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Darn digital scales...... Nope not I, after the hell of two bands this was the golden ticket for me....I had a coworker with duodenal switch and she either had a bad surgeon or just rotten luck. She ended up on TPN feedings off and on for a very very long time. Not to mention she had other issues that were over looked during a psych eval. The RNY has been the gold standard of WLS . The surgeons are performing different malabsorbtive techniques with RNY now as to not have the horrific complications of malnutrition and Vit deficiencies. Still there are risks with any major surgery, you have to feel you have chosen the right procedure for you. Watch out for the "mills" many WLS MD's are doing the surgery then only see you for one year. If you needed a revision or had an issue you are SOL with those MD's . Researching these surgeries is very educational. I for one researched the heck out of the band and I ended up here with RNY and wished I chose it first.......

Thanks so much for the info! I too started wanting lap band, but after hearing and reading the huge number conplications and revisions chose the sleeve. I'm hoping it's covered, I don't really want to go the route of gastric bypass. I kinda like my intestines the way they are. I would love the codes when you get time.

Hello, I had lap band last January. Thou I have lost weight but have not been doing well. I have had a a port issue from the beginning. Which consist of constant soreness. It went further and I had sever pain and ended in the hospital in for 4 days. With no explanation of why. I have lost 40 pounds and am happy with it. I finally got approval for port revision surgery along with the possibility of removal of adhesion. I also may have a hernia and my band has been empty for a long time. I also have reflux bad. I have no fills since July. A lot of not doing well is partially my fault as I have no restriction and I am hungry. I hope this surgery helps and I can have a fill and get back into the swing of things. Has anyone have similar issues? Would love to hear from you.

Great news. I do not have to wait 3 months. Final appointment 3/22 hopefully revision in April Sent from my SM-G900P using the BariatricPal App

