Wheetsin

You will pay the lower amount. So if 20% is greater than your OOP, you will pay your OOP. If 20% is lower than your OOP, you will pay 20%. HTH

Just my observations/research/opinions... The band as a long term solution - sometimes. Beyond the 4 year mark, I know, and have seen, and have read about, and have been told about a LOT more people who have it removed than who still have it. I personally do not have faith in it as a long term properly functioning device. I think people who keep their bands for more than a few years, and are truly complication free (not to be confused with have unknown/undiagnosed complications), are the exception rather than the rule. If your plan requires a supervised diet, you probably can't get around it. Having a history of going to the doctor and being weighed for your visit doesn't count, they want it to be doctor's visits specifically for the purpose of supervised diet. I had my band under UHC and they did not require the supervised diet, nor did I have comorbidities, and I was approved in about 3 days. But that's all so specific to your particular plan, take it with a major grain of salt. I've recently submitted my paperwork for revision surgery and my current provider (no longer UHC) requires a 6 month diet for all bariatrics. We're trying to see if the fact that I've had a lapband for going on 5 1/2 years, and have technically been under the surgeon's care during that time, will count. They are also trying to see if there's a waiver for revisions, or if it's truly required for all bariatrics. The office staff are more optimistic about that than I am, but we'll see.

I paid $20. Out of pocket rate was about $16k a the time, IIRC. Negotiated rate paid out about $7k.

You might enjoy this recent thread: http://www.lapbandtalk.com/topic/131158-surgeon-gave-impression-gastric-bypass-was-better/

You can cut it, just don't go below the skin surface. Alternately, if you let it be, it will eventually disappear.

Water, potassium, Calcium. In that order. Ae you following a low-carb diet? Intense, or increased (if you already suffered from them) leg cramps almost always come with a low carb diet. I went from cramps in toes/calves pre-op, to cramps where my entire thigh muscle would completely seize. Talk about hurt. If you are having a hard time kneading them out, moist heat really helps -- hot wet towel, shower head, etc. Hubby knows the routing to go microwave a hand towel if he wakes up to me rocking on the bed & kneading a lower body part.

Sounds like you're learning your "eating windows" as I call them - the times of day you can & cannot tolerate foods. These normally develop a few weeks to months post-op (if you're going to have them), and will likely change over time. I currently cannot eat before 11 without discomfort, and generally not after 7. My best chances are between 1 - 4. Breakfast was the first meal I began having problems tolerating. It took me a while to connect it with time of day. For a long time I was trying to connect it with specific foods.

I'm here to research VSG, I don't have it yet -- but I do have an AGB. The day of my AGB surgery (my fiurst surgery, BTW) was the closest I have come in my life to a panic attack. I got to the hospital OK, got admitted, got to the prep area, changed into my gown, all OK. A little nervous, but mostly about the IV (also my first). After changing into the gown and walking back to the bed -- I froze. I couldn't get into the bed. You could have lit the floor under me on fire and I would have stood there & burned sooner than getting into that bed, I literally couldn't move. I very seriously contemplated calling the whole thing off. I couldn't breathe, and just started trembling & crying - almost unheard of for me. Good thing my husband was there to help me rationalize. I got into the bed, got the IV & hooked up to the monitor and my heartrate was something like 185! They asked if I wanted something to calm me down, I said YES - and poof. MUCH better. Moral of the story - tell them you're nervous up front, and get medical help. Gotta love the Versed, that wonderful Milk of Amnesia. They understand, and it's in everyone's best interest for you to be as relaxed as possible. They will help you. Second surgery (gall bladder removal) - totally different story. My mentality was "gotta do it" and I was almost ambivalent to it. No nerves, no anxiety, just a desire to be done with it. I was telling the nurse a recipe as they rolled me in, and I clearly remeber them telling me they were going to start my oxygen and saying, "See ya on the other side." Then I wake up to a bit of pain, and a nurse wanting me to finish giving her the recipe. Try to really focus in on the things you will gain from the procedure. I find that's often the greatest comfort.

