New with LOTS of questions!!

I've recently made an appt for a consult to have lap band surgery, and have been trying to do as much research as I can before that appt (3/7/08) so that I can go in with informed questions.  Also, I don't want to find out a bunch of new info that day and start questioning whether or not I want to do this.  For example, I read that you should avoid carbonated drinks after surgery, and for a major Dt. Coke addict that was a bit of a shock.  But at this point there is very little I wouldn't give up to get rid of this weight, so I know it would be worth it.  Anyway, I've been reviewing messages for some time tonight, and have many questions for those of you who have had the surgery or are close.  I would love to hear from anybody who can answer one, some, or all of my Q's.  Thanks in advance!! 1.) How long did it take you to get in for a consult? 2.) Were you denied by insurance, and if so why or how did you resolve it? 3.) How long was it between your first consult and the actual surgery? (this one I've really been wondering about) 4.) Was there anything that happened after the surgery that you weren't expecting?  5.) What was the process between the first consult, and the surgery itself (like psych testing, having to go through a diet program, what/how long is the pre-op diet, etc.)? 6.) Did you lose any weight between the initial consult and your surgery, and did that affect anything about your surgery? I know this is a lot of questions, but in my control-freak mind I would like to know exactly how things may go so that I can be a bit more prepared for it.  I know that everyone is different, so I don't expect anyone to be able to guarantee how my process might work.  But to tell you how uninformed I am, I got on this board today thinking that if my first consult is on March 7th, and I qualify by the surgeon's and insurance co's guidelines, maybe I could get in for surgery by the end of March when I have a week off work.  Uuummm, that hardly seems like it's very realistic based on the length of time most people waited.  So I thought I would just ask and try to get a handle on what the norm is.   Thanks so much for reading this, and helping me on this journey.  I appreciate all your support, and am so happy to have found this site. Thanks~ *Angel

I didn't have lapband, but I'm sure some of our lapbanders will answer your questions. I just wanted to say welcome and good luck on your journey! kristi

I will try to answer some of your questions.

1.)  I attended an intial weight loss class in September 2006, thought about it for a few weeks and picked up the paper work the middle of October.  It took me a couple weeks to fill out the paper work because I had so much diet and exercise history, I had to get it all straight.  After I turned in my paper work, it only took me 3 weeks (I think, not more than that) to meet with my surgeons.

2.)  I was not denied by insurance.  I was approved in record time on Jan. 3, 2007.  I was approved in 5 minutes over the phone.  That is not the norm.

3.)  My first consult with my surgeon was the one in November 2006, and I had my surgery Jan. 30, 2007.

4.)  My surgery went very smoothly.  There were no surprises except how good a felt after about a week.  I did go through a little depression about 4 days after surgery.  That lasted on a couple days.  I think because I was coming off the pain medication (although I would not call it pain--just discomfort--on a scale of 1-10, I was about a 2 or 3). 5.)   I started the testing process in mid-Dec. 2006 with blood work.  Couldn't do anything else until the blood work was done as all the other drs. needed to see that.  Had my appointments with the pulmonary dr., the dietitian, psychologist, support group, pre-op class all between Dec. and my surgery date.  I did not have to have a diet program before surgery--just the pre-op diet which lasted 2 weeks.  That was the roughest part of the whole process, but I made it.  But I did lose 15 pounds during that 2 week period.  It did not change my surgery except made it easier to operate because my liver was less fatty.  Both weeks were liquid, the first one being liquids (like protein shakes, soup, jello, pudding, etc.) and then a few days before surgery, clear liquids.  That was so long ago, I hardly remember it now.  Good thing!! Do not do what I did which was have a "last supper month" before surgery.   I think I was anxious and nervous and after I realized what I was doing, and realized that I would be able to eat real food again, I calmed down.  I did have quite a time with carbonation cravings after surgery.  I was a big diet pop drinker, too.  It took me about 6 weeks to overcome that craving.  But I knew I had to do it.  I made it through that and have not had a craving since.   I always tried to put things into perspective.  That all the things I had to go through were for my benefit and would help me achieve the goals I was aiming for.  They have all been worth it.  I hope that helps and that others will have some more insights to share with you.

They have some great popsicles that are diet soda flavored (coke, root bear, orange) and have no carbonation in them!! :)