HI Everyone, :laugh: I am really really struggling...I am seriously having the fight the insurance co & my PCP blues. Pasted below is draft copy of a letter that I am working on to send to the insurance co. and maybe even the insurance consumer division. Although a really tight squeeze for now, I am working on Plan B. Dr. Alvarez in Mexico, 9750 for sleeve. Here struggling...having gained 18 pounds since September 15--all of my clothes are fitting way way way toooooo tightly! Bumming Here's my letter! I just dont know what to do.... Any insight is greatly appreciated! I am not sure if I should be outright saying I want to request an appeal or just asking for an update. Please review and give me your insight. Thanks! Group/ID Number: XOH842901948/H06800 Primary Care Physician: Dr. Derek Kelly Diagnosis: 278.01 Morbid Obesity Procedure: 99241 Office Consultation Referred For: Office Consultation Requested: 12/9/08 Denied: 12/9/08 Services Requested: Consult with Dr. Vitello for a Sleeve Gastrectomy Referral Authorization No. 23,562'Denied (Referral Denied'This is a request for an out of network non-contracted provider with Managed Health Care Associates Managed Health Care Associates 2740 W. Foster Avenue, Suite 411 Chicago, Il 60625 FAX: 773-271-0264 Illinois Department of Insurance Consumer Division 100 W. Randolph Street Suite 15-100 Chicago, IL 60601 Greetings I a writing to formally request an updated status of the referral decision rendered in December 2008. First of all, the services requested are inaccurate. Since October 2007, Dr. Derek Kelly has provided referral authorizations for me to see Dr. Vitello regarding lapband adjustment. From October 2007 until September 2008, I visited Dr. Vitello for lapband adjustments and presented with complications of my adjustments on a monthly basis. Resultingly, September 2008, I had to have emergency surgery to remove my lapband due to slippage. I followed up with post-operative care with Dr. Vitello, who then consulted with me regarding revisional bariatric surgery. In the interim, I informed Maria, of Dr. Kelly's office and contacted the BCBS of IL to be advised of my benefits coverage and protocol for seeking revisional surgery. At that time, I was advised of the criteria for coverage, which I meet now and did so at the time of request, and advised Maria of the same. She advised me to have Dr. Vitello submit the referral authorization and that she would handle the request, as she had handed the processing of all of my prior referral authorizations to Dr. Vitello. Upon mutual interest, Dr. Vitello petitioned for referral authorization for revisional bariatric surgery, vertical sleeve gastrectomy. My last follow up appointment with Dr. Vitello was October 31 and the referral authorization was submitted twice by Dr. Vitello's staff (University of Illinois at Chicago) before warranting a response by the Managed Care Group. This petition submitted in full disclosure, my operative and post-operative reports and medical necessity substantiating the need for the procedure. According to my insurance terms, bariatric surgery is a covered benefit as long as it is deemed medically necessary; this is furthered for revisional bariatric surgery with indication that as long as the first bariatric surgery was medically necessary, there is no waiting period for clearance for the authorization of a revisional surgery. Additionally, according to my policy's terms and conditions, I have been advised of the following: Repeat of a covered bariatric surgery may be eligible for coverage only when ALL of the following criteria are met: For the original procedure, patient met all of the screening criteria, including BMI requirements The patient has been compliant with a prescribed nutritional and exercise program following the original surgery Significant complications or technical failure (i.e., slippage, etc.) of the bariatric surgery has occurred that required take down or revision of the original procedure that could only be addressed surgically Patient is requesting reinstitution of an acceptable bariatric surgical modality. Dr. Vitello submitted his referral authorization to Dr. Derek Kelly indicating my request to reinstitute an acceptable bariatric surgical modality, vertical sleeve gastrectomy. On December 9, I received paperwork advising of a decision of denial for a consultation. It indicated the denial was based on the fact that the services are available in-network and the request was from a non-contracted provider. The basis of this claim request for out-of-network coverage is due to this surgical procedure being revisional bariatric surgery, which is an acceptable bariatric surgical modality. Secondly, the letter advised of an alternative for the non-approved service, to contact Dr. Kelly for a referral to an in-network specialist. On December 15, 2008, I met with Dr. Kelly in follow-up to the denial. Dr. Kelly advised that he needed to submit supplemental supportive documentation along with the referral for processing to secure an affirmative decision. Dr. Kelly then proceeded to review my operative report records from the surgery and reviewed my other health records in my medical file and interviewed me regarding my health status. Dr. Kelly indicated this procedure should take approximately 30 days maximum and to anticipate an affirmative response to proceed with revisional bariatric surgery and that I had his medical support in substantiating the medical need. I have been waiting since December 15, 2008 and to date am more frustrated now than ever. For the past 2.5 months, I have meticulously called Dr. Kelly's office regarding a status update. Maria, the administrative assistant, has provided several updates. The updates have included the fact that the previous medical director retired and was replaced and the new director was then on vacation, to the medical director making request for additional paperwork (which was submitted), to the medical director needing to meet with Dr. Kelly regarding the details of the approval process for this type of referral authorization, to the medical director and Dr. Kelly being unable to meet to further discuss the nature of my referral, to Brenda communicating that there was never a properly submitted referral from Dr. Kelley to the Managed Care group which resulted in the initial denial decision. In my first direct contact with Brenda Blazek, the Referral Coordinator who signed the referral denial letter, she claimed to know nothing regarding my case and further indicated that there was no documentation in my file. When I followed up with Maria with Dr. Kelley's office, she advised that Brenda did not find any information in my file because all of the information was being held by the medical director. Whatever the real case is, this is neither professional nor acceptable in accordance to my patient's rights under section 502(a) of ERISA. Just yesterday, I called and spoke with Maria five times to get an updated status, to exhaustedly be declined, yet promised an update by the end of the work day. I have not spoken with Maria, nor have I missed an update call from Maria. This has been my experience for the last 2.5 months. Below is an excerpt of the fax sent to Dr. Kelly, which was confirmed as received by Maria on February 5, 2009. Maria, I would like to reiterate that on 12/9 the referral authorization stated that the procedure, Vertical Sleeve Gastrectomy, is a covered benefit in-network; however my request was to have the procedure done by an out of network provider. Additionally, this was confirmed by Tammy on yesterday at 12:50 with Blue Cross Blue Shield that this is a covered medical benefit as long as it is deemed medically necessary. My appointment with Dr. Kelly in December was to have provided me with a specialist referral to have the procedure done or we could have executed an appeal. I think Dr. Kelly submitted an appeal for coverage of the procedure; however, I am requesting to have this surgical procedure done by Dr. Vitello or be advised of the in-network provider who can perform this surgical procedure. Even in accordance to the appeals process, the timeline has been elongated to address issue of medically necessity when that is not the matter'the issue is approval for out-of network coverage or referral to an in-network specialist. I hope this clarifies the situation more. I will call you tomorrow to see if you have an updated response. Additionally, I was contacted by the non-contracted provider's office as a follow-up to the request in January and February. Last week, I advised them of the insurance referral hassle that I have been experiencing and they formally resubmitted their request, directly to Dr. Kelly (attention Maria), to the medical director of the Managed Care Group and to Brenda Blazek. To date, no response has been received; however, they have confirmed receipt of such documentation. Resultingly, I am assuming that since the only official documentation I have received to date is the referral denial, then I am evoking my patient right to request an appeal, specifically an expedited appeal process. However, I am highly dismayed because Dr. Kelly advised that there would be no need to execute an appeal. I would like to seek clarity first on the status and if this is in order, I would like to request an activation of the appeals process and under separate cover I will or will have my attorney to handle the appeals process. Before escalating to that level, I am very much interest in seeking resolve immediately. If and when I need to activate an appeal, I am requesting an expedited appeal process because my health at this point is continually declining and it is therefore imminent and serves my best interest to not further jeopardize my quality of life by waiting for a decision. Since December, the following symptoms I have presented: my breathing has become labored and therefore results in extreme shortness of breath my severe obstructive sleep apnea condition has worsened (hypopnea with severe oxygen desaturation) my acid reflux has returned my amenorrhea has returned and I have again began experiencing tumultuous joint, knee and lower back pains __________________ Originally posted at www.lapbandtalk.com

