After having the band for a year I have developed some pretty strong feelings in respect to self pay and the band.

First of all, I had a years worth of free fills. The problem with this can be that you may not get to your stable long term sweet spot within this time.

If you have a surgeon who wants to follow the "protocol" fills. This would basically be about .5cc per month. Well, that only gets you to about 6cc's in a year. I have found that this is NOT going to probably be the end of your need for fills. I dread to think of people paying from the very beginning and doing this slow fill process.

I early on decided to get a fill every 3 weeks as swelling would go down and maximize my fills, usually .75 or even a full 1cc.

I am just at 1 year and 10.25cc in a 10cc band. They have told me that they have seen as much as 13cc in a 10cc band.

Overall, I have come to the conclusion that for self pay people the best and safest bet is to not get the band at all. The gastric sleeve done with the intent of hopefully not doing the DS later, is the best bet for self pay people.

Why? Well your costs are all right up front, when they generally cover everything and complications happen up front instead of later when you already have a lot invested. You also don't have the constant fill appointment expense or upkeep of the band.

These are just some considerations I have come to realize that are important to self payers. These are just reasons to not get a band if you are self pay versus insurance. I'm not going to get into all of the other reasons, as this is an area specific to self pay concerns.

I agree, hind site is 20/20

This is an old post, but for people considering the lapband and not having insurance coverage, it's food to hear more views. I am self pay and only had 3 fills to lose all of my weight other than to refill after being emptied for a hyst. Not all and I would dare say most people never need a full band and certainly do not need monthly fills. IMO the reason many people have problems and complications is related to having too many fills and/or keeping their band too full.

Well you may be right, but I don't know how you are coming to your conclusions? Do you know "most people", so that you can really even form an opinion about "most people". I don't think so, I think you are totally guessing, which isn't really all that valuable or accurate.

In fact, I had a lot of fills, and it may lead you to believe I was overfilled, when in reality, it turns out I had a slow leak. When they defilled me, they figured it out.

Now back to the subject of this post. Since I'm paying out of pocket, do you really think I want to pay for another surgery to fix a leak....when I could just pay for a sleeve and be done with the cost forever? I THINK NOT.

Simply put, the band is much, much more expensive in the long run and sometimes the short run. It is not a good idea for people who are self pay. All of the risk, is shifted to when it costs the patient to fix, instead of all the risk being up front and covered by the surgeon.

At this point I think the band was the best thing I could have spent the money on for myself. I reached my sweet spot with my 2nd fill. I guess you could count it as my 3rd fill because they put some in at surgery. My fills were free for 3 months and then only $20 after that.

$10,000 well spent in my case.

Well you may be right, but I don't know how you are coming to your conclusions? Do you know "most people", so that you can really even form an opinion about "most people". I don't think so, I think you are totally guessing, which isn't really all that valuable or accurate.

In fact, I had a lot of fills, and it may lead you to believe I was overfilled, when in reality, it turns out I had a slow leak. When they defilled me, they figured it out.

Now back to the subject of this post. Since I'm paying out of pocket, do you really think I want to pay for another surgery to fix a leak....when I could just pay for a sleeve and be done with the cost forever? I THINK NOT.

I'm sorry you had such problems after such a short time and after paying out of pocket. My opinion, I did say it was my opinion, comes from reading for the past two yrs the many problems so many people have had when being overfilled and after having many fills in the first yr. It's also from attending monthly support group meetings for 2 yrs and hearing from people with few fills vs those who keep going back, and it seems like those who have free fills are the ones who are most likely to keep going back. This might cause problems, sticking needles in the port frequently, don't you think, even if not overfilled? If not, it just makes sense that leaving it undisturbed would be the best way to go if possible.

I do not want to get into the pros and cons of each procedure with you. Everyone has their own reasons for their decisions based on their research and what is best for them. I'm glad I made the choice I did and can see many reasons I would never have that procedure done. It's sad you had not decided to have the sleeve to begin with. I wish you the best though from here on out! I have not spent any money on my band or had any fill or unfill since 10 months after surgery and have not had any problems. Hopefully this will continue because I love it!!

OK, I'm going to agree with you. So most people having trouble with a band, are having those problems because of getting too many fills.

Your first theory....more fills increases your chances of having a leak? Ok, I had about 13 fills, as apposed to your 3? So you really think 10 more fills is going to cause a leak in a port that is suppose to be able to have thousands of fills without leaking? Or maybe the thing leaked from the very beginning? Either way, how is this a good product, if it is so unreliable or the doctors so often make errors using the band.

