I don't even know what to think...

[madrisere 0]

I had my band put in back in 2005, so I've had it for quite awhile...I've never lost and significant amount of weight. 20 lbs maybe? I got pregnant in 2010 and started having pain in my port area around 12 weeks...I got pretty bad towards the end of my pregnancy I felt like the port area was RIPPING from my body. Everytime I sat down, stood up, rolled over or got in/out of bed it would I would get that ripping feeling. Awful. After I had my son, my Bariatric Dr had me get an upper GI and some other test I don't recall the name of (they did have to put me under for it)....the results of the rest? Everything is fine. Well my port area still hurt...it felt like it had moved or tilted.

Fast forward 2 years later....I'm STILL having port pain. Except NOW under my scar where the port is, it started turning purple and you can see 2 areas (almost like staples or stitches) are pulling inwards.

My Dr saw it and said it looked like an infection and thinks my band is eroding.

I'm schedule for removal on Tuesday.

His office called to tell me the time and update me on insurance approvals. I've been approved for the removal and then she said "your insurance doesn't cover gastric bypass so I'm not sure if we can get that one to push through like the Dr wanted" WHAT?! My Dr never even mentioned ANYTHING about a GB! I told him when I was there I didn't want anything else!

I don't know if he's getting approval incase there's a problem where I'd HAVE to get it? I'm kinda confused.

I don't want a bypass.

I'm really just nervous about this whole thing. I'm happy to FINALLY get this stupid band out of me. It's been nothing but pain since my pregnancy...it's never really helped me and I need it GONE.

I'm worried the recovery will be hard...I have a 2 year old and it takes a lot to keep up with him.. My parents will be staying over for 2-3 days and I can only hope/pray that's enough for me to keep up with him.

Does anyone have any info as to WHY my Dr would be requesting approval for a Gastric Bypass without discussing it with me first? Shouldn't that be something I request?

[DELETE THIS ACCOUNT! 12,703]

Take control of the situation and tell him NO. Period.

It's your body and 100% under your control. Simply tell him you don't want it.

[carol285 145]

Why haven't you asked your doctor this question & I mean ASAP?!?!

[sp70 193]

He can not do anything without your consent. Before you sign the surgery consent form, make sure you read everything that is written on it. Not sure why he would seek approval for something that hadn't been discussed. I would clarify to put your mind at ease. Best Wishes!

[madrisere 0]

I just want to cry at this point. I'm sitting at the hospital waiting to get an endoscopy. Got a call from my Drs office that my insurance company denied removal....even after he thinks there's an infection and eroding. I have to get this thing out....I just have to. I never imagined I'd have to pay out of pocket for this.

[HotButterFly 981]

A synonym for *insurance company* is *DIRT BAGS*.... How can they deny removal?!! Keep trying, I'm sure they'll come through!

[lisacaron 5,075]

I suspect that the reason they are now denying removal is because your doctor is trying to put it through as a revision type of surgery!

Call your insurance company yourself! Tell them what is going on, that the band is eroding and perhaps causing infection as well.

If you need to get another doctor to corroborate this information, Speak to the ER doctor or your PCP, and maybe even find another bariatric doctor that will do what YOU want and not what he wants to make more money!

You can speak with your insurance company and find out what their side of the story is directly and then decide where to go from there.

Best of luck to you!

[Lady VS 1,147]

I'm so sorry you are going through this. I would try and appeal. Maybe your doc can write them a letter stating that its medically necessary for it to come out. Good luck and best wishes.

[madrisere 0]

We are def. going to appeal...although I'm feeling pretty discouraged with everything right now. My Husband and my Drs office have been on the phone with the insurance company for most of the day. My Drs office has escalated it up, telling them this can turn into a life threatening issue if it isn't taken out. The endoscopy showed my band has definitely slipped. The insurance company doesn't care...they said even if I went into the ER, I'd have to pay out of pocket. My Dr has said he will be speaking with the board of the insurance company regarding this whole thing (they called it peer to peer), I'm really not sure if anything will happen with that. I want to keep hope that everything will work out...I certainly can't afford to pay out of pocket for everything (seriously...insurance is a freaking joke!).

[Lady VS 1,147]

Wow!! That is so crazy. I sure hope it all works out for you.

[stacielynntate 88]

Wow this is just crazy. Any update? I sure hope the insurance company comes around.

[madrisere 0]

Not much to update on unfortunately my dr did the peer to peer review...they still said no. My Drs office called me Friday and said "we've done all we can to help you at this point. If you want the surgery, I can call back and give you the estimated cost next week" and that was it. Still haven't heard back from them about the cost. My DH has been speaking with the people at work who select insurance plans for next year to see if anything will be covered.....if I can hold out until Jan. it'll be my best bet. Aside from maybe contacting a lawyer :/

[HotButterFly 981]

Where do you live???

[madrisere 0]

I'm in Florida

[madrisere 0]

.