So I have a band that worked great for 18 months. Then I stopped losing weight and found out this winter that I had a dilated pouch and probably a small slip. I'm fighting the insurance company who doesn't want to take it out or revise to a VSG. I suspect I'm going to end up being self-pay after months of angst but that's another story.

I was in la-la land with the band for the first two years. It was working so I just ignored how unpleasant it was. Sliming and vomiting. Heartburn. The contant feeling of swelling. Even on a fairly good week eating solid foods isn't that pleasant. I can always feel the food sit waiting to make it through the stoma. I'm never sure if it's going to get through or not. I can't lay down after eating. Mostly if I'm eating healthy food I'm thinking about trying to avoid discomfort.

I don't think I really feel full like I expected. I should have clued in when the surgeon warned me that I'd have to learn the new signs for being full with the band. I thought I'd feel satisfied after eating. Sometimes I do, sometimes I can eat more and don't. Sometimes I'm in pain and vomiting not knowing when whatever is stuck in there will make it down.

The sleeve is a serious choice. It can't be undone and if I'm self-pay I'm taking a big financial risk. I thought I did my research on the band but I didn't pay too much attention to the side effects. Like everyone I assumed it would never happen to me. The idea of having to be uncomfortable when eating for the rest of my life - I'm not sure if that's something I can live with, even if I get to a good and healthy weight that I can maintain.

I know that foamies, pain with overeating, and other things can happen with the sleeve. But what does it feel like on a day to day basis? How much of the standard discomfort I feel with the band will I feel with a sleeve? Will I feel food sitting around? Or food kind of up in my throat? How about the feeling of pressure or the near-constant feeling of swelling or inflammation? I just want to know what I can realistically expect my life to be like if I woman-up and go for it :-).

Thanks,

Britt

So I have a band that worked great for 18 months. Then I stopped losing weight and found out this winter that I had a dilated pouch and probably a small slip. I'm fighting the insurance company who doesn't want to take it out or revise to a VSG. I suspect I'm going to end up being self-pay after months of angst but that's another story.

I was in la-la land with the band for the first two years. It was working so I just ignored how unpleasant it was. Sliming and vomiting. Heartburn. The contant feeling of swelling. Even on a fairly good week eating solid foods isn't that pleasant. I can always feel the food sit waiting to make it through the stoma. I'm never sure if it's going to get through or not. I can't lay down after eating. Mostly if I'm eating healthy food I'm thinking about trying to avoid discomfort.

If I dare to mention those symptoms on the band board I'm blasted from the banded newbies for being a band hater. I guess I am a band hater, I experienced everything you are referring to above. There isn't a single part of your life that isn't affected by a band. Going out to eat with friends is nothing short of embarrassing. I hated it. Trying to eat lunch at work turns into a puke fest, going out to dinner with your spouse is a waster of time and money.

Most everyone loves their band for the first 6 months. Then at about 1 year the problems are getting bad but the scale is moving and at this point we are living proof that we will do bloody anything to lose weight. We puke, slime, vomit in ways we did not know were possible until we became banded.

You know what is the most bizarre of all of this? It becomes a way of life. You don't realize how bad is bad until you don't have bad anymore. The transition from normal to banded life is so slow you don't fully realize the impact it has on your life until you don't have the problems anymore. As you get your life back you realize just what you gave up for a band.

I don't think I really feel full like I expected. I should have clued in when the surgeon warned me that I'd have to learn the new signs for being full with the band. I thought I'd feel satisfied after eating. Sometimes I do, sometimes I can eat more and don't. Sometimes I'm in pain and vomiting not knowing when whatever is stuck in there will make it down.

Feeling full with a band IS different than with a normal stomach or a sleeve. Full usually means... one more bite and I'll hurl. Having a sleeve full goes back to full, the way it is supposed to be.

The sleeve is a serious choice. It can't be undone and if I'm self-pay I'm taking a big financial risk.

Why would you want to reverse your surgery type? You won't have the same kinds of problems you do with a band.