Wow Tiffykins, that's quite an ordeal. I think I read in a past post of yours that your leak was from your esophagus? What was the issue with your band - were you an erosion? All in all, how long did your recovery take - until you could resume normal activity? My band is completely unfilled - fortunately. And while I'm told my slip is bad enough that they don't want to attempt a reposition or reband, it's not really messing with me that much. I'm "tolerating" it in such a way as that I don't present with many of the typical symptoms. But who knows what I look like on the inside. I know that from my band surgery, there is a lump of scar tissue I can feel from the outside (if I "try"), so I know it's likely to be an issue. I suspect my surgeon will put me on a significant liquid diet prior to any procedures. His "generic" liquid pre-op diet is only 2 days, but I've heard his revision diet is more like 6 weeks. I never wondered why, but maybe it's to prevent secondary or tertiary swelling caused by processing solids. I too have had someone tell me that revision patients are at 3X the risk for complications. I think I'd gladly take a second procedure if it's an option. I'll just tell him to use blanket sutures & mesh "just in case" -- just do my sleeve as though I already have a leak. Yes, how to treat leaks is on my list of questions, and how to diagnose: how many leak tests, when, which types of tests does he use, how frequently -- as well as his accessibility to me or other providers post-op. He's only about 45 minutes from home, but when I live 5 minutes from another hospital, that can be significant if there's an emergency.

Agreed. My guidelines for myself: call on 2nd day of no fluids, call on 4th day of no solids. I'm glad you got it resolved. In case your surgeon didn't advise you, you might want to stick to mushies for a day or two wen you get filled//unfilled. Two main reasons: being stuck -- let alone being stuck repeatedly and/or having to bring food up -- can cause a fair bit of swelling around our bands and swelling can cause foods to "sneak up on you." It cal also take a few days for fills & unfills to really make any difference. No idea why this is true, but I've seen it a LOT.

I stand corrected -- 1/4 cc is about .05 tsp. I misread the placement of the "." Not sure how I missed that, but good eye for detail & thanks for catching it.

Has anyone seen stats on the incidence of leaks specific in AGB - VSG revisions? I mean universal stats, not any particular revision surgeon's stats. My grandfather died of sepsis from a stomach ulceration, and an aunt recently spent 12 weeks in the hospital after a surgeon nicked her esophagus during a procedure to remove a tumor. It's definitely a risk that is close to home. (If you can't tell, I'm one of those analytical/data sponge type people!) It makes sense that 2-in-1 might lead to hier rates of complication, and the rationale for doing a revision in 2 separate surgeries make perfect sense. I wonder why the tendency is to do them in a single procedure. I'm also adding to my list of questions for the surgeon -- does he take precautions for this, what type of staple technique does he use, assuming I have significant scar tissue, what changes? Etc.

Just my observations... and if you're specifically seeking posts to help you feel better you may want to read the next paragraph & then stop. Good = With the help of my band, I went from a BMI of about 56 to about 34. That's something like a starting weight of 385 lbs to a low weight of 225, give or take a few pounds in either direction. That's also about 9 clothing sizes. And the majority of that happened in the first 18 months. (I maintained 250 for about a year and a half before I finally started dropping again). Bad = Most banded people I know are 5+ years out. These are people from my surgeon's support group, people I've met in person from the "local" section of messageboards, people I've coincidentally run into, etc. I'm not even talking about people I know virtually. Most of them -- and by "most" I'd estimate it around 85% -- have had their bands removed, or are showing some questionable symptoms. The more time passes, the less & less the band, statistically speaking, looks like a viable long term option. Do keep in mind that this is a support forum, so it naturally draws a large population of people who have, or suspect they have, some kind of problem and are looking for quick answers. You find a much higher concentration of people with problems here, than you do in the general banded public. I compare it to product reviews. Most people who leave product reviews are people who have had problems with the product. Average Joe user who never experiences a problem usually has no motivation to leave a review.