Hi Angel!! Welcome to a wonderful journey!! :) I'll answer your questions based on my experience...I was also told that the length of time depends on the surgeon and the insurance company you use.  1. I got a referral for a surgeon from me GP. It happened to be a good connection and I was in within that week. Very unusual though...I know some people that waited months for their consult. I believe my surgeon typically has a wait of 3 months.  2. I was not denied by my insurance. I have anthem blue cross blue shield. The only requirement they had for the surgery was 2 comorbidies. No psych eval, 6 month diet plan or anything! I had to do more requirements for the dr. than the insurance.  3. I had my first consult in February (or beginning of March) and had surgery in June. I could have done it much quicker, but I procrastinated and talked myself out of it for a bit.  4. The only thing I ddn't expect after the surgery was how many incisions I had. I told the dr. I didn't want to know anything ahead of time that they were going to do to me. So that's mostly why. For some reason I had it in my mind that I would only have 1 incision- not realistic...but yah know! :)  5. Like I said ealier, I had to do more for the surgeon than the insurance company. I had to have a letter stating I was mentally able to undergo the process, had to attend a nutrtion class (which I would recommened even if not required as it answered tons of questions), and had to get a letter from the doctor. I also had to keep a food diary for 3 days and attend 1 support group. My pre-op diet was 2 weeks. I could only have liquids. I had a horrible headach for a few days and then was fine. I would do it again in a heartbeat though!  6. I did loose weight in between times. I had been losing for awhile- just not at a pace I needed to. It did not change anything about my surgery other than reinforcing to me that I needed to fo this to help myself become healthier.  Let me know if you have any other questions!!

I had gastric bypass surgery on March 15, 2007. My husband is active duty army and I had my surgery in the military treatment facility (Evans Army Community Hospital). So that makes my story very different from what yours will be. I have attended many support groups with people that are both lap band and gastric bypass and have talked online with many that have had both. Wherever you are considering having your surgery that should have an orientation class that goes over some of the basics of the surgery, the process, and their "norms". You should also be able to ask questions...bring in a list of them, they will be more than happy to answer.  Before my surgery I was information starved...the more I learned the more I wanted to learn. I think that is an awesome attitude to have. "I read that you should avoid carbonated drinks after surgery" Absolutely. Some people will and do drink carbonated drinks sometime after their surgeries...but it is not recommended at all. Carbonation in drinks depletes the body of calcium, other nutrients, and is useless nutritionally. Everything you put in your mouth needs to serve a purpose. You don't have that much room so you need to make what you do get in worth it. "for a major Dt. Coke addict that was a bit of a shock." With gastric bypass we can't have soda or anything with sugar in it at all or we get sick. Some people can tolerate more sugar than others...but I can't have hardly any. Lap banders are a bit more flexible with what they can eat and tolerate after surgery. But you have to go into this surgery with the attitude that you will be giving up your addiction to food. I didn't believe I was addicted to food until after my surgery when I wasn't even hungry and I wanted to eat everything...it was head hunger. If you look at your situation as an improvement in your health that will also result in a better quality of life and emotional happiness...then you might be able to get over some of these small sacrifices. I was addicted to Coke and tons of other foods. If we weren't addicted to food we would never have become obese. These weight loss surgeries are out interventions for our food addictions. The surgery is a shock and it takes some time to get used to. It takes quite a bit longer for lap banders to see the weight loss that gastric bypass patients see...but even for us it takes awhile to see the difference in ourselves...We wake up thinking it's going to melt off immediately...but it takes a few months. In the mean time we don't have our comfort food...our friend for so long. "But at this point there is very little I wouldn't give up to get rid of this weight" You really have to commit to these surgeries. Lap band's can be removed (and even their own website states that lap bands probably need to be replaced at some point...the body rejects foreign objects) but you need to have the mental determination to go through with the process with all the negative aspects. Almost everyone is sucessful with these surgeries and almost everyone is very happy that they did it. "1.) How long did it take you to get in for a consult?" I had an appointment with my primary care physician sometime in December...had my consult in middle of January...had all my appointments, tests, etc done and surgery was scheduled for beggining of March but pushed back to March 15th because someone else needed an emergency surgery (my surgeon is a general surgeon so he treats other problems).
"2.) Were you denied by insurance, and if so why or how did you resolve it?" Different insurance companies require different things. My insurance didn't even approve me...at a military treatment center it is at the discreation of the surgeon as to whether or not we need the surgery. This is helpful for people who are 0.1 under the BMI for the insurance company. I was above and beyond the requirements for the surgeon and the insurance company. Research what your insurance companies requirements are to have the surgery and start getting paperwork to show you qualify. "3.) How long was it between your first consult and the actual surgery?" 3 months. However, alot of civilian insurance companies require 1 year of documented nutrition counseling and dieting attempts before they even start you on the path to surgical intervention. Almost everyone also requires certain testing (gall bladder ultrasounds, blood tests, pysch evals, etc.). Some also require a certain amount of support group attendence. So it will also depend on how determined you are to get all of these appointments completed and paperwork sent back to your doc. "4.) Was there anything that happened after the surgery that you weren't expecting? " I think alot of lap banders don't lose as much weight as they wanted. I've met alot of lap banders that eventually have gastric bypass so they can lose the rest of their weight...it can be really hard for the gradual weight loss while enduring the hardship of not being able to eat what you want. Lap banders lose their weight in 2-3 years (depending on how hard they are working...if they are dieting right...exercising...and lucky with their metabolism). Gastric bypass you lose most of your weight in the first 6 months with most of it gone in 1 year....we also lose more than lap banders. I am not trying to convert you I'm just stating the facts. There have been scientific studies saying that if you are significantly obese that gastric bypass is much more sucessful than lap bands. It seems the more light weight obese patients have lap bands. When I originally started wanting a weight loss surgery I wanted the lap band. But the more I looked into it for my situation I realised that gastric bypass is what I needed. There are many many sucessful people with both surgeries...everyone has to figure out what's best for them...because they are different. I had alot of pain after my surgery...but I had a previous c-section with the same amount of pain. Most gastric bypass patients don't have much pain. Almost all lap band patients are in and out the same day with only mild soreness. Mild depression is common after surgery because we are losing one of our best coping mechanisms...food. It's not one we should have though...but it's the one we were using and it's harder to adjust to that for some people. "5.) What was the process between the first consult, and the surgery itself (like psych testing, having to go through a diet program, what/how long is the pre-op diet, etc.)?" -My psych testing was taking a computer exam saying if I heard voices and talking with a doc for about 30 minutes to make sure I understood the permenent reprecussions and stress of a major surgery. It was easy and quick.  - Had two two-hour nutrition classes detailing how to eat right after surgery. - Had a gall bladder ultrasound to make sure I didn't have any stones...after gastric bypass with such quick massive weight loss you can get stones...if you already have some they just take our your gall bladder during the surgery. - Had some blood work done. - Went to a support group meeting to make sure I knew there was support out there for me before and after surgery. - We had no diet program or pre-surgery diet or anything. - We had an orientation with the surgical nurses going over the surgery and what to expect in the hospital.
"6.) Did you lose any weight between the initial consult and your surgery, and did that affect anything about your surgery?" Some hospitals require that you are under a BMI of 50 so you want to make sure that you are under that mark...I've heard of people being weighed right before surgery and if they had gained a pound they would have cancelled. I imagine you just need to talk to your surgeon or nurse to see what their requirements are. I went from 302 lbs to 298 lbs and it didn't effect anything. But I could drop or gain 10 lbs due to hydration.

