gingersnap

Lizbeth, How did it all turn out? Did you get your surgery?

I must say this is not what I was expecting to hear. Thanks so much for posting this information and please keep us updated on what you find out. I'll keep hoping and praying for coverage. It's a shame that there is a better surgery than gastric bypass but our insurance companies are not willing to support it at this time.

I had to have my lapband removed due to a slip and I think the Sleeve is worth waiting for since this is a decision I have to live with for the rest of my life. I am watching Medicare to see if they approve it in late March and then as I understand Tricare will follow. I'm not near an MTF and I already have a doctor I want to do the surgery at a great hospital near by. Best of luck with your situation. Please keep us posted on your progress.

Missy, I completely understand having complications with the band. I started experiencing problems which resulted in a serious slip that almost strangulated and "killed" my stomach which would have resulted in death. I had no idea it could be that serious and I was teriffied afterwards. Since September I've gained almost 50 lbs back, and I'm so depressed that my band is gone and my fat self is coming back. I would have already had the Sleeve if it were approved. Now I'm back to hiding from the world and waiting for the Sleeve to be approved. My sister had the Sleeve 3years ago and has had amazing results even with some complications along the way. Good news is that she has not regreted having the surgery and highly recommends it for those who need it. I've been following the Medicare approval process because as I understand it Tricare will not cover VSG until Medicare does. There should be some news at the end of March about Medicare so keep your fingers crossed that they approve it and get the ball rolling with Tricare. But please if you have problems getting food and liquids down please see your surgern ASAP. It really could be life or death and the band is not worth the risk. Bands are having higher and higher complication rates and there are a lot of them being removed. Good luck and please keep me posted on how you do and what decision you make! I'll be praying for you!

Shae, Thanks so much for your guidance. I have already a trusting relationship with my local weight loss surgeon and I'm holding out for Tricare to cover. But if we get a no them I'm going to have to try the MTF approach. March is just around the corner and I'm hoping to hear good news by then. Keeping my fingers crossed and trying not to gain anymore weight.

This doesn't directly relate to your question but I thought I would share my story to show support for your decision to go with the Sleeve. I had the Lap Band in 2007 in Boston and had slow weight loss until I started having complications about 10 months ago and then the weight fell off. But I also couldn't keep anything down. During my second hospitalization for dehydration etc. the Band had completely slipped, so bad that I was in serious risk of the blood supply being cut off from my stomach and the organ dieing which would have resulted in my death. My Surgeon did emergency surgery to remove the Band and has refused to put in another one and with good reason. The Band is great when you don't have complications but it is not as permanent as they may lead you to believe. From the evidence that I have read surgeries to remove the band will surpass putting them in in the near future. I have three siblings that have had WLS surgery 2 with Bypass one with Sleeve. One Bypass sib is still 100+ overweight and the other overweight but is much healthier. The one that had the Sleeve has been much more successful and is living a healthy and productive life. At this point in time Tricare in a civilian setting is not being covered. I'm hoping and praying by sometime next summer Tricare will cover but until then your best bet is at an MTF. Good Luck and please keep us posted.

I'm not aware of any Tricare Changes that would allow Sleeve coverage. I'm in the Charleston, SC area and we do not have an MTF that I'm aware of. My surgeon at MUSC would do the Sleeve in a heart beat as soon as it's covered. I had to have my Lap Band removed in September and it would fall under Tricare to have another surgery covered without going through the previous qualifications of being 100+ lbs etc. Please keep posting if you hear anything at all. I'm fighting so hard to keep my weight off but have already regained 35lbs since my band removal. I need the help of the sleeve ASAP to keep the weight off.

This looks promising! Medicare is now in the consideration process for coverage of the LSG and as I understand Tricare follows Medicare. So we maybe looking at approval sometime next summer. https://www.cms.gov/medicare-coverage-database/details/nca-tracking-sheet.aspx?&&fromdb=true&NCAId=258 http://www.internalmedicinenews.com/news/gastroenterology/single-article/cms-considers-coverage-of-laparoscopic-sleeve-gastrectomy/fc3fe54035.html

This sounds promising. As I understand it Medicare must approve before Tricare will. They are looking for feedback by October 30th and I plan to give plenty of feedback and would love for others to do the same! http://www.internalmedicinenews.com/news/gastroenterology/single-article/cms-considers-coverage-of-laparoscopic-sleeve-gastrectomy/fc3fe54035.html

I feel for you! Please keep us posted on what you find out. I do have hope that Tricare will cover it soon, my surgeon says they are about a year out and I believe them. Because when I had my LapBand they did not cover it so I picked up another insurance through my work and had the LapBand. Then like magic within a year they covered the LapBand and I was able to drop my insurance and go back to Tricare Prime 100% for all the follow-up and unfortunately the removal of my band. Now it's a hurry up and wait situation until they cover the VSG!

My Doctor wants to remove my band! He wants to try a newer procedure of removing the band through my esophagus which requires an incision in my stomach. Has anyone heard of this or experienced this procedure? I'm heading to my Dr. tomorrow because I have not been able to keep any fluids down for 5 days and I have no fill. I know when I go into see the doc tomorrow he is going to want to remove it ASAP. I'm scared about life without the band and I'm trying to figure out what to do next. I have Tricare Prime and I'm leaning towards the VSG procedure if they will approve it. I've lost 140lbs with the band and don't think I'm strong enough to keep the weight off without help.

