very new and very nervous

Hi to all..I not only have never posted to a message board before, I have also never talked with or anyone about my obesity - denial has been my best friend. Can t believe there is a whole network out there of people just like me. So...... I am now at a point where my osteoarthritis is so severe in my knees that I have no social life, have no friends, may very well lose my job and career - my husband is barely there because I can't do the things he wants to do. I have been afraid about gastric bipass but think that lap banding might be perfect for me - I am losing hope that I can ever maintain a healthy weight and am pretty desperate - frequently depressed to the "gee-I-wish-I-could-just die" point. Would appreciate any advice or help or anything at all....I have never even asked for help before (major total failing of mine). Know this is too long for a board posting, right? I will learn - I hope. Does anyone know if there is a secret to getting insurance coverage - I have coverage with MVP, an HMO in New York. I have arthritis to the point of handicap and want to have both knees replaced but not until I lose weight. I have "mild" diabetes but diabetes is a severe risk in my family. I have reflux disease and bladder incontinence - do you think that's enough? THANKS!!!!! Forgive the rambling, please.

hi cheri, i have mvp also. just call them and ask what their criteria is, also ask what surgeons and hospitals they deal with. i live in syracuse had to go to utica for my dr. i just had an rny on 3/5/7. and i'm feelin ok. good luck.....sue

DID YOU GUYS FIND OUT What the criteria was?? thanx

HI there, To me it sounds like you would qualify but give MVP a call to find out what their criteria is. Many surgeons offices will also take care of calling insurance companies for you. I had my surgery on 11/22/06 and feel great. I had RNY and would do it again in a heartbeat. I am now back to the weight I was in high school and can't remember the last time I had this much energy. Good luck to you and keep your chin up you are on the right track to a healthy life. Diana

Hello, you sound like you are at the point of going forward. It took me over a year to decide and boy am I happy I did, it May it will be two years and I had an open gastric bypass and wouldnt go any other way. I have two friends who had the band and they have already put the weight back and more. The band does not work in the long term. The bypass will make you keep it off. You must though change your life once the weight starts coming off. I have lost 138 pounds! I am so happy I did it. I am able to eat everything again in much smaller portions -- i go to the gym five days a week! Up until two years ago I never set foot in a gym. I have my life back, I changed jobs, I was at a job I hated for years, I ride bikes with my seven year old, my husband had it too 14 months ago. I had slight high blood pressure -- they will work with you, contact your insurance and then go for a consult. GET YOUR LIFE BACK!

Hi Cheri, You are not alone! There are MANY of us who hear you loud and clear. This website, particularly this forum, is a wonderful help for us all. First, do your research, nobody can tell you which surgery is better for you. But remember to weigh and measure both ends of the spectrum. Initially, I too was totally for lapband, but after my research, then I chose the gastric bypass, which I had done laproscopicly 7.5 months ago and so far I am down -90lbs and actually "living life to the fullest" in years. You loose soooo much sooooo fast, it's totally awesome. Most of all I feel WONDERFUL and I only regret not having it done sooner. I wish you good luck and success and don't forget, research, research, research. Either way, your brain is not opereted on, it is a true lifestyle change, you must learn to change your ways of eating and incorporate exercise (no matter how little initially) WLS is only a tool, the rest is up to us. Maryellen

Hi Cherie. I was lap band all the way as well. After researching and personally knowing two other people that had it, I decided to go with the Lap RNY. They both gained half of their weight back only because they have failed to follow up with their fills. If there were holidays, they would postpone fills so that they could pig out. There are too many ways to get around it. It was not the responsible thing to do by any means. but I'm afraid that I need something a little more of a restrictive measure. There are so many Lap Banders here that have done fantastically and wouldn't have it any other way. You have to ask yourself what kind of personality you to determine which surgery is right for you. They are both hard work. I think that you have enough criteria to be approved. I wish you luck & TakeCare- Diane

Hi Cheri - just wanted to let you know that you have finally come to the right place. Yes, there are a whole POPULATION of "us" out here and all of us have all experienced some form of the same challenges - mental, physical and emotional - dealing with our obesity and making the decision to fight it with the help of surgery. You will find that many of us here battle the same things that you do. I too have osteoarthritis in both knees. Knee replacement is definitely in my future, however, losing 160 pounds made it so much easier and also made it possible to put off knee replacement for a while. Insurance approval is always a touchy thing because it is very individual. You do not say how much you weigh but if you are obese and it appears you do have the co-morbidity factors to qualify you as a case for medical necessity, IT WOULD APPEAR that your insurance would see you as eligible for surgery, if your particular plan covers weight loss surgery. You need to call MVP yourself and see what their policy is on weight loss surgery. Check the types that are covered (some plans do not cover lap band, only RNY and DS) and check what their requirements are for approval. Most insurance want letters of medical necessity from your PCP along with your medical records to show that your obesity has negatively affected your health. Many also require that you show proof that you have tried unsuccessfully to lose and sustain weight loss through more "conventional" methods for at least a 6 month period. This can be a simple as going to your PCP and having him/her advise you on a proper diet, document it in the file, and you go once a month to be weighed, measured and consulted with. Cheri, this is not an easy process for many of us and when we wait until our lives in really in a bad way before we get moving, it can be more emotionally challenging. But please do your research and investigate weight loss surgery thoroughly before making your choice but don't let fear stop you from taking this step if it is for you. Sometimes, NOT taking the step will end up taking even more from you. WLS is by far one of the single best things I ever did for myself and although the initial steps were a little scary, I can honestly say my only regret is that I didn't do it sooner. All the best to you!

Oh and one more thing, please don't just look into the lap band because it appears to be the least invasion. Really do your homework on the other types of WLS. The roux-n-y and the dudodenal switch (if you qualify) have a record of having more long term effectiveness and are more widely recommended for the seriously obese. I am not saying that lap band does not work --- what I am saying is that based on what I have read over the past 3 years, all the WLS patients I correspond with, studies I have read about, etc. the odds of gaining more weight back after several years tends to be greater with the lap band than with other types of weight loss surgery. Just something for you to keep in mind.