Search the Community

Well in a round about way...I have BCBS Fed and my requirements where to have a BMI of 40 documented for 2 years. I didn't have a BMI of 40 in fact my BMI's that were documented were 32-35 ish I did however have Exactly 40 at my first weigh in with my surgeon after gaining 5 lbs to qualify. The insurance companies are weird little creatures. I worried myself sick that that would be just the ticket they needed to deny me but I was approved 1st time around so it's really hard to say. I also had no comorbidities. Try not to stress too much.@@Toodie1974

ok I get it everyone is doing great no complications its like getting a tooth pulled really? I hardly think getting a tooth pulled compares to invasive surgery. If we compare things it needs to be apples to apples and not oranges to apples. I just wonder why everyone needs to over compensate regarding how great and easy this surgery is. Its only making me more apprehensive as I would really like to get this surgery but not at all costs. I have gerd now and its horrible. I would just like some real honesty from posters not bs. If its hard I want to know why? The poster who said her doctor said you will not die from this surgery and you think he is so great who is your doctor so I can go to him I realize Sue is exagerrating and really negative but I dont want the comlete opposite either just the truth please.

I feel your pain. I had hoped that I'd be one of those that could stop taking all my diabetes meds the day after surgery and never look back...haha...no such luck. All I can tell you is to keep doing what you're doing and as you lose weight, I'm betting your BS will improve. I stopped taking my meds (2000mg of metformin and 2 doses of glimiperide per day) 2 days after surgery, and my BS stayed pretty low for about 10 days, but then it starting going up again. Now, I am 3 weeks post-op and am taking 500mg of metformin a day and that is keeping me in the 85 to 125 range. I am also trying to eat low carbs, and am not having anything sugary. What does your doctor say about it? Hang in there - I'm sure it will improve as you continue to lose. Good luck!

You don't need to weigh everyday, you will be discouraged, I weigh every two weeks. Also just bc you had this surgery doesn't mean your going to lose 10 pounds in a week every week. You didn't gain all your weight over night, your not going to lose it over night. Sw 256 Cw 185 Surgery 3/17/17

Well I am at 5 months now and since I was 3 months I’ve honestly eaten basically every type of meat. I limit the red meat and don’t tolerate greasy food well so I limit it a lot, but I have tried about everything without issue. I prefer shrimp and other seafoods or chicken because they are less likely to make me feel bad. I haven’t eaten ground turkey yet and don’t really plan to start. It is super unappealing to me. I like regular turkey but ground turkey and chicken are not something I am interested in trying. I also love beans for variety. I think adapting to focusing all my meals on protein has been a big change for me personally. Has taken some adapting but the results have been awesome so I’m all in. I also gave up yogurt after week 4 bc I was able to hit protein goal without it.

Hello Everyone, I am a fairly new member to this site. Like many others I have been heavy all my life. I have tried many diets such as Atkins, Weight Watchers, Slim Fast and those weight lose pills. On a couple of occasions I have been able to lose as much as 30 pounds. However, over time I have gained all the weight back. Today I had my consultation with Dr. Abkin in Florham Park NJ. I must say that I instantly likes the surgeon, he was very through at explaining the procedure an answered all of my questions. His office is also absolutely beautiful, clean and can accommodate larger people. His staff were also very friendly and professional. Dr. Abkin is also one of the well known doctors in NJ for bariatric surgery. He has many accolades as well and was one of the first doctors to do lapband surgery in NJ. After my consultation was over, I was so excited. I came home and scheduled my Psych Eval, Nutritional Assessment, Labwork, and will be going to my doctor this Saturday for my medical clearance and necessity letters. I have Horizon BC & BS (NJ Direct). I was also able to schedule a Tentative surgery date for Sept. 24th. I had to schedule it far out because I wanted it to be during a time when I didn't have classes. I also wanted to wait until after the summer because I am scheduled to take a vacation. I am 5'5 and my Pre Op weight is 284. I am hoping to get down to an ideal weight for my height which is between 145-155.

@Diva302The reason I asked is bc I've never known a full DSER to have success with the patches. Keep a very watchful eye on your bloods as time goes on.

