any body have band out and not regain?
Cerita,
Hello! I had my band out 7-13-09 unexpectedly due to an erosion. I was devastated as I thought I was going in for a port repair. I came out without a band. It has easily been the HARDEST thing I have ever done. I don't consider losing my band a failure however; as I lost 136 lbs. in 11 months. I just MISS IT terribly. I haven't gained any weight since. I play with 4 lbs. up and down. I take Meridia now and it helps with the hunger, although nothing like my band did. I am waiting on an answer from my insurance company re: a revision surgery so I can make a decision on whether I can self pay or not. I strongly suggest an appetite suppressant!!!!!!!! I am scared to death of gaining. I eat the same as I did with the lap band and exercise, but its hard. I can't imagine going back!
Teri
Hello! I had my band out 7-13-09 unexpectedly due to an erosion. I was devastated as I thought I was going in for a port repair. I came out without a band. It has easily been the HARDEST thing I have ever done. I don't consider losing my band a failure however; as I lost 136 lbs. in 11 months. I just MISS IT terribly. I haven't gained any weight since. I play with 4 lbs. up and down. I take Meridia now and it helps with the hunger, although nothing like my band did. I am waiting on an answer from my insurance company re: a revision surgery so I can make a decision on whether I can self pay or not. I strongly suggest an appetite suppressant!!!!!!!! I am scared to death of gaining. I eat the same as I did with the lap band and exercise, but its hard. I can't imagine going back!
Teri
Teri -
Thanks for your hearfelt reply. I am so PROUD for you. Maintaining that must be an amazing feeling. I too am awaiting insurance approval. But I am so determined not to hurt my 100# loss. I have about 60-65 to go, and would like to prove that I can get there without anything, but that nagging fear is rearing its ugly head. I was waiting for the revision decisions when things got urgent and it had to come out last thursday. So I am officially DISBANDED, with no option for another.
So here we go. Thanks for all the ideas...and you are truly an inspiration!! SO PROUD OF YOU!
Thanks for your hearfelt reply. I am so PROUD for you. Maintaining that must be an amazing feeling. I too am awaiting insurance approval. But I am so determined not to hurt my 100# loss. I have about 60-65 to go, and would like to prove that I can get there without anything, but that nagging fear is rearing its ugly head. I was waiting for the revision decisions when things got urgent and it had to come out last thursday. So I am officially DISBANDED, with no option for another.
So here we go. Thanks for all the ideas...and you are truly an inspiration!! SO PROUD OF YOU!
"The Dutchman's Treasure"
SURGERY DATE 9/27/07
Cerita,
Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
On October 20, 2009 at 10:28 AM Pacific Time, teri0021 wrote:
Cerita,Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
Hi Teri...
I know this is an old post but I have a question for you.
~~ I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery.~~
Did you ever find an attorney to appeal this? Just wondering how you would get ins to pay for a non covered procedure. WLS benefits require an additional premium and if that premium wasn't paid I was just wondering how one gets it anyway. I know quite a few people that would love to get WLS covered but they don't have WLS benefits.
On March 12, 2010 at 7:15 AM Pacific Time, MidwesternGirl wrote:
On October 20, 2009 at 10:28 AM Pacific Time, teri0021 wrote:
Cerita,Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
Hi Teri...
I know this is an old post but I have a question for you.
~~ I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery.~~
Did you ever find an attorney to appeal this? Just wondering how you would get ins to pay for a non covered procedure. WLS benefits require an additional premium and if that premium wasn't paid I was just wondering how one gets it anyway. I know quite a few people that would love to get WLS covered but they don't have WLS benefits.
Hey you! Naaaaa - didn't go anywhere. My surgeon told me to give it up. I thought it was worth a try since the erosion began when my tests were being done by Kaiser and they missed it. He said it didn't matter. He said my employer could add a policy just for me to pay the additional premium but they never went that route. I'm just going to have to find a different job (I've been here for 8 years) or hope that my employer grows enough (we are a small group now with Kaiser - right at 50 employees) to be a big group next November - and they choose the plan that offers WLS.
