DENIED~

Just wanted to add something to this post. In the past couple of months I have attended 3 different bariatric seminars with 3 separate hospitals and delivered by 3 different surgeons. I was told by each one that they usually do removal and revision surgery at the same time and recommend that fir obvious reasons. However, each one told me that they have noticed that the patients who have had removal and revision about 6 months down the road are more successful than those who have the all in one. One surgeon told me he feels this has to do with the fact that when the band is removed, a certain part/area of the stomach (the part above the band) is lazy or sluggish due to the damage the band causes and unfortunately, this results in the formation of a small pouch at the top of the stapled sleeve. However, if the band is removed and the stomach is given some time to "lay out for a while (I wanna say this is what he said. It has been a few weeks since I attended)", the sleeve surgery takes much better. When the surgery is then done, the upper part of the stomach is no longer as stretched out and the chances of a lil pouch being there is lessened significantly. I hope this makes sense. It sure did when it was explained to me, but i have a feeling I'm not doing a very good job in relaying what was said to me. Lol 

I have been quite curious about this for some time and have asked about it in past posts. It was interesting to have an opportunity to ask surgeons and receive professional answers/opinion on this. Thoughts??

You explained it just fine.  Thank you.  I didn't think of this.  I'm leaning toward getting band out with promises from DH that I can get the sleeve if I gain weight. 

Good to know! I really thought it might come across as a bit confusing lol. I hope everyrhing works out so that you will be able to get revision surgery. My band has to be removed, and i am contemplating revision surgery. I have been without a fill for several years, and my fear is having to go through everything all over again like the first surgery. I got through it but not sure if i could deal with the discomfort all over again

:(

I had a friend in your boat. If your insurance will pay for bad removal your surgeon can just charge you thr difference, which won't be that much. The majority of your bill are from the OR, meds ans anesthesia. 

They actually tried this but the insurance company actually said that if they try to qualify the sleeve with the band removal they won't even qualify the band removal.  UGH!  It would cost me $15k for the sleeve cash pay.  So that's a no go.  Now I need to decide if the band just needs to be removed. 

I would highly recommend that you have the band out.  I just had my endoscopy on Friday and after learning all the damage my band has done, I can't imagine wanting to leave it in - with or without the sleeve afterwards.  The damage the band is causing isn't worth it.  Just my two cents.

read my blog page on how i appealed and won. gotta read your policy. even if you have to pay its so worth it.  D

I'm really glad you were able to get it approved.  The reason my insurance will not is there is an exclusion clause on the policy.  I guess teachers are a chunky bunch.  But, last time with the band they had the same clause but somehow got approval; or so they thought.  I saw the paperwork myself before surgery.  AFTER my surgery the insurance company came back and weren't going to pay.  It took 3 years of me and the surgeon and the anesthesiologist fighting them to get paid.  It was AWFUL because I was about to go into collections with the anesthesiologist until my surgeon stepped in the situation and somehow got it taken care of although I'm really not sure how.  Perhaps he paid but I'm not sure???  He told me that since he told me I was covered that he would not make me pay him and he did not win with the insurance company last I heard.  So...I'm thinking all that is in my file and they aren't going there again.  It helped also that he's a family member of a close friend of my family.    

I'm just hoping with all this insurance regulation they will be forced to cover it eventually.  Also, if obesity is somehow deemed a disease like alcoholism was in the past, they would likely have to cover it. 

Until then I need to decide if I get my band removed or not.  I'm leaning toward getting it out.  I have an appointment next week with the surgeon and tentative surgery date of Aug 6.  I simply can not afford to cash pay now.  I just paid $4000 for hysterectomy, (why I want to do it now as my deductible is satisfied this calendar year.)  we just bought a new house AND we have 2 kids in college.  Next year will be expensive for us. 

Thank for your support!  I welcome input on band removal or not?  I eat low carb so I've been losing this last month. 

I had band removed and sleeve at the same time. My insurance covered it 3 days in hospital..I was so glad to get that band out. I hope something can be worked out for you to have both done at the same time and be covered...I had Blue Cross.

Have you considered having the surgery done in Mexico which would be thousands less if you need to pay out of pocket?? 

I had my surgery in Mexico and not only did I save thousands of dollars, but I did my research and found a surgeon who is trauma surgery trained, and his clinic is accredited by the US Joint Commission.  My insurance did not cover the surgery so I had to seek other options and Mexico was the best for me.

Dr. Maytorena and his staff are amazing.  It might be worth the phone call to find out what they can do about your situation and get you on the road to recovery so you can get your life back. The name of the center is  Long Term VSG ....  Ruben is the coordinator and absolutely fabulous.  They have a FB page as well as a You tube channel.  

Hope that helps.