Report the Lap Band to the FDA
Hello,
In December of 2004 I had lap band surgery with Dr. Alan Geiss in Syosset New York. My decision for Lap Band surgery was based on research I had made while trying to decide the least evasive route to weight loss surgery. In June of 2003 my mother had Lap Band surgery followed immediately by acute kidney failure and she was placed on dialysis for four days and luckily her kidneys came back to full function. Slowly but surely after her "scare" as we call it now her weight loss started and was successful. In October of 2004 shortly after my second son was born and my father had passed away I decided emotionally I was ready to lose weight. I consulted Dr. Geiss and went through all my pre-surgical testing and had the procedure in December of 2004. After staying in the hospital for one night I was able to return home to my family. The day I returned home from the procedure I received a phone call from my insurance company at that time which was Blue Cross Blue Shield in Rochester NY to tell me that they were denying coverage for the procedure. At that time I had said that I had already had the procedure and my surgeons office told me that they had a claim number and it was already cleared. I had followed up right before the procedure with Dr. Geiss' office to be sure everything was clear for the procedure to take place. I was told by Dr. Geiss' office staff that the surgery was approved and she already had a claim number. The Representative from BCBS said that the claim number I was referring too was a number they had given Dr. Geiss' employee that they were going to research the procedure to verify its coverage. So on the day I returned home from the procedure my insurance company advised me that they denied the procedure and I would be responsible for the bills and if any "complications" did arise which were found to be from the lap band surgery I would be personally responsible for the bills. I immediately called Dr. Geiss' office to advise them about the call I had just received and the BCBS representative and demanded to have the Lap Band removed. The Dr's secretary told me to calm down that there was some sort of error and she would call me right back. After three hours I received a phone call back from Dr. Geiss' office that the call I received from BCBS was correct and the procedure was not covered but not to worry Dr. Geiss' had decided to absorb the bills and he would continue treating me as he had before. I was livid at this time I told them I would have never had the surgery had I known it was not approved by the insurance company and that the bills were the last thing on my mind I was more worried about my health and what would happen if I did have any complications from the lap band I would not be covered. My biggest fears rolled through my head. I was so upset at how this could happen. I thought I had done everything in my power as the patient to be sure the T's were crossed and the I's were dotted and now my whole life had been thrown into a spiral. I continued to visit Dr. Geiss after the procedure and he did "absorb" the hospital bill of $24,000.00 and somehow continued to treat me with submitting to BCBS and it was covered. My weight loss had not been as positive as Dr. Geiss and his team had wanted it to go. I was very hesitant at first to had the band adjusted for fear of complications, but I did follow the "rules" of the lap band and did start having it correctly adjusted soon after. On my visits I would never had the correct weight loss and the doctor would always question me on how I was doing things wrong and how I must have been drinking at the wrong times and always told me I was not following the rules. I adamantly denied not following the rules I was trying to lose the weight as had as I possible could. I was following the same 1800 calorie diet I had from when I was pregnant and had gestational diabetes, I was exercising doing everything in my power to lose the weight it just was not coming off. I would always leave the office even more depressed from what I was cause it was always made to be "my fault" that the band procedure was not working. In January of 2006 my husbands job was transferred to North Carolina and we moved down here. I had seen the Dr. for the last time before I moved. When I arrived down here I tried to make appointments at Duke and with Dr. Paul Enochs for follow ups. When I called Duke they wanted $1000 for me to just walk in the door to be seen. Since we had just moved here into a home we did not have the money for that. Dr. Enoch wanted $500 just to be seen. I could not believe what I was hearing. And both surgeon's offices had told me the adjustments would most likely not be covered since they were not covered by insurance in NY. The secretary at Duke informed me that whatever Dr. Geiss had done in NY to have the procedure's covered would not be done there and that I would be responsible for payment at time of service. I was floored. I did not have any kind of money for the procedures, so I decided to leave the band adjustments alone and would visit Dr. Geiss on trips back up to NY. In April of 2008 I had gone through a horrible time where I could not even keep water down for over 2 days. Frantically I called Duke and Dr. Enoch's office to which I was told I needed payment up front. We are having difficult financial times so I decided to call Dr. Geiss and drive to NY to see what the problem was since we couldn't afford the money the surgeons wanted. Once there again I was sent to have a GI series and check for to be sure the band had not slipped. All my tests came out clear and I was told it was my "environment" or the things I was eating. I had asked Dr. Geiss' team what that could me my environment was not going to change anytime soon. My sons at are 3 and 5 and I was working full time as is my husband 60+ hours a week. Melanie Dr. Geiss' assistant told me the best thing to do would be to drain the band back down and leave things be. So to avoid more problems I could not afford I had the band drained. I am writing this letter because I am still at the weight I was before my procedure in 2004 with a lap band that is not covered. (which had I known from the beginning I would have never had done) I am eager to have the Gastric Bypass surgery that would so benefit my size and weight. I am looking for a surgeon to help me give the boost my body needs so I can be there for my family and get on with my life. I am desperate for a change to end this cycle of my life. Please if you or a surgeon in your office can help I would be greatly appreciative for the opportunity.
