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6 months w/ nutritionist



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Has anybody on this form got approved with OXFORD Liberity insurrance QUICKLEY? My main question is, if anyone knows if OXFORD requires you to see a nutritionist for 6 months before considering/approving you for surgury? SOME insurances Companies require this......does anyone know if OXFORD is one of them that require this? Thank-you!

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centerfolds I'm sorry I don't have any info. But I do wish you the best of luck. Insurance is so frustrating sometimes. Have you called the insurance company? Some ins co's have websites that your PCP can look up the requirements for treatments. M

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Thank-you...well I called the company & they said I need the dr. to call.I just got all my reports like medicial,physc,ekg, chest xrays & blood work.All reports in FAVOR of surgury.The thing is....Ive heard some insurrances approve within a week....others make you do 6 months with a nutrisinist...others simply deny you.Im going for the Rny gastric bypass.....BUT if its a 6 months wait OR if I simply get denied.....Ill be in MEXICO within 2 weeks TOPS getting banded!With the prices in Mexico,I can afford self pay for the band! I just want to find out either way so I can get the ball rolling! Thank-you for your reply!

Eddie

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Eddie I'm a little confused. Are you trying for the lapband through your ins or for RNY? Look at the thread SCREAMING in FRUSTRATION. You will see my travails with the ins co. But if you don't have an exclusion it is worth the effort to pursue insurance coverage.

By the way what is your BMI and do you have any comorbidities?

Myra

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OK.....Im trying to get approved for RnY gastric bypass in the usa by my insurrance co. which is OXFORD.IF they tell me to do 6 months with a nutritionist ...I cant wait another 6 months & be this heavey...OR if I get flat out DENIED ..........I will do self-pay & settel for the lap-band & get it done in MEXICO which would be my only affordable option....Im 37-5'9''...my BMI is 43.6. So far I got my medicial report by my primary dr.which is favorable for surgury.he states I have severe acid reflux disease which I take Nexium for daily.That I suffer from joint pain,mainley in myknees & shins from the weight.And he put all my failed diets & personal trainers & nutrinest & says Ive seen a psyc & had no weight loss & I have been obese all my life. I had an EKG & chest xray.

I have a psyc report that says I would benifit from surgury.Basicially all reports are favorable.I JUST got everything TODAY.I gave them to the DR. & hes gonna submit them to the insurrance & see if I get approved or what. If I get denied....Mexico self pay....If they say 6 months witha nutritionist....Mexico self pay. Im thinking of Dr.Huacuz.. Best price & heard a lot of good & really dont buy the bad...What do you think of all this? Thank-you! Eddie

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Hi Eddie. I am curious why you would chose RNY over lapband. Are both covered through you benefit plan? I know some people choose the RNY over Lapband because they don't want to deal with getting fills etc etc. I have a brother, first cousin, and sister in law that had the RNY. But I personally didn't like to have my insides rerouted. Ya know what I mean.

What type of research have you done about the different type of surgeries. I don't mean to sound pushy I am just really wondering. You have to make the final decision on whats right for you and I wish you good luck whichever way it works out.

Myra

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Well,I heard the Rny is the gold standred of weight loss surgury & was told I would lose MORE weight & quicker with the Rny than the band.I myself am not to keen about having my insides rerouted BUt Im a sweet eater & ice cream eater & was told that the bypass might be the better opperation for me.... Whats you oppinion ALSO...what do you think my chances are of getting approved by my insurrance? also...are you going to get banded in Mexico...if yes...by who>

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Alright this is MY personal opinion. If you are a sweet eater you need to research "dumping syndrome". RNY is an malabsorption surgery. In other words you can't process sugars and they give you bad diarrhea if you eat them. Also by bypassing part of the intestines you have life long alterations such as Vitamin and mineral deficiencies that you have to take meds for the rest of your life. I am sure like all things in life there are exceptions but this is the general rule.

Yes you lose weight rapidly but RNY's have a tendency to regain after a few years. Lapbanders lose slower but after twoish years are pretty well equivalent to RNYers.

Now don't get me wrong Lapbanding is not the cure all you can regain with lapbanding if you don't make healthy choices.

Lapband is reversible. Another words they can take it out if you have complications. Mortality rate for RNY is like one death per 200 surgeries.

Now you have to realize which every way you go you have to make a commitment to changing your dietary lifestyle. Lapbanding provides restriction but you are still responsible for make healthy choice in what you eat. You are encouraged to eat Protein first, then veggies and then carbs.

If you look at www.lapband.com you will see INAMED's (the maker of the lapband most folks in the US have) website and it gives explanation about the lapband.

As far as your insurance I don't know. Alexandra the owner of LBT is an insurance whiz and hopefully she will chime in.

I am being banded in Dallas next week but there are others who have gone to Mexico maybe they can tell you more.

Do a lot of researching before you make a final decision. Alot of people are desperate to lose the weight and sometimes don't get all the information that they need about their choices.

Myra

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I was banded in Mexico by Dr. Roberto Rumbaut - he has an excellent reputation and success rates in the WLS arena by physicians, patients and by Inamed - the manufacturer of the Inamed Band. Dr. Rumbaut also does RNY. If you decide on RNY have you considered doing it in Mexico? I'm not a fan of RNY for lots of reasons, including personal experience with a friend who had RNY, but you're right about eating sweets and ice cream - the lap band won't help you with those.

You should do more research about Lap Band AND RNY before going forward. After, I think it's 3 years, lap band patients have lost the same amount of weight as RNY patients without having their insides re-routed. As for my friend (and a large percentage of RNY patients I understand), she's steadily regaining her weight and has some pretty serious health issues related to malabsorption.

Ultimately everyone has to choose their own path - with the guidance of their doctor and a second opinion - good luck on your weight loss journey whichever path you choose.

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Donna & myra.....Thank-you...seriousley.You both bring out some good points.I WOULDNT get the rny in Mexico...feel it too serious of an opperation for there.Id go with the lap-band though.Im sooo undecided.I did do a LOT of research & learned a lot....still dont know for sure what opperation I want though! Ill stick around!!!! Thanks a million!

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Eddie one more thing. If you choose lapband and go to Mexico you need to have aftercare arranged prior to surgery. Meaning you need to find a fill doc in the US or be prepared to travel to Mexico for adjustments.

I will probably think of more later.

Should you chose to have lapband or RNY in the states you could apply for a loan through Capital One Healthcare. They are fairly easy to get financed through.

M

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WILL keep ya posted! let me know how you are doing also.Congradulations...8 days to go!!! bet your excited to start your new life! I cant wait till I can go to the mall & buy off the name brands & the racks!Im a 4X or 5 X...have to go to the big peoples store! No name brands...before I go out at night Ill try 20 things on & look for the outfit & dark colors like black that hide the fat & make me look skinnier....cant wait for all that to be over!!!! Good luck & God blees ya & have a smooth & safe procedure! eddie

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Centerfolds, in my experience Oxford does NOT require the 6-month supervised diet. If they did, they would have told you that. If you are medically qualified for bariatric surgery, Oxford approves quickly.

Good luck with whatever you decide!! (Oh, and just for the record, I'm not the owner of LBT, just a moderator.)

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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