My attorney also said it was pretty much a dead end.
Any more ideas?
Teri
On March 12, 2010 at 9:10 AM Pacific Time, teri0021 wrote:
On March 12, 2010 at 7:15 AM Pacific Time, MidwesternGirl wrote:
On October 20, 2009 at 10:28 AM Pacific Time, teri0021 wrote:
Cerita,Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
Hi Teri...
I know this is an old post but I have a question for you.
~~ I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery.~~
Did you ever find an attorney to appeal this? Just wondering how you would get ins to pay for a non covered procedure. WLS benefits require an additional premium and if that premium wasn't paid I was just wondering how one gets it anyway. I know quite a few people that would love to get WLS covered but they don't have WLS benefits.
Hey you! Naaaaa - didn't go anywhere. My surgeon told me to give it up. I thought it was worth a try since the erosion began when my tests were being done by Kaiser and they missed it. He said it didn't matter. He said my employer could add a policy just for me to pay the additional premium but they never went that route. I'm just going to have to find a different job (I've been here for 8 years) or hope that my employer grows enough (we are a small group now with Kaiser - right at 50 employees) to be a big group next November - and they choose the plan that offers WLS.
My attorney also said it was pretty much a dead end.
Any more ideas?
Teri
It's usually a lost cause for everyone but I was hoping you could find a way. I disagree with your doc, your employer could not obtain WLS benefits for you and not everyone. The laws don't work that way. It's a "group" policy for a reason.
My only other suggestion is self pay. :o/ I know I know.. i've done it twice so I know. ;o)
On March 12, 2010 at 9:16 AM Pacific Time, MidwesternGirl wrote:
On March 12, 2010 at 9:10 AM Pacific Time, teri0021 wrote:
On March 12, 2010 at 7:15 AM Pacific Time, MidwesternGirl wrote:
On October 20, 2009 at 10:28 AM Pacific Time, teri0021 wrote:
Cerita,Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
Hi Teri...
I know this is an old post but I have a question for you.
~~ I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery.~~
Did you ever find an attorney to appeal this? Just wondering how you would get ins to pay for a non covered procedure. WLS benefits require an additional premium and if that premium wasn't paid I was just wondering how one gets it anyway. I know quite a few people that would love to get WLS covered but they don't have WLS benefits.
Hey you! Naaaaa - didn't go anywhere. My surgeon told me to give it up. I thought it was worth a try since the erosion began when my tests were being done by Kaiser and they missed it. He said it didn't matter. He said my employer could add a policy just for me to pay the additional premium but they never went that route. I'm just going to have to find a different job (I've been here for 8 years) or hope that my employer grows enough (we are a small group now with Kaiser - right at 50 employees) to be a big group next November - and they choose the plan that offers WLS.
My attorney also said it was pretty much a dead end.
Any more ideas?
Teri
It's usually a lost cause for everyone but I was hoping you could find a way. I disagree with your doc, your employer could not obtain WLS benefits for you and not everyone. The laws don't work that way. It's a "group" policy for a reason.
My only other suggestion is self pay. :o/ I know I know.. i've done it twice so I know. ;o)
I'm so not familiar with this stuff. Thanks for your info girly. I love all your help. Will have to fill you in on my kid and the ADHD stuff as you were a HUGE help for me back in the day.
