Band Over Bypass-Cigna-WORRIED-PLEASE READ

Hello All,

First post here.  Looking for some support!  I had gastric bypass RNY in 2004.  I was 265 and got down to 137 at my thinnest and leveled out at 150 for 5 years.  I have been gaining and gaining.  I am always hungry, even when other people who have "normal" stomachs are full, I am still hungry!

I am now 220 and scared.  I just had all my paperwork submitted to cigna PPO today.  It is being reviewed and has been transfered.  Does anyone have feedback on getting Band over bypass approved by cigna? 

Issues I have-

1. Weight regain
2. Dialated pouch0 had upper GI
3. Dialated stoma- Had upper GI
4. New stomach merged with old stomach? Anyone hear of that?  
5. No sleep apena(even though my partner says I DO... The at home test said no....)
6. Always hungry

I did the full workup at Dr. Shawn Garber's Office in NY. How long does Cigna take to approve?  

My blood work shows normal(slightly high cholesterol).  BMI is 35.  I just hope I get approved so I can feel normal again.  

Any feedback would be amazing!  

Thanks!

Adam 

Well I know of some people who have had great success with BOB but I also had a band alone for 7 years and I wouldn't wish that experience on satan himself. It was the worst 7 yrs of my life and actually I still have damage from the band that I will have to live with the rest of my life! It left my stomach so that it empties too slow and it causes great pain on a daily basis and as I say I will have to just live with it because there is no way to fix it! Not to mention the other normal problems with the band like slipping, erosion and all kinds of other things like damage to the vagus nerve. Personally I wouldn't ever allow anyone to do that to me but as I said the band and I didn't NOT get along well!

thanks for the message even thought it was negative...  Do you believe a redo of the gastric bypass or a sleeve would be better for my revision?  have you had a revision?  I need support not making me feel awful about what my surgeon  is suggesting.

Adam

I did the Band Over Bypass and it didn't work for me. It caused more problems then ever. I then did the Distal RnY and that WORKED! Im at my smallest ever with minimal complications. I regret getting the Bypass. If I were to do it all over again I would get the Duodenal Switch. I strongly suggest looking into the Duodenal Switch as a revision.

Adam,

  I would stongly suggest you not get the lap band.  I had the lap band for 5 yrs and I must say it did work.  Until....  I started having pain in my side, went to the ER several times, They couldn't figure out where the pain was coming from.  I dealt with this for a couple yrs, finally I found a really good bariatrics surgeon, under x-ray he watched me drink barrium and found that over 50% of my lapband had erroded into my stomach.  I had surgery to remove the band but with that came more pain.  I wound up with three infections, 1 in my stomach cavity and 2 in two different incisions.  What was suppose to take 2 weeks to recover from took me 3 months.  My husband played doctor every 12hrs, cleaning and packing my two incisions, this was painful and not something I would wish on my wost enemy.  To date I do not know 1 person (personnaly) that has had good long lasting luck with the lapband.  My mom has trouble daily with her port and at times not being able to eat without throwing up.  A "friend" of mine had such bad issues that she is in a law suite with her doctor and has since had a revision to the sleeve.  Someone else I know never lost the weight she thought she would and has since put weight back on.  I on the other hand had to wait over a yr for complete healing before I could have RNY which I had on 24 March 2015 (YAY).  Anyways, I wish you the very best in what ever decision you make.

I'm sorry if I made you feel bad I didn't mean to do that I just don't want anyone to have to feel as sick and as awful as I do everyday!! The band is a very poor surgery and even the Mayo Clinic has stopped doing them several years ago because of the poor results so I just want everyone to be aware of that.

Now this is just my personal opinion because I haven't actually had a revision and will never be able to now because of other health issues. However before I was unable to revise I was looking into the sleeve because to me that sounded like the most normal way to live.

They remove the part of the stomach that produces grehlin (the hunger hormone). That helps take away a lot of the hunger so many people feel all the time and sounds like you have that issue. It may not take it away completely but should dampen it some. Also you get to keep your pylorus in tact which helps keep you feeling full longer. You also have less chance of dumping and other blood sugar issues.

So for me those are the reasons I was wanting to have the sleeve I was also looking at the DS or duodenal switch which is a sleeved stomach but also has an intestinal bypass like the RNY only done a bit differently. With that you get the restriction plus malabsorbtion but I don't feel I need the malabsorbtion so was decided on the sleeve for me.

There are so many options for revision it can be baffling to decide, I realize that. So you just really have to trust your surgeon and his advice and determine for your self which surgery is the one you can comfortably live with for the rest of your life. Only you can make that final decision.

I wish you all the best and hope you are able to sort out all the info for the different options. Maybe it would help to write all the options and their pros and cons down on paper so you can compare at a glance what it is you like and dislike about each one. I wish you the very best and hope everything goes smooth as silk for you!

Howdy, and welcome! Just a caveat, you can feel free to take or leave my opinion -- I'm only 11 days post-op and can't speak much from personal experience, mainly just from my own compulsive researching and knowledge of other people's situations. If I were you, I would look into a revision to the original RNY instead of a BOB. You say your pouch and stoma are dilated and the staple line separating off your "new" stomach has allowed food to slip back through into your old stomach (gastro-gastric fistula). Those are all mechanical failures with the surgery itself, and they certainly could explain why you're hungry all the time. If I were you, my first priority would be to repair those issues and get my pouch working the way it's supposed to again. For example, these days the remnant stomach is physically cut away from the pouch so a fistula can't form. Talk to your surgeon about what's possible in your case.

I would never get a band, but that's all based on the experiences of people I know with them. I'd estimate fewer than 20% still have their bands. A couple are very happy, but the vast majority have permanent damage from slippage and esophageal dilations. That said, bands are very low-risk procedures (to say nothing of the long-term risk), so depending on your medical condition, that might be what your surgeon thinks is best (although if high cholesterol is it, BOB is probably not your only option). But bands in general are going the way of the dodo, and for good reason.

Did you call Cigna and ask them if they even cover the BOB? 

I had to fight them for almost a year until they finally approved my lap band to gastric bypass.  I don't remember seeing BOB as an approved revision. 

Just want to warn you incase your denied.

Good Luck, Cigna is not easy to work with.

Also since you live in NY, and before you make the decision to go with the BOB, call Dr. David Greenbaum for at least a consult. He does many Gastric Bypass revisions. That's the problem with the Bypass, too many damn revisions! Dr, Greenbaum is in South NJ, but he does phone consults. My mom went to Dr. Garber for a revision and it hasn't worked. I have been on this revision journey for 15 years. And the Distal RnY was my best decision.