I had the band in 2008 and lost all my weight.. In April 2014 I found out it has eroded.. I had a revision from band to bypass on May 21 2014. It is awesome! I wish I had the bypass first! It is awesome. I have had no problems. I'm at a normal BMI. Feel free to message me if you have any questions.

I have BC/BS Federal Texas. I just found out that I have what the Dr. said I have what is called mechanical breakdown of my 4 year old lap band and now a hernia too boot that I never had in the beginning. I now have to have the band removed, the hernia done and a revision to RNY and I am trying to see if this might be a procedure that would be approved or not? Hope some one will answer me back

I didn't realize the hospital in Mac had a support group. I had surgery 7/1/15 which was revision from band to sleeve. Surgery was done at Legacy Good Sam in Portland but hard to get back to in the evening from the Forest Grove area. I am gonna have to check out the support group dates and times. How are you all doing after surgery?

I just got home yesterday from having sleve done with Aceves. I can't say enough good things. There was another lady there who had just had a revision and was doing amazingly well. I had the pleasure if talking with her and she is highly educated, spent a lot of time researching and was thrilled with her results. If you private message me I will see if she fill vontact you hirectly if interested. I know that during my research he has been praised for being the best at revisions. He's cautious and gives you extra home at thd hospital to recover. He has performed a lot of revisions and that's why you read so much, many doctors refuse to mess with it. Do your research and it will give you the piece of mind you need.

I had the band to sleeve revision in February. I wasn't that successful with the band but have noticed that the sleeve stops me from eating too much because I'll actually get a little nauseous vs. that stuck feeling. As far as the surgery, for me it was easy. No issues and the recovery was very quick but you should go to the Band to Sleeve Revision section and read the experiences that others have had.

