Question:
why are my drs saying NO to Lapband and pushing the Gastric???
i am on medicare - medical 52 yrs old, bmi is 54.1 and was told that medicare would not pay for lapband if my bmi is over 50 and that diabetes does not go away with the lapband!!! others have told me this is not true!! i have a 2nd opinion on 8/20 and pray they will say YES!!! I am ready for a brand new life without the additional 145 lbs! — allegra314 (posted on August 16, 2008)
August 16, 2008
I don't know this for a fact; however, one reason could be the added cost
of the lap band upkeep. You will be seeing your doctor on a regular basis
for your fills. The other may be that it takes longer to drop the weight.
— phyllismmay
August 16, 2008
I was wearing a size 28 jeans and am now in a size 18 jeans. Most people
who have Gastric Bypass surgery continue to lose weight after surgery for
about a year or so, then their weight stabiizes. I am 6 months out, so have
at least 6 months more of losing to look forward to. Having this surgery
was the BEST decision I've ever made in my life. I had high blood pressure,
was a borderline diabetic, and had joint, knee, foot pain every day. All of
those problems are GONE and I am not taking any prescription medications
anymore. I feel so much healthier and look so much better too. This website
is full of wonderful people who go out of their way to help others - many
have helped me. I strongly recommend you use this website as much as
possible, for support. I also recommend you consider having the RNY Gastric
Bypass surgery instead of the Lap Band. People who have Lap Band
statistically speaking, tend to lose less weight, and tend to gain more
back. Also, Researchers have discovered that Gastric Byapss cures over 90%
of Type 2 Diabetics, and prevents Diabetes. This is miraculous!!!!! Lap
Band does NOT do that. The reason Gastric Bypass cures Diabetes is because
of the changes made with this surgery to the small intestine. Most
Diabetics are cured of Diabetes within several days of surgery, before
weight loss has even started!! Lap Band can cause Diabetes to go away, but
only after the person has lost a lot of weight; it is the weight loss the
gets rid of Diabetes with Lap Band. With RNY Gastric Bypass, the patient
does not have to wait until they've lost a lot of weight before the
Diabetes goes away, because when the surgeon modifies the small intestine
(called the Duodenum) during Gastric Bypass surgery, it cures Diabetes in
many people, so their Diabetes goes away almost right after surgery, before
they've even begun to lose weight. Lap Band works by restricting how much
you can eat, but still let's sugary foods like ice cream pass through.
Gastric Bypass works way better, by not only restricting the amount of food
you can eat, but also stopping you from eating sugary and greasy foods by
making you feel nauseated if you do. This is a good thing, it is a tool to
give you the self-control not to eat those bad foods. Gastric Bypass also
reduces the amount of a hunger-causing hormone called Ghrelin. And, Gastric
Bypass causes some of the fats and calories from the foods you eat not to
be absorbed by the body, they just pass on though. I feel Gastric Bypass is
far superior in every way to Lap Band. I feel Lap Band is moreso for people
who don't have a lot of weight to lose, and do not have psychological
over-eating issues with food.
Some thing important to remember if you have surgery - once you're at the
food stage where you are eating regular foods, it's important to make
protein foods your first choice. Eat mostly meat, tuna, chicken, low-fat
cheese, beans. After that would be vegetables, then no-sugar added fruits.
Stay away from carbohydrates such as breads, potatoes, crackers. I made the
mistake recently of eating too much carbs - and found I was sooo hungry and
couldn't figure out why>>>? Members here helped me figure out that
the carbs I was eating spiked my blood sugar, then when the blood sugar
crashed, it made me overly hungry!!! As soon as I cut out the mashed
potatoes and crackers, and went back to chicken, tuna, cottage cheese, my
hyunger was completely back under control again!!!!
Anyway, god bless and keep you, and just go for it, you will be so glad you
did!!!!!!!!
— Gina S.
August 16, 2008
There are probably two main reasons. First of all, the lapband has the
least success of all the surgeries available. Most people initally want the
lapband because it's the least committment and the most reversable--but
going into this sort of thing with that sort of half-hearted committment is
only dooming yourself to failure. Listen to your doctor and discuss which
one is truely the best fit for your condition, not the one you're most
comfortable with. Second, the only proven cure for diabetes to date is the
surgery that removed a portion of the stomach. Search Youtube for the video
clip from 60 Minutes on this topic. They're still unsure WHY this is, but
it seems to be bearing out in case after case. Best of luck!