In December of 2004 I had lap band surgery with Dr. Alan Geiss in Syosset New York. My decision for Lap Band surgery was based on research I had made while trying to decide the least evasive route to weight loss surgery. In June of 2003 my mother had Lap Band surgery followed immediately by acute kidney failure and she was placed on dialysis for four days and luckily her kidneys came back to full function. Slowly but surely after her "scare" as we call it now her weight loss started and was successful. In October of 2004 shortly after my second son was born and my father had passed away I decided emotionally I was ready to lose weight. I consulted Dr. Geiss and went through all my pre-surgical testing and had the procedure in December of 2004. After staying in the hospital for one night I was able to return home to my family. The day I returned home from the procedure I received a phone call from my insurance company at that time which was Blue Cross Blue Shield in Rochester NY to tell me that they were denying coverage for the procedure. At that time I had said that I had already had the procedure and my surgeons office told me that they had a claim number and it was already cleared. I had followed up right before the procedure with Dr. Geiss' office to be sure everything was clear for the procedure to take place. I was told by Dr. Geiss' office staff that the surgery was approved and she already had a claim number. The Representative from BCBS said that the claim number I was referring too was a number they had given Dr. Geiss' employee that they were going to research the procedure to verify its coverage. So on the day I returned home from the procedure my insurance company advised me that they denied the procedure and I would be responsible for the bills and if any "complications" did arise which were found to be from the lap band surgery I would be personally responsible for the bills. I immediately called Dr. Geiss' office to advise them about the call I had just received and the BCBS representative and demanded to have the Lap Band removed. The Dr's secretary told me to calm down that there was some sort of error and she would call me right back. After three hours I received a phone call back from Dr. Geiss' office that the call I received from BCBS was correct and the procedure was not covered but not to worry Dr. Geiss' had decided to absorb the bills and he would continue treating me as he had before. I was livid at this time I told them I would have never had the surgery had I known it was not approved by the insurance company and that the bills were the last thing on my mind I was more worried about my health and what would happen if I did have any complications from the lap band I would not be covered. My biggest fears rolled through my head. I was so upset at how this could happen. I thought I had done everything in my power as the patient to be sure the T's were crossed and the I's were dotted and now my whole life had been thrown into a spiral. I continued to visit Dr. Geiss after the procedure and he did "absorb" the hospital bill of $24,000.00 and somehow continued to treat me with submitting to BCBS and it was covered. My weight loss had not been as positive as Dr. Geiss and his team had wanted it to go. I was very hesitant at first to had the band adjusted for fear of complications, but I did follow the "rules" of the lap band and did start having it correctly adjusted soon after. On my visits I would never had the correct weight loss and the doctor would always question me on how I was doing things wrong and how I must have been drinking at the wrong times and always told me I was not following the rules. I adamantly denied not following the rules I was trying to lose the weight as had as I possible could. I was following the same 1800 calorie diet I had from when I was pregnant and had gestational diabetes, I was exercising doing everything in my power to lose the weight it just was not coming off. I would always leave the office even more depressed from what I was cause it was always made to be "my fault" that the band procedure was not working. In January of 2006 my husbands job was transferred to North Carolina and we moved down here. I had seen the Dr. for the last time before I moved. When I arrived down here I tried to make appointments at Duke and with Dr. Paul Enochs for follow ups. When I called Duke they wanted $1000 for me to just walk in the door to be seen. Since we had just moved here into a home we did not have the money for that. Dr. Enoch wanted $500 just to be seen. I could not believe what I was