Am I out of options? Help!

Have been thinking about the lap band surgery for over a year now...  In the past couple of days I really feel like I've decided that I want to do it and I'm ready to do it.  Just called my insurance company to see if it is covered and I found out my employer excluded it from our plan!  I'm feeling heart broken right now.  Is there any other options for me?  I'm not sure what the surgery and fills cost if you are paying out of pocket.  Most likely this wouldn't be plausible for me.  I am single, working full time and going to graduate school full time.  Money is tight.  I don't know that I could pay for this surgery. But please, anyone thats been through this let me know what you did!!!!

My option when my insurance excluded WLS was to self-pay in Mexico.  I had a great experience there, and great care.  I am now seeking a DS, however, as the band has not been a good choice for me.

I requested your friendship... I'd like to talk more about your experience in Mexico.  Thanks!

HI, Can you tell me why the band has not been a good choice for you?  I have really been trying to decide what kind of surgery I'd like to have.  I was all decided on the duodenal switch then my insurance company denied it.  I have to do some doctor documented weight loss program first
for 6 months before insurance will consider approving my surgery.  It's all such a bunch of bs because I have pages and pages of diet history, but  you have to play the game.  Anyway, I was kind of thinking about the lapband, but it didn't seem like it has as great a success rate.  Can you share your experience of the lap band with me?  Thanks! Hope

There is a lot of published data out there showing the band to be less effective than RNY or DS.  It also is neccassary to have the band adjusted every 4-6 weeks until the optimal restriction  is reached.  Ultimately, for me and many others, it becomes neccessary to diet while the band is in.

In my case, if I had been good at dieting, I would never have become morbidly obese.  On my last fill, despite me still able to eat larger meals than I should be able to eat, it was determined I was overfilled, so fluid as removed.  This resulted in me being able to eat more.   So, I travelled from Omaha to Tijuana 6 times to get the band to the right spot.  (I have a VG band, which is imfamous for being difficult to get adjusted properly. )  In fact, Imamed now has a new model (Apex?) that is designed for better results.

Bottom line in my opinion.....band may be effective if you need to lose 30-50 lbs, but for those of us in the Super-obese category  the results are less than the gold (RNY) and platinum (ds)standard n some people (average 3 year EWS about 30-40%.)  But it has not worked for me, and I need a procedure that is more effective and suited to my requirements.

Hey,  Thanks for all the info.  I totally agree with what you are saying and that is why I wanted the duodenal switch in the first place. Dr. Sudan said with the duodenal switch the stomach funcitioned more like a normal stomach and that you coud drink and eat during your meals.  Plus he said there  was less vomiting and that there was no little pouch for the food to get stuck in.  Also there is no dumping symdrome with the duodenal surgery. Plus, I think the weight loss is optimal because of the  malabsorbtion issues.  I really wanted the duodenal procedure and now Dr. Sudan is moving.  I thought he was the top in his field and am not sure where to turn to find another surgeon as qualified as he at that particular prodedure.  Will you be having the RNY or the duodenal switch?  I have a long way to go towards gettting insurance approval before I can have surgery.  Good talking to you.  Keep us informed about your surgery and good luck.  Hope

Hello;
I was also a patient of Dr. Sudan's; I have been there since Nov. 1st. I am a Medicare patient and his leaving has really put me in the lurch. Also;. Dr. K tried to convince me to switch from a DS to the Band. Probably because that is what Dr. Forse performs.

I am going to move over to Methodist and Dr. Gary Anthone; I went to their seminar last Thurs and was very impressed.Dr. Anthone came from USC and has performed over 1000 DS surgeries. I have a friend who had Dr. Anthone perform his DS and he just raves about him. My only problem  is that they are not yet a Center of Excellence (they expect to recieve that designation any day now). On the good side they told me that my 6 months of medically supervised weight loss will be credited to me and I will not have to repeat it. I know insurance is a big problem for a lot of people. But maybe it wouldn't hurt to let them investigate it for you. They seem very knowledgeable. Maybe they can find a way. Anyway I wish you the best of luck.

MyPappyBlue

Here's some food for thought.(sort of speaking).....I had my band done by Dr. Holloway in Scottsbluff in 02. I lost my weight in about a year and have done just wonderful. I know his office has a private pay plan and he also does fills for some that have had the surgery in Mexico. Dr. H goes to Ogallala monthly for visits and fills. He is totally awsome! Beth in North Platte

Hi, It is such a heartbreaking thing when your insurance company won't pay for wls. There are loan companies who will loan money for surgery. You may have to wait until you finish grad school and get a job that does cover wls. Please be careful before you go to Mexico. Do lots of research and make sure you have a local surgeon who is willing to take care of your band adjustments before having surgery. This will save you a lot of hassle later. Dr. Holloway does do band adjustments for mexican bands. It would mean coming to Ogallala to see him. He is aggressive with his fills and will need to see you monthly for the 1st year. That will make you more successful with the band. We do have a private pay option but the money has to be paid before having surgery. Good luck. Mona

Hi Mona,
My insurance won't pay for my lap banding, but I am still wanting to have it done.  I will have to go to my bank and take out a loan, as I don't have the money up front to do it other wise.  I had to change my Aug. date, as I couldn't get off from work, so I will be seeing Dr.Forney in Sept.  I feel kind of sad that I couldn't get the Aug. date, as I want to get started ASAP.
Kathy H