I thought I did my research on the band but I didn't pay too much attention to the side effects. Like everyone I assumed it would never happen to me. The idea of having to be uncomfortable when eating for the rest of my life - I'm not sure if that's something I can live with, even if I get to a good and healthy weight that I can maintain.

I know that foamies, pain with overeating, and other things can happen with the sleeve. But what does it feel like on a day to day basis? How much of the standard discomfort I feel with the band will I feel with a sleeve? Will I feel food sitting around? Or food kind of up in my throat? How about the feeling of pressure or the near-constant feeling of swelling or inflammation? I just want to know what I can realistically expect my life to be like if I woman-up and go for it :-).

Thanks,

Britt

It feels just like it did before I ever had WLS but I get full faster. Life with a band vs. sleeve is like night vs. day.

Thanks Wasa, your input is really helpful! Unless I gain another 30 pounds Fed BCBS isn't going to budge on fixing this. I got their appeal acceptance and they totally threw down the gauntlet to make sure I knew that the 35 BMI was non-negotiable. I'm guessing I will eventually win having them take the band out but that won't help much since my doctor here does explant and vsg as two separate surgeries six weeks apart. And I can't seem to find anyone except for Dr. Cirangle who'd do it all at once and just charge me for the additional procedure cost. But I understand that he has an $8k post-op program which would put me back up higher than just scheduling with Dr. Aceves in the first place. I need to check on that but Dr. Cirangle's business office never returned my calls or emails after I had a consult with him and my first conversation with the coordinator.

I completely trust Dr. Aceves and would be happy to go to him. But I would worry about some future complication that the insurance company would refuse to cover. Ah, why does it have to be so hard.

What I meant by the VSG can't be undone is that if a few years from now some complication occurs my stomach can't be restored. I don't know what problem could come up, it's just that I'm a little more cautious this time around.

Thanks again!

Britt

Dr. Cirangle's office can be disorganized. I always get my appointments rescheduled because they mess up the calendar. But he's great!

I think other surgeons do it as one procedure though. Some prefer it that way and some prefer for you to heal in between so it's going to vary.

Thanks Wasa, your input is really helpful! Unless I gain another 30 pounds Fed BCBS isn't going to budge on fixing this. I got their appeal acceptance and they totally threw down the gauntlet to make sure I knew that the 35 BMI was non-negotiable. I'm guessing I will eventually win having them take the band out but that won't help much since my doctor here does explant and vsg as two separate surgeries six weeks apart. And I can't seem to find anyone except for Dr. Cirangle who'd do it all at once and just charge me for the additional procedure cost. But I understand that he has an $8k post-op program which would put me back up higher than just scheduling with Dr. Aceves in the first place. I need to check on that but Dr. Cirangle's business office never returned my calls or emails after I had a consult with him and my first conversation with the coordinator.

I completely trust Dr. Aceves and would be happy to go to him. But I would worry about some future complication that the insurance company would refuse to cover. Ah, why does it have to be so hard.

What I meant by the VSG can't be undone is that if a few years from now some complication occurs my stomach can't be restored. I don't know what problem could come up, it's just that I'm a little more cautious this time around.

Thanks again!

Britt

If your insurance will pay for a future complication if a US doctor did your surgery they would pay for it if a non US doctor did your surgery. "Where" you have surgery is not the issue, it is "what" your insurance covers.

I think everyone worries about a surgery type that is not reversible. I fretted over that as well. It's a lot easier to come to terms with it after it's done. ;o) After it is done you kind of sit back and wonder why you fretted over it. Also, when you are having band problems and it goes on for months and months, when you switch to a surgery type that you still lose weight without battling your stomach on a daily basis, it's a huge relief.

Have you talked to Vicki the insurance guru? She's a wealth of information. I'd push insurance and appeal everything you possibly can before considering self pay anywhere.

I have BCBS/PPO (NY) and they wanted a 6-9 month paper trail of documentation before they would "consider" paying to get the band out of me. They would not pay for VSG and I could no longer live with band so I went to mexico... no regrets.

I had my band removed and could not be happier. It's not like you feel different. You just can't eat as much. There is no food getting stuck, one day you can eat a certain food and the next day you can't.

