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Blue Cross Blue Shield Federal - Basic (Texas) (lap band to rny or sleeve)
band2RNY posted a topic in Insurance & Financing
Ok. I wonder if anyone has had this experience with FEPB. I'm having lap band revision to sleeve or RNY. I call the insurance company on Wednesday of last week and the guy said I was approved. All excited... didn't rush into anything until the next day. I get a call from my doctors office Friday saying that they need more documentation ( 3 month diet plan, psych eval, etc.) I never had to have all this when I had my lap band in 2010 so I was fuming because I already purchased airline tickets for family members to come down to Texas for surgery. I called the insurance and they sent out two letters. One that is approving the procedure for lap band removal. The 2nd letter is coded for the sleeve/rny and it says before they can look at it need the 3 month diet, etc. So, I call... and I told the lady what happened and she had referred it to the person that sent the letters out to look at it. She called me back and I explained to her basically you are approving one surgery and you are pretty much going to force me into doing two surgeries. She was so persistent on the documentation telling me over and over they need that. I asked her do you even look at the cost of two surgeries and does that justify me not having to do the 3 month, diet. etc. She said they do but that they still need the documentation????? Has anyone gotten through this problem without having to jump through hoops? -
Insurance Approval
Pinkgirl1234 replied to Titaniumsleeved2014's topic in Gastric Bypass Surgery Forums
Every time I get a flare up I am running to the doctor....oh yeah...they will see that getting a revision is cheaper for them in the long run. -
Finally! My surgeon talked with the dietician!
divaliciousdee posted a topic in LAP-BAND Surgery Forums
My surgeon talked with my dietician and she totally revised my eating plan. He said that the diet is per Doctors orders and the nutritionist's job is to make sure calories and nutrients aren't being sacrificed. Well with that said I told him about not being able to have yogurt or cream soup stuff or sf pudding etc. He had her change the diet. I can have thin deli slices, yogurt, sf pudding lowfat cheese slices, eggs(soft scrambled or poached). My surgeon said that the liquid phase was okay for a week and full liquids does include cream soups thinned etc. Kathy I can have egg drop soup with the egg but to got slowly! I feel so much better now. he also said I ws doing very good and the weight loss is great but not typical so don't get discouraged if it slows down after the next 4 weeks. He said that all the surgeons who perform this procedure have different diet plans. Unfortunately my dietician had RNY in mind for me and that is the diet plan I was on. I guess she got confused since the majority of the patients are RNY. I had a slice of lowfat cheese..yum and 3oz of fat free turkey and ham... and I was full WHoo Hoo! I am on my way. -
Hi, everyone just wondering if there's any revision sleeve to bypass patient of there that have United Healthcare. If so was it extremely hard to get approved for the revision surgery and did it take a long time for the approval. Also I'm only 14 months out from being sleeved and just wondering if I would have to go through the entire process again. I'm having extreme complications with gerd not to mention I've only lost about 30-40lbs with the sleeve. My BMI is still over 40 and my health issues have become more complicated. My diabetes is worse than ever, my blood pressure is staying up and the GERD has me in pain and vomiting a lot. Any advice anyone??
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I thought $5,000 was alot of $! Medicare usually pays for most of the revision for me, but I cancelled my Part B a couple yrs ago (I never once used it) and thats what covers my drs charges. The insurance coordinator estimated $5,000. My PA assurred me on the way out (in tears) that he would do whatever it took (even charge 50%) to make sure I got my revision. Now the insurance coordinator said that he never got that approved and it's still $5,000. Came up with $2500 but not the $5,000. That will be impossible. Almost impossible to come up with 50%. Good luck with ur surgery!
