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What I'm cooking for dinner tonight!
Fanny Adams replied to Luscious's topic in LAP-BAND Surgery Forums
That's how I'm approaching it. I was never one for lots of junk food, takeaways or sweets. I had them now and then of course, but those weren't the things that made me fat. What made me fat was eating a dinner that should have fed 3 people at most sittings and pushing it to the equivalent of 4 servings on special occasions (that seemed to occur quite often :rolleyes2:). I'm trying to just stick to good healthy cooking, fat free as much as I can, and I use my sandwich plate as my serving size judge - if I can get it on the sandwich plate (no piling it up allowed!!), then that's what I'm allowed. So far it has been working for me. The loss isn't as fast or dramatic as it has been for some, but it is steady and I don't have any problems with hunger - feel full all the time - and no PB problems from being too tight. That's what I call the sweetspot anyway :cry_smile: -
I am also waiting for insurance approval. Finally the psych doctor gave the surgeon her report...she was sitting on it since august 14th!!!! Of course, no one knew this until I started calling my insurance company and they didn't have any paper work on me. They were suppose to mail it out mon or tuesday...my surgery is scheduled for SEPTEMBER 20th..Yup, and I bet my insurance company won't come back with an answer, or a denial, then I will have to appeal, and everything will be pushed back..Its very upsetting..esp. when I am trying to do the liquid diet..it doesn't help to have this on my mind. My husband needs to take time off of work, but we can't give an exact date because we have to wait for approval, same with someone walking our kids. I have HMO BC/BS of New England I live in NH. Anyone have them?
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I have BC/BS of IL *** - was denied the first time, second time went right through. It took me about 9 months from seminar to surgery though.
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Keep the faith. Maybe your HR lady can get it added or your employer can purchase a rider to your current policy? 2-3 months isn't really that long to wait. I just started a 6 month supervised diet because my doctor's office knows it's a requirment of the insurance company I am purchasing a new policy with. My current policy with BC/BS won't cover any WLS. I'm not even 100% sure I'm going to be covered by the new company.
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What is the $10,000 max lifetime? Do you mean "out-of-pocket maximum"? There could be a number of things going on: They haven't been fully reimbursed by insurance, so the bill was sent on a cycle before it shows the adjustments and payments? (This has happened to me before). There is a difference b/n the fee surgeon's charge for "uncovered" services and then what they charge the hospital. They should have explained this to your friend before surgery. Most hospitals offer a financial screening before your surgery to tell you what the estimated charges will be and how much you will most likely owe. Mine did this, and then they offer a discount if you pay that amount up front THEN let the insurance work out and bill/refund the difference. I think mine said my portion would be something like $1200 and they gave me a 20% discount; once all was run through Anthem BC, I actually got a refund of $200. It could just be that after the deductible plus other co-pays, that the percentage left over (of the 90/10) was close to $20,000. I checked into the hospital at 8am and was discharged the next day at 5pm. I had one overnight stay, no complications, no tests run (CT, leak, etc.) Just your basic bed, IV fluids, hooked-up to machines, monitored by nurses, blood drawn periodically, etc. and the total charges billed were something like $112,000 for the hospital. The anesthesiologist is a separate service, and he was $2000. Thankfully I have a $1500 out-of-pocket maximum, so once I hit that number everything went from 90/10 to 100% covered. Had it been a higher number, then upwards of 10% of the "write-off" amount would have been mine to pay, somewhere around $5500. Are there any exclusions to the 90/10? Sometimes labs, diagnostics, durable medical equipment do not qualify or qualify at a different rate (like 50/50).
