Hi everyone.

I'm glad I found this site.

I see my primary doctor on May 11th and I'm worried she won't submit a referral for me. I don't know why I have so much doubt -- I clearly qualify. Wondering how hard it is to get your doctors to agree with sending a referral.

Edit: So after being on here for hours, I may not qualify as much as I thought. I'm 5'0" and weigh 214 pounds. I would say I'm small frame b/c if I squeeze REAL tight the tips of my fingers overlap. Now, I would also have to have high-blood pressure for TriWest to approve me.

Edited May 2, 201016 yr by FattyCakes
Update

I had the same fear that my pcp would not recommend the surgery for me. Took a lot of guts to bring it up with her on my part. She never seemed concerned about my weight and one time, years ago, I inquired about Meridia and she gave me a very condesending talk about "taking in fewer calories than I burn." :biggrin: (Oh really? Is THAT how it works?) I was bracing for a very direct conversation with her about everything and to my surprise, she could not have been more supportive We talked at length about the surgery and she felt it was very safe (as far as surgery goes) and said she has several patients who have done it and acheived excellent results. She had my letter ready that day and it was extremely well-written and supportive. I hope you get pleasantly surprised, too! As for your insurance - I hope that goes your way as well. Sounds like they are a little behind the times with their requirements...

I had the same fear that my pcp would not recommend the surgery for me. Took a lot of guts to bring it up with her on my part. She never seemed concerned about my weight and one time, years ago, I inquired about Meridia and she gave me a very condesending talk about "taking in fewer calories than I burn." :biggrin: (Oh really? Is THAT how it works?) I was bracing for a very direct conversation with her about everything and to my surprise, she could not have been more supportive We talked at length about the surgery and she felt it was very safe (as far as surgery goes) and said she has several patients who have done it and acheived excellent results. She had my letter ready that day and it was extremely well-written and supportive. I hope you get pleasantly surprised, too! As for your insurance - I hope that goes your way as well. Sounds like they are a little behind the times with their requirements...

Oh, that is sooo great to have her support you when you thought she wouldn't. I feel the knot in my stomach every time I think about tomorrow. I asked the NP if the doctor has ever written referrals for the lap-band and she said yes. This is my first time seeing this doctor.

Hi, I'm Karen, 47, from Texas. My insurance gave a cursory approval - I had pre surgery objectives to meet. one of those being 3 months of diet and exercise. I have completed all of those and am now just waiting for insurance approval that I've met all my criteria so I can set a surgery date. It has been 2 weeks since my info has been submitted and this is a very frustrating time just hoping that I can get my band and start my new life.

Hi, I'm Karen, 47, from Texas. My insurance gave a cursory approval - I had pre surgery objectives to meet. one of those being 3 months of diet and exercise. I have completed all of those and am now just waiting for insurance approval that I've met all my criteria so I can set a surgery date. It has been 2 weeks since my info has been submitted and this is a very frustrating time just hoping that I can get my band and start my new life.

That really stinks! You do your part and then they drag their heels when it's their turn!

Oh, that is sooo great to have her support you when you thought she wouldn't. I feel the knot in my stomach every time I think about tomorrow. I asked the NP if the doctor has ever written referrals for the lap-band® and she said yes. This is my first time seeing this doctor.

I think going in there like you're taking charge of an out of control situation (we all know the definition of insanity by now) and letting the doc see how informed you are about the procedure and process will help a lot. Doc's don't want patients who think they are getting a magic band that will automatically cure them. It's only a tool, and it only works if we choose to use it. You'll do great!!!! Let us all know how it goes. In the off-chance it doesn't go well...your surgeon can recommend a pcp who will be more symphathetic :biggrin:

Thanks. I see my PCM tomorrow. She's all into healthy eating and stuff, so I'm worried she'll tell me that's the ONLY way. I know I can do it that way, I just need this small little tool to help me.

Yes, waiting 6 months would stink. I hope the Naval hospital helps you out.

I went to one doctor before the one that referred me. She was like that too. It was weird, I thought that she would have been more towards me getting it done too. She said that she comes from a family that is obese too, and look at her. She said she has to try hard everyday to look the way she does, and all it takes is will power. That is great if that is what you are able to do. I need something to help me too just like you. I hope I can get as much information as I can from this orientation on thursday.

