Help?!?! US to UK band revision maybe?

Hi Everyone!

I'm in need of some redirection and was hoping that someone out here would be able to help me out. I'm an active duty military spouse and was banded at our last duty station in 2008. My weight loss was slow but I was happy with that. I didn't want to loose too much too fast. I went to see my doctor on a monthly basis and was able to loose 70 pounds out of the 116.5 I had set as my goal over the course of 3 years. I wanted slow, I never intended for it to be THAT slow but again, the weight was gone and I was happy. 

Fast forward a few years later and we got orders to England. I was super excited about this but worried about how my band care would be. So here we are visiting family as we make our way across America and over to England. While we were in Florida, I started feeling a little sick. I felt food not going down so well and a few times I either foamed and would spit or just felt the pain of food being stuck, sometimes even over night. My husband was worried that my condition would get worse as we flew across the pond so we called Tricare, found a local band surgeon and went to pay him a visit. Turns out, he was the top surgeon in that area and after checking my band under x-ray and determining that everything was ok, he decided it was best to deflate my band. My heart sank because I had been at my sweet spot, and loosing consistantly, for months. He advised that I'd need to find someone to pick up my care once we got settled into our new home. 

So I'll admit, I took advantage of being able to eat whatever I wanted when we first got here. I mean, there was fresh baked bread everywhere! And tons and tons of cakes and pastries to try! By the time I was settled and able to see my PCM, I had gained 20 pounds. I wasn't proud of that but I felt I had gotten all the "trying new foods" bit out of my system. I made my appointment and met with my new doctor. First off, he gave me a really hard time about having been banded. He made me feel like I took the easy way out when in fact, the decision did not come easy for me. He gave me the referral I needed and I was off to see my new band doctor in London. The doctor there is great, I like him and his assistant even though they are really hard to get a hold of. He gave me a very tiny fill the first time I saw him because he wanted to do it under scope- made sense since he was not the one who placed my band. By the time I was able to see my doctor again in London, my referral from my insurance had expired (here they are good for 90 days where as in America my referrals were good for 12 months!) so I had to go back to my PCM. Again he gave me a hard time this time saying I was taking advantage of my insurance. Why? I don't know, the insurance company (Tricare) doesn't sign his checks (he's active duty as well) so it really shouldn't have mattered. Anyhow, I get the referral and back to London I went. The doctor there is aggressive with fills and filled me to capacity. I left knowing I'd be too tight and days later, when I wasn't able to even drink water, I went back. He took everything out and suggested I come back in a few weeks. Again, I had to get a new referral and again it was the same cycle: doc here on base was a jerk, London doc overfilled me (my sweet spot was 6.7-6.9 CCs in a 10 CC band and I swear I've told him this at every visit) and again I had to get liquid taken out. I've been doing this for the past 2 and a half years now. I have gained nearly all my weight back- I think I'm 5-6 pounds lighter today then the day I was banded. I'm frustrated. I'm disappointed. I need help. I need direction. 

The very last time I saw my doctor in London it was the same thing- he gave me a very big fill, I spent 4-5 days puking EVERYTHING up and by the time I made it back to his office, I had lost about 16 pounds. He unfilled me again and suggested I think of a different surgery. He said that with all the fills and unfills I was stretching out my actual band and that eventually it'd loose it's elasticity. He suggested I go for gastric bypass but honestly, the thought of that scares me. Don't know why, but it does. I told him, if I could do it again, I'd go for the gastric sleeve. He said it's HIS preferred surgery and the preferred surgery of the insurance companies out here in England. My thought? I'd check to see if my insurance covered it- which apparently Tricare does not. My next thought? I'd apply for this insurance and have them revise my surgery. The problem? I'd start from square one and have to jump all the hurdles again. His assistant told me from start to fini****'d take me over 2 years and there was no guarantee the insurance would pay for it. She suggested I self pay but there's no way I can afford it. 

So I guess my question for the board is, are there any spouses overseas that have had their band taken out and another procedure done? If so, which one? Why? And any advice on what I should do would be greatly appreciated. I just hit my 5 year band-aversary and have been feeling like such a failure. I don't think the band was the right choice for me as someone who will be moving with her spouse every few years. I don't want to knock the band because at one point I thought it was the right choice for me. If I could do it again, I'd push for the sleeve because I wouldn't have to worry about finding a band doctor to do my fills at every base. 

Thank you for taking the time to read my rant and for any advice/suggestions you may have. 

Blessings! 

Hello,

We are sorry for all you are going through!  If you have not done so already, please post this to our LAP-BAND Forum and our United Kingdom forum.  The UK forum is not very active but you never know if someone will see it and be able to respond. Also post this on our Revision Forum too.

Please keep us posted on how you are doing.

