dishdiva

Way to go, bulldog. I'm getting ready to leave my job and was trying to decide if I'd stick with Cigna under COBRA or buy a new policy. I wanted to buy a United HC policy since they do cover it, but they don't sell individual policies in my state. Bummer. To answer the original poster's question: Cigna was a nightmare for me. They verbally gave approval to my Dr.'s office and we scheduled the surgery. Then, they denied the claims. I appealed, used a lawyer, etc., without success. Now I have to have the band removed and they just denied pre-approval on that. Memo to my family: if I die of band-related complications because Cigna wouldn't pay for the removal, please sue Cigna. Good luck.

I used Walter and thought he was fine; didn't successfully resolve my situation. I know he's been successful with others. I felt it was money well-spent because I could walk away knowing I did everything possible to fight the insurance company.

There's also a code for band removal, I'm told by my surgeon's office.

Hey Peach: Just curious, did you have your surgery in Georgia and if so, who was your surgeon? Congrats. Elizabeth 08-28-03 -60

I've had the same problem -- coughing with liquid "refluxing" out of my nose/throat. Soooo miserable. An unfill didn't remedy my situation, although I know it does most people. Alexandra offers great advice. That has helped me in the past. Sadly, I am going to have to have my band removed because these episodes are so bad and miserable that they are not worth it. I'll have about 10 good days a month, on average. And one week is typically really bad, with difficulty getting liquids down...or fluids get so "stuck" that I have to induce vomiting. My best guess is it's related to my monthly cycle and Water weight?? I'm so tired half the time that it's affecting the rest of my life. I had a slipped band once before that was re-positioned and I'm guessing it has slipped again. Did a barium swallow, but Dr. couldn't tell from that if it had slipped. Anyway, I'm sure everyone's situation isn't as dire as mine... especially since I think you have fills that can be reduced. Again, see Alexandra's advice above and hang in there... so often it does get better. Elizabeth 8-28-03 -60

I'm so glad you found this board, which is so wonderful for support for everyone. Pre-banded. Banded. Not banded. Everyone. I've had problems with my band (currently working on insurance for removal), but yours sure do help me put it all in perspective. Thanks for sharing and best of luck to you with your recovery and weight loss maintenance!

Do you have a fill??? An unfill typically helps. However, there ARE some people on this board who had their band removed because of unresolved reflux that did not respond to medications. I'm in the same boat...only bland diets and eating early helps...doesn't eliminate. Not what I signed up for. I will likely have to have mine removed. I did NOT have reflux ever beforethe band.

People magazine had an excerpt from her book and she doesn't admit it....more of the same -- portion control and hard work. Guess she's like the rest of us on the boards -- some of us tell, some of us don't. Never thought about the lawsuit angle. Seems that would be a stretch for legal grounds. No one's suing Carnie Wilson or Al Roker, are they?! Or who's the singer with the band (who disappeared

Isn't it crazy how some of us have huge tabs and others very few. I get ill thinking about cost per pound...but I'm up there. Lisa, why so much for your removal surgery???

Since I've had continuing problems with my band -- which I'll detail in another post soon -- I am faced with the liklihood of having my band removed. Last night -- one of those middle-of-the-night thoughts...I decided when I have it removed, I want the band. I paid for it, after all. Then I read Lisa's post about her removal and Jack's question about Dr. Billy letting her keep it. (He didn't; said it had to be returned to Inamed.) Well I say if Inamed gets it back, we're due a refund. On my bill for my original surgery, I think the band itself was billed at $5000! I'm half kidding; the money spent went for a product that did do its job...for awhile. Warranties?!!! VERY hypothetically -- what if someone thought the band was flawed and caused their problems and wanted to have the band "studied" by someone other than Inamed, say for legal recourse. That is NOT where I'm headed, at all...just curious that you can't keep it. I do know Inamed has to report problems to the food & Drug Administration. One of us should probably do some online digging to see what the latest findings are. Anyway...for another day. Just rambling...another night of insomnia because of reflux and feeling like I have a huge fill when I actually have no fill. Yuck. Tomorrow is another day. Elizabeth 8-28-03

Hi Diane: I was banded in August of 2003. Lost about 55 pounds, most of that in the first year. Good luck to you...do you have a date?

Great point, Megan. I was banded a few months before you...also have challenges with depression and like everyone on this board, am an emotional eater. You are so right...it IS so hard when you can't use food in the way you've been accustomed. And lots of us didn't "THINK" we were using food...but, oh yeah. Laura, you have great support in the wonderful people here. That is one blessing you can count!

And does anyone know how long you can go with a slipped band that's been unfilled? I went nine months before having it re-positioned. The Dr. said I shouldn't wait "too long," whatever that meant. And don't some people walk around with a slip without ever knowing it? Tough Enuff, noted that you've lost 50 pounds. GREAT! Is that putting a dent in your goal? That would be a factor in my decision. I'm in the same boat. Cash pay original surgery. Fluke that insurance paid for re-positioning. Afraid I have a second slip and then what?! I don't understand how an insurance company can deny something if it's medically necessary and if the band slip is threatening your overall health? I've also lost 50 pounds, about half my goal. But, I feel like with the start the band gave me, if I did have to get it removed, I would have a good jump start towards getting at least a little more weight off. Good luck to you. And get that unfill ASAP if you haven't already.