It may not make sense when you think about it, but even 1/4 cc -- which is about half a teaspoon -- can make a HUGE difference in restriction. I know someone (a nurse) who adjusts her fills in 1/5 cc increments. Point being, even if you get ALMOST full, whatever capacity is left is HUGE in terms of the difference it can make. I know it's natural to think "I'm at 9 out of 10 ccs and don't feel anything yet" and worry, but that 1 cc that's left will make more impact than the 9 already in there. I'm not sure if it's still the case nowadays, but a handful of years ago surgeons would sometimes overinflate the band if need be. I don't think it's condoned, but I believe they're built for it. BTW, I've had 1/4cc make the difference between not eben being able to swallow my own saliva, and being able to eat whatever I want.

I wish I had known... ...how much it hurts when something is stuck. "Productive burp" doesn't really sound like something that can be downright agonizing at times. ...that things getting stuck, and the ensuing pain, don't just happen when you make a mistake. Sometimes it really isout of your control. ...how inconsistent restriction can be. And that it would probably change over time. Multiple times. ...then the rates for complications now. ...I would be allergic to the leather recliner I bought to sleep in post-op. ...my surgeon was going to transfer primary patient care to a PA and stop seeing all but the most dire complications personally. Etc.

Except fpr the people who just come for the RnR forum. Yes, we have those people too. I honestly don't see too much clique behavior related to duration of band. I see it more related to personality types. I'm a little over 5 years out. I rarely have questions anymore. 99.9999% of what I post is to help others from my experience/knowledge/lessons learned/etc. If I do have a question, someone with a similar time out is probably going to give me a more relevant answer, so naturally that's who I'm going to seek. What cliquey behavior do you see, if you can give specifics? (Not linking threads, just observed behaviors.) I started a thread a while ago for people 5+ years out and there was VERY different information there than what you generally find here - and it's GREAT. Support is support, but someone newly post-op, or even a year or two out isn't going to have the same qualitative answers. Using me just for example - is that something you would consider cliquey behavior, because the title of my thread might exclude people who are < 5 years out? A lot of the bafflement I've seen here tends to root cause its way to natural stalls in weightloss. Keep in mind that very few people here really understand complex body processes such as metabolism. Or even weightloss. I'd hate for someone to be following guidelines, go some period of time without losing weight (fat), and infer from your message that they must have an erosion. I'm with you on the scale vs. fat (I've been preaaching weight vs. fat for the majority of the time I've been here... and awareness of BMR, and awareness of glycogen processes, and...), and I'm with you on the logic behind comparing weightloss rates, though I understand that comparison is our (human not bandster) fundamental mechanism for evaluating proper function of a system, and I understand that seeking benchmarks is just another aspect of comparison. I'm not the best messageboard personality. I don't sugar coat things, I don't encourage behaviors I think are harmful, I don't fall into pity party bandwagons, and I don't tell people what they want to hear if it isn't what I really think. And I don't deal well with the warm/fuzzy aspects of things. I try to share information and objective perspectives. That combination sometimes pisses off the general messageboard population. People here tend to love me or hate me, and it usually cones down to what they're really after when they post. Don't worry too much about people taking your post as a personal attack. At least you've demonstrated some "give a ****" and a bit of emotional investment in your health & theirs. It's not a bad model to follow.

I don't get that, but when something is stuck I know I'm ready to bring it back up when I have to fight to swallow. It's kind of like throat nausea, for lack of a better description. I'm pretty far post-op, but I never had pain related to swallowing when I wasn't.

Your band can't swell (other than counting fills as swelling) so you won't need to worry about that. What are you experiencing? It will be a lot easier for us to give an opinion on calling your surgeon or not if we know your symptoms, than for you to try and compare slip stories, find the one you most resemble, and act accordingly. In the same way that it's easier for me to list the toys my daughter doesn't have, than it is to list the ones she does.

Are you actually throwing up (vomiting), or are you brining up stuck foods/saliva? Totally different answers in terms of other damage that can be caused, what to do, etc. Need to know what's actually happening...

Jello was included in my clear foods. Different surgeons categorize their dietary requirements different ways. "Water" is a perfect example. Per my surgeon, Water is water, nothing else is water. So things like tea, crystal light, etc. do not count toward WATER intake. With some surgeons, Jello counts toward water intake. Don't worry about what's said on the forums so much as what your surgeon's guidelines are, unless you have some really serious reason for doubting their advice. I'm not sure why you can't make your own Protein banana smoothie...? Did someome tell you it has to be made by someone else?

