Alexandra

Bonjeanie, as I understand it the MGB is really not considered a safe and effective surgery. It's not done much at all these days. However, there are lots of other options and almost all of them can be done laparascopically. I know there are many, many doctors who do both RNY and lap-banding who will do one on top of the other if necessary. Your best bet is to find an experienced laparascopic gastric surgeon and talk with him about your specific case. It may be a good idea to talk with more than one, if you can. You might start by looking at the OH website (obesityhelp.com) to locate bariatric surgeons in your area. Good luck!!

The answers to your last questions probably depend on the attitude of the person doing the medical review of your application. It's certainly worth an appeal if it is denied; after all, medical opinions can vary and if your doctor feels you are a qualified candidate for bariatric surgery he will have to make the case.

Hey Babs! Nice to hear from you. I'm sorry you're having trouble finding someone to get a fill from. Maybe there's a FillCenter somewhere in the state? Good luck with everything!

You should ask your doctor about that. I know there have been cases where the tubing is palpable, and in one case I know of it actually eroded through the skin and was visible. I'm thinking this is NOT the way it's supposed to be.

When symptoms like the ones you two describe arise out of nowhere, it may very well be a slip. But it may also be irritation caused by something else, and there's no way to tell without the proper examinations. Good luck with your testing and PLEASE let us know how you're doing!!

The insurance policy was approved and I have my group number in hand. Just waiting for Monday, July 2 when I can fax my new insurance info to the doctor, and they can start with the request for precert. Watch this space for updates!! FINGERS CROSSED!!!

Believe me, I know how you feel. But from the insurers' and medical establishments' points of view there's a difference between a chronic battle with weight (we ALL feel that way, after all) and a chronic battle with morbid obesity. I'm not saying it's smart for insurance carriers to exclude treatment for weight management--but that will only change when something is done on a national level. Im just explaining why it is the way it is.

Karen, thanks for such a wonderful, insightful post! There's not a single word in there I disagree with. You're an inspiration!

My insurer was Aetna at the time, and when I first applied 2002 they excluded the band across the board. Neither Aetna nor my employer excluded bariatric surgery, mind you, Aetna just carved out the Lap-Band itself. They said it was "experimental." I fought that through two appeals and an external review, and finally won. Aetna had to cover my band, and sometime after that they revised their coverage policies and no longer exclude banding from their covered bariatric treatments. BUT: every state is different, and large groups can often configure their own contracts, so it's not safe to say that Aetna covers the band in all situations. In my state (NJ), in small group plans, for qualified individuals, Aetna covers banding in the same way it covers other bariatric surgeries. Now that the band is six years out of FDA approval and is covered by Medicare, most carriers treat it the same way. If coverage is not available it's NOT because there's anything special about the band versus other kinds of bariatric surgery. It's more likely that bariatric treatment is excluded entirely due to state allowances or employer decisions. If you're medically qualified and are seeing any other reasons for denial, APPEAL. It's crucial that we all know our rights and take appropriate, aggressive steps to get the care we need.

If you have had a band for 5 or more years... where are you, weight-wise, related to your over-all goal? I'd had my band for 3.75 years when it was removed for slippage. I lost 130 lbs which got me closer to a "normal" weight than I'd ever thought possible. It was relatively easy maintaining this loss, and THAT was my goal. So I'd say I reached it, in spades. What complications, if any, have you experienced? I had occasional bouts of reflux and irritation, seemingly kicked off by allergic congestion. I also think my band was too small from the start, leading to chronic irritation in the fourth year. What are the best things about the band? The best thing was the control it gave me over food. The incredibly liberating feeling of having a half a sandwich for lunch and NOT BEING HUNGRY for hours was a complete miracle to me. What are the worst things? The hardest part of the whole thing for me was learning that a half-sandwich really is enough food. Learning how little my body needs to survive and thrive was quite difficult. And without my band, I'm finding it impossible to apply that knowledge because I'm hungry. The band gave me the ability to eat only what I need to live, and lose the compulsion to eat more than that. would you do it again? ABSO-FRICKIN'-LUTELY. I am in the process of jumping through hoops to get a replacement band. Whatever it takes, I'm gonna do.

What the carriers are looking for is evidence of a chronic battle with morbid obesity, and I can't say I blame them. They are trying to avoid people who, for whatever reason, have gained a lot of weight just recently and want the band as a quick fix. This surgery is expensive and there are lots of people who might qualify just based on weight, so there have to be other considerations. When I applied my BMI was well over 40, and I'd had two pregnancies in the previous five years as well. I was worried they'd discount the weights from those periods, so I included whatever evidence and records I had from before the pregnancies that showed my weight. In your case, if you've had co-morbidities that required treatment before your pregnancies, medical notes from that time will support your case.