hearing. And both surgeon's offices had told me the adjustments would most likely not be covered since they were not covered by insurance in NY. The secretary at Duke informed me that whatever Dr. Geiss had done in NY to have the procedure's covered would not be done there and that I would be responsible for payment at time of service. I was floored. I did not have any kind of money for the procedures, so I decided to leave the band adjustments alone and would visit Dr. Geiss on trips back up to NY. In April of 2008 I had gone through a horrible time where I could not even keep water down for over 2 days. Frantically I called Duke and Dr. Enoch's office to which I was told I needed payment up front. We are having difficult financial times so I decided to call Dr. Geiss and drive to NY to see what the problem was since we couldn't afford the money the surgeons wanted. Once there again I was sent to have a GI series and check for to be sure the band had not slipped. All my tests came out clear and I was told it was my "environment" or the things I was eating. I had asked Dr. Geiss' team what that could me my environment was not going to change anytime soon. My sons at are 3 and 5 and I was working full time as is my husband 60+ hours a week. Melanie Dr. Geiss' assistant told me the best thing to do would be to drain the band back down and leave things be. So to avoid more problems I could not afford I had the band drained. I am writing this letter because I am still at the weight I was before my procedure in 2004 with a lap band that is not covered. (which had I known from the beginning I would have never had done) I am eager to have the Gastric Bypass surgery that would so benefit my size and weight. I am looking for a surgeon to help me give the boost my body needs so I can be there for my family and get on with my life. I am desperate for a change to end this cycle of my life. Please if you or a surgeon in your office can help I would be greatly appreciative for the opportunity.
Typically surgeons and their staff don't post here unless they are looking for free advertising. We are all WLS patients exchanging info here.
A couple of thoughts, Dr. Geiss sounds very cool to pay for your surgery. The office staff made a mistake and he did everything he could to take care of the error, he couldn't go back and undo what was wrong but he did make it right in every possible way. Most surgeons would have handed you the bill and told you to figure it out since insurance coverage is ultimately our responsibility.
If you were consuming 1800 calories with a band that is probably why you weren't losing well. Usually WLS folks consume much less. My doc suggests 800 calories a day. You didn't say how many hours of hard cardio you are doing, are you getting the required exercise?
If your insurance does not cover WLS then you are in the same boat as many here. Self pay. A revision to bypass is going to be pretty expensive. A revision to a sleeve is going to be cheaper and there is no aftercare such as with RNY. If you are self pay for aftercare wouldn't it be cheaper to go with a procedure that doesn't require aftercare?
I went to Mexico for my revision from band to sleeve. $12,500 for new patients. Mexico is a pretty nice option for those without WLS coverage. You can get a surgical loan, get the surgery, and get your life back but you are looking at 600-800 calories daily and LOTS of exercise. If you don't want to devote the effort to calories and exercise then WLS probably isn't for you. But if you do want weight loss bad enough then this is a great option.
Good luck to you!
A couple of thoughts, Dr. Geiss sounds very cool to pay for your surgery. The office staff made a mistake and he did everything he could to take care of the error, he couldn't go back and undo what was wrong but he did make it right in every possible way. Most surgeons would have handed you the bill and told you to figure it out since insurance coverage is ultimately our responsibility.
If you were consuming 1800 calories with a band that is probably why you weren't losing well. Usually WLS folks consume much less. My doc suggests 800 calories a day. You didn't say how many hours of hard cardio you are doing, are you getting the required exercise?
If your insurance does not cover WLS then you are in the same boat as many here. Self pay. A revision to bypass is going to be pretty expensive. A revision to a sleeve is going to be cheaper and there is no aftercare such as with RNY. If you are self pay for aftercare wouldn't it be cheaper to go with a procedure that doesn't require aftercare?
