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When I first got this band, I was so positive and so just hopeful. Now, I'm like, great, another diet, I just have the band now. Now, all I do is worry about slips, erosions, etc. Not so much erosions, I worry about slips. I'm so happy for the people this lap-band works for. I want it to work for everyone. I don't want anyone to have problems with it. It's just with me an adequate fill = reflux, as in carry a double bagged grocery bag with me reflux. Sigh. I'm not eating too much, when I have a fill, I just can't eat but fattening foods. Jeesh, to think I got this to eat more healthy. Well, enough blogging for now. I hope some of you can relate. I sometimes feel so alone in this. Everyone is like it will work if you work it. Well, I have complications called reflux with a a fill.. How the hell am I supposed to work it when every time I get a fill I am sliming up a protein shake? AGRR. I'm really trying with this. I really am.

You know if vsg in the states was maybe a difference of a couple of thousand I would very likely stay in the states but most surgeons here are starting around $11k and even conservatively Mexico is still less than half. Unless you're independently wealthy these numbers do matter. I won't lie - I would love to get this done locally for several reasons - the language barrier - the sheer hassle of flying out of the country (and then having to fly back with a sore tummy) and being close to my regular physician in the event of complications. Omg I'm starting to talk myself out of Mexico !! But seriously unless I found someone here for maybe $8 -$9k I can't afford to do this anywhere but Mexico. Ironically, it's likely a vast number of Mexican surgeons trained here and have performed far more of the procedures.

One year gone and took 87 pounds with it. Yupeee!!! I'm happy and sad. Happy that I feel good and have not had any complications. I feel energized with alot more self esteem and do feel like my life is in a new phase. Sad, because my goal was to loose 100 pounds in one year. It's getting much more harder now. I've caugt myself going into old bad habits. I feel like my body continues to fight me. Hunger is also against me. It's harder to loose the pounds. I stay in a range of 10 pounds. Loose 4 one week then two weeks later those same 4 or 5 are back. I have now decided to take things to another level. I enjoy walking and have put some jogging into my excercise. But feel I need the advice and encouragement of a physcial trainer. I have now looked into that and plan on starting soon. Mentally, there's been alot of confusion and alot of emotions. There's alot of ups and downs. Alot of my history has come out, for some reason. I need to continue seeing my pyschologist, who had previously warned me that many things in my head would awaken and I would have to face them. I trust that with his help and GODs presence I will work thru this. :smile2:

October the 13th, a Friday no less. Good thing I am not superstitious! I decided yesterday to go ahed with the Lap-Band surgery. In the end, I felt that the risks involved with having the surgery, and hopefully escaping obesity, outweighed the risks of not having the surgery and remaining miserably obese and of deteriorating health. I decided on Dr. Rumbaut in Monterrey, Mexico. Dec 19th is the date! If my insurance would pay for it, I probably would have stayed with a local doctor in Texas. However, as I am a self pay, I might as well go with the best as the costs are about the same. Rumbaut is $10,600 and I will need to pay my own travel expenses, now and for followup care. Self-pay in Austin comes in at $12K minimum. Even though Rumbaut is less, I am sure it will end up more by the time I consider travel and other expenses. However, the difference in cost, when considering the overall expense, is negligible. For me, it came down to what I thought would provide the best odds for a successful surgery with minimal complications and best overall opportunity for reaching the desired outcome. Rumbaut seems to be undisputed as the best. So, given the opportunity to have him perform my surgery, I almost feel like I have a responsibility to myself and my family to use him. It cracks me up, about the people who jeer about going to Mexico for surgery. Their opinion is based on ignorance at best, racisim at worst. My goals for te journey are clear and simple. 1. Lose weight. 100 pounds would be great. 140, while unimaginable today, would be beyond my wildest dreams. 2. Get off the CPAP machine! I estimate I will need to get down to about 240 to meet that goal. 3. Feel Great. I feel like shit now, so any improvement would be welcome. My knees hurt, my back hurts, amy ankles hurt, my hips hurt. I get winded walking up a single flight of stairs. Well. That is enough for today.

RE:If the erosion rate is 1% why don’t you reflect costs for complications and band removal? I FIND THIS IS AN OLDER THREAD. ARE THERE DRs IN MX WHO OFFER THEIR SERVICES WITH NO FEES AFTER COMPLICATIONS WITH THE BAND, EROSIONS, REMOVAL ETC? THE PRICE YOU PAY FOR YOUR SURGERY INCLUDES ALL THIS? THANKS MUCH, PAM

I am looking to get the band "off label", and have a "low" BMI of 31 so my insurance won't cover the surgery. I am wondering, If there are complications afterwords, swelling, infection etc and I need an adjustment, would my insurance cover that? Thanks!

