Alexandra

I don't think there's any general distinction that can be made in this regard. Every doctor has his or her own feelings about WLS, and whether the degree is D.O. or M.D. makes no difference.

Penni, that's very exciting news! So good to hear you have more options open to you. And it's wonderful that you have an avenue that will cover Dr. Billy!! You are in the best possible hands, and that must be a huge relief for you. How/when you can change your insurance depends on your employer and the laws in your state. In NJ you can only switch during open enrollment, which is the annual anniversary of the plan. So you might have a wait in front of you, but whenever open enrollment comes around switching shouldn't be an issue. Good luck with whatever you decide. I'm rooting for you!!!

I agree, Leatha. Lucky has very clearly summarized what seems to happen in long-term bandsters. The take-bottom line is that we get different signals that we're overdoing it--reflux, etc.--but they can be just as reliable a message to eat less. They're just less immediate messages.

Kittylover, there isn't any one "form" to use for an appeal. If your carrier has specific procedures they want followed, you'll have to get that information from them. Generally an appeal is just a letter with any additional information that wasn't provided earlier, and it's VERY important that you know exactly why the initial request was denied. Your appeal should address the precise reasons that the carrier denied you in the first place.

Vera, you are absolutely beautiful, please know that. Congratulations on 3 years and getting to your goal!! You have so much to be proud of, and it looks like you're really enjoying your life and family. Well done!!!

Wow, it is so good to see you back! What a nightmare ordeal, thank goodness it wasn't worse. How wonderful to hear that LBT played some small role in your convalescence. :biggrin1: Take extra good care of yourself, sweetie! It's great to see you!

BandedBandit, I just got another tiny fill after about five months of being totally unfilled. Now my fingers are crossed that things will stay cool. When I went in this morning I was totally prepared to be told that I couldn't get any fill, and I would have gone on my merry way. The worst thing would have been being told that my band would have to come out! What I'm saying is...why would you remove your band completely even if you are unable to get a fill? You said your idea of a decent portion has changed, and so has mine. But would it STAY changed if the band were out of me entirely? I have no confidence that it would. Even though I'm at least 40 pounds overweight by "normal" standards, I am no longer 150 lbs overweight and that to me is a HUGE victory. As long as I don't go back THERE I feel like it's all been worth it, and continues to be worth it. We have to make peace with our bands if we want to keep them long term. If that means we reach a point beyond which it's no longer adjustable, then that's what it means. As long as it's in the right place and not causing me problems, I'll take whatever intake-limitation it can provide, for as long as I can get it.

That post was very funny and I'm sure intended to be hyperbolic, but I want to inject a note of seriousness here too. If anyone's personal trainer is anything less than understanding and responsive, get a new trainer. I started out with a trainer when I was 250 lbs and had been "working out" for a few months. I was in no kind of shape at all. My trainer was a body builder named Steve who intimidated the hell out of me as soon as I saw him. But within a few minutes it became clear that he knew what he was doing--this program was about ME and not about what other people could do or some benchmarks he insisted I hit. If he put me on the elliptical it wasn't to go for 10 minutes at a certain level no matter what, it was to go until my HR hit the right number and then to sustain it for X minutes. Lifting weights was about seeing what I could do and then continually trying for just a little more each time. That's the sort of consideration and care we all deserve, and if a PT isn't delivering we can walk out the door. No one should pay to get abused.

I'm heading for bandiversary #3 on August 20. In my experience, people who have been banded this long and who don't have problems simply drift away from support boards. There's very little to say or read that hasn't been repeated a million times, and unless there's trouble there's no point in hanging around. The most successful bandsters are the ones you WON'T hear from, because they're off living their lives. To be honest, it's one of the reasons I remain a moderator; it makes me come here and read up on things. It reminds me that I am a banded person and my weight has always been a problem for me (even if it's not right at the moment). If I weren't a moderator I'd likely have dropped away too.

Is it so hard to tell the difference between criticizing our country or its government (OK to do here) and calling another poster names (not OK to do here)? Please remember the terms of service you all agreed to when you joined LBT, and refrain from insulting other members. This is the last time I'm posting a warning on this thread; next time it will be locked.

This area of the board is for discussion of any and all topics for whomever may be interested in partaking. Bill, while you are of course welcome to comment on other posters' material, please keep away from making personal comments. This thread will have to be locked if we can't keep it from getting insulting. Thanks.

Again, that depends on your carrier. If you're going to a surgeon with cash in hand, there will be no requirement for any documented past attempts. That is strictly an insurance hoop, and not all carriers have it. And holy cow, what kind of doctor would tell you to "find Jesus"? I hope he meant that figuratively. Anyway, treatment for hypothyroidism wouldn't count as a documented attempt at weight loss; it's just treatment of an unrelated medical condition. Are you seeking insurance coverage? Have you spoken to your carrier?

Heartbreaking news. Thanks for letting us know, Greg. Ryan will be remembered in our hearts for a long, long time.

The one I hate is when they solicitously ask "how are you feeling?" with this concerned look on their face. Hello, I've been banded for THREE YEARS, I'm obviously feeling fine!!

Hi Shannon, These are requirements that vary depending on whether you're self-paying or trying to have insurance cover it. And then it varies from insurance carrier to carrier. Call your doctor and insurer and see what they say. My carrier was one that sets a high bar when qualifying people for bariatric surgery. They say that the BMI just be >40, or >35 with comorbidities. The patient must show that he or she has been morbidly obese for at least 5 years and be able to recount other attempts at weight loss and control. There must be a recent 6-month attempt with doctor supervision, and of course the usual nutrition and psychological evaluations. My guess is that if your carrier covers bariatric surgery, their requirements couldn't be any harsher than these.

