Anyone else for the bonus plate of band + hiatal hernia?

helensmith · October 11, 2006

:faint: Well i saw the doc today, and i find out i have a hernia in stomach area , she is debating on even doing surgery now and is though thinking of doing them both at same time too, she said she needs to think on it. now i got to go get a cat scan of tummy, see a heart doc, and phyciatrist of course, my doc i see him on monday for my letter. and she saying insurance saying 6 month diet from doc , insuracne told me they did not need that i am now at stage of giving up hope , just a big merrygo round

:deadhorse:

sueol · October 11, 2006

Helensmith-Don't give up, I was so depressed for about 3 weeks waiting for insurance. I too have an hiatal hernia and my doc is doing it all at the same time. My insurance denied me two times and on 10/2/06 I was denied and approved within 3 hours. Power of prayer. Keep on praying and don't give up hope. That is what the insurance wants. Keep up the fight. Good luck.

BJean · October 11, 2006

helensmith: You didn't say if your hernia is a hiatal hernia or some other type of hernia in the stomach area.

I had a hiatal hernia. When I went to my doc's seminar about LB surgery, they told us there may be some people who are not a candidate for LB surgery. One of the reasons he said that someone might not be a candidate for the LB is having a hiatal hernia. I was so afraid that I would not be able to get the surgery, because I knew I had a HH for years.

However, I had the required upper G.I. tests and they discovered that my hiatal hernia was relatively small. When I consulted with my doc (surgeon) later, he said that only large hiatal hernias would make it difficult for a patient to have the Lap Band. He also added, however, that one of his current patients who had a very large hiatal hernia, came in and had the hernia repaired and was waiting one year after that surgery to have the Lap Band surgery.

Until you know more about what kind and size of hernia that you have, no one can probably be certain if it will keep you from getting the Lap Band. Unless of course, you have a doctor who doesn't want to do the surgery if there is any kind of hernia, either hiatal or other. My surgeon is an expert in laprascopic hernia repair, so he may be unusual in that regard.

I had my hernia repaired at the time of the placement of my Lap Band. The doc said it was not a problem and only took a few minutes. I have not had any complications at all, and in fact, do not have the pain in my chest from the hiatal hernia that I had before the surgery.

Good luck and keep us posted on how you're doing!

helensmith · October 12, 2006

geesh , i appreciate your prayers , the herinia is form so many opertions on stomach area it is wearing and has a size of a baseball that pouches out but stomach under right breast is size of football and about 1" bigger thank left side i thought that was just from the scaring where they cut me open 4 times on stomach does not hurt i think its a insisional hernia, but i just got apt for cardiac doc next fri and waiting on phyc to call back and doc for apt for cat scan and then i get blood work done so i will know with in a few weeks i guess, my doc put on paper of referal for bariatric surgery for me (quote ) This is to certify that Ms Smith is under my medical care. She has hyuperlipidemia and worsening type 2 diabeties. she has failed a number of diest and has tried to lose weight unsuccessfully over the past frew years, she has asthma and memorrioids tthat have been exacerbated by her condition as well, while her blood pressure is currentyl controlled, i do not expect her other conditions to improve without some weight loss. i think that she is a good candidate to undergo bariatric surgery. ( end quote) now with him saying that i i have been with him for a few years trying to loose weight will that be sufficent enough for the six months ? i am so depressed, :help:

BJean · October 12, 2006

Helensmith: I totally understand your depression - I've sure been there! And I still fight it every day. I hope you can get a handle on it because the depression just complicates and tends to undermine our efforts sometimes.

Every insurance company is different. I guess part of it depends on how good your policy is and how long you've been with the company, etc. Insurance was not even an option for me. I had to find the money elsewhere because my insurance company flat out denied us with no chance for appeals.

I've read here at LBT that some companies will agree to take a second or third look at the recommendations of your doctor(s) (would your cardiac doc consider writing a letter?) and will eventually agree to pay - if you and your doc will keep trying. If you are determined to get the surgery, your doctor will be more determined as well. If you give up too easily, they will too. It takes effort on your doctors part but if you really believe you want it, they won't mind putting out the effort and getting the paperwork done - several times, if necessary.

Please don't give up hope. It sounds like you have several hurdles to overcome yet, as far as tests, etc., are concerned. If any insurance company is willing to pay, it looks like yours should. And all of this just takes some time.

My doctor doesn't like to see a patient and schedule LB surgery right away. He says we all need a period of time to work on a plan and get used to the idea in our heads. So don't be depressed - be pro-active - figure out what you need to do to get the help you want, and keep poking them until someone says YES!

Veggestyle · October 13, 2006

I finally know when my surgery date is: November 20th!!! I will be having a hiatal hernia removed as well. I definitely plan to report back here and let you all know how it goes! I hope everyone is doing well! :bounce:

MarySue33 · October 13, 2006

I was just banded on Monday and my surgeon repaired a previously unknown to me hiatal hernia, too. I am self pay and I am starting to think that maybe that's a good thing -- that perhaps the insurance will pick up some of the cost of the surgery now, including anesthesia, etc. Has anyone else had experience with that aspect of it? Even if I have to pay for it myself, it's fine with me. I am just glad that it is fixed now and I am starting out right.

BJean · October 13, 2006

My doctor and hospital are submitting their invoices to my Insurance Company, with the hope that they will cover some part of them because of the hiatal hernia.