Tiffykins

I'm assuming you have TriCare?? If so, I believe if they haven't yet they are going to start covering the sleeve. Have you checked?

They aren't covering it yet. But, I went on base to the Bariatric clinic, met with a surgeon who has done all surgeries, he agrees that a revision would be my best option. I asked about getting a referral to a civilian that I have spoken with, and has done several band to sleeve revisions. He agreed to send me to him which essentially cuts out the approval process for Tricare Prime. Since I went on base first, if they send me off base, I get approval without having to go through all the BS.

Eglin AFB here in NW Florida does the sleeve more than the band. My other surgeon choice is Dr. Althar. I've been in contact with his office, nurse and Tricare liasion since the beginning of March. We're just waiting on a Hematologist appointment since I had all this "mystery bleeding". The on base surgeon wants me to see the psych again just because John is gone, and I feel really defeated by the other surgeon situation.

My main concern is the adhesions that the on base surgeon believes are on the tubing and port area of the band. That's my biggest worry is that I'm still going to hurt.

Did you smack that nurse upside the head? I hate people like that!

I hope you write an appropriate testimonial on OH, did you?

Not yet. . . I want to choose my words very careful. One of his bypass patients saw my story, and she was shocked, and when I told her who my surgeon was, she hasn't replied.

I forgot to mention that I've gained back 13 pounds from my initial loss of 27 pounds. I had loss 30, but it wasn't charted at their office.

The husband being deployed isn't helping, but I have found that I clean house instead of eating.

I was banded Oct 1, 2008. The complications started the day of surgery when a nurse held my ankles and made me reach above my head, grab the bedrails and pull my butt into the hospital bed. I had a shredding pain spread across my abdomen. No big deal they said, hit the pain pump. The next morning I woke up to an enormous bruise that was about 7" wide by 10" long across my abdomen under my port site sutures. I was scared. . .But was reassured that nothing was wrong with me.

Fast forward 10 days, suture removal, the bruising has now spread to my side and down even further my abdomen. The port site suture could not be removed because of swelling. The nurse dug around in one of my lap sites to remove sutures, and she couldn't get them out. YAY. 2 weeks later, I had cottage cheese consistency, old blood spewing from the lap site, it's now the size of a lima bean, and I see all the way to the pink layers of my abdomen, right through the fat. The infection is now tunnelling through my tummy. YAY YAY. They didn't seem too concerned, just keep it clean. Okay, off I go, 6 weeks later, the little hole is now getting smaller, it closes one day, but to my surprise there was something growing behind it. LOVELY. Prescription of Levaquin should resolve that. . .

I quit having restriction around Thanksgiving with a total of 2.5cc in my "band", in the tubing really. Was told to just stick to the diet, and to remember I am ahead of the game with 25lbs gone. December rolls around, not restriction, can eat more than I should, trying to be good. Called office about not having restriction, am told that it may take 25+ fills to get restriction and I need to accept it. REALLY?

I'll throw out this and it maybe TMI for some. But, our sex life suffered substantially because the port area was so sensitive, sex was sometimes impossible. . . Even though my husband is the most understanding, loving, and supportive husband in the universe, I hated feeling that we could not be intimate because I hurt so badly.

Okay, now fast forward end of Jan. Lost 1 pound in 2 months, YAY. I have a lot pain in my port area especially about my monthly cycle. Told surgeon, he looks dumbfounded. Manipulates the port for 15-20 minutes, I get 1cc finally. Thought I had restriction, yeah, not really. February, port pain is becoming more and more noticeable. And when I say pain, I mean pain level 6-8 on a daily basis. I go in for a fill even though they don't want to give me one, and he can't get to the port after 20 minutes of gouging around in my abdomen. It's swelling, bruising... I ask about the bleeding, and they finally agree to test me for R5 factor, reaction to Heparin. I am NEGATIVE. I received 5cc of heparin over a 30 hour hospital stay.

Okay, March 3rd, went in for a fill under fluoro, yep port is flipped, he digs on me for another 20 minutes, 5 different sticks, and can't get it under fluoro. I'm devastated. . . I ask him "why do I hurt everyday?" his reply " I honestly don't know ". . . Hmmmm this is not good.

6 days later, I show up for another attempt under fluoro even though they tell me it is to be done the next week. He agrees to try again, I get to radiology, and he says " have I accessed the port since repositioning it?" Ummm I was just here 6 days ago, and NO you haven't repositioned my port. He chuckled and said "oh dear, I've forgotten your chart." The fluoro table is at a 25degree angle, he manipulates the port and is able to give me 1cc, and tells me "see ya in 60 days". . . And off he went.

