UPDATE: I'm going to have LapBand surgery instead

[Dave_NW 92]

Hi all. Just wanted to provide a bit of an update on my situation.

For those who may not have been following my posts, I was working toward having sleeve surgery, which I thought was to have happened within the next few weeks. My Internet research misled me, and my insurance company agent specifically misinformed me, and I didn't know until last week that my insurance carrier will not pay for sleeve surgery at the civilian hospital they referred me to. For reasons I still don't understand, they WILL pay for it if I have surgery at a military treatment facility. This logic escapes me, since the civilian hospital is a center of excellence, highly rated, and considered the best in the area for weight loss surgeries. But it's a non-issue, since my insurance won't pay. No room for discussion.

At the urging of some great folks on this forum, I've been looking into getting things referred to the only military treatment facility in my state. I finally got through to someone at that facility's surgery center today, and had a frank discussion with them about my situation. I was told that if I jumped through all the hoops to make the various appointments they require to evaluate me, if I were to get my medical history transferred to them, and if they approved of the things I've done with my current surgery center, and didn't make me repeat anything I've been through, then yes, it would be possible to have surgery there -- in nine months to a year. He said if they decided not to accept what I've done, and make me do everything over again, it would be well over a year before I could expect to have surgery. Apparently, as a retiree, I am near the bottom of the priority list for surgery.

Needless to say, I'm frustrated, angry, and extremely disappointed. I don't want to wait that long. I've given it a lot of thought, and have decided to go ahead and have lap band surgery, which I can have done by my civilian surgery center within the next several weeks. I realize a lot of people on this forum have terrible things to say about the band, but I've read on other forums about many more who have had good success with it. I'm going to give it a shot. If it turns out to be the wrong choice for me, then I'll have it revised to the sleeve. Hopefully, at that time, my insurance carrier will pay for it. If not, I'll make that trip to Mexico and pay for it myself.

I wish everyone here the best of luck with things, and I look forward to reading of your weight loss success. Even though I won't be one of you, I'll be rooting from the sidelines for you. Thanks for all the great support you've given me in the last few months. You are a great bunch of folks.

Dave

[ladyrider 1]

Sorry your insurance company let you down. But it sounds like you have researched all the facts and made an intelligent decision. I wish you the best! Please keep us posted on your journey.

[Tiffykins 673]

Dave, I really don't understand why whoever you spoke with at Madigan told you all of that because I know that hasn't been the case with other sleeve patients there.

You know my experience, opinion on the band, and while I do wish you the very best, I would urge you to really look at the stats on the band. Revisions are not fun, they are more expensive than regular sleeves, and most importantly, it's not the surgery you really want. I do understand that you really have to do what is right for your life. But think long term, not the "right now".

The band is a good tool for some, but the stats do not lie. Please talk to a couple of the ladies and other members that have shared their experience with Madigan before you go with the band. You know how people can be at an MTF, and I know you want surgery now. My concern is that you want the sleeve, but you're settling on the band.

Check out the complications forum on lapbandtalk.com and obesityhelp.com really look at the band to sleeve revision forum here. Think twice, cut once. I do not regret my band decision because the sleeve was not an option for me from the beginning with Tricare. BUT, if I could have avoided the pain and suffering that I endured with my band, I surely would have chosen to do without all that drama in my life.

[val 7]

Hi all. Just wanted to provide a bit of an update on my situation.

For those who may not have been following my posts, I was working toward having sleeve surgery, which I thought was to have happened within the next few weeks. My Internet research misled me, and my insurance company agent specifically misinformed me, and I didn't know until last week that my insurance carrier will not pay for sleeve surgery at the civilian hospital they referred me to. For reasons I still don't understand, they WILL pay for it if I have surgery at a military treatment facility. This logic escapes me, since the civilian hospital is a center of excellence, highly rated, and considered the best in the area for weight loss surgeries. But it's a non-issue, since my insurance won't pay. No room for discussion.

At the urging of some great folks on this forum, I've been looking into getting things referred to the only military treatment facility in my state. I finally got through to someone at that facility's surgery center today, and had a frank discussion with them about my situation. I was told that if I jumped through all the hoops to make the various appointments they require to evaluate me, if I were to get my medical history transferred to them, and if they approved of the things I've done with my current surgery center, and didn't make me repeat anything I've been through, then yes, it would be possible to have surgery there -- in nine months to a year. He said if they decided not to accept what I've done, and make me do everything over again, it would be well over a year before I could expect to have surgery. Apparently, as a retiree, I am near the bottom of the priority list for surgery.

