Newbie with a few questions

[XForeverYoursX 6]

Hi guys, I'm in the beginning stages of looking into the lap band surgery. I've struggled with weight loss for the past 11 years, typical yo yo dieting. nothing has worked for the long haul. I was wondering what are the beginning stages of this surgery? how do you go about finding a reputable surgeon? I just moved to Florida and still don't even have a regular physician.

has anyone had it done with a BMI of 38? I'm getting 2 different numbers, one website says it's 38 the other says 36.3

thank you so much guys!

[kliichow 42]

I have not had the surgery yet. I have had a lengthy battle with my PCP sending the appropriate documentation; she is a wonderful doctor and very supportive of my decision, but the office is a bit disorganized. I should also mention that my BMI is 67, so I am on the higher end of the spectrum, but that has not dampened my enthusiasm.

That said, I was fairly lucky in that I work at the only hospital in my area that performs bariatric surgery. So, my surgeon, Dr. Wilson, offers seminars, education classes and other helpful tools on a regular basis.

When I first started my journey to have the surgery, I quickly learned that my insurance would absolutely not cover it. The hospital offers 2 insurance options and I had unwittingly chosen the wrong one. It was a big disappointment to learn that I would have to wait at least another year before I could even consider having surgery, but it turned out to be a blessing in disguise because that time allowed me to do a great deal of research and make an educated decision.

I will say that you are going to need to find a PCP ASAP, because with most any insurance these days you will have to submit proof of supervised weight loss attempts, lab work, physician's progress notes, and other documentation that you cannot get otherwise.

To find a surgeon in your area, start with your insurance. Go to their website and search their provider look-up for surgeons. Another avenue you can explore is the search function here on BariatricPal. Good Luck.

[2muchfun 8,928]

36 for me. I've seen patients on the forum as low as 30 so it's been done.

[lisacaron 5,075]

I think there are many out there with the BMI of 30 that either have co-morbidity issues and/or have done it self pay. I think the standard these days for most insurance companies is a BMI of 38-40 lowest at 30 with more then one co-morbidity associated with weight.

When it came to my surgery I did not let anyone control the information that was sent to the surgeon's office or the insurance company but me. When I took a test, be it pulmonary or cardiology or what ever it was that needed to be done. I had the results sent to me with CC's to the surgeon. If I did not get a copy of the reports at the visit I hounded them the next day for it. I put together my medical profile and kept copies which I sent over to the surgeon in it's completion so there was never a question of them not having something the day of surgery. Even on the day of surgery I had a copy of all tests and results in a folder just IN CASE they were missing something and needed it.

I wasn't about to sit there waiting for them to look through files at the Dr's office while I was prepped and ready for surgery. I can't tell people often enough to be your own advocate! Trust in your doctors, listen to and follow their instructions but when you have a question or don't understand something speak up or have someone who will speak up for you present. You have a right to all your medical information including tests and clinical notes. Ask for copies and keep a file on yourself as up to date as possible.

Ultimately these guys work for you! When you have your car worked on you keep the receipts from the repair shop right? You keep a log of when you need to change your oil or have your tires rotated and you should at the very least do the same for the vehicle you live your life in. In the end it helps to streamline the process so your not waiting on anyone to fax things to your insurance company or your surgeon. You have it in hand and can present it to them yourself.

Getting down off the soap box now

[PrettyThick1 1,860]

If you're looking for insurance to cover it, you'll need to check the guidelines for your carrier. With your BMI you could be covered if you have at least one co-morbid condition. The rules are a bit more relaxed for self-pay. The band was my solution to end the yo-yoing and to stop several health conditions that were just starting to take hold: diabetes (March 2013), sleep apnea and fluctuating blood pressure. I'm glad to say that I'm over all of these conditions and I'm feeling splendid! Good luck on your decision!

[BandedBrunette481 310]

Like everyone else said, it varies based on your insurance provider, but I had a BMI of 39.2 during my first consult appointment and one comorbidity and I was told my insurance would not cover anything under 39.9 without two comorbidities (after the holidays had rolled around I gained a few pounds and finally qualified). If you want to self pay then your BMI would probably be fine. I'm not as certain about the qualifications needed for that. As far as doctors go, I suggest getting online and doing some research. I started by looking at the big hospitals in my area and then chose one that had good credentials and good surgeons. My hospital was awarded/recognized as a Bariatric Surgery Center of Excellence, so basically they are known for doing good work. I didn't have a specific surgeon in mind, I was just placed with mine. I was ok with that because they all had great reputations and skill sets (yeah, I googled them!) Some people want specific surgeons though. The road to weight loss surgery can be long and daunting, but it's all worth it in the end good luck with everything!

[kayzoog 129]

You can do it with a BMI as low as 30, but you would have to self pay. I think BMI 35-40+ co-morbidity is when insurance would cover it, but there are a lot of hoops to jump through. My insurance will not cover any bariatric surgery no matter what. I was bummed that my insurance doesn't cover it for me, but I decided to go ahead and self-pay. Based on my research and the people in this forum, I think it will be money well spent! Good luck to you as you begin your journey!

:)K

[XForeverYoursX 6]

About how much was it for self pay

[kayzoog 129]

Mine is about $15k.

[XForeverYoursX 6]

Holy crap

[She's_Sleeved 93]

I am just getting started, I am scheduled for a free seminar on March 15th at West Palms of Pasadena in St. Petersburg, Florida. I called the office and they mailed me a very detailed information packet. It is a lot of well laid out information. It even has the self-pay breakdown which is $15,800. But that includes every thing from your initial visit, testing, doctors and hospital fee's to the surgery and 1 year office visits and fills. The patient coordinator is very personable and is willing to answer any questions you have and he is also a lap-band patient so he knows exactly what everyone is going through. Good luck!