New to the message boards, Memphis TN

Hi....my name is Arlene and I have been doing alot of reading on lap-band surgery. I've been reading some of your posts and wondering if this will even be an option for me. I have dieted most of my adult life and most of my teen years as well, but never supervised (except for a supervised diet at age 13-15?, was given uppers of some kind but that was long ago and I don't even remember the doctors name or where exactly that I lived as we moved 3 times during those years) Anyway...in December of this year I was feeling so bad (sleep apnea, restless leg syndrome, shortness of breath, steadily climbing bp, etc) that I decided to go on Atkins, again not Dr supervised, but I did tell my Dr I was doing Atkins sometime in early January. I did really well the first 3 months and lost 32 lbs (was 292 at beginning with BMI of 42) but stalled and stayed stalled for the next three months. My Dr suggested upping my exercise, but I hurt my knee using the treadmill (had achilles tendonitus and plantar facietis last year too) Unfortunately most of my problems I have simply suffered with, the apnea included. I just had a cortisone shot in my knee to see if that will help the swelling and pain and go back in two weeks if no improvement. I've done really well getting rid of my carb addictions, sure, I've lapsed occasionally in the past month since there has been no weight loss, but for the most part I no longer eat sugar, potatoes, rice, white-flour foods, caffeine (have been de-caffed for 18 yrs) but have difficulty controlling my portions. I do have hypothyroid, my thyroid was radiated in 1995 after unsuccesful response to hyperthyroid meds (I had graves disease that went undiagnosed for 6 months as I didn't lose weight but actually gained weight although I had all the other symptoms) So, here I am, 44 yrs young, feeling like I am 64 most days, despairing that I'll ever live to see my childrens children and not knowing what steps to take next...any suggestions would be wonderful. I have insurance through my DH's work with Cigna, an HMO policy. Ummm...can't think of anything to add, but it's nice to meet ya'll. Arlene

Hi Arlene! Nice to see a new face on the message board! I'm not familiar with your insurance company but I'm sure someone on this board is and will be able to give you some good insight on which doctor to use and etc. Ohh Congrats on lossing 32 pounds on your own! That's really fantastic! Anyways, if your trying to start your journy to WLS - The best thing to do is talk to your doctor and start making those appointments and finding a doctor in your area, hopefully there's a seminer you can go to - to learn more about the surgery and about your doctor. Good luck with your journey - please do keep us updated! -Katie

Welcome aboard Arlene, Glad to have you. I am a fairly new member myself. I know what you mean about all the diets and the diet pills. I have a medical history of diets that started when I was 14 year old and continued until I was around 45. Unfortunately, my insurance requires that I be on a physicians supervised diet plan for six months prior to surgery and all of my diets were not in the last six months. So I am starting one with my PCP next week. Hopefully, I will be able to have my surgery next Feb or March. Good luck with your insurance company.

WELCOME ARLENE! You are in the perfect place to find the answers you need to get started on this journey! I am sure it is a little different in how you get started ,depending on your particular insurance and doctors etc. I started by first calling the insurance company to see if they had any exclusions. Then did a search on here for surgeons in my area that were in the insurance's network of approved doctors for my particular insurance. Then started calling down the list til I found what I was looking for and asked them all sorts of questions as to how to get started. Different doctors want different things I found in the initial processes anyways. Then you get your pcp to give you a referral to see the surgeon you chose and go from there. I wish you a whole lot of luck and if you need anything just holler.. there are alot of great people here and I am sure you can find the answers through someone here! Also there is a section here about different insurance companies and the successes and such of others who have used it.. you may take a look there for approvals and etc. Maybe youlle find an answer there. Best of Luck to you! Dawn knoxville

