GeezerSue

Blue Cross of California (not BC/BS) just changed their policy, based on new research that show that banded people with BMI's over 50 generally do not lose enough weight to get out of the MO category and get rid of the comorbidities that are so badly impacting their lives. I think I posted about this somewhere (but I guess not here.) Wherever it was, everyone wanted to argue about it. But after looking at large groups on follow-up, there were not enough people who started with a BMI's of over 50 and got to BMI's under 40. Of course, the stats, two or three years out are the same for RnY. But they GET to a lower weight before the weight rebounds. So they can blame the RnY patients for the weight regain. The study I read "blamed" the band. I don't want to rain all over your parade, but even if you beat the "experimental" denial (which I think you have a good chance of doing), you may still have THIS hurdle to deal with.

Those are the three. I don't think any one of them is bad. You might want to compare post-op follow up (ask at all the boards...except, of course...any of the fan-club boards), accommodations, and finally prices. I picked Rumbaut. He HAS a band; he did the pre-FDA trials; he did junior high in Ohio so his inglés es mejor que mi español.

Alexandra, my dear, you are NEVER wrong. And if you are, you're never wrong here. "Desat" refers to oxygen desaturation. You wear that little pulse-ox thingy on your finger while you sleep and the machine records and prints your O2 levels. I think that would be a very reasonable primary screening thing. People whose O2 levels never drop to below 92% or some other figure could be sent on their merry way. Let's work on legislation or something. The testing is not only expensive AND an overnight excursion, but the crap they use to glue the electrodes to your scalp ought to be illegal. And the VA pretty much just SANDS them off your skin, with alcohol-soaked emery paper or something.

Maybe not...but when I told my husband's cardiologist that I was sure I didn't have sleep apnea because I had no symptoms, he told me he didn't have any patients with (what he guessed was) my BMI, (it was about 50 at the time) who DIDN'T have sleep apnea. I don't know. Maybe he said it to scare me into scheduling the test. (His partner was my pulmonologist and he had been recommending it and I had been fighting it for months.) But I had the test and it was positive, and while I was SURE I didn't have sleep apnea, turns out it was severe. And earlier this year I went to the VA and ended up seeing one of those "just passing through between real gigs" doctors who decided to spend some time on the west coast and get paid in the process. He, too, was a cardiologist and, of all the stuff I've got going on with my out-of-shape-ness, THAT was the one issue he decided to discuss with me...for about forty minutes. He didn't go off on diet and exercise and my weight. He spent most of forty minutes on sleep apnea...which is a REALLY long visit at the VA. He got me back up to the sleep clinic and retested in record time, and I'm back (with my weight regain) in one of those stupid Bi-PAP machines. Anyone--fat or thin--can have sleep apnea. But I know that I've read that a higher percentage of people with more severe sleep apnea are heavier people. I was first screened with a pulse-ox and I kept an overnight journal...maybe that's a cheaper way to go. People who don't repeatedly desat during the night might not need more expensive testing. (Because no one who doesn't need that goo in their hair should have to go through that...ugh.)

Horgan is one of the most respected band surgeons in the country. His bedside manner occasionally comes under attack, but I know that for people with complications who have gone to him to fix other surgeons' errors, he is quite compassionate.

Good call. She probably wouldn't be filled. Which could mean that it's not band related (probably the case)...or could mean that the band itself--even unfilled--is causing the problem and the solution is more complicated than just unfilling. But worth keeping an eye on.

Rumbaut place my band three years ago. I'm having it removed, because I'm having complications TOTALLY UNRELATED TO HIS SKILLS. It is just not the right surgery for me. (I posted in DeLarla's thread.)

