Alexandra

Yeah, well, at this point no Muslims have run for national office -- can you imagine that picture? Insofar as 28% of people saying they wouldn't vote for a Mormon, I'm hard-pressed to call that "bigotry." Personally, I couldn't vote for any ordained and currently active cleric because I'd have serious doubts as to his or her first allegiance. Aside from that, though, I don't care what someone's religious affiliation is as long as they keep it where it belongs--far away from policy decisions. But the point in the article is well taken, and a terrific argument for removing ALL discussion of religious adherence from the public discourse. People's religious affiliation is simply.not.relevant unless they have made it a public issue (such as those candidates pandering to some specific religious bloc, or declaring themselves to be born again as though that somehow is a credential for public office). Let's talk about the ISSUES, policy, and the public welfare. NOT what people do at church or in their personal lives.

Heck, we answer ANYTHING!! :welldoneclap:

I absolutely agree with this, but think it goes toward medical ethics than the "rights" of the provider or the patient. Any doctor who was unwilling to help a patient in need, even if it's just with a referral, is not living up to the medical code of ethics.

I agree with ABP. There's no reason to test whether there'd be any ill effects of smoking the day after, right? There's certainly no benefit to it, and you'll have pain meds to use if you're uncomfortable. Give yourself AT LEAST a week. And even better, wait until you're fully healed and back on solid food so the loss of inhibition that goes with getting high (and this goes for any mood-altering substance, alcohol, whatever) won't send you grabbing for the chips before your body is ready. Your stomach needs to heal so your band will set in place properly, and that process can take way more than a week. Good luck with your surgery!

Fran, I know of many people who had good experiences with the Lindstroms, so don't base your expectation on this one person's story. Why were you denied coverage?

I'd have to agree with Jack here. The doctor has a "right" to withhold services from any patient--he's a professional and unless he's under a contract to a government or hospital that says otherwise, he's in charge of his own actions. Is he behaving ethically? I'd have to say yes, unless he somehow misled the patient into thinking she'd get the desired service if she went to him. He's not "making" her travel hundreds of miles to obtain a desired elective procedure, that's her choice. And of course, in these days of ever-narrowing specialties, it's entirely possible to find gynecologists who don't deliver babies, or obstetricians who won't do abortions. It's not a matter of "rights" in the scenario posed at the outset. The patient doesn't have a "right" to an abortion; it's her job to find a provider that will do it.

This is such a refreshing opinion to hear and is, indeed, living by the Golden Rule. I agree, QT, you are very cool!!

That actually is a consolation, and I've heard it before. Still, we're paying so much now that it's hard to imagine what would be a "tolerable" increase. On the other hand, our Governor has signed a bill that is supposed to give people earning less than $200K an up to 20% rebate on property taxes for 2007. If it really happens, that'll be a nice chunk of relief for us. Fingers crossed.

The fluoroscopy with barium test is what my surgeons refer to as an upper GI test. It can diagnose a slippage or pouch/esophagus dilation. They can assess your restriction and confirm the position of the band. It really tells them a lot, which is great for us because it's such a simple procedure. Definitely have this done first, because it can settle some questions. You should probably have all your fill taken out at the same time, and then let it be WAY MORE than a couple of weeks before you have any more put in. If ever. Endoscopy is required to diagnose erosion, and it may be necessary if they don't see clear answers under the fluoroscope. But to be honest, most cases of erosion I've heard of didn't involve pain of any kind, and there was usually a lessening of restrction if anything.

Everyone's experiences are valuable--but crossposting multiple times is not acceptable. Anyway, with regard to finding an attorney in your area, try calling the Bar Association of your city or state. Look for doctors with experience in battling HMO decisions. It's a huge area of attorney practice, and they don't have to be particularly schooled in bariatric issues. You are being denied medically necessary treatment, and if the carrier doesn't have an ironclad reason (such as an exclusion on your contract) any attorney with experience in this area should be able to help you mount a good appeal.

We have deleted all but two of the posts. Crossposting is considered spamming, and is inappropriate no matter what the content of the message.

Candle, what state are you in?

ABP, you are very much NOT alone in what you're going through, and you're taking the right steps to address it. I'm 3+ years out and have had symptoms on and off for the last year, so maybe my experience can help. I'm in close touch with my doctors, and had an endoscopy last year because I really thought I had an ulcer or something horrible going on due to all the pain. The endoscopy showed just a really inflamed esophagus, and they took out all my fill and put me on Prevacid. I waited several months before going in for another adjustment (not two weeks--that's nuts), and then had only a tiny bit put in. A month later my symptoms were back, so I had the fill removed again. Another four months go by, I had an even tinier fill replaced, and now three months later I'm having reflux and some occasional pain. My next test is an upper GI (which is a barium swallow under fluoroscopy) and at that time they'll probably remove the fill. If that doesn't relieve my symptoms, or if they come back, I will then see what my options are. The most important thing is to retain my health, and maintain the weight loss I have achieved. But I have to face the fact that my band may not be there forever to help me do that. And if it's not, I must have faith and determination in myself to make it happen. We know how to do it--we did it. Take control of your health, and that means first and foremost finding out what's going on with your band and your innards. Please don't be ashamed--this was not just another diet; it was a medical device implanted in your body and it's unsafe to just ignore its condition if you have symptoms or pain. Please keep us posted! Thanks for sharing and I'm so glad you found us. We'll probably have a lot to talk about in the next few months.