— suezahn4me
August 16, 2008
Below is a Link you can click on, or copy & paste. It is for CBS
News.com an is an article and 12 minute Video on the TV Show "60
Minutes" with Leslie Stahl, about Gastric Bypass surgery and how it
affects Type 2 Diabetes and reduces the risks of many types of Cancer. It
is an excellent article and video and well-worth reading and watching.
http://www.cbsnews.com/stories/2008/04/17/60minutes/main4023451.shtml
— Gina S.
August 16, 2008
I had the Lap-Band and I will be honest, it does take work. My husband
also had the lap band and he has dropped 150#'s in 7 months. It is taking
me a little more work but I'm okay with it. My Mom in law has also dropped
about 130#'s and has taken her 16 months. It varies on your commitment to
either surgery. I would seek a second opinion. My doctor was awesome! He
let you make the choice, probably because he does both.
— MySonsMama
August 16, 2008
I don't know about the medicare/insurance aspect of your question as I was
a self pay for LapBand 2 years ago as I had BCBS and WLS was a plan
exclusion.
Of course it is possible to get rid of diabetes with LapBand, mine was gone
within 2 weeks of surgery and my hypertension was gone within 1 month. The
co-morbids of obesity can be cured with all types of WLS as you lose the
weight, it just happens quicker in most cases with RNY because of the
section of stomach/intestine that is removed. I would also recommend the
CBS special report on this as the other authors before me wrote about.
Very informative and impressive show.
I had LapBand at 402# with a BMI of 71, so it is possible.
I was very upset by another author's comment that people choose LapBand
because it takes the least amount of commitment and that it is reversible.
This information may be her personal opinion, but it is completely false.
Most people choose the LapBand because it is adjustable, NOT because it is
reversible. Also, it takes a huge commitment because we only have
restriction, we don't have malabsorption so our weight loss is slower. We
have to commit to a complete change in lifestyle forever to diet and
exercise.
I would also like to add that I am pro WLS, not just pro LapBand... I
believe each person has to choose which is the right surgery for them based
on all of the variables after completely researching all of the options.
Good luck to you,
Dawn Vickers, RN, BLC, CLC
— DawnVic
August 16, 2008
If someone is telling you that lap band is less successful they are
wrong........it is a great surgery and you the patient have the most
control....you do not continue to see your Dr on a regular basis for
life.....you will see your surgeon for about a year for the fills you need
to be successful....but you will not have mal nutrietion like with other
surgeries....and if after several years you start gaining a bit of weight
you can go in for a fill and off it comes.......every surgey that they do
can be a failure if the person getting it does not want to follow thier
Dr's orders or they decide to eat around the surgery......you do have to
work with the band but there are few and far between band patients that are
going back in for revisions because they have gained thier weight back....I
have seen alot of RNY Patients that have gained a lot of thier weight back
after five years because they eat more than they should over long periods
of time and stretch out thier stomaches.....then want to get lap band to
correct what happend....this is not true of all RNY patients....but it's
your choice.......I hade the same choice and chose the less invasive non
organ altering surgery and am happy I did. And I don't have to take mulit
vitamine and B12 shots for the rest of my life.......and I can eat any
foods I want ( even those with sugar ) with out dumping.......I just eat
less and am just as happy........and there are several people in our
Support Group that were diabetic and no longer have to take meds....there
are several who have been on high blood pressure and chosestrol meds that
no longer take those either...and I am one tha was able to get off my meds
at three months out of surgery.........if you want to research the band
further so you will be better informed then go to Yahoo Groups and type in
Bandbuddies........join that group and ask all the questions you
want....they are great and will give you all the info you need to make the
decision that is best for you....by the wat I am 62 and went from a 22/24
size to a 10/ 12 and I love my band.....