I just had the adenosine nuclear stress test, which is like having a heart attack, I'm told. there is no treadmill involved. It was time consuming, and--as promised--the last part was pretty much like having an elephant land on your chest while your veins all try to explode. BUT...it doesn't last long. HOWEVER, THE sleep APNEA TEST IS CRITICAL!!! This is meant to educate, not terrify. While this patient had RnY, the outcome could have been the same with ANY SURGERY. http://www.obesityhelp.com/morbidobesity/information/showcomplarticle.php?ID=1033479097

At the risk of being my reliable cranky self, I wouldn't go for an online diagnosis. While I supose anyone who has posted could be right, so could this article from the medical journals which states: INTRODUCTION: Patients are frequently referred for chronic cough. The causes are various. CASE REPORT: We report two cases of chronic cough that occurred after laparoscopic adjustable gastric banding for treatment of morbid obesity. In both cases, the computed tomography scan showed an important oesophageal dilatation. The cough disappeared after the band deflation. CONCLUSION: Oesophageal dilatation after laparoscopic adjustable gastric banding is a new cause to be included in the aetiology of chronic cough. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12910122&query_hl=7 Print out the abstract, take it to your doctor and ask if your cough could be band related. Reason is, if it is being caused by esophageal dilatation (widening of the esophagus) and if it is caught soon enough, an unfill seems to cure the problem and leave you with a healthy esophagus. If symptoms persist, you don't want to take chances. Sue

NO! But I am in the process of getting my band removed and having the DS (Biliopancreatic Diversion with Duodenal Switch) if all goes well! "Why?" you ask. (I can hear you.) The band is restrictive. After a year or two post-op with the bypass, when the body kind of overcomes the malabsorptive thing, the bypass is restrictive. The DS--although a more extensive surgery and although requiring a far more skilled surgeon--leaves you with a larger stomach, an intact pyloric valve, the ability to eat most kinds of foods (although each person has different tolerances and bowel issues may ensue if those are not discovered and honored), the ability to take NSAIDS, and a bunch of other reasons, including malabsorption that continues beyond the two year mark. (That also means that enormous effort to make sure nutritional needs are being met must be observed.) AND...(I should start a new thread, huh?)...because the band has caused and is causing me physical problems. I am one of the 11% of banded people whose esophagus stops working (it's supposed to "massage" the food on through to the stomach) once we are banded. Yesterday, under flouroscopy, two surgeons, a lab tech and my husband and I watched as I drank barium with a completely unfilled band. It just sat in the esophagus. Lump-o-barium, if you will. I had to wash it through with Water...and remember the drink is a liquid. You can imagine what solid food does. So, I've seen a DS surgeon. He wanted all of the saline out NOW, to provide a little relief to the stomach. As soon as the insurance says "Go," I'll get unbanded and re-routed. I'm scared--because I'm not half as dumb as I look. But I need to get rid of the band and I really feel a push to have another wls surgery before I "age out" of that possibility. (I'm too close to 60 for comfort.) In answer to your question, no bypass. But I would have a wls called the DS. Sue

Just read up a few responses! He is not only "Inamed certified," he is one a a very few surgeons who GOT Inamed's band approved in the US. He's beyond certified.

Rumbaut did the PRE-FDA testing which allowed the FDA testing to be done in the states. He's a band pioneer...and a band patient. And he proctored the guys who now consider themselves to be the experts...if that tells you anything.

October 2002

Your immediate post-op weight loss was merely fluids. You rehydrated and then lost fat. Step away from the scale! Use your belt to see how you're doing.

Let the body heal. THEN decide how to proceed. (And don't consider only band and RnY; have her look into the DS as well. I say that because the DS leaves a larger stomach area than RnY.)

Not always. If you have a MEDICAL reason...you need a breast reduction, for example...or the hanging pannus that was the result of your losing weight is causing intertrigo (and you've been going to the doctor and documenting that you are trying more conservative approaches) and backaches (and you have gone to the chiropractor to document that the hanging pannus is the cause of the problem), then you will likely just have to pay what you pay to go to any other specialist. (My daughter and I have different insurances. She had a BR...no WLS was involved...and she paid about $50. I pay a $35 co-pay with anay specialist, including the PS.) BTW, I had both the panniculectomy/abdominoplasty and the abdominoplasty/breast reduction while MO and insurance paid. If I lose a hundred more pounds and need another surgery, I'll get another surgery and insurance will likely pay again. But I needed it and got it.

