luv2laugh

I had a 2nd band put in 2 years after the first due to a slippage. I went on liquids for a week before the operation to get the inflammation down, and my surgeon was able to put in a new band at the same time he took out the slipped one. He warned me that he wasn't going to be sure he could put the band in @ the same time until he went in and saw if there were any complications. I found the 2nd time around much easier.

Yes, they finally paid for the removal AND the replacement after multiple denials, and asking for more information. The total ended up being $21,000. I even sent them a fax with everything I went through explaining that I had to have it put back in or I would gain all the weight back, and end up back on high blood pressure meds, a c-pap, etc. In the long run, it would save them $$ by keeping me healthy! Good luck with your appt tomorrow. I was contemplating doing a gastric sleeve revision, but my doctor had only done 1, and we didn't have enough time to get approval. So, I figured if the lap-band has another issue, I'll change it then.

Just an update - Insurance FINALLY paid the bill ($21,000 total) after multiple denials, and doctor sending new requests for coverage. Most insurance companies just keep denying patients hoping they will give up. DON'T - keep fighting, cause in my case, we won. :thumbup: WOOOHOOO!

After having a barium xray swallow and showing my stomach prolapsed up through the band, I was scheduled for "must-do" surgery. Got a denial for $14,000:eek: (plus $3,000 from anesthesiologist) for everything. Doc sent an appeal saying it was an emergency, had to be done, couldn't live with the band that way, etc... Also stated I had been slowly losing, until the surgery, and now that I'm not at my sweet spot, has gained a couple pounds. This basically shows that I NEED a working lap-band® in me to keep from gaining the 90 lbs I had lost. Well, now they approved the removal, but DENIED the replacement band. Apparently, my bmi is 39.9 (needs to be 40 to be covered or between 35-39.9 with a co-morbidality) and I'm too SKINNY for the replacement band to be covered. Doc is putting in a 2nd appeal. For some reason the hospital and anesthesiologist never sent their own appeal (I thought the doc doing it was enough, but it isn't). What do I do? Is my credit going to get all screwed up? The $14,000 bill from the hospital was 30 days overdue on Dec 5th... I called and told them we have asked for an appeal. My husband and I are beside ourself. I am scheduled for a fill on thursday, but I don't want to go because I don't think they will cover that either! The good news is my new insurance (BCBS PPO) starts Feb 1st, and I think fills should be covered because it's a medical device that's already in me?? (but there is a $1500 deductible per member, and $3,000 per family) My current insurance is United Healthcare. Any suggestions? Do I need to hire a lawyer?:rolleyes2: Oh and the total kicker is the hospital didn't weigh me the day of surgery... they asked me how much I weighed.. I said 217... (last dr's visit").. However, it was more:unsure: (since I got unfilled because I couldn't swallow my own spit. then I could eat more), but I said the lesser number because I didn't want my surgeon to be upset that I gained a few pounds ... Brenda

Sweetsue - I don't understand why the doc wouldn't question the diminishing "fill" from the band? I would suggest flourscopy/barium swallow to make sure you didn't have a slip (of the band). I had really bad heartburn, and after throwing up a lot, my stomach prolapsed up through the band and had to have the band removed surgically. (I had a new one put in). At the point where I couldn't swallow my own spit, :tongue2: I had a total unfill, and I thought it fixed the problem. But after the doc saw my flouroscopy xray, he said my band had to be removed. He said even though the swelling would go down, it would keep happening because the band slipped. I am now almost 2 months from my revision, and feel great. I am able to sleep lying down again without choking. I do not have to take otc heartburn pills anymore, etc. However, I'm still not at my sweet spot, and have gained a few pounds. BUT, I do not want to rush my fills, for fear of overfilling and redoing the damage again. :biggrin: It must be hard to have to pay out of pocket, but I wouldn't get another fill until you can eat normally without throwing up. Good luck in whatever you decide.:smile2: Brenda

Hey Typo - 1st step - you are here. 2nd step - you realize what you did in error, and are willing to change. 3rd step - Let's try and keep motivated - I was banded 2 years ago, just had a revision, and want to start losing again too. I need to plan out my food, keep the crap (slider foods) out of the house, and get to the gym at least 3x's a week. I am commited to it. Brenda:thumbup:

