Anyone have Revision Lap Band to RNY approval from BCBS Federal?

I had Lap Band surgery in Apri 08.  I want to get a revision from the Lap Band to RNY.   Was wondering if anyone has done this before and if they had BCBS Federal Insurance?  I checked with one doctor in Norman, Ok and they called BCBS for approval for me and BCBS Federal said  they would only pay for the revision if there was a slippage, or errosion on the band.  My problem is that I only lost 17 lbs and gained back 13 lbs.    I've had 3 fills.  I wish I had done more research I would have chose the RNY instead of the Lap Band.  There is nothing I can do about that .  I told my lap band doctor that I am always hungry 1/2 cup of food is not enough for me .  I'm not sure if this is because I'm a diabetic.  I know I don't have the will power.  The doctor said that I have to change my mind set and eat only 1/2 cup of food.  Easier said then done.  I have done some research and come to find out that Lap Band does not work for everyone!!!   If I have to I will pay for the RNY out of my pocket.  It would be real nice if the insurance would pay.   Does anyone feel me out there???    

Thanks Good People!!! 

Don't quote me on this but I have BCBS federal and I was told that if I still qualified for surgery that they would do my revision.  Turns out I had a gastric fistula (my original surgery was a bypass, but I regained significanly).  Insurance approved me without the song and dance that you usually go through because of that, so I can't be sure what they would have done if it was just me wanting to revise the surgery with no technical "problem" (although I consider low weight loss and weight regain a problem).

I would say, go ahead and get the tests done that need to be done as if you weren't a previous lapband patient.  I had NO idea I had a fistula (I was certain I had caused all my weight regain).  Your insurance should pay for the testing to see if everything is working.  What if it did slip (or something).  The surgery to "fix" it could be the RNY!  

I called BCBS Federal and they said as long as I have a medical neccesity to have the surgery it will be approved.  They need to have it documented from the doctor's office.  I'm going to be seen by Dr. Gorospe and I know he will check out my band to see what's going on.  I will keep you posted to what happens with me.  Thanks so much for replying to me. 

       

Hi Virginia,

I too had a failed band and like you wanted to revise to the RNY.  I researched the RNY extensively and someone pointed me to the DS forum.  I went there and researched the Duodenal switch and never looked back.  Check out the DS board and research all surgery options.  I am so happy with my DS and even happier to have the band out.  Good luck with any surgry you decide to get.

Jass

Hi there!  I am so glad to find this web site.  I am 20 months status post a lap-band.  I haven't lost 1 single pound since the day I had surgery.  I have had 7 or 8 fills, and am at 3.0 cc's in a 4.0 cc band.  I have restriction - probably the best I've ever had (since my last fill 3 weeks ago), but I've found that all the fills in the world won't give you willpower.  I have not made good choices in food or drink, and I hadn't been exercising until 2 weeks ago.  Now, I work out for 1 hour 2 days a week - and it's tough.  I'd like to make excuses as to why I can't go, but my co-worker doesn't take "no" for an answer - and that's my saving grace.  I am very disappointed, frustrated, and disgusted - to say the very least.  I feel terrible because I have failed WLS - I am a statistic - and not in the way that I wanted to be.  I feel that, although I haven't always made good choices, my portions are so much smaller than pre-band - why am I not losing any weight.  I don't get it.  I thought for sure that working out would make all the difference in the world, and granted its only been 2, going on 3 weeks, I havent' seen but maybe a pound lost.  I am really considering a revision to the bypass, although some people on lapbandtalk have suggested the DS to me.  I don't know what to do.  I've called my insurance (BCBS PPO) and it sounds like they will cover the bypass - I didn't ask about the DS, yet.  I have mentioned revising from the band to a bypass to others on different forums, and I get the same common response -- "if you can't follow the band rules, what makes you think you'd be able to follow the bypass rules?"  I don't know the answer to this, other than maybe the "dumping syndrome" would steer me away from sugars - although, I've heard that not everyone dumps.  The PA at my surgeon's office told me that the bypass MAKES you follow the rules - and the comment to this is "she doesn't know what she's talking about".  I know everyone has their opinion, and I like to hear them all.  That being said, I wish I would've known that the band isn't for everyone, and requires the most effort of any of the WLS.  I just don't know what to do -- any and all advice is welcomed here.  thanking you in advance.

That's what I mean, we cannot make good choices because we are hungry for the bad food.
With the RNY I have heard that you don't get hungry, so if you are not hungry you won't have the problem of eating the bad food and then you will lose the weight.  With the band I get hungry just like before without the band, we have the liberty to eat the wrong kind of food, white bread, potatoes, fried food, icecream etc.... without dumping or throwing up.  If you eat like that after the RNY  you will either dump or  throw up.  The rules for the RNY will be easier to follow because you lose your appetite.  As far as DS, I don't think BCBS will cover that, although I'm not sure.   I will let you know how it goes with me.  Hope the very best for you, in what you plan to do. Like everyone tells me to do research before you get another operation to make sure it will work for you.  The surgeon thats doing my operation says that RNY is the GOLD STANDARD of WLS!!!  He should know he has done 4000 surgeries.     Thanks for replying.          

I am soooo glad that there is someone out there that thinks the way I do - it helps confirm that I'm not crazy!  Thanks for your reply, Virginia.  Exactly what I was thinking, exactly why I was thinking the bypass is the better choice for me -- the terrible physical side effects if you eat something you shouldn't.  However, like I mentioned before, others on different web site forums have said that not everyone experiences dumping - so I'm being told not to bank my successes on that.  It's such a hard decision - and each person is so very different although we're all here for the same outcome.  I've been researching a bit - I actually did quite a bit of research 2 years ago, when I was trying to decide whether to have WLS or not - and at that time, I was positive I was having the bypass, until I got to the surgeon's office and sat thru the lap band consultation class, that's when I changed my mind, because the band sounded so much safer than the bypass.  That being said, I didn't realize that the band does not work for everyone, and it takes the most effort of any WLS.  I think had I realized that, I would have went with the bypass from day 1.  Good luck to you, I wish you the best of luck.  Please keep me posted, and updated on any new advice or info you come across.  Thanks so much! - Stephanie

Just letting you know - I had RNY in June, and am painfully hungry less than 1/2 hour after eating, until the next meal.  I am more hungry than I ever was prior to surgery.    I have to use a huge amount of self control - and without the dumping would have been a total failure.  And I read that many people don't ever experience dumping.  I was told, wrongfully, that the surgery would take away my hunger, and it didn't.

Thanks for the warning FernTate.  I have changed my mind about the RNY.  I'm going more towards the DS.  I hear more great things about it.  I'm sorry to hear about the problems you are having with the RNY.  Thanks for your input.  I hope thing turn out better for you.