mila1013

it is very difficult to answer this question, remember you are on a sleeve board. wls is very personal. never go to a surgeon that only does one or 2 surgery types as they will sway you the way of the surgeries they perform, example rny and band. also remember that information you recieve really should be of 5+ years as before that it is really the honeymoon phase, those experiences are very different as I had no issue with the band before 6+ years. The band has excellent short term results but the worse long term complications of all wls (band, sleeve, rny, and DS) I had the band going on 8 years, got down to 125lbs, excellent results no issues whatsoever but in my 7th year it was like a snowball no matter what the surgeon or I did there was jsut no fixing it, so permanent band explantation last week. I believe the band is great for short term only there should be a time limit on it like 2 years or whatever that time limit is, the allergan rx for drs specifically states it is not a permanent implant. I am waiting insurance info for my sleeve, found out wednesday they denied me, i was expecting that, now just have to wait to see why the denied me as they would not tell me on the phone, investigationa/experimental is an oldie but goodie for bcbs, but i will appeal. keep researching and talk to both sides that have been out 5+ years, for the sleeve talking to DS patients that were stagged is a good start. So your question is not easy to answer. hope that helps....good luck in your choice it is not an easy one to make when you take everything into consideration. Mila

I don't think you can post pdf, but you can give info like title, author and journal info name, then people can look it up...that would be great thanks for the post

wow great, congrats, what a way to start off

yep i am new too, had no idea, but it doesn't surpise me at all, this is advertising also why should it be any different....

hi, so this seems like a 2 part question. Just because you got RNY approval does not mean you have to have it and you are in a great spot, they have approved you for wls, not it is stricly a case of the kind you want. First I can't see how you would be approved for a surgery that was not pre authorized, in other words, your surgeon would ask for the sleeve (or DS, with your bmi it would be easier to get DS approved as there are more DS articles out there for you to bombard bcbs with) while i know the sleeve is part one of DS, bcbs are morons, you have to know your apponent and how to play that stupid game they put you through, anyway,the question is not about your insuance in that state, it is your specific plan not all insurance plans in that state are the same. So asking question about bcbs in a certain state really is futile. get a copy of your subscriber agreement and read it and know it, that is your legal contract between you and bcbs, not what anyone else has or says. good luck with navigating through insurance, they intentionally make it difficult. I have bcbs (not your state) and they have denied my perauthorizations 100% of the time, I have had to appeal every time since procedure I have had -and that would be 7 by the way, currently I am waiting for me sleeve denial, so predictable of bcbs.....

Cristin you didnt provide specifics so it is difficult to answer properly, "a lot of extra weight" can be a perception issue. You should not be able to eat anything because you are the tightest the first few months after surgery after a few months, some laxity will set it. I find it interesting and shocking that only 50% of your stomach was removed as all peer reviewed journals I have read document on a certain % being removed for a sleeve (more of the stomach is left if the DS will be done) only removing 50% of the stomach is a disservice to the patient and they will need to be resleeved. you are not talking about a difference of a few tablespoons here like bougie sizes 32Fr to 40Fr you are talking about 30% of your stomach still there, for what reason? if you are going to be sleeved that amount left is not proper (unless going to a DS) I will tell you I have read thousands of pages of peer reviewed journals have personally talked to 2 international experts and what you describe will have issues....others can chime in, hope you find your answer MIla

Nancy every insurance policy is different so it is difficult to answer this. Medical emergencies should be covered on all policies. the complication you should worry about is leaks that can be devastating on the body and financially, again read your contract for specific language. of course the cost of surgery can not be applied to your deductible it is denied and hence not covered, only covered services can be put to the deductible, but you can write it off on your IRS taxes....

