JaxBandster

I got my lapband almost exactly five years ago. I was self pay so did not need to jump through the insurance hoops to prove that it was medically necessary for me to have it although I could have if I had insurance at the time. I wasn't employed but I had come into some money so I could afford to do it self pay. A wonderful thing so I thought at the time. Now my lapband has eroded and I need to have it removed but my insurance is giving me the run around trying to say that I got it for "cosmetic" reasons. I guess if an insurance company doesn't give their blessing that it is medically necessary then they assume that it wasn't. Anyway, I was just wondering if anyone had experienced this before and what the outcome was. I'm terrified that my insurance company isn't going to cover the removal of my band much less the revision surgery to the gastric sleeve that I want just because I was original self pay. Thanks for any input anyone can provide.

Thanks Denise, It is what it is. In hindsight, I wish I had done things differently (gotten the sleeve in the first place) but hopefully this will all work out in the end and I can get back on track!

It has been a while since I have written, but it's been because I've been in a holding pattern waiting for my new insurance coverage to kick in. Fortunately, my band hasn't given me any issues besides some minor pulling feelings and twinges. I have had no sign of infection thus far thankfully. While I was waiting for the updated insurance, I gave a great deal of thought about who I wanted to do my surgeries. The doctor I had been going to for my band maintenance is a capable surgeon and a nice enough person, but I wasn't comfortable with his level of expertise in doing band to sleeve revisions. I did some research and found another surgeon here locally who has been doing sleeves for more than four years and has been doing band to sleeve revisions about once a month and is doing them on an increasingly frequent basis. In his words, a band to sleeve revision is not bariatric 101 surgery. It is more complicated due to scar tissues and adhesions from the band. I like his forthright attitude and his confidence, so I am waiting for a call next week to schedule the first surgery to remove the band. We will then wait three to six months and do the revision to the sleeve. He indicated that he will probably keep me overnight in the hospital for the band removal as he uses a stomach tube for drainage and that will need to be removed and he also wants to make sure there are no leaks. However, he also said that in all likelihood I can have the surgery on Friday and be back to work the following Monday as long as I have a sedentary job which I do. I am ready to get this process started. Let's do this thing!

Went for my upper endoscopy today. Band erosion confirmed. You can clearly see half the band on the inside of my stomach. Will be meeting with my surgeon soon to come up with a plan of action. Here's hoping my insurance will cover revision to the sleeve.

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.

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.

This has been a fairly easy journey for me so far. I think the hard work is now upon me. I know that the last 20 lbs or so are the hardest to lose. It is also way too easy to get complacent at this point. I also have to start working out now in order to tone my muscle so I'm not so flabby and so I will be prepared for the surgery. Time to hunker down and get serious!

July 7th was my 5th month anniversary. I have lost 74.5 lbs since my pre-op appt on January 9th so that is six months worth of weight loss. I think I've had four fills and have over 6.5 cc in a 10 cc band. Not sure exactly as he doesn't tell me. I went in yesterday for my check up and we decided I didn't need another fill. I lost 11 lbs last month and there have been several times when I got stuck momentarily while eating things like eggs and fish so he wants to wait and see if I'm just eating too fast and not chewing well enough or whether I'm too tight. I am 25 lbs from goal but will have a tummy tuck after I lose another 8-10 lbs.

I went back yesterday for my monthly check up. No fill for me!!!!! I'm at my sweet spot. He even said if he did anything he would take some out. I said no way!!!!! There have been about four times this past month where I momentarily got stuck but I think it was more my fault than the band being too tight. (Not paying attention, eating too fast, and not chewing well enough). So I am going to work on that this month. I lost 11 lbs since the last time I was in! Dr. C told me that if I lose 8-10 more that he will do my tummy tuck! Wooo Hooo! So I have instructions to join the gym and start toning up and to continue as I have been doing. Hopefully when I see him next month I can schedule another surgery date

Lori! Holy smokes girl!!! I'm so relieved to hear you are okay!!!! What a terrible ordeal! I would be majorly stressed and definitely not worrying about gaining/losing weight right now. The important thing is to get everything back in order. I live in Florida and every year is a waiting game to see if we will get hit by a hurricane or not. Thankfully we don't have any big trees in our yard yet as we are in a new subdivision but we are only 8 miles from the beach so we would get slammed pretty good if we were to ever get a direct hit. Hope you get things back to normal soon!!!