Pam / Ft [email protected] ....Bandster Bites Silverware
— pphillips4720aol.com
August 16, 2008
According to the research that I have seen, about 50% of the patients with
the Lap Band do NOT get the results that they were looking for. The higher
the person's BMI, the harder it is to achieve the results that one wants
with the Lap band in a reasonable amount of time. That may be ONE of the
reasons that the surgeons are reluctant to recommend this procedure for
you. Another reason may be that almost ONE PERCENT of the patients with
the Lap Band end up with some sort of severe complication that requires a
second surgery and some sort of a repair and often a REVISION to a
different type of weight loss surgery. Occasionally, the damage is so
severe, that the patient is left with nearly no stomach left. While the
LAST circumstance is RARE, it does happen often enough to be a concern.
This may be ANOTHER reason for your surgeons not recommending the Lap Band.
Many weight loss surgeons have STOPPED offering the Lap Band to many of
their Weight Loss Patients except in rare cases where it is medically
NECESSARY due to these factors. The risk of complication and thus,
LITIGATION is too HIGH. Frankly, if a procedure were to have a failure
rate of 50% and a complication rate of 1 in a HUNDRED, I would try to steer
AWAY from it. I was initially looking at the Lap Band MYSELF when I
started looking at Weight Loss Surgery. I ended up getting the Vertical
Sleeve GASTRECTOMY, which has been shown to be the SAFEST weight loss
surgery now commonly available! I have now lost ONE HUNDRED POUNDS in a
month and a half! The Vertical Sleeve Gastrectomy is a RESTRICTIVE
procedure ONLY, like the Lap Band, and I do NOT have to deal with all of
the other issues that I would if I had the Gastric Bypass. You may want to
see if you can try to get THIS procedure instead of the GASTRIC BYPASS. It
is ALMOST exactly as effective as the Gastric Bypass, lacking only a few
percentage points and being STATISTICALLY as effective. I have a post on
my homepage that is called "Surgical Comparisons." To find out
more about the various options available and more about the Lap Band,
Gastric Bypass, and the Vertical Sleeve Gastrectomy, go to my Homepage and
look for "Surgical Comparisons." You can find my Homepage at:
http://www.obesityhelp.com/member/hubarlow/ . If you cannot find the post
on the Homepage, look in the March Archives for 2008. Use this as a basis
for your own research. Please DO your own research. YOU are ultimately
responsible for your own health. There are people on the boards who try to
pass themselves off as EXPERTS who are NO SUCH THING! They are exactly
what I AM. They are PATIENTS who have done some RESEARCH! SOME of them
are DANGEROUS! They provide advice that can cause people to become ILL!
This is why it is of the highest importance to DO YOUR OWN RESEARCH! I
hope this helps. Hugh
— hubarlow
August 16, 2008
This is one of the those topics that'll open up a lot of debate..
lapbanders vs. Rny'ers. I, myself, went in expecting to go lap band. I
went with all the hype of it being minimally invasive.. and the thing that
troubled me most was that I'd have something foreign in my body and the
constant need for fills that first year was troublesome to me...as well as
the fact that I had heard that some insurance plans only covered so many
fills. Band slippage, and having issues with the band down the road also
concerned me. I don't begrudge anyone that wants the band, but for myself,
RNY was the way to go. I don't have any nutrition issues, I take my
supplements...we all have to....and I have been taken off blood pressure
meds, blood sugar meds, and no longer have acid reflux. I'm down over 100
pounds in just under 10 months and I feel like a million bucks. I'd do
this again in a heart beat and both surgeries come with risks... so truly,
one isn't less invasive than the other. I had my rny done laparascopic and
didn't have much pain or discomfort at all afterwards. I was a bmi of over
54....and I wanted that gone quicker....so this surgery was right for me.
You have to find what's right for you... so if your insurance is dictating
what surgery to go with, that's one thing...but don't push off the advice
of a surgeon that's done 1000's of these...because everyone I talked to
recommended the RNY for me. And they did all the surgeries...including the
DS. Best of luck... hugs... Cheryl
— Cheryl K.
August 16, 2008
Your concern about diabetes--Type 2 goes away in about 90% or RNY patients.