I went to Mexico for my revision from band to sleeve. $12,500 for new patients. Mexico is a pretty nice option for those without WLS coverage. You can get a surgical loan, get the surgery, and get your life back but you are looking at 600-800 calories daily and LOTS of exercise. If you don't want to devote the effort to calories and exercise then WLS probably isn't for you. But if you do want weight loss bad enough then this is a great option.
Good luck to you!
That's something you should have pushed, and even if they did give a claim number to the office it is still ultimately our responsibility, it's our insurance. But really, your surgeon was great. Taking care of $24K worth of bills was pretty fantastic. I realize the mistake shouldn't have happened to begin with but it did happen. He fixed it in every way he humanly could.
trust me i did everything i could to be sure on my side with the insurance. I saw what my mother went through when she went into kidney failure after her surgery and i wanted to be sure i was covered for anything and everything that could go wrong. I was truly grateful for the dr to take care of the bills and let him know how grateful i was. I also did fight myself with the insurance company as best i could. Dont forget this was back in 2004 before they had your insurance benefits etc. online for you to view.. I did the best i could from where i was and i fought the policy that the surgeon was told first before the patient for the simple fact that things like what happened to me could happen to other people. The company my husband was with also faught to have policies changed as well.
The fact is i was extremely greatful for the way things worked out but in the end i probably would have decided against the procedure if i had known it was not covered as i now have the band inside me and god forbid anything should happen i am on my own.. for being as young as i am with such a young family and a hard working husband i would have never put us in a financial bind should something have happened.
Now in order for me to get the band back up and running i am to pay for it all out of pocket when i have insurance and did the whole time but it is now a pre existing condition that i can not do anything about. Trust me if the money was there i would have no problem paying 1000 every three months to have the adjustments but its not so i am at a catch 22 with things i can do.
The fact is i was extremely greatful for the way things worked out but in the end i probably would have decided against the procedure if i had known it was not covered as i now have the band inside me and god forbid anything should happen i am on my own.. for being as young as i am with such a young family and a hard working husband i would have never put us in a financial bind should something have happened.
Now in order for me to get the band back up and running i am to pay for it all out of pocket when i have insurance and did the whole time but it is now a pre existing condition that i can not do anything about. Trust me if the money was there i would have no problem paying 1000 every three months to have the adjustments but its not so i am at a catch 22 with things i can do.
Oh, I do understand the cost issues. I was self pay for a band and self pay for a revision to a sleeve. My insurance would have covered the sleeve revision but the problem is that I was very sick with the band and I did not have time to jump through their hoops. I also did not care for the surgeons contracted with my insurance company, not for a revision. For a 1st surgery, maybe but not a revision. So I decided to self pay with a surgeon I trusted.
You don't need testing to go to MX. If I would have used my insurance for my original surgery I would have had to do a 6 month medically supervised diet, a NUT eval so she could tell me my diet wasn't great, a psych consult to tell me I have food issues, a sleep study to show me I do not have sleep apnea, and a bariatric consult to tell me I was fat.
I already knew those things. You get medically pre approved on line by answering a bunch of medical questions then when you get there they do a bunch of labs, xrays, EKG, etc. Then you have sugery and you are done.
Seriously, look at the sleeve. There is NO aftercare, no maintenance, nothing to do. You have a small stomach. Period. The risks and complications for a sleeve (long term) are less than for banding, bypass. You can't go to just anyone for a sleeve and honestly, there are only two docs in MX that I would go to for a sleeve but they are so easy to work with. Just a tiny stomach. If your issue is food quantity, this is the way to go.
I already knew those things. You get medically pre approved on line by answering a bunch of medical questions then when you get there they do a bunch of labs, xrays, EKG, etc. Then you have sugery and you are done.
Seriously, look at the sleeve. There is NO aftercare, no maintenance, nothing to do. You have a small stomach. Period. The risks and complications for a sleeve (long term) are less than for banding, bypass. You can't go to just anyone for a sleeve and honestly, there are only two docs in MX that I would go to for a sleeve but they are so easy to work with. Just a tiny stomach. If your issue is food quantity, this is the way to go.
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