Needless to say, I'm frustrated, angry, and extremely disappointed. I don't want to wait that long. I've given it a lot of thought, and have decided to go ahead and have lap band surgery, which I can have done by my civilian surgery center within the next several weeks. I realize a lot of people on this forum have terrible things to say about the band, but I've read on other forums about many more who have had good success with it. I'm going to give it a shot. If it turns out to be the wrong choice for me, then I'll have it revised to the sleeve. Hopefully, at that time, my insurance carrier will pay for it. If not, I'll make that trip to Mexico and pay for it myself.

I wish everyone here the best of luck with things, and I look forward to reading of your weight loss success. Even though I won't be one of you, I'll be rooting from the sidelines for you. Thanks for all the great support you've given me in the last few months. You are a great bunch of folks.

Dave

[chilo1 62]

Dave I wish you the best of luck, and we will always be here for you!

[thinoneday 445]

dave, best of luck with the band. . I have the same feelings as Tiffy does regarding the band. . . however the decision has been made in your mind. . .did you ever maybe think about self pay? It's not any different then paying for a car monthly. . .I only pay 300 per month. . I got a great rate at my bank 3% and that was the route i took. . . you may want to consider that as well. . in any way, good luck !

[feedyoureye 3,087]

Theres alway Mexico first....

Good luck with whatever choice you make.

[LilMissDiva Irene 3,282]

Wow... Well all the best.

I would first urge you to consider doing some serious research on the band. How far out from surgery are these people who have been "successful" with their lap-bands and made it actual goal? Not just 50-60 Lbs or halfway there...

How many actual bandsters can you find that are more than say 5-8 years out and still "loving their band"? That's not really that long considering you will want to have your surgery forever, correct? Why would you go into a surgery with the thought that you might someday need to revise? I beg you to find at least a dozen, and speak with all of them directly too - not just them posting. Ask them the hard questions!

May I also remind you that a revision is much more complicated than just having the sleeve on a virgin stomach. You go through a lot more and your risk for complications are much greater.

I got a 10'000 loan from my bank and my payments are about 225.00 per month. Best loan I've ever gotten and let me tell you - I love my car!!!! A car is disposable though... I know it won't last forever. This time I wanted something permanent.

Regardless I will support anyone's decision, however knowing the lap band is not your ultimate first choice, I have to voice my true opinion.

Good luck!

[clk 3,519]

Dave, best of luck regardless of what you decide.

That said, I agree with the others and think that you should really be certain you're willing to take a lesser option simply because it's easier to do.

I also have Tricare, and being overseas meant that having it done at a MTF isn't an option. Tricare doesn't cover VSG and no MTFs in my area are doing the sleeve. I almost started the process to get the band instead, because I wanted surgery right away. Somehow, being fat for more than half my life became intolerable once I decided on the surgery.

After revisiting LBT for a few months the trend stood out a second time: people love their bands for six months to a year, and then the complications begin. Only a handful of the folks on that board are two or more years out and still happy. There are way too many complications. Too many people can't find their sweet spot, can't keep Water down, have to unfill completely because of issues. That's not even counting the ones with slippage and erosion - the folks that usually find their way to this board and get revisions to the sleeve!

I did an unsecured loan through USAA for a good interest rate. I went to Dr. Aceves in Mexicali and had wonderful, top notch care.

If I were you, I'd make sure that you're willing to face the very real issues of life with a lapband before you make the decision to put one in your body. I'd either start the process with Madigan and see if they're wrong about the time frame, or I'd self pay and get it done either in the states or Mexico.

My sleeve was worth every single penny of the small payment I make to USAA each month, I promise you.

Best of luck to you. You know what you're willing to live with, so only you can make this choice.

~Cheri

[thickinphilly 1]

Dave

i can only imagine what you are going through all this that we do to get to a surgery date and then to be let down. i'm really sorry you have to settle for the band just because your insurance will not cover the sleeve. i haven't had my surgery yet but if for whatever reason Aetna decides they will not cover it i don't know what i would do. Best of luck with the band if you go through with it.

[peatie 4]

I'm sorry you were misled. I can only sympathize with the frustration you're feeling at the moment..."let's get this show on the road and lose some weight."

Don't be penny-wise and pound-foolish.

If $ were not an option and your insurance said you could get WHATEVER surgery you wanted, which would it be?? If it's still the sleeve, I'd reconsider a loan and getting it done in Mx.

