kshallow

It may make a difference in regards to insurance if there is a problem with your band that can be medically diagnosed ( slip, prolapse, erosion,etc.) If they will cover the revision. I was very sick with a slipped band, a "mechanical failure" See what your endo test comes back with. If there isn't a clear problem with the band itself, start contacting your insurance company, plead your case complete with documentec doctors visits, fills, UGI'S, ER visits, testing, etc. Any substantiated way you can document that a covered revision will save them money in the long run could help. As far as low BMI, mine was 27 at time of revision.I made my case to ins co. this wasn't about me losing a tremendous amount of weight, it was about lifelong weight maintenance (again, cost effective for them if I avoid any weight-related medical issues) good luck

This is the letter which was submitted to BC (in addition to my med records and other supporting documentation) I did win the appeal and my band to VSG surgery is scheduled for April 5th. This is also my account of life with the band for those who are seeking experiences from all sides
Hello,
I had the lapband procedure three years ago (2010). Initially, everything seemed fine but only a few months after having this procedure, problems began including the inability to swallow solid food, acid reflux, night cough, vomiting, and constant pain and pressure in my upper back and chest. For the next two and a half years, my life was a series of doctors appointments having the band filled and unfilled as well as upper GI's (the current count is 6) to view the band placement and swallowing ability, and try to determine the source of all the problems. Despite these chronic issues, I followed all the nutritional recommendations of the band "lifestyle" and was successful in losing over 80 pounds during this timeframe.
In the past year, the physical problems persisted to the point that even when I was able to eat healthy solid food, I was living in a constant state of pain and discomfort and frequently vomiting. I recently had another upper GI test done at St. Joe Hospital Tuesday 1/15/13 with a follow up appointment the next day with my surgeon. The band has indeed slipped down my stomach and the films clearly show a portion of my stomach protruding over the band way out of placement.
After meeting with my surgeon following this last upper GI, it is his recommendation the band be removed. He, as well as the surgeon's insurance coordinator advised me that insurance will cover the removal and/or placement of a new lapband. It is the opinion of both myself and my surgeon that placing another lapband and/or repositioning the current lapband is not a smart decision given the history of chronic pain and problems associated with my body and the lapband. It is my surgeon's recommendation that upon removal of the lapband, he perform a vertical sleeve gastrectomy (VSG) procedure at the same time. This is a covered bariatric procedure which involves no foreign article in the body as does the lapband. It is my desire to have the lapband removed and have the VSG procedure done.
I have been informed that to qualify for the VSG procedure, I would need to meet the initial qualifications for bariatric surgery (a BMI of at least 35 with co-morbities). If this were the case, the last three years of my life working hard to lose 80 pounds in spite of living in chronic discomfort and often inability to eat for days or weeks on end would be in vain. I do not want the ineffectiveness of the lapband to be a factor in my desire to remain healthy, maintain a low BMI, and to be able to eat solid healthy foods. To suggest I need to GAIN weight in order to qualify for a bariatric procedure that works for me goes against the entire idea of getting the surgery in the first place.
I am writing requesting the removal of my current lapband and VSG procedure being done at the same time be covered by insurance. Currently, I am only able to drink liquids, eat very few soft foods, and know that even with these things, swallowing often brings pain and vomiting. I am tired of living in pain due to the mechanical failure of the lapband. There have been nights when I have not even been able to swallow my own saliva. Currently, there is no Fluid in the band at all. It is wide open and still feels like a vice around my chest when I swallow food. I started this journey with the goal to get healthy and be at a healthy BMI. That remains my goal today.
I followed the protocols for qualifying for initial bariatric surgery in 2010. I met the requirements, I attended the seminar, I did all the reading. I learned all the nutritional guidelines and stuck to them as the band allowed (resulting in a large weight loss) I followed my doctor's directions, dutifully had the band filled and unfilled as directed. I went on liquids when directed, ate when directed, and refrained from eating when directed. I went through 6 UGI's complete with barium swallows as directed. I did everything I was supposed to do in order to make my life with the lapband successful. As my doctors will attest, the mechanical failure of this lapband is not due to any lack of efforts on my part. I had been unable to sustain weight loss before bariatric surgery and now with a slipped band and the need for its removal, I am facing the same situation as I was in 2010. I have worked very hard for the weight loss I have achieved and it is very likely I will be unable to maintain my weight loss without further surgical intervention.
Blue Cross was supportive in my initial request for approval for lapband surgery and I am hoping Blue Cross will be supportive in covering the lapband to Vertical Sleeve Gastrectomy revision surgery. I have done everything on my part at my doctor’s direction and now I am appealing to you to help me move on with my life with VSG. I will also appeal from a monetary standpoint. Following this letter, please find an itemized list of the BCBS money that has already been spent due to my lapband complications. I am displaying this because VSG is a one time surgery with very little follow up necessary. There is no need for ongoing check ups, UGI’s, or lapband adjustments. This revision surgery makes sense from a physical quality of life standpoint as well as monetary one.
My surgeon is recommending this revision surgery and will be forwarding my medical records, UGI results, and his recommendations to you as well. Dr. Jacob Roberts, DO is my surgeon and has graciously offered to meet with a medical review team or director in order to directly discuss the need for this revision surgery (please find his contact info attached) Also, please feel free to contact my surgeon’s office as well as the insurance coordinator for any additional records or information you may need.
Thank you for taking the time to review my case.
This is the letter which was submitted to BC (in addition to my med records and other supporting documentation) I did win the appeal and my band to VSG surgery is scheduled for April 5th. This is also my account of life with the band for those who are seeking experiences from all sides

