Taking first steps to lap band revision

Hi Everyone!

I'm working on getting my revision surgery.  I've been having trouble with the band since 2010.  Well actually, it was never right, but 2010 is when the worst of the pain started.  I couldn't afford to get the revision (had a different insurance when I had the lapband placed), so I've just had to live with it.  This year my husband had a small accident and required emergency surgery.  That satisfied our deductibles, so if I'm going to do it, it has to be NOW!

I'm so worried that my insurance is going to put off approving the surgery and I wont be able to do it.  

As of now, I've had my consult, had my UGI, done the seminar and I'm waiting to see a psych.  I don't know if he is requiring the ekg and chest xray as he hasn't ordered them yet, but I assume that is next.  He explained the surgeries very well and is a very confident surgeon, but I am still a little unsure about the timeline and the process.  

I'm extremely nervous (HATE surgery/anesthesia).  

I haven't yet decided on which surgery, but I'm leaning toward Gastric Bypass.  

I would appreciate any friendly advise on the subject of revision/bypass/sleeve... any information is welcome.  I'm looking to make more friends this time around.  I pretty much kept to myself with the first surgery.  I didn't do support groups (and probably wont this time).  I hope to find my support group here, online, since this is the most convenient way for me.  

I wish you all well, wherever you are in your journey.  

Hi there,

I also have a lap-band and am about 1 month from having surgery. I am in a very similar boat to you! My husband needed knee surgery earlier this year which met our deductible (and then some) and it turns out surgery will basically be free since we're at our out-of-pocket maximum for the year (ouch).  My insurance is Anthem BCBS PPO and here was my timeline:

• June 19th - First Consult with Surgeon. Met with insurance pre-approval person in the surgeon's office and she gave me the checklist.
• July 7th - Nutritionist Consultation & EKG/Heart clearance (EKG/Heart wasn't required for pre-approval but instead a requirement to be done before the actual surgery... I just did these two the same day because they were both out of town).
• July 21st - Upper Endoscopy
• August 12th - Submitted to Insurance for Approval
• August 17th - Approved for Surgery & Scheduled for Surgery
• September 28th - Surgery Date

I was also concerned that since it's the 2nd half of the year, they would drag their feet and I wouldn't get approved in time.  I was diligent about getting all of my appointments done ASAP, and since my lap-band was in 2011 I didn't have to re-do some of the requirements (such as psych eval, sleep study) and a lot of my records pertaining to my previous approval were provided by my previous surgeon.  I also was VERY persistent with everyone involved to ensure there were no delays in getting the right information gathered. I would have been submitted before the end of July if it weren't for my Gastroenterologist who took over TWO WEEKS after my EDG to provide the report to the surgeon.

So, 6/19 start date, 9/28 surgery date is about 3 months-ish.  Everyone is different though, and some insurances and surgeons require a different amount of tests done at different points in the process.  I think you can do it if you get those requirements done ASAP and are persistent with all parties involved. Make it known to them that your goal is surgery before the end of the year!

I personally decided that a Gastric Bypass (RNY) is the best way to go for me. I decided against the sleeve because my prior experience with the tool only limiting the amount I could eat didn't work enough for me - I also wanted the benefit of bypassing the hunger hormone section of the small intestine and the mal-absorption phase.  I am a candidate for the DS surgery, but don't realistically think I can consume the amount of protein/nutrients required to be successful with that surgery.  The RNY, I think I can handle!

I also kept to myself after my lap-band. Only a few people knew and I have never been the type that would go to a support group. I think that is one of the contributing factors to my failure with the first surgery.  This time around, I feel so much different and so incredibly READY. I know what to eat, what to expect, what kind of problems others have experienced.  The ObesityHelp community is truly awesome, and I am sure this time around I WILL meet my goals.  I sent you a friend request! We can do this!! 

The best of luck to you! Hopefully my revision surgery won't be too long after yours... I'm shooting for early October but am waiting to see what the doctor says. 

I'm not the support group type either but I sure like it here at OH so I will be checking in frequently :)

Wow, we are definitely in a similar boat!  Right down to the same insurance!  I'm glad to hear that Anthem approved your surgery so quickly.  The doc is requiring that I do another psych eval (grrr).  I never did a sleep study.  I hope they don't throw that in the mix! 

Thanks for replying to my message.  I'll be looking forward to hearing how your surgery goes.  I'm so extremely excited and I just want to get it done NOW!

I'm leaning towards RNY for the same reason.  I don't think restriction will be enough.  The band was great.... if you like throwing up every single meal.  Oh, and the pain. 

Good luck in your journey.  Be sure to keep me updated! 

Ooh, yay same insurance! You'll find this helpful then-

When I talked to their Utilization Management department (the people who approve the claim) they say their standard for turnaround on decisions is 5 business days. So insurance should not be dragging their feet!

Oooh perfect!  Last time I had Tricare and it was 2 days with no problems.  I've seen so many horror stories with insurance companies, I started to get very concerned.  I feel better now.  This looks likes it's going to go along just fine.  Once I have the psych eval and all the blood test fees and imaging fee**** the surgery will be free for me, too (or pretty damn close).  I have a TON of medical bills I can't pay right now, but I might as well get the surgery while it's FREE!

I'm starting to imagine myself at 150lbs.  I haven't been there in 16 years (pre-pregnancy).  I was 19 the last time I felt good...

Awesome - you can do this!  Keep us updated on how it's going for you and don't hesitate to reach out to me (or the boards of course!) if there's anything you need!

Thanks for the support.  I definitely will update as I progress.  Good luck with everything. 

Hey there,

I just spoke to the surgeons office.  They haven't had  chance to look at the images yet, but they said that if there wasn't a slip that my insurance wouldn't cover the conversion (revision) without a 3-6 month diet.

Did you have a slip or any type of problem that caused insurance to pay for it?

I had an Upper Endoscopy done, and the Gastroenterologist who did it said that everything looked fine.  I never did a barium swallow or anything. My understanding is the claim was submitted without indicating there was something wrong with my band (that I know of).

They submitted me without a supervised diet but said that there's a chance they would reject the claim and I would need to do 6 months.  Thankfully it came back approved without me needing to do the diet.