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hi skinnydippn~ i live in jackson and was banded Jan 29th 2007 by Dr Ken Cleveland at CMMC. I was at the CMMC seminar last week and got up and spoke about my lap band experience. Hope things wotk out for you and you're able to be banded. Keep coming to this site and you'll glean some good information and support.

I had a hard time getting scrubs to fit my arms. There is a lady at the uniform place that laters tehm for me. She takes some of the material she whacks off when she shortens my scrub bottoms(i'm 5'2") and uses it to make a "V" under the arms to allow me more room. Down the road,,I hope to have it surgically removed....and I dont really care what it looks like,,scar-wise,lol. My thinking is,,,surgical scars,,no matter how many or how big,,CAN'T be as grotesque as all that fat I was lugging around! Til then, I'll do the best I can with what resources I have available. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

Dr Ken Cleveland, Central Mississipi Medica Center, Jackson, Mississippi, USA banded 1/29/07

rivekthr6~~~ I've had 3 fills and last week had a tiny bit removed. THE FOLLOWING IS SIMPLY MY EXPERIENCE AND OPINION: My surgeon lays me on an exam table with a small pillow underneath my back, a little abuve my waist. He palpates the area slightly beneath my port incision then asks me to raise my head off the table. He inserts the needle, all the while palpating for the port. The port must offer some resistance, because when he inserts the needle in it, I can feel sort of a 'pop'. He aspirates, to be sure he's actually stuck the port. If he'd drawn back blood or any Fluid other than the clear saline, he'd know not to inject. He then injects the predetermined amount and quickly withdraws the needle. He doesn't deaden the area first,,as the stick is so minimally painful and the whole procedure so quick. I've found that deadening the area (in alot of diff procedures) hurts worse than the actual procedure itself. The whole 'fill' procedure lasts about 3 minutes. A bandaid and a handshake and I'm out of there. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS 1.8/4cc band