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Need Lap Band Buddy / Mentor Another looking for a friend!
bobbiezhere replied to bobbiezhere's topic in LAP-BAND Surgery Forums
Wow Mymiserys - that is an awesome loss! How do you feel? Did you find the weight just fell of you quickly??? Amazing that your almost at goal! Will you be happy losing those last few pounds? Or will you revise your goal??? -
I had gastric bypass in 2013. It was a revision from lapband to bypass. Everything has been great as far as weight loss. I am pretty much at goal and have been for over 6 months now. But I have had issues that I question whether they are from the bypass. I never had these things before bypass. I have "low blood sugar" attacks. I call them that, and my doc's office agreed it sounds like classic low blood sugar. But what happens is, first my thinking feels a little strange, weak...then my body is weak, I feel very dizzy, I sweat - immediately am wet head to toe, have to lay down. I was told to eat Protein every 2 hours, and sometimes I do forget to eat that often...but it has happened even when I had eaten about an hour before. I eat 2 string cheese pieces and wait for this to pass. It is really scary. It has happened twice as I was driving my car. Next issue is that I have developed severe GERD. Never had it before, even with the lapband. I am on Omeprazole now. I have had bad gas lately too. I can feel it in my stomach and all thru my guts. The worst thing that happened to me, and there is no research linking this with bypass, I developed an auto immune disease 4 months after surgery. It is Alopecia Universalis. It means that your immune system attacks your hair follicles all over the body and your hair falls out all over the whole body. I am 61 years old. It is very rare for this disease to start this age. It is a genetic plus environmental trigger type of disease. But I have been reading and 80% of our immune system in in our gut. And there are people who have found "cure" for alopecia by diet change. That isn't scientific, but I really wonder...I had allergies and had a weak immune system before bypass and I really think that the bypass pushed it past the point where the alopecia could come into activity. There is no cure but there are treatments and I have shots all over my scalp every month of steroids, which fight the immune response. I now have eyelashes and eyebrows back and some head hair, although I can't go out without a wig or hat. That makes me wonder if I regret the bypass. I can't say I do. All my life my weight and my addiction to sugar have been a huge problem. As I got older it was harder to manage my weight and I am so happy to be back to my young adult weight again! Also, I do get dumping syndrome so I don't eat sweets at all. It has really helped me. Tracy
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Let me ask you a question- I called Cigna and they confirmed that revision coverage is different than starting from scratch and showed the 4 bullet points. I qualify for all but 1 - the one about the band causing the medical problem. The surgeons office said that because of that- I need to see the nutritionist, psyc etc... So that it will be easier to get approved in 3 months vs no wait with the revision. I'm worried that after all that hardwork- what else do I need to do
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Just thought I would post these really delicious Protein bars and if anyone else has favourites they recommend please tell us them. I use Protein Bars as a Meal Replacement several times a week if I am on the run or somewhere there is no good food choices to pick from. I only like them if they are really tasty and it satisfies my chocolate craving because they are solid they also keep me feeling full for a long time. My favourite so far is an energy bar called "six star body fuel" that has 15 g of protein. I love the double chocolate chip flavoured one that has a real brownie cake taste. It tastes best when you unwrap it and microwave on high for 10 seconds. It costs about $1.67 at the Real Superstores and at 45 grams it has only 170 calories. My next fave Protein Bar is "PowerBar triple threat", the Chocolate Caramel fusion flavour. It has 225 calories and 10 g of protein and is 53 grams. It sells for about $1.99 each at the Real Superstore. Donna VBG/87 Revised By Dr. Cobourn to Lapband/06 251/164/125 goal
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Anyone had surgery greater than 5 years ago?
catwoman7 replied to sdtoin's topic in Gastric Bypass Surgery Forums
I don't think I've ever heard of a bypass to sleeve revision. I do hear of the other way around (sleeve to bypass), but that's usually because of problems with GERD. And yes - I've heard of bypass to DS, but like the poster above said, it's a very complicated surgery that very few surgeons are trained/qualified to do. -
If you are getting 50 ounces in at 3 days post op you are doing well. You are going through a healing process so you can't expect to get in so quickly. After my sleeve 2 years ago it took me 3 to 4 weeks to get that much Fluid in. You'll get to the goal amounts don't rush yourself. I am having a revision to RNY in August so I'm dreading having to do it all again.
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Considering a revision - read this!
bearhugs1975 replied to AnneElliot's topic in Revision Weight Loss Surgery Forums (NEW!)
