Band to sleeve - lots of questions

I had the band placed in February 2009.  I met with a new surgeon today about getting revised to the sleeve.  He thinks it is a good option.  One of my main concerns is my BMI now is 36.  When I had the band, it was 41 with no comorbidities.  The doc said I have what they call "soft" comorbidities, reflux, joint pain, hypothyroidism - and I can't remember what else.  I am worried about being approved from insurance.  Does anyone have any experience with the "soft"comorbidities and approval?  Of course, if I am denied, it won't be long until I hit the 40 BMI mark.

Next, how long after surgery is the liquid diet?  I forgot to ask that.  Does the sleeve give you a full feeling without the urge to throw up all the time?  With the band, I never felt "full", just knew if I didn't stop eating I would throw up.  

The bariartic coordinator said since the sleeve is relatively new, it is harder to get approved, but I would have an easy time getting approved for RNY if I was denied the sleeve.  If I don't have any other options, I will do the RNY, but it scares me to death.  Any advice if that is the route I end up going? 

Oh, I have BCBS Federal.  Has anyone had experience with them and a revision?  Thanks!

Oh, 

I would check your insurance's Bariatric Surgery Medical Policy. Call up and ask them to send it to you. That way you know what they require. Mine (and most) insurances require that you had not lost more than 50% of your excess weight in at least two years after your original surgery. It sounds like you might be on the border of that.  Hope that helps a little. It's a good place to start.
~Amanda

I have Cigna - they just paid for my Band to VSG revision - I copied this from their published policy:

CIGNA covers revision of a previous bariatric surgical procedure or conversion to another medically
necessary procedure due to inadequate weight loss as medically necessary when ALL of the following
are met:
• Coverage for bariatric surgery is available under the individual’s current health benefit plan.
• There is evidence of full compliance with the previously prescribed postoperative dietary and exercise
program.
• Due to a technical failure of the original bariatric surgical procedure (e.g., pouch dilatation) documented
on either upper gastrointestinal (UGI) series or esophagogastroduodenoscopy (EGD), the individual has
failed to achieve adequate weight loss, which is defined as failure to lose at least 50% of excess body
weight or failure to achieve body weight to within 30% of ideal body weight at least two years following
the original surgery.
• The requested procedure is a regularly covered bariatric surgery (see above for specific procedures).
NOTE: Inadequate weight loss due to individual noncompliance with postoperative nutrition and
exercise recommendations is not a medically necessary indication for revision or
conversion surgery and is not covered by CIGNA.

Good luck

I called my insurance company yesterday and talked to a nurse about exactly what is required to have a revision.  She was very helpful.  I do have to go through another psych eval and nut consult like before.  Also, I have to be two years out from my band surgery, which is Feb 5, so not too far away.  I am very excited - a little nervous, though.  I am only down 15 pounds or so from my previous surgery, so I qualified there.  Also, the doctor needs to document that I have been compliant with diet and exercise.  I said, How do I prove that?  I don't have a personal trainer.  They said they just take our word for it, which is great since I have no "proof."   Any words of wisdom to prepare for the surgery?  I'm nervous about the drain.  I've had one before and thought it was very painful.  I will get over it, though.  Thanks!!!!!!!!!!!!

They are making those drain tubes smaller these days - more narrow.  I didn't find it painful, but then again I was on he pain pump when it was taken out.  Congrats on your progress!
Amy

Just wanted to encourage u to post about your band experiences on the band forum. Most ppl that have problems do not post about it on there and it would be nice if they did b/c then other bandsters that are experienceing the same thing would realize they are NOT alone! Also I think if is very helpful for those that are researching the band to see what the band is REALLY like!

My BMI was 36 when I had my revision on October 8th, 2010.  I had severe reflux and only lost 54 pounds with the band.  I also still had sleep apnea. 

I have Blue Cross Blue Shields of NC and they don't approve the sleeve because it is still relatively new.  You need to look on your morbid obesity policy section and see if they cover sleeve. 

I was scared of the RNY but mainly I was scared of the weight gain that some people have.  I am so happy with the RNY.  I really have had no problems. 



Tamara

The sleeve is night and day different from the band. Soooo much easier to live with. No more puking, sliming, or foaming like a rabid dog. You'll love your sleeve!

The drain was no big deal for me.