contacted the HR benefits manager who was livid that this had happened. She informed him that they have never covered bariatric surgery and that there is NO appealing this situation. I am having a very hard time believing that nothing can be done, especially on the part of CIGNA's more than one error. They informed my doctor's office that the employee who told them that I was approved would be reprimanded - do they honestly think that is going to make me feel any better? What about the others who sent me the information in the mail and by phone? I contacted CIGNA on Tuesday and said that they apparently have problems with training their employees. This is not something that can be brushed off as a slight error! CIGNA needs to pay for their mistakes! One other thing of mention is that CIGNA has paid ALL of my claims regarding this preparation for the surgery, including my BARIATRIC Vitamins at 100%!! I just don't get it. I don't know what to do with myself at this point. I am just absolutely heartbroken and numb. I've worked so hard for this and to have the rug pulled out from underneath me at the last minute is just wrong. Thanks for reading and your understanding! losinit512