Higher BMI people will lose wt faster with the RNY. Lapband surgery is
designed for people who want to lose around 100 pounds, but some have
exceeded that amount. I've lost almost 160 pounds in 27 months from RNY,
including losing 8-9 pounds in the past 3 months. If you really want to
lose 145 pounds--many insurance companies are more willing to pay for RNY
since it has a high wt loss success rate. Lapband surgeries are not without
complications either. Many lapband surgeries are later revised into RNY due
to poor wt loss results. Since gastric has a better success rate, the
surgeons are just offering you guidance in your decision. DAVE
— Dave Chambers
August 16, 2008
I had RNY WLS and I can tell you the reason after studing the options for
three years was the amount of people that I came accross with Lap Band that
had to have RNY revisions to lose all there weight just did not make sence
to me to consider Lap Band if I was going to have to pay out of my pocket
for two surgeries. I find that at my age and having had Diabities for 25
years, that I realy needed the first third of the small intestine move so
it did not process food, as that is the part that absorbes sugar and fat,
as well as carbs. The only hard part of RNY is you can not eat sugar, fat
or many carbs without filling like you had a low blood sugar attack, and
there is noting to take to correct that feeling until it is over. The good
news is you don't do that more than once or twice. I was off of insulin
when I came home from the hospital and 4 weeks later only took ove of my 6
diabitic medications. 6 weeks after surgery I was off all drug for
Diabities, blood pressure and Colestrol. I am 8 months out and now have a
BMI of 30 after being at 55. I still am losing which not too many lap band
people can do that are as heavy as I was. Take the advise of the medical
professionals as they know what will be most sucessful. Personally now, I
am glad I don't have a foregin object in my body and I don't miss shots so
I know I am glad I don't have to have fills. Taking vitamin supliments for
the rest of my life is no big deal. Best of success to you!
— William (Bill) wmil
August 16, 2008
It has to do with your BMI being so high. My insurance would not cover the
lap band for me due to my BMI. With a BMI of 54 the best and more
permanent results will come from the bypass.
— mary_rn
August 16, 2008
I had Lap Band and my BMI was 50.4 and medicare DID pay for my lap band. I
was on insulin 4 times a day and now back on oral medications and my PCP
said with more weight loss I would probably be off of the diabetes
medication. I had the lap band 4-16-08, I am down 42 pounds and lots of
inches. I do the diet and exercise program and my doctor is very happy. I
was over weight my 150 pounds and my doctors have done nothing but
encouraged me. I have heart problems with lifelong dvts, plus degenerate
joint disease (two knee replacements, metal rod and screws in my back) My
first surgeon told me the same thing and then MY cardiologist said no for
gastric bypass and I was never told that by the first surgeon (his
cardiologist) okayed that for me, but mine called me and told me with great
reluctance to go against a fellow cardiologist but he wanted me to know the
truth. I found another surgeon, a great surgeon, who cared about me and he
was a God send to me. I had the surgery and I just love the band. I know
that it is hard work, but isn't any diet and exercise program. I am
smaller now than I have been in 17 years. Do what you want and find a
doctor who will do it your way. Here is a comparsion site that might help
you also:
http://health.ucsd.edu/specialties/lapband/about/options.htm
Good Luck...
— dyates2948
August 16, 2008
I have to admit, I started to read the answers posted and then started to
feel as if it were more of a "whose right/whose wrong" arguement.
In the end, please realize that most RNYers are very happy with the
outcome, while most Lap Banders are happy with the outcome. One
speculation for why your doctors may have a preference of RNY - and if I am
repeating someone, i apologize - Insurance companies are becoming
increasingly difficult to deal with where weight loss surgery is concerned.
And though there is a potential for complications and/or failure with
either surgery (YES, you can gain weight back after RNY if you are not
careful!) the Lap Band procedure has statistics that show that patients
fail to maintain their lap band and/or gain most or all of their weight
back more often than RNYers. To make a long, complicated insurance issue
short: Your insurance company does not want to pay for the same surgery
twice! Your doctors may be pushing for RNY because the statistics show
that your likelyhood to succeed is greater, and they might as well get what
they can out of your insurance company, becuase it will be unlikely that
your insurance company will pay for the revision - if you so choose - down
the line. Depending on what your insurance covers, your doctors may also
recommend that a lap band be placed until you can lose enough weight for
them to safely do an RNY, but to be honest, my BMI was 72 and they went
right for the RNY with me! Good luck!