But, wait a minute....these people are doing self fills? The doctors are doing them, and they are suppose to know what they are doing. Are you saying the doctors don't know what they are doing, or that they are just out for the money they get doing the fills?

This is classic....you blame the consumer for the problems with the product. You never suggest it may be a bad product or the people selling the product, may not be competent. The only theories are those that leave the fault on the patient. That is just to convenient for the people making money off of this product.

I wasn't implying your band leak was your fault. It's not unusual for any product to have a few with defects and there are indeed Dr's who are not competent. People, however, may bring many problems on themselves.

They think the band should take away all of their hunger and they should not have to be responsible for any control over what and how much they eat (and the band will never control head hunger). They get fill after fill, but never will lose weight because they have never dealt with their psychological problems related to overeating.

After a fill, they try to start eating regularly again rather than going on liquids for a day and easing into regular eating.

They get stuck, PB, and go right back to eating, rather than allowing swelling to calm down, thus resulting in more PB's and possible band damage.

They get overfilled and rather than go back and get a tiny bit removed, they eat slider foods or stay on mostly liquids, PB alot and think being anorexic or bulemic is band success.

Many of these people still may not lose their bands because they are very durable. However, some will have problems and then will blame that damn band or the Dr. who placed it.

I'm just saying that people have to take responsibility for their actions and how they deal with their emotional eating problems and the way they use their band.

This would have nothing to do with your band possibly being defective starting out with a leak!

I would think 13 fills should have been a red flag to the doc long before #13.

I agree with everything you said jms, but I think those expectations from people aren't proving to be statistically realistic.

Note, you see how in the very next post hummingbird thinks the doctor should have been concerned well before #13, but they certainly weren't.

Well, as they fill more and more, I was concerned, but they weren't, heck more fills, mean more money for them, and almost no one gets diagnosed with a leak while still in the warranty period.....I wonder why that is?

Frankly, I am really happy, I had the leak. Forced me into doing something about the band.

I think I see everyone's point of view and feel terrible for anyone with complications such as a leak. It's failure of the product not the doc or (ridiculous) the patient. Overall I think lapband is a great choice and only becomes cost prohibitive in terms of us self-payers if there is a complication.

In the absence of a complication (and these are much more frequent with procedures such as sleeve or bypass), I can't agree that its better to have your stomach removed and tossed in the trash (sleeve) to save money on fills! There is no way the cost of fills comes close to what the great majority of us have already wasted on binge food, gyms, pills, diet programs etc!

xavier, you are correct about the complications being the problem for self payers. Especially, because they have to pay to have it fixed.

Thats why I think the sleeve is much better for self pay. The complication rate is actually lower then the band. And if you are going to have complications that cost money, they are in the beginning, when any good doctor will pay for the extra costs.

The band, it seems the complications always come later, and conveniently when the self payer will have to pay for it.

As for effectiveness, well now were on to an entirely different subject that frankly makes the band a real loser. It is so much easier of a life, and so much easier to lose weight, and after four months I'm already below my best weight ever obtained with the band.

Never having to worry about getting stuck, and being past the period of complications, I am now worry free. I just work at making sure I get my Protein and Water in, or I will forget to eat and drink, and its as easy at that.

I'm glad you got what you wanted but you are dead wrong about the complication rates and I would ask you to cite your reference. Morbidity and mortality are way higher for sleeve than band.

Sorry, but your the one who brought up the complications rate being higher then the band first.

So, since you brought it up first, you should be the one showing the proof. I'm not going to waste a bunch of my time convincing the obvious unconvincable.

I'm not going to bother.....there is plenty of information out there showing the statistics on complications of sleeve versus band. And no you don't get to lump bypass with the sleeve against the band....they are two entirely different surgeries.

You can carefully word it to make it sound better or worse, but you need to actually look at all of the statistics. And yes, most importantly you should look at the statistics of your doctor in reference to the surgery they are going to perform on you.

Another thing that is very deceptive, is how the band surgery complications statistics are constantly being referenced from "surgery complications". Well, I agree most band complications happen later, when they don't have to count them anymore as complications from the surgery.

Pretty convenient way to count.

Heck my band, doesn't even count as a failure. Everytime you filled it, it leaked out after 3 weeks, but it was long after the surgery...an entire year....so that doesn't count as a complication from band surgery. OH PLEASE....the statistics are manipulated to whatever suits them, and if you can't figure it out, you just plain ignorant.