I have had a weight problem all my life. Around the age of sixteen I became more weight consious and managed to lose. I was able to maintain close to a normal range but it was ALWAYS a struggle and I was NEVER as slim as I could be. Now I am 47 and weigh the most I ever have. It seems every year I am 8 to 10 lbs heavier than I was the year before. I consider it an accomplishment just to not steadily gain. I have not been banded but I am trying to lay the groundwork for it.I'm considering trying through insurance but I'm at the point that if they tell me I gotta document a diet for 6 mths or some kinda BS like that I'll never be able to wait that long. I'm already contemplating just going to Mexico on self-pay. Either way I'm not quite in the position to do either. The only point to this is just to get it off my chest. I'm sure there are people like me out there and I just want them to know that they are not alone. Thanks for letting me vent.
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Have you talked to your insurance company about pre-op diets? If not, give them a call and ask. I don't know what kind of insurance you have, but my insurance company answered all my questions over the phone.
I was very fortunate that my insurance company did not require a pre-op diet. My surgeon required a two week diet to shrink the liver (Sugar Busters Diet).
I know it's very frustrating for you right now. Hang in there and hopefully your insurance company will not require the 6 month supervised diet.
Whatever you decide to do, I wish you the best of luck.
When I first went to the informational meeting, I too was told I would have to be charted weight loss for so long, prior attempts with a dietition, physc eval, liquid drink for pre & post op & all this HAD to be done through THIER hopspital/drs/pharmacy, etc! Unlike most it was my insurance copmany that didn't demand that much(AND wouldn't pay for all that!), so I became discouraged & put it aside. Then I looked into other Drs/Hospitals....I found one, granted, it is a 2 hr drive from my home, a bit of a drive for exams, but I am going to switch to a local DR once all the preop stuff is done.
So, Vent & look into other alternatives as you get the ball rolling for your first option...you never know what you will find out!
Good Luck in your journay.
Ilene
Banded 12/20/07 Dr. Redd Theif River Falls MN
I so understand about the six month waiting period. When I found out that I had to have six months of documented dr visits, I went off on the nurse because I felt they could have told me that earlier. I do have to say though that I think it was benefecial for me to wait. My mind was in the right place. I was very confident and knowledgeable by the time of my surgery. So, my wish for you is to not get discouraged but to spend this time making certain that is what you want to do and be comfortable with the decision.
hang in there ... you are a "now" person like me and having just gone thru the procedure, I understand the why of all the pre-op stuff. I had been considering the procedure for some time but didn't want to part with the $'s, then I was told I had to pay $'s for a pschy (sp) evaluation and chest xrays, EKG, and the dreaded colonoscopy. I had been putting that one off for years..thinking I'd lose weight 1st to avoid embarrassment. When told I had to, I considered it a "sign". It was nothing. Won't hesitate to get next one. All in all, I've had about every medical test (which is good to get it all done once) and now 1 week post op and enjoying the reduction of those uncomfortable feelings. I lost 36 pre op and haven't checked since surgery but already enjoying smaller clothes and have more energy. Hope it all works out for you! You can do it!
My insurance at the time had a 12 month documented, medically supervised, nutritionist supported weight loss effort clause. Among others. I fulfilled all of the others, had the sleep study, the psych evaluation, the cardiologist approval, and was 10 1/2 months into the 12 months--was seeing my Dr. twice a month---once as a nutrition consult and once as a medical consult. This alone was a battle with the insurance, but I am in a rural area, and there are no nutritionists! So 10 1/2 months into it, ironically on my way home from a Dr.s appointment, I was in a car accident. I was taken to the hospital, because where the car slammed into me, it pinned my knee between the dash and the door. I ended up having surgery on my knee. I missed (although I DID call) my nutrition appt. When I made it back for my medical appointment, his office manager, (also his wife) informed me I would have to begin over again, that insurance requires it to be consecutive, and my missing my appointment nullified it! I was furious!!! I appealled it. Was denied. Appealled it again, and about this time was figuring out the Dr.'s office is the enemy! They were the ones reporting to insurance, they just wanted to continue to get the huge payoffs for another year as well as my bi monthly co pay! I changed Dr.'s the day I realized that. Did me no good with insurance, they insistes they would pay when I had abided by the requirements. However it would be 2 years before they would pay for another sleep study, or psych eval, and 5 for another colonoscopy---without a purposeful referral (?)---so all of that would have to be redone, it has to be within 6 months of surgery---out of my pocket! Another year---I was devastated! Then come a phone call---the insurance of the woman who hit me, wanted to settle! I expected them to pay my bills, I had no idea I would get $$$----but I did! I have been told I settled to quickly, but I saw my band---I took that cash and ran to Mexico!!! Never looked back, never regretted my decision.
It has been over a year and a half, I am closing in on goal---and to think I would have just been getting started! And with the year we had (DH had heart surgery etc) I may not have been able to meet the consecutive clause again! Glad it worked out for me, and hoping it does for you too!!!! Here's to a successful banding in 2008!! Kat
I would suggest you contact the insurance company to see what is required for YOU. Each insurance company and program is different. I attended 3 different sessions within an hour from my home and each one had a different program and my insurance company was willing to go along with their program. The first program was in a teaching hospital and had a 6 month diet program included in the process - I believe that was so they could do studies in the program. When I submitted for pre-approval, I was denied. Two months later, I attended another orientation at another hospital (closer to my home) and within the last 2 months, I have gotten all my pre-approvals and pre-certs and have been approved for surgery on the 4th of Jan.
In my initial conversation with my surgeon - I asked about Mexico because I too was prepared to be a self-pay and she told me that very few doctors will do fills for those who had surgery in Mexico and would not even see those patients because of insurance concerns. If something has not been done correctly in Mexico and the patient comes to the US for a fill and something goes wrong, they will sue the US surgeon. She told me of a patient of hers that went to Mexico to be banded and came home and when she didn't lose weight went to her primary physician and SHE HAD NO BAND!!! THe surgeon took her money and there was nothing she could do about it.
Look at your options and try to find a program with a coordinator - they are worth gold and are much easier to contact than a surgeon.
I found my surgeon using this website and my surgeon in Delaware seems to be a keeper.
Without a doubt, if you choose to go to a Dr. outside the US, make your arrangements ahead of time. Not all surgeons in Mexico are out to screw you over, same as not all in the US are upstanding! So with that in mind, plan accordingly. My Mexican surgeon insisted before he banded me that I have follow up care closer to me. He helped me arrange that with the surgeon I would have used had insurance come through---he has done my fills without issue of my being banded in Mexico. Many will simply because that is where they were proctored in the procedure. Where I live there is no close Dr. dealing with bands, so even the one I found and use is over 6 hours away one way. So my surgeon also ask me to contact my local ER and find out about emergency unfills. They would not even talk to me, they did not refuse, they just blanket stated they could handle it. Well I knew from this board that is not always true. So I contacted my former oncologist, and they are adept at accessing ports, and he agreed to both speak with my surgeon in Mexico and provide an emergency unfill should I ever need it. Taking off blindly to have surgery with no details for aftercare is not something anyone should do....but it can be dealt with responsibly. One of my surgeons things he does is the morning you leave the hospital, you have a swallow test done under fluoro, so you get to see your band in place and working---and he gives you a copy of those X rays---for you to have if you go to another Dr. Some surgeons or Dr.s will see no one other than patients they have done. That includes patients banded in the US that have moved. So you do need to do some prep work before hand. My mantra to my kids was always to be proactive rather than reactive----it fits here too!
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