I was on soft food 10 days after my revision but all my Dr. has me shooting for is 94g of Protein daily. I found some great ideas on a website called The World According to Eggface - give it a google if you are looking for ideas

OK...I got the results from the endoscopy...band is OK in normal position and no problem. I wish there would have been. It might have helped expedite the switch to Vertical Sleeve. So the doctor told me I don't qualify for the sleeve as I don't weigh enough. I would have to gain weight to get my BMI to 40. At least 20 pounds! Who wants to do that. And then I would have to lose weight before the VS procedure. It's like I am back to square one. I also would have to have the psych eval again and other pre surgery exams and tests. AND to see if I qualify to even proceed I need to get an upper GI (had one 1 year post op) and a sleep apnea test. This would be to see if I have any issues that would qualify me w/o the 40 BMI. I think my insurance company will cover me if I meet the qualifications. I thought having a revision would be a lot easier. Anyone else go thru this? The doctor seems pretty positive that I will qualify one way or another. I am SO bummed. I almost feel like having the band removed and call it quits and go back to regular weight loss means.

I was like that too. I didn't lose or gain for months, then I got tighter and started losing. I liked losing the weight. But the constant of the food coming back up caused my band to slip. You don't want that to happen. Tell your Dr. It's better to have an unfill now, and let your stomach heal, than to have to have revision. Call your Doctor.

I had the lapband in 2008 and just had it removed on 2/4 and had the sleeve done at the same time. From all the posts I've been reading, those that have had the "revision" surgery are not losing as fast as those that are having the sleeve. But I also had an easier time adjusting because I had been through it before with the band

The VSG is a fabulous tool if you don't have any pre-operative issues such as diabetes or gastric reflux disease. It in my opinion works just as good as the bypass (and I'm revising to bypass soon due to GERD) as long as you stick to the post op plan. Take a list of all of the pros and cons of both and whichever ones mean the most to you place more emphasis on. Good luck with your decision.

As I have been reading the posts the past few months I saw how first time Sleevers had issues with certain foods. As someone who had revision surgery- I'm not having any issues. I waited a few months before trying things - I had my first cupcake for my sons birthday - no issues. ( I was only able to eat 1/2). Had my first popcorn at the movies - no issues ( split a small with my son- no butter) last night I had my first Subway sandwich- 6 inch flatbread. Had no problems ( took me 45 min to eat it and I was stuffed the rest of the night). I'm curious as to others- have any food issues since the revision? I have no plans to make this the norm for me, I knew that his birthday week I was going to be the 1 week I splurged ( still lost 2 pounds- before the subway sandwich)

I made some rookie mistakes yesterday when I added fruit and vegetables to my protein shake. I put so much in that there wasn't room for hardly any ice. By the end of the drink, it just tasted like lukewarm beet juice. Today's is much better! 1 scoop of market pantry chocolate protein 3 tablespoons of organic fat free vanilla yogurt 1/2 large organic cucumber 1 handful of organic blueberries lots of ice This is a much smoother taste. And according to the interwebs, cucumber is a natural anti-inflammatory!

I had lapband to sleeve revision and sorry to rain on your parade, but I am complication free. I have had NO problems and only wish I had done this last year. getting sleeved was one of the best things I could have ever done. EVER.

I'm sorry you are going through this, I know it's not an easy decision. But I would not let anyone pressure me into a surgery that I didn't feel 100% comfortable with. Do you know how many sleeves this surgeon has performed? It's not very common any more for Surgeons to promote the Band over the Sleeve, so it would concern me that maybe he's just not as comfortable doing the Sleeve if he hasn't done that many? Is he aware of the high # of complications and revisions from being Banded? Is there another surgeon who has equal experience, that you might consider or at least get a second opinion? Keep reading and researching til you feel comfortable with your decision, there is complication and revision threads in most of these forums if you haven't already read them. Good luck!!