Hi Sissy! I definitely don't eat three times a day anymore. Usually just once and I try to make sure it's really high in Protein. I drink a lot of Water and I've also recently discovered diet green tea. I would say that for the first few fills I could still eat pretty much whatever I wanted. A lot of my weight loss at that point was attributed some to my band and a lot from pure discipline and determination not to fail. This last fill (the fourth) definitely has me good and tight and I have to be very careful about what I choose to eat and to make sure I chew thoroughly or I know I will get stuck. Restriction is different for everyone though and while I seemed to have reached my sweet spot at my fourth fill, others might not reach it until later and some after only one or two fills. If you find you are still battling hunger, the only things I can suggest are what I recommended above with the high protein/low carb program and the drinking of water. Don't drink with your meals as it will only wash food through your pouch and you will get hungry again sooner. If you are hungry between meals and it gets unbearable, try eating a high protein snack such as a meat and cheese roll or a hand full of peanuts. Don't forget that sugar free Clear liquids are always an option. Sugar free Jello, a popsicle, pudding or the like are always good for a snack although not quite as filling. Track your food! It will really help you to see just how much you are eating. Stay away from the carbs, they convert to sugar in your body and they make you hungrier. You can do this. I promise!!!

Oh my gosh yes!!!!! It's amazing! I walk in places with my head held high, brimming with confidence, I feel attractive, energetic and just wonderful! These feelings only increase as the weight drops off! Isn't it great?????

Ezma you are definitely in my thoughts and prayers. I'm so sorry you are having to go through this additional surgery but hopefully everything will go smoothly and you will be back on track again soon. At least it's good to know there is a reason why you were having difficulty and it can be fixed! Gotta look for the bright side! Good luck and let us know how it goes as it is still possible for any of us to have to go through the same procedure.

Katie, See my list of suggestions under the topic "Onederland". There may be some ideas there for you.

Hi Sissy, I'm sorry to hear you are struggling. I know it is difficult at times. I know there were plenty of times when I thought I was eating a ton and in fact I was probably eating more than I should. Here is what I do. 1) I don't eat if I'm not hungry. This is not as easy as it sounds because sometimes my stomach growls and I think to myself that I'm hungry, but really I'm not. I will go get a bottle of Water and drink that and I'm not "hungry" anymore. 2) I eat Protein. Lots and lots of protein. eggs, bacon, tuna (both salad and raw shashimi), steak, chicken, pork, fish. That is what I focus on for meals. 3) Then I eat veggies. Preferably fresh and steamed since that is the way I like them best. Canned veggies have a tendency to have a lot of sodium in them which will make you retain water. 4) I don't deprive myself. If there is something I want I have a small amount of it. Maybe several bites of my husband's dessert. Several bites of potatoes or rice. I measure out my carbs carefully to make sure I'm not getting too much. Besides converting to sugar in your body, carbs also make you feel hungry. 5) I keep my carb intake below 30 gms a day. 6) At first I recorded all my food in Fitday so I had a firm understanding of how much I was eating. Now that I have the hang of it I don't do it so much. 7) I haven't started exercising yet but the more I lose the more active I get. I've been working in the yard more and just getting out more. 8) I drink a lot of water. It keeps you from feeling hungry and it helps remove impurities and fat from your body. 9) Eat slow but not too slow or you will never feel full. I try to make my meals last about 15 minutes. Eating the protein first will help you feel full faster. Sometimes you just have to sit and ask yourself, am I eating this because I'm still hungry or because it tastes so darn good? Once I started realizing that I was eating for the sheer taste of the food, then I understood that I was eating for the wrong reasons. Hope some of these help!!!!