I "fired" my pcp when she withheld letter of med necessity b/c of her personal opinion of WLS. We are all entitled to an opinion but when it comes down to making an informed medical condition for yourself, your opinion trumps. I ended up scheduling a meeting w/the head doc in that practice after repeated requests and appointments to get a letter of med necessity. A different doc in the practice ended up giving me the letter. One of the first things I asked about when seeking a new pcp was their take on bariatric patients/ procedures. Through awful complications with the lapband and then conversion to the sleeve, it was important for me to have a dr that would support me.

One procedure:my surgeon doesn't make the determination until he g
ets in there and gets a good look at the condition of the stomach and extent of damage from the band. Although he nor I wanted my health put at risk in any way, I was relieved to get the surgery part and move on with my life minus the demon-band.

Many of us ex-banders can relate to all of your post. If you start to read through the band to sleeve forum, you'll see (unfortunately) very similar stories to your own. There does seem to be an initial honeymoon band period but eventually, the story continues with inability to eat much beyond sliders and sugar. Dilitation, pain, chronic vomitting, prolapse, etc, etc, etc. It's proved NOT to be a long term weight loss solutio . If you do revise, you'll find the sleeve is what the band was supposed to be. No more stuck food, no more vomitting, no more inability to eat in the morning, no more slider foods only. The sleeve allows you to lose weight AND eat healthy dense foods without fear. Hope all works out with revising

Hi Sarah! I had some of the same problems and will be seeing a new surgeon this Friday to discuss removing the band and revising to the sleeve. I too thought the band was great in the beginning and lost weight, but I was either too tight or too loose. There was no "sweet spot" for me. I was kidding myself by saying it was a good thing. I too was throwing up constantly. There were days that I couldn't even get liquids down and still others I could eat tons. Finally several months ago, I lost all restriction. I'm guessing I have a leak. I thought I'd try to lose the weight by myself, but of course that's a lost cause. I just got fed up with being sick all the time. With my band, anything healthy (lean meats, veggies, fruits) made me sick as a dog. I finally just stopped eating so I wouldn't be sick. That's not healthy either. I just wanted to be able to eat healthy foods and keep them down. But of course now I'm never full...ever.
I'm now having a lot of port pain that is new and different. I'm seeing a new surgeon as the one who did my band never listened nor did his staff. I've been doing a lot of research and have pretty much decided on the sleeve. I feel very sad and frustrated as I thought I was doing the right thing 4 years ago by getting the band. I'm just ready to get back on track. Good luck and keep us posted on your journey!