— zandeldm
August 17, 2008
As a basndster that started with a similiar BMI I can say that there were
Dr's pushing the bypass. One even said anyone with more that 100 lbs to
lose he would never do a band. I choose another Dr. I have lost 98lb &
still going. The band is new enough that those use to the bypass want to
see the fast results. We lose more slowly, but for longer. If you have done
your research & know the band is the correct surgery for you, find a
supportive surgeon.
— Donna O.
August 17, 2008
Everyone has their opinion! Whatever worked for them they believe in.
Forget about everyones opinion...Do research, read about each. Each surgery
takes a certain amount of commitment and work. There is no magical answer
or surgery!! Read, read and see what you think will work for you. Go to
more than one doctor and see what they say like you are...The more you
inquire, the more you will learn. Why does one person buy a red shirt while
the other buys a blue? lol Good luck!!
— Linda R.
August 17, 2008
Do your research! Weigh the pros and cons of both and then talk to several
surgeons before you decide which one you like and trust the most. This is
a lifetime relationship you are going to have with your surgeon, so make
sure it is someone you want to have in your life for the duration.
I had the RNY on 03/27/2008 and had been taking meds for Type 2 diabetes
for 3 years. Within 3 months I was completely off any meds for diabetes
and I have lost 63 lbs. No matter what surgery you have it is going to
take work and commitment on your part.
— irish4girl
August 17, 2008
You need to contact Medicare (medicare.gov or 1-800-Medicare). If
Medicare's policy is that they won't pay for Lap Band for someone with a
BMI over 50, it doesn't matter what the 1st, 2nd, or 50th doctor says...
if your BMI is over 50, they aren't going to pay for Lap Band. You need to
think about how important it is for you to have WLS... if Medicare won't
pay for Lap Band, are you able/willing to pay for it yourself (credit
cards, commercial/friend/family loan, whatever)? Are you able/willing to
get your BMI down to 50 to qualify for Lap Band? Is your need/desire for
WLS strong enough that you are willing to pursue other WLS procedures?
I suspect that the issue is what Medicare will (and won't) pay for... the
doctor you saw is probably pushing you towards "Gastric" (you
didn't specify, RNY?) because you don't qualify to have Medicare pay for
the Lap Band... it may be "Gastric" or nothing. My guess is
that if you called him up and told him you were going to pay for it
yourself, he'd do a Lap Band.
Good luck to you! Please let us know what you find out form Medicare and
how the 2nd opinion goes.
Best wishes,
— mrsidknee
August 17, 2008
I'm with Hugh about Vertical Sleeve Gastrectomy (VSG) being superior to
lapband. They both restrict capacity for food without the malapsorption
feature of RNY. It poses less complications and it's permanent; you don't
have to keep going to the doctor for adjustments. There is no risk of
breakage like you have with the band. I think insurance companies will
become more weary of covering the band because of the growing statistics
that show average weight loss is far less than you have with VSG or RNY.
No matter which WLS you choose, it's only a tool. You have to do the work
to lose as much weight as you desire and maintain the weight loss. But of
the 3 surgeries, lapband has the worst track record for losing and keeping
weight off, and it requires the most maintenance after surgery.
— AlmaRene
August 17, 2008
Watch this video.
http://www.cbsnews.com/stories/2008/04/17/60minutes/main4023451.shtml
Your doctors are telling you the truth. The Gastric Bypass is curing
diabetes in almost all cases. The lap band may bring down the glucose
numbers, but rarely cures the illness.
You can easily loose more weight with the Bypass.
You don't need to keep going back for more fills.
Do it once and get it over with.
I do not know of anyone who got the Bypass that was dissatisfied.
Sometimes lap-banders have to end up getting a Bypass later.
Medicare and the doctors recommend this surgery based on years of medical
school and years of experience with the 2 surgeries. The lap-band is best
for those with less than 100 pounds to loose. Why argue with medical
degrees, experience, and statistics? Would you argue with the orthopedic
surgeon about which cast to put on your broken arm?
