abraxasbear

Feeling very discouraged today. I called to follow up on the preauthorization for my band removal, and after placing me on hold, the rep came back to tell me they'd decided today to DENY, on the basis that it's "not medically necessary." This, after the surgeon has said it needs to come out as soon as possible. Apparently a badly dilated pouch, with nausea and vomiting, isn't what they consider "necessary" to deal with. :( Has anyone had success appealing for band removal, with no revision surgery? Especially with BCBS Federal Employee Program?

Feeling very discouraged today. I called to follow up on the preauthorization for my band removal, and after placing me on hold, the rep came back to tell me they'd decided today to DENY, on the basis that it's "not medically necessary." This, after the surgeon has said it needs to come out as soon as possible. Apparently a badly dilated pouch, with nausea and vomiting, isn't what they consider "necessary" to deal with. :( Has anyone had success appealing for band removal, with no revision surgery? Especially with BCBS Federal Employee Program?

Anyone here who had to get pre-authorization for a band removal, without any subsequent revision? My pouch is seriously dilated, and the surgeon wants to remove it ASAP. I'm not willing to do any further WLS. If you had to do this, did you have any trouble getting insurance to authorize it?

Anyone here had to get pre-authorization for removal of the band, without any further revision? Mine is causing problems (serious pouch dilation) to the point the surgeon wants to remove it ASAP, but it's being submitted for pre-authorization. If you had to go this route (as opposed to ER sudden removal, etc.), did you have any trouble getting it approved?

CONGRATS, Ninejuan1, on getting set up with a new doctor and back on track! I'm afraid my own "return to the office" has turned out a little different, but it's important that I went. The doctor withdrew Fluid to make sure my band wasn't leaking, and I immediately had a sharp, burning pain traveling up my esophagus. That's not supposed to happen, so they set me up for an upper GI. The upper GI led to an endoscopy this past Wednesday. It turns out that my pouch is seriously dilated, and my band needs to be removed. I go in next Tuesday, and presumably will schedule surgery ASAP. It's a serious issue, and needs to be taken care of---it's good that I didn't continue to shy away from the office due to my embarassment, etc. Things will work out okay. The doctor would like to revise me to a gastric bypass, but I think I'm going to try some other approaches before getting another WLS.

I just called the office. My doctor is booked up pretty heavily right now, but they fit me in on May 30th during the time of day he doesn't normally schedule anyone. Apparently he really wants to get me in there. I wish it was sooner, so I could just get it over with, but I guess it's committed anyway.

So glad to have found this discussion this morning! Just last night, I posted the following in the "general discussion" thread (evidently the wrong place for it): "I had lap band surgery over two years ago, in November of 2010. I began at 339 pounds, lost twenty in the pre-surgical two week low carb diet, and after surgery got down to 249. Then I bounced, and everything seemed to go wrong. Looking back, I think I was over-eager about increasing my fills, and it got me to the point where there was zero hunger control, etc. Now, I'm back up to 325 pounds. My band is still at around 9cc, but it doesn't really do much at all for portion control anymore---just creates problems with certain foods at times. I feel like my eating is completely out of control again, and I'm discouraged as hell. I haven't been back to my bariatric doc's office in about a year and a half, just out of sheer embarrassment. That said, I can't handle being this big again, and I need to do something, but I'm honestly afraid of going back to the doctor. Has anyone else been in a similar situation? Is it possible after this degree of failure to get back to a place where the band is actually helping again and serving its purpose, or have I likely just screwed this option up permanently?" Just like you, Juan, I haven't been to my doctor since November of 2011. I just got off the phone, after scheduling a new appointment for May 30th. He was heavily booked up, and it wasn't a time of day when he usually schedules people, but he wanted to be sure and get me in. I have to say I'm nervous about seeing him, but it's time to swallow my pride and just do it!

Mis73, I think you bring up a good point. I think I really approached the band as a "portion control" tool, rather than a "hunger control" tool. Ugh!

I had lap band surgery over two years ago, in November of 2010. I began at 339 pounds, lost twenty in the pre-surgical two week low carb diet, and after surgery got down to 249. Then I bounced, and everything seemed to go wrong. Looking back, I think I was over-eager about increasing my fills, and it got me to the point where there was zero hunger control, etc. Now, I'm back up to 325 pounds. My band is still at around 9cc, but it doesn't really do much at all for portion control anymore---just creates problems with certain foods at times. I feel like my eating is completely out of control again, and I'm discouraged as hell. I haven't been back to my bariatric doc's office in about a year and a half, just out of sheer embarrassment. That said, I can't handle being this big again, and I need to do something, but I'm honestly afraid of going back to the doctor. Has anyone else been in a similar situation? Is it possible after this degree of failure to get back to a place where the band is actually helping again and serving its purpose, or have I likely just screwed this option up permanently?

I'm at 10cc in a 14cc band, and I'm travelling to Peru for two weeks in October. I'll be taking part in some ceremonies with traditional healing plants, which are known to sometimes induce vomiting. Knowing that vomiting could be an issue with the band, I asked my doctor about this. Much to my surprise, he recommended that I get a partial (as in "most") unfill before my trip, and refill afterward. As he put it, you don't want to be out in the jungles of Peru, having a problem with the band. I have some real misgivngs about this idea. In talking with the guides leading my planned trip, the vomiting reaction is not really common (they've had only one person vomit, and he'd worked himself up ahead of time to the point that he was overanxious and probably brought it on himself). Naturally, I also worry about regaining weight during the trip. Finally, if I do get a "big" unfill before the trip, can it all be replaced afterward, or would I have to work up a little at a time, just as I did to get to my 10cc? Has anyone else here been temporarily unfilled for travel purposes? Has anyone not had an unfill prior to travel, and wish they had? Thoughts? Experiences?