Revision not approved by my insurance

Norma 1010
on 10/11/12 4:12 pm - Pflugerville, TX
Well, I had my lapband 10/15/10.  Lost about 50-60 lbs in the first 7 mos, then started having problems with meeting restriction, my port flipped and had to have a port revision on 5/2011.  After my port revision I had a couple of visits with my surgeon and on both visits he couldnt access my port until he finally scheduled to have it done under fluoro. So I basically went about 5 most with no fills and no restriction. During this time I didn't lose any weight, but worked hard to maintain my weight, and believe you me it wasn't easy. Between May 2011 My Dad  became sick and was admitted to VA hospital and diagnosed with cholangio carcinoma with metastasis to liver. Sept 2011, mom admitted to the hospital with bilateral pneumonia and diagnosed with pulmonary fibrosis and given a prognosis of 6-12 mos. We put mom with hospice care Oct 2011 and so sad to say that mom passed away Aug 31st of this year, Although dad refused surgery and chemo, he is currently stable. Moms death has been hard on all of us. I have a hx of depression/anxiety  and unfortunately my depression took a nose dive in the last 4 mos, Anyway during the past year I continued to see my surgeon , but never able to meet the right restriction, I was either too tight and vomiting all the time or not tight enough and able to eat anything and with my I was going through my emotional eating was helping. I last saw my previous surgeon in August and by that time my total weight loss was only 40  lbs from surgery. He asked me If I would consider revision and of coarse I jumped at this idea, but unfortunately I wasn't approved. My surgeon wouldn't  try to work and gve the band a second chance so I decided to go with another surgeon. UGI didn't show that there was any problems with my lapband and thinking back to all I had been through in the past year (moms illness, dads illness, my depresssion, moms death), I felt this may of had an impact on my band and I wasn't ready to give up. So I went to see another surgeon last week and we discussed everything. She was very understanding, supportive, and actually listened to what I was saying.  She said we would start from scratch. She checked my band to see how many cc's I had and acccording to her I only had about 4cc, take or give 1 cc. so she filled me up to 5cc. She did say that sometimes stress can affect your band, I have noticed a difference in my eating, but I'm still able to tolerate bread, and I don't want to be able to eat bread,  I'm returning to see her in one month, but she did say that if I needed to see her before then, just to call her, I really see that my new surgeon is more compassionate and takes the time to  listen to what I have to say and I know that she'll manage my band alot better.  The other surgeon always did what he wanted and never really asked what I thought,  Long story short, I'M NOT GIVING UP ON MY BAND JUST YET.  and I'm hoping I can beat this depression so I can get out and start exercising again.  Have any of you out there gone through something similar through this and if so how did you deal with it?

WITH GOD, EVERYTHING IS POSSIBLE.

HW:   317 lbs
GW:   180 lbs
CW:   285

                                    

(deactivated member)
on 10/11/12 8:08 pm
On October 11, 2012 at 11:12 PM Pacific Time, Norma 1010 wrote:
Well, I had my lapband 10/15/10.  Lost about 50-60 lbs in the first 7 mos, then started having problems with meeting restriction, my port flipped and had to have a port revision on 5/2011.  After my port revision I had a couple of visits with my surgeon and on both visits he couldnt access my port until he finally scheduled to have it done under fluoro. So I basically went about 5 most with no fills and no restriction. During this time I didn't lose any weight, but worked hard to maintain my weight, and believe you me it wasn't easy. Between May 2011 My Dad  became sick and was admitted to VA hospital and diagnosed with cholangio carcinoma with metastasis to liver. Sept 2011, mom admitted to the hospital with bilateral pneumonia and diagnosed with pulmonary fibrosis and given a prognosis of 6-12 mos. We put mom with hospice care Oct 2011 and so sad to say that mom passed away Aug 31st of this year, Although dad refused surgery and chemo, he is currently stable. Moms death has been hard on all of us. I have a hx of depression/anxiety  and unfortunately my depression took a nose dive in the last 4 mos, Anyway during the past year I continued to see my surgeon , but never able to meet the right restriction, I was either too tight and vomiting all the time or not tight enough and able to eat anything and with my I was going through my emotional eating was helping. I last saw my previous surgeon in August and by that time my total weight loss was only 40  lbs from surgery. He asked me If I would consider revision and of coarse I jumped at this idea, but unfortunately I wasn't approved. My surgeon wouldn't  try to work and gve the band a second chance so I decided to go with another surgeon. UGI didn't show that there was any problems with my lapband and thinking back to all I had been through in the past year (moms illness, dads illness, my depresssion, moms death), I felt this may of had an impact on my band and I wasn't ready to give up. So I went to see another surgeon last week and we discussed everything. She was very understanding, supportive, and actually listened to what I was saying.  She said we would start from scratch. She checked my band to see how many cc's I had and acccording to her I only had about 4cc, take or give 1 cc. so she filled me up to 5cc. She did say that sometimes stress can affect your band, I have noticed a difference in my eating, but I'm still able to tolerate bread, and I don't want to be able to eat bread,  I'm returning to see her in one month, but she did say that if I needed to see her before then, just to call her, I really see that my new surgeon is more compassionate and takes the time to  listen to what I have to say and I know that she'll manage my band alot better.  The other surgeon always did what he wanted and never really asked what I thought,  Long story short, I'M NOT GIVING UP ON MY BAND JUST YET.  and I'm hoping I can beat this depression so I can get out and start exercising again.  Have any of you out there gone through something similar through this and if so how did you deal with it?
 
What reason did your insurance company give you for refusing the revision?

Jean M.
on 10/11/12 9:02 pm
Revision on 08/16/12
Norma,

I know it's discouraging to have your insurance turn down the revision, but you've been through so much in the past few months, maybe it's better to do some emotional healing before tackling the revision project again. I'm glad you've found a surgeon with better communication skills, and I'll be rooting for you as you give that band another chance.

Jean

Jean McMillan c.2009-2013 - Always a bandster at heart
author of Bandwagon (TM), Strategies for Success  with the Adjustable Gastric Band & Bandwagon Cookery. Bandwagon for Kindle now available on Amazon.  Read my blog at: jean-onthebandwagon.blogspot.com 

   

 

 

 

NanaB .
on 10/11/12 10:51 pm
Keep your spirit up! Those who are part of a regular support group online or in person tends to do well and stay motivated. Exercise and getting your band back functioning are the key to your success. Good luck.

Original Lap Band * 9/30/2005 * 4cc 10cm band*,  lost 130 pounds. 7 Great years! 

Revision surgery to AP small lap band *11/13/2012*, due to large hiatal hernia. I am hopeful about continuing my band journey uneventful and successful. I loved what my old band did for me and I am looking forward for my new band to Keep my weight downsmiley

pineview01
on 10/12/12 12:05 pm, edited 10/13/12 3:17 pm - Davison, MI

My insurance would not approve a revision.  I had the band romoved anyway due to all the medical issues and PAIN.  I had already given my band two second chances and 18 months of a Hail Mary.  So, the band came out and I tried fighting the insurance.  They have taken the medical problems under considerations and have approved a 2nd Psych Eval as the first step of fighting their decision.

Keep trying if you really have issues after you give it a second chance.

As Jean said give your head and heart a chance to heal too!

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Most Active
×