Hotpink, the hair loss is TEMPORARY. I've experienced some hair loss after both surgeries AND after each time I had a child. It's an excuse to cut your hair short (which makes it much less noticeable) and let it grow back thicker than ever before. I know it's alarming, but it's really not as drastic as it seems in the vast majority of cases. Unfortunately, unless you are really malnourished already, more protein is not likely to help (though that's one of the most popular "remedies.") What does help is time and patience.

Hi Jody. Here are the answers to your questions: 1) No, nothing can be excluded as a pre-existing condition if you are coming from another group plan. HIPAA laws require full coverage if you have continuous coverage without a lapse. That's why COBRA exists--so you can continue coverage from an old job while waiting for your new job's insurance to kick in. 2) In general, non-employer groups that provide insurance only provide bare-bones coverage. It's certainly worth looking into, but they're usually last-resort kinds of things for people with no other source of insurance. 3) Every state has its own rules about medical underwriting and whether carriers can exclude you for prior conditions. Check with your state's bureau of insurance or health to find out what the rules are where you live.

Vanessa, if you're having complications you owe it to your self and your health to have them checked out and taken care of. It is not the worst thing in the world to have one's band removed--and sometimes it is a blessing. Keep it all in perspective; remember, this is about your HEALTH not about getting into a certain size. Let us know how you're doing!!

Thanks everyone! I woke up this morning in a really good mood and had to think about why that was for a few minutes. :scalesno: Crossed fingers definitely appreciated!!

Same thing just happened to me. I assume it has something to do with the server tweaks that Alex B told us would be happening. It'll be cleared up in time.

I just clicked "submit" on my application for the new insurance plan. It will go into effect on July 1, and as soon as it does we can start the request for precertification process for my re-banding. Step 1: COMPLETE. Man, I sure hope my doc's office is right and this carrier looks kindly on rebanding. :pray:

Brown sugar is no different to your body than white sugar. It's less refined, is all.

Are you sure that's not your port? Many people can feel their ports.

I just discovered a great new product--Crystal Light with caffeine! They are the "singles" packets that you add to bottled water, and there is a version called "Energy" with added caffeine in Wild Strawberry flavor. I love these singles things because Crystal Light and other bottled flavored waters are usually way too sweet for me. This way I can add one packet to a 32-ounce bottle of tap water and it makes the perfect drink for me! What will they think of next?

As I understand the Federal COBRA laws, you can stay on your plan (as long as the plan stays in existence) for up to 18 months at your own expense after you lose eligibility. The plan you continue on will be the same plan you were on as an active member; the group can't change your plan unless they are making overall changes to the entire group's plan. Check with the HR department at Tufts, but I'm 98% sure that's the way it will work in your state as with all the others.

Fingers crossed, I'll be a REbanded newbie on August 13. There, I said it. I've been scared to post in this section for fear of jinxing it. But I'm on board, once again, as an August bandster!! (Even the first time around I was an August bandbaby.) It's a great time to be banded!

Well, what are the things you want to know? How much do YOU know about the surgery and program? For my money, the most important thing when shopping for a banding surgeon is the breadth of the practice. I mean, does he just install as many bands as he can and send people on their merry ways? If that's the case, even a doctor who has done thousands isn't a doctor who is going to help much. I want a doctor with a robust aftercare program, well-run support groups, an individualized protocol for fills. If all that is in place, I'd not worry even if he's only done 50 or so bands (though I realize that's an unlikely combination of features). Think about what you want to know about the procedure and the treatment, and write your questions down. Then listen to his answers, and ask followups. Remember this is a two-way conversation; don't let him do all the talking. I just realized you've probably already had it by now. I'd be interested to hear how it went.

Hi Regina, At the moment LBT is in the process of moving to a new server, and there are all sorts of things that need to be tweaked, I gather. I'm moving this thread to the appropriate section so the owner will see it, and I'm sure he'll fix whatever is broken as soon as possible.

Rachel, I'm so glad you had an unfill! That will allow you the space to take the best possible care of yourself and heal up. Once you DO start to feel better, though, take care to not overeat because you think you "can." Once you do go back on solids, take it very slowly and carefully. Try to remember how lousy these last few weeks were and realize how easily you could be right back in that same place. Take good care!!