Denials aren't typical assuming a few things: * You don't have an employer-enforced exclusion. Did you check on this? Just because [insurance company] doesn't exclude something, does not mean it is covered in your plan. * You meet the plan's medical requirements for the surgery. * You don't mee tthe plan's qualifications for denial (a concern more in future years than right now). WIth those conditions met, you should (not will, but should) be approved. If you are not, you need to find out the specific reason for your denial and appeal it. Insurance companies follow guidelines. They cannot arbitrarily deny procedures. Their rationale may not make sense to you, but there does have to be some rationale there. (Used to work for an insurance company)

There's also foaming, which is what happens when you bring up slime that has been churned by the esophagus a little too much, or too violenty, or who knows what. Like cream can become butter with enough elbow grease, slime can become foam with enough esophagus grease. Looks just like a really, really rich shampoo lather.

You should ask Jack about Triscuits.

I'm saying it, so it must be definitive. PB = I don't really use the term PB. If I'm going to call something a "productive burp," which I'm not, it's going to be a "wet burp" where I think I'm just burping, but bring up a little stomach mojo. I did that pre-band. I think everyone does that at some point in time. So it's not a band thing. What I do with my band is nothing like a burp. Sliming = producing copious amounts of thick saliva, presumably my body's attempt to lubricate the nugget blocking my stoma. Yakking = bringing up stuck food/water/whatever, because I'm not going to call it a PB. Mine typically involve the nice "hwuuuhhh" wretching sounds associated with vomiting, but usually just once or twice and on a much smaller scale. And without anything from my stomach being included. May or may not include chewed food. Almost always resembles egg whites (slime). Vomiting = bringing up stomach contents. Can you please use that in a sentence? I first suspected I had a slipped band when, after sliming, I finally yakked and noticed that it tasted a bit like vomit instead of tasting like the usual nothing/chewed food. I should invent a new term for the phenomenon when gagging/wretching is able to push the blockage through and you never quite have to full on yak. Many times I would be all set to yak (sink Water running lukewarm, stack of paper towels so I can wipe up my slime "slides", sleeves rolled up, etc. and I would gag/wretch, and only slime would come up. Or just the action of the gag/wretch seemed to dislodge the nugget. I always metaphor-ized that into wretching = toilet plunger action.

Thanks for the responses! I've had my band over 5 years. I'm not sure how long it has been slipped since I didn't have the normal slip symptoms. I'm guessing since 2008. I lost about 175 lbs with my band, and regained about 60 with a pregnancy. I'm now about 90 lbs from goal, was about 30. > My body is tolerating the slip well. I don't get sick, I have some reflux but not often, etc. I'm completely unfilled but still have moderate restriction, but I always had restriction from the start. My surgeon's PA suggested we could leave the band in as long as I did not present with additional symptoms or discomfort, and I considered that, but I'm wary of damage being done that isn't detectable until it's too late. And I'm too fat and too bad at maintaining weightloss to go it alone. And don't want a malabsorptive procedure. Which lands me here. For those of you not familiar with the "soft stop" term - some AGB patients have a physical signal that their pouch is nearing capacity and it's time to stop eating. That's the "soft stop." The "hard stop" being the pain/emission when you eat too much. A "soft stop" is often something like a sigh, or watery nose, or slight headache. I know some people who will sneeze, or their eyes will Water. I never had that, but when something was stuck, I would always hiccup & burp (together, more like a hiccurp) when I was finally clear. anonynurse - what did your surgeon do to detect the adhesions prior to surgery? Rev Me Up! -- did your surgeon detect the adhesions prior to surgery? My gallbladder was taken out about a year after my band went in. I do have some concerns about adhesions & scar tissue, how they will be handled, the impact on the procedure, etc. I know that with both prior surgeries, and just my tendency to scar, it may be a problem. I will definitely ask my surgeon about this. It seems like port removal can cause some complications. I've read 10 - 15 encounters of complications related to the effort required to remove the port. (I'm actually a little surprised they remove it, if it can cause that much trouble.)