Alexandra

It can be soooo frustrating to have what look like road blocks thrown in your way when you first hear about the band and are so convinced it's the right step. Believe me, I know. It took me almost a year from the time I went to my seminar to the time I was finally banded. But this can be a very valuable time for us! Bariatric surgery is no small thing, and NOT something to be entered into lightly. When kismet throws up obstacles, we should use the opportunity to take a deep breath and keep examining the situation. Dogged determination is what it takes to be successful with the band, and this is a great way to practice that quality. I personally feel that being close to your doctor is among the most important things when it comes to banded life--you'll need access to support groups and possibly medical care, and you don't want to ever have to say "I can't go because it's too far, too expensive, too..." Don't give up!! The band is spreading across the country and that doctor who has now done only 12 may well have done 50 by the time it's your turn. So don't hesitate to get in line. Keep studying, keep asking questions, and start working on your health. All of these things will stand you in very good stead when it's time to go under the knife.

Hi Ruthie, Sorry to hear about your slippage. I know there have been instances where an unfill resolves the situation, but I don't know how common that is. My band had to be removed a month ago due to slippage, but I'm getting a new one on June 4 so all is not lost. The great thing about the band is that even if the "worst" happens and it has to be removed, our stomachs are still whole and functioning normally. Good luck, and be very gentle with your tummy!

Kimmie, check the Insurance section for sample letters. Look in the thread titled "Just Starting to Explore Options..." The text of your letter depends very much on the specific reasons you're appealing. Or are you just writing something for your first request? What's the subject of your letter?

Yep, Kathy, your specific insurance policy can have all sorts of riders and exclusions if your employer is large enough to negotiate them with the carrier. Call your human resources department and make sure you have the documentation on your policy that lists all the exclusions. If you DON'T see bariatric surgery on that list, then you need to do further exploration. If you DO see it, then you might have a problem. It's very unlikely your employer would be able to modify the contract until the next anniversary date, even if they want to.

I'm not big into jewelry either. The diamond on my engagement ring is from my grandmother's engagement ring that she gave me on the occasion of my first engagement. It's an old-mine stone that I've had reset more than once. Both of my husbands gave me enhancers for the ring when we got engaged, rather than new rings; the one I have now is sapphire and diamond. (I had the diamond enhancer from my first marriage made into earring jackets.) I also wear a necklace with two gold charms; one a seagull my DH gave me on our first Valentine's day, and the other a mother-and-child from my first mother's day. I have other charms for the necklace but I almost never change them. My DH loves to buy me jewelry on the rare occasions when he can, and it's always real and small. I have a great collection of small, dignified earrings that I love--from opals to amethysts to garnets to diamonds to alexandrite to pearls. He's had a couple of pairs designed for me, too. But my ring and necklace are always on me; they don't come off. Our 12th wedding anniversary is next month--there's a little box in his nightstand that he doesn't know I know is there. I haven't looked in it, though. I like surprises. :biggrin1:

Hi Rainer!! I've met your nice hubby in real life, and I can't wait to meet you at a support meeting. You and I can be baby bandsters together, since my re-banding is scheduled for June 4 and it feels like I'll be starting from scratch. Welcome to LBT, and I'm sure I'll see you around!!

Wow, Evilah, did you not have any symptoms? That (minus the hiatal hernia) was my diagnosis before my unfill last year. Esophagitis and gastritis are usually pretty painful! Or maybe these are just diagnoses the doctor put down so insurance will cover the tests? If you actually have these conditions and don't feel them, you might want to talk to your doctor about whether banding is right for you. See, the success of banding relies on the patient being able to sense when he or she has had more food than the pouch can hold. In people who can't feel that (such as can happen with long-term bandsters) they can easily eat more than they should and risk slippage, or even damage the esophagus. This is pretty much what happened to me after 3.75 years. If you already have descreased sensation in those areas, you may really have something to think about.

I'm going in for my RE-banding on June 4 with Dr. Abkin. I'm so psyched and can't wait to get back to bandland!! I'm definitely going to the support group meeting on the 30th at Abkin/Bertha's offices. Anyone else going to be there?

I don't think there's any way to definitively determine the cause of a slip, unless it's obviously due to some physical trauma. They can happen over time or immediately, and if it's the former who knows why it happens? I don't really care, I guess. All I know is that I'm going to be VERY careful when I get my new band. Popcorn, on which I know I overindulged a few times, is a thing of the past.

I also love Promax bars, and any Atkins bar other than the granola-type ones. As for price, the best prices I've found for any brand are at Trader Joe's. I don't know what it is about that store, but they are just always cheaper than anywhere else!

