Alexandra

Jacqui (or anyone), what do you think of Hyundais? They were really maligned for years here but now they're earning a great reputation. They have a 10-year warranty and are coming out with new models that are pretty good-looking! (I just wish they'd do something about that cheesy slanted H emblem that looks like a Honda wanna-be.) I have no experience with Kia but will be watching this thread. Our Toyota Sienna is about to bite the dust and we'll be looking for a replacement within the year.

If you could or wanted to do any of these things BEFORE being banded, you'll be MORE able to do them after you lose weight. The band will not in itself prohibit you from taking any crazy chan... I mean, doing whatever extreme sports might float your boat. Have at it! :biggrin1:

Will they be doing your refll under fluoroscopy? Unless they are, I'd be worried that 1.5 cc is too much. Most people find after being unfilled for a while that they can't tolerate what was an acceptable level before. And in any event, they shouldn't go into the fill with a preconceived notion about what they're going to give you. I'd suggest taking it slow, and being really cautious. If there's no fluoroscope being used, I'd tell the doctor to stop at 1 cc no matter what it feels like. And if it feels tight before that, don't be shy about stopping earlier. If there is a fluoroscope in use they'll have a visual on what they're doing, but even then they should err on the side of caution. Too little fill is always easy to remedy. Too much can lead to big problems. And if you had only 1.75 in a 4cc band, you don't have a lot of margin to play around with.

I found those percentages comforting, actually. They seemed much more realistic than what I'd seen for other bariatric surgeries--much more attainable. I wanted something that would WORK, and if I could actually get to that place of having lost even 50% of my excess weight it would have seemed a miracle to me. That's what being morbidly obese all your life does to you--you absolutely don't believe you could ever be normal. As it turned out, before my slip I'd lost 130 lbs of what was probably (medically speaking) 170 lbs of excess weight. So 70-75%, roughly. It was a miracle, and I can't wait to be banded again to get back to that place where maintaining that loss is even possible without my life being a hell of hunger and constant dieting. THAT is the success that banding held for me, not reaching some imaginary number that's just a point on a chart. And it delivered in spades.

I know we've heard it a lot that VG bands are less likely to slip or cause erosion because of the larger stoma area and gentler pressure. Is it true? Let's hear your VG band stories of complications. (I'm hoping there won't be many!)

I've been thinking of you, Karen, and so glad to see you post! Congratulations on your next step, and heal quickly!! :hug:

We have to remember that it's not the BAND that tightens spontaneously. It's wrapped around our stomachs, and that is human tissue that changes in density with Fluid fluctuations. It's not at all uncommon for people to feel tighter at times of greater Water retention (like right before or during a period) or congestion (like during spring hay fever season). That's when retained fluid makes the stomach tissues thicker, which in turns makes the stoma smaller and our banded stomachs feel tighter. At times like that we have to be EXTRA cautious and eat as carefully as we can. One PB can lead to irritation, which can lead to swelling, which can lead to increased restriction, which can lead to more PBs, etc., etc., etc. And if a fill is too much to start with, well, it can be a neverending vicious cycle.

What exactly do they mean by "ruin your entire life"? If your entire life revolves around eating to the expense of any regard for your health, then I'd agree. But that's the only circumstance in which I can say that being banded would "ruin" one's life.

I think you'll find that a lot of people have reflux from time to time while banded. It's usually a sign that the band is too tight, that tissues are irritated, or something else is going on. It's a symptom of a problem that needs attention, not a routine result of being banded.

Lanny, I hate to be a hardnose but why is it YOUR job to come up with things to feed HIM? He's the one being banded, he's the one who's going to have to live with the quantity restrictions and he's the one who's going to have to adjust his palate. Does he want to be banded? Does he understand that a meal will be half a chicken breast and some green Beans? The great thing about the band is the time we are given to learn and adjust to our new capacity, but if all he likes now are meat and potatoes he really should think hard and long about what he's getting himself into. What works for one person may not work for another, so any suggestions other people make are only that, suggestions. I was never able to eat eggs while banded, for example. It's not that he won't be able to eat meat, but there will definitely be times when things he loves will be difficult to get down. And even if not, he'll suffer nutrionally if he doesn't learn to like more high-Protein things. If be concentrates on the potatoes, for example, he'll quickly find that's all he will be able to eat that meal. And one cannot live on potatoes alone. I'm not trying to be a wet blanket, but your post has me a little concerned that you are taking responsibility for what he will be eating. That's got to be HIS job. What does he say?

If you've been hanging around here any length of time, you'll have seen similar messages from SCORES of people. The fact is that the first fill may very well not make any significant difference in the way you feel. It may also take a week or more to "kick in." No matter what, you shouldn't be trying to eat solid food until tomorrow, and on liquids you won't feel any restriction. Give it time. The first fill is often a "baseline" and only has minimal if any effect on the way a bandster feels. It's often only the second or even the third adjustment when any real difference is felt. But your experience may be different, and you may feel something in one day, one week, three weeks, or maybe not until you have more Fluid in your band. The rule of thumb is always to take it slowly after an adjustment until you really see what the effect will be. Don't leap to conclusions just because you don't feel anything that day.

