Question:
Any advice welcome

I am 5'3 and 219 i have never been this big i have type 2 Diabetes,high blood pressure,high cholestrol,depression and nerve problems due to the diabetes.My primary ins. is Medicare i have Anthem thruogh my husbands work that covers me too. My primary doctor recommended this surgery because on my last loss attept i lost 17lbs. My meds were changed and in one month gained all back He told me without help and off the meds i couldn't do it without help the meds i am on the side effects of some of them is weight gain.That why he recommed the lap-band surgery. I called Kings Daughters and have my first visit next week [Tuesday] i don't know what will happen i filled out my paperwork to take with me. When i told a few people that i know they realized this time i'm finally going to do something. I have bben told i don't need surgery if i stop eating so much and excercise i would loose it also told yesterday that i wasn't heavy enough.Am I?    — [Deactivated Member] (posted on November 15, 2009)

November 15, 2009
What is my next step. I called Medicare they told me they do cover the surgery. Does anyone think i have a chance. Everyone keeps knoting me down. EXCEPT MY LOVING HUSBAND he said he wants me healthy and happy again he supports my decision. Any Advice? Thanks Sherry
   — [Deactivated Member]

November 15, 2009
Hey there! I say keep pushing forward! I didn't have a lot of support either about getting the surgery, but I kept going through the process and I had my RNY on 11/6. I was 5/7, 275lbs pre surgery and I had a lot of the same issues including asthma. Of course, with diet and exercise you will lose weight, but its a lot easier said then done. Some people think that we use this surgery as a "quick way out" but that's not what it is. It is a tool to help us come back into a healthier way of living. That was my goal and still is. Go through with your Dr's appointment. That is the first step. Please feel free to contact me anytime. I had a lot of naysayers too and I have no regrets.
   — DeShanna C.

November 15, 2009
Thank you so much that helped i'm not giving up i'm doing this for ME and a healthier and happy life. I have Astma too i forgot to add that.
   — [Deactivated Member]

November 15, 2009
Do you think i will have alot of problems getting a approval from Medicare?
   — [Deactivated Member]

November 15, 2009
First off, no one should tell you to or not to get the surgery unless they have a medical degree. I would talk with the people are Kings Daughters and see what they say. As far as heavy enough, on a BMI scale you are considered obese, plus with the type 2 diabetes, high BP, and high cholesterol, I would say you are a good candidate for lap band. Good luck :)
   — Nina15137

November 15, 2009
Thanks you guys are great finally someone who understands WISH ME LUCk
   — [Deactivated Member]

November 15, 2009
Hi. Had my lapband on 11-9-09. Medicare only covered one doc in my area and they knew their stuff. Mostly, I paid 20% of everything and $800 for hospital admission deductible. Medicare will only cover the surgery if you are admitted (not an out patient). Medicare does not require prior approval or 2 years of special diets.
   — dixie K.

November 15, 2009
Do you mean i need to stay overnight in the hospital for them to pay. I thought they all were done outpatient that is lap-band.I have my first appt. with Kings Daughters next week Tuesday
   — [Deactivated Member]

November 15, 2009
I just want you to know that at your weight and height your BMI is 38.7, which puts you in the obese range. In addition, you stated that you have type 2 Diabetes, high blood pressure, high cholesterol, depression, and nerve problems due to the diabetes. Do not let other tell you to have the surgery or not to have the surgery. All I can say is the surgery is a tool and will help you but is not just a quick fix to the problems you have. Medicare should help cover the procedure and Anthem should pick up most of the rest so you have that part covered. I too have problems and I am still in the process of getting this surgery done to help so I will be around to enjoy my children and in the future my grandchildren. I exercise and eat a low fat, sugar free, high protein diet of 1000 calories a day and still have only lost a few pounds. Sometimes it just not that simple to lose the weight god knows I have tried everything out there short of not eating. Just keep moving forward and following your dreams of becoming healthy. I think you should have no problems being approved to have the surgery. To answer your last question even with the lapband you will have to stay overnight after the surgery. However, if you had the by-pass you would be in the hospital for about 2 to 3 days. Good Luck.
   — lscheller

November 15, 2009
Thank you so much i will do this for me no matter what it takes and for however long i want my life back. God Bless You and Good Luck to you
   — [Deactivated Member]

