kellyk

I am hoping someone here may be able to give me some guidance or answers. I had the lapband surgery in Mexico by Dr. Ortiz in May 2005. In October 2006, I moved from Michigan to Florida and became self-employed as of January 1, 2007. I applied for private health insurance (not employer-provided) in December 2006 with Aetna. I was declined coverage due to the lapband. I have also contacted Humana One here and have been advised that they automatically decline coverage for any applicant who has had the lapband procedure. This has absolutely nothing to do with the fact that I had the surgery in Mexico. It is the procedure itself that is causing me to be declined coverage. I have no health issues whatsoever and have lost over 70 pounds since the lapband. I am now at a healthy weight and have maintained it for 2 years. I am now sitting with no health coverage whatsoever and am being told that I will not ever be able to have it unless I become employed by a company that provides coverage as a benefit. Has anyone here run into this problem? I have to tell you, if I had known that having the lapband would cause me to be denied insurance coverage afterwards I would have NEVER had the procedure.

My friend, PaulaM and I are scheduled to have surgery with Dr. Ortiz on May 25th. Paula is on the road today but asked that I post this thread to ask if any of you regret having the band. I think Paula is 99% prepared to go forward with the surgery, but continues to have lingering worries/doubts. If any of you are uncomfortable with posting any regrets, please PM me and I will share with Paula when we speak later today. By the way, Paula is nearly a pack-a-day smoker and she is having to quit smoking for the surgery. This is extremely hard on her. Did any of you have to quit before surgery? How did you manage? Any tips? Did most of you go back to smoking after the surgery? Dr. Ortiz says that about 30% of his patients continue to abstain from smoking after being banded. We are wondering what all your experiences have been.

I had a phone conference with Dr. Ortiz about 2 weeks during which I asked that same question. He cannot answer whether there will be insurance coverage, but he told me that if the band had to be removed, he would not charge me any fee for his time to do it. I would still have to pay for the hospital. He said the hospital's fee is around $3,000. But at least he will waive his fee! May not be a perfect solution, but it is a compromise. I would really encourage you to ask his office to arrange a phone conference for you to speak to Dr. Oritz directly. He was very generous with his time and patient with all my questions. I was extremely impressed by his professionalism and obvious pride in his work. I am being banded by him on Wednesday. Leave tomorrow morning!

Lawyer and mediator. I do estate planning (wills, trusts, etc) and probate litigation (you know, when someone feels Mom loved their sister or brother more than them or can't understand why they were cut out of her will)

Thank you to everyone who has replied. Vinesqueen, thank you for the link to the prior thread -- the posts there were overall very encouraging. And Lasonyadj, thank you for the link to the thread on the other board. The posts there are very sobering and I kind of hate for Paula to see them, but she wanted to know! She will just have to keep in mind that the thread is on a board for all WLS and not just lapbands. Doing the countdown -- just 5 more days 'til surgery!!!

I told Paula that I was pretty sure the responses would be overwhelmingly in the positive -- no regrets. But didn't figure that response would be so small. I will chalk it up to the fact that it is obvious from this board that nearly everyone is happy with their band and grateful to have it. In fact, I told Paula that. But she still wanted me to ask. So keep the responses coming, please!

I have not had my surgery yet but I had my hair done yesterday and I was asking my hairdresser how I could avoid hair loss from the surgery. She suggested I take prenatal vitamins. She said that is very effective. I am going to try it and see. She said that she has a client who had by-pass about 6 months ago, was not taking any vitamin supplements and her hair really started thinning out. Once she started taking the prenatal vitamins, my hairdresser said it helped -- took about 6 weeks to notice any difference though.

(I am cross-posting this in the Insurance Forum too. Wanting to maximize viewing by members because I am so perplexed and need to hear from others ASAP.) I am scheduled to have surgery with Dr. Ortiz on May 18. I made one more phone call to my insurance company (PHP of Mid-Michigan) to verify that follow up treatment would be covered. Unfortunately, my call only raised more questions and concerns for me. I had called some time ago and had been assured that any "complications" from the surgery would be covered. Today I was told that if I presented with vomiting or internal bleeding, as complications from the surgery, those would be covered. But, if I required any "follow-up" procedures dealing specifically with the band, including its removal, those procedures would "not likely" be covered. I think in order for me to go forward with the band in Mexico, I have to assume the worse case scenario -- no coverage for any follow-up procedures. I am just wondering how big a gamble I am taking if I go forward. Anyone with any insight? Those of you who were operated on in Mexico, have you had any subsequent insurance problems? Please let me hear of any. I was so determined to have this surgery but now I am thinking that I shouldn't if I will not have any insurance coverage. While I have drummed up the $9500 to have the band implanted, I don't have excess funds to deal with more surgeries in Mexico. Help! <!-- / message -->

Thanks, everyone, for your replies. I had a phone consult with Dr. Ortiz tonight and I feel very reassured about my decision to have him handle my surgery. He told me that he really insists that any follow up care be conducted by him because he wishes to make sure that I am a success. He said that if there were any subsequent complications with my band, he would see me and not charge me any doctor fee. He said that if I had to have the band removed, the hospital fee is about $3,000. If my port needed to be revised, the fee for the hospital is around $350. He did stress to me that the complication rate for this surgery is very low but not zero. I was extremely impressed by Dr. Ortiz. He seems extremely dedicated to his patients. He spent a little over 30 minuites on the phone with my friend and me and answered our many, many questions. He is very personable, has a good sense of humor, and seems to be very empathetic to his patients' situation. One week from today I will be in Mexico. I am excited and nervous although I am not nearly as nervous after speaking to Dr. Ortiz.