I have been talking to the insurance co everyday to just get things clear for myself and I think, but don't quote me on this that is just has to be 6 mo. The lady at BC told me I could go to my own dr once a mo and have them document the nutrition, exercise etc and that would suffice. HTH, Beth

Hello Miss.Susan: I have BC/BS Calpers Netvalue, which required that I either see a nurtitionist or my primary care doctor for the required 6-month supervised diet. I saw a combintaion of both. If I could not make it to the nutritionist I went to my PC. So starting January 2008 I started seeing the nutrionist once a month on a Saturday, which was very convenient for me. She documented my weight loss and/or gains. We atlked about exercise, protien and always discuss the banding/surgery. We talked about nutrition and Vitamins, and so much more. Anyway, my six-months required attendance was completed back in July, however I continue to meet with her monthly because I value the information she provides me and she keeps it real!. :smile: I will conitnue to meet with her after the surgery as well.

I'm a Newbie (2nd post) and I need some help (sorry in advance for the length, but I'm hoping someone can throw me a lifeline). I'm 49 and have been successfully dieting for 30+ years...so why am I fat (I'm the Yo-Yo Queen!). My health started deteriorating at age 45, it became harder to lose, and I started giving up hope, which isn't like me. My family history (4 siblings and I'm the "skinny one"), is a nightmare of obesity related issues- Diabetes, Stroke, Heart Attacks, Hypertension, sleep Apnea...etc. I can feel myself "circling the drain". But I don't have a diagnosis of any of, what I'm learning are the "Big 4" comorbidities---Did sleep study-neg., borderline cholesterol, didn't do the fasting diabetes test but reg. blood test came out borderline he did another simple blood test that looks at some number that show if you've had sugar issues over the past month and it was OK, my blood pressure has been high (140 something over 90-96) the last few Dr. visits but not sure what it takes for an official hypertension diagnosis (although I'm wondering if I don't qualify as hypertensive). I've got many minor comorbidities. I've developed adult onset asthma a few years ago, exertional dyspnea- shortness of breath, osteoarthritis, had a hysterectomy and bladder sling surgery both for incontinence which has since failed so I'm currently starting testing for another possible surgery. I decided to "just look" at Lap Band a few months ago. After weeks of research and lurking here I saw that it was the perfect answer for me. I brought it up with my PCP who didn't discourage me, but said I wasn't the typical "Metobolic Nightmare", and he gave me some Dr. names. I had recently lost weight on the Alli pills/diet so I was just under a 35 BMI then and I asked for a diet plan which they gave me. I got the insurance info. from Highmark PPO Blue (need 35-40 BMI with comorbidity and 6 mo. diet). And no, self-pay is not an option for us with 2 kids in college. I then signed up for 3 hospital's intro. seminars in Pittsburgh to find out as much as I can and to select a possible Dr...especially since it's a longer term commitment. I've since found that it looks like most people only go to one...not sure why since each seminar gave me new information/very different approaches. I went back to my PCP to further discuss this and was 1 pound below 35 BMI. I stopped the diet and have now attended 2 of the seminars (I was at a 36/37 BMI then). The first at St. Margaret's (Dr. Means) never even called me after. The second at Magee (Dr. Eid), called and said they thought I wouldn't get approved, but I could pursue it if I want. I asked if I should call them back if I get the diagnosis of hypertension (since I'm thinking I'm qualified by my numbers and I haven't asked my PCP if I am officially hypertensive yet), but Magee didn't give me the warm fuzzies that even this would do it (Does it take more than one comorbidity? Insur. doesn't say so). I suddenly went from so hopeful to very discouraged. I go back to my PCP for a weigh in on Monday. I was planning to "restart the diet" then as my BMI is closer to 37 now and in the seminars they said they need to see some weight loss, but not below the min. BMI. I'm trying to pull together some info. on what my PCP needs to document at these visits (thought I'd give them a form to fill in each time, but I can't find one). Do I need to journal anything? I also planned to discuss my blood pressure numbers and what the cut off is for hypertension. Do I need to be on blood pressure medication for it to be considered a comorbidity? What else can I do with the PCP that would help my approval? I'm scheduled to go to Allegheny General's seminar next Thurs., 13th. Is there something else I need to provide at the seminar that would help with approval? My husband just announced that his insurance will be probably be changing in June as the status of the joint-venture he works for changes...let's see 6 mo. would be done mid May...AHHH! I know I would be the poster child for Lap Band after everything I've read...I can follow any diet, I used to teach exercise classes, I can hardly move without pain now...why is this so difficult? :frown: I need some input...should I just give up now or what else can I do? :thumbs_up: Thanks for reading....