Hi Arlene, I have CIGNA HMO through my work, and they are a bit of a pain to work with but the key is perseverance. Check with your PCP & see if he/she knows a bariatric surgeon they would recommend then check your policy to see if that surgeon is on it. I went with a surgeon here in Knoxville (where i live), he is not on the list but CIGNA has a thing (they won't tell you about it either, you have to let them know you know about it) where if there isn't another doctor on the list that does that surgery within 50 miles of you then they will give you an out of network referral. They did this for me for the consult visit, even though the HMO doesn't offer out of network benefits, because of the 50 mile policy of theirs. My PCP's nurse was a godsend because she not only found out about this but was able to get a case manager assigned to me. They turned me down for the surgery, after the consult, the first time saying I needed a nutritional eval. & then the second time because they wanted six months of a physician supervised weight loss plan that included monthly weigh-ins & also wanted doctor's notes regarding what he/she had prescribed (diet wise and/or prescription wise). This had to have been done within the last (I think) 3 years. Well finally after they had nothing to complain about or deny me for they approved the surgery & I am waiting on a date now from the surgeon. I hope this helps you in some way along your journey. Greg

Hi Arlene, Welcome aboard. I have been researching the wls for over 2 years. I am in the process now of getting all my tests and physc eval done so I have everything to turn into my insurance. I was approved once before 2 years ago but had to stop after the company I worked for at the time changed insurance companies two weeks after my approval. Anyways, there are some really good doctors in Memphis. All ask for different paperwork, tests and are covered under different insurance companies. The more you are on the site and talk to people the more you will learn. I have 3 doctors names that come highly recommended in Memphis. I personally am going with Dr.Woodman now everything fits better for me money wise due to my insurance company with him. He will do surgery at Methodist and is on my insurance list of Dr.s. He mostly does surgery at Baptist though. There is also a Dr. McGrath who works out of St. Francis hospital which my insurance will not cover. I have also heard alot and talked to alot of patients of Dr. Alston. Don't know much about his insurance and hospital preference though. Hope this helps and if you have any more questions just email me. Tara

Hello Arlene, Welcome aboard!!!!!!! I also have Cigna Ins(PPO).Just with what little I have done so far,They don't seem that hard to work with.I work for the Tri-Star corp and ran into the surgeon I wanted was "OUT OF NETWORK",but i also came across a number for Intracorp,which is the place the actual approvals are sent to.I'm not sure if HMO would be the same.I can give you the number if you need it.I have talked to a very nice lady there and she has been very helpful.If the Ins Co. tries to tell you about "OUT OF NETWORK" garbage then keep asking questions.They gave me a "Medical Adequecy". What this meant for me was that the "Out of Network"surgeon will become"In Network" and the cost for me would be less.I also ran into the problem with having to go to a Tri-Star Hospital or I pay 100%.This is not a problem though.I plan on going to Centennial for my surg. If you need that number let me know.I won't be on this weekend because I have to work all weekend but I'll be back Monday. Good Luck!!!! April

Dear Arlene, Welcome!! I don't know anything about Cigna. But there is a Obesity Surgery Seminar in Memphis soon. It is being presented by my surgeon, Dr. Atul Madan. The seminar is Saturday, July 17th. 10:00 a.m. - 12:00 noon @ 7945 Wolf River Blvd in Germantown. Call 448-6944 to register. There is also a support group meeting that should have loads of info. July 12 @ 6:00 p.m. 66 N. Pauline Street Conference Room A. Hope this helps some. Welcome again, Eva C.

Hi Everyone, Thank you all so very much for your responses! It looks as if I have my work cut out for me and need to get into battle-mode. I know Cigna has a site to look up the Dr's and Surgeons available to my particular plan, so I can go there and do a search on the Dr's everyone has mentioned in this area. Now, time to find my policy and read through all the small print looking for the info I need. I'm hoping the visits to my PCP since January will count towards my Dr's weightloss visits, as I have spoken to her about my struggle to lose weight each time I've seen her, even though most of her advice has been to exercise more and she just nods when I talk about low-carb(I got the impression she didn't really know much or approve of low-carb/Atkins) It looks as though if one has a BMI under 40, you need at least two medically proven conditions attributable to weight? I wish I knew more about the psych eval, as I have no clue to what they may be looking for in order to approve or deny. The support here seems phenominal, and I just want to say a huge thank-you to all of you as I learn to use this site better! Hugs, Arlene

Hi Arlene, Ive heard that Dr. Woodman, who is the only surgeon in Memphis that does the band, is wonderful. Lots of the nurses where I work have had surgery with him and have had good results. I wish you the best in whatever you decide to do. Anne