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So, I'm not going through the thinking phase - oh boy where do I start?! First off - I'm going for surgery 6 weeks sooner than originally planned. I was excited to get it done after the holidays because it meant I wouldn't have the issues or discomfort of sitting at holiday dinner with my big Italian family. I will be on liquid. There goes the antipasta, lasagna, and ham. AND! My birthday is 4 weeks after surgery! The lifestyle of drinks with my friends, Red Lobster as a birthday dinner, and some awesome flavored cake is done-zo. But this is stupid little things that I know I'll get over and beyond all doubt get through. I have faith I can make it through the insanity. I am worried about my relationship though. He didn't like the idea of the surgery in the beginning.... or even 2 years ago when I was first contemplating it. (Just a little background : my fiance is a chubby chaser, as were all of my exes). I'm afraid that no matter what he says, and though his fears were that I would be the one to leave him, that he will lose attraction once I start losing mass amounts of meat from my bones. With all that I have put aside for him, and the bs I've sucked up and dealt with, and all of the things I've looked past for him - I don't think he'll have that ability to just accept my weight loss. And I fear my ultra confidence and new vanity will give me that slight boost I was looking for to leave. \ I have read a few people say they see people get these surgeries for vanity reasons that they won't admit to. I was actually fine with living how I was and looking how I do. I enjoy my curves. I knew I only attracted guys with BBW fetishes. But I was all good. I was happy. I knew I could and did get guys. But then I had my beautiful little girl. For her, I want Mommy to be healthy, and able to run after her, and pick her up without back pain, and be around for decades to come without some sort of mortal complication. So it's not always vanity - but I know I will look damn amazing, even if not attracting the same guys. Which I'm fine with. As long as I can spend eternity with my pride and joy.
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I know I should of put them all in one. I cannot do patches Bc I'm allergic to adhesive. When I finally get a nurse out I will probably get IV vitamins Sent from my iPhone using the BariatricPal App
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I have BC Ca - and i was required to go to a center of excellence - it was in the wording for bariatic surgery to be covered.. You gotta ck w/your carrier to see what they require - I didn't have to do any supervised diet - I just gave my surgeon had my history of diets.. I can tell you from what I have read on these boards - Every carrier is different just like every surgeon is diff - ck w/your carrier and see what they require.. Good Luck
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Unflavored Protein Powder
DeletedAccount replied to megamedic691's topic in Protein, Vitamins, and Supplements
I'm still on my pre-op diet, but I'm using Opportuniteas grass-fed whey protein isolate. I found it on Amazon. I haven't noticed that it has any flavor at all, so I can mix it into broth. -
Anyone Have This Issue, Im Totally Confused But My Benefits Hotline Said Bc My Companys Main Headquaters Is Out Of Nebraska Thats Where My Insurance Is Designated For... But They Dont Discriminate For Where U Live, Im Confused!
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Had Surg Monday 2-6, I Can Drink Just Fine! Kinda Scary!
mommy794 replied to mommy794's topic in POST-Operation Weight Loss Surgery Q&A
Cool bc I do like to drink water and tea all day at work! I don't go back til the 3rd but I'm glad I don't have to worry about getting dehydrated. I just don't want to spring a leak from drinking too much -
For me, even though BC/BS manages our plan, my DH union (NEIB) says what we need. Fortunately, I don't have to do the 6 months of supervised dieting... :wink_smile: Tonya
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Hi, I am new to this . I started the process on Aug. 12, 2008 I am also with bc/bs of ga. What problems did u have with the insurance co. The doctor office has not sent my approval request in yet. my bmi is 40.7 now. with sleep apnea and joint pains in the leg, any info u have i would appreciate. thxs
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I'm having the same problem! Everything was submitted on 5/5 and is still pending in Nurse Review. I was told by the insurance company that it takes 15 business days!!!! I have Anthem BC/BS PPO.
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Any Dr Recommendations For Ca?
CaliKat replied to DreamsOfSkinny's topic in PRE-Operation Weight Loss Surgery Q&A
Dr. Cirangle wasn't the cheapest, but he is one of the best. He is widely known by his peers in the medical field to be one of the most expierenced and highly skilled VSG surgeons in the world. People from all over the world fly to SF to see him. I was a self-pay and there were tons of cheaper options but Dr. Cirangle had the best stats, the best aftercare and a no-BS program that I totally respected. I would reccomend Cirangle in a heartbeat to anyone still looking to find their VSG surgeon. -
Question about weight history... ups & downs?