I really don't have any thoughts about it, just what I read back in 2002. It was discredited and very few insurance carriers covered it. Of course, I don't mean to say that insurance carriers are the final authority, but that's just the impression I got at the time. If you're doing research now you will know a lot more about it than I do.

I am not sure why it is this way, but the medical qualifications for banding have always included having controlled symptoms of things like high blood pressure, hypothyroid, diabetes. That is to say, if one presents with uncontrolled issues in this vein, the doctors will want to make sure that the correct medications are on board before they approve the patient for surgery. I know of lots of people who have been diagnosed with one condition or the other during their pre-surgical testing who then have to wait a bit longer while that condition is managed. Don't worry--a hypoactive thyroid in no way means you're not eligible for surgery. Your doctors are just trying to get it managed before they will approve--and if your levels aren't responding the way the docs expect them to, they have to investigate and find out what the problem is. For example, if it turns out that your levels are wacky due to some other issue then it may not actually be safe to undergo surgery at this time. I had to see an endocrinologist prior to surgery, too. Once I got the right medications to manage my hypothyroidism, it was no longer an issue. Really, this is the best thing for your health, so try to be patient.

I swear, I think I am the only person in the world who buys coffee when I go to Starbucks. Really, there are lots of skim options there, you just have to read the menus. Many people manage to live a very successful banded life without terminating their Starbucks habit.

Unfortunately, if you have a large-employer plan and the employer has chosen to exclude all bariatric treatment from the policy, there is very little you can do. If there is a more specific exclusion, such as exclusion of banding but not RNY, you might be able to appeal that on the grounds that it's preventing a preferable treatment. But if your employer has the right to design its own policies and its chosen this route to save money, you may be at their mercy. Take a look at your contract and see how the language reads. Then check with your state's department of health or insurance (whichever one has jurisdiction over health insurance plans) and see if you have any recourse. Good luck!!

Unfortunately, if you have a large-employer plan and the employer has chosen to exclude all bariatric treatment from the policy, there is very little you can do. If there is a more specific exclusion, such as exclusion of banding but not RNY, you might be able to appeal that on the grounds that it's preventing a preferable treatment. But if your employer has the right to design its own policies and its chosen this route to save money, you may be at their mercy. Take a look at your contract and see how the language reads. Then check with your state's department of health or insurance (whichever one has jurisdiction over health insurance plans) and see if you have any recourse. Good luck!!

Bonjeanie, as I understand it the MGB is really not considered a safe and effective surgery. It's not done much at all these days. However, there are lots of other options and almost all of them can be done laparascopically. I know there are many, many doctors who do both RNY and lap-banding who will do one on top of the other if necessary. Your best bet is to find an experienced laparascopic gastric surgeon and talk with him about your specific case. It may be a good idea to talk with more than one, if you can. You might start by looking at the OH website (obesityhelp.com) to locate bariatric surgeons in your area. Good luck!!

The answers to your last questions probably depend on the attitude of the person doing the medical review of your application. It's certainly worth an appeal if it is denied; after all, medical opinions can vary and if your doctor feels you are a qualified candidate for bariatric surgery he will have to make the case.

Hey Babs! Nice to hear from you. I'm sorry you're having trouble finding someone to get a fill from. Maybe there's a FillCenter somewhere in the state? Good luck with everything!

You should ask your doctor about that. I know there have been cases where the tubing is palpable, and in one case I know of it actually eroded through the skin and was visible. I'm thinking this is NOT the way it's supposed to be.

When symptoms like the ones you two describe arise out of nowhere, it may very well be a slip. But it may also be irritation caused by something else, and there's no way to tell without the proper examinations. Good luck with your testing and PLEASE let us know how you're doing!!

The insurance policy was approved and I have my group number in hand. Just waiting for Monday, July 2 when I can fax my new insurance info to the doctor, and they can start with the request for precert. Watch this space for updates!! FINGERS CROSSED!!!

Believe me, I know how you feel. But from the insurers' and medical establishments' points of view there's a difference between a chronic battle with weight (we ALL feel that way, after all) and a chronic battle with morbid obesity. I'm not saying it's smart for insurance carriers to exclude treatment for weight management--but that will only change when something is done on a national level. Im just explaining why it is the way it is.

Karen, thanks for such a wonderful, insightful post! There's not a single word in there I disagree with. You're an inspiration!

My insurer was Aetna at the time, and when I first applied 2002 they excluded the band across the board. Neither Aetna nor my employer excluded bariatric surgery, mind you, Aetna just carved out the Lap-Band itself. They said it was "experimental." I fought that through two appeals and an external review, and finally won. Aetna had to cover my band, and sometime after that they revised their coverage policies and no longer exclude banding from their covered bariatric treatments. BUT: every state is different, and large groups can often configure their own contracts, so it's not safe to say that Aetna covers the band in all situations. In my state (NJ), in small group plans, for qualified individuals, Aetna covers banding in the same way it covers other bariatric surgeries. Now that the band is six years out of FDA approval and is covered by Medicare, most carriers treat it the same way. If coverage is not available it's NOT because there's anything special about the band versus other kinds of bariatric surgery. It's more likely that bariatric treatment is excluded entirely due to state allowances or employer decisions. If you're medically qualified and are seeing any other reasons for denial, APPEAL. It's crucial that we all know our rights and take appropriate, aggressive steps to get the care we need.