Truer words were never spoken. If there were any other way for me to REALLY lose 65% of my excess weight, I'd have tried that too. This is the only thing ever that has allowed me to lose even 30% of my excess weight AND KEEP IT OFF. It was those last four words that got me onto the table and will keep me forever grateful for the band.

Sounds like you could use a fill. Why the reluctance? Your band was designed to work best when it's adjusted precisely for you, and now is when that happens. Go for it!

Lucky, I know EXACTLY what you're talking about. I even think I posted about it in precisely those terms: non-acid reflux. It's reflux, though, no question about it. It's a tad less unpleasant than if acid is involved, but no less a sign of a negative situation. You are too tight. You might also have a slip or hernia situation, but not necessarily. At this point it may be due to swelling, so baby yourself and it may pass as your body gets used to the fill. After a while if neither behavior modification nor medication is helping, you may need an unfill to set things straight. Don't fear the unfill. It's a MUCH better tack to take than risking some damage. And it doesn't necessarily mean you'll gain weight. You'll sleep better, be able to eat better, and after some time has passed you'll see where you stand. The band is ADJUSTABLE, remember, so don't be afraid to have it adjusted. Your health and comfort is the most important thing. :hug:

Banded or not, I would have stayed far away from anything like this. I see why you're asking the question, though. IMO being banded would be deemed an "unfair advantage" if anyone found out, so I wouldn't enter such a contest unless everyone knew and had agreed in advance that it was OK.

Shel, I am SO glad to hear you're doing better!! My fingers are crossed for us both on the 17th. Let's get through those appointments with no forecasts of doom, leave with perfect restriction, and NEVER have to fiddle with this puppy again! :Banane27:

Ah, now I understand. Thanks. I don't think it's worth burning any bridges over. It wasn't like he harmed you in any way, after all; people get imprecise fills and unfills all the time, just usually not on purpose. Arrogant doctors are all over the place, and you now know where one is so you can avoid him. If he does this to lots of people his reputation will suffer, and so will his practice. Gack!!

Well...I don't know about awesome , but I am not at all unhappy. (I hover between 210 and 220 and that is a range in which I can't even detect the shifts. That's why it's so funny to me when people freak out about three pounds up or down, because I routinely go 5-8 pounds up or down and can't even tell.) Oh, I COMPLETELY agree!! My inclination was to do the same, but my doctor wanted a followup fluoro to see how the issues I had back in March have resolved. So I was going to do that anyway when my new insurance kicked in (which it did, August 1.) But over the last couple of months I've been aware of having to consciously fight hunger more frequently, to the point where it's actually interfering with my life. And I'm eating too quickly again. I'm hopeful a teensy fill will help with these things and NOT make me so tight that it's ... interfering with my life. If I can't get that fill I will absolutely be satisfied and happy. What would be the worst is if I get the fill and in two weeks am suffering through my vacation with heartburn, reflux, inability to eat and sleep, and have to go crawling back to my surgeon for an unfill and possibly risk a slip or more esophageal problems. THAT is totally not worth the few pounds I would lose in the process. My appointment is the 17th, and I just bought a bunch of Protein shakes and even aloe vera juice for the few days following. I am going to be as careful as humanly possible about babying the new fill so as to avoid problems.

Shelly, Leatha, and Babs, I too completely understand your perplexity. I too think it's an ever-evolving situation with long-term bandsters, and our own experience is the only guide. What's true for one person just will not be true for another. Shelly, I hope and pray you find the answer and can reach a settlement with your band! Babs, you too. I'm heading in for another fluoro test and maybe small fill next week, and am determined that this one will be my last. If there's any hint of a problem on the fluoro, I'm going to say no thanks to the fill and go about my merry way, facing a lifetime of not-restricted enough to lose weight but restricted enough to help me keep my weight stable... ...for the rest of my life. *crosses fingers*

These are worth repeating. If you weren't sure you needed an unfill, why did you seek medical advice on the matter? If you were eating OK and not having trouble, what made you think you needed an unfill? A great piece of advice about banding is don't mess with a good thing. We can be surprised how much difference is made by what we think is even the tiniest adjustment in fill, whether in or out. So if we are at a good place in our restriction the best rule of thumb is always: let it stay the course. I completely agree the backup doctor's action was wrong, though. I'm sorry you went through that. Some doctors are just so condescending!!

Hi Michaelms, Welcome to LBT! I'm coming up on three years banded and am settling in for the long haul. The band is designed to be permanent, but like any implanted medical device things may happen that require maintenance or removal/replacement. It's only been in use for 15 years worldwide so there's not a large body of information on the very-long-term, but I'm hoping to find out! As far as what happens when you reach ideal weight, you can always have the band adjusted if you're having any trouble getting in enough calories. (That's the beauty of it!) In my experience, as I lose weight I lose a bit of restriction along with it, so I don't expect to have any problems at all getting in enough calories. When and if the band is removed, there is unlikely to be any long-term complications. The shape of the stomach may have been permanently altered, but it will still work the same way as before banding since no systems have been altered. There are several people on this board who have had their bands removed, and as far as I know none of them are dealing with any resulting complications. Keep asking questions! :biggrin1: