Hi folks. I'm Dave, and I'm one of the new guys here.

I feel a bit weird right now, because for the last several months I've been researching and working toward getting the vertical sleeve gastrectomy (VSG) surgery. Of the three main types of current bariatric sugeries, that seemed the best fit for me. I'd double-checked with my insurance carrier, and was told yes, the sleeve was covered. So I'd done all my homework, I attended some seminars, got my PCM to refer me to a weight loss surgeon who does my surgery type, and I got myself all psyched up for a marathon appointment with my surgeon and his team. After weeks of waiting I finally saw them yesterday.

Things were going great until they said that I must have a misunderstanding. They said my insurance (Tricare Prime) does not cover the sleeve surgery. It seems the insurance agent I'd spoken with had misinformed me. After a bit of discussion and a visit to Tricare's website, it turns out that they're right - Tricare won't pay for it. They'll pay for LAP-BAND®®® and RNY bypass, even stomach stapling (which nobody does anymore) - just not the sleeve.

So I had no serious option except to change directions right in the middle of things. And that's how I came to be here. RNY isn't something I'd want to do to myself, so I accepted the band as my only other choice.

I mean no disrespect to anyone here, but I feel like I was at a great sale, and they ran out of my selection at the last minute. After all this time of anticipating and studying and planning for something else, all of a sudden I need to go 90 degrees in another direction.

Is there anyone here who went through this sort of thing? Did you who chose the band do so after ruling out the other choices? Why? Or was the band your first choice? Can you please help me get my head around why the band is my best option? Help me feel good about this unexpected change. I want to feel great about this, but need some insider knowledge. What do you think?

Thanks,

Dave

I am sorry I can't offer any answers to your specific questions but would like to say that I can see where you felt like someone pulled the old bait and switch on you. :drool: That really sucks. Insurance is hard enough to get through without the misinformation you have had to deal with.

The good news is at least the band has a proven track record and there is a TON of info on this site from real life people...not just numbers.

I wish you every happiness and the best of luck as you move forward with your future.

I had originally met with a doctor who convinced me i needed gastric bypass because for as much weight as i needed to lose it wouldn't happen. I have about 200 pounds to lose. After I went through a few months of the process, I noticed some things about the doctor that I didn't like and stopped the process. Two years later, I came full circle and was revisiting weight loss surgery again. I had recently had a friend get a vertical sleeve that she battled her insurance for a year to get approved. It was the biggest mistake ever. She is unbelievably sick and has lost 175 pounds vomitting for a year. She is now seeing a specialist and going to have to have her surgery revised and they are going to attempt to give her a gastric bypass. Without going into too many of the details of how her surgery went wrong.................it was a deciding factor in why i didn't want a sleeve! I had a cousin who had gastric bypass a few years back and almost died. He was in a coma for a little over a month. He had a long healing process but unfortunately has since then also gained most of his weight back. Both situations were probably on the extreme end, but to have two close people in my life have something horrible happen, I don't think it's a coincidence. These surgeries are very invasive and very dangerous and this magnified the risks.

I began strongly researching lapband in October 2009. I met a few surgeons, went to two seminars, and talked with a relative and family friend who had the surgery. Neither of them had any complications and had not known anyone with complications. They both highly recommended the surgery and have both been as successful as someone with a sleeve and gastric bypass. My concern again was would i be able to lose all the weight i needed to. As one person final put it "you will lose as much weight as you want depending on how hard you are willing work to lose it and keep it off". Neither surgery is a gurantee. Is the band easy? absolutely not. Will I lose the weight as quickly as other surgeries? absolutely not. Two years from now when the weight is gone, will it matter how I got there? Not to me. It's a less invasive way to have the same end result. The risks involved are far less than that of sleeve or RNY.

I was banded on August 13, 2010 after a 6 month nutrition program (insurance required). I am down 70 pounds. 50 of that has been since my two week pre-op diet. Granted I do have nearly 200 pounds to lose, so it might initially come off a bit faster. (results vary)I am very happy with my decision and have been working very hard to be compliant and i think based on my results, i'd have to say the lapband is working. I wouldn't change it for the world.

So yes, the lapband technically was my second choice because i didn't go through with the RNY. But i'd like to consider it my more educated second choice :thumbup:

Two years from now when the weight is gone, will it matter how I got there? Not to me. It's a less invasive way to have the same end result.

Angela, thank you SO MUCH! I appreciated your entire post, but the statement you made that I've quoted above hit me like a ton of bricks. I realized it's not about speed, it's about longevity. How does the old adage go? "Slow and steady wins the race."

Thank you! :thumbup:

Dave

I chose the band over the others because it is adjustable and reversable... the other surgeries are not. seems as though the other complications are more serious. We are all different so why not have something that can be customized to your needs and lifestyle changes? We are always evolving, and we don't all have the one size fits all body.. for me the flexibility of the band and not permantly altering the plumbing were a big sale for me. It has been a year and I am so pleased with my choices, not only with my band but with my surgical team. good luck in what you choose.

Glad something in there spoke to you dave! It just made sense to me to go with a band. As you can see by my profile, i'm quite young and hopefully have a long life ahead of me. The thought of butchering my insides was scary! My friend that had sleeve issues is only 28 and had major issues and having to have surgery to try and reconstruct her digestive system to one that is going to physically work for her! That's a lot to go through! And it's like she put it, it was a major decision she made and she wishes she would've researched her decision more. She was shocked at my progress with the band because she too had been told, "you have too much weight to lose, the band won't work....." i hate that statement!

I too was leaning toward the sleeve. I couldn't find a surgeon that I felt comfortable with to perform the sleeve. I decided to research the band some more by reading blogs of banded people. I came to the conclusion that I liked the fact that the band is reversible. I also saw that if the band failed for me I could always revise to the sleeve. I was banded on 04/05/10. I am down 75lbs. It is working great for me.

Thanks, everyone. Your confidence in your choice tells me it is a "real" option after all. I think this is going to be okay. I just need time to adjust my perspective.

I had a long talk today with a coworker who is banded. He's down 60 pounds in 9 months. Those are valid numbers I can relate to. He's my age and was my size. If I can be 60 pounds lighter in 9 months, I would be a very happy camper. So the journey continues. :thumbup:

Dave

WOW, this is an eye opener for me! I've been researching the band and I met with the surgeon the other day and she talked a lot more about the sleeve and how it might benifit me and so forth so I was really considering changing but now since this I will double check everything. We are also Tricare Prime getting it done at an MTF. The surgeon didn't say anything about it not being covered, I would think they would know! Crazy!

I am fine with getting the band but personally it is a little scary for me to have something inside my body and I'm a little worried about fills while moving around the world!

The place I am having my Surgery done also does the Sleeve. My ins is BCBS of NC. When I called them on the phone they told me that they would cover the Sleeve but when I talk to the lady that handles the INS part she said that BCBS of NC will tell ya that over the phone but when she submits the paperwork they never approve it.

I think right now there is only 3 or 4 ins companies that will cover the Sleeve.

Luke

I had originally met with a doctor who convinced me i needed gastric bypass because for as much weight as i needed to lose it wouldn't happen. I have about 200 pounds to lose. After I went through a few months of the process, I noticed some things about the doctor that I didn't like and stopped the process. Two years later, I came full circle and was revisiting weight loss surgery again. I had recently had a friend get a vertical sleeve that she battled her insurance for a year to get approved. It was the biggest mistake ever. She is unbelievably sick and has lost 175 pounds vomitting for a year. She is now seeing a specialist and going to have to have her surgery revised and they are going to attempt to give her a gastric bypass. Without going into too many of the details of how her surgery went wrong.................it was a deciding factor in why i didn't want a sleeve! I had a cousin who had gastric bypass a few years back and almost died. He was in a coma for a little over a month. He had a long healing process but unfortunately has since then also gained most of his weight back. Both situations were probably on the extreme end, but to have two close people in my life have something horrible happen, I don't think it's a coincidence. These surgeries are very invasive and very dangerous and this magnified the risks.

I began strongly researching LAP-BAND® in October 2009. I met a few surgeons, went to two seminars, and talked with a relative and family friend who had the surgery. Neither of them had any complications and had not known anyone with complications. They both highly recommended the surgery and have both been as successful as someone with a sleeve and gastric bypass. My concern again was would i be able to lose all the weight i needed to. As one person final put it "you will lose as much weight as you want depending on how hard you are willing work to lose it and keep it off". Neither surgery is a gurantee. Is the band easy? absolutely not. Will I lose the weight as quickly as other surgeries? absolutely not. Two years from now when the weight is gone, will it matter how I got there? Not to me. It's a less invasive way to have the same end result. The risks involved are far less than that of sleeve or RNY.

I was banded on August 13, 2010 after a 6 month nutrition program (insurance required). I am down 70 pounds. 50 of that has been since my two week pre-op diet. Granted I do have nearly 200 pounds to lose, so it might initially come off a bit faster. (results vary)I am very happy with my decision and have been working very hard to be compliant and i think based on my results, i'd have to say the LAP-BAND® is working. I wouldn't change it for the world.

So yes, the LAP-BAND® technically was my second choice because i didn't go through with the RNY. But i'd like to consider it my more educated second choice

Angela, you may be young but you have a good head on your shoulders! I think if anyone could be a spokesperson for Lapband, you could!

I am lot older than you. in fact, I'm a new GREAT grandmother (a very young 64 year old), but you could have been the very one to convience me on the Lapband. I'm like you, I don't want my 'plumbing' re-routed, or anything re-arranged. I've never asked for surgery until now. I know that if I add ten more pounds, I will not be able to carry our new baby across the room. And that is a very sad thought to me. I have a lot of miles ahead of me and more things to do than I can count. I'm ready to enjoy the rest of my life!

I will have my surgery on 10/18. Since I live in a small town, i have to travel to Atlanta Ga. for surgery. But if that's what I have to do, I will. Please keep me in your prayers.

Keep me updated with your progess. It looks like you are doing great!! Keep it up. We're in it for the long haul. We're just not going to have to 'haul' as much. :thumbdown:

Take care,

Pat (PitPat)

Thanks Pat

I've always been told I am "well-spoken" and very responsible for someone my age!

Here's a little more of my "whole story" on how I decided on weight loss surgery.

I've been overweight since as long as I can remember. The only time I know i was skinny was at age 3 because i've seen it in pictures! I grew up with a family where EVERYTHING revolved around food, parties, holidays, funerals, everything! My dad was a large man with many many health problems. He had diabetes, thryroid issues, heart disease, kidney failure, hypertension, the works! He had heart surgery in his 40's to clogged arteries, it was the first time my family all took the initiative to "get healthy", for his sake. Well it didn't last long! He was a stubborn man. He went back to his old ways, gained more weight and ended up on insulin and then gained about another 100 pounds after that. He even discussed gastric bypass with his endocrinologist. He was told he wouldn't be a candidate because he was just too unhealthy.

On December 22, 2005, we celebrated an early christmas because I had to work on christmas day. My dad insisted we go to the bank so he could give us all our annual $100 and insisted we go buy my brother a BBQ pit :tongue2: He started getting irritable and asked that we hurry up and go eat dinner. So we picked a place and went assuming that his sugars were running low. I remember sitting with him outside the restaurant and telling him i'd found a store with 5x and 6x shirts we could get him. He said "well, i need to work on this weight, it's not good to be this way, i don't' think i'll need those 6x shirts". Table was called and we went inside. We were at a steakhouse and my dad ordered a veggie plate! I thought it was strange, but he barely touched it. He just sat back and watched all of us eat. Thinking back on it, his eyes were so glassy. He told my mom he had "indigestion" from some tamales he had earlier. He asked her to go with him outside because he was not feeling well. My mom came inside and asked us to pay the bill and pack up because he wanted to go to the hospital. Needless to say, we didn't make it to the hospital.........he died en route.

I got to the hospital, walked passed the trauma room and all I heard the nurses saying were "he's flatlined". I was in shock. I couldn't believe it, we had all thought it would be like all the other times where he would go in for a few days and leave. He was 54. I was 20. His highest weight at that point was nearing 450lbs. I was already weighing 340.

Experiencing his death and illnesses scared me enough to realize I needed to change. My mom begged me for years to take care of myself because I was heading down his path. I wouldn't listen, i was being just as stubborn as him (I am just like him in every way!). I needed to make this choice to take control when I knew I was ready. Nobody else could do it for me.

My mom says he's been my guardian angel getting me through all of this. This has absolutely been the best decision I have ever made. It was a scary one because i'm young.........young people should be able to handle this! But I realized this was a lifelong problem that I needed a lot of help to get under control. Part of me accepting my choice was accepting that I could NOT do this without surgical help and support. All my other diet attemps failed, i'd go back to my old ways. And it's because it was just that, a "diet". I was not making those "lifestyle changes" that I needed

I truly look forward to the future I have. I look forward to having children with my husband, being able to play with them, and being healthy

Now as far as spokesperson goes, that would be a "dream job"! Once I got down to goal of course! I love public speaking and motivating and encouraging other folks when I can. I had my co-worker convinced, she's now started her journey and she thanked me for that! It was very flattering :tt2: :thumbdown:

Angela -

I am so glad to see someone else her who has a large amount of weight to lose - I need to lose just over 200 pounds! I have had a few people tell me that band won't help with that much to lose, but I am not interested in cutting up my insides and dealing with mal-nutrition issues for the rest of my life. I'm almost 10 years older than you, but I can relate to having family pressure to lose weight and needing to reach a point where I am doing the for myself and not to please someone else.

I've found a great surgeon with a wonderful and supportive staff. Now, I'm waiting for final insurance approval so I can set a surgery date - I'm hoping for mid-November...

Kathy