Nancy Carle, RN (Bypass, down 45 pounds in 2.5 months)
— nancycarle
August 17, 2008
I'm 51, had lap gastric bypass 6 months ago, was type II diabetic. Took my
last diabetes meds the day before surgery. also off high blood pressure
meds. my AIC is in the low 6s. with the bypass, many people get immediate
relief from type II diabetes, with lap band, diabetes improves as the
weight comes off. most people lose more weight with bypass than lap band.
I'm glad I had the gastric bypass, although it's not for everybody, it is
irreversible and requires permanent lifestyle changes, which for me is a
good thing cause if I could have gotten healthier without this tool I would
have done it years ago. Make sure your surgeon specializes in WLS so you
can trust their advice.
— Susan C.
August 17, 2008
Here we go again with this same old tired debate. I have a band and
I"m very happy with my choice. Like others have said, the band is
adjustable - whether it's been 6 months or 6 years. RNY doesn't offer that
option. A stretched pouch with RNY and it's all over. Look at Carnie
Wilson and Randy Jackson (American Idol Judge). There is something tho,
that you should read. As a matter of fact, I think this should be required
reading for any WLS patient. Go to the OH website and click on the PEOPLE
tab. Click on memorials and look for Jessica O. Read her story. It takes
a while and you WILL cry but it's so worth reading. And to the people who
say you don't get the results in a "reasonable amount of
time"...what do they consider reasonable? We've been fat our whole
lives. Rushing weight loss does nasty things to our bodies, particularly
our skin and hair. And I don't think any of us took this step just to
trade one set of problems for another. Take you time, talk to real
patients of all the different surgeries and then make your choice. Good
luck.
— Carla_B
August 17, 2008
Point blank ask the doctor why they will not cover the lapband. When I
first looked into surgery I talked to my PCP about Lapband because it was
less evasive than Gastric bypass. She told me that for me the Lapband
would not work because it can be beaten without too much effort. I was a
sweets addict so she explained to me that all I would have to do is drink a
couple of chocolate shakes each day and I would not loose the weight
needed, the liguids go right through the band and you have consumed 1000 +
calories and then eat the solid small meal. She told me she had several
patients who drank their calories, shakes, booze whatever and did not loose
the weight. The band works for some people, but it would not have worked
for me and I am glad I went with the gastric bypass, I lost 160 lbs., 5
years ago and have kept it off. Everyone needs to remember that each of
the surgeries will work for some people but none of them will be right for
everyone. You need to find the one that works for you and do not let
anyone bully you into choosing which one will work for you, research it and
decide.
— tazfan
August 17, 2008
I would say what my friends told me. I have a BMI of 50.7, so I had
decided to do the lapband, they said that I would not be as successful
losing the weight that I needed to. So I am going for the RNY. Also, I
believe that the gastric does correct diabetes because the surgery bypasses
the part of the small intestine that contributes to it.
— jenks621
August 18, 2008
I was banded on 4/29/08 and have to say that I disagree with some of the
comments posted. The comment about the lapband being the least successful
is very wrong - - any of the surgeries can be unsuccessful - - it depends
upon each person's dedication and commitment to the tool they have been
given. None of the surgeries are cure alls - they are TOOLS to help us
lose the weight. When I was discharged from the hospital on 4/30/08, I was
taken off my diabetes medicines and my glucose levels have been dropping
ever since. My A1C is normal and I as of two weeks ago, I am off my blood
pressure meds and cholesterol meds. So the lap band is successful and I
would highly recommend it to anyone who is interested. As of today I am
down 51 pounds since my surgery. As a FYI - my first fill on 6/26/08 was
covered as part of the surgery so there was no co-pay. At my fill on
8/15/08 I did have a co-pay. The best to you, and remember, the decision
is YOURS - - not your doctor's, not your family or friends, not anyone on
this website. You have to make the decision that you are comfortable with
as it is a lifestyle change forever! Nancy
— Monte57
August 19, 2008
Most surgeons are unable to take medicare. Usually only state funded
hosptials. Doctors that push bypass need to think about a different
career.
— ljtrowern
August 26, 2008
As I posted before, probably because of your BMI, I am choosing gastric
bypass, because of the amount of weight that I need to lose, but you have
to choose for yourself. I don't know about medicare and their rules. Good
Luck with whichever you have. Kerri
— jenks621
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