Carrin, picking wls is and always will be difficult, mobid obesity via surgery has proven more difficult for surgeons than originally thought with subsequent failures in all wls types. no surgery type is perfect and they all have wls failures due to regain. I am currently waiting for my sleeve denial through my insurance co, that was submitted last week, it should come in by next week, they will deny via investigational, I will appeal. "30 percent of patients who undergo LSG will experience weight regain and require a second step approach, I still believe that we prevented that 70 percent of our patients from having a RYGB or DS, which I consider highly efficacious but at the same time a procedure that has a high incidence of morbidity. In these cases, I do not see the LSG as a failure but more as a ?first step? to a second long-term final approach" bariatric times july 2010. for me I have to do what is best for me at this time, the band is gone and since I did well with it, I am sticking to a restrictive procedure. I think the band is great, but I think it should be used short term only, before injury happens-removed and another wls used. It actually is concerning to me that the band is now being heavily advertised in commercials, etc, a time when so many reports are coming in and europe and australia are starting to abandon the band. this will bring a disaster to the US in the next 5 years or so. be very careful going to a surgeon that only does the band, or rny or any one specific surgery as they tend to sway in that direction. also realize that when getting experiences here or anywhere the first few years (<5) really are the honeymoon, you need to know beyond 5 to get a good grasp of reality. it is a difficult road we travel, and always will be.....good luck to all and peace and success with the choice that has been made...:svengo: Mila

hi all, I have not actually posted this, just bits and pieces out there, so I thought I would put it all together in as short a thread as I could: I was going into my 8th year with the band, but last week it was removed due to complications. I was banded at 135 kg, in 15 months I was down to 56 kg. I maintained this for years, actully the first 5 years were the honeymoon for me. I actually had no adjustment to the band in over 4 years, then the 6th year I started with heartburn, no big deal, loosened the band a little, took medication, and gained about 9 kg bringing me to 65 kg which was ok with me, since I was on the thin side. So then the fun starts, in my 7th year I could no longer eat lunch, (I had not eaten Breakfast in years which is common for bandsters) so no breakfast and no lunch. After 5 months of that I went to see my dr, I had lost all sense of normalcy, there was not a day that I was not sick and it became debilitating (at this point I knew I was going to lose the band) the band was completly deflated, upon an endoscope and barium swallows I was diagnosed with erosion, severe esophogeal dysmotility, band slippage, megaesophagus, hiatal hernia, pseudoachlachia. The next month the band was removed, the hiatal hernia repaired and the slippage fixed and a new band inserted. (after researching this, peer-reviewed journals say that subsequent banding is abandoned by most surgerons as it produces little to no weight loss, and results in reoperation via removal or converting to another wls) After 8 weeks I was going to have the new band filled, but upon barium swallow, the dysmotility was so severe, this band will have to come out too, as this is contradicted for the band. So last week I had my second band removed. I have not had a working band, in about 15 continuous months now and in that time going from my 65 kg, I am now at 87 kg. I will have to wait about 6 months to see if my EG junction (esophogogastric). I will never be able to have a band again, so I am looking into a sleeve, in 6 months. I hope everyone finds what they are looking for, and gets healthy.... Mila

oh gosh we sound so alike, not many bandster out there that far out. I can tell you that the complications I experienced are expected for the time frame, and are WELL documented in the literature, actually the FDA conditional approval in 2001 specifically questioned the esophogeal injuries late term with the lap band. the band is great short term but not long term. the major long-term complications increases constantly over time, according to a linear pattern. As in Europe, and before the appearnace of long-term complications, the enthusiasm related to the apparently simplicity of the procedure and good early results might drive a considerable number of surgeons and patients to choose banding. As more reports come in from europe and australia banding is going down in those countries, but the US is about 10 years behind. Reoperation rates could be a disaster, with thousands of patients requiring reoperations, with their associated risks, because of severe long-term complications. The results coming in from Europe and Australia should serve as a warning. Most people do not know the lap band is not a lifetime product (allergan directions for us-RX physican copy) the band is great short term, long term it has the highest reoperation and complication rates over all wls......it is what it is, I would anticipate that in less than 5 years europe and asutralia will abandon the band and the us in 10 years......

It is nice to see you here too!!! I don't think you are a loudmouth, I like honesty. I guess I liked my band---I was willing to give up stuff to stay thin, but it was not to be, very surgery has its thing. I was hungry for about 4 months post op too!!! looking forward to chatting--- Mila

this makes absolutely no difference for surgery or any type. I myself personally have had 2 surgeries with my period-no big deal. if it makes you feel better ask your surgeon before you go in, don't be embarrassed, because the whole OR room will see you naked anyway!!! it is a normal part of life, don't worry about small stuff like that....