Hi, KarenB. I live in the mid-Michigan area. Work in Lansing. Glad to know that you are pleased enough with Dr. Ortiz to send your daughter to him. As for the fills, I always planned on paying for those out of my own pocket. Did you go back to Ortiz for your fills? I am planning on him doing at least my first fill.

Thank you, Hagerteresa for your reassurance. And Alexandra, I will call the insurance department or bureau tomorrow. Thanks for that tip! What you say makes sense to me but it seems like insurance issues never make sense to me. Sure is frustrating! Thanks again.

I am scheduled to have surgery with Dr. Ortiz on May 18. I made one more phone call to my insurance company (PHP of Mid-Michigan) to verify that follow up treatment would be covered. Unfortunately, my call only raised more questions and concerns for me. I had called some time ago and had been assured that any "complications" from the surgery would be covered. Today I was told that if I presented with vomiting or internal bleeding, as complications from the surgery, those would be covered. But, if I required any "follow-up" procedures dealing specifically with the band, including its removal, those procedures would "not likely" be covered. I think in order for me to go forward with the band in Mexico, I have to assume the worse case scenario -- no coverage for any follow-up procedures. I am just wondering how big a gamble I am taking if I go forward. Anyone with any insight? Those of you who were operated on in Mexico, have you had any subsequent insurance problems? Please let me hear of any. I was so determined to have this surgery but now I am thinking that I shouldn't if I will not have any insurance coverage. While I have drummed up the $9500 to have the band implanted, I don't have excess funds to deal with more surgeries in Mexico. Help!

A girlfriend and I were planning to go to Mexico later this month. Originally, I was scheduled for surgery with Dr. Ortiz on May 26 but got moved up to May 18 when my friend said she wanted to go too. May 26 did not work for her and I did not want to delay to a date in June. Since we scheduled the surgery last week, my friend began having some serious reservations about the operation. She called me this afternoon and said that she just is not ready to have the surgery in 2 weeks and is thinking that she will wait until sometime in the fall to go. I know she feels like she is letting me down, but truly I am not disappointed with her decision. I would not want her to go unless she was 100% convinced this procedure was right for her. I still want to go to Mexico as scheduled and will see if my mother will go with me. But I was wondering, did any of you go alone?

Actually, KarenB, my surgery is currently scheduled for May 18th. It was originally scheduled for the 26th. Sorry that I will not be seeing you after all! I called Sandy from Dr. Ortiz's office today to see if she thought I should bring someone with me. She told me that many, many people come by themselves. She said that it was totally up to me but that I should not feel it necessary to bring a family member or friend. Thanks live2canoe for the advice on packing lightly. I will plan on just bringing a rolling carry on bag so I am not having to lift and carry. I have developed a nasty sinus infection and went to the doctor today. He wrote me 3 prescriptions and I have started them this afternoon. I am determined to wipe this out before flying to Mexico. I don't want this to get in the way of my going. By the way, I broke the news of my surgery to my mother tonight over the telephone. I was very pleased by her support of my decision. I was super surprised that she knew about the lapband and was aware that Mexican doctors have more experience than US doctors so far. Wow, aren't mothers amazing? I am going ahead and booking my flight tonight. This is all now seeming very real to me. I know you have all heard this before, but I am so full of differnt emotions -- sometimes I feel so excited and thrilled and other times I feel scared and wonder what the hell have I signed up to do. But mostly I am excited. Thanks for all your support!

A girlfriend and I are scheduled to have the surgery later this month. My girlfriend and I spoke this morning by telephone and she is starting to have some reservations about going through with the surgery. She pointed out to me that some people suffer terribly from nausea after the surgery. She knows that this would be a big concern to me because ever since I was a child, I have not handled nausea like a normal person. I pass out! No kidding. When I was 18 years old, I had a bad stomach bug, was nauseous and passed out while sitting in a chair in the kitchen. I knocked out my 2 front teeth! That was the worst harm that I have experienced from passing out due to nausea. Doctors had my brain ct-scanned to see if there was some physical reason for my losing consciousness. But the scan came back negative and the doctors have said that I just have a very low threshold for tolerating nausea. I have learned that when I am feeling nauseous, I must lay down immediately. I will not even attempt to drive a car if I am feeling sick to my stomach. I did not think that nausea was that big an issue on an on-going basis after the surgery but my friend says that she has read to the contrary in a number of lapband chat rooms. Can you all tell me whether she is right? Because nausea is so terribly debilitating for me, if she is right, I will need to reconsider. But I am hoping so much that she is wrong. Second, my friend suffers from migraines and she said that according to her research, once someone has this surgery, they cannot take anti-inflammatory and pain medications or IMITREX. If this is true, then she said that she cannot go forward with the surgery because she must retain the ability to medicate herself whenever she is struck with a headache. She said that she also takes Excedrin Migraine when a headache is first coming on. Can you all tell me whether my friend's research is correct? Her husband is not yet supportive of her having this surgery and so she has been doing research in an effort to persuade him of its merits. The problem now is that she is getting a lot of negative information. While I desperately wish to have this surgery, I also want to go in to it with my eyes wide open as to any potential problems -- and nausea would be a biggie for me and medications would be a biggie for my friend. Thanks for any replies to this post!

Thanks, everyone, for your prompt replies. It looks like most people who have replied so far did not suffer much nausea or did so for a short time after the surgery. I will share the replies with my friend who suffers from migraines and see what she thinks. Angeleyes: You said that you had a lot of problems with nausea after surgery. Can you give me an idea of how long you were plagued with it? I am a concerned because I am planning on having surgery in Mexico and live in Michigan. The thought of flying for 6 hours or so while nauseous is not appealing in the least! I would hate to pass out in the airport or on the airplane! Again, thanks everybody. Anyone reading this, please share your experience with the surgery with me and if any of you also suffer from migraines, please tell of your ability or inability to take appropriate medications.