November 15, 2009
I'm betting that the people who are telling you that "all you have to do is eat less and exercise more" have not been struggling with their weight their whole life like we have. If you're anything like me, we've tried every diet out there. I have had success in the past losing weight, but I've never been able to keep it off. In fact, I've always gained the weight back and more. I'm encouraging you to do your research to make sure you know what you're getting in for. It is a life long change in eating habits, but the surgery is a tool that keeps you from being so hungry. That allows you to eat less and maintain your weight loss. There's a lot of new research showing how weight loss surgery helps you control your diabetes. I think you should talk to the surgeon about that when you talk to him. If you'd like to see how I've done, go to my site (profile name "KimM" or group name "healthy life journey"). I had the Lap-Band surgery 5 years ago. I am at my goal weight and have been maintaining my weight loss for the last year and a half. I feel 20 years younger, my blood pressure is normal, my joints don't ache, my sleep apnea is gone, I don't get short of breath with normal daily activities, and I can now do things I had not been able to in years. I wish you the best as you decide whether to have the surgery or not. You deserve to be in good health. The healthier you are, the more you can be a blessing to those you love and care about. God Bless.
   — KimM

November 15, 2009
Sherry, The job I do requires I evaluate hospital stays for necessity and other things. Medicare, when they they say outpatient means less then a 24hr stay. In my area most of the RNYs done laproscopic are out in just over 24hrs depending on the time of day you have your surgery. In medicare language its called observation and you are not actually "admitted" to the hospital even though you are spending the night. With some of your medical history your doc may be able to make a case for you staying longer just be sure he knows that medicare says 24hrs or less. As a rule physicians don't pay attention to that kind of thing. Best of luck crabbyKelly
   — kmom1420

November 15, 2009
Sherry, When I had my RNY I was on Medicare and they covered it. I was type 2 diabetic, high blood pressure, high cholesterol and asthmatic. Medicare approved me with none of the six month food logging and what not. I am sooo grateful I had this surgery done, and would do it again if I had to in a heart beat. No second guessing for me. I no longer take diabetes meds, high blood pressure meds or cholesterol meds. I have not had an asthma attack in forever! I too had limited support when I was going through the process except for my husband. Now that it is done and people see the new me they are all supportive. I now have a new life. Keep going on and if you need to share or talk just contact me!
   — Denise L.

November 15, 2009
From what you have said you should qualify because you have a BMI of 38.8 and have several comorbidities. If I were you I would opt for an RNY bypass instead of a LapBand as I think it's a more effective surgery over the long haul.
   — rkurquhart

November 16, 2009
I AGREE WITH BOB, OR EVEN THE VGS (SLEEVE) I HAD MINE DONE JULY 22,08 AND HAVE LOST 122 POUNDS, FEEL GREAT AND NO PROBLEMS WHATSOEVER. BUT WHAT EVER YOU CHOSE, GOOD LUCK AND I WILL BE PRAYING FOR YOU.
   — [Deactivated Member]

November 16, 2009
Have you considered the verticle sleeve surgery. It has less complications than any of the others and has a great success rate. I had VSG 7 1/2 months ago and I have lost 88 lbs. I am off my sleep apnea machine and the arthritis in my knee is pretty much gone. My high blood pressure is doing better but sometimes that is not always a weight related issue and it runs in my family. I know not all insurances cover VGS however your doctor can list it as a first stage RNY and get the insurance to cover. It is worth considering because you don't have to deal with something forgien in your body or go back for lots of fills. Your stomach is simply made smaller but still works basically like it did before but the hunger horemones are removed. I recommend checking out as much information as you can before choosing what to do. I hope you have great success with what you do choose.
   — Lisa von Wallmenich

November 16, 2009
When i read what all you guys wrote i cried thank you all so much i have my first appt. Tuesday i'll keep you all posted Your experiences helps me.And the bad comments did come from people that has never had a weight problem!
   — [Deactivated Member]

November 16, 2009
I will tell you it isn't a easy road and like the other commentor, you will have negative people saying things. I had my surgery 3 months ago and so far I have lost 64 lbs and quite thrilled. You will have bunps in the road, but it is only temporary!
   — FSUMom

November 17, 2009
I am 5'11 and was 282 the day of surgery. I am considered by my surgeon as a light weight. My insurance (TriCare) required a weight of 100% over ideal weight or have co-morbidities. I had high blood pressure and was pre-diabetic. My family doc had to refer me to my surgeon. He told me that he didn't think I weighed enough to get the RNY....obviously he was wrong. The only people who can tell you if you will qualify for surgery are your insurance and your surgeon. Good luck!
   — wearfamily2004

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