Sarah, that is great, congrats on your surgery, I think in the next year or so when the clinical study is further along more info will be out there, so potentially another wls type to add to the procedures we have....

congrats on your surgery, glad you are doing well

I do not believe you will find 10K anywhere in the US, Mexico yes. And the 35K you were quoted seems inflated to say the least, and I have not seen any self pay near that amount (unless you had complications, open vs lap, bleeding, leaks etc something that made you have to stay longer)

while every insurance policy is differnt, weight loss surgery and true complications are mutually exclusive. if you have wls and you are indeed dehydrated and go to the ER or are admitted that is a true "emergency" and the diagnosis of dehydration is made and you are give IV fluids and that really should have no bearing on them paying for that er visit. Mila

the question of getting too thin is but a temporary issue if at all, the "tightest" you will be is at the begining of surgery over time that will somewhat disipate, furthermore a dietician can help move food around if it that does become a temporary issue, years out the issue is potential regain as with all wls, band, sleeve, RNY,DS. Anorexia is an eating disorder and really is a psychological issue which manifests itself through eating, those 2 issues are vastly different, to address underweight due to anorexia is a psych issue to address underweight due to sleeve is a nutritional/volume/type of food issue, which could easily be temorarily addressed by high calorie liquids. I would not worry about getting underweight do to the sleeve , as that can be addressed with dietary modifications, it is the regain that is very difficult to address after all the wls........ Mila

congrats, great work feels good....

thanks Lynn, ya there is virtually no mortality with the band, but high on the morbidity scale. Once those complications start, it is like a avalanche, they are virtually unable to be stopped, and I tried everything I could to keep my band........

what you are feeling is from the CO2 that they inflate your abdominal cavity with. It will disipate in a couple of days, try to walk around as much as you can, and I know those deep breaths hurt a lot but keep doing them 10xs an hour so you do not develop pneumonia. I have had 3 interabdominal surgeries, that CO2 hurts for a few days and radiates to the shoulders, it is a stabbing pain, know it is normal and will go away... Mila

Give the office a call, Dr Cottam is a wonderful, kind, great surgeon (801) 746-2885) , he will not pressure you either, if you are not right for the surgery or have questions he is great, he will also refer you to another surgeon if you end up wanting a different surgery type in your area. I am sure they will work with you, Sandee in the office is great and she will take some info and have Dr Cottam call you back. Being long distant you can have the bulk of the work done before you get there locally. They also have a discount for out of town patients at a local hotel that I believe will take you and pick you up from the hospital, airport etc, free shuttle service to these places, since the hospital is so close, just mention you are one of Dr Cottam's patients to get the discount, so you don't have to get a car. the hotel is Crystal Inn 230 West 500 South Salt Lake City, Utah 84101 good luck with picking the surgery that is right for you..... Mila

increased carbs will stimulate appetite, especially if they are aver 100 gm/day Mila

oh how confusing. if they refered you can't you use that to help you, that they don't have any providers that can do the surgery on base? can you talk to someone else? anyone esle on base that can help you? i mean it is not your fault that you can't have it where they want you to, try to find someone who can help you with this, everyone picks different sugery types for different reasons, it is very difficult to pick the surgery type as it is based on so many reasons, hope you get some answers soon.... Mila

ohh that must have been very difficult for you, it seems like you have good communication with him. we forget PCP are people too, and make mistakes, i agree you did catch him off guard, give him some time to think about it. i disagree that people who have the sleeve "can't stop losing weight" this may be a temporary modification and a RD can help with this, dont worry about that. the most concerning thing i read in your post was "the band is temporary" you should never go into wls thinking it is "temporary" when i decided on the band it was my intention on keeping it for life, but unfortunely it was not the case. i called my pcp last week when i sent him some info since i needed a letter of medical necessity to submit to insurance. he called me and we spoke, basically he didn't know what the sleeve was, but he knows my obesity struggles, he also knows that i am not a RNY or DS condidate. (i did get down to goal weight of 126lbs with the band) While he was not sure what hte sleeve was he did support me after he read the info i sent him. doctors, people etc all have their favorite "WLS" there is no "perfect" solution for everyone or every surgeon. if i didn't have complications to the band i would have had it for life, but that was not to be and now i am looking into having a sleeve....give your pcp some time to adjust to the news....he may come around when he has looked at it objectively or at least support you for the choice you have already made, he is there to help you.... Mila