HCPCS Codes Description S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ICD-9-CM Diagnosis Codes Description 250.00 Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled 250.02 Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled 278.01 Morbid obesity 401.0 – 401.9 Essential hypertension Page 20 Page 20 of 28 Coverage Position Number: 0051 414.01 Coronary atherosclerosis of native coronary artery 416.0 Primary pulmonary hypertension 416.8 Other chronic pulmonary heart diseases 574.00- 574.91 Cholelithiasis 575.10 Cholecystitis, unspecified 997.4 Digestive system complication V45.3 Intestinal bypass or anastomosis status V85.35 Body Mass Index 35.0-35.9, adult V85.36 Body Mass Index 36.0-36.9, adult V85.37 Body Mass Index 37.0-37.9, adult V85.38 Body Mass Index 38.0-38.9, adult V85.39 Body Mass Index 39.0-39.9, adult V85.4 Body Mass Index 40 and over, adult Experimental/Investigational/Unproven/Not Covered: CPT* Codes Description 43845 Gastric restrictive procedure, with partial gastrectomy, pylorus-preserving duodenoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch) HCPCS Codes Description No specific codes ICD-9-CM Diagnosis Codes Description All codes *Current Procedural Terminology (CPT ® ) © 2006 American Medical Association: Chicago, IL. 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HCPCS Codes Description S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline ICD-9-CM Diagnosis Codes Description 250.00 Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled 250.02 Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled 278.01 Morbid obesity 401.0 – 401.9 Essential hypertension Page 20 Page 20 of 28 Coverage Position Number: 0051 414.01 Coronary atherosclerosis of native coronary artery 416.0 Primary pulmonary hypertension 416.8 Other chronic pulmonary heart diseases 574.00- 574.91 Cholelithiasis 575.10 Cholecystitis, unspecified 997.4 Digestive system complication V45.3 Intestinal bypass or anastomosis status V85.35 Body Mass Index 35.0-35.9, adult V85.36 Body Mass Index 36.0-36.9, adult V85.37 Body Mass Index 37.0-37.9, adult V85.38 Body Mass Index 38.0-38.9, adult V85.39 Body Mass Index 39.0-39.9, adult V85.4 Body Mass Index 40 and over, adult Experimental/Investigational/Unproven/Not Covered: CPT* Codes Description 43845 Gastric restrictive procedure, with partial gastrectomy, pylorus-preserving duodenoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch) HCPCS Codes Description No specific codes ICD-9-CM Diagnosis Codes Description All codes *Current Procedural Terminology (CPT ® ) © 2006 American Medical Association: Chicago, IL. 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Weber M, Muller MK, Bucher T, Wildi S, Dindo D, Horber F, et al. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004 Dec;240(6):975-82. 121. Weiner R, Blanco-Engert R, Weiner S, Matkowitz R, Schaefer L, Pomhoff I. Outcome after laparoscopic adjustable gastric banding-8 years experience. Obes Surg. 2003 Jun;13(3):427- 34. 122. Weiner R, Bockhorn H, Rosenthal R, Wagner D. A prospective randomized trial of different laparoscopic gastric banding techniques for morbid obesity. Surg Endosc. 2001 Jan;15(1):63-8. 123. Westling A, Bjurling K, Ohrvall M, Gustavsson S. Silicone-adjustable gastric banding: disappointing results. Obes Surg. 1998 Aug;8(4):467-74. 124. Westling A, Ohrvall M, Gustavsson S. Roux-en-Y gastric banding after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg. 2002 Mar-Apr;6(2):206-11. 125. Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y-500 patients: technique and results, with 3-60 month follow-up. Obes Surg. 2000 Jun;10(3):233-9. 126. Zinzindohoue F, Chevallier J-M, Douard R, Elian N, Ferraz J-M, Blanche P, et al. Laparoscopic gastric banding: a minimally invasive surgical treatment for morbid obesity: prospective study of 500 consecutive patients. Ann Surg. 2003 Jan;237(1):1-9. HCPCS Codes Description S2083 Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline CIGNA's medical coverage position on pneumatic compression devices for the treatment of vascular diseases of the lower extremi Go to page 19,,close to the bottom. The degree of gastric restriction can be adjusted by accessing the reservoir through the skin and adding or removing saline (CPT 90772 or HCPCS S2083). https://www.oxhp.com/secure/policy/gastric_surgery.html Sorry about the delay,,I've been gone. For teh life of me,,I cant remember the exact site I found it the first time,,but here is a site that says the same thing. My surgeon's office is connected to teh hospital and they don't seem to want to give me a call back. I'll try them again. If I were you tho,,I would contact the part B Medicare carrier in YOUR state and ask them what the correct code is and tell them they obviously need to send a rep out to educate your physician's office insurance coder,,hahahaha. I used to coordinate workshops between our member physicians and Medicare to educate them on changes and new codes. lyndalafe,,,,,i worked in health insurance for a gazillion years,,we only gave info to the patient who was our subscriber or the physician's office performing the procedure,and then it had to be in writing, stating exactly what they7 wnated to know. Anytime it was a question

Denise~~ Saw my surgeon about that left arm pain. Mine too was not in my chest or so much the shoulder, but in my bicep and down my arm. He said sometimes teh phrenic nerve in the diaphram can be aggravated by the surgery, but it causes shoulder pain,,not radiating down the arm and numbness,,like I'm having. He said mine sounded more like something cervical related. I AM going to Water aerobics 3 times a week and never had any pain beefore that,,hmmm,,maybe I pinched something. Anyway,,now I have NO pain, but stil some numbness. As long as it doesnt bother my hand or fingers,,I can live with it. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

Hi ya'll~ Last week I got my 3rd fill and I think its a tad too tight! I was able to swallow water right afterwards, so I left his office feeling good. Thought perhaps this fill would hit my sweet spot. Before teh fill I had 1.7ccs, I think, in my 4cc band. He pushed me up to 2.0. WELLLLLLLL I got home later and fixed supper and almost died trying to swallow anything. I've never hurt that bad or had that kinda of hurt before. I read some posts,,seeing what others had to say about similar experiences. Lots of folks said after THEY got a fill, it was tight and took a few days to a week or two before it settled down. So,,,I just tried to eat soft things,,no go. Anything with the consistence thicker thatn water sticks in my throat(?) and kills me. It goes down,,,but it hurts like hell. Still,,I was giving it time to 'settle down'. Its now one week after that fill and it hurts as bad today as it did the first bite. I've got an appt in the morning,,wish me luck! hahahaha I was a self-pay, so my fills/office visits for a year are included in my one time fee. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

ktkt,,, I don't count calories. My surgeon nor dietician ever mentioned calories to me. I'm comfortable that IF I eat the foods I'm supposed to, in the amounts I'm supposed to, exercise, get all my water,,things will fall into place. So far,,it's worked for me. But then,,that's just what I'm doing. I had a fill last week and it's so tight I can't eat anything without having terrible pain. SOoooooo in hte morning I'm going to see my surgeon and see if I'm just a tad too full in my band. Hopefully,,I can find that sweet spot. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