Update: The band was removed Tuesday evening the same way it went in. I guess if the band had eroded they could have removed it through the stomach and out the esophagus. But now I have to learn to live without the band.

VSG is not likely to be covered by Tricare, but I don't need the RNY as I am close to goal. I'll have to wait for Tricare to cover it. Hopefully they are close? Are you tricare? Any experiences with getting Tricare to cover VSG?

My doc is not a big lapband fan as the European studies and current US studies are showing high failure rates over time, so the option of revision or replacement is out of the question with this doc. I have had a CT scan, Fluro/barium swallow, and endoscopy over the past three months. They believe my band has tightened due to scarring of the stomach lining.

I had the same thoughts...take it out the same way it went in. However he suggests that it is a newer way that has more advantages than the older way. I have a lot of questions for my doc but wanted to see if anyone has experienced this or had more information.

So I was told that when I get pregnant that I would have to have a high risk OBGYN? Has anyone had that same experience? Is the process any different? What makes a bannder high risk?

Hi Christie, I'm sorry to hear about your frustration, I've found myself where you are several times. But just think in our past lives we would have gained 20lbs in this situation. I'm at a stand still at the moment but I hold out hope that I can get it together! I just try to have more good days than bad to help balance out everything. I just got back from vacation and I'm ready to give this another try. Have you tried using the thedailyplate.com to help track your calories? Its been the only thing that has really helped my weight loss when I'm stuck. It's amazing how we can get down so many calories with so little room in our stomachs! Hang in there and maybe I'll see you at a support group meeting soon! gingersnap

I was denied by Tricare Prime for LapBand surgery May 07. With no coverage and determined to have the Surgery I picked up Harvard Pilgrim through my work. Harvard Pilgrim covered everything but I had the extra cost of the insurance about $150 per month for the last year. Do any of you think that Tricare would reimburse for the premium cost of Harvard Pilgrim over the last year? I'm dropping HP this month going back to Tricare fulltime. I'm not even sure about how to go about this!

I love the Daily Plate....I really never started losing weight until I started using it. For those using the daily plate about how many calories are you averaging and still losing weight? I have to stay about 950 or I'm at a stand still.

Hi Everyone, I had the lapband in June of 07 with another insurance so I'm hoping I can drop the new insurance and have coverage with Tricare again and they will cover the Fills! This is Great News!!!! Here is an articel that was in the Air Force Times Today: Tricare now covers lap-band surgery - Air Force News, opinions, editorials, news from Iraq, photos, reports - Air Force Times Tricare now covers lap-band surgery By Karen Jowers - Staff writer Posted : Wednesday Jan 23, 2008 13:13:50 EST Seriously overweight Tricare patients have a new surgical option available to them: Tricare now pays for what is commonly known as “lap-band” surgery, in which surgeons place a hollow band around the stomach at its upper end, limiting the amount of food that can be eaten. Although the Tricare policy change was announced just recently, the coverage is retroactive to Feb. 1, 2007. Patients who received the surgery since then can submit a claim for reimbursement, a Tricare spokesman said. Tricare officials stress that laparoscopic adjustable gastric banding surgery is only for morbidly obese patients — those more than 100 pounds over the ideal weight for their height and bone structure, and whose weight is associated with severe medical conditions known to have higher mortality rates. Tricare will also cover the surgery if a patient has had an intestinal bypass or other surgery for obesity and requires a second surgery because of complications. “We at Tricare are careful to only cover procedures that have been proven safe and effective, and are accepted by the medical community,” said Army Maj. Gen. Elder Granger, deputy director of the Tricare Management Activity, in an announcement of the policy change. “We’ve added this procedure because, for some beneficiaries, it may be the right course of action to preserve their health.” The band, which can be tightened or loosened over time, creates a small pouch and narrow passage into the larger remaining part of the stomach. The procedure is reversible and does not require the stomach to be cut, stapled or opened, so there is less risk of infection, although there are possible side effects.

I was banded July 23 and had hair loss that started one week prior to the surgery. I was getting more than enough Protein so I can't blame that. Its now three months and I'm still experiencing a large amount of hair loss. I see another Doctor on Friday to find out if there is anything they can do to help. But during my search I've found that just a few have hair loss directly related to the band. Good Luck! gingersnap

My first fill was 1cc and I spent the last month struggling to keep food down. The only time I was able to eat was late at night, if I was lucky. I finally gave up and asked for a 1/2cc unfill on Monday. Now I feel like I have no restriction at all and can eat anything I want. I'm not sure what to do? Has anyone else had this problem? My weight loss has been slow so far and I'm so afraid of gaining anything back. I'm even thinking of going back on a low carb diet or back to weight watchers. :help:

opsgal, I've been through everything with Tricare with no luck...I was denied but expected it. I had to pick up additional insurance through my work. I didn't want an inusrance company to determine what I should do with my body. Good Luck!