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Overwhelmed with insurance requirements



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I have a couple questions......I've been approved by PCP, Lupus Reumatologist and surgeon, had a full physical, EGD( stomach scope) I was told I have hiatal hernia and I'm curious if anyone here had one repaired while getting a band? Also, I was told my insurance covered lap band surger..plus the surgeon would only perform lap band because of my auto immune disease. Insurance company didn't mention that I have to enroll in a health care program $500 and weekly visits with nutrisionist and pysc until doc office called for approval. I'm also required to hire a personal trainer for three times a week for several weeks and then two times for the remainder of 6 months. I'm having a hard time motivating myself esp since I have bad joint issues and know working out will cause me a lot of pain..not to mention the money it will cost! I haven't read on here where anyone else has had to go thru this. I have Washington teamster/First Choice. I'm hoping after having surgery that the weight loss will help my joints like I've read it has for others. Any suggestions where I should go for a trainer that wouldn't break the bank?

Thanks, Barb

Thanks, Barb

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I have not read about anyone else having to have personal trainer and all that. Sounds a bit extreme and sounds expensive! Good luck

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How about a local YMCA? It does sound extreme to me and perhaps you could get your insurance to provide physical therapy through a hospital setting instead. They would be more in the know about how to save your joints and the work- out would be more gentle. Just a thought.

I had a hernia repaired during my second lapband surgery and it was no biggie. I didn't have much pain with it at all. I had had pretty bad reflux prior to that though. I'm better now. I have arthritis too (ankelosing spondelitis) and I can tell you I feel much better with the weight off!

Good luck on your journey!

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The YMCA is a great idea. My local Y has personal trainers and I'm sure they are less expensive than a private one. I also had a hernia repiared while getting my band. I've only noticed a couple of times that I had pain from it except when I've pushed it and lifted too much. The most annoying thing with the hernia repair is the 5-10 lb. weight limit. Good luck with all of your requirements :)

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I would call the insurance myself to see exactly what they need. I have NEVER heard of such a requirement and I have been reading this board for a year. I second the Y they tend to have really good prices. I would also ask your insurnace if they are insisting that you get a trainer if they will pay for part of the gym membership. Many insurnace companies will pay as long as you can show you'be been going to the gym. Before my first meeting with Band doctor's office I got a print out from my gym showing every visit for the last year. The doctors' office submitted it to my insurance with the rest of my tests.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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