Contemplating Surgery

Hi All, I am so glad i found this message board! I've always been a yoyo dieter and always on the plus size side but since I had my twin boys last year I am a stay at home mom and wow I have gained a lot of weight. I have a few questions if you could help me out please :) First question is ... is it really that hard to get approved? I see people doing a 6 month diet (please dont take offense) and it seems silly to me to prove to the insurance company that diets dont work. I have aetna insurance if any of you can help me with that question. Also how long is recovery? I would need my husband to take time off from work, I dont think I should be lifting heavy boys after surgery. I live in Harford County if any of you know of a lapband surgeon in my area that you would recommend. I dont really have any documented evidence of my weight loss in the past I've always done it on my own except for one time I did do a program called quick weight loss...it worked great I got skinny and then gained it all back double pretty fast. Thanks in advance I look forward to hearing from the experts here :)

Hi Teresa, I'm not an expert, I will not be having my surgery until March 20, but I will answer what I can. As far as the insurance approval, I can't help you there. I am self-pay. My insurance wouldn't pay a thing. I did ask my surgeon about the six month diet thing. He said companies change insurance all the time and they make you wait six months and if your company still has them they will pay. He said most don't even care if you lose weight, so it kind of makes sense what he says. I am not having lap band so I don't really know the recovery time on that. I'm sure someone on here will respond and there is also a board just for lap band if you want to check that out. Welcome and good luck, Wanda

Hi I didn't have any problem with Carefirst approval, but that was 3 years ago and I think they are now on that 'supervised' diet wagon too. Actually, the supervised diet is not just to 'prove' to the insurance co that diets don't work, it's also a period of learning to be compliant with your program so that you will be able to adapt post op. My doctor is in Salisbury and does both RNY and band, but I know there are several doctors in Baltimore who do lap band, so I am sure someone will chime in with a name or two. Best wishes as your WLS journey continues. Hugs, Mo

Hi teresa Welcome to the boards. I am not sure about our insurance but there is an insurance form on her vand you can see what others have gone threw with aetna. Recovery is different for everyone. I had open rny and your thinking of lap-band correct? I think recovery is quicker for lap-band. I know Dr Sweitzer at John's Hopkins Bayview does lap band. I had Dr magnuson from there and he only does open rny. I wish you the best on your journey and dont hesitate to ask questions. We may not know the right answers but can lend a helping hand to get them. Take care kelly

Hello my wife had by-pass surgery back in Oct. 2005 and as this week has lost 185lbs she was around 450 lbs before the surgery. my wife did not need anyone to take time off tobe with her, but she did take about 2 months to fully recover and you will not be able to lift for alittle time.She hated the protein drinks the Ins wait is for two reasons one they are Ins companies and they want to make money they want ppl go on a 6 months plan to see if will work and for ppl only 50 lbs overweight or less it should work. many ppl in the few years have had weight loss surgery and it cost alot of money and to be honest I have seen about 20 % of ppl *****ally did not need it with them being only about 20-25 lbs over weight have it so they would look good not for health purpose's. and Ins companies would like for ppl to give up and let it go and forget it, to save money.just another roadblock. just do what they want and have your doctor say you need for health reasons. I am around 600 lbs myself and just got to the point where the surgery would cost me around 40000 dollars and I would have to cover 20-25 % of that then cause of my wife going back to work which changes our Ins. I will have to wait till Nov-Dec of this year enless I can find another way to get assitance for it. I had to get medicaid cause I could not get regular Ins cause my bmi is to high. and the Maryland State Ins Plan does not cover weight loss surgery (figures) I have fought with my weight since my teens and I am 43 right now and in last 2-3 years is when my weight really shot up and its taking its toll its been about an year now I been trying to get help to get this surgery and each day I get alittle closer. I filed for SSD but was turned down they said my condition only made me part disabled and that I cannot no longer work in my past field. but I can still work part time in another field. I got a lawyer and appealing. Please don't give up its worth the time and red tape and everything else. you will feel so much better and live a better and longer life.

I have bc/bs and I have to have had 6months supervised diet in the last 2 yrs. Which I didnt have either. But I am almost at my 3 month mark. I dont have to loss weight, just supervised sit and wait for 6 months. Which doesnt make sense!!! It is so nerve racking. But it will happen, I know it will. Bonnie Island girl

Hi Teresa, Welcome I didn't have to do the six month supervised diet. The best way to find out is to call the number on the back of your insurance card and find out if there are any exclusions for Weight Loss Surgery. If there's an exclusion, it will be hard to get them to approve. If there are no exclusions for WLS, you can then ask about what it is they need in order to review your precertification. I don't know of any doctor's in the Harford County area, but I know that my doctor (Averbach) and Singh at St. Agnes (southwest baltimore city) perform both the lap band and RNY surgery. They have a great practice and they are certified as a Center of Excellence. As far as recovery, everybody is different. I know of a friend who was out shopping at the mall the week after RNY surgery. It took me 3 weeks just to feel "human" again I was lucky and have short term disability insurance so I didn't return to wor****il about 5 1/2 weeks after my surgery. After most surgeries there is a limit to how much you can pick up usually for around 6 weeks. I hope my 2 cents worth helps Take Care, Terry

Hi Teresa, Welcome to the MD board. This is a great place to come for questions just like the ones you asked. As for my experience, I didn't have to do a supervised diet but my pcm had to recommend me and with my past history in my medical records showing some weight loss and always gaining it and more back they approved me. Recover time for me was as individual as the people having or seeking this surgery. I had laproscopic RNY 3/15 last year. I would have returned to work 14 days after surgery except that I became dehydrated from not being able to drink anything and was rehospitalized. My pancreas was aggrivated by the drain tube, causing pain and dehydration. I had a total of 3 1/2 weeks off of work (I was a bank teller then). I was still very weak and tired all the time but I made it. I was about 2 1/2 months out before I felt like myself again. I don't regret this decision at all. It was the best decision of my life, besides my husband, my daughters and accepting Jesus. It'll be well worth the 6 months wait if that is what you have to do. Hugs, Robin

Thank you all so much for taking the time to reply to my post :) Your words of advice and encouragement are very much appreciated. I did look in the ins forum and it seems like aetna is one of the easier companies to work with for surgery. I had called them a while back and they would approve it with the doctors recommendation. I just wondered what type of hoops I might have to jump through. This is a great forum, people seem so helpful and sweet :) Thanks again!