Enough of a reason for revision?

Felicity Q.
on 8/12/15 3:45 pm
DS on 09/28/15

Hi friends,

My claim is submitted to insurance to revise my lap-band to an RNY and I am now in the wait-and-doubt-myself phase. I had no official complications with the band - no erosion per my EGD, nothing that caused me to have to have to see the emergency room. The band was done in 2011, and I had several fills done to get the right amount of restriction.

Now, over the past 4 years I have lost about 40lb at the most, and regained and lost up to 10 of it. I occasionally have to throw up after drinking water and OFTEN dense proteins won't pass, no matter how much I chew them.  The other night, I even found that some shrimp I had eaten the night before hadn't passed overnight - not to the point of throwing up, but there was pain around the band when I woke up, and drinking water caused me to start the pre-throwing-up salivation.

I'm miserable with the band, saw almost no significant weight loss. I'm worried now that I won't be approved for a revision because you could argue that if it's mechanically sound, then it's not medically necessary and they won't do anything about it!

If it's not filled enough, then I won't be able to eat anything.  If it's considered filled too much, then unfilling some will just mean I can eat more and maintain this high and miserable weight.

Any advice? Does this sound familiar to anyone else's problems with the band? I haven't been asked to do a barium swallow x-ray (or whatever) so I don't know if the band is slipped? Or can they tell that with an EDG?  Ugh. I just feel useless right now.

Lap-Band 2011 | DS Revision 9/28/15 | HW: 380 in 2011 | GW: 140

Blog: http://felicitywls.blogspot.com/ | Twitter: @FelicityQ13

Baby1234
on 8/12/15 4:51 pm

I know how you feel.What is your insurance?

Felicity Q.
on 8/12/15 9:23 pm
DS on 09/28/15

I have Anthem Blue Cross (PPO)

Lap-Band 2011 | DS Revision 9/28/15 | HW: 380 in 2011 | GW: 140

Blog: http://felicitywls.blogspot.com/ | Twitter: @FelicityQ13

Lisa09
on 8/12/15 6:01 pm - NH

Stay positive. If you're morbidly obese and/or have co-morbidities, I would think you qualify.  The band isn't working for you. My WLC says they're doing a ton of revisions from band to RNY. I'm also in the process of the same revision, but they haven't sent me to insurance yet. I had a barium x-ray the other day but I thought it was to see if the band was in place so they can take it out easily.  If your insurance denies, you can appeal. Be positive. Don't worry about something that hasn't happened yet. Stay on your game, girl!

Felicity Q.
on 8/12/15 9:26 pm
DS on 09/28/15

Thanks for the encouragement, Lisa! Was your band slipped? Did you have any issues with it?

I'm definitely fat enough (lol) - I had a BMI of almost 55 when I went to the bariatric center to inquire about a revision. Just curious if anyone else had a revision without any major issues with it (no slip, no erosion, no initial weight loss - I didn't lose any to regain!).

Lap-Band 2011 | DS Revision 9/28/15 | HW: 380 in 2011 | GW: 140

Blog: http://felicitywls.blogspot.com/ | Twitter: @FelicityQ13

Lisa09
on 8/13/15 6:55 pm - NH

I didn't have any slipping or major issues with the band, Felicity, just that it didn't work well. I complained about sliming and vomiting and never got the right fill. I had it done in 2007 and way more now than I did then. Good luck!!

Felicity Q.
on 8/14/15 8:18 am
DS on 09/28/15

Thanks again Lisa! Did you get approved for a revision the first try?

Lap-Band 2011 | DS Revision 9/28/15 | HW: 380 in 2011 | GW: 140

Blog: http://felicitywls.blogspot.com/ | Twitter: @FelicityQ13

Baby1234
on 8/13/15 1:34 am

Insurances are all inconsistent.

Karen D.
on 8/16/15 7:06 pm - NY
Revision on 11/24/15

You just dictated my story.  I have the same issues and not sure that I will get approval for revision.  I'm seeing my doc this week.  I've noticed though the last couple weeks I seem to have a bit of heartburn which I've never had in the 9 years I've had the band.  I have not lost well and am still pretty heavy despite working out every day and changing my eating habits greatly.

Keep us posted...

Felicity Q.
on 8/16/15 8:39 pm
DS on 09/28/15

Thanks Karen, I definitely will!  Per my surgeon's office, I should find out  sometime this coming week!

Glad to know that there are others like me!

Lap-Band 2011 | DS Revision 9/28/15 | HW: 380 in 2011 | GW: 140

Blog: http://felicitywls.blogspot.com/ | Twitter: @FelicityQ13

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