:thumbup:My team says I am doing great. Starting weight shortly before surgery was 293 and I am now at 277.... 16 lbs so far. My incisions have all healed, I have had no gas pains, nausea or any of the other uncomfortable complications I have read about here. Stayed on full liquids day 2-10 and still incorporate a lot of full liquids such as yogurt, cream of wheat and protein water into my daily diet. In fact you could say I am on full liquids all day, eating whatever else will go down comfortably for dinner, keeping an eye on my own personal nutritional goals. I was doing this for awhile before surgery anyways, and has now bwcome habit. I worry about progressing too fast with the diet. I asked my doctor if I ate something wrong, would it cause any problems with the band, such as slipping? He assured me that might have been true in the “old days” but that he now ties the lapband in securely by bringing up some of the lower stomach and stitching it around the band. The band will not slip by eating something wrong. He did say if I had a prolonged bout of throwing there was a slight chance of slippage, but unlikely. He also said that before the first banding the stomach pouch will not stretch as there is little restriction, any excess food just slips through to the lower stomach. His said I would be limited in what I eat by what felt comfortable “slipping through” and could gage how much swelling is remaining from the surgery by what size goes down OK. I would learn from trial and error what I could eat and what would be not be nice to me. So I have tried out various other foods to see how they feel, being sure to chew very well. This is very much feedback trial and error, as if I forget and do not chew well it does not feel good going down. I have the best luck on foods that are on the soft slippery type, like fish(scallops, red snapper), noodles, eggs and various oatmeals, even soggy morning cereal. All with no problems. No gas, bloating nausea or any other complications that I can feel. All went down just fine. Rice, flour tortillas and anything fibrous that can’t be chewed into pieces get “stuck” and I have to wait for it to clear before eating more. Not painful, just annoying. My nutritionist did say to avoid coffee as that has tannic acid which could cause ulcers on the band. I wonder if that applies to tomato products, such as spaghetti sauce, as tomatoes have tannic acid, as does wine, I think. I will need to verify that with her. I am thinking it may be the daily prolonged use of coffee that could cause an ulcer, but for now I just say no. The temptation is to keep pushing the limit, such as gobbling down a Burger King Steakburger ( I did not even though I probably could if chewed well), but I had better have enough self discipline to not do that or I have wasted my life, time and money on a procedure I do not respect. I log everything on FITDAY.com (have done this for years) and keep a careful eye on my calories, cards, proteins, etc. When I was on full liquids I was taking in about 800 calories and usually met the 60 protein goal. I am looking now at keeping my calories around 1200, so that I will continue to lose weight. My doctor has taken me off the high blood pressure med as I now test in the normal range. I have reduced my glyburide by 50%, and am slowly reducing my 24 hour insulin. I am experiencing fasting glucose of 120, which is about 100 points lower than pre lapband. So far I am very happy with my lapband.

After 19 months I've only just had my first fill a few weeks ago. I am one of the small precentage of banders who had complications. (Not sure what that was about) Still After all these months I believe this was a good choice for me. I was one who had been underweight for the first half of my life. I only breifly was at a normal weight. The rest found me at 279 lbs at my heaviest. a few persons I know had by-pass surgery. I'd even cared for by-pass patients during my early nurseing years. I knew that was not for me. This banding thing, after musch time on the net and my PCP's cry of too many "pre" stuff to name. Another diet, more shots and pills were not going to do it. An accident had slowed me down physically and mentally. I gained back the 45 lbs I'd lost on my last plan and swing dance class plus a few more. After surgery I lost 100 lbs because I was sick then gained back 20lbs once I could eat again. Now. I get to use my tool, learn new coping skills and cooking methods. I 'm learning to understand my relationship with food and make changes to be healthy for the rest of my life. This is wonderful. I love my surgeon. He confrenced with all my doctors during my illness and I count him as my friend. I'm grateful for the person who created this web site and I'm most thankful for a chance to live a truely abundant life. :frown:

There are a small percentage of people that do have complications and it's good to acknowledge those because you really do have no idea exactly how it will go for you. But there are also huge numbers of people that don't have complications and do really well. Most people that I've heard of that have complications, usually get past them and end up being a success. For me, it was with the risk. I was miserable, in pain constantly and had some scary medical issues. Now I'm 162 lbs lighter and just hit a healthy weight according to the bmi charts and I'm only 9 lbs from goal. It hasn't been easy and I had a few minor issues in the beginning, but it's been 100% with it and I'd do it all over again if I had to. Your body will be better able to handle whatever health issues that come your way at a healthy weight plus you'll be able to enjoy the benefits of no longer being overweight. It really feels great!