Band_Groupie replied to adagray's topic in Insurance & Financing
After navigating some of my insurance maze (still pre-band) I can reinforce what you said about checking with your insurance directly. It's a simple phone call and you can probably get a print out online or they'll send it to you. I found that even when others had the same insurance co. as mine they widely varied from state to state and in my case even from areas of the same state. I have BC/BS, but specifically Highmark PPO Blue for Western PA, others with BCBS had very different requirements (I don't have to provide any history and others have to provide 3-5 years). If you don't want to call, I'd suggest you repost with the insurance co. name and specific state/area and hope that someone with the same policy would answer your questions (there's also the state by state forum you could try). You're yo-yoing sounds just like me...good luck!:thumbup: -
Oh, Denise, that would be a blast! I plan on being in much better shape by next fall so we can try some harder ones! We drove Trail Ridge Rd. 2 days before it closed for winter. We did Bear Lake (by shuttle drop off)-Nymph Lake, Dream Lake, (Emerald Lake path was closed), Lake Haiyaha (hiked thru icy trails and over large boulders). Then Alberta Falls, Mills Lake, Cascade Falls, Copeland Falls, Calypso Cascades, and Ouzel Falls (hiked thru hrs. of gentle rain, then huge snow flakes - beautiful!). Can you tell I love Water falls? This is from a person who lives at sea level, climbing to highest pt. of 10,500! Huffing and puffing, but very, very happy! And the elk! Amazing! Huge! Beautiful! I fed one grass out of my hand in the downtown park. She had the softest, gentlest muzzle - just like a horse. The park ranger said they think Estes Park Golf Course is their salad bar. Sure, enough, there were at least 50 of them munching out. But I didn't bother the wild ones in RMNP. Your surgery is next Wednesday! Less than a week away, girl! You'll be hiking down those trails in no time to find natural things to decorate your house for this Christmas.
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Hi- new and with some questions
Makulafamy replied to gottadance's topic in Tell Your Weight Loss Surgery Story
Hey gottadance, I just wanted to add that you will quickly learn on here that everyone is different and so are their doctors rules. Tina reminded me of this with her suggestions. Lots of docs, (even those doctors that are banded themselves) allow soda. It goes right down while it it doesnt have any nutiritional benefit, the myth that it will stretch out your band due to carbonation is just a myth :tongue2: I try to stay away from it though bc it makes me want to snack. There is a great bloggin community out there that revolves around the lapband, and Jenny has a great post about drinking soda. here is a link Life's Little Journey: Reasons Why I Love Dr. Fielding Also, many bandsters drink. I dont bc it has so many empty calories, but...ask your doc (when and if you get one). I dont know why you would get drunk faster. One of the best things about lapband is that we still absorb everything like normal. People with gastric bypass do not, and thus get drunk really fast...the drinks dont have a chance to absorb... :w00t:) -
After surgery pain levels
Yo-yo girl replied to Comissc's topic in PRE-Operation Weight Loss Surgery Q&A
Honestly it varies a lot but I can tell you that going by how much some postops struggle I thought the pain was going to be much worse. Like Syntax said, the worse is waking up from anesthesia Bc you’ll be nauseous disoriented and in pain. My pain was more discomfort than pain. I felt lots of tightness under my breast bone and my pouch felt tight too. Came to find out it was just the muscle where they put in the liver instrument. As far as gas you may or may not be too bothered by it. In my case I truly believe my doctor didn’t blow me up with it or used very little because I’ve had no gas at all and my tummy feels like any other given day. In my experience everything went so well though so take everything I’m saying with a grain of salt. I know this isn’t the usual and people do suffer from lots of pain, nausea and incision soreness which hasn’t been my case. In another thread someone asked how this surgery compares to a C section and all the ladies said a C section is much worse, much painful and longer to recuperate from and women have them all the time lol so that should give you and idea. I think you’ll do fine and the pain won’t be anything you couldn’t tolerate, you’ll also be given pain meds but by day 3-4 you won’t even need it. Yo-Yo Girl from New York City -