I have tried to keep upbeat during my journey even though it has been through it all. Band 2009 revised to sleeve 2014 and revising to bypass in April. One thing that I do know, is if I hadn't been through this journey, I would still be diabetic. I take the good with the bad and being diabetic for me was the really really bad. My family has had both my maternal great grandmother and grandmother losing legs to diabetes, my mother is diabetic and when I was diagnosed in my 30s I wasn't having any of that. Yes I have had so many complications, but I also have my life and I am thankful for that. I am concerned that someone on this page is so adamant on not getting revised that they are trying to scare people into making decisions that are only their own to make, not their families, not truly their spouses, this decision is truly only between that person and their doctor. My spouse is supportive, my mother is not. I don't really care. I have not been diabetic since 2009 and that was my main goal! -
Considering a revision - read this!
AnneElliot posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Pasta, red meat, or rice. Some ppl can and others cant. There's no guarantees which one you will fall into. I will lose weight. But I won't be able to eat like a normal person ever again even in moderation. 2) Acid reflux is a serious issue with the sleeve. I never ever had an issue with the band. I am dealing with rather bad GERD even though I am taking prescription meds. I have chatted with folks that it got so bad over the yrs that they had to revise to gastric bypass. 3) Vitamins! You can't live without them. Daily intake or I will develop issues. Are committed to do that? 4) NSAIDS! Even if your surgeon tells you that you can take them. There's significant debate on whether sleeved folks should take them or not. These meds are very hard on a normal stomach let alone a thin sleeve! Continous use will most likely lead ulcers which are very dangerous with little or no stomach left.Think about aging and the lack of NSAIDS. 5) You can still get stuck! I just had to vomit food yesterday. You still experience that nasty slime....eww! I cried the first time it happened cause I lived with that for 8 yrs. Please feel free to message me. Think about life beyond weight loss cause there's no turning back with the sleeve -
Considering a revision - read this!
bearhugs1975 replied to AnneElliot's topic in Revision Weight Loss Surgery Forums (NEW!)
I have tried to keep upbeat during my journey even though it has been through it all. Band 2009 revised to sleeve 2014 and revising to bypass in April. One thing that I do know, is if I hadn't been through this journey, I would still be diabetic. I take the good with the bad and being diabetic for me was the really really bad. My family has had both my maternal great grandmother and grandmother losing legs to diabetes, my mother is diabetic and when I was diagnosed in my 30s I wasn't having any of that. Yes I have had so many complications, but I also have my life and I am thankful for that. I am concerned that someone on this page is so adamant on not getting revised that they are trying to scare people into making decisions that are only their own to make, not their families, not truly their spouses, this decision is truly only between that person and their doctor. My spouse is supportive, my mother is not. I don't really care. I have not been diabetic since 2009 and that was my main goal! -
Considering a revision - read this!
AnneElliot replied to AnneElliot's topic in Revision Weight Loss Surgery Forums (NEW!)
@bearhugs1975......so you had a journey filled with complications post op from your initial revision and yet you recommend the revisions! Lool. So you're a triple threat in the world of WLS! Please be honest, your complications are due to your revision! These ppl are asking questions to seek advice and not hear meaningless platitudes. They want to avoid our mistakes! There's no shame in admitting your revision from the band to the sleeve led to so many complications you needed to be revised to the bypass. That the revision may have staved of diabetes but led to more surgeries and other issues -
Considering a revision - read this!
ColleenErin1974 replied to AnneElliot's topic in Revision Weight Loss Surgery Forums (NEW!)
There is honesty with positive support and then there is bullying. Being supportive and honest does not require negative attitudes. I'm sorry your surgery didn't go well,but don't push your opinions and negative feedback on people who need to hear about the good their surgery can do for them. There is always pros and cons to getting WLS. You don't need to try sabotaging others hopes. We all know the risks surgery has and we sign consent to have it done. Complications suck, but we deal with them as they come. Statisticly, more WLS goes off without a hitch than having complications happen. I hope you have a successful revision this time around. -
hope you are having luck on your hunt to find someone to cover the revision. Have you called http://www.legacyhealth.org/weight ? I am going through them. There staff is very nice and helpful. Give them a call. talk to their insurance guru. She may have a few insurance companies that cover those costs. If not, look into a self-pay outside the US?.?.?.
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I have the same insurance. They didn't require a 6 months waiting period. I was approved very quickly for both the Lap Band surgery, and the revision to the sleeve 12 month later (I got approved for revision t 192 lbs). The only things required were a nutritionist consultant, a chest x-ray, and phsyc consult, and blood work. Both times I had my surgery date 4 to 5 weeks after submission. Oh and I also had to write a letter about my dieting history, medical history, and family weight and medical history. Best of luck!