I have a question for all of you out there, what made you go for the lap band, and not the gastric bypass? My mom did the gastric bypass three years ago and she looks amazing, my sister did the band two years ago, but now she is pregnant. What are your views on pregnancy after getting banded?

I have so many questions, I just don't know where to start.

Stayce

I'm in Tricare North. They have received my appeal and will hopefully hear something by the end of the week or beginning next.

I went to one doctor before the one that referred me. She was like that too. It was weird, I thought that she would have been more towards me getting it done too. She said that she comes from a family that is obese too, and look at her. She said she has to try hard everyday to look the way she does, and all it takes is will power. That is great if that is what you are able to do. I need something to help me too just like you. I hope I can get as much information as I can from this orientation on thursday.

I have a question for all of you out there, what made you go for the LAP-BAND®, and not the gastric bypass? My mom did the gastric bypass three years ago and she looks amazing, my sister did the band two years ago, but now she is pregnant. What are your views on pregnancy after getting banded?

I have so many questions, I just don't know where to start.

Stayce

I went to a seminar on the 5th and it was very informative. They went over all three procedures. I've heard a lot of bad things from people who've gotten the bypass and it's not reversible like the band. And if you get pregnant you can keep your band in. The recovery is also faster. Oh, and a lot of people with the bypass have gained the weight back. :scared2:

I'm in Tricare North. They have received my appeal and will hopefully hear something by the end of the week or beginning next.

That is great, I wish you the best of luck!!

I went to a seminar on the 5th and it was very informative. They went over all three procedures. I've heard a lot of bad things from people who've gotten the bypass and it's not reversible like the band. And if you get pregnant you can keep your band in. The recovery is also faster. Oh, and a lot of people with the bypass have gained the weight back. :scared2:

My mom went from almost 400 lbs, to now 150 lbs. She looks amazing. The reason I am going towards the band is because it is a much slower way, I can exercise to get skin to tighten back up. My mom has extra skin because she lost weight so fast.

I want this so much that I would love for it to happen tomorrow, but I know that is not going to happen. I know there are tests that have to be ran and all of that, I just wish it was done and over with and I could start over. Ready for a new life, healthier life, and a happy life!!

My PCM said she would put in the request to Tricare! She gave me a really hard time about it though. It's simple to her you know... just make that change in your lifestyle is basically what she kept saying. It wasn't until the end that she said she would do it, so it was worth the hassle. I'm thankful. :scared2:

That is great!!!! I am so excited for you!! Maybe we will be doing it right around the same time!!! I wish you luck!!!

I'm going in for a physical on December 8th, I'm going to talk to my PC doctor about getting the lap-band, I brought it up a few months ago and

she didn't gave me a positive answer, she put me in the Mediterranean diet, I have try many diets, I do good for about 3 days and that's it, one time i did well for a month but went right back to eating a lot, if i'm sad i eat, if i'm happy i eat, I'm just tired of wasting my time and having so many let downs, wish me luck, I'm 5 1, 196 pounds female, and I have Blue Shield of California, does anybody know if i need to have a referral from my pc or should i talk directly with a doctor that performs the lap-band surgery?

Thanks for the info. I have Tricare also and was turned down once. I appealed and waiting on the results. Everyone please keep me in your prayers that this goes well and I get approved.

Tricare doesn't make sense. But for those of us who have it, we deal with it. And yes, they are in the process of changing their policy but as with any federal program, who knows when it will take effect. I am 100 pounds overweight with no co-morbidities and am currently waiting on my appeal. I was not measured at my surgeon's office since they have never had to deal with this policy before. They took my word that I was 5" 3" (as have every doctor I've seen in the past 25 years). I was just remeasured at a military medical clinic and found to be 5" 1". That puts me well within Tricare's standards for "morbidly obese" (meaning I qualify) but now I have to wait for the appeal. And yes, they frustrate me (as if you couldn't tell). If you have concerns, talk to your PCM, your surgeon and your Tricare specialist. They will help you out.