Yes Ladies and Gentlemen! I have reach that magical number!!! Stepped on the scale this morning, down two lbs, and voila! 199!!!! How cool is that! I have 29 more lbs to lose to goal! Only twenty-something! I'm so excited! Oh! And I was at the Harley dealership this morning waiting for my bike to get serviced and this hunky motorcycle cop came in and as our eyes met I smiled at him and he winked at me!!! Wooo hoooo!!! :biggrin:

Yeah I've been losing a lot lately. I hear that it will eventually come back though. I had a nurse tell me it was due to the rapid weight loss. I get a lot of protein so I know that's not it.

Ezma I'm so sorry to hear about your turn of events. What a rollercoaster ride you've been on lately! Please keep us informed about what happens with the port. I know my doctor also said he could do port revisions and the like in the office. No wonder you were struggling! Keep on swimming girlfriend!

Many people plateau and some even gain weight about three weeks to a month after their surgery, especially right after transitioning back to mushies and then to regular food again. I'm not sure the reason for this, but I can tell you that I've seen it a hundred times since being on this and other forums. Focus on healing right now. The weight loss will come as you begin to get your fills. There is no need for panic. Just watch your carb intake (I try to stay under 30 grams a day) and drink LOTS of Water (it will help you feel less hungry). Good luck!

Keep up the great work! You are really starting to see a difference!!!!

Babedoe When I was trying to find some jeans that weren't baggy on me I was trying to find 14W's but there weren't any. I was in a 16W and finally found an 18 Misses that worked for me. Maybe try a 16 Misses? You are just going to have to try on a bunch until you find ones that fit. It took me about six different tries until I found the right one. If it wasn't for my stomach I'd probably be in a 16 but still have to accommodate all that skin.

Well I can definitely relate to your experience. I have had a gall bladder attack and know exactly the kind of pain you were in. I can understand how you could confuse the pain as being band related since the pain originates from the same area as your gall bladder. I am glad that I had mine taken out a long time ago. I didn't ever want to experience that kind of pain again. Unfortunately I still did due to my hiatal hernia, but had that fixed when I got my band and haven't experienced any pain since. I'm really glad that your ultrasound tech was experienced and knew to look for something else besides something band related. Obviously, everyone else thought that is what it was. Glad to hear that you are okay now and that they caught it in time!

Thanks RSG!!!! I really admire your positive attitude. I know it can be difficult to sustain when you get frustrated with the weight loss but you are always looking for the silver lining and that's something very admirable! I'm going to be looking to you for support and motivation!

Hi Michelle! I know what you mean about the four months. It seems like just a few weeks ago we were sweating out waiting for surgery! I'm with you on not being too tight. I definitely know I have restriction this morning. I was drinking my shake and gurgled a bit so I know I was tweaked good. The true test will be tomorrow when I get back on real food. Congrats on the shorts NSV!!!! I love those! I'm not ready for shorts yet but it seems I have to go buy a new pair of jeans every couple of weeks! It's really hard to try and figure out what size I am as I am making the transition from plus size to misses! Yeah! It's a pain but one I will gladly bear! I cut my hair short once. I really liked it. It was so easy to take care of. But everyone else said I looked like Sharon Osborne (Ozzy's wife) so I decided to grow it back out (not that she looks bad or anything!) I've now gone completely off the deep end and bleached the underneath sections of my hair while keeping the top black. It's a really cool rock and roll effect especially with the shag hair style but my family thinks I've gone off the deep end. My 16 year old daughter thinks it's cool though! LOL The one nice thing about hair is that it will always grow out! Keep up the great work!

That black and white shot is just adorable!!!!!! I can definitely tell the difference from your prior pictures that you have posted! Great job!!!