4/15/09 Off with her head!

I’ve been working on getting down another 10 lbs. before banding. I actually went down 1 ½ lbs. below the 10 lbs. last Thursday, but I knew I’d have to face a weekend of big meals and Easter candy with my family back home so I didn’t want to celebrate my goal too early. As I told you yesterday, I ate pretty healthy and had NO candy (very hard for a chocoholic), but I still gained a pound with all those family (high calorie) meals.

There were many temptations ‘Drink Me!’ ‘Eat Me!’ and I only faltered once.

I ate a sliver of the ‘Tart’ and I paid for it with a one pound gain.

I’ve been back on my pre-op plan and after three mornings back home I feel confident that I can report I’ve officially lost my second ten pounds.

So, I’m screaming ‘Off with her head!’ and knocking another Ten Pound Head off my Ticker.

Go to the Head of the Class-Trivia Question:
What movie is coming out March 2010 that relates to my post?

Tim Burton is making Alice in Wonderland with live action and animation mixed. Stars: Johnny Depp plays the Mad Hatter, Anne Hathaway plays the White Queen, Helena Bonham Carter plays the Red Queen, Alan Rickman plays the Caterpillar, Crispin Glover plays the The Knave of Hearts, Stephen Fry plays the Cheshire Cat, and even Christopher Lee is in it, too. Let’s hope it’s better than Charlie and the Chocolate Factory (not my favorite version).

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*In response to Comments:

My banding is a week from today, April 22nd. As far as what you're supposed to lose, well that is a loaded question, because it depends on your insurance, your current BMI, and your Dr. Here's a parts of 2 responses I gave to other posts and this should answer this (sorry that the information overlaps some). Oh, and I lost 9 pounds in the 6 mo. before approval, I've lost more since then. PM me if you have more questions as these pieces of posts might be confusing. Good luck!

*In response to someone who wanted to know if they could go below the min. BMI (either 35 or 40), and how much to lose:

You can try, but you probably won't get a straight answer from your insurance co. on this (and you're going to have to figure out a clever way to ask 'what happens if I fall below my minimum BMI before approval?' either 35 or 40). I've found that the insurance person at the surgeon's office is the best source for an answer to this, as they deal with your insurance co. all the time (hopefully, if you're local). Be aware that even they are not legally allowed to tell you directly not to lose weight, so just ask the question so it's worded correctly, or pay careful attention to their answer.

My theory is better safe than sorry. I attended 3 seminars and 2 of them actually put in their handouts that the expectation for the diet is not to gain any (people get denied for gaining even one pound) but they don't expect a huge WL. My surgeon's sample PCP letter includes the phrase "was unable to lose any significant amount of weight". My PCP 'gets' this as she's had other WLS patients.

I think after you've had the discussion with your surgeon's insurance/billing person, if the expectation is not to lose much, then I'd have a frank discussion with my PCP. I'd ask my PCP to focus the time on helping to educate me on the changes that will be needed after the surgery (we discuss exercise, diet/protein, no liquids with meals, things like that). If your PCP doesn't know much, see it as an opportunity to spend a few min. each month educating them.

*Another post answer:
- Personally, I've found the insurance person at my surgeon's office to be the best source of information since she deals with my ins. co. all the time. Call that person with a list of your questions...ie. your ins. co. will never tell you or spell out in their policy that they expect you not to lose below the minimum BMI, and the ins. expert at your surgeon's office can't legally tell you that either, so word your questions carefully and listen to what they DO say
- Make sure you're well over the min. BMI you need (35 or 40) at your first weigh in.
- Make sure you know if you are allowed to fall below the minimum (35 or 40) BMI during your 6 mo. (see second bullet point above). None of the three hospitals I intitially looked at expected you to lose more than a few 5-10 pounds and not go below your min. BMI. I've seen so many complain about how counter-intuitive this is (I did too), but some people have to go through so much more than this to get ins. approval that it's laughable to complain about this. I should say that I've seen some ins. co.'s that want to see a certain % of weight loss (5-10%, or sometimes it's a specific # of pounds the surgeon gives you to lose) and they do want you to succeed. Those stories are less common, they seem to be mainly people who are well above the 40 BMI and I'm not sure even then if you can go below your min. BMI.