Major lap band complication
My daughter had a lap band done in 2008 when she was a 21 year old student on our insurance. Last month, she was visiting Scotland and got really sick. At the hospital in Scotland they did tests that showed her band had slipped and she was totally blocked. 2/3 of her stomach had slipped up over the top of the band and they told her she had to have it out immediately. The did laproscopic but could not safely take it out that way. So they just cut it in half. They also cut the tube leading to her port. She was told that when she got home to the US she had to have it removed. She has been having horrible pains where the tube to the port is now poking her in the side. She is home and we went see a doctor. She is now a high school teacher and has her own insurance. Her insurance does not cover bariatric surgery and the doctors say that her insurance will not pay to remove it because it's bariatric. The doctor here says that by cutting the band where they did in Scotland, they have left rough edges that are going to erode into her stomach and cause major damage. They say it's medically necessary, but that they don't think her insurance is going to cover it. Does anybody have any suggestions? She doesn't have the money to pay cash for an operation (and neither do I), it's going to cost a fortune.
I'm terribly sorry that your daughter is going through this. I would recommend possibly giving Dr. Michael Baptista a call. He is a very kind and compassionate surgeon and he might be able to possibly help your daughter.
Florida Surgical Physicians, Jacksonville Florida
9471 Baymeadows Rd, Jacksonville, FL 32256 Phone:(904) 724-2263 Maybe they will have a payment plan or something of the sort. Or your daughter may want to look into getting a loan because this is a very dangerous situation she's in currently. I wish her the best.
Avoid kemmerling, Green Bay, WI
Dr. Baptista was the doctor who put in the lapband. When the complications started in Scotland I reached out to him and he tried to help as much as he could. However, when we went to see him when we got back, he insisted that there was no way that his lapband could have slipped that the doctors in Scotland didn't know what they were talking about. Then he said that he could remove the old band and put in a new one, but my daughter told him that she did not want a new band that the things that had happened to her a frightened her away from having a new one. Once she said that she didn't want a new band, his whole attitude changed and he was through with her. The insurance company said the only way that they might possible cover it is if the physician wrote a letter saying that it was medically necessary. When we asked him to do this he flat out said no, that it was a waste of his time. And then they stopped returning my daughter's calls. He may be kind and compassionate if you go along with what he wants you to do, but if you don't want his lapband anymore, he is done with you.
This is a very dangerous situation and it must be removed immediately no matter what you have to do! Get it out even if you do have to pay for it or both of you get loans to do it what ever you have to do I don't think you realize how dangerous this is to have those loose ends in there and a lap band just floating around in there could easily kill her if it gets to the organs and punctures one of them! The lap band is dangerous enough on its own but one with pieces just loose in the body is a lethal situation! Try going thru the ER with extreme pain and beg them to get it out. Any band can slip ot doesn't matter how well it is taken care of!
We are working on it. As of today she is scheduled to have it out on August 14th. However, they may not do it if there is no insurance. We have already discussed the ER thing. Nobody warned us in 2008 that she was setting herself up for a lifetime of having ailments not covered by insurance if the company should decide that they were caused by the lapband. If we had been told that, we, as her parents wouldn't have let her do it. I only posted here because I was hoping that someone might have an idea on something that would work with the insurance company.
My doctor once said to me that if I go to the emergency room with a gallbladder attack (I was asking about gallbladder but this may help you too) then they would have to pay for it because its life threatening. If I am just discomforted then its "elective". Hmmm...so perhaps she can get a doc to say its life threatening and then insurance would pay not as bariatric surgery but as prevention of a life threatening issue? Get another opinion with another doctor. Some docs are better at getting insurance to pay than others.
I wish her well!
My doctor once said to me that if I go to the emergency room with a gallbladder attack (I was asking about gallbladder but this may help you too) then they would have to pay for it because its life threatening. If I am just discomforted then its "elective". Hmmm...so perhaps she can get a doc to say its life threatening and then insurance would pay not as bariatric surgery but as prevention of a life threatening issue? Get another opinion with another doctor. Some docs are better at getting insurance to pay than others.
I wish her well!
they would have to pay for gallbadder because it is a covered surgery.
They DONT have to pay for ANYTHING,life threatening or not,if it is not a covered benefit.
The hospital HAS to do the surgery,if it is life threatening at the time the person is seen in the ER,but insurance can legally refuse payment for it,period,if it is not a covered procedure.