hi itsme I also have Horizon BC/BS of NJ and I went to my first info seminar the beginning of the year and thats when I found out that most insurances require the 6 month doctor supervised dieting. I was upset that I had to wait 6 more months but I took this time to find a new doctor - my old one never weighed me in the 15 years that I had been seeing him - and get the ball rolling on the surgery. I can say the 6 months did go pretty fast and before I knew it it was over. During the 6 months I did go to my doctor once a month and we tried a few different things and of course nothing worked!!! I also went to another seminar just to get a feel for a few different surgeons - I am putting my life in this persons hands so I want to make sure that I am making the right decision on the surgeon I pick. My PCP also set me up with the phych consult and some other testing that alot of the insurances require. Yeah I was bummed that I had to wait the 6 months but for me I feel like it gave me more time to make the best decision and to get some stuff that is required out of the way. I have my consult with the surgeon I selected on Oct 17th and I am hoping that I have everything required at that time so that I dont have to wait any longer. good luck on your journey and definitely get the 6 months started even though your insurance is changing many insurances require the 6 months so it cant hurt to start now!!
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BCBS Lower BMI approval?
jane13 replied to tiffie00's topic in PRE-Operation Weight Loss Surgery Q&A
@@tiffie00 - I am a BCBS Fed employee spouse. I had a BMI that was a bit higher, but other health issues such as high blood pressure and they added pre-diabetic. I also could show trips to the doctor and being placed on meds to help also lose weight, Weight watchers, etc. I also was told I was a bit shorter, just under 5'8" and they could use that to bump up my BMI... IMHO think your medical history will probably be enough to get you approved : PCOS & Type II -
BCBS FEP: Psychological evaluation prior to approval?
elchewtoy replied to Linda Hamsing Rosen's topic in Insurance & Financing
Blue Cross Blue Shield/ FEP….. I am so confused! I was told that the surgery is covered; but BC/BS FEP will not approve the paper work till after the surgery is done?????? Can some one shed light on this? E -
okay, NOW I'm panicking...
Diamondeyed replied to Bree's topic in Mexico & Self-Pay Weight Loss Surgery
Went with BC and dl... Border Patrol ask me why was I there...said I had surgery, he said have a nice day! -
well I am having it done - that is if the insurance will pay. I would have needed it even if I had never gotten fat or lost the weight. I was HUGE when I was pregnant, to the point that I had to wear a girdle to hold my belly up bc it hurt so bad. Have you ever seen those women on tv who had sextuplets? I wasn't quite that big but darn near to it. I agree with the other girls, it really all depends on the person, some people just never get that overhang of skin. I'm talking about tummy tuck only, as far as my arms and legs, and butt, they bounced back to normal and I'm happy with them. Just the overlap of skin on my tummy, which btw isn't just about cosmetic, it actually hurts to roll over, the skin stretches and pulls, feels like it might rip, and I get horrible rashes.
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I am going to give a really honest and respectful response. I don't think it's a lack of motivation. You clearly have a disorder if you were prescribed medication for it before. Disorders don't just go away bc they remove half your stomach. I am a mental health counselor and have a master's degree. So I'm not just spewing uneducated opinions. You need counseling to restructure the relationship you have with food. You can take all the medication you want, you can get the surgery 100 times if you don't work on the cognitive part of the process you'll continue to backslide. I really hope you understand this and go speak with a counselor not just the psychiatrist. Please let me know how you're doing. Good luck to you. Sent from my LGLS770 using the BariatricPal App