Life is very normal with the sleeve. Mac's aunt had this same surgery a long time ago for stomach cancer and has lived very well with it.

I am not sure what complications you're thinking could come up.

I was thinking about a leak or infection that's not detected during the initial hospital stay. Or some other related stomach complication like cancer or reflux - anything that the insurance company could claim was related to the partial gastrectomy and therefore not covered.

Usually I have the will to fight. But I just want the band out. I called Dr. Cirangle's business office today to find out what my portion of the cost of revision would be if the lap band removal was covered. I think that'll determine a lot about what I'm willing to wait for vs. what I'm willing to pay for. I'm at the point where $11k feels easier to come by that creating more paperwork and wading through two more rounds of appeal... Especially since I have confidence in Dr. Aceves and also feel better knowing that I'd be under care for 3 days after surgery and not just sent home asap.

Even though I'm only 25 pounds away from the BMI requirement I just can't gain that weight again. It's not worth the money. I had to fight a bit to get the lap band covered the first time around with a different insurer, they didn't agree that my comorbidities justified the band. So my BMI went up from 35 to 38 while I battled it out. It was so demoralizing and it seemed so stupid - the general implied advice that if I just gained more weight my surgery would be covered without question.

I definitely appreciate everyone's input. The sleeve seems like exactly what I hoped the band would be. I'm just more cautious this time around. And scared I guess that even if the VSG feels better what if it doesn't help me lose more weight. I wish this all wasn't so hard!

Thanks,

Britt

I only gained back 15 lbs when I started

having band problems. As far as I was concerned, that was 15 too many. I couldn't wait to get to Dr. Aceves and get that band out.

Dr. Aceves has never had any complications. He is an excellent surgeon and is extremely experienced with band to sleeve surgeries.

I was thinking about a leak or infection that's not detected during the initial hospital stay. Or some other related stomach complication like cancer or reflux - anything that the insurance company could claim was related to the partial gastrectomy and therefore not covered.

It's going to depend on where you live and what your policy says but a lot of them will cover that sort of complication even if they don't cover the surgery. That's what my insurance told me.

I have a weight loss exclusion so my surgery wasnt' covered and I was worried about complcations. The insurance company wouldn't promise but they implied rather heavily that a leak would be covered. They flat out stated a band removal wouldn't be covered.

I definitely appreciate everyone's input. The sleeve seems like exactly what I hoped the band would be. I'm just more cautious this time around. And scared I guess that even if the VSG feels better what if it doesn't help me lose more weight. I wish this all wasn't so hard!

Thanks,

Britt

I was gun shy about another WLS as well. I was really scared that a sleeve would just make my problems permanent but it didn't, it fixed everything.

Life can be so miserable with a band and you just get to the point that you can't trust another WLS. I know exactly how you feel. You don't want to live life like this anymore but you don't want to gain weight either. It's a hard decision to make.

Dr. Aceves has never had any complications. He is an excellent surgeon and is extremely experienced with band to sleeve surgeries.

I doubt that he's never had a sleeve complication, it's leaks. He's never had a leak with a sleeve. He's probably had some other types of complications.

Oh, I thought you told me he hasn't had complications when I told you about my friend. You said you didn't want her to be his first one. Maybe I misunderstood you.

I thought the OP was saying she was worried about cancer down the road. Dr. A or no doctor for that matter has control of that.

Oh, I thought you told me he hasn't had complications when I told you about my friend. You said you didn't want her to be his first one. Maybe I misunderstood you.

I thought the OP was saying she was worried about cancer down the road. Dr. A or no doctor for that matter has control of that.

Yes, that was the lady that wasn't planning to follow the post op diet. I didn't want her to be his first leak, it wouldn't even have been his fault.

She still can't eat. She is extremely nauseous all the time and pukes often. I asked her if she is taking her Effexor and she said no, she is not able to take any pills at all.

If you watched Michael Moores documentary "Sicko", you will remember that insurance companies are looking for a way to get out of paying for just about everything. If its not the VSG, they will find something else. I hope you get to change insurances to one that accepts pre existing conditions.