How great to hear from someone with so much time banded! Glad you shared your anniversary!! I've wondered if there were any different issues with those banded for a long time, but haven't noticed anyone with 10 years behind them before. Thanks for blazing the way!! banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

Bullwinkle,,,I apologize that the tone of my post offended you. I would never intentionally try to shame or finger-wag anyone. Thank you for calling me on the carpet. I will be more careful in how I say things from now on.

We should be getting 60-80 grams of Protein a day. Looking at what you listed for supper, I hope you made up the other grams at earlier meals. vegetables- 1/4 cup has 1 g of protein low fat yogurt- 1 cup has 7 g of protein 1 ounce of low/no fat cheese has 7 grams of protein gingersnaps-i'd venture to say has zero If I ate for supper what you listed, I'd only have gotten 23g of protein. Where did the other 37 minimum grams come from? 57 if you go to the maximum grams? Hard Proteins will stay with you longer giving you a better sense of fullness. Yogurt is tasty to me,,but as far as staying wth me and making me feel full,,nada. Gingersnaps,,,,nada,,useless carbs. I'd worry more about the protein count than I would about the fat count. That's why my surgeon and dietician stress: Proteins FIRST,,veggies SECOND, carbs,,,only if I have room for them. For ME,,when I was eating the wrong things,,I never felt full. If I eat in the order and amounts I'm supposed to ,,I'm full. That's just my take on it. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS 2cc/4cc band

well,,,today is Sunday and tonight i was able to eat solids for the first time without the pain from my fill Thursday. I guess it just needed time. Heck,,I dunno,,whatever it was,,passed.

Welllllllllllll I AM post-menopausal and 53. I was banded 1/29/07 and my pre-surg weight was 331 and I'm 5'2". As of last Thursday I've lost 66 pounds. I knew I had to do something or I was going to be miserable the rest of my life or dead. Choosing to have the band is the best thing I've ever done for myself.

Now ya'll have me worried! I went for my 3rd fill last Thursday and he mashed and poked and hunted for my port. He said he might have to do it under fluro,,which would be a first for me. He hit it tho, whew. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

cathy,,,bless your heart! Glad to hear you got relief. I had my first episode with pb'ing Thursday, after my 3rd fill. I'd not had a problem with any food prior to getting that last bit that put me at 2cc's in a 4cc band. To quote Rosanne Rosanadana (us middle-aged folks will remember her,,lol) "I thought I was gonna DIE!!!" Mercifully,,it only lasted a minute or so,,but I'm still having trouble eating anything solid or semisolid. My doctor has never said to do only fluids for a afew days after a fill,,but freom reading what others have shared,,I think its a good idea, for me. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

WTG TIM!!!!!! Can't wait to get your report. Hope the catheter was't TOO bad,,lol. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

2bthinang~ Congrats! I know its a hard decision to make and one you've put alot of thought into. Honestly,,I had a sort of feeding frenzy right before my surgery as well. I hope you have a good support system within your significant others. The more I involve myself in actitivites that don't revolve around food,,the better I do. I've read posts here,,I can't recall the thread right now,,but they wer listing all teh things they CAN do now, rather than moaning about the things they can't do. For example: I can do my own pedicures I can park farther away from the mall doors and not be exhausted by the time I reach them I can be a good example for my daughter who has her own weight problem I gained the confidence to walk from the locker room to the pool at the gym I gained the confidence to start looking for a job I can manage my finances better now that I don't spend bizarre amounts of money on binge/expensive eating None of us are perfect in our journey. Keep on posting and reading. So many sucessful people share their stories. You are not alone. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS 2cc/4cc band

Thanks Terri! I appreciate your redirecting me to your post. I think I was panicing and half-way read it the first time,,guess I just needed to spew out my feelings. This morning I got up,,fixed coffee and had a Atkins bar thingie. Of course it choked me half to death as I tried nibbling such tiny bits youd have to have a magnifing glass to see them. My wellbutrin feels like its stuck in my throat,,I mean above my adams apple. The good news is ,,,the coffee went down! hahaha Youre right,,,fluids for me for the next few days. My surgeon has never told me to do fluids right after a fill, but I've never had a problem until now. Thanks again!! banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