Approval went through and I finally have a date. It's going to be a little complicated because my hubsband will be away and I have to travel by myself to have my surgery. Thanks goodness I have good friends to help with kids and it may be more relaxing recovering in a hotel for a couple days. The only downside is that I have to tell more people than I origionally wanted to. I'm so excited to have this done. I start pre-op diet monday!!

WOW! You poor thing. Technically three surgeries in a matter of 2 weeks?! I can imagine the gas has you all bloated up and it wouldn't be unheard of for it to settle in your back. Mine was mostly in my shoulders and chest. I agree with the others' advice, walk when you can. It will help the body re-absorb the gas. I've also heard chewable gas-x helps although I never tried it. Maybe you need more time for your body to heal. This was an unforeseen complication as well as a second surgery that was only 10 days ago. Depending on your job and circumstances, I would think you should be allowed more time to recouperate. Here's wishing you good luck and Hope that the gas dissipates.

Good advice about checking out more expensive Dr.'s too...I found a Dr. in my city that would do the surgery for $4,000 less that the surgeon I decided to go to. However, fills are much more expensive, he only gives one fill for free after surgery, basically...LOTS of hidden costs. The surgeon I am going to costs more, is about 4 hours away, but has an awesome track record. He also gives you a year of free fills. The best part is he has his own surgery center...so any complications..slipped band, leaks, etc...he fixes for free. I will have to pay for anasthetic...but that is all. That is a very comforting feeling since I am self pay...defnitely worth the extra $4,000.

Hello! I had my surgery on 4/11 and had horrible complications afterwards due to the pain meds that I was on. I am now feeling a TON better and have an appointment on Thursday! I'm so excited to start this journey. I'm supposed to get a fill on that day, so I feel that my weight loss journey is barely about to begin A few times before and after surgery, I really started to regret my decision to get the lap band. Now, I am SO thankful!!! Last time I checked, I was down 26 pounds since my pre-op! I'm proud of myself!!!

Hi Y'all, I Relaize This Forum Is For People W/ Lab Band. I Am One Of Those People, I've Been Banded Since 1/07 And Couldn't Be Happier. My Problem Is My Mom. After She Saw My Succsess W/ Lap Band She Went Through The Process Of Getting Approved Through Her Insurance. She Had Everything Riding On Getting Approved And Kept Gaining Weight. She Then Found Out That Her Insurance Didn't Cover Lap Band But, Would Cover Gastric Bypass. Which To Me Makes No Scense What So Ever. Any How, She Went Ahead And Got The Gbp. Despite Me Warning Her Of All The Complications. She Had Her Surgery 1 Month Ago, And Has Been In The Hospital Twice Now. Once For Dehydration And To Stretch Her Stomach And Again Another Time To Strech It Out Even More. The Reason She's Having Her Stomach Stretched Is She Couldn't Even Keep Water Down. She Still Can't Eat Anything She Looks Horrible Very Weak And Pale. Her Doc Says They Can't Strech Her Out Any More. She's So Miserible And Wishes She Would Have Never Done This To Her Self. She Cries All The Time Bc She Can't Eat Anything W/o Throwing It Up And She's Hungry. She Also Says She Has No Support And Can't Go It Alone. We Live In Different Cities And She's A Widow. I Looked To See If There Were Any Gbp Support Websites Like This One And Couldn't Really Find One For Her. I Know Any Time I've Had A Question, Concern Of Needed Support I've Always Found It Here. My Hope Is Someone Will Read This And Maybe Know What I Can Do To Help Her Or Know Of Someone In A Similar Situation She Can Talk To. Anyone Please Help. I'm Very Worried About My Mom. Thanks Y'all.

I've been on this road for about 12years.I didn't gain alot of weight until I got married. I was 149lbs. when I got married 12yrs.ago. My son came and my daughter,:)Then I had abad car accident and was out of work for 7months. I.ve lost and gained. and lost and gained. A year and a half ago I went through everything, and was even approved for Gastric Bypass. The day before , I canceled! The girl across the street from my mom had had the surgery 5months before and she died that morning from complications. I was very upset! I saw an article on T.V. and asked my doctor about it. It's been a journey since April. I had my initial visit and now I'm down to the waiting for the insurance company. I hope it gets approved , i'm worried because I dropped out at the last minute. I'm also concerned with the liquid diet , but i"ll cross that bridge when it happens one thing I like is my liquid diet seems to have more choices then other people have.:car:

Best wishes tiffanie;) your right it just scares me to think I could possibly die or suffer from complications. I know every surgery has them but it doesn't make it easier lol. Sent from my ADR6400L using VST

Hello Fellow Sleevers! I am almost four years out from my surgery. I have gained back about 10-15 pounds, depending on what you consider my lowest weight. I am working at taking it off right now. I have never exercised or watched what I ate (oops) but am now starting to realize that maybe I should heed the doctor's advice from 4 years ago. I still feel great and have zero regrets. I have referred several people who have all had the surgery with zero complications and no regrets so you that have not had the surgery yet just wait...you will have a couple of rough spots but it is so worth it. I changed jobs and have been sitting behind a computer A LOT so I think that along with seasonal Reese eggs/Christmas trees/valentine hearts are to blame. After a few years, your realize what you can and cannot eat more of (bread vs. crackers) and you will probably put on a few pounds from your lowest weight but the tool is there and it is much easier to lose. I am just now starting a diet and it will be much easier to diet with the smaller stomach. At the time of my surgery it was private pay only since it was brand new and it was $12,000 and I hear now it has gone up quite a bit. BTW, I was a size 16 and am now a big 6-8 (was a 4-6 and will get there again...). I lost a total of about 75 pounds..just in case anyone is curious. Have a great day! Luck

@@Supermomof2 Always check with your surgeon about any pain you are unsure about. What might be normal to someone might be a complication for another. I know that I've read others complain of pain in this area - or the left - depending on where your surgeon removed your stomach from. To get more fluids - try different temps - some you may tolerate and be able to drink more than the other. Constantly sip - tea (hot or cold, flavored - decaf), crystal light, Powerade zero, Vitamin Water zero, broth, infused water, Protein shakes (if allowed count as liquids). Eat sugar free popsicles, shaved iced, crushed ice with sugar-free non-caloric liquid (like a slushie or snow cone). Hang in there!!!

Hi everyone...my name is Sue and I just found this forum. I thought it would be nice to be able to "talk" with others who have had the same surgery as I have. I had my banding done last summer. So far I have lost 77 pounds (I'm just over half way to my goal) and have had very few problems or complications. I'm extremely happy with the way things have been going since the surgery and would do it again in a heartbeat. I had my surgery done at Loyola Medical University in Maywood, Illinois by Dr. Sarker. Anyway, it's good to be here. Sue

What's your sign? My sign says "Stupid," but I'm told that I am a Cancerian. How would you rate your physical recovery post op (1-10, 1 being miserably long healing, 10 being fast & easy healing) A 10. I was horseback riding after two weeks. No pain meds after the recovery room and then I only gave myself one dose. How would you rate your emotional state post-op (1-10) 10. I was on an emotional high. I was so glad to have gotten it done. How would you rate your food tolerances? Can you keep things down r do you find that many food 'don't agree with you' now? 10. I can eat anything. I don't though. How would you rate your general success with the sleeve. Have you made goal or are you on target to do so? (1-10). 9. There are probably faster losers out there and people who stay on track better, but I rank. I am 30 pounds from goal. Please if you had complications, etc please give details. N/A

Help Center -Department of Managed Care This I my appeal letter to ask that you reconsider and approve the Sleeve Gastrectomy Weight Loss Surgery that was denied by Anthem Blue Cross because they consider the procedure investigational. I believe this surgery is exactly the tool I need to improve my health and the quality of the rest of my life. I have been told by several of Anthem Blue Cross customer service representatives that 43775 is a covered procedure and that as long as my HMO approved they would pay for the surgery. This is not what I am being told now. I have been getting the runaround on this for two months. I received a letter from my HMO dated 2/6/10(copy enclosed) stating this is not a denial of service but Anthem considers this procedure experimental and has to go to the Utilization Dept for a decision. The number to call this department was on the letter. I called this Dept. a minimum of 5 times and was told they don’t know what I am talking about, this dept. doesn’t handle HMO. So I call my HMO and they say “oh you have to appeal” so I send my appeal letter to Anthem on 2/16 and wait the 30 days for a decision. On the 28th day they inform me that I cannot appeal because I haven’t been denied, oh and the people in the Utilization Dept. don’t know that their department handles this?? So they send it back to the Utilization Dept and now I have officially been denied. This part of this process has taken two months, very frustrating. I. PATIENT BACKGROUND My name is Jeani Xxxxxxx and I am insured under group plan xxxxxxxxxx. My member ID # xxxxxxxxxxxxx. I am now 59 years old. I am 5/5 tall and at this time I weigh 233 lbs. I am seeking approval for weight loss surgery. I have been overweight to one degree or another since I was a young child and was advised by my pediatrician to diet at age 10. I have made numerous efforts at weight loss throughout my teenage years and adult life. I dieted frequently as a teenager and young adult. Numerous times I have lost 40-80 pounds or more but eventually the weight returns. Weight loss programs I tried include juice fasts, traditional calorie counting on quite a few occasions, Weight Watchers, Slim Fast, Nurti-system, the Atkins diet, Cabbage soup, Mayo Clinic diet, the Zone, gym membership, lap swimming, weight training, water aerobics, walking programs, various buddy-system diets and individual, self hypnosis, ”Think yourself Thin” “ Think yourself Thin Automatically, tape you listen to in the car” Dexatrim, Metabalite, Hoodia, Green Tea Extract, and numerous other fad diets. In all cases I lost weight but each time the weight crept back, usually with a little more. Eventually I realized that traditional dieting seemed to actually cause weight gain due to increased hunger that seems to occur after significant weight loss. I believe science is only now beginning to understand the reasons for this phenomenon which is consistently reported by clinically obese people. Studies also show that genetics plays a larger role than once thought and there are morbidly obese people in my family as well as slim people. My co-morbidities include high blood pressure, high triglycerides, low good cholesterol, have had abnormal EKGs, borderline diabetes, and osteoarthritis in my hip, which my doctor said weight loss would help significantly. I have also had sever back pain most of my life. I take hydrochlorothiazide and verapamil for high blood pressure which is effective. I take medicine, Niacin for high triglycerides. I have a family history of cancer as well as strokes, heart disease and severe arthritis. I take nabumetone almost daily and ibuprofen to help with severe leg pain related to arthritis in my hip. I have taken ibuprofin for back pain that i have had most of my life even when I was not overweight. I believe I will need NSAIDS even after WLS which is why I need the sleeve as this is the only WLS that you can still take anti-inflammatory medications. I buy over the counter ibuprofen as I can get 500-200mg pills for $10.00 which last over 6 months, whereas when getting prescription I only get 30 -800 milligrams for a co-payment of $10 which only last a month. My excess weight and other health issues makes everyday activities difficult including housework, shopping, standing, walking significant distances, working and recreation. It effectively makes my world smaller limiting the number of things I can do each day. I have lived with obesity for years and strongly wish to change this aspect of my life. I fear the consequences of my high triglycerides especially considering the family history i have of heart disease. Many members of my family died of heart attack and stroke. I was stunned to learn that my weight is in the obese category but heartened to learn of this newer treatment with fewer side effects and shorter recovery. I am highly motivated to succeed with VSG and understand that food intake will be significantly limited for the rest of my life and that I must continue to exercise to be successful. Before I found out about the arthritis, which is the result of a subtle fracture at some point in my life that affected the curvature and angle of my right hip bone (this was found by an MRI that was done after pain medication didn’t help and physical therapy made the pain worst), I used to walk a minimum of 30-60 minutes a day at least 5 days a week. Since this pain in my leg as a result of the hip arthritis I no longer can do that and I am afraid that the weight will just continue to creep up on me. My particular problem is in volume eating. I eat good food, lots of chicken and turkey, lots of fruits and vegetables, the thing is I am always hungry and I eat until I am full. Having a smaller stomach and feeling full sooner seems like exactly the kind of help I need. I had given up on traditional dieting as it always resulted in failure and am pleased to have found the VSG surgical option which appears to be the only tool offering a realistic possibility of lifelong weight control for me. I believe VSG is the best surgery for me because it offers restriction like the lap-band and the RNY but without the malabsorption of the RNY. The RNY is not an option because I very much need regular doses of nabumetone and ibuprofen for the leg pain related to my hip pain and even once I lose the weight believe I will still need ibuprofen for my back pain which I have suffered with most of my adult life. Tylenol is not effective for me. I am allergic to codeine, vicodin, any pain medication of that type I cannot take. Narcotic pain relievers make my head seem fuzzy but do not help with pain. I have the same concern about the lap band. I also understand that as many as 27 percent of lap band patients require band removal and weight loss is often unsatisfactory (I think the number is even higher now). Most importantly, the VSG removal of a large portion of the stomach removes many of the cells that produce the hormone ghrelin which is known to cause hunger and appetite. The RNY and lap band don’t have this advantage. At age 59 I am concerned about the side effects of the RNY and do not want to spend 6 or more months with dumping syndrome and feeling rotten. I also worry about the ability to take and absorb other medications I might need in the future as I age. The VSG appears to offer the fastest recovery, weight loss similar to the RNY and the least amount of side effects. One recent publication, “The Best Bariatric Operation for Older Patients “ by Drs Lee, Cirangle, Taller, Feng and Jossart, 2005, concludes that “These data suggest that the best bariatric operation for older patients may be the laparoscopic VG because it achieves the greatest weight loss with the shortest operative time and the fewest complications”. I have investigated this procedure very thoroughly including attending support groups and talking with others who have had it. I have completed most of the preoperative testing and strongly believe this is the best procedure for my circumstances II. THE VSG SHOULD NO LONGER BE CONSIDERED INVESTIGATIONAL The only stated reason for denying approval for the VSG is that it is investigational and …” current available medical studies do not show that this service improves health outcomes, is as good as or better than standard alternatives, or shows improvement outside the research setting”. It is respectfully submitted that this conclusion is incorrect. The conclusion ignores the 36 studies now available on the effectiveness of VSG which indicate that excess weight loss is similar to the RNY and that complications from surgery are actually lower than RNY. It also ignores the fact that the VSG is now widely performed and is routine for many bariatric surgeons and has long been performed outside the research setting. Anthem’s policy on Surgery for Clinically Severe Obesity is set forth in a document with an effective date of April 22, 2009. This document reviews the various forms of bariatric surgery and explains when weight loss surgery is considered medically necessary. VSG is excluded from ever being medically necessary because it is designated as investigational and that “…there is insufficient convincing evidence in the peer reviewed medical literature, in terms of safety, to support the use of …sleeve gastrectomy…other than biliopancreatic bypass with duodenal switch, in individuals with clinically severe obesity.”. Nevertheless, the lap band and Realize band procedures are approved as medically necessary in this same document based upon what appears to be two three year studies involving 219 and 352 patients respectively. There is now a considerable body of data and studies supporting the safety and effectiveness of the VSG as a primary procedure for weight loss. The June 2009 Supplement to Bariatric Times reporting on the Second International Consensus Summit on Sleeve Gastrectomy (available at www.bariatrictimes.com) includes 10 papers pertaining to the safety and effectiveness of the VSG presented by leading bariatric surgeons. In Reducing Risk in Bariatric Surgery: Rational for Sleeve Gastrectomy, Dr. Eric J. DeMaria concludes that “A growing body of evidence suggests sleeve gastrectomy may be an appropriate primary bariatric surgical procedure primarily due to low risk and ease of surgical revision when required.” In the paper presented by Drs Jossart and Cirangle, four years of data showed a 68% excess weight loss by VSG patients, a figure not largely different than RNY patients of the same time range. Most significantly, in Debates and Consensus: a Summary by Dr. Michael Gagner, important questions concerning the VSG were debated and conclusions reached by the 400 conference participants. Question 6 was as follows: “Question 6: In your opinion, is there currently enough published data to support the sleeve gastrectomy as a primary procedure to treat morbid obesity on par with adjustable gastric banding and Roux-en-Y gastric bypass? Several groups presented cohorts of patients with follow-up periods of 4 to 8 years the day before. Jossart and colleagues in San Francisco presented eight years’ experience including 1,200 cases, whereas at more than four years, weight loss resulted in a similar curve to gastric bypass. At higher BMI (greater than 55kg/m2) a plateau of nearly 40kg/m2 demanded a second stage, but below a BMI of 55, the operation was terrific. Schauer and colleagues assessed the literature from 35 reports, studied more than 3,000 published sleeve gastrectomy cases, and found an extremely low mortality rate (near 0.12%). Results have shown excellent weight loss and co morbidity reduction that is comparable to or exceeds other bariatric operations and that the sleeve gastrectomy is safe and efficacious. Himpens of Belgium analyzed his patients from 2001 through 2002(sic) to attain six-year follow-up. Sixty-five percent of 46 patients were considered a “success” (%EWL greater than 50 ) at two years. At six years the success rate was maintained at 59 percent. Weiner from Frankfurt and MacMahon of Leeds, who started in 2000, also had similar results. *** Certainly, the audience thought there was enough evidence published to support the sleeve gastrectomy as a primary procedure to treat morbid obesity on par with adjustable gastric banding and Roux-en-Y gastric bypass with a yes vote of 77 percent. This is perhaps the strongest contribution to this second consensus conference.” A review article entitled “Systematic Review of Sleeve Gastrectomy as Staging and Primary Bariatric Procedure” was recently posted on the web site of the American Society of Bariatric and Metabolic Surgeons dated May 26, 2009. The authors are Drs Brethaur and Schaur and Jeffrey Hammel M.S. of the Bariatric and Metabolic Institute of the Cleveland Clinic, Cleveland, Ohio. Thirty-six studies involving 2570 patients who had the VSG procedure were analyzed. Their conclusion was: “From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reductions that exceeds , or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been acceptably low. Long-term data are limited but the 3- and 5- year follow up data have demonstrated the durability of the SG procedure. “ To date ten thousand patients have had the VSG surgery with good success. Many are going to Mexico or other foreign countries because their insurers refuse to pay for the VSG even though it is less expensive than the RNY procedure, the so called “gold standard” of weight loss surgery which takes several hours and requires a hospital stay of 3 or 4 days. The VSG can be completed in one hour by a skilled surgeon and most patients stay only one night in the hospital. While there is certainly follow up care, the repeated fill and unfill procedures required by gastric banding are unneeded for the VSG. Nutritional supplements are much less of a problem than with the RNY. Many insurance companies are recognizing the value and cost effectiveness of the VSG and have approved the VSG for at least some patients, including BSBC Federal, Tri-west Tri-care Prime, United Healthcare, the Veterans Administration, Aetna, Blue Care Network HMO, Healthnet, Anthem BC of Connecticut, Definity Health/United Healthcare, PPO, Empire Blue Cross Anthem, and UHC. The VSG sleeve gastrectomy is now routinely offered by Kaiser Permanente to all patients that qualify for Weight Loss Surgery and would not do so if this surgery was not proven to work. I don’t think it is fair that if you have five people, one with Kaiser, one with United, one with Aetna, one with Cigna and me with Anthem Blue Cross of California, the other four will be offered the sleeve and I will not. The California Department of Insurance has recognized that VSG is widely accepted by the American Society for Metabolic and Bariatric Surgery as a standard procedure at medical centers for excellence. In Decision #EI09-9645 the physician reviewers reversed the health plan’s denial of the patient’s VSG request and concluded that VSG was the most appropriate option for the patient. The same conclusion was also reached in EI06-5882 though the patient had significantly more co-morbidities. That decision noted the important fact that the VSG is nothing more than the first part of the duodenal switch operation which includes the second step of intestinal modification and as such, the VSG portion has been performed for many years as part of the DS procedure. Some patients have the VSG first as part of a two stage procedure and find that they do not need the second stage. Thus, the VSG is not as new and investigational as Anthem’s conclusions seem to imply. Anthem does cover the DS procedure which includes the VSG as one part. According to an article published in the Detroit Free Press on August 17, 2009, Blue Cross Blue Shield of Michigan, in conjunction with the University of Michigan, has been compiling a large detailed data base on bariatric surgery in order to improve surgical outcomes and provide cost savings. In three years of data collection, it appears that the VSG now accounts for as much as 12% of all bariatric procedures. This percentage indicates that the procedure is far beyond investigational status. This data base indicates that 10,000 VSG procedures are known to have been performed. My Anthem group policy excludes investigational procedures and defines that term as procedures: “ 1) that have progressed to limited use on humans, but which are not generally accepted as proven and effective procedures within the organized medical community; or 2) that do not have final approval from the appropriate governmental regulatory body; or 3) that are not supported by scientific evidence which permits conclusions concerning the effect of the service, drug or device on health outcomes; or 4) that do not improve the health outcome of the patient treated; or 5) that are not as beneficial as any established alternative; or 6) whose results outside the investigational setting cannot be demonstrated or duplicated; or 7) that are not generally approved or used by Physicians in the medical community. It appears that the VSG, based upon the articles cited above, has been performed on thousands of patients, has been accepted by a consensus of participating members of an international conference devoted to this subject, is widely accepted by the ASMBS, does not require FDA or similar government approval, is in fact supported by at least 36 studies analyzed by highly respected physicians, is as effective as the RNY and more effective than gastric banding in terms of percentage of excess weight loss, has fewer complications than the RNY, has as good or better reduction of co morbidities as other procedures, and has results that are similar in studies by both United States and foreign physicians. The VSG therefore no longer falls within the definition of investigational procedures excluded from coverage. The conclusions stated in the previously cited Anthem Policy on Surgery for Clinically Severe Obesity are simply no longer correct and that policy should be updated to include VSG coverage or disregarded. With the VSG patients lose about 68% of excess weight and lower BMI patients like me often do much better. Weight loss will most certainly help my back and hip pain and improve ability to exercise. High triglycerides, high blood pressure, and borderline diabetes are corrected in about 76 percent of WLS cases and I am hoping for this result. It is therefore highly likely that my health will be improved by this procedure and I respectfully ask for your reversal of this denial. I am a mother and soon to be a Grandmother and I want to improve the quality of my life so that I will be healthier and able to help raise my grandchildren and be able to take an active role in their life.Thank you for your review of this matter. I greatly appreciate the fact that the state of California has a procedure to help insured patients who find themselves in disagreement with their insurance companies. I strongly believe this decision will greatly affect the quality of the rest of my life. Thank you for your time. I eagerly await your decision regarding this. I can be reached as indicated below if further information is needed. Enclosed is a copy of my denial letter from Anthem Blue Cross My HMO is Healthcare Partners Primary Care Provider is xxxxxxxxxxxxx Gastric Surgeon xxxxxxxxxxxxx Sports Medicine xxxxxxxxxxxx who ordered MRI and diagnosed arthritis Cardiologist xxxxxxxxxxxxx did my last EKG and stress test All these doctors agree Weight Loss Surgery is a good option for me. Respectfully yours, Jeani Anderson xxxxxxxxxxxxxxx xxxxxxxxxxxxxxx (xxx) xxx-xxxx Work info: xxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxx xxxxxxxxxxx CA 91101 (xxx)xxx-xxxx ext. 244

Good evening bandsters, Just wondering who here has had band related complications and did your insurance cover it? whether you were covered for the procedure or not. Thanks!

Hi! I am doing well, starting to feel like my old self. Just really tired, not sleepy, but just fatigued. Like yesterday I did some minor cleaning and I felt exhausted lol. I am think doctors prefer sleeve because of less complications? I am not sure. But yea, so far I am happy with my revision. I will know the real deal once I start eating food again

My sister had a Bypass, I got a band many years later. She had severe complications which resulted in about 5 surgeries to try to fix and almost died because of the complications. She is thankful she did have the surgery, however they do repipe your insides which if you eat things with too much sugar or something that doesn't agree with you then it can cause "Dumping"syndrome which is a massive case of diarrhea and it just comes out, or at least it did in her case. She also is not supposed to eat various foods, corn, sodas, and some other things too. It alters the absorption of both foods and medications, now when she has to be medicated it takes a Horse's dose for her to feel anything. Having the band, alot of people can eat whatever they want but you are restricted on the amounts. There are some that cannot eat certain foods, but for every one person who cannot eat something the other 10 seem to be able to. It also does not alter the absorption of medication or nutrients in your food. There is no repiping of your insides, it is just restricted which can be reversed if needed. She also after a huge depression issues overdosed on a medication intentionally. With the bypass they are unable to pump your stomach in this situation. The Gin she washed down the pills with is what saved her life because that somehow kicked her liver into overdrive to help her body burn through the medication. However she was OUT for several days. I will add that this was after the death of our Dad, her fiance cheating on her and dumping her in the hospital on two occasions (what a winner huh) and being told she would never be able to have children because she couldn't have babies. I will also note that she has son that will turn 5 in October!! With a band they can remove the Fluid in order to get to the stomach in case they need to pump the stomach.. however.. hopefully NObody needs this info.

Lol- yup, MFP always said I was near death with my low calories, low carb and low fat diet so stopped using MFP after that. Besides I am not really a tracker. I like to keep post op things ultra simple as life is complicated as is. Stopped tracking after month 1 and never looked back. All turned out fine in the end.