Goals shouldn’t be based on pounds lost bc our bodies are unpredictable. Goals should be activity-based. Also, your doctor sounds abusive and I think you know that. No one is going to make you see him and he cannot reverse your operation as punishment. Find a new doctor but in the meantime, drop this guy.

Here are some of my comments. Nothing here shows anything about your individual insurance company. I explained how SOME insurance co's work and repeatedly suggested you read your own policy and verify for yourself. >>Then perhaps a six month medically supervised diet. Some have to try to lose weight, others MUST lose a certain amount of weight such as 5% of your excess weight.<< >>Not every insurance company covers banding, some will only pay for bypass (for example). Some will only pay for banding up to a certain BMI and then if you are larger than their stated BMI they won't pay for anything other than bypass.<< >>If your policy requires a six month medically supervised diet ...<< >>Some insurance co's are amazingly stupid and anything over a BMI of 50 they will only pay for bypass ...<< >>... but that's what they do often times ...<< Nope, nothing in there about blaming BC/BS of CA for anything. Just how SOME ins co's do things.

First, I know nothing about the sleeve....but let me say this... I have been 100% successful with the band, and in my case, it was the easiest, most effortless thing I could have done. What was difficult was the first 4-6 months, getting the band adjusted just right, and learning to modify my eating habits to match the bands demands. A lot of people never do get to that "Magic" place....the band is adjustable, and individuals can choose how they want it adjusted. They can choose how and what they want to eat, buy how much Fluid is in the band.....There are so many variables to get it perfect, and because of that, it has been said the success rate is low. Least that's what I've heard. My Dr. once told me I was one in a thousand as a band patient....just too many variables and peoples personalities, likes and dislikes, that he now will recommend the sleeve or RNY before the band. The PA told me she is fed up with people coming in to have fluid taken out of their bands so they can enjoy weddings, vacations, etc, etc. You can't do that with the sleeve, and my Dr. understands that. With the sleeve or RNY, It is what it is....you have to live with it..there is no adjusting. So, after saying all that, IF I knew I would be as successful with such ease with the sleeve as I had with the band, I would have gone with the sleeve. But again, I don't know, have no experience, as to how the sleeve actually performs with people, and how much work, or not, one needs to put into their success. Would I have been as successful with the sleeve? I really cannot say. But the band has been nothing short of miraculous for me.

You look SOOOO GOOD!! I feel the same way about my legs. Almost wish in hind sight I did the circumferential TT bc it would have lifted my butt and thighs at the same time. I don’t want the inner thigh scar. It’s tough but for now I’m doing nothing. Just going to enjoy my big perky boobs and nice tight flat tummy!! Keep us updated on WhT you decide. I’ll never say never! Who knows I may end up in the future doing it too!! As Greentealael said “once your down the PS rabbit hole” lol

I don’t do thrift shops bc I’m afraid of bedbugs so everything I purchased was new. I buy one pair of jeans for each size down and I wear workout leggings a lot bc I’m at the gym everyday. The leggings last a lot longer than the jeans. My gym tops can last several sizes and don’t look too bad oversized. I have 4 dressy tops and I just rotate them out. That’s it! I also bought them all on sale none of them cost more than $15. I’m a stay at home mom though so I don’t have the challenge of buying work clothes.