I had a band for 7 and a half years... started having a lot of trouble with reflux and vomiting at about year 4 but put up with it because i was scared to have it taken out (i had lost nearly 40 kilos).... but then i started gaining weight anyway because it always had to be unfilled to try and settle the reflux. So last year i decided to revise to a sleeve. I had the band removed in November - lucky i did too because it had slipped and 'was a mess' (the words of my surgeon that removed it). Ive been waiting since then for my stomach to heal and will be sleeved in just over 2 weeks. Ive regained a lot of weight but let me tell you - having that band out was like a huge sigh of relief! My doc seems confident that the healing time will reduce the risks significantly, considering how mangled my stomach was, but maybe thats just his process - I see lots of people on here that do the revision in one step and have great recovery and results. Im scared still but excited at the same time. Best of luck

Welcome to the family Zafiro - happy to have you here. Your apprhension is normal, we've all gone through it or are going through it. I am almost 4 months out and I can say now that I am not the least bit sorry that I had the surgery -- now, if you'd ask me about month 2, I'd have had a hard time saying that. My worst post-op issue has been esophogeal spasming and the surgeon believes that is caused by the fact that I had a hiatal hernia repaired and also believes it will dissipate by 6 months out -- I can tell you it has definitely gotten better from where I was at 1 month. There are a lot of people on this forum who have revised from the band to the sleeve -- PLEASE PLEASE PLEASE read their stories before settling on the band. ASK LOTS OF QUESTIONS - SOMEONE HERE WILL ANSWER YOU!

I am reaching out to anyone who can share help in getting Gastric Sleeve approved by Humana Medicare after an emergency Lap Band Removal with a low BMI 30. Are there Any Advocates that can help with a denial and now trying to Appeal? This is just not fair. I am sure there are a lot of Lapband removals Out there. Medicare guidelines are not up to the times of all these problems that are going on with failed Lapband and medical issues causing patients. Thanks for any feedback. BTW they told e to reapply when I reached 35... I have 3 of the comorbids and my band was successful too for me for 5 years.

I had mine for exactly 6 years before revision. My story is of band failure also. One year after placement and many attempts at the sweet spot I never found it. I was under and overfilled for a year and then no one could penetrate the port for adjustment. I lived with an un serviced band for 5 years and had revision about a year ago with no -complications or scar tissue. It was 1 day outpatient surgery.

I'm still looking for my green zone. Also getting very frustrated. I got another fill yesterday and am now up to 7.5cc. I asked about revision surgery as well. I've lost 20ish lbs since having the band that I've kept off. I've lost up to 40lbs and gained back when I was off work and had no insurance for over a year. I've gained 7 since this time last year and I've had 2 fills this year (before the one yesterday), but I keep hanging on to those pounds. Not gaining, but not going down. I haven't felt any real restriction yet!! I'm on liquids again today and then soft/mushy tomorrow. I'm not sure what I'll do if I can't make something happen this go around. Right now I feel so dang hungry though.My body still trying to make that adjustment I suppose. If i can get back to my real workouts I know it would help...I've been in an aircast for a while due to tendon/plantar fasciitis. Which I know would really get better if I could lose some weight!!! I guess all we can do is keep fighting for it.

Thanks everyone - great responses and discussion. For me personally, I probably SHOULD be worried about the forced change of relationship with food, but I am actually looking forward to that part. I know it will be rough at first, but I want to eat like a normal woman, small quanties and and based on what I need to fuel my body and no more. I probably should be more concerned about the fact that being obese is slowing killing me (I have sleep apnea, early onset arthritis and borderline blood pressure. I have insulin resistance, and will likely become diabetic if I don't get the weight off and keep it off), but there is something about surgery that focuses your worries on a specific event...lol My conscious fears are really surgery and recovery related. I know that MOST people have no major problems, but I guess the thoughts that keep creeping in is what if I am one of the unlucky few that get a leak, a stricture or has a problem during surgery. I realize that my odds of dying on the table are very low,but it is still in the back of my mind. As a revision from the band, I probably have a higher risk of leaks and I know that can be a real recovery nightmare. You are right, I feel great about my surgeon's skills and support, but I know that even so, bad things can happen. I am trying to keep my mine focused on all the benefits of losing weight and becoming healthier. All the sleevers I have met are just so happy with their new life - I keep trying to focus my "eye on the prize" but I do sometimes get a little overwhelmed with the fears. I keep trying to visualize myself 6 months post surgery - alot of weight gone, feeling healthier etc and with NO long term complications.