DrHekier

Do you have a secondary insurance? Sometimes if you have Medicare only and no secondary, Medicare will only cover 80% of the charges, leaving your secondary insurance to cover the remaining 20%.

While on vacation many years ago to a location with many mosquitos, I took an antihistamine. (May have been Zyrtec.) It obviously didn't prevent being bitten, but it seemed to help me personally tremendously in terms of getting the bitten swollen areas to shrink in size and stop itching. Talk to your doctor.

If it is simply flipped, she will not need a new port. In cases of flipped ports what typically happens is that the tissue through which the port is sutured gives way and the the port is free to turn around in the subcutaneous pocket. Securing it back into position is a straight forward procedure that depending on the patient often won't require general anesthesia; IV sedation is often enough. But it does need to be done under sterile conditions, generally in the operating room. Nothing can be done to prevent flipping; it is a relatively uncommon phenomenon and resuturing the port in place should be just fine. Don't feel sorry she had this surgery. You are seeing a very minor adverse event now. Fast forward 30 years from now if she didn't have the surgery. With morbid obesity she increases her risk of heart disease, stroke, diabetes, breast cancer, etc.... She could be laying on her deathbed from some obesity related comorbidity 30 years from now and you would wish that something could have been done in the past. I'm hopeful you'll soon feel this is the best thing she has ever done for herself. And for you.

Ask the surgeon directly if you can. Our practice is to generally to repair hiatal herniae if we encounter them. Two of our five bands today had hiatal herniae and were repaired at the same time. One of the other patients had a prior hiatal hernia repair, and the 'scar tissue' from the the prior surgery made the band placement much more challenging than usual, so it's not uncommon for some surgeons to decline to perform Lap Band surgery if a person has had a prior hiatal hernia repair or fundoplication.

Let us now how it went; I would suspect it's only an overfill not a slip, since you tolerate food in the evenings.

In case you are worried that you might have a leak because you don't feel restriction, note that many people don't feel a significant amount of restriction with their first fill.

Legend has it that Pablo Picasso was sketching in the park when a bold woman approached him. “It’s you — Picasso, the great artist! Oh, you must sketch my portrait! I insist.” So Picasso agreed to sketch her. After studying her for a moment, he used a few pencil strokes to create her portrait. He handed the woman his work of art. “It’s perfect!” she gushed. “You managed to capture my essence, in one moment. Thank you! How much do I owe you?” “Five thousand francs,” the artist replied. “B-b-but, what?” the woman sputtered. “How could you want so much money for this picture? It only took you a second to draw it!” To which Picasso responded, “Madame, it took me my entire life.”

Is your inflammation at your port site, or at an incision other than the port site?

My understanding is that Medicare does not need pre-approval. If the procedure is covered, than the physician does not require pre-approval.

Any word on a support group in Fayetteville? I heard the hospital there only does gastric bypass

GEHA apparently now covers the Lap Band.

If you have only one appeal left, perhaps you should entrust it to an attorney with experience in these matters. Many have used Walter Lindstrom www.obesitylaw.com ; he himself is a former WLS patient. Each insurance company is entirely different. Some will accept weight loss programs or even gym memberships. Others will only accept MD supervised programs. Good luck!

As my note from above, it appears that at least one insurance company is saying the Lap Band is experimental because they are using data showing that the GB is superior. So I suppose what they are saying is that the LapBand is experimental in the sense that the GB is more effective. I think there is a sufficient amount of data to support the LapBand over GB.and

I completely agree with Dr. C. The VG has a much larger capacity than the other two sizes of Bands, and as a result is more likely to have retained air. As Dr. C says, it takes a fill or two to 'prime it', that is to say, get the air out. It is not uncommon for us to see less fluid come out on fill #2, than what was put in on fill #1. We even see this at times with the 9.75 and 10 cm bands.

Generally gallbladder removal (cholecystectomy) should not affect your stomach directly. Some patients will note a difference in ablility to digest fatty meals, and as a result may have loose stools, or diarrhea, for a short period of time after surgery. This is because the flow of bile into your intestines is altered, and bile salts help package fat for digestion/absorption in the intestine.

In addition to the Surgical Review Corp. linked to above, Medicare will cover surgery at centers certified for Bariatric Surgery through the American College of Surgeons, a seperate program. I don't have the link for that handy. From a sticky above I found this link for Medicare approved Bariatric Surgery sites: http://www.cms.hhs.gov/MedicareApprovedFacilitie/BSF/list.asp#TopOfPage

From our experience with one insurance company that is denying the band they are saying that it is 'experimental' because they believe the gastric bypass is better than the Band. You can consider an appeal and you and/or your surgeon should provide articles comparing the LapBand to the bypass. Good luck!

We just banded a patient from Fayetteville, and are unaware of any support groups there. Certainly let us know if you can get a group together!

For solid food, gastric emptying is often seen by about 90 minutes, but may last a few hours. Certainly wouldn't expect anything to remain until Monday! Have a great Monday and a great Lap Banding experience!

Many of our patients don't feel much restriction until the 2nd or sometimes even 3rd fill. In fact I think there was a thread here on this website with a poll asking how many fills it took for people to feel restriction. Also, it appears that those patients with the Vanguard or VG size Lap Band (which you have) may take just a bit longer to get to their sweet spot of restriction because with the larger size band there is more variability during your fills. Make sure you go to your surgeon's support groups. That way you can ask questions with people who are farther along than you, and also at the same stage as you. Our patients seem to get the some of best education from other patient's in the support groups. Of course, this site is a support group in and of itself, and you will find many people willing to help! Good luck!

Have you had a recent fill? To me it sounds as if some of your symptoms might be related to restriction from the band. If you had a recent fill, maybe you need a small amount of fluid removed from the band.

The only issue that I can think of is if you go on to have a stereotactic biopsy. For a stereotactic biopsy, you need to lay on your stomach for about 30 minutes or so. (Go to google images and search 'stereotactic breast biopsy') You may be a bit sore, especially at the port site. Since you have a palpable mass, there is a good chance you would be a candidate for an ultrasound guided biopsy, for which you lay on your back. Now of course, the mammogram and/or ultrasound may show you do not need a biopsy at all. Keep us informed, and good luck!

Here's the link to the clinical policy bulletin by Aetna, revised March 31, 2006: http://www.aetna.com/cpb/data/CPBA0157.html

Both the 9.75 and 10 cm bands hold 4cc. The Vanguard (AKA VG or 11cm Band) holds 12 or so cc's so you have one of the other ones.

My understanding is that in 2002 the IRS ruled that obesity is classified as a disease in its own right, and medical expenses for treatment are tax deductible. So get that money back from Uncle Sam!