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Hi Guys, My first post on the forums, so please let me know if I'm posting in the wrong place! I'm tentitively booked for Lap Band surgery on Nov 4 with Smartshape in Vancouver, Canada. I've done a lot of research myself, but have found the company to be somewhat pushy for the sale and less eager to supply information about the process, what they provide etc. I know they provide 5 years post op covrage, but so have have had no luck in getting them to provide to me in writing exactly what this entails, under what circumstances and stipulations etc. I' be really grateful to hear about other experiences with SmartShape, particularly their aftercare support and services and if anyone has ever had any issues with them. I'd also love to hear from anyone else in the Vancouver area who has had the surgery! My only other reservation is that alot of people seem to get the band revised to a sleeve. The band has been "sold" to me as something you can have for the rest of your life, so if you've had a band for many years, I'd lovee to hear your experiences too. Thank you all for your help!
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Another newbie with many, many questions!
WASaBubbleButt replied to ash's topic in Tell Your Weight Loss Surgery Story
I would not get a band. Had one and revised to a sleeve. Bands are very hard, everything under the sun affects restriction, complications are very high, and in three years of posting on message boards I have never met anyone banded for 10 years or more. I don't think many keep them for 10 years. We hear about these people but I have yet to meet one even on message boards. Sleeves are easier, far easier than banding. Complications are low, weight loss is better and faster, people are happier with sleeves than they are bands. BTW, welcome to the forum! -
I am scheduled for a sleeve revision from the band December 16th. Yay! My question is, will it be easier for me to start an exercise plan before my surgery or will it not matter because I cant exercise for a while after anyways.....yes I know all exercise is healthy, but what can you still even do post op....and when? Sent from my SM-J700P using the BariatricPal App
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Another newbie with many, many questions!
Elisabethsew replied to ash's topic in Tell Your Weight Loss Surgery Story
Welcome! I too had a band and was miserable with it. After 3 years and 1 day, I revised to a sleeve and got the band out. Although I followed all the rules, the band never worked for me and the acid reflux was horrible. With a sleeve, it works right away. You have no appointments to fill it and then unfill it, etc. There is no foreign device inside you squeezing your upper stomach and the weight loss is proven to be faster and in a higher percentage than with the band. Some MDs say 6 months and some use a year as a guideline for getting pregnant so ask your OB/GYN. As for recovery, the sleeve was a much easier recovery than the band was. I went back to work as an RN and did two 13 hours shifts one week post-op. -
Sleeve to Bypass
Bryn910 replied to nomorefattypatty's topic in POST-Operation Weight Loss Surgery Q&A
Everyone is different. Not all foods that bother one will bother another. I had the revision 7 months ago and I am able to tolerate every food I have tried under the sun. Dairy bothers me sometimes but only straight milk. The revision for me was fine, no complications. I lost weight at a faster rate but now I have stalled for quite some weeks. But I am also working out more and weight lifting. -
What Do You Say To Coworkers About Gastric Sleeve Surgery?
redmtn posted a topic in Gastric Sleeve Surgery Forums
Finally am going to get my revision which I am really excited about but not quite sure what to say at work. I feel so shameful, I know I shouldn't, but do I tell the truth or make up something?? It will be over 2 week Christmas break but I will be gone a few days before and then more? I think it might have something to do with how I failed to lose weight with the band......so what if this also fails or something happens. Thanks! -
Conversion from lapband to sleeve - lower BMI
JRT Mom replied to Stella84's topic in LAP-BAND Surgery Forums
I think it is ridiculous that if you need to have a revision to a bariatric procedure from a failed initial one that you have to wait to regain all your weight before you can get another! If you met the criteria for the first procedure and had surgery and now need another the insurance company should be satified that the patient is still a candidate. Most of us had our first surgery because of health considerations and to expect us to regain all that weight to have the revision surgery is unhealthy and a waste (waist!) of time. I have to have a lap band removed and fortunately (or unfortunately) I have already regained enough weight and have two new comorbidities so I don't have to gain even more to get my revision.
