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Self pay then slippage, now what?



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Hi all,

I was banded in November 2007 (self pay), found the sweet spot after two fills, was loving my band, lost 50 pounds in 6 months, then a major slippage. I took 5 colace (stool softener) tabs, they must have stuck together, I then had a violent episode of vomiting, then noticed a slight difference in restriction and over the course of the next month, it became progressively worse until I had to go to ER as I had not been able to get down even a sip of Water and was becoming dangerously dehydrated. The doctor removed the Fluid from the band and immediately the symptoms disappeared. He told me that it was a major slip but that there was the possibility that the stomach may reposition correctly and if it did that he would try to refill the band. He wanted to give it three weeks for the stomach to possibly reposition. Since the visit to ER was considered an emergency then my insurance covered it. I have BCBS Federal but self payed in Germany (where I live but am visiting the states for the summer.) The German Dr. also told me that it is German law that my insurance has to pay if there are any problems after the initial self-pay (has anyone ever heard of this?)

These are my questions:

When I go for the followup to see if we can try the refill, will my insurance now cover this?

If I have to have surgery to reposition the stomach and lapband will my insurance cover it or:

Will they pay only to remove it or:

Will they refuse to even do that, can the band just stay in there forever unused without causing any problems?

Thank you in advance to anyone who may have any information on this rather complex issue.

Sincerely,

Traveler

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I am also self pay. Part of the 16k was also to cover after care, fills, defills, any problems with slippage or erosion. Check the contract you signed in Germany, I think they should correct the slippage.

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Michee, thanks. I hate to admit this but I don't even remember signing a contract. Whatever paperwork I have is in Germany right now and I'm in the states. I did find something on this site referencing that some states require insurance to cover complications regardless if it was a self pay. So at least what the German doctor said does not seem totally out of line, however him telling me this indicates that I should be relying on my insurance and not him for any solutions to complications. In fairness to the Dr. I believe that he did a wonderful job and that this slippage was my fault due to the Colace (if I could only go back in time to that fateful night..........) My life has changed dramatically since the band and I am desperate to keep it, wish me luck and thanks so much for your timely advice!

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

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