I left feeling like I was just ridden hard and put up wet. It was horrific. . . I called a week later and spoke with his nurse who proceeded to tell me " you haven't been happy since the beginning" I argued and said " No I haven't been happy since I have been ignored, and brushed off, and having complications that are trivialized by you and your husband." I told her I wanted my chart, and it took me driving down there and waiting an hour and a half to get my measley chart. She proceeded to tell me " you should of had gastric bypass like I told you". LOVELY.

I am not sure if I would of been successful with the band, but I know that I am so glad that I am getting the revision. The PB, sliming,getting stuck on crystal light was just too much for me to tolerate. I followed the rules, I worked my butt off for that 1lb loss between Thanksgiving and January 22nd. I truly feel like I was set up for failure by my surgeon, and I am so grateful to have the approval that I need to have the band removed and revision to the sleeve in June.

I was one of those ecstatic band patients until I had problems. Couple that with lack of concern and aftercare from my surgeon, I don't regret my choice for the band initially, I am sad it took me this long to get the hell away from my original surgeon.

I have mentioned this before, that I think the doctors really emphasize the reasons for problems as being something the patient did, to get them off the hook. They want people to think, if you follow all of the rules, you won't have a problem. I think we can all agree, that is just not a good representation of the reality.

But it sells bands!!!

That is the absolute truth. . . I followed all the rules, I've begged the surgeon to help me, and now I've finally given up on the band working for me and revising to the sleeve in June.

It's taken me months to get the courage to actually make this change, and not feel like I failed. . .

wow! thats awesomw! i also have a suvillian doctor. so far its gone by fast. did you have to do the 6 months of seeing the dietician? I dont know yet if im going to have to do that. what was your bmi? good luck!

It was pretty awesome. I had to see a nutritionist twice pre-op, then she came by my room before I was discharged post op. I had to have my psych consult and that was the extent of my pre op requirements. Everything has been covered by Tricare except for the nutritional consult which cost me $50 because I didn't want to wait 3 months to see the on base dietician/nutritionist. I chose to pay the $50 fee to get it done and over with.

My initial consult was July 22nd. I had my Nutritional and Psych consults on July 29th, and I was approved the following Monday.

My BMI was 49.4 pre op, and today 22-23lbs lost my BMI is 45.2

Tricare has been phenomenal through this entire process. I also want to state that I had zero co-morbidities and was approved strictly on my weight. Tricare did not consider my BMI, or anything else. I did not have diabetes, thyroid, or any other of the standard co-morbidities that Tricare normally requires. I was 140lbs overweight, and that was enough for Tricare Prime approval.

Tricare Prime approved my surgery with a civilian pcm to a civilian surgeon. It was a cake walk, 7 days from consult to approval. . .

I will attempt to keep this short and kind of the cliffnotes version for you.

October 1st 2008 - LapBand placed

October 2nd - recovering in the hospital, one of the nurses made me pull myself up into the bed, and I pulled something at my port site. An enormous hematoma developed that spread from the mid-abdominal line and extended down about 6-8 inches down my belly towards my belly button and stretched to the right side of my body.

7-8 days post op - The hematoma is still present and continues to spread across my abdomen. My surgeon "diagnosed" the condition as Heparin Induced Thrombocytopenia with no blood study being ordered. My bloodwork including my platelets and RBC was normal pre-op. They can't remove my sutures because of the swelling at the port side and the enormous hematoma that is present. At one of the lap sites, the sutures can not be removed because there is a "scab" of some sort grown over it, the nurse "digs" around in the lap site and determines she can't get to them, and tells me to come back in a week.

3 days later, a disgusting dark brownish "cottage cheese consisitency" substance starts coming out of the lap site that the nurse dug around in. I go in, he "cleans it out" and I have an open wound and can see into my abdomen. I saw nice pink tissue, not a layer of fat, it is gross, and takes another 3 weeks to heal properly. That is only after, it seals up then gets infected and I demand to be put on antibiotics.

All of that healed by the week of Thanksgiving and I got my first fill. 2cc's, still no restriction. I wait until January 21st to go back in for another fill because my doctor refuses to give more than 1 fill every 2 months even though I call mid-December questioning my fill schedule. January 22, another fill, 1cc in, for a total of 3.5cc in a 10cc band, I was miserable. I had no restriction, was hungry all the time. He told me to call him back in 3 weeks for an update. I did as I was told, and he told me to come back in.

Oh yeah, I was down 30 pounds from October 1st to December 18th. I weighed in today and have gained 8 pounds since December. I am extremely "thick" through my abdomen, I carry the majority of my weight in my abdomen, and have always had constant port pain. Well, today he could not access my port. We are doing a fluoroscopy (spell check on that one), he dug around in my port site for several minutes and could not get in the port. He drew back blood on a few tries, it was beyond painful, it was more than pressure, I have a huge pain tolerance and I was almost in tears. I have a large amount of scar tissue around the port site due to the "popped" port suture (this is my assumption). He does NOT use fluoroscopy on a regular basis, and my port has always been "Weird" (almost inverted) since I came home from the hospital. My band has never had restriction except for immediate post op swelling. I also want to mention that I was given a total of 5cc of heparin during my hospital stay (over a 30 hour period), and had a horrible recovery. My blood pressure dropped dangerously low, I have never "thrown up" and only gotten something stuck 3 times and it was microwaved meat.