Regards,

Member Services

You seem really  unlucky! I don't know how your insurance works but there are good band doctors here as well as the awkward ones you seem to be encountering. In th UK, once our "package" comes to an end, typically after anything from six months to two years (depending on what we signed up to and paid for) we pay for our own fills. So independent hospitals (I.e. not NHS ones) are used to taking on people they did not band. There are several chains of hospitals which do bariatric surgery, three of the best known being The Hospital group! WLS and Spire. Fills typically cost around £100. 

Rather odd to be told you were stretching the actual band! I thought that was not possible!

and also odd about UK insurance companies  preferring the sleeve. In the UK we do not have the sort of insurance you have in the US. We either use th NHS or we pay for additional insurance but this would never cover bariatric surgery of any sort.

,

, 

When we were in the US the doctor's office took care of all my insurance paperwork- they made sure my referrals were good for 1 year and billed the insurance with no problems. Here they are only good for 90 days which poses a problem. It's hard to get a hold of the London doctor- my calls go unanswered so I've resorted to emailing his assistant and typically it takes her a week to return my email. Even when she does, appointments don't come easy because he only sees patients certain days of the week and sometimes it conflicts with my schedule. I am in Norfolk and have to travel to London for these appointments- it's who my insurance has referred me too. Recently I was seen at a Spire hospital in Cambridge for something unrelated to my band and saw they have a bariatric ward however, I did not get any other info from them. Luckily, my insurance covers my fills it's just a HUGE PAIN to get them. I've switched doctors and even this new doctor gives me a hard time about getting the referrals. I've gotten to the point where I've given up. 

I thought it was odd he'd say that too but both him and his assistant said that after so many fills, over the course of several years, the rubber lining in the band looses it's elasticity. They were not designed to be inflated and deflated so often. I'm still not so sure this applies to me- I have not had it inflated and deflated what I would consider too often. Even here, I've been down to London for this less than 10 times. 

I may have been wrong in using "insurance" as the word. I was told NHS prefers the sleeve. I assumed NHS was the insurance. I was told thru NHS it would take me 2+ years from start to finish and even after going to all the appointments, it was not guaranteed it'd be covered. Thing is, if I were to start the process with NHS, by the time my 2 years came I'd be gone to the next location :( I'm not looking for an overnight fix, but would like to be heading in the right weight loss direction within the next 6 months...

The NHS is the taxpayer funded National Health Service and is not an insurance scheme. We do not pay for treatment nor do we pay insurance premiums, it all comes out of taxation. It covers all necessary medical care for all UK citizens but bariatric surgery is only done on the NHS for those with serious co-morbidities. So the majority of wls in the UK is self pay.  This means that most of us pay for our own after care unless the NHS agrees to take us on.

if the doctor you were referred to in London was an NHS doctor, many of them are less than sympathetic towards obesity surgery although it is getting better.

if you could pay for your fills etc. you could refer yourself to a hospital like Spire.  And probably for not much more than the cost of your train ticket to London!

Ok, that all kinda makes sense now.

I'm pretty sure the doc I see in London is NHS or at least has some sort of ties with it. He and his staff have been very kind and helpful when I do see them. It's just the getting out there that's the problem. I have to wait until my doctor has an appointment available, then I have to wait on my insurance to approve the referral, after that it's getting a hold of the London doctor and finding an appointment that fits both schedules. When I do go out there, it's a quick trip- I usually drop my kids off at school, get on the train, see the doc then head back before the kids make it home. It all goes by soooo quickly! 

I will have to check and see if I can start going to the Spire in Cambridge from now on. It's soooo much closer

There is no rubber in a lap band, not unless you were banded in Mexico and got a MidBand.  In a Realize or Allergan band there is only silicone, titanium, and medical grade plastic that does not have elasticity that will give out.

Once again (!!!!!!!),  idb and I agree! I thought it a pretty weird comment from the doc!

Oh wow well I don't know how it works in the UK but I know for a fact that military treatment facilities (MTF's) do the sleeve gastrectomy here in the states. There are several military wife sleevers on here! So I know it's POSSIBLE to get the sleeve done through the military. I'm just not sure if there are MTF's in the UK that could help you out so you would need to do your own research on that.  If there are MTF's in the UK, you might be able to get treatment. There are some UK folks that travel to nearby countries that are far cheaper to get the VSG procedure. I've seen a few of them post on other sites about traveling through medical tourism to nearby countries to get bariatric surgery from the UK. I went to mexico to get VSG because I had no insurance coverage for weight loss surgery.

Well this is certainly HOPEFUL news! I haven't checked into MTFs in my area or any surrounding countries yet. I started my journey thru ObesityHelp my first time and decided this was the best place to start this time around.  We don't plan on going back to the states until this coming summer- if I could have something set up for that time it'd be great as well.