This is the letter which was submitted to BC (in addition to my med records and other supporting documentation) I did win the appeal and my band to VSG surgery is scheduled for April 5th. This is also my account of life with the band for those who are seeking experiences from all sides
Hello,
I had the lapband procedure three years ago (2010). Initially, everything seemed fine but only a few months after having this procedure, problems began including the inability to swallow solid food, acid reflux, night cough, vomiting, and constant pain and pressure in my upper back and chest. For the next two and a half years, my life was a series of doctors appointments having the band filled and unfilled as well as upper GI's (the current count is 6) to view the band placement and swallowing ability, and try to determine the source of all the problems. Despite these chronic issues, I followed all the nutritional recommendations of the band "lifestyle" and was successful in losing over 80 pounds during this timeframe.
In the past year, the physical problems persisted to the point that even when I was able to eat healthy solid food, I was living in a constant state of pain and discomfort and frequently vomiting. I recently had another upper GI test done at St. Joe Hospital Tuesday 1/15/13 with a follow up appointment the next day with my surgeon. The band has indeed slipped down my stomach and the films clearly show a portion of my stomach protruding over the band way out of placement.
After meeting with my surgeon following this last upper GI, it is his recommendation the band be removed. He, as well as the surgeon's insurance coordinator advised me that insurance will cover the removal and/or placement of a new lapband. It is the opinion of both myself and my surgeon that placing another lapband and/or repositioning the current lapband is not a smart decision given the history of chronic pain and problems associated with my body and the lapband. It is my surgeon's recommendation that upon removal of the lapband, he perform a vertical sleeve gastrectomy (VSG) procedure at the same time. This is a covered bariatric procedure which involves no foreign article in the body as does the lapband. It is my desire to have the lapband removed and have the VSG procedure done.
I have been informed that to qualify for the VSG procedure, I would need to meet the initial qualifications for bariatric surgery (a BMI of at least 35 with co-morbities). If this were the case, the last three years of my life working hard to lose 80 pounds in spite of living in chronic discomfort and often inability to eat for days or weeks on end would be in vain. I do not want the ineffectiveness of the lapband to be a factor in my desire to remain healthy, maintain a low BMI, and to be able to eat solid healthy foods. To suggest I need to GAIN weight in order to qualify for a bariatric procedure that works for me goes against the entire idea of getting the surgery in the first place.
I am writing requesting the removal of my current lapband and VSG procedure being done at the same time be covered by insurance. Currently, I am only able to drink liquids, eat very few soft foods, and know that even with these things, swallowing often brings pain and vomiting. I am tired of living in pain due to the mechanical failure of the lapband. There have been nights when I have not even been able to swallow my own saliva. Currently, there is no Fluid in the band at all. It is wide open and still feels like a vice around my chest when I swallow food. I started this journey with the goal to get healthy and be at a healthy BMI. That remains my goal today.
I followed the protocols for qualifying for initial bariatric surgery in 2010. I met the requirements, I attended the seminar, I did all the reading. I learned all the nutritional guidelines and stuck to them as the band allowed (resulting in a large weight loss) I followed my doctor's directions, dutifully had the band filled and unfilled as directed. I went on liquids when directed, ate when directed, and refrained from eating when directed. I went through 6 UGI's complete with barium swallows as directed. I did everything I was supposed to do in order to make my life with the lapband successful. As my doctors will attest, the mechanical failure of this lapband is not due to any lack of efforts on my part. I had been unable to sustain weight loss before bariatric surgery and now with a slipped band and the need for its removal, I am facing the same situation as I was in 2010. I have worked very hard for the weight loss I have achieved and it is very likely I will be unable to maintain my weight loss without further surgical intervention.
Blue Cross was supportive in my initial request for approval for lapband surgery and I am hoping Blue Cross will be supportive in covering the lapband to Vertical Sleeve Gastrectomy revision surgery. I have done everything on my part at my doctor’s direction and now I am appealing to you to help me move on with my life with VSG. I will also appeal from a monetary standpoint. Following this letter, please find an itemized list of the BCBS money that has already been spent due to my lapband complications. I am displaying this because VSG is a one time surgery with very little follow up necessary. There is no need for ongoing check ups, UGI’s, or lapband adjustments. This revision surgery makes sense from a physical quality of life standpoint as well as monetary one.
My surgeon is recommending this revision surgery and will be forwarding my medical records, UGI results, and his recommendations to you as well. Dr. Jacob Roberts, DO is my surgeon and has graciously offered to meet with a medical review team or director in order to directly discuss the need for this revision surgery (please find his contact info attached) Also, please feel free to contact my surgeon’s office as well as the insurance coordinator for any additional records or information you may need.
Thank you for taking the time to review my case.
This is the letter which was submitted to BC (in addition to my med records and other supporting documentation) I did win the appeal and my band to VSG surgery is scheduled for April 5th. This is also my account of life with the band for those who are seeking experiences from all sides