Somethingelse, your insurer will likely have a formal policy with regard to fills, and your doctor might know what that is. Certainly a number of fills/adjustments should be covered, since they are an integral part of the treatment--the surgery itself is only the START of the treatment. But carriers are slow to comprehend the nature of gastric banding, and some have placed limitations on fills by creating arbitrary schedules, or putting a cap on the number. Call your carrier and ask. That's the only way to know for sure. Even so, they will probably say something like "indication of coverage is not a guarantee of payment" which is standard CYA language in the insurance industry. They won't ever make any promises; it all depends on how the claim is coded when it arrives.

Yikes, Sunta, that is really unnerving! I know that allergy congestion was a big source of my issues, and water retention from other reasons also contributed to tightness. Good on you for getting immediate attention.

Anna, every case of slippage is different and the treatment depends on several factors. In my case, the slip was pretty severe and the band had to be removed. When the slip is so bad that an unfill does nothing, a surgery will be required to reposition or remove the band.

That is absolutely BEAUTIFUL! Congratulations!! :biggrin1:

Fills should be covered by insurance, if it covered the banding in the first place, because they are an integral part of the treatment. But you'd have to check with your insurer to see if there are limits or conditions on the coverage.

Oh, no, I meant the regular hay fever kind of allergies. When I get them I get really congested, and when the band is tight everything inside gets inflamed. That's what led to my first spring go-round with internal swelling back in 2006, and I think what started it this last time. I don't take allergy meds year-round and sometimes I'm a bit slow on the uptake when I start to get symptoms. I won't be making THAT mistake again.

Hi Mary, welcome to LBT!! :welcome2:

Congratulations indeed, MsDad!! :nod:

Fluoroscopy is an x-ray that shows moving images, like an x-ray movie camera. That's the way a lot of surgeons do their fills, so they can see exactly what the effect is of adding a particular amount of fluid to the band. It's a very precise tool, but not all doctors do it that way. It adds to the cost of a fill quite substantially, since it's done in a hospital or radiology suite.

Hi Lisa H, Over the last two years of my banding, I'd had two or three episodes of negative symptoms, mostly reflux that happened at night. Each time I had an unfill that resolved the problem, and each time I got refilled I could tolerate less saline and the problem would come back after a while. The last time this happened the fluoroscopy showed a big slippage. Personally, I think my band was too small from the start, since even at my most filled I had less than 2cc of Fluid in my 4cc band. Back in 2003 there was only one band size available; now there are more options. I don't know exactly what caused my slippage, but as I say I kind of think the band itself was too tight from the start. Over time, the sensations in my esophagus got less pronounced and it was easier to eat too much. I think my actions led to it slipping, to be honest, though it might have done so anyway just by virtue of it being too tight at certain times--allergies in particular led to problems, it seemed. As for whether one needs to go back for fills, for life, it seems to me that eventually one has to reach a "happy place" with their band and restriction. There will come a time when either a) we've lost all the weight we want/can/need to; the band can't be tightened any more without serious risk; or c) some combination of the above. Unless fluid leaks out of the band, there's no reason to keep going back for more.

Hi Lisa, I'm going to copy your post into a thread about my rebanding, and answer you there. Just so we don't hijack this thread. Follow this link to the thread about it.

Totally understandable. Well, in that case you may just have to suck it up and pay it. It's not a totally unreasonable amount for five years of unlimited aftercare with fills. $1200/year is what it amounts to, and if you get six or eight fills (under fluoro? Does it cover the fluoro?) and see the doctor a dozen times over five years it starts to make a little more sense. It does cover you no matter how much attention you will need, right? Make sure of that. If you're paying a premium price for access to a local doctor, you want to be very sure you get the ACCESS you want.

I love this option, too. Thanks, Alex! It's a wonderful control feature. You da MAN!!

Many doctors have a "program fee" that is charged for the various things they provide that aren't covered at all by insurance. Things like support groups, supplements, extra tests or publications, all of these can add up and it's the rare practice that supplies them all just for the cost of the medical procedures. So in principle there's nothing wrong with it. But that does sound like a lot of money for incidentals. Fills for five years, though, is GREAT and might be worth paying for that up front since many carriers only cover limited fills (on a schedule, say, or only a limited number or for a limited period of time). All in all, if the doctor can guarantee that this would be the only money you'd be shelling out it might end up being a good value. Another surgeon's office might not provide the various levels of support this one does, and you might be left in the cold or finding that you have to pay for one thing after another. So it's something to consider.

Hi Sheree, It often seems that people are not being responsive, but over time and as you post more you will definitely get into conversations. It might just take a little persistence. Keep at it! :biggrin1: