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Aetna has always required a nutrition program. There were some very minor changes made to their Clinical Policy Bulletin for Obesity surgery on 12/18/09. The only changes were: "This CPB has been revised to state that the StomaphyX device for bariatric surgery repair or revision is considered experimental and investigational. This CPB is revised to state that a multidisciplinary preoperative surgical preparatory regimen or a physician-supervised nutrition and exercise program must have a substantial face-to-face component. This CPB is revised to state that the preoperative surgical preparatory regimen must be for three consecutive months, and must be provided proximate (within 6 months) prior to the date of surgery." The full CPB can be found at Obesity Surgery I highly recommend for anyone considering WLS to thoroughly review your insurance company's policy yourself. Its important to verify that you meet the requirements, but also to argue your case if it goes to appeal. I had to do two appeals w/Aetna to get approved. The way I was approved was by arguing that I met the intention of the requirement as stated in the background. So, it helps to read the whole thing, not just the summary.

I know this is a topic that gets a lot of judgment on this forum. All I am asking is kindness in response. I am looking into getting my sleeve turned into RNY. I successfully lost all of my weight and kept it off for two years. I then got pregnant with twins. It was a high risk pregnancy and I didn't gain any weight during the first two trimesters. Due to pressure from my OB and my own fears about my babies I began to eat as much as I physically could. To be clear, I am not blaming anyone but myself, I am just explaining that it wasn't the typical slipping back into bad habits situation. After I gave birth to my premature daughters (who are now fine, healthy, amazing), I was stuck in the habit of continually overeating. It's a rut I continually fight to get out but I am now looking at revision to RNY because of this. Does anyone have success stories, words of wisdom, or revision after pregnancy experience? Thank you, Jen

YES! I have it and I'm wondering how much worse it will get after my revision. I honestly haven't been doing anything to try to fill it out as of yet, so hopefully someone will have some great tips on exercises. I looked into beach body's Brazilian butt, but never ended up doing it. Youtube probably has some good workouts too.

I am looking for Boston people that love their surgeon. Specifically to do either a DS or a SIPS procedure. It’s ok if you don’t know if they do or not I will call around thanks!!

Congratulations on your new beginning! I have the same background as you with having the sleeve, now the hiatal hernia with GERD, and in the process of having a bypass revision. With the revision, did your surgeon say how much weight to be expected to lose? I didnt lost much with the sleeve either.

Mikell, First congratulations on your weight loss. I have lost 87 from sleeve and hoping for approval for the RNY revision asap because my reflux is killing me. Anyway my arms are like BAT wings flapping in the air. I absolutely hate it and my biggest fear was excessive skin just hanging off me. Actually some pretty bad nightmares about the extra skin just lagging behind my body as I vwalk. Thank God I haven't and hopefully don't get to that point. Lol Anyway yeah I feel ya!! Still another 90 lbs i have to loose so if you find any answers please share them. Allie in SC Sent from my SM-G960U using BariatricPal mobile app

I hope all goes well in getting your revision to sleeve and that you are on your way to feeling your best soon.

I never had to go through all of this because I was private pay for my lap and and then my revision was done as an emergency surgery (so it wasn't planned) but I did work for an insurance company and while they all have their own rules and guidelines but the surgeons know the criteria. Just go with it and do everything they tell you. I can also tell you if you are denied go through their appeal process because a lot of times it gets approved the second time around. I may wish I had gone through all the hoops as I now have about 60,00.00 in medical bills from the revision and insurance hasn't paid any of them.....YIKES!!!

Congrats on your revision. My story is extremely similar I was banded in nov. 2013 lost 130 lbs but had a baby in 2016. Through those years i threw up at minimum 5 times a day everyday it was horrible. I had my revision surgery on 12/1/17 and I am loving my sleeve! 12/1=259lbs now 1/4/18=231 Sent from my SM-G930P using BariatricPal mobile app

I will be sucking on some sugar free popsicles, taking some pain meds, and cuddling with my cats. A true partier at 25 years old I go back to work on the 9th so I want to get as much rest as possible! Katy W- Louisburg, NC Lapband revision to VSG with DS HW- 297 Weight at Surgery-279 CW- will update at two week appt

I am getting revised from the sleeve 4/20. Severe gerd and esophageal dismotility. I have been wondering the same thing. Did your doctor give you any idea on weight loss? I know it will be slower, I kinda just want to loose the bit I have put on because of the limitation on what I can eat.

I dont think i've seen a story quite like mine on here yet - so I will detail what happened to me so hopefully if anyone else has had the same problems they can let me know. I was banded 08/08/2008 - I lost 7kg on 3 weeks of Optifast before surgery. I had my band put in, and when I awoke from surgery I was very very sick with vomiting. They pretty quickly gave me anti nausea and I was ok. After a few days I was able to start working from home. I did as my surgeon said (and ignored advice on the forums - because my surgeon has done so many patients. He's a leading surgeon in Australia) and did liquids for 2 weeks and then went to mushies after it. I lost another 7 kg's over the next couple of months. I had Fluid put into my band - and really struggled to eat food. Its been so long now, I dont remember what these initial stages were really like. I went back to my surgeon and advised I was having trouble eating. They worked with me on the kinds of foods to eat - and I changed my diet. It was like I was eating around my band. It was never what I thought it would be like. I couldn't eat the foods they had once told me would be possible. I had all the fluid out - and I ate a small steak. I felt full, but it was ok. I say that I ate a steak - because with nothing in my band now I couldn't dream of eating red meat like steak. I would throw it all up for hours. I must not have been prolapsed at this time. I had fluid put back in, and a couple of times it had to be removed straight away as within 24-48 hours I wouldn't even be able to drink Water. They then over the next couple of months tried very small increments of fluid in the band - which would have the same reaction and wind up getting taken out. I was then sent for a gastroscopy (found nothing) and a barrium meal (also appeared fine). I went back to my surgeon in frustration, and he ordered video nanometry. This found that I had a prolapsed band. I had nothing in my band, but continued to throw up and couldn't eat a lot of solid foods. In total, I lost 7kg on the preop diet, and 7kg after being banded. I have gone through a year of hell - not knowing what was going to make me sick, feeling uncomfortable so often and all to see no real weight loss. Since the video nanometry revealed the prolapse, I have seen my surgeon. He's got me booked in for surgery this week to revise the band and place it back in, in the correct position. What I am unsure about is wether or not I even want to keep the band. Im not sure I can live life with this much pain and uncertainty. Frankly, I just became single a couple of weeks ago - and although the idea of being slim appeals - I just dont think anyone would tolerate my constant sickness and issues that the band gives me. Maybe life with the band isn't like this for other people - but this is all I have known. Im wondering if I should just get it removed all together. If you have any thoughts, please share. Thankyou for reading...I know it was long.

I had the RNY, poop smell depends on what I've eaten, some days it's normal, other's... it's down right foul. I keep a bottle of Poop-purri in my desk for work poops. I'm using PatchMD patchs, my Vitamin D is low, but it was low before surgery (the joys of living in the north) so I take extra Vitamin D supplements, but all other blood levels were within normal ranges. For me, I was revised from the Band to RNY, I didn't have the choice for the mini. But between the 2, if the mini has more complications than the RNY... I would have chosen the RNY if I had the options.

You always should follow what your surgeon and Nut tell you to do. They are the trained professional. If you trusted them to do your surgery you should trust them with the food stages. Every surgeon has different rules, even though we are having the same procedure. It is their years of training and experience that made them dictate their post op eating plans. My revision surgeon has you go right to purée but my original surgeon 9 years ago had 6 week transition period. Also my Nut is very clear that it is all about protein. We don't count calories in the beginning.

I started with a bmi of 28 (band revision) and lost 14 lbs the first month. Since then (4 mths post op) I've lost a total of 22 lbs. While that doesn't look like alot, I've lost 50% of my excess weight in 4 mths, which is fabulous. I knew it would come off slower, since I started out much lower. And those last 22 r definitely the hardest! Good luck to u

I'm wanting to get a revision to the sleeve I had in 2015 I've gained roughly 70lb and I feel like I or the sleeve failed me. So I want the bypass now. Any input on this

Hi, I'm in columbus and had my revision surgery in Cincinnati ( West Chester). I don't know how to send a PM on here but would love to talk to you. Maybe you will see this? Thanks. Katie

Had revision from band to sleeve on June 15. With my band, I could hardly drink water for most of the day & it took FOREVER to get my tiny pills that I have to take daily down! I guess I got so used to that "stuck" feeling after every drink/bite, that I have that expectation still with my sleeve--but nope! Not stuck here!!!!! And it is WONDERFUL!! Plus I just started full liquids yesterday and I can definitely feel restriction already! I can't wait to see what solids are like! Plus I'm down 12 lbs woohoo!!!

My one year surgiversary for my sleeve is 9/13. I am thrilled with it! My surgery was uneventful as well as my recovery. I was self pay and chose to go to Dr Hargroder in Baton Rouge, LA. The cost then was 11,900 and that included everything. I considered Mexico but my husband was more comfortable with my staying in the states and Dr H was a 6 hr drive from home. If it had just been me, I probably would have gone to Mexico to either Dr A or Dr H, they both have lots of happy patients over on obesityhelp. As for why I chose the vsg, I didn't like the rerouting aspect of the DS or the RNY. I didn't like the foreign body aspect of the band. I heard too many people having to have revisions due to slippage, erosions, etc. I also didn't want the maintenance of fills and unfills. With my vsg it was one surgery and no maintenance, that's my kind of surgery. With any surgery there are risks of complications so you have to take that into condiseration as well. There was also a recent study about all wls and it said that the bigger, higher rated hospitals have smaller complication rates. If you want specifics, I posted about it a week or so ago on my blog and there's a link to the article included. __________________ Originally posted at www.lapbandtalk.com

What kind of options are there if insurance won't approve a band to sleeve revision? Like where can I go where it is inexpensive to self pay?

3 months ago this was a random thought, revision surgery! Best thought I ever had, I’m ready for 7:45 6/12...I’ve ordered the vitamin patches, tomorrow will stock up on protein beverages, have gained so much insight from others on this forum and the Facebook page...working tomorrow till 3am then to the hospital at 5:45. I’ve lost weight since the process started, took pics and measurements today, I’m fired up and ready to go! If I have any surgery twins let’s keep in touch and inspire and motivate each other!

I have made two appeals to the review board in this six week period. did your insurance state only one "type" of weight loss procedure in a lifetime? doc and I presented medical issues with the band and the leakage problem. They agreed to revise, but only to band. What on earth did you put into a 57 page appeal?

Hi, I'd love to see what we have in common surgery-wise as well as apart from surgery. (I'm being sleeved in March 2015, a revision surgery from the band that was placed in March 2011.) When I'm sufficiently recovered, I would welcome the opportunity to meet up in the borough. Let's go for a walk, a light-bite, or a cup of coffee and discuss our surgeries and more!

I'm a potential lap band revision and I am scared to death that the sleeve will not work for me. My BMI is 32. It was a little higher when i had my band installed less than a year ago. I have only lost about 20 lbs with the band and I am constantly hungry, constantly getting food stuck and spitting up, etc, etc. Now I am experience acidic stuff coming up when I PB / Spit up. Gross! But I'm scared to take the plunge and have another surgery. And even more afraid that if I do take the plunge, that I won't lose anything. boo!

If you believe it will be the solution, it can be. I was bashed heavily when my failed me. What you need to accept is that the band is just crap. Honestly, I fought to make mine work because I didn't want to fail. BUT, I really sat back and thought "what has this damn thing done for me lately?" It caused me to be in severe pain daily, the food restrictions were numerous, I'd puke on Water some days, so it definitely wasn't "my" fault that it had to come out. Just have faith in yourself, and the sleeve. Seriously, I dropped all but 7lbs with the sleeve alone. AND, I did it in less than a year. So, if I can do it so can you. Get the band out before you end up with permanent damage like I did in 8 short months. I know people that wait and wait and then wait some more hoping it resolve on it's own, but sadly the numbers don't lie. We just happen to fall into that 1 in 4 bandsters will have to revise. You're not a failure, and you won't be with the sleeve.