How many liquids are you guys drinking on day 2? I decided to stay in the hospital today bc I'm struggling big time Sent from my iPhone using the BariatricPal App

I start my 2 week liquid diet on Tuesday the 9th. My surgery is the 23rd. I'm glad I found this forum to help me with what's to come after I start the liquid diet. I am going to be on strictly liquids with Sf jello and Sf Popsicles. I have no doubt this is going to be the hardest thing I've ever done in my life yet. It makes me really nervous. But I know how important it is for surgery and to prepare. I'm concerned bc right now I am taking a lot of med and get really nauseous if I don't eat with them. Also hypoglycemic, so I'm sure I will feel a few waves of nausea, but just have to keep up with the protein drinks and take it a day at a time!!

Speaking as someone with a ph.d., you know what the difference was between those of us who graduated, and those who quit? Those of us who graduated didn't quit. Really. That was it. Persistence. We put up with whatever BS, jumped through whatever hoops, dealt with inevitable delays and were like stubborn MULES that were NOT going to quit until we had it. The ones that quit lost patience. I don't think I was always intelligence, ability, or anything intellectual. Persistence. Same thing that made you keep at it until you hit weight/fitness goals. How many guys like you quit on the weight a long time ago? But not you, right? My first 3 years were no problem. Due to health, pregnancy, unsupportive spouse issues my last year took me four years. Persistence. Good luck. You will do great.

Hi everyone I am scheduled to be banded on July 8th (NYU). Im a virgo so of course i am waiting for the other shoe to drop:tongue: . I havent heard anything from my insurance (HIP) but my BMI is 44 and i have High BP and diabetis. I didnt do a six month diet plan with a doctor bc i was told i didnt have too. Im just wondering if HIP makes you jump through hoops like the others thanks guys Justice :thumbup:

RE: BC CA appeals.... I'm pretty sure there is an 800 # on the back of my BC of CA card for appeals, or you could call the 800 # for pre service reviews. Otherwise go to their web site. There is also information on the home forum page here regarding appeals processes in different states.....the 2nd or 3rd topic?? On the bright side, I've heard several stories of people getting denied, then getting quickly approved on appeal. I hope NOT to have to be in that boat. I still have to wait and see if I'm approved. good luck

About a week... My doc Office took care of all this - I went directy to surgeon - 5/31 had tons of test due to age and never going to the doc - no supervised diet - was approved on 6/20 after shrink appoint on 6/14 - surgery 7/17 When I called them (bc ca) they said it was covered under my policies if medically necessary - bmi 42 - high blood pressure and slight sleep apnea.. I qualified