Surgery within a few weeks is not normal. Surgery within a few months is lightening fast and not likely. Waiting for surgery for a year happens frequently. I think the average person probably has to wait around 6 months. It is very different for each program and insurance company. I highly suggest going to a support group in your area where you can talk to other people who have been there and done that in your exact situation. Good luck!

Now I'll make my attempt to answer your questions (Hopefully these are still in time).

1). It took nearly a year because I'm on Medicaid & Medicare (Medicare primary) and when I first called CBSI, they were in the process of becoming a Medicare approved bariatric clinic at the time.

2). No. In fact, Dr. Metz told me all they needed to do was submit some paperwork and *VOILA!* - Instant approval.

3). It took a few months. But most of that was gathering information from my other two doctors at Rose (One of which is my PCP).

4). Nope.

5). I saw just about the whole crew. I'm not sure who you're going through (You never mentioned that in your post), but if you go through CBSI at PSL, you WILL get the proverbial "red carpet" treatment as they'll make sure you see the whole crew (Or at least those who are there at the time).

6). I did lose a little weight just before surgery but I figured the best way to keep it off was to undergo the surgery anyway.

Hope this helps.....

Cheers

Here ya go: As you can see from my write-up in my profile, Dr. Schoen did an outstanding job across the board with my WLS. In response to your questions: 1.) How long did it take you to get in for a consult? A. less than 30 days
2.) Were you denied by insurance, and if so why or how did you resolve it? A. Initially denied by Aetna. After the denial, I found out what they needed for approval and Dr. Schoen's office and I delivered the goods (e.g. 3 month pre-WLS diet and exercise program, 5 years weight history, history of prior weight loss attempts, etc.). Got approved within 4 months after initial rejection.
3.) How long was it between your first consult and the actual surgery? (this one I've really been wondering about). A. My consult was end of April, 2005 and I had WLS Aug. 25, 2005.  
4.) Was there anything that happened after the surgery that you weren't expecting? A. The dynamics of my marriage changed dramatically.   
5.) What was the process between the first consult, and the surgery itself (like psych testing, having to go through a diet program, what/how long is the pre-op diet, etc.)? A. Lost 52 pounds prior to WLS, changed my eating habits and went on a liquid diet for 3 months, started walking and worked with Kelly the Nut (superb nut by the way.)  
6.) Did you lose any weight between the initial consult and your surgery, and did that affect anything about your surgery? A. See 5 above; Dr. Schoen wasn't going to perform the WLS unless I took off 10% of my weight. By the way, I gained 9 pounds in my first month of the "diet and exercise program" thus his reaction.  Since I was super-obese, the weight loss allowed him to perform the WLS laproscopically rather than open, and it shrunk the liver to make the WLS safer. In retrospect, I was glad Dr. Schoen was as adament as he was since the pre-WLS diet and exercise program allowed the transition to my new life post-WLS much easier.  Best of luck on Wednesday. Give Dr. Schoen, Wendy and Kelly my regards. 2 thumbs up for their WLS practice.    

Thanks a lot for the info.  I'm assuming this in response to the PM I sent you?  I have a follow-up question...about #4, how did the dynamics of your marriage change?  I will wait for your response, but this is something I'm concerned about (not in a good way), and will discuss more later. I will be glad to tell them hi...will they know you as Boner??  *Angel