This is the letter which was submitted to BC (in addition to my med records and other supporting documentation) I did win the appeal and my band to VSG surgery is scheduled for April 5th. This is also my account of life with the band for those who are seeking experiences from all sides
Hello,
I had the lapband procedure three years ago (2010). Initially, everything seemed fine but only a few months after having this procedure, problems began including the inability to swallow solid food, acid reflux, night cough, vomiting, and constant pain and pressure in my upper back and chest. For the next two and a half years, my life was a series of doctors appointments having the band filled and unfilled as well as upper GI's (the current count is 6) to view the band placement and swallowing ability, and try to determine the source of all the problems. Despite these chronic issues, I followed all the nutritional recommendations of the band "lifestyle" and was successful in losing over 80 pounds during this timeframe.
In the past year, the physical problems persisted to the point that even when I was able to eat healthy solid food, I was living in a constant state of pain and discomfort and frequently vomiting. I recently had another upper GI test done at St. Joe Hospital Tuesday 1/15/13 with a follow up appointment the next day with my surgeon. The band has indeed slipped down my stomach and the films clearly show a portion of my stomach protruding over the band way out of placement.
After meeting with my surgeon following this last upper GI, it is his recommendation the band be removed. He, as well as the surgeon's insurance coordinator advised me that insurance will cover the removal and/or placement of a new lapband. It is the opinion of both myself and my surgeon that placing another lapband and/or repositioning the current lapband is not a smart decision given the history of chronic pain and problems associated with my body and the lapband. It is my surgeon's recommendation that upon removal of the lapband, he perform a vertical sleeve gastrectomy (VSG) procedure at the same time. This is a covered bariatric procedure which involves no foreign article in the body as does the lapband. It is my desire to have the lapband removed and have the VSG procedure done.
I have been informed that to qualify for the VSG procedure, I would need to meet the initial qualifications for bariatric surgery (a BMI of at least 35 with co-morbities). If this were the case, the last three years of my life working hard to lose 80 pounds in spite of living in chronic discomfort and often inability to eat for days or weeks on end would be in vain. I do not want the ineffectiveness of the lapband to be a factor in my desire to remain healthy, maintain a low BMI, and to be able to eat solid healthy foods. To suggest I need to GAIN weight in order to qualify for a bariatric procedure that works for me goes against the entire idea of getting the surgery in the first place.
I am writing requesting the removal of my current lapband and VSG procedure being done at the same time be covered by insurance. Currently, I am only able to drink liquids, eat very few soft foods, and know that even with these things, swallowing often brings pain and vomiting. I am tired of living in pain due to the mechanical failure of the lapband. There have been nights when I have not even been able to swallow my own saliva. Currently, there is no Fluid in the band at all. It is wide open and still feels like a vice around my chest when I swallow food. I started this journey with the goal to get healthy and be at a healthy BMI. That remains my goal today.
I followed the protocols for qualifying for initial bariatric surgery in 2010. I met the requirements, I attended the seminar, I did all the reading. I learned all the nutritional guidelines and stuck to them as the band allowed (resulting in a large weight loss) I followed my doctor's directions, dutifully had the band filled and unfilled as directed. I went on liquids when directed, ate when directed, and refrained from eating when directed. I went through 6 UGI's complete with barium swallows as directed. I did everything I was supposed to do in order to make my life with the lapband successful. As my doctors will attest, the mechanical failure of this lapband is not due to any lack of efforts on my part. I had been unable to sustain weight loss before bariatric surgery and now with a slipped band and the need for its removal, I am facing the same situation as I was in 2010. I have worked very hard for the weight loss I have achieved and it is very likely I will be unable to maintain my weight loss without further surgical intervention.
Blue Cross was supportive in my initial request for approval for lapband surgery and I am hoping Blue Cross will be supportive in covering the lapband to Vertical Sleeve Gastrectomy revision surgery. I have done everything on my part at my doctor’s direction and now I am appealing to you to help me move on with my life with VSG. I will also appeal from a monetary standpoint. Following this letter, please find an itemized list of the BCBS money that has already been spent due to my lapband complications. I am displaying this because VSG is a one time surgery with very little follow up necessary. There is no need for ongoing check ups, UGI’s, or lapband adjustments. This revision surgery makes sense from a physical quality of life standpoint as well as monetary one.
My surgeon is recommending this revision surgery and will be forwarding my medical records, UGI results, and his recommendations to you as well. Dr. Jacob Roberts, DO is my surgeon and has graciously offered to meet with a medical review team or director in order to directly discuss the need for this revision surgery (please find his contact info attached) Also, please feel free to contact my surgeon’s office as well as the insurance coordinator for any additional records or information you may need.
Thank you for taking the time to review my case.
This is the letter which was submitted to BC (in addition to my med records and other supporting documentation) I did win the appeal and my band to VSG surgery is scheduled for April 5th. This is also my account of life with the band for those who are seeking experiences from all sides

Her band BUSTED inside of her! In what way is this a band that is working properly? Her surgeon then would neither repair it or provide an alternate solution. I know this isn't my story to tell but can we stop being so damn hard on each other and just BE there for one another? I have no doubt everyone here has had enough "tough love" to last a lifetime.

Mattie what does your dr say? Will he give u another fill soon? How many cc's are in your band now? I feel your frustration!! When I've posted previously looking for some specific suggestions the LAST thing I needed to hear was "remember the band is just a tool" we KNOW it's a &"$@:& tool!!! You know how to lose the weight and you DO deserve for the band to be doing what it's intended for. Call your dr, tell him all this, talk to him re your fills.