I'm 6 months banded and just got my 3rd fill Thursday. I'm at 2cc's in a 4cc band. My weight loss is consistant, but I told my surgeon I was eating too much and not really satisfied. I'm doing everything I know to be right. SO,,,he fills me from 1.8 to 2ccs. Now,,,I cant eat anything with any substance. I tried some refried beans with melted cheese and it felt like I swallowed a baseball. Everything I've tried to eat since has been painful. My question is,,,,when you feel too tight,,does it relax any after a few days? I have no problem going back and let him take me back down to maybe,,1.9 ccs,,lol. Amazing how little fluid it takes to push you over the edge. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

BeautifulME, Congrats on making the decision to get banded. I am divorced and live alone. A friend drove me to the hospital at 5am and I was prepped and sent up to the holding area. Met the anesthesiologist and saw my surgeon again along with his surgical nurse. They started hte meds in my drip and the next thing I knew,,I was in my room. It was about 5pm when I got my senses about me again. I have a low threshold to pain so I wont lie and say it wasnt painful. I punched that PCA button constantly,,lol. Got up and went to the bathroom a few times.Spent the night, got up the next morning, still hurting a bit. Friend came and got me about noon and took me by the pharmacy then home. Be sure to read the list of things to have prior to surgery. I sat in my recliner when I got home and slept alot. Took my pain and nausea pills often. I was able to walk around ok,,the act of sitting and rising was painful at the incision site, but on a scale of 1-10 with 10 being the worst, my pain at this time was a 5. Had no problems drinking or swallowing pills. All in all,,my surgery was alot less painful than I had expected. Remember that we each have different experiences. Be sure to do exactly what your surgeon instructs you to do and I'm sure you'll recover just fine! Keep on posting. You are NOT alone! banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

Did I miss something,,or did you say how much you've lost so far? Sounds like you need a fill, but let me ask you this first. Are you eating your hard Proteins first, then veggies then carbs? Are you eating 4 or 5 or 6 times a day, about 1/2 cup per time? Are you drinking 8 glasses of Water a day? If youre doing all that and you still feel hungry, then I would say you need a fill. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

Congrats on your new band! I take the Flintstone ones,,,yes,,they are a bit tart,,lol,,I think most vitimins are tho. I also take chewable Calcium Caltrate + Vit D. To me, they're almost a treat,,lol,,kinda sweet and tasty! Started taking Biotin abut a month ago,,also chewable. It's supposed to retard the hair loss that some people may experience. My surgeon added an Iron pill--its tiny-because my blood level was a bit low last time he checked. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

I got my 3rd fill yesterday. Now it's up to 2cc's in a 4cc band. He said that was the most he's put in anyone. Pfft, Anyway,,,this is the first time I feel what I think is 'restriction'. It feels like I've swallowed a golfball and can't get it to go down. Probably didn't chew it well enough. My question,,,any physicians/nurses with bariatic experience that can explain to me why it hurts going down? The band is placed below the newly created pouch,,and the purpose of eating hard Proteins is that they will stay in your pouch longer,,,when it finishes its digestive stage, shouldnt it be passed through the banded area easily? You dont feel it go in your mouth and then go thru the band,,there is a time lapse there. Just curious,,,,,,,,,,, Banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

Ok,,,,I've seen this thread for so long I finally felt a need to say something. I think that Lee could lose alot more weight if he lost that huge CHIP on his shoulder. To address the other aspects of his post would require me to abandon my Southern belle manners, so I'll refrain. Unless he keeps it up. banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS

I paid $16,500 for my surgery. It included one year of office visits/fills. After researching the band and related topics regarding the surg/aftercare/emotional aspects, etc, I called them Jan 10th and had my presurg workup done, nutrition visit, psyc eva and had my surgery Jan 29th. I met all the requirments, ie, BMI was over the limit, Hypertension, shot left knee, depression, blah blah blah. My weight loss is less than others who had theirs done at the same time,,and it is higher than some. All I care about is that my surgeon is pleased with my progress,,and so am I. I compare myself TODAY against how I was before the band. Physically and emotionally, I'm in a much better space. Keep on posting and reading posts. Use what you can and disgard the rest. You are not alone on your jorney!! banded 1/29/07 Dr Ken Cleveland-CMMC-Jackson, MS