Sounds like you've got the right game plan. I had Cigna PPO as well and was denied through the appeals process (with a lawyer). They claimed no medical necessity although I met requirements. Ended up paying myself. Good luck!

I was rebanded in March of this year after a slip that occurred about a year after my original surgery in '03. I haven't heard of any stats on slips for re-banders... but it's probably about the same as it is for the rest of the band world. Although I would guess rebanders are more careful the second time around.

I also was cleared for mushies earlier than most by the nutrionist because I wasn't keeping liquids down. Then I moved to solids probably way sooner than most. I'm big on testing boundaries..."let's just see how far we can push this band..." Did it cause my slip? Probably. I'll never forget after my revision surgery, I told my surgeon that I had zero restriction, unlike the first time when I got full after two teaspoons of Jello. I said something like, "I feel like I could eat as much as I want..." his reply was "DON'T." Not exactly great advice for a fat girl. Anyway, I still push my boundaries because I feel like my band hasn't been working right from the get-go. Would my outcome be different if I was 100 percent compliant with doctors orders -- sometimes ambiguous...sometimes conflicting with other doctors? Who knows? Elizabeth 8-28-03 -49 and holding steady

My revision was covered under diagnotistic surgery code...with a different surgeon than the one I use now. I might need to have mine removed, but the staff of my current surgeon seems hesitant about going down that coding route.

I'm with them...sounds like your band is too tight. I know the feeling of being so miserable you make yourself vomit. But BE CAREFUL. I had a slip last year and it's probably from vomiting. The trick is to avoid getting to that place of misery that the only relief is making yourself sick... Elizabeth 8-28-03

Oy vay.... Lisa, so sorry about your problems. I know from my own complications that just having the dang band out of you will make you feel better. And it's given you such a great head start on your weight loss...I know you'll do great band-free. I totally know that feeling of something's not right. I've had it for awhile now. And I had recent endoscopy and barium swallows with people unfamiliar with the band... how would they know a stretched pouch if they saw one?! I think that's a big part of the problem -- in general -- too many medical personnel aren't familiar with the band and recognizing problems. Only the surgeons are. But they're sending patients to radiologists and gastroenterologists for these procedures... Anyway... I missed my Dr.'s call yesterday to discuss results from recent barium swallow...he said it wasn't an emergency, so that's good. Will update you guys when I know something. Hang in there, Lisa! Elizabeth 8/28/03 1 slip. 1 revision. Lots of reflux. No fill. -49 and holding steady

...and that 25 percent probably includes people who might have lost a little weight, not goal weight, because of slippage, erosion or other complications... and some complications are a direct result of "user behavior." Elizabeth Banded 8/28/03 -49 Unfilled & Holding Steady

I'm not kidding you...I think I had a piece of plastic in the Lean Cuisine chicken Enchilada a few years back!! I also remember something funky with a Healthy Choice product -- not as gross as a cockroach. And, I had a bone in some StarKist boneless albacore tuna not too long ago. I guess these things happen, but they can do better than coupons! Hope the plastic wasn't too disruptive on your band -- or elsewhere. Elizabeth Banded 8/28/03 -49 Unfilled & Holding Steady

I may have missed it somewhere in this thread, but what the heck is PCOS?????? Elizabeth 08-28-03

I've had that problem...as have others. You're lucky you've lost most of your weight before the problem kicked in. Do a search of some of the threads using acid reflux in the search box... you'll find some ideas (stop eating early...flush out the pouch drinking Water...try taking something like pepcid before bed... raise the headboard a few inches...) I have the same thing...throwing up whatever's left helps a bunch. But hardly a good remedy since hurling can damage band/increase slippage risk. I'm probably going to have to get band removed if it doesn't resolve somehow. Prescription meds haven't worked. Do you have a fill? Taking the fill out or reducing it is helpful. Good luck to you. Elizabeth 8-28-03

Thank you Paula... you guys are right, as usual...sticking to liquids helps FOR SURE. Dr. reviewed my endoscopy report, etc. and we decided to do a barium swallow one more time to get more information.. re: pouch size and band placement. He'll compare it with the one I had done shortly after my March re-positioning surgery. I'll get an appointment hopefully the week after Thanksgiving...and will update everyone as soon as I know something. Reflux is better... not gone, but better. He advised nothing solid after 5 p.m. -- and avoid fatty and spicy foods. Knew about the spicy, but give up my favorite fatty foods??? Okay, okay! And remembing to not lay down after eating! Thanks so much everyone!! Elizabeth

You guys are the best! After being miserable for a few days, it was such a relief to suddenly remember I could come here for some band love! I did call the Dr. and have an appointment for tomorrow. Have my report from the endoscopy and went and picked up my films from two barium swallows after my re-banding in March. So I'm armed! And, things did improve later today. Don't know what it is -- all of the sudden I'll start feeling better....kept a little bit of food down... so yay me! Updates to follow. Elizabeth