And of course, then there's New Jersey. On our house, which we bought for $240,000 12 years ago and even though it's now probably worth $650,000 on the market (due to nearby development) -- it has never yet been reassessed -- our taxes are $9000. We pay another $2000 in taxes for our backyard, which lies in the neighboring municipality. And we're deed-restricted from subdividing. Nice, huh? I live in fear of the moment the town announces a reassessment plan. Half of us will probably have to leave. And considering my family has been here since 1933 that will be quite an unhappy day. Our state income tax is quite reasonable, though.

Hi Gaynor, I'm sort of in the same situation. At this point I think I have all of .5cc in my band, and am probably going to have that taken out in the next week or so. I have great restriction (whereas in the past have had much more Fluid with the same effect), but am having reflux at night and can't really sleep lying down. I'm worried, actually, that once this fluid is done that will be it for adjustments, and if the condition of reflux returns I won't have any more options. The level of restriction I have now is enough to help me maintain or lose (if I want to put forth the effort), and I'd be very happy to maintain it as-is. But it's hard on my health to sleep in a reclining chair, and in trying to avoid reflux I'm eating way too much soft stuff. There's much more going on inside than just the level of fluid in the band. Our bodies are adaptive, and over the long term our stomachs may adjust to the constant pressure of the band in some way. Our esophagi may work less well (which I suspect is the cause of my reflux) and it's going to take close observation to see what the situation is in each person. IMO, don't worry at this point about restriction. The band has helped you reach your goal and now it's up to you to stay there. The more important thing is maintaining the health of your (our) digestive system.

Tell your doctors and especially the anaesthesiologist of your prior experiences and fear. Believe me, they don't want you to be scared and they certainly don't want anything to go awry during surgery. Be honest, and you'll get the care and support you need. Good luck, and don't worry!! :hug:

Hi Alexis!! I'm Alexandra, and also a patient of Drs. Abkin & Bertha. You're in great hands!! Just follow their instructions and pay attention to Linda's pre-op class, and you'll do just fine. :biggrin1: LBT is here for questions and support when you have them. See you around! :clap2:

Blue Cross is different from state to state, and each state has its own rules about appeals. In New Jersey, my surgery was denied by a different carrier for the same reason; they said banding was experimental. I was able to appeal it and it was overturned, and my surgery was covered. Find out exactly what your policy says. Check with other people IN YOUR STATE who have BCBS coverage. Find out what your state's policies are on appeals and challenges to HMO decisions. There is no good medical reason to exclude gastric banding if other bariatric surgeries are covered, and the people regulating health insurers in your state probably agree. Check it out, and good luck!!

StephT (and everyone else): You can absolutely call the carrier to find out if they've received everything they need. This is crucial! So much time is wasted because someone didn't get a fax or something--it is your job to check on things and make sure they are moving along. Call member services and say you want to find out if a request for preauthorization of surgery has been submitted, and what the status is. OF COURSE you have the right to ask!!!

Many doctors and just about all insurance companies have this six-month requirement of supervised attempt at weight loss. You can't invent it if it's not there, so get started now! As for the other attempts, what I did was make a chart to the best of my memory with the date, my weight at the start, the type of diet, how long I was on it, and my weight at the end. I had about 10 different attempts on this list, starting with WW at age 8 and weight-loss camp at age 10. Obviously I had to estimate or even guess at the weights and details for a lot of it, but when I was done it was impressive (depressing?). So tell you doc you want to start now on the 6 month supervised diet, he'll supervise and take notes each time you visit (at least once a month, better to be every two weeks or even every week). When the six months is up you'll have all the information you need to proceed.

That completely depends on how it's done. I have mine in the hospital under fluoroscopy, and the total tab is about $800. Thankfully, it's covered by insurance.

Oh, Carrie what a hassle! If it makes you feel any better, I'm experiencing the same fill--pain--unfill--OKforawhile--refill--OKforawhile--pain--unfill cycle that you are in. So please don't feel you have done anything wrong by seeking continued care and attention. Questionable mass? Get a second opinion! That doesn't have to come from a surgeon...see a gastroenterologist to get that diagnosed if you think there's anything really there. Yikes! But I have to say that there really may come a point (and I think I'm there) when some people can't tolerate any fill at all. I may have to have my current .5 ccs removed soon and if they take it out I'm sure that will be it for me. I don't want to have my band removed but will be happy to live with no fill if it means no reflux. I've always figured the band would take me to a certain point and no further, and now I know what that point is. Good luck!! I hope you and your doctor "make up" and find a way to continue your care. Keep us posted!

JeninCo, don't go away mad. This is the part of the site that gets all sorts of weird stuff posted in it, and as ... interesting ... as it gets sometimes I hope it doesn't detract from the main focus of the site. All the other sections are dedicated to banding issues, and I'm sure you'll find answers and inspiration there. This section is for ranters and ravers, and the opening post in this thread certainly fits that description, doncha think? :success1:

Wow, that does seem a totally uncalled-for response. But I don't think there's anything to be gained by confronting him--it was due to his defensiveness and wasn't an implication of anything against you or your husband. Chalk it up to his living a lifetime of slights and suspicions that he still is responding to. Don't take it personally.

Hi Silly! :success1: So many times I've heard people share stories about the conditions they found while undergoing presurgical testing. It is indeed a blessing! If your condition is fixable (is it?) perhaps you'll find the strength and stamina to work on getting healthy without surgery. It's great they found it!! Welcome (again) to LBT, and I hope everything works out as you desire.