FXDF2008

Spoke with the M.A. at my surgeon's office this afternoon. Asked the following questions and received the following answers. If anyone can suggest other questions I should ask when I meet my surgeon, I would appreciate it very much. 1. From your experience, are removals and revisions generally covered by employer insurance even if the original surgery was either self-pay or covered by another insurer? A. Removals are usually covered as they are considered a complication and medically necessary. Revisions depend on the coverage. 2. If they do cover the revision, do they typically require the mandatory six month weight loss program requirement? A. Insurance requirements are rapidly changing - hard to say at this time. 3. Pending the results of the endoscopy, would it be harmful to wait until my new benefits take effect at the beginning of the year before removing the band? A. Depends on the results of the endoscopy 4. Could the removal and revision be done at the same time? A. No. You need time to heal from the removal 5. How many removals and revisions has my surgeon done? A. Quite a few (no numbers provided, will ask surgeon directly) 6. Generally, how long is the recovery for the removal and for the revision to the sleeve? A. Removal of the band, about the same length of time when having the original surgery. Revision depends on the patient. 7. Is the removal procedure inpatient or outpatient? A. Usually outpatient 8. Typically, how long is the hospital stay for the revision. A. Overnight 9. Is there a stomach tube with the revision? How long does it stay in? A. Sometimes. Depends on the patient. She informed me that she will contact my PCP in the morning to make sure they have all the information they require in order to make the referral for my endoscopy. They want that done ASAP. She also suggested that I speak with a rep from BCBS during open enrollment to discuss my specific situation and what actions I need to take to assist in getting approved for the revision. I know that everyone's situation is unique and everything I asked here may not apply to your situation, but I hope that my experience can help others in similar situations.

Hi CowgirlJane, I know that BCBS AL does cover the sleeve. I just don't know if they cover revision after band failure especially if the original procedure was either self-pay or covered by another insurer. This remains to be seen. I am currently waiting for a call back from my bariatric surgeon and have a boatload of questions written down so hopefully things will be somewhat clearer this afternoon.

I have had my band since February 2007. Yesterday, I went in for an upper GI to check and make sure my pouch hadn't stretched. I haven't had any pain or discomfort, no vomiting, or acid reflux. My only complaint was that despite having an almost full band, I could at times eat much more than I thought I should be able to. Hence the decision by my doctor to do the upper GI. As reference, I began at 277 before my lapband surgery. I got down as low as 183, bounced back up to 223 and am now sitting at 211 with a BMI of 32. My goal weight is about 165. This is in a period of almost four years. When I drank the contrast liquid, we watched as the Fluid went down the esophagus, into the pouch, and through the stoma. We also watched as some of the liquid went AROUND my band! The only way that can happen is if a portion of the band is now INSIDE of my stomach. Preliminary diagnosis is band erosion. Next week I will be scheduling an endoscopy to determine the extent of the erosion and see how much damage has been done to my stomach. In the brief conversation I had with my doctor after the discovery, he stated that the only option for treatment is removal of the band. You could have knocked me over with a feather. I have become dependent on my band and to think of not having restriction is a scary thought for me. Like others, the thought of going back to the weight I was at before is not an option. My doctor has indicated that once the band has been removed and I have healed from that surgery (after about four months), I can either be re-banded (I don't think so), or I can do a revision to either bypass or gastric sleeve. I am not keen on the idea of bypass. It just seems so extreme and there's no where to go after that surgery. So I am leaning towards the sleeve. From everything I have read, the majority of people who have had this procedure are very happy with it. Yesterday was spent trying to wrap my head around the prospect of having two surgeries next year. Talking with my family and trying to understand my options. I am fortunate in that my situation is not an emergency. There is no infection and I can eat properly. (The doctor did deflate my band completely). I also have insurance through my company and the enrollment period is coming up in the next couple of weeks so I can make decisions accordingly knowing that I am going to have these surgeries. It is still yet to be determined if my insurance company (BCBS AL) will cover either surgery (scary thought), but I'm willing to fight for it. I was self pay for my band so I don't know if that will impact their decision or not. I know they do cover WLS and have the typical six month waiting period (not sure I would have to do that given the circumstances). I will be posting here with my progress and experience for the benefit of others who may encounter similar complications and decisions. I would very much like to hear from others who have had band erosion and have done the revision to the sleeve or those who have the sleeve and what their experience has been with that type of surgery. I can't believe I'm at this point again. Ugh.