Teri
On March 12, 2010 at 9:26 AM Pacific Time, teri0021 wrote:
On March 12, 2010 at 9:16 AM Pacific Time, MidwesternGirl wrote:
On March 12, 2010 at 9:10 AM Pacific Time, teri0021 wrote:
On March 12, 2010 at 7:15 AM Pacific Time, MidwesternGirl wrote:
On October 20, 2009 at 10:28 AM Pacific Time, teri0021 wrote:
Cerita,Thanks for the kind words. If you don't mind me asking, why did you have to have the removal? It is a hard surgery. I had to be in the hospital for 4 days with drains and heavy duty antibiotics. I was pretty sick. That surgery was harder on my body than the band itself. It took me a long time to recover. My doctor said I couldn't even think about a revision until the first of the year. I got the denial letter yesterday. I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery. You see, I began having port pain and swelling (signs of erosion) in April. My doc is a contracted surgeon through my insurance (my insurance plan does not pay for bariatric surgery) but I had to self pay. So when I began having complications, he had to fight with the insurance to get my tests paid for. I had an ultrasound and Upper GI, as well as a Barium Swallow. All came back negative in May/June. Well, he decided that I just needed a port repair/replacement. So my surgery was scheduled for July 6. I began to have fever. He re-scheduled me for July 13th. I went in and they did an Upper GI while I was under and I had 4 erosions that had completely scarred over. So they had been there for some time. My point being, my insurance company docs had missed something during the tests if they had completely scarred over.
I hope you are healing well. Some people still have restriction from the scarring. This did not happen to me. :-( I still feel my side on occasion, because I used to feel for my port. Its not there anymore. I have emotional days often. Mealtime is often difficult. I fear that I am eating too much, or the wrong thing. I try very hard to stay away from carbs.
Take care!!
Teri
Hi Teri...
I know this is an old post but I have a question for you.
~~ I am going to have my lawyer write a hefty appeal letter as I plan to fight very hard to get my insurance to pay for a revision surgery.~~
Did you ever find an attorney to appeal this? Just wondering how you would get ins to pay for a non covered procedure. WLS benefits require an additional premium and if that premium wasn't paid I was just wondering how one gets it anyway. I know quite a few people that would love to get WLS covered but they don't have WLS benefits.
Hey you! Naaaaa - didn't go anywhere. My surgeon told me to give it up. I thought it was worth a try since the erosion began when my tests were being done by Kaiser and they missed it. He said it didn't matter. He said my employer could add a policy just for me to pay the additional premium but they never went that route. I'm just going to have to find a different job (I've been here for 8 years) or hope that my employer grows enough (we are a small group now with Kaiser - right at 50 employees) to be a big group next November - and they choose the plan that offers WLS.
My attorney also said it was pretty much a dead end.
Any more ideas?
Teri
It's usually a lost cause for everyone but I was hoping you could find a way. I disagree with your doc, your employer could not obtain WLS benefits for you and not everyone. The laws don't work that way. It's a "group" policy for a reason.
My only other suggestion is self pay. :o/ I know I know.. i've done it twice so I know. ;o)
I'm so not familiar with this stuff. Thanks for your info girly. I love all your help. Will have to fill you in on my kid and the ADHD stuff as you were a HUGE help for me back in the day.
Teri
Nope, that does not ensure you will have WLS benefits. It's an additional premium for your employer. Just like fertility treatments, it's not automatic, it's a matter if your employer wants to pay a lot of money for WLS benefits for the entire company. :o(
I'd start talking to them now and begging. But if you do not meet the qualifications (35/40 BMI, cormorbidities, etc.) you will won't be covered, I'm going by memory but you are a pretty low BMI now, aren't you?
If there are lots of people that are interested in WLS at your company, might be cheaper for everyone interested to go in together and pay the premium and have your employer take it out of your paychecks. But you'd be paying for benefits for the entire company. It would be expensive and unlikely that your employer would agree.
The Standard of Care is do revise at a lower BMI but that doesn't mean ins will pay, they will not.
PM me and tell me about your son!
Teri - I was "DISBANDED" also (after 8MOS. and -80lbs including pre-op weightloss). I loved my band but it didn't love me. I knew when I lost that it was impossible to have a new one. I tried desparately not to gain the weight back - it's now a year and 8months later I've gained back 60 of the 80--- old habit's are hard to break! I'm pursuing a second surgery as we speak!
Losing your band is defintely emotional - my heart goes out to you.
Be well,
Christine
Losing your band is defintely emotional - my heart goes out to you.
Be well,
Christine
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