I'm in a bind myself. I have United healthcare, and had no problem getting my surgery paid for in 9/07 since I was morbidly obese. On 11/5/09, I just had a revision surgery to remove/replace my LAP-BAND® VG to a LAP-BAND® APL... Doc said I was all set. I called and they didn't say I wasn't covered. Today, I just rec'd a letter from UHC saying my surgery is NOT covered. WTF???? :thumbup: I am very upset.. I HAD to have the surgery. It was NOT optional. Their reason was that I was NO lONGER morbidly obese, and therefore was not able to get the surgery! Not too mention, without the surgery, my stomach had prolapsed up over my band, and 1 night I coudn't even swallow my own spit.... Will keep you posted. Brenda

You should not have to suffer like that. :biggrin: Ask your doc to do a barium swallow under flourscopy to see what's up. If nothing shows on that x-ray, ask for a endoscopy which is a scope that goes down your throat. If you are throwing up, your stomach is probably inflamed and you should go back to liquids for a few days and then mushies, etc.. and try to ease back (like when you were first banded). BUT, definitely go to the doctors to help diagnose why you can't eat like a normal person. If this doctor won't help, get a second opinion. I had issues, and just thought it was "normal". It wasn't until I mentioned to my doc about my heartburn, that he told me to get in the office right away to get some tests done. I was rebanded a couple weeks ago, and I feel FANTASTIC.:biggrin: I wish I did it a couple months ago!

yep - it happened to me too. I was just rebanded on Nov 5, 2009. (originally banded 9/07). I started getting reflux off/on. It progressively got worse. I was taking pepcid AC every night. Then my friends noticed I had a "little cough" during the day. (I did it so often I didn't even notice it!). Couple times I woke up with acid coming out of my nose! I got sick, and threw up multiple times one night. I believe that is when my band slipped. After a few times, I realized what I was throwing up, wasn't something that should be in my stomach. It was dark brown. (basically it was blood). I felt sooo tired from having to sleep upright for weeks (thinking that would stop the reflux). Everytime I would start to go into a deep sleep, I would start coughing. I think my esophogus would relax, and the contents of my belly would just come right up it. I called the doc on call @ 5am. He wasn't a lap band doc. He ordered me a prescription for anti nausea, and said to go directly to the ER if I couldn't hold liquids down. (I stopped puking @ 3am). I went on liquids and it seemed to get a little better. Oh, and I had to sleep in another room (for weeks) because my coughing all night was keeping my hubbie up - and he needed to sleep so he could go to work! The next week, I went to a support meeting and talked to MY lapband doctor. He said, get into my office in the a.m. This is NOT right. You should not be having these symptoms. The next day, he did an immediate total unfill.. MAN WHAT A RELIEF! I felt wonderful. Had a barium swallow @ 2pm. Went home and slept soundly that night for the first time in months. Well, I thought everything was fixed.. but the doc called me @ 7am to see how I was. He said the xray showed my stomach had prolapsed up thru the band. The stitches even came undone! Said the only way to fix it was surgery. So, a week and 1/2 later - rebanded with a new LAP-BAND® APL (had the VG 10 cm before). I FEEL GREAT.:bored: I am bummed that there is a higher % of it happening more than once though. So, Please - do NOT ignore your symptoms - tell your doc, and get it fixed. It can escalate to be a dangerous situation. I am a couple weeks out from my surgery. Still on mushies, but sooo glad to be able to sleep laying down thru the night without reflux! WAHOOO!

Wow! You are doing fantastic. It usually takes a couple fills before you feel any restriction (and sometimes more). So you are very disciplined to try to eat 1 cup or less at a time and as we can see by your weightloss it's working. Keep up the good work!

I also had freezing hands/feet:frown: all the time since losing weight. I thought it was just because I had less fat insulation. (I use to sweat all the time!). But I had my doc do blood work and I was anemic.. on an Iron supplement now and it has definitely improved. I also had low vit d levels (and currently take a Multivitamin everyday REGULARLY). Definitely worth having your doc do a blood test!:wink2:

Hi Tracy, It's hard to stop grazing especially if it's a habit you had pre-surgery. One thing that helped me was to only eat sitting at the kitchen table. I absolutely try not to nosh in front of the tv. Another thing I find helpful is to play on my laptop while watching tv (this way I can't do any hand to mouth action!). I even took up jewelry making to keep my hands busy. I always have a drink nearby (water/crystal lite, or a Protein drink). 80 % of the time people think they are hungry, they are actually just dehydrated or thirsty. The other things that may help you with head-hunger is to keep a journal. When you feel like getting something to eat, write down how you are feeling, what you are thinking about, how "hungry" you really are on a scale of 1-10. Then think - does this taste as good as thin feels? The band, even when restriction is good, still will allow you to graze small amounts all day. So hope some of these ideas help. Would love to hear what others do also, as I battle with this myself. :wink2: Brenda