Anyways, I am scared out of my mind and need some direction, help, guidance. I can not change surgeons as I am married to an Air Force member, and our surgeon choices are very limited. There is only one other surgeon in our area and he won't take me for at least 1 year. Changing surgeons is not an option due to insurance rules with Tricare. I am so upset, I've had nothing but problems with the band since having the surgery and now this. I truly feel like it isn't my band, it's been my after care, and my surgeon. I know the band works, but I think it may not be the WLS for me. If I have to go through another surgery, I am considering a revision.

I do not have the emotional fortitude to continue with this, and it's been emotionally draining. My husband is about to deploy, I am a mom to a wonderful 10 year, and have a career that is being affected by my appointments and constant issues. . I have not really had issues with the band, but just not getting the results that I feel I should be getting. I have occasionally cheated, and have 'eaten around the band' on occasion, but for the most part, I have followed the band rules, yet am left feeling like I am not getting the results that I would like to get. I do not know what to do anymore.

I'll take any advice, support, or direction you are willing to give me.

Thank you for your time and input.

Regarding the referral, make sure your PCM's office puts "to diagnose and TREAT obesity" that is some of the wording that Tricare requires for the referral to be approved and for you not to run into issues for future appointments. Apparently, the word " treat " is the keyword that Tricare looks for in their approval process and for aftercare appointments.I had to get my PCM to edit his letter of referral so Tricare would approve all of my visits.

My fills and follow up appointments have been covered 100% with zero out of pocket cost. I have Prime, but I have a civilian PCM and civilian surgoen due to our MTF always being overbooked. . .

I have very few problems with bread/grains. Tortillas have been my "go to" bread type food. Toasted breads are easier, but I haven't had a sandwich since being banded in October. I have very little restriction, and can eat thin crust pizze without issue. . . Rice and Pasta haven't been challenging, but I don't miss them like I do actual bread.

Muffins, cornbread, and biscuits were not a favorite for me before surgery, so I haven't tried them post-op.

I have Tricare Prime. I had my first surgical consult on 7/22/08, my pysch and nutrition eval was 7/29/08, and my surgery was approved literally 10 days later.

I had/have ZERO co-morbidities, my height/weight was 5'2"/270, so I was clearly 100lbs over my ideal weight by the MetLife. I am consider "medium" frame by the insurance standards therefore my approval was very quick. I did not have to complete any pre-surgery diet, or observations. I filled out the questionaires and a 7 day food log.

Tricare Prime isn't typically that difficult to get approval through, it really depends on how your surgeon's office codes everything and gets you in the system. At least that was my experience. Pretty much, my surgeon's nurse told me exactly what she was going to do to get me approved even though I had zero weight related medical problems.

Welcome Tiffany. I am so sorry you are in "bandster hell", it isn't a fun place to reside. Since you were banded Oct. 1, I would think that your banster hell days are probably getting close to being over. Hang in there! It gets better.

How many fills have you had?

Thank you so much for your encouragement.

I've had 2 fills (at only 3.5cc) and pretty much I'm past frustrated with my surgeon. He is extremely passive when it comes to fills, refuses to give "anyone" a fill more frequently that every other month, and even then he only gives 1cc. To me, it's quite ludicrous since by all the guidelines, I am too loose and my band should be adjusted. I understand filling it slowly, but every 60 days? I lost 20lbs the first 16 days, and have had to kick my butt for the other 11lbs. It's just frustrating, and I went in and pretty much vented my frustration and he gave me a 1cc fill 2 months after my first 2cc fill. . . It's crazy, I would switch surgeons if the other bariatric surgeon in our area didn't "make my skin crawl". I just feel trapped, I just feel like I am being treated like a "number in the little program" instead of an individual patient. I am calling my nurse next week to let know that the 1cc fill that I got on Jan 20th, has not accomplished anything. . .

I guess we'll see what happens. Thanks again for your words of encouragement.

Quick intro:

Tiffany

32 years old, married, Air Force wife, insurance agent, mommy to a 10 year son, we live in NW Florida (might as well be Alabama), and I was banded on October 1, 2008. To date, I've lost right at 31 pounds. I'm in what is apparently called "bandster hell", it's miserable, I'm frustrated, but haven't given up. . . It's been an amazing journey thus far.

That's me in a nutshell. Thanks for having me, and hope I can get to know others for some much needed support.