DrHekier

Boy this is almost inconceiveable. How could Fluid get into the Band, but not get out of it? How could there be some sort one-way valve that allow fluid into the port/band, but not out? I must not be understanding something here. I think of it in terms of a bicycle tire. How can you have a leak that allows air in, but not out of the inner tube? I assumed it was a matter of fluid in the tissue around the port, i.e. a seroma. So I think what you are describing is fluid around the port in the subcutaneous pocket where the port is located. Thoroughly confused....

When the fluid is drained is it within the port or from the tissue pocket around the port, ie. the port site? I would suspect the latter. It sounds like you may have developed a post operative seroma, i.e. a fluid collection. Do you have medical conditions that increase risk of infection that can be controlled, such as diabetes? In some situations the port may need to be moved to another site.

.It's a contract; once you sign up for an insurance you have to play by their rules. But sometimes you need to get an attorney to make sure they are playing by their rules as well.

A recent TEC assessment recognizes the benefits of the Lap Band when compared with gastric bypass. TEC (Technology Assessment Center) was founded by BCBS to evaluate new technologies in medicine. This is a non binding assessment that does not require any individual BCBS carrier provides coverage for a particular procedure, however one would think that it would make such coverge more likely. http://www.bcbs.com/betterknowledge/tec/press/tec-in-press.html This link may change as the announcement moves from 'in-press' status to 'published' status.

Be careful. In some cases after 3 denials you have no recourse at all and the case is closed. Might be time to get an attorney. Try Walter Lindstrom at www.obesitylaw.com

We hope for the best Sherry. If you wouldn't mind, please update us as to what you and Dr C find. We can all learn from your experience. Thanks to Dr C for helping out!

There are some services that expedite passports that I saw when I did a google search. At the very least, call the surgeon in Mexico. Maybe he or she can offer advice. Hopefully the surgeon in Mexico that put in the Band would offer to help somehow. For example, you might try to get a copy of the results of all your tests, including any images, and fax them to the surgeon in Mexico.

Sounds like possibly an intermittent slip. No contrast went through the UGI when the Band was empty, so that seems like possibly a slip. I am assuming you had a VG Band, if it was the Inamed/Allergan Band, since they had 8cc in. That is the largest Inamed Band and it is unlikely that you would have obstruction nearly a year later without a slip. How hard is it for you to go back to Mexico to see your original surgeon? I would recommend to get a complete workup by your Lap Band surgeon. All the best. Please keep us posted.

I agree that you should start with an unfill. Since you had a Band in Mexico, is your local fill doctor a surgeon?

There is no consensus regarding cholecystectomy and obesity surgery. Some surgeons are concerned that taking out the gallbladder at the time of lap band placement can increase the risk of infection. 1) Removal of the gallbladder (cholecystectomy) is termed in surgery a 'clean-contimated' case. This term is reserved for surgery in which you cut across an organ that has bacteria within it and possibly intorduce bacteria into the abdominal cavity. The gallbladder has bile, which empties into the intestine, and therfore can have bacteria within it. 1a) There has been at least one report in the literature of surgeons performing cholecystectomy at the same time as lap band placement and no increase infections were noted. 2) Many reports show a low number of patients go on to require gallbladder removal after lap band surgery. A few years ago I recall a presentation at the annual meeting of the American Society of Bariatric Surgeons on whether cholecystectomy should be performed at the same time as weight loss surgery, and there was no consensus. Bottom line, discuss it with your surgeon and learn your options from them. Good luck!

I can recommend Dr. Bob Basu in Houston. He is a faculty member with the Baylor College of Medicine. http://www.bcm.edu/plasticsurgery/physicians/basu.cfm If you choose to see him, tell him I said hello!

An upper GI can be ordered to make sure you aren't flipped, although a first step would be to take some fluid out of you band.

The 'supervised diets' sometimes mean that your weight loss program must have been supervised by an MD. If that were the case, you may need to visit your physician monthly and have them document each month that yes, you are on a supervised diet, have seen a nutritionist, etc..

I'll ask some of our Louisiana patients to take a look at the forum here. Most are from the Shreveport area. Congratulations on your new band!

Hello to all. I think it's great that we have so many people supporting each other on this board. Since one of our patients suggested that we establish some sort of feedback on our website, I just added a new feature. I just added a blog to our home page at www.noscales.com Just go to the website and click on the 'blog' button at the bottom of the screen. Every few days I'll try to have myself, Dr Keilin, Betty, Amy, Tammy, Deb, Angie, or Jamie from our office post some thoughts. The best part is people can add comments! On the bottom of each blog entry is a button marked 'comments'. (It currently reads '0 comments') You can press that button and leave your own thoughts if you like and comments can be anonymous. Let me know what you think about this new feature, and also what topics you would want to hear more about.

I think GEHA only covers the procedure if done at a facility which is certified as a Center of Excellence

I know that small piece of metal is MRI safe, so I would assume it probably wouldn't set off an airport metal detector. I'll ask our patients.

More about this excellent doctor here: http://www.debakeydepartmentofsurgery.org/home/content.cfm?content_id=274&fac_pk=42&view=pt_brief&menu_id=37 He was named Chairman of the Division of General Surgery apparently not long after I finished my training there! Good luck!

I think she implied the insurance wouldn't cover the Lap Band. We have seen some insurance policies in the past which strangely state that if your BMI is greater than 50, you can only have the gasric bypass not the Lap Band. Maybe that's what she was referring to.

Margo, I am assuming your doctor's office is experienced in Lap Band surgery, so most likely it is generally dependent on your insurance policy requirements. We have been doing this for several years and have done hundreds of patients and we still have some that require 6 months of 'paperwork' or even more! More and more insurance companies want what we call 'a 6 month multi' That means you need documentation of a multidisciplinary approach to weight loss in including diet, exercise, nutrition, etc. Then factor in some of the games insurance companies play (oh, we never got the paperwork, send it again... etc) If you don't have any documentation to support a 6month multi before you see your surgeon you would have to start a program afterwards. By the way, it works on both ends. I just got reimbursed on a Lap Band we did on August. The insurnace pre-approved and pre-authorized the procedure, yet it took about 5 months for them to pay for the procedure and this only after countless phone calls. :girl_hug: So if it can take five months for the insurance company to pay for a surgery they have pre-authorized and pre-approved, it can certainly take that long for them to approve it in the first place.

I had the pleasure of having some training by Dr John Sweeney when I was a resident at Baylor in Houston. He was recruited to Houston by Dr. Brunicardi, the Baylor chairman, and was a great addition to the program. He is truly a superstar when it comes to laparoscopic surgery, and his personality and demeanor are beyond reproach. A true gentleman! He'd be a superb choice!

Most of our patients tell us that after 2 or 3 days it becomes a habit and the pre-op diet is easy to stick to. Good luck!

I sent you a private message. Please respond via private message if you want me to pursue getting you a contact. Hope all is well.

We once had a patient submit photos showing that her weight was essentially unchanged for one specific year that she didn't have medical documentation of her weight. Good luck!

I'm with Dr. C, I have never heard of the endoscope approach, but if it works, please let us know! I agree with Dr. C that a slip doens't mean you will have to lose your band. You might get by with a laparoscopic surgical procedure that will keep your old band.