DrHekier

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.

Do you have a secondary insurance? Sometimes if you have Medicare only and no secondary, Medicare will only cover 80% of the charges, leaving your secondary insurance to cover the remaining 20%.

While on vacation many years ago to a location with many mosquitos, I took an antihistamine. (May have been Zyrtec.) It obviously didn't prevent being bitten, but it seemed to help me personally tremendously in terms of getting the bitten swollen areas to shrink in size and stop itching. Talk to your doctor.

If it is simply flipped, she will not need a new port. In cases of flipped ports what typically happens is that the tissue through which the port is sutured gives way and the the port is free to turn around in the subcutaneous pocket. Securing it back into position is a straight forward procedure that depending on the patient often won't require general anesthesia; IV sedation is often enough. But it does need to be done under sterile conditions, generally in the operating room. Nothing can be done to prevent flipping; it is a relatively uncommon phenomenon and resuturing the port in place should be just fine. Don't feel sorry she had this surgery. You are seeing a very minor adverse event now. Fast forward 30 years from now if she didn't have the surgery. With morbid obesity she increases her risk of heart disease, stroke, diabetes, breast cancer, etc.... She could be laying on her deathbed from some obesity related comorbidity 30 years from now and you would wish that something could have been done in the past. I'm hopeful you'll soon feel this is the best thing she has ever done for herself. And for you.

Ask the surgeon directly if you can. Our practice is to generally to repair hiatal herniae if we encounter them. Two of our five bands today had hiatal herniae and were repaired at the same time. One of the other patients had a prior hiatal hernia repair, and the 'scar tissue' from the the prior surgery made the band placement much more challenging than usual, so it's not uncommon for some surgeons to decline to perform Lap Band surgery if a person has had a prior hiatal hernia repair or fundoplication.

Let us now how it went; I would suspect it's only an overfill not a slip, since you tolerate food in the evenings.

In case you are worried that you might have a leak because you don't feel restriction, note that many people don't feel a significant amount of restriction with their first fill.

Legend has it that Pablo Picasso was sketching in the park when a bold woman approached him. “It’s you — Picasso, the great artist! Oh, you must sketch my portrait! I insist.” So Picasso agreed to sketch her. After studying her for a moment, he used a few pencil strokes to create her portrait. He handed the woman his work of art. “It’s perfect!” she gushed. “You managed to capture my essence, in one moment. Thank you! How much do I owe you?” “Five thousand francs,” the artist replied. “B-b-but, what?” the woman sputtered. “How could you want so much money for this picture? It only took you a second to draw it!” To which Picasso responded, “Madame, it took me my entire life.”

Is your inflammation at your port site, or at an incision other than the port site?

My understanding is that Medicare does not need pre-approval. If the procedure is covered, than the physician does not require pre-approval.

Any word on a support group in Fayetteville? I heard the hospital there only does gastric bypass

GEHA apparently now covers the Lap Band.

If you have only one appeal left, perhaps you should entrust it to an attorney with experience in these matters. Many have used Walter Lindstrom www.obesitylaw.com ; he himself is a former WLS patient. Each insurance company is entirely different. Some will accept weight loss programs or even gym memberships. Others will only accept MD supervised programs. Good luck!

As my note from above, it appears that at least one insurance company is saying the Lap Band is experimental because they are using data showing that the GB is superior. So I suppose what they are saying is that the LapBand is experimental in the sense that the GB is more effective. I think there is a sufficient amount of data to support the LapBand over GB.and

I completely agree with Dr. C. The VG has a much larger capacity than the other two sizes of Bands, and as a result is more likely to have retained air. As Dr. C says, it takes a fill or two to 'prime it', that is to say, get the air out. It is not uncommon for us to see less fluid come out on fill #2, than what was put in on fill #1. We even see this at times with the 9.75 and 10 cm bands.

Generally gallbladder removal (cholecystectomy) should not affect your stomach directly. Some patients will note a difference in ablility to digest fatty meals, and as a result may have loose stools, or diarrhea, for a short period of time after surgery. This is because the flow of bile into your intestines is altered, and bile salts help package fat for digestion/absorption in the intestine.

In addition to the Surgical Review Corp. linked to above, Medicare will cover surgery at centers certified for Bariatric Surgery through the American College of Surgeons, a seperate program. I don't have the link for that handy. From a sticky above I found this link for Medicare approved Bariatric Surgery sites: http://www.cms.hhs.gov/MedicareApprovedFacilitie/BSF/list.asp#TopOfPage