Anytime you go into a situation with "well, i can always do ____ if this doesn't work out.." then it's really not the right choice.

LB sounds more like a right now choice to me, but not the RIGHT choice.

I don't want to make you feel bad for choosing the LB, but before you completely commit to it, please exhaust all options of the sleeve.

I'm with Aetna, and if they decide not to cover me, but will for RNY or LB, then I'm self-paying in Mx. The other choices are just not options for ME.

[feedyoureye 3,087]

You have to make up your own mind, but I have to say I think that people here are giving some very sound advice. Patients is a virtue.

[M2G 1,836]

I know this was not an easy decision for you, and I'm sure I would be incredibly frustrated with the mis-information from your insurance. I have been trying to place myself in your shoes and 'what would I do' type thinking.

Originally I wanted the band, because my initial research on the sleeve called it mostly part of a two-step surgery and I did not want 2 surgeries, so I focused on the band instead. It wasn't until my husband begged me to do more research that I found this site, OH, etc. After switching surgeries, I don't think that I could go back to the idea of the band. At my very first NUT appointment back in May, the first thing I said to her was "I cannot imagine myself at 90 years old with this device inside of me" and she sort of shrugged and said "hopefully you will have mastered some better habits by then", but the truth is that I just don't view the band as long term.

With the sleeve, I like the idea that I need to learn to live within the limits that the sleeve provides.

I know this isn't easy for you, and I wish you the best luck in whatever you have to do for you. If you do get the band, don't forget to stay in touch over here!

[vicki s 146]

Hi all. Just wanted to provide a bit of an update on my situation.

For those who may not have been following my posts, I was working toward having sleeve surgery, which I thought was to have happened within the next few weeks. My Internet research misled me, and my insurance company agent specifically misinformed me, and I didn't know until last week that my insurance carrier will not pay for sleeve surgery at the civilian hospital they referred me to. For reasons I still don't understand, they WILL pay for it if I have surgery at a military treatment facility. This logic escapes me, since the civilian hospital is a center of excellence, highly rated, and considered the best in the area for weight loss surgeries. But it's a non-issue, since my insurance won't pay. No room for discussion.

At the urging of some great folks on this forum, I've been looking into getting things referred to the only military treatment facility in my state. I finally got through to someone at that facility's surgery center today, and had a frank discussion with them about my situation. I was told that if I jumped through all the hoops to make the various appointments they require to evaluate me, if I were to get my medical history transferred to them, and if they approved of the things I've done with my current surgery center, and didn't make me repeat anything I've been through, then yes, it would be possible to have surgery there -- in nine months to a year. He said if they decided not to accept what I've done, and make me do everything over again, it would be well over a year before I could expect to have surgery. Apparently, as a retiree, I am near the bottom of the priority list for surgery.

Needless to say, I'm frustrated, angry, and extremely disappointed. I don't want to wait that long. I've given it a lot of thought, and have decided to go ahead and have lap band surgery, which I can have done by my civilian surgery center within the next several weeks. I realize a lot of people on this forum have terrible things to say about the band, but I've read on other forums about many more who have had good success with it. I'm going to give it a shot. If it turns out to be the wrong choice for me, then I'll have it revised to the sleeve. Hopefully, at that time, my insurance carrier will pay for it. If not, I'll make that trip to Mexico and pay for it myself.

I wish everyone here the best of luck with things, and I look forward to reading of your weight loss success. Even though I won't be one of you, I'll be rooting from the sidelines for you. Thanks for all the great support you've given me in the last few months. You are a great bunch of folks.

Dave

dear dave, i am very new to this site, but not to lapbandtalk.com, because i was banded on 6/9/08. i slipped in march and had my band revised. i lost 104 lbs with the first band, and gained 35 with the second because i fell of the south beach diet and didnt get back on. the band is work, but it really does work if u work with it..lol....anyway, since i have lost my mojo, the doctor feels i should go with the sleeve so my surgery is nov. 1. i am not sorry i got the band, i did lose 104 lbs and probably would have continued to lose if not for the prolapse. im not sure how the sleeve with work for me, but i do not blame the band on my failure. I am still down 70 lbs, and am greatful. goood luck with your band and let us know how you make out. also visit lapbandtalk.com you will get alot of support over there......good luck again vicki

[cielle 0]

Best of luck, Dave, with whatever you decide. I know a few people who've had the band and have had success long term and I hope that if you decide to go in that direction that you have every success with it.