Whatever you are looking for you will see… AND... When you change the way you look at things the things you look at change! Tips for Improving Your Body Image: Accept your genetic body type: Remember that your weight, height, and bone structure are strongly determined by your genes.. Healthy bodies come in all shapes and sizes. Stop comparing yourself to others. How others look has nothing to do with you. Be media conscious. We are bombarded with media messages telling us our bodies are not perfect… Most fashion and women’s magazines focus on an ideal of beauty that is just not something that anyone in real life can be. Remind yourself that the body images you see are manufactured by make up artists, hair dressers, airbrushing specialists, fashion designers, lighting specialists, and cosmetic surgeons. Also know that many fashion models have eating disorders and are not able to maintain their low body weight in a healthy manner. Create a Why I Like Myself List. Think about all the things about you that you like… are you Funny? Creative? Honest? Intelligent? Think of all the reasons you deserve to love yourself and write them down. Remind yourself of all the things you are besides a body. Read this list daily and add to it every time you think of something else you like about you. Create a Body Appreciation List. Think about how your body has continued to show up for you no matter how much you fed or starved it, exercised it or not. Write these things down. Remember that your heart has continued to beat, your lungs continue to breathe, and your liver continues to detoxify your body. As well, maybe your body has learned a new skill, gotten stronger, taken you to the top of a hill, rejuvenated during sleep, or allowed you to comfort a child, share love with a spouse, or go shopping with friends!. Celebrate your body and the marvelous things it can do. If you’ve had Weight Loss Surgery note all the things that your body can do now that it could not do before. How has your life changed because of the changes your body has gone through? Read this list daily and add to it every time you are grateful for something your body has done. Stop thinking that thinner thighs are the answer to all of life’s problems. When you find yourself hyper focused on your body stop for a moment and ask yourself what you would be doing, thinking, or feeling if you were not obsessing about your body. What is this preoccupation stopping you from being present to in your life? Are you in anyway benefiting from focusing on what you believe to be your physical flaws? Commit to feeling the feelings that arise as you ask yourself those questions and really listen to the answers you hear/feel. “Act as if you” were comfortable in your body even If you are not quite “feeling it” yet. How would you walk, what would you wear, how would you speak to people, what kind of self talk would you be speaking, what kind of eye contact would you make with others? Use these questions as a guide for “acting as if”. Notice how it feels to carry your body with an air of love and respect. Speak (and think) only kind and loving words and thoughts to and about your body!! If you find yourself being critical of your body, stop and acknowledge that this will not support you feeling good about yourself. Then, respond to yourself as you would to a best friend. For every negative thing you catch yourself saying about your body, apologize to your body and say 2 loving/ appreciative things about your body. Make a decision to truly “nourish” yourself. Read a good book, take a bubble bath, schedule a massage, get a haircut, dance to your favorite song, make plans with a friend, take a nap, ask for a hug, give yourself permission to say “no”, meditate, pray. Make it your intention to move and enjoy your body: go walking, swimming, biking, dancing, do yoga, tai chi, etc… not because you have to but because it makes you feel so good. Your body deserves to be treated well. Surround yourself with people who celebrate and appreciate you. Say “thank you” to compliments without discounting them. Know that you can control your experience of your life by the thoughts you choose to think. How you experience your life is a direct consequence of your predominant thoughts and feelings. By making a decision about the thoughts you choose to think (which are the precursors to your feelings) you take responsibility for creating your reality. So if you decide to think about what is not good about your body you will attract to you experiences of your body not being good enough, and more than likely will live in a state of “waiting till things get better (i.e. my thighs get thinner)” before you can really be happy. If you choose to think about what is good about you, what you like and appreciate about you, you will feel gratitude and be more likely experience your life as abundant and joy-filled! The next time you find yourself being critical of a particular body part, sit down and write a letter to that body part telling it exactly what you don’t like about it and how it makes you feel. Then have that body part write back to you telling you how it felt to read that letter. Then write back to that body part…….. and just notice what happens………. If you have any thoughts or comments about this blog I would love to hear from you. You can respond below to this blog or email me at louisa@louisalatela.com.

I was unable to locate specific guidelines for the BC Complete Medicaid program dealing with bariatric surgery. I don't believe they have a separate criteria but I may be wrong on that; however here are their guidelines for other plans. I've included a LINK and the PDF. Good luck! Michigan BCBS Bariatric Medical Policy I've also attached the PDF file in case the link doesn't work. BCBS Michigan Guidelines.pdf

Hi all, My sleeve surgery is scheduled for May 8th. When I met with the surgeon last week to schedule the surgery, the first thing he asked me when he walked in the room was "so why the sleeve?" I answered him and he proceeded to tel me that he thinks bypass would be better for me because on the sleeve, I will most definitely get heartburn for the remainder of my life, also that bc i have a family history of diabetes, that with the sleeve I am more likely in 10 to 15 years to still develop diabetes, and lastly that with my height and weight and getting the sleeve, I will only ly lose about 5 lbs but with the bypass, i will lose around 60 to 80. I have foe a lot of research and found that the sleeve is the best option for me and I stuck to my guns, even as he stared me down waiting for me to change my mind. But now I second guessing my sleeve decision and thinking the bypass would be better for me. Anyone have any experience with this dilemma? Thanks in advance

Ive told mum and two sisters and I only told my sisters in case something goes wrong and they can help my mum and deal with kids. Im single parent, told ex manager and thats it. I am terrible, its not that I cant lie, its I have to tell the truth lol so I will say had medical problems so couldnt eat, hernia op which meant I still couldn't eat and then was so fed up with food lost my appetite. Its not quite the truth but its not quite a lie.