I don't think a child that young can follow through on a project such as "clean up your room." I used to have to sit there with my kid and make the project less formidable. I'd sit and say,"First, put away everything that is blue. I don't care what it is, what shape it is...if it's blue, put it away." When EVERYTHING that was blue was back where it belonged, I'd change it a little and say, "Now put away everything that's round. Wheels, cars, buttons, toys...anything that's round." It would take forever, and we would take breaks, but she (and I) have a lot of dificulty (and become paralyzed) by BIG MESSES and just stare at them. She's thirty now. When she is cleaning her apartment, she occasionally calls and (jokingly) says, "Mommy! Tell me what color to start with!"

The "program fees" are the latest way to make up the difference between what the doctors get paid and what they think they should get paid. It's not just for LapBand. while researching the other surgeries, I have found $800 "program fees" and $3000 "program fees." They are charging that because, so far, it is not prohibited by their insurance contracts. Once it is, they'll probably charge $3000 for pre-paid parking, even you you take a bus. It's about the money.

Many years ago, I very nicely told my mother that I would no longer communicate with her when she behaved that way and would need AT LEAST a two day time-out to recover from the verbal assaults. If she did it when we were on the phone, I'd just hang up (and keep hanging up if she called back) until the two days were up. In person, I'd just turn around and walk out. Even if we were in the middle of lunch in a restaurant, I'd say, "We're done. I'm leaving. Do you want a ride home?" OR, "We're done. I'm leaving. I'll take a bus back to my car." (I never actually had to do that, she drove me.) It actually stopped. It only took a few times, and the phone part lasted longer because she couldn't "read" my responses as well, but it stopped.

That's why comparing WEIGHT lost is fairly meaningless, even considering that higher weight people may lose more pounds faster. (No offense to those who DO put their weight in their sig lines.) What WOULD be important is changes in BMI. Then we could kind of compare to each other.

Two things: 1--most of the very most experienced doctors have the least restrictive pre-op diets; AND, 2--I don't recommend using the term "to cheat" regarding any of this journey. I think it shows that we are in a "game" mind-set and that that getting away with "cheating" might be a good thing, and I really think that those who use that language often are just not ready for the changes that are needed to succeed. IMHO.

PLEASE stop assuming that a panniculectomy or abdominoplasty or reduction mammaplasty is purely cosmetic. INVESTIGATE!!! My surgeries were covered (BC-PPO) and when I finally lose more weight and regain the same symptoms, I'll need a revision and that should be covered, too. Our daughter's BR was covered by her insurance (Aetna). OF COURSE, the insurance companies automatically denied the preauthorization the first time around. That's what their computers are programmed to do...certain codes are just flat out denied by the computer without human review. If you are willing to accept that response, they will save a lot of money and you will spend a lot of money. But all you have to do is develop data which shows that YOU meet the criteria that YOUR EMPLOYER and THE INSURANCE COMPANY agreed to. Once you do that, they have no choice but to honor their end of the contract.

#1--What they all, but mostly Tropicana, said. #2--The only reason you "have time" to shower and brush your teeth is that you have made it a priority. It works for exercise, too. #3--If you are not taking care of your baby's mom, then you are not really tending to your baby's needs. Twelve-year-olds need moms, too. Are you doing all you can to be there when your baby is 12? #4--The band isn't about having surgery and then carrying on as usual. It's about making life-saving changes in your daily life. This part takes a tremendous amount of work, but unless you sign on, all you've done is had needless surgery. Good luck...

WARNING: MY LAST SCIENCE CLASS WAS HS CHEM, IN 1963. They passed me with a "Gentleman's D," to keep me from returning and taking the class yet again the following year. Seems they were still holding a grudge about the thing with the zinc and magnesium and the Bunsen burner and the explosion and all. Gawd...you'd think they would have planned on inquiring minds wanting to know. Just so you know I'm a less-than-reliable source for scientific issues.

PS--"Esophageal dilatation" (widening of the esophagus) is also a treatment for "esophageal